Australian and New Zealand Journal of Public Health最新文献_第2页

Mental and neurodevelopmental health needs of Aboriginal children with experience of out-of-home care: a Western Australian data-linkage study 有家庭外照料经历的原住民儿童的心理和神经发育健康需求：西澳大利亚州数据链接研究。

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-10-01 DOI: 10.1016/j.anzjph.2024.100181

Benjamin Harrap , Alison Gibberd , Melissa O’Donnell , Jocelyn Jones , Richard Chenhall , Bridgette McNamara , Koen Simons , Sandra Eades

Objective

To identify additional mental and neurodevelopmental health needs of Aboriginal children born in Western Australia, who are placed in out-of-home care (OOHC), relative to Aboriginal children born in Western Australia who were not placed.

Methods

Data-linkage of hospitalisations, health registries and child protective services data for all Aboriginal children born in WA between 2000 and 2013 was used. Children placed in out-of-home care between 2000 and 2019 were matched to children never placed and prevalence and cumulative incidence estimates of mental and neurodevelopmental health conditions were compared.

Results

Children placed in out-of-home care had a three times greater prevalence of mental and neurodevelopmental health conditions generally. The prevalence of foetal alcohol spectrum disorder was ten times higher, and post-traumatic stress disorder was seven times higher for those placed in out-of-home care. Cumulative incidence plots highlighted for different conditions the ages at which the rate of diagnosis diverges between the two groups.

Conclusions

Children placed in out-of-home care had greater mental and neurodevelopmental health needs generally when compared to children never placed in out-of-home care .

Implications for Public Health

Child protective services must ensure culturally safe, comprehensive, wrap-around services for Aboriginal children and their families are provided. Approaches should build on the strength of children, families and culture and avoid stigmatising children and their parents.

目标：确定在西澳大利亚州出生并接受家庭外照料（OOHC）的原住民儿童与在西澳大利亚州出生但未接受家庭外照料的原住民儿童相比在精神和神经发育健康方面的额外需求：方法：对 2000 年至 2013 年期间西澳大利亚州出生的所有土著儿童的住院、健康登记和儿童保护服务数据进行数据链接。将2000年至2019年期间被置于家庭外照料的儿童与从未被置于家庭外照料的儿童进行配对，并对精神和神经发育健康状况的流行率和累积发病率估计值进行比较：结果：被置于家庭外照料的儿童的精神和神经发育健康状况的患病率普遍高出三倍。胎儿酒精谱系障碍的发病率是被置于家庭外照料的儿童的十倍，创伤后应激障碍的发病率是被置于家庭外照料的儿童的七倍。累积发病率图突出显示了两组儿童在不同疾病诊断率上的年龄差异：结论：与从未被安置在家庭外的儿童相比，被安置在家庭外的儿童普遍有更大的精神和神经发育健康需求：儿童保护服务机构必须确保为原住民儿童及其家庭提供文化上安全、全面的全方位服务。所采取的方法应以儿童、家庭和文化的力量为基础，避免对儿童及其父母进行侮辱。

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引用次数: 0

How do we fund Public Health in Australia? How should we? 我们如何资助澳大利亚的公共卫生事业？我们应该如何做？

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-10-01 DOI: 10.1016/j.anzjph.2024.100187

Alan Shiell , Kate Garvey , Shane Kavanagh , Victoria Loblay , Penelope Hawe

Objective

To map how public health is funded in Australia. To assess whether changes to funding methods might improve system performance.

Methods

Review of publicly accessible documents and discussions with public health key informants.

Results

Australia spent $140 per person on public health in 2019-20, (1.8% of total health spending). But there is considerable state and territory variation. This money flows through multiple channels and payment mechanisms. Responsibility for what is funded is largely delegated to authorities close to the problems. This makes it easier to choose the best mechanism for funding an activity. Much information is hidden from view, however. This makes it impossible to assess whether the potential for population benefit is fully realised.

Conclusions

Australia avoids some of the difficulties experienced elsewhere because funding is largely devolved to states in block grants; they shape their own investments. The US, by contrast, prefers categorical funds for specific purposes. Three suggestions for making the funding system here more visible, useful and accountable are canvassed, including ‘satellite accounts’.

Implications for Public Health

Funding needs to be more transparent before it is possible to assess whether public health system performance could be improved through changes to the way public health is funded.

