Belinda Cash, Elsie de Klerk, Adrienne Matthys, Anne Gemmell, Suzanne McLaren
Objective
This research explored the experience of facilitating and participating in an inclusive choir for people living with dementia in a regional Australian setting.
Setting
Sing Out Choir, a dementia-inclusive community-based choir in regional New South Wales.
Design
Two focus group discussions were held to explore the experience of choir stakeholders. Audio transcripts were analysed using inductive thematic analysis.
Participants
Twenty-five current members of the Sing Out Choir, including people living with dementia (n = 8), informal carers (n = 8), volunteers (n = 6), and choir staff (n = 3).
Results
Four themes were identified following analysis of the discussions: active encouragement promotes engagement with the choir; the choir as a place of inclusiveness and belonging; the positive benefits of choir participation; and the complexities of establishing and sustaining a dementia-inclusive choir in a regional setting.
Conclusion
The Sing Out choir provides an important opportunity for meaningful social connection for people living with dementia and their carers in this regional area. Establishing and sustaining dementia-inclusive choirs in rural and regional settings require significant time and commitment to secure initial and ongoing funding, appropriately experienced staff, an appropriate venue, and volunteer support.
{"title":"Singing out: The Experience of Being Involved in an Inclusive Choir for People Living With Dementia in Regional Australia","authors":"Belinda Cash, Elsie de Klerk, Adrienne Matthys, Anne Gemmell, Suzanne McLaren","doi":"10.1111/ajr.70134","DOIUrl":"10.1111/ajr.70134","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This research explored the experience of facilitating and participating in an inclusive choir for people living with dementia in a regional Australian setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Sing Out Choir, a dementia-inclusive community-based choir in regional New South Wales.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Two focus group discussions were held to explore the experience of choir stakeholders. Audio transcripts were analysed using inductive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Twenty-five current members of the Sing Out Choir, including people living with dementia (<i>n</i> = 8), informal carers (<i>n</i> = 8), volunteers (<i>n</i> = 6), and choir staff (<i>n</i> = 3).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four themes were identified following analysis of the discussions: active encouragement promotes engagement with the choir; the choir as a place of inclusiveness and belonging; the positive benefits of choir participation; and the complexities of establishing and sustaining a dementia-inclusive choir in a regional setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The Sing Out choir provides an important opportunity for meaningful social connection for people living with dementia and their carers in this regional area. Establishing and sustaining dementia-inclusive choirs in rural and regional settings require significant time and commitment to secure initial and ongoing funding, appropriately experienced staff, an appropriate venue, and volunteer support.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145812436","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Wai Yee Yum, Louise Ann Clark, Getahun Kebede Beyera
Objective
To provide a snapshot of the GP obstetric workforce and understand why GP obstetricians chose to provide or not to provide intrapartum care to women in rural Australia.
Methods
Online survey collecting quantitative and qualitative data to characterise the current GP obstetrics workforce.
Design
Descriptive, cross-sectional study.
Setting
Australia.
Participants
All RANZCOG diploma and advanced diploma members were invited to participate via the Facebook groups ‘Rural Obstetrics Down Under (RODU)’ and ‘GPObsDU’. The survey could also be shared with eligible colleagues.
Main Outcome Measures
Social and geographical demographic details of doctors, work locations and scope of practice and self-reported factors leading to their decision to provide or not provide intrapartum care to women in rural Australia.
Results
A total of 95 eligible responses were received. A large proportion of respondents were females aged 35–44 who were balancing work with caregiving responsibilities and living in rural or remote areas with a local birth service. Seventy percent of respondents provided intrapartum care. Factors influencing the decision to provide intrapartum care included professional satisfaction, continuity of care and community service, while barriers included lack of support, safety concerns and work-life balance.
