Public Health Research & Practice最新文献

Objectives and importance of study: Despite the abundance of mental health research during the pandemic, there is limited evidence exploring mental health presentations to Australian general practice. This study examined the utilisation of telehealth for mental health consultations in Australian general practice during the COVID-19 pandemic. The objectives were to: 1) determine the proportion of mental health services delivered via telehealth between March 2020 and November 2021; 2) determine the types of mental health consultations most frequently delivered via telehealth; and 3) model the sociodemographic characteristics of patients using telehealth mental health consultations, including consultation type.

Study type: Retrospective observational study.

Methods: We used Medicare Benefits Schedule service item numbers to distinguish mental health consultations in de-identified electronic general practice data. We stratified the proportions of face-to-face, video, and telephone mental health consultations by state and consultation type. We used two mixed-effects logistic models to assess the variation in the likelihood of i) a telehealth (video/telephone) compared to a face-to-face consultation and ii) a video compared to telephone consultation; by sociodemographic characteristics.

Results: The study comprised 874 249 mental health consultations. Telehealth use peaked in Victoria (61.6%) during July 2020 and in NSW during August 2021 (52.5%). Telehealth use continued throughout 2021 with an increase in video consultations from July 2021 onwards in both states. Proportions of mental health treatment plan consultations via telephone decreased from July 2021 with a concomitant increase in video. Telehealth was more likely to be used by females, in Victoria, in regional/remote regions and during 2020. Video was more likely to be used than telephone for mental health treatment plans/reviews compared with mental health consultations. Compared with people aged 25-29, video was most likely to be used by ages 20-24 and least by those aged 80 and over. There was no evidence for sex differences when comparing telephone and video.

Conclusions: This study presents a comprehensive understanding of the important role telehealth played in the delivery of mental health consultations during the first 21 months of the pandemic, including sociodemographics of patients utilising telehealth. The findings can assist general practices with future planning for the delivery of mental health services via telehealth.

Objective: Gaps and complexities exist in cancer referral and diagnosis in Australia, leading to delays in cancer treatments. Developing evidence-based referral pathways is important for promoting better and more timely cancer diagnosis and care. Type of program or service: This paper describes a toolkit endorsed by the Cancer Institute NSW as a guide for promoting best practice in localising cancer referral and diagnosis pathways in line with the national Optimal Care Pathways. Use of toolkit: Employing methods in the toolkit yielded an increased understanding of cancer care pathways, strengthened collaboration between tertiary and primary sector stakeholders, and enhanced the project skills of Cancer System Innovation Managers. The toolkit has become a valuable guide for consolidating referral pathways for various cancers in the NSW local health districts and could apply to cancer services in other jurisdictions.

Lessons learnt: The pilot project showed that the toolkit is useful in developing referral pathways and reflects best stakeholder engagement practices. Local evidence should be generated to support systematic change and should include the perspectives of cancer patients and clinicians. NSW local health districts continue to use the toolkit methods to optimise care to improve outcomes for people living with cancer.

Objectives: To report on efforts to engage culturally and linguistically diverse (CALD) communities to provide an effective and appropriate public health response to coronavirus disease 2019 (COVID-19), and to report how a tailored, interagency response addressing specific community needs was rapidly rolled out in a pandemic setting. Type of program or service: A novel, rapid, interagency public health campaign led by NSW Health and Sydney Local Health District (SLHD) was established in response to a local outbreak of COVID-19 in the multicultural suburb of Lakemba, in Sydney's south west, in October 2020. The public education and testing campaign was run over 2 weeks and involved in-language development of COVID-19 resources, establishment of a local pop-up testing clinic, 'COVID Safe' inspections of local businesses, engagement with local community leaders and distribution of written and verbal in-language education by cultural support workers.

Methods: We describe the campaign impact in engaging CALD communities in a pandemic setting, including the impact on COVID-19 testing rates, identification of close contacts and engagement with local businesses, as well as learnings from a multi-agency debrief at the conclusion of the campaign.

Results: There was an 87% increase in COVID-19 testing in the local area during the campaign. Despite 890 close contacts being identified during the outbreak, only 17 cases of COVID-19 were identified. Regulators visited 127 local businesses to provide 'COVID Safe' education and advice. SLHD cultural support personnel worked with the community to provide verbal and written in-language resources and education. Community and religious leaders were engaged to act as 'COVID Safe' champions.

Lessons learnt: A key to the success of the Lakemba campaign was the rapid, multi-agency collaboration between NSW Health, SLHD and regulators. An important lesson from the COVID-19 pandemic has been the importance of providing a flexible, tailored public health response that reacts to the target community's needs. This is even more important in our CALD communities, where mainstream health messages are insufficient. The Lakemba campaign is an example of how such a response can be undertaken rapidly while maintaining the key principles of community partnership, engagement and equity.

Objectives: Health Promotion Units within New South Wales (NSW) local health districts (LHDs) frequently collaborate and test innovations to address priority health issues or approaches to support the implementation of a health promotion program in a way that is consistent with the needs, resources, and contexts of their regions. Compatible with learning health system approaches, mechanisms to facilitate the exchange of evidence and expertise across districts could improve the collective impact of health promotion services across the state. This study aimed to assess the use of a health promotion Community of Practice (CoP) model as a strategy to achieve this. Type of program or service: This paper describes and shares experiences from the development and piloting process of a CoP model to develop, evaluate and exchange learnings to improve approaches to support the adoption of an effective healthy lunchbox program ('SWAP IT') across three LHDs.

Results: The functioning of the CoP was supported by key activities, funding and infrastructure over a 2-year period, including: planning workshops, implementation check-ins, and knowledge exchange meetings. A particularly novel aspect of the CoP was the harmonised evaluation of different, locally developed strategies to facilitate program adoption across the three LHDs. The alignment of the CoP with local and state priorities, as well as the operation of the CoP in a way that did not impose significant time demands, was seen as important for the sustainability of the CoP.

Lessons learnt: Findings from the piloting process suggest that a formalised CoP shows promise as an effective model to enhance health promotion collaboration, information sharing and practice across LHDs, which may be suitable for broader application across the state.