目标：绘制澳大利亚公共卫生资金来源图。评估改变资助方式是否能改善系统绩效：方法：查阅可公开获取的文件，并与公共卫生主要信息提供者进行讨论：2019-20 年，澳大利亚在公共卫生方面的人均支出为 140 澳元（占卫生总支出的 1.8%）。但各州和地区之间存在很大差异。这些资金通过多种渠道和支付机制流动。资金的使用主要由与问题密切相关的部门负责。这样就更容易选择资助某项活动的最佳机制。然而，许多信息是不为人知的。结论：澳大利亚避免了其他国家遇到的一些困难：结论：澳大利亚避免了其他国家遇到的一些困难，因为资金主要以整笔拨款的形式下放到各州；各州自行决定自己的投资。相比之下，美国更倾向于为特定用途提供分类资金。本文提出了三项建议，包括 "卫星账户"，以使澳大利亚的资助体系更加可见、有用和负责：对公共卫生的影响：在评估是否可以通过改变公共卫生的供资方式来提高公共卫生系统的绩效之前，需要提高供资的透明度。

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引用次数: 0

Emergency contraception access in Fijian community pharmacies: A descriptive study 斐济社区药房提供的紧急避孕药具：描述性研究

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-09-26 DOI: 10.1016/j.anzjph.2024.100191

Lieu Thi Thuy Trinh , Jane Estoesta , Virginia Macdonald , Deborah Bateson , Clare Boerma , Claire Rogers , Rashika Gounder , Angela Dawson

Objective

To assess pharmacists’ knowledge regarding emergency contraceptive pills (ECPs), their attitudes towards women obtaining ECPs, and ECP counselling and dispensing practices.

Methods

An online cross-sectional survey using Qualtrics was distributed via pharmacy emails and networks to recruit registered pharmacists working in community-based pharmacies.

Results

There were 22 valid respondents, predominantly female pharmacists (68%), with an average of 7.5 years of registration. All pharmacists knew the correct time frame after unprotected sex for ECPs to be effective, and 73% knew how ECPs worked, but only 50% knew that there were no contraindications. Most pharmacists (86%) knew that ECPs should be available to all women and girls, but only 59% thought that a married woman should not have to get permission from her husband to buy ECPs. Information or education for clients on the correct use of ECPs was mainly provided by pharmacists (59%), mostly through verbal communication (96%). Only 5% of pharmacists had used the emergency contraception methods wheels.

Conclusions

There were gaps in pharmacists’ knowledge regarding ECPs. Biases, judgemental attitudes, and suboptimal practices existed.

Implications for public health

Targeted education and training for pharmacists is needed to improve access to ECPs in Fiji.

目的评估药剂师对紧急避孕药（ECPs）的了解程度、她们对女性获得 ECPs 的态度以及 ECP 咨询和配药实践。方法使用 Qualtrics 进行在线横断面调查，通过药房电子邮件和网络招募在社区药房工作的注册药剂师。所有药剂师都知道 ECPs 在无保护性行为后的正确有效时间，73% 的药剂师知道 ECPs 的作用，但只有 50% 的药剂师知道 ECPs 没有禁忌症。大多数药剂师（86%）知道应向所有妇女和女孩提供 ECPs，但只有 59% 的药剂师认为已婚妇女购买 ECPs 无需征得丈夫同意。药剂师（59%）主要通过口头交流（96%）向客户提供正确使用 ECPs 的信息或教育。只有 5% 的药剂师使用过紧急避孕方法轮。对公共卫生的启示斐济需要对药剂师进行有针对性的教育和培训，以改善紧急避孕药具的使用。

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引用次数: 0

Preventive healthcare practice by allied health professionals: Results from a cross-sectional survey in rural and regional Victoria 专职医疗人员的预防保健实践：维多利亚州农村和地区横断面调查的结果

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-09-24 DOI: 10.1016/j.anzjph.2024.100192

Stephen Barrett , Stephen Begg , Sally Harris , Paul O’Halloran , Breanne Kunstler , Bruce Bolam , Kevin Masman , Michael Kingsley

Objectives

To describe the frequency of preventive healthcare practice (assess, advice, refer for support) provided by allied health professionals (AHPs) practicing in regional and rural healthcare settings to address smoking, diet and physical inactivity. To identify factors that influence the delivery of preventive healthcare practice.

Methods

AHPs working in public healthcare services in the Loddon Mallee region of Victoria were surveyed. Clinicians reported on the proportion of clients where they had provided preventive care. Likert scale questions measured factors influencing preventive healthcare practice.