Conclusions
Intrapartum care is professionally rewarding and a highly regarded part of many diplomates' work. However, increased support for skill maintenance and upskilling, flexible work arrangements that can accommodate the modern diplomate and their family needs, and strengthened partnerships between midwifery, GPO and FRANZCOG teams are needed to empower all diplomates to practice and continue practicing to their full scope.
{"title":"GP Obstetricians in Rural Australia: Factors Influencing the Provision of Intrapartum Care","authors":"Wai Yee Yum, Louise Ann Clark, Getahun Kebede Beyera","doi":"10.1111/ajr.70117","DOIUrl":"10.1111/ajr.70117","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To provide a snapshot of the GP obstetric workforce and understand why GP obstetricians chose to provide or not to provide intrapartum care to women in rural Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Online survey collecting quantitative and qualitative data to characterise the current GP obstetrics workforce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Descriptive, cross-sectional study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>All RANZCOG diploma and advanced diploma members were invited to participate via the Facebook groups ‘Rural Obstetrics Down Under (RODU)’ and ‘GPObsDU’. The survey could also be shared with eligible colleagues.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Social and geographical demographic details of doctors, work locations and scope of practice and self-reported factors leading to their decision to provide or not provide intrapartum care to women in rural Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 95 eligible responses were received. A large proportion of respondents were females aged 35–44 who were balancing work with caregiving responsibilities and living in rural or remote areas with a local birth service. Seventy percent of respondents provided intrapartum care. Factors influencing the decision to provide intrapartum care included professional satisfaction, continuity of care and community service, while barriers included lack of support, safety concerns and work-life balance.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Intrapartum care is professionally rewarding and a highly regarded part of many diplomates' work. However, increased support for skill maintenance and upskilling, flexible work arrangements that can accommodate the modern diplomate and their family needs, and strengthened partnerships between midwifery, GPO and FRANZCOG teams are needed to empower all diplomates to practice and continue practicing to their full scope.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145806448","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Stephanie Caldwell, Elizabeth Forster, Ramon Navarro Balbuena, Bronwyn Griffin
Background
Stroke is one of the most common causes of disability and timely treatment is crucial to reduce morbidity and mortality. Regional and remote communities in Australia face a higher incidence of stroke and encounter significant challenges in accessing timely treatment and effective management.
Objective
The scoping review aimed to analyse existing literature regarding stroke in regional and remote Australia, focusing on patient characteristics, stroke type, interventions, and outcomes. Identifying gaps could trigger future research and highlight what strategies need to be implemented to support this Australian population.
Methods
Arksey and O'Malley's methodological framework and the PRISMA-ScR checklist were used to guide this scoping review. Search dates included 2013 to August 2023, using the Medline (EBSCO), Embase, Scopus, and CINAHL databases.
Results
A total of 22 studies were included. The majority of stroke patients were male; participant ages varied, with means ranging from 64 to 74 years and medians from 64 to 78 years, in studies reporting mixed First Nations and non-Indigenous populations. Stroke risk factors were more common in First Nations people, except for atrial fibrillation, which was more prevalent in non-Indigenous people. Reported door-to-needle times for thrombolysis ranged from 77.5 to 100 min. Haemorrhagic strokes were associated with higher mortality. Patients frequently required multiple transfers to access imaging and treatment. Telestroke services were shown to improve care in several regions. However, outer regional and remote patients were less likely to receive thrombolysis, be prescribed stroke prevention medications, or receive care in a stroke unit.
Conclusions
Regional and remote Australians experience significant delays in accessing stroke treatment at a comprehensive stroke centre. Stroke is occurring at much younger ages among First Nations people. Addressing modifiable risk factors and implementing equity-focused strategies, supported by targeted research into regional and remote populations, is essential to reduce the stroke burden in these communities.
{"title":"Mapping Stroke in Regional and Remote Australia: A Scoping Review of Characteristics, Interventions and Outcomes","authors":"Stephanie Caldwell, Elizabeth Forster, Ramon Navarro Balbuena, Bronwyn Griffin","doi":"10.1111/ajr.70132","DOIUrl":"10.1111/ajr.70132","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Stroke is one of the most common causes of disability and timely treatment is crucial to reduce morbidity and mortality. Regional and remote communities in Australia face a higher incidence of stroke and encounter significant challenges in accessing timely treatment and effective management.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The scoping review aimed to analyse existing literature regarding stroke in regional and remote Australia, focusing on patient characteristics, stroke type, interventions, and outcomes. Identifying gaps could trigger future research and highlight what strategies need to be implemented to support this Australian population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Arksey and O'Malley's methodological framework and the PRISMA-ScR checklist were used to guide this scoping review. Search dates included 2013 to August 2023, using the Medline (EBSCO), Embase, Scopus, and CINAHL databases.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 22 studies were included. The majority of stroke patients were male; participant ages varied, with means ranging from 64 to 74 years and medians from 64 to 78 years, in studies reporting mixed First Nations and non-Indigenous populations. Stroke risk factors were more common in First Nations people, except for atrial fibrillation, which was more prevalent in non-Indigenous people. Reported door-to-needle times for thrombolysis ranged from 77.5 to 100 min. Haemorrhagic strokes were associated with higher mortality. Patients frequently required multiple transfers to access imaging and treatment. Telestroke services were shown to improve care in several regions. However, outer regional and remote patients were less likely to receive thrombolysis, be prescribed stroke prevention medications, or receive care in a stroke unit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Regional and remote Australians experience significant delays in accessing stroke treatment at a comprehensive stroke centre. Stroke is occurring at much younger ages among First Nations people. Addressing modifiable risk factors and implementing equity-focused strategies, supported by targeted research into regional and remote populations, is essential to reduce the stroke burden in these communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kathryn W. Fitzgerald, Katrina Fyfe, Sandra C. Thompson
Objective
Develop a framework to guide the design and delivery of dementia training for the rural and remote health and aged care workforce.
Methods
Phase 1 was a scoping review of barriers and enablers to dementia training in rural and remote settings. Phase 2 comprised semi-structured focus groups and a national health and aged care workforce survey. Findings from these phases were integrated to develop the framework.
Design
A two-phase mixed-method study and integration of the results to develop the framework.
Setting
Rural and remote areas across Australia.
Participants
There were six hundred and twenty-five rural and remote participants.
Main Outcome Measures
Representation from all seven Australian states and territories.
Results
Synthesis of the results identified three overarching key principles and seven actionable practices for consideration when designing or delivering dementia education to the rural and remote health and aged care workforce.
Conclusions
The first Rural and Remote Dementia Training Framework offers a practical guide for employers, training providers and professional organisations to design, deliver and evaluate dementia training programs, ensuring they meet the needs of the rural and remote health and aged care workforce in Australia.
{"title":"Development of a Rural and Remote Dementia Training Framework","authors":"Kathryn W. Fitzgerald, Katrina Fyfe, Sandra C. Thompson","doi":"10.1111/ajr.70133","DOIUrl":"10.1111/ajr.70133","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>Develop a framework to guide the design and delivery of dementia training for the rural and remote health and aged care workforce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Phase 1 was a scoping review of barriers and enablers to dementia training in rural and remote settings. Phase 2 comprised semi-structured focus groups and a national health and aged care workforce survey. Findings from these phases were integrated to develop the framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A two-phase mixed-method study and integration of the results to develop the framework.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Rural and remote areas across Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>There were six hundred and twenty-five rural and remote participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Representation from all seven Australian states and territories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Synthesis of the results identified three overarching key principles and seven actionable practices for consideration when designing or delivering dementia education to the rural and remote health and aged care workforce.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The first Rural and Remote Dementia Training Framework offers a practical guide for employers, training providers and professional organisations to design, deliver and evaluate dementia training programs, ensuring they meet the needs of the rural and remote health and aged care workforce in Australia.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12715451/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145783814","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sarah Cowan, Helen Waaka, Cameron Wells, Mania Campbell-Seymour, Turuki Tahuri, Jevon Puckett, Andrew Ing, Jamie-Lee Rahiri
Introduction
Health inequities, particularly for rural and Māori populations, persist in Aotearoa New Zealand (NZ) due to geographical and structural barriers to accessing healthcare. Te Whatu Ora—Health NZ aims to reduce these inequities, including through rural outreach clinics. This study evaluates the impact of rural outreach general surgical clinics in the Hawkes Bay region on access to benign elective surgeries for rural and Māori populations.