Results

In total, 115 clinicians completed the survey. AHPs reported that they assess for smoking and physical activity behaviours but not diet. Preventive health practice that included providing advice or referrals for follow-on support was rarely undertaken. Availability of screening tools and automated referral letters increased the likelihood of preventive healthcare practice.

Conclusions

Greater attention to addressing modifiable lifestyle behaviours by AHPs might be warranted to match the rates of risk factors in rural and regional Victoria. Integrating support systems, for example, embedding screening questions within clinical assessments can assist preventive healthcare practice.

Implication for public health

Many AHPs are not promoting healthy behaviours to prevent poor health. We present some strategies that could potentially improve this.

目标描述在地区和农村医疗机构工作的专职医疗人员（AHPs）针对吸烟、饮食和缺乏运动等问题提供预防性医疗服务（评估、建议、转诊支持）的频率。方法：对在维多利亚州洛登马利地区公共医疗保健服务机构工作的AHP进行了调查。临床医生报告了他们提供预防性保健的客户比例。李克特量表问题测量了影响预防保健实践的因素。AHPs 报告称，他们对吸烟和体育锻炼行为进行了评估，但未对饮食进行评估。包括提供建议或转介后续支持在内的预防保健实践很少开展。有了筛查工具和自动转诊信，就更有可能开展预防性保健实践。结论为了与维多利亚州农村和地区的风险因素发生率相匹配，可能需要全科医生更多地关注可改变的生活方式行为。整合支持系统，例如在临床评估中嵌入筛查问题，可以帮助开展预防性保健实践。我们提出了一些有可能改善这一状况的策略。

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引用次数: 0

Revising a right to food road map—perspectives of Australian key informants 修订食物权路线图--澳大利亚主要信息提供者的观点

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-09-20 DOI: 10.1016/j.anzjph.2024.100189

Rebecca Lindberg , Vivien Yii , Elizabeth Millen , Stephanie Godrich

Objective

In Australia, an estimated 1 in 10 households experiences food insecurity. The objective of this study was to devise a visual synthesis to summarise the activities, processes and principles that support the right to food for everyone in Australia.

Methods

Semi-structured key informant interviews (n=30) were conducted during 2019–20. Content analysis synthesised perspectives and assisted co-authors in revising an initial draft (shared during the interview) to finalise the road map through semantic realist data analysis and re-design.

Results

The six components of the right to food road map summarise the actions, processes, and principles to address the human right to food. These include i) policy leadership, ii) advocate and enact, iii) empowerment, iv) resourcing, v) monitoring and accountability and vi) healthy, equitable and sustainable food systems.

Conclusions

When all the right to food actions, processes and principles are present, the “cogs” within the map are hypothesised to interact and realise the right to food for all Australians.

Implications for Public Health

Considering the cost of living pressures and unrelenting demand for food relief, better solutions are needed for food insecurity. Human rights - this language, their international recognition and as a “method of working”, offer an alternative to the dominant responses to food insecurity.

目标在澳大利亚，估计每 10 户家庭中就有 1 户面临粮食不安全问题。本研究的目的是设计一份可视化综合报告，总结支持澳大利亚人人享有食物权的活动、流程和原则。方法在2019-20年期间进行了半结构化关键信息提供者访谈（n=30）。内容分析综合了各种观点，并协助共同作者修改初稿（访谈期间分享），通过语义现实主义数据分析和重新设计，最终确定了路线图。结果食物权路线图的六个组成部分总结了解决人类食物权的行动、流程和原则。其中包括 i) 政策领导，ii) 倡导和颁布，iii) 授权，iv) 资源配置，v) 监督和问责，以及 vi) 健康、公平和可持续的食品系统。结论当所有食物权行动、过程和原则都存在时，假设地图中的 "齿轮 "会相互作用，实现所有澳大利亚人的食物权。人权--这种语言、国际认可以及作为一种 "工作方法"，为解决粮食不安全问题的主要对策提供了一种替代方案。