Methods
A retrospective cohort study was conducted on all adult patients who underwent elective general surgery in Hawkes Bay from August 2015 to December 2023. Data on patient demographics, ethnicity, rural status, clinic type and surgery type were collected. Primary outcomes were time from referral to first specialist assessment (FSA), waitlist to surgery and total time from referral to surgery. Data were analysed using chi-square and Mann–Whitney U-tests, with statistical significance set at p < 0.05.
Results
One thousand three hundred and ninety-seven patients met the criteria, of whom 19.4% (N = 271) resided rurally, and 24.1% (N = 337) identified as Māori. Rural patients had a longer median waitlist-to-surgery time (95.0 vs. 83.0 days, p = 0.006) and overall referral-to-surgery time (143.0 vs. 129.0 days, p = 0.04) compared with urban patients. Māori patients waited longer for surgery than non-Māori patients (p = 0.088). Outreach clinics had longer overall wait times than central clinics (p = 0.003).
Conclusions
Despite outreach clinics in our district, rural and Māori patients experience longer delays in receiving elective surgery. Additional investment in rural outreach clinics and equity-focused prioritisation could improve access and reduce healthcare disparities for these populations. Further qualitative research is needed to explore patient perspectives.
{"title":"Investigating Postcode Lottery: Do Regional Outreach Clinics Improve Waiting Times to Elective General Surgical Care for Rural and Māori Populations?","authors":"Sarah Cowan, Helen Waaka, Cameron Wells, Mania Campbell-Seymour, Turuki Tahuri, Jevon Puckett, Andrew Ing, Jamie-Lee Rahiri","doi":"10.1111/ajr.70127","DOIUrl":"10.1111/ajr.70127","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Health inequities, particularly for rural and Māori populations, persist in Aotearoa New Zealand (NZ) due to geographical and structural barriers to accessing healthcare. Te Whatu Ora—Health NZ aims to reduce these inequities, including through rural outreach clinics. This study evaluates the impact of rural outreach general surgical clinics in the Hawkes Bay region on access to benign elective surgeries for rural and Māori populations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A retrospective cohort study was conducted on all adult patients who underwent elective general surgery in Hawkes Bay from August 2015 to December 2023. Data on patient demographics, ethnicity, rural status, clinic type and surgery type were collected. Primary outcomes were time from referral to first specialist assessment (FSA), waitlist to surgery and total time from referral to surgery. Data were analysed using chi-square and Mann–Whitney U-tests, with statistical significance set at <i>p</i> < 0.05.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>One thousand three hundred and ninety-seven patients met the criteria, of whom 19.4% (<i>N</i> = 271) resided rurally, and 24.1% (<i>N</i> = 337) identified as Māori. Rural patients had a longer median waitlist-to-surgery time (95.0 vs. 83.0 days, <i>p</i> = 0.006) and overall referral-to-surgery time (143.0 vs. 129.0 days, <i>p</i> = 0.04) compared with urban patients. Māori patients waited longer for surgery than non-Māori patients (<i>p</i> = 0.088). Outreach clinics had longer overall wait times than central clinics (<i>p</i> = 0.003).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Despite outreach clinics in our district, rural and Māori patients experience longer delays in receiving elective surgery. Additional investment in rural outreach clinics and equity-focused prioritisation could improve access and reduce healthcare disparities for these populations. Further qualitative research is needed to explore patient perspectives.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145770055","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Sustaining Nursing Programs in Rural and Remote Australia Through UDRHs","authors":"Sabina Knight, Geoff Argus, Isabelle Skinner, James Debenham, Catrina Felton-Busch, Jessica Elliott, Kehinde Obamiro","doi":"10.1111/ajr.70129","DOIUrl":"10.1111/ajr.70129","url":null,"abstract":"","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Luke Wakely, Claire Quilliam, Kerryn Bagley, Casey Stubbs, Jodie Bailie, Jo Spong, Clare McHugh, Natalie Ellis, Tony Fallon, Robyn Doney, Louise French, Josie Clarke, Carol McKinstry
Aims
This commentary highlights the development and impact of a rural disability research Community of Practice (CoP) within the University Department of Rural Health (UDRH) framework. It aims to demonstrate how privileging rural lived experience as a core qualification for research participation fosters inclusive, place-based inquiry that addresses the intersectional challenges faced by people with disabilities in rural Australia.
Context
People with disabilities in rural areas face compounded inequities due to geographic isolation, limited access to services and policy frameworks that remain metrocentric. Despite national and international efforts to promote inclusive disability policy, societal acceptance of the social model of disability has been slow. The UDRH programme, which embeds academic staff within rural communities, provides a unique platform for authentic engagement and research that reflects local realities.
Approach
In response to the need for coordinated, rural-led disability research, the ARHEN Rural Disability Research CoP was established in 2024. With 27 members across nine UDRHs and four states, the CoP operates through a flattened hierarchy and task-focused collaboration. It promotes co-designed research, peer support and advocacy, ensuring rural perspectives are embedded in national and international disability discourse.
Conclusion
The CoP exemplifies effective rural leadership in disability research, challenging metrocentric norms and amplifying rural voices. By prioritising lived experience and inclusive collaboration, it informs more responsive policy and strengthens rural research capacity. This model offers a pathway for equitable, community-driven inquiry and policy reform.
{"title":"Strengthening National Rural Disability Research Capacity Through a Community of Practice","authors":"Luke Wakely, Claire Quilliam, Kerryn Bagley, Casey Stubbs, Jodie Bailie, Jo Spong, Clare McHugh, Natalie Ellis, Tony Fallon, Robyn Doney, Louise French, Josie Clarke, Carol McKinstry","doi":"10.1111/ajr.70131","DOIUrl":"10.1111/ajr.70131","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>This commentary highlights the development and impact of a rural disability research Community of Practice (CoP) within the University Department of Rural Health (UDRH) framework. It aims to demonstrate how privileging rural lived experience as a core qualification for research participation fosters inclusive, place-based inquiry that addresses the intersectional challenges faced by people with disabilities in rural Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>People with disabilities in rural areas face compounded inequities due to geographic isolation, limited access to services and policy frameworks that remain metrocentric. Despite national and international efforts to promote inclusive disability policy, societal acceptance of the social model of disability has been slow. The UDRH programme, which embeds academic staff within rural communities, provides a unique platform for authentic engagement and research that reflects local realities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>In response to the need for coordinated, rural-led disability research, the ARHEN Rural Disability Research CoP was established in 2024. With 27 members across nine UDRHs and four states, the CoP operates through a flattened hierarchy and task-focused collaboration. It promotes co-designed research, peer support and advocacy, ensuring rural perspectives are embedded in national and international disability discourse.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The CoP exemplifies effective rural leadership in disability research, challenging metrocentric norms and amplifying rural voices. By prioritising lived experience and inclusive collaboration, it informs more responsive policy and strengthens rural research capacity. This model offers a pathway for equitable, community-driven inquiry and policy reform.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145776566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elizabeth A. Johnston, Xanthia E. Bourdaniotis, Susannah K. Ayre, Hayley Fung, Nicole Craig, Fiona Crawford-Williams, Rebecca J. Bergin, Jon D. Emery, Raymond J. Chan, Belinda C. Goodwin
Objective
To identify facilitators and barriers to improving communication of survivorship care information to rural cancer survivors from the perspective of healthcare professionals.