{"title":"Revising a right to food road map—perspectives of Australian key informants","authors":"Rebecca Lindberg , Vivien Yii , Elizabeth Millen , Stephanie Godrich","doi":"10.1016/j.anzjph.2024.100189","DOIUrl":"10.1016/j.anzjph.2024.100189","url":null,"abstract":"<div><h3>Objective</h3><p>In Australia, an estimated 1 in 10 households experiences food insecurity. The objective of this study was to devise a visual synthesis to summarise the activities, processes and principles that support the right to food for everyone in Australia.</p></div><div><h3>Methods</h3><p>Semi-structured key informant interviews (n=30) were conducted during 2019–20. Content analysis synthesised perspectives and assisted co-authors in revising an initial draft (shared during the interview) to finalise the road map through semantic realist data analysis and re-design.</p></div><div><h3>Results</h3><p>The six components of the right to food road map summarise the actions, processes, and principles to address the human right to food. These include i) policy leadership, ii) advocate and enact, iii) empowerment, iv) resourcing, v) monitoring and accountability and vi) healthy, equitable and sustainable food systems.</p></div><div><h3>Conclusions</h3><p>When all the right to food actions, processes and principles are present, the “cogs” within the map are hypothesised to interact and realise the right to food for all Australians.</p></div><div><h3>Implications for Public Health</h3><p>Considering the cost of living pressures and unrelenting demand for food relief, better solutions are needed for food insecurity. Human rights - this language, their international recognition and as a “method of working”, offer an alternative to the dominant responses to food insecurity.</p></div>","PeriodicalId":8620,"journal":{"name":"Australian and New Zealand Journal of Public Health","volume":"48 5","pages":"Article 100189"},"PeriodicalIF":2.6,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1326020024000657/pdfft?md5=1cb7e1326e875e76ec931f9a56e49f93&pid=1-s2.0-S1326020024000657-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142274803","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

“Freedom to move through the house”: How a healthy housing initiative improves quality of life in Aotearoa New Zealand "在家中自由活动"：健康住房倡议如何提高新西兰奥特亚罗瓦的生活质量

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-09-18 DOI: 10.1016/j.anzjph.2024.100190

Elinor Chisholm , Amber Logan , Clare Aspinall , Cheryl Davies , Philippa Howden-Chapman , Ellie Johnson , Nevil Pierse

Objective

This study explores experiences of the Healthy Housing Initiative (HHI). Aimed at children at risk of housing-related illness, the HHI package includes the provision of items such as curtains, heaters, bedding, and insulation, advocacy to encourage landlords to install improvements, and education and advice to help people optimise their home environment.

Methods

We conducted semi-structured, in-depth interviews with 20 people living in rental housing who received the HHI intervention.

Results

Participants felt heard and supported by HHI assessors. They reported that the intervention increased the warmth and dryness of the home, improved their respiratory and mental health, reduced their bills, and enabled the use of more parts of their home. However, some continued to live in cold and damp conditions due to structural inadequacies and energy poverty.

Conclusions

The qualitative evidence presented in this study shows how health-focussed interventions also benefit quality of life.

Implications for public health

This research emphasises that healthy housing interventions can yield extensive benefits by adopting a holistic and home-based approach. Such interventions have the potential to create improvements in individuals' lives far beyond health.

本研究探讨了健康住房倡议（HHI）的经验。健康住房倡议 "一揽子计划针对有可能患住房相关疾病的儿童，包括提供窗帘、取暖器、床上用品和隔热材料等物品，倡导鼓励房东安装改善设施，以及提供教育和建议以帮助人们优化家庭环境。方法我们对 20 名居住在出租房并接受了 "健康住房倡议 "干预措施的人进行了半结构化的深入访谈。他们表示，干预措施提高了家庭的温暖度和干燥度，改善了他们的呼吸和精神健康，减少了他们的账单，并使他们能够使用家中更多的地方。本研究提供的定性证据表明，以健康为重点的干预措施也有益于提高生活质量。对公共卫生的启示本研究强调，健康住房干预措施可以通过采用全面和以家庭为基础的方法产生广泛的益处。这些干预措施有可能改善个人的生活，远远超出健康的范畴。

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引用次数: 0

Act fast, stop COVID: The successful implementation of the first decentralised Victorian COVID-19 contact tracing and monitoring unit 快速行动，制止 COVID：维多利亚州首个分散式 COVID-19 接触者追踪和监测单位的成功实施

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-09-10 DOI: 10.1016/j.anzjph.2024.100186

Bridgette J. McNamara , Jessica McDonald , Kelvin Heard , N. Deborah Friedman , Frances Diver , Eugene Athan , Amanda J. Wade , Fiona Brennan , Melissa Warburton , Caroline Bartolo , Callum Maggs , Nicole Miller , Megan Smith , John Stenos , Daniel P. O’Brien

Objectives

To describe the operational model, epidemiology and outcomes of COVID-19 cases managed by the first decentralised Victorian Public Health Unit (PHU) in the Barwon South-West (BSW) region in 2020.