Setting
Metropolitan and rural health services provide care to rural cancer survivors.
Participants
Healthcare professionals (n = 31), including cancer specialists, general practitioners, nurses, care coordinators and allied health practitioners.
Design
Qualitative descriptive study using semi-structured interviews to assess current practices for communicating survivorship care information, perspectives on how this information should be delivered and factors that may affect the implementation of a new method for delivering this information. Responses were categorised as a facilitator or barrier to improving information delivery. Barriers and facilitators were mapped to constructs of the Consolidated Framework for Implementation Research to identify the settings and contexts in which they occur.
Results
Facilitators included the evidence base and relative advantage of improving survivorship care information delivery to rural cancer survivors, indicating that healthcare professionals perceive this initiative as important and valuable. Participants also reported a tension for change (i.e., current practices for information delivery are not sustainable) and mission alignment, meaning improving survivorship information to rural cancer survivors is within participants' organisations' goals. Barriers included local conditions, policies and laws and financing, including challenges accessing support services in rural settings and limited funding for post-treatment care.
Conclusions
Guiding principles and suggested actions for improving survivorship care information delivery to rural cancer survivors are proposed, including strategies for minimising burden on healthcare teams, formalising transitional practices, streamlining referral pathways, partnering with community services and including family carers.
{"title":"What are the Facilitators and Barriers to Improving the Delivery of Survivorship Care Information to Rural Cancer Survivors? A Qualitative Study Using an Implementation Science Framework","authors":"Elizabeth A. Johnston, Xanthia E. Bourdaniotis, Susannah K. Ayre, Hayley Fung, Nicole Craig, Fiona Crawford-Williams, Rebecca J. Bergin, Jon D. Emery, Raymond J. Chan, Belinda C. Goodwin","doi":"10.1111/ajr.70125","DOIUrl":"10.1111/ajr.70125","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To identify facilitators and barriers to improving communication of survivorship care information to rural cancer survivors from the perspective of healthcare professionals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Metropolitan and rural health services provide care to rural cancer survivors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Healthcare professionals (<i>n</i> = 31), including cancer specialists, general practitioners, nurses, care coordinators and allied health practitioners.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Qualitative descriptive study using semi-structured interviews to assess current practices for communicating survivorship care information, perspectives on how this information should be delivered and factors that may affect the implementation of a new method for delivering this information. Responses were categorised as a facilitator or barrier to improving information delivery. Barriers and facilitators were mapped to <i>constructs</i> of the Consolidated Framework for Implementation Research to identify the settings and contexts in which they occur.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Facilitators included the <i>evidence base</i> and <i>relative advantage</i> of improving survivorship care information delivery to rural cancer survivors, indicating that healthcare professionals perceive this initiative as important and valuable. Participants also reported a <i>tension for change</i> (i.e., current practices for information delivery are not sustainable) and <i>mission alignment</i>, meaning improving survivorship information to rural cancer survivors is within participants' organisations' goals<i>.</i> Barriers included <i>local conditions, policies and laws</i> and <i>financing</i>, including challenges accessing support services in rural settings and limited funding for post-treatment care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Guiding principles and suggested actions for improving survivorship care information delivery to rural cancer survivors are proposed, including strategies for minimising burden on healthcare teams, formalising transitional practices, streamlining referral pathways, partnering with community services and including family carers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145758469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
To summarise administrative and interview data relevant to the care of pregnant people with high BMI in rural British Columbia.
Methods
In this mixed methods analysis, we report administrative health data linked to maternal postal codes, to determine variations in rates of local births across BMI groups (n = 3247) and to examine associations between BMI and adverse maternal–newborn outcomes (n = 2527). Qualitative data from 169 healthcare providers and administrators at rural hospitals in BC were analyzed to understand rural providers’ experiences when caring for pregnant women with high BMI. Two clinical guidelines that were developed to improve care for women with obesity are presented, as examples of rural CQI initiatives.
Results
The proportion of local births decreased as BMI increased: 72.7% of those with normal BMI gave birth at rural hospitals compared to 34.9% with a BMI ≥ 40. For underweight, overweight, and obese women who gave birth at rural hospitals, the incidence of adverse perinatal outcomes was higher (IRR 1.85; 95% CI: 0.49–3.76, IRR = 1.19; 95% CI: 0.74–1.80; IRR = 1.81; 95% CI: 0.87–3.35), compared to those in the normal BMI range, but the associations were not significant. Healthcare providers also described challenges with maintaining quality and safety when caring for patients with high BMI in a low-volume rural setting and noted that a specialist ‘cookie cutter’ approach to managing and transferring people with high BMI was not practical in rural communities.
Discussion and Conclusion
Strategies that improve the care of pregnant women with high BMI must take into account the social risks incurred by birthers and families who leave the community alongside the clinical risks of remaining, with attention also given to the impact of adverse outcomes on health care providers. These processes must be underscored by engagement from regional referral specialists to ensure local providers are clinically supported and that there are efficient transfer pathways to higher levels of care should this be needed.
{"title":"‘I Am Not Going, So You're Doing It’: Management of Pregnant People With High BMI at Rural Hospitals in British Columbia: A Mixed Methods Analysis","authors":"Kathrin Stoll, Jude Kornelsen, Stephanie Lin, Christy Trafananko, Cecilia Jevitt","doi":"10.1111/ajr.70126","DOIUrl":"10.1111/ajr.70126","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To summarise administrative and interview data relevant to the care of pregnant people with high BMI in rural British Columbia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this mixed methods analysis, we report administrative health data linked to maternal postal codes, to determine variations in rates of local births across BMI groups (<i>n</i> = 3247) and to examine associations between BMI and adverse maternal–newborn outcomes (<i>n</i> = 2527). Qualitative data from 169 healthcare providers and administrators at rural hospitals in BC were analyzed to understand rural providers’ experiences when caring for pregnant women with high BMI. Two clinical guidelines that were developed to improve care for women with obesity are presented, as examples of rural CQI initiatives.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The proportion of local births decreased as BMI increased: 72.7% of those with normal BMI gave birth at rural hospitals compared to 34.9% with a BMI ≥ 40. For underweight, overweight, and obese women who gave birth at rural hospitals, the incidence of adverse perinatal outcomes was higher (IRR 1.85; 95% CI: 0.49–3.76, IRR = 1.19; 95% CI: 0.74–1.80; IRR = 1.81; 95% CI: 0.87–3.35), compared to those in the normal BMI range, but the associations were not significant. Healthcare providers also described challenges with maintaining quality and safety when caring for patients with high BMI in a low-volume rural setting and noted that a specialist ‘cookie cutter’ approach to managing and transferring people with high BMI was not practical in rural communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>Strategies that improve the care of pregnant women with high BMI must take into account the social risks incurred by birthers and families who leave the community alongside the clinical risks of remaining, with attention also given to the impact of adverse outcomes on health care providers. These processes must be underscored by engagement from regional referral specialists to ensure local providers are clinically supported and that there are efficient transfer pathways to higher levels of care should this be needed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12705911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145764585","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Kelly McGrath, Lynda R. Matthews, Rob Heard, Nicola Hancock
<div> <section> <h3> Objective</h3> <p>This exploratory study sought to document compassion satisfaction, burnout and secondary traumatic stress in Australian rural and remote rehabilitation healthcare workers and compare the results with other professionals working in the Australian healthcare system who had previously completed the Professional Quality of Life Scale Version 5 (ProQOL5).</p> </section> <section> <h3> Design</h3> <p>We used a mixed methods approach, comprising a cross-sectional design and survey methodology with participants recruited via homogeneous purposive sampling. Data were collected using a web-based self-administered survey comprising demographic and work-related questions, ProQOL5 and open-response questions.</p> </section> <section> <h3> Setting</h3> <p>Rural and remote Australia where 28% of the population is spread across 99.3% of the country's eight million square kilometre landmass. These locations are sparsely populated, with the lowest number of health professionals relative to population size nationally.</p> </section> <section> <h3> Participants</h3> <p>Australian rural and remote rehabilitation healthcare workers that held membership with their professional body. They provide rehabilitation services to clients in workers' compensation, life insurance, the Australian National Disability Insurance Scheme (NDIS) and other rehabilitation settings in rural and remote Australia. Responses (<i>n</i> = 29) were included in the analysis; two were excluded due to non-completion of the survey. Most were female (86.2%), above 35 years old (76%), employed full-time (72.4%) and were rehabilitation counsellors (44.8%). Two-thirds were from Queensland and New South Wales (65.5%).</p> </section> <section> <h3> Main Outcome Measure(s)</h3> <p>Compassion satisfaction, burnout, secondary traumatic stress as measured by the ProQOL5. These outcome measures were reviewed in relation to demographic and workplace factors among rehabilitation healthcare professionals working in rural and remote Australia. Open-response questions were included in the survey to provide further context to the ProQOL5 results.</p> </section> <section> <h3> Results</h3> <p>Workplace and organisational factors were connected to compassion satisfaction and burnout outcomes, including work-life balance and workplace culture. When compared to other Australian healthcare worker groups, Australian rural and remote rehabilitation healthcare workers experienced significantly poorer compassio
{"title":"Levels of Compassion Satisfaction, Burnout and Secondary Traumatic Stress in Rehabilitation Healthcare Workers in Rural and Remote Australia and Their Associations With Demographic and Work-Related Variables","authors":"Kelly McGrath, Lynda R. Matthews, Rob Heard, Nicola Hancock","doi":"10.1111/ajr.70128","DOIUrl":"https://doi.org/10.1111/ajr.70128","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This exploratory study sought to document compassion satisfaction, burnout and secondary traumatic stress in Australian rural and remote rehabilitation healthcare workers and compare the results with other professionals working in the Australian healthcare system who had previously completed the Professional Quality of Life Scale Version 5 (ProQOL5).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>We used a mixed methods approach, comprising a cross-sectional design and survey methodology with participants recruited via homogeneous purposive sampling. Data were collected using a web-based self-administered survey comprising demographic and work-related questions, ProQOL5 and open-response questions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Rural and remote Australia where 28% of the population is spread across 99.3% of the country's eight million square kilometre landmass. These locations are sparsely populated, with the lowest number of health professionals relative to population size nationally.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Australian rural and remote rehabilitation healthcare workers that held membership with their professional body. They provide rehabilitation services to clients in workers' compensation, life insurance, the Australian National Disability Insurance Scheme (NDIS) and other rehabilitation settings in rural and remote Australia. Responses (<i>n</i> = 29) were included in the analysis; two were excluded due to non-completion of the survey. Most were female (86.2%), above 35 years old (76%), employed full-time (72.4%) and were rehabilitation counsellors (44.8%). Two-thirds were from Queensland and New South Wales (65.5%).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measure(s)</h3>\u0000 \u0000 <p>Compassion satisfaction, burnout, secondary traumatic stress as measured by the ProQOL5. These outcome measures were reviewed in relation to demographic and workplace factors among rehabilitation healthcare professionals working in rural and remote Australia. Open-response questions were included in the survey to provide further context to the ProQOL5 results.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Workplace and organisational factors were connected to compassion satisfaction and burnout outcomes, including work-life balance and workplace culture. When compared to other Australian healthcare worker groups, Australian rural and remote rehabilitation healthcare workers experienced significantly poorer compassio","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 6","pages":""},"PeriodicalIF":2.1,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145739847","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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