Methods

The Barwon Health team used a clinician-led, locally-based interprofessional model of care, combining clinical care and monitoring, contact tracing and public health measures.

Results

From 7th March to 5th October 2020, 575 confirmed COVID-19 cases (82 in Wave 1; 493 in Wave 2) were identified in residents of the BSW region. Overall, 4.7% were admitted to local hospitals (0.7% to intensive care units) and 1.7% died. COVID-19 incidence in the region was 129 cases/100,000. Wave 2 in the region featured community transmission in high-risk settings and among culturally and linguistically diverse and mobile populations. Within 3 months of the initial local case in Wave 2, SARS-COV-2 was eliminated from the community.

Conclusions

A local interprofessional model of care was key to the containment of community transmission and complex outbreaks with the elimination of COVID-19 in the community.

Implications for Public Health

Key successes and learnings from the BSW PHU contributed to the improvement of statewide systems and responses and provided an impetus for the implementation of a decentralised public health model for Victoria.

目标描述 2020 年巴原西南（BSW）地区首个分散式维多利亚州公共卫生单位（PHU）管理的 COVID-19 病例的运作模式、流行病学和结果。方法巴原卫生团队采用临床医生主导的本地跨专业护理模式，将临床护理和监测、接触者追踪和公共卫生措施结合起来。总体而言，4.7%的患者入住当地医院（0.7%入住重症监护室），1.7%的患者死亡。该地区 COVID-19 的发病率为 129 例/100,000 人。该地区第二波的特点是在高风险环境、文化和语言多样性以及流动人口中的社区传播。结论本地跨专业护理模式是遏制社区传播和复杂疫情的关键，并在社区消除了 COVID-19。对公共卫生的启示 BSW 公共卫生单位的主要成功经验和教训有助于改善全州的系统和应对措施，并为维多利亚州实施分散的公共卫生模式提供了动力。

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引用次数: 0

Establishing the Vaccine Safety Health Link: A large, linked data resource for the investigation of vaccine safety concerns 建立疫苗安全与健康的联系：用于调查疫苗安全问题的大型链接数据资源

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-09-10 DOI: 10.1016/j.anzjph.2024.100188

Hannah J. Morgan , Hazel J. Clothier , Philip Witowski , James H. Boyd , Gonzalo Sepulveda Kattan , Gerardo Luis Dimaguila , Aishwarya N. Shetty , Jim P. Buttery

Objective

Post-licensure vaccine safety surveillance of adverse events following immunisation is critical to ensure public safety and confidence in vaccines. This paper aims to describe the governance structure and data linkage methodology behind the establishment of the largest linked vaccine safety surveillance data resource in Australia – The Vaccine Safety Health Link (VSHL).

Methods

The Vaccine Safety Health Link contains linked records from the Australian Immunisation Register with records from hospital, perinatal, mortality, and notifiable disease datasets in near real-time. Linkage is done by the Centre for Victorian Data Linkage who receive the datasets in an identifiable format which then undergo standardisation, enrichment, linkage, quality assurance and de-identification, prior to being supplied for analysis.

Results

The VSHL data resource allows sensitive and rapid analysis of a broad spectrum of suspected adverse events to ensure the safety of all vaccines administered. It is also used to refute spurious concerns where no associations are found, upholding trust, and maintaining vaccine confidence.

Conclusions

The Vaccine Safety Health Link's surveillance design complements existing vaccine safety surveillance methods. Challenges encountered and lessons learnt using Vaccine Safety Health Link would benefit linkage projects globally.

Implications for public health

In its first two years, The Vaccine Safety Health Link has been used for 14 vaccine safety investigations. Studies into these conditions would not have otherwise been possible. The Vaccine Safety Health Link also partners with the Global Vaccine Data Network™ for approved collaborative studies with a combined population of over 300 million people.

目的对免疫接种后的不良事件进行许可后疫苗安全监测对于确保公众对疫苗的安全和信心至关重要。本文旨在介绍澳大利亚最大的链接疫苗安全监控数据资源--疫苗安全健康链接（VSHL）--建立背后的管理结构和数据链接方法。方法疫苗安全健康链接包含来自澳大利亚免疫登记册的链接记录，以及来自医院、围产期、死亡率和应通报疾病数据集的近乎实时的记录。链接由维多利亚州数据链接中心（Centre for Victorian Data Linkage）完成，该中心以可识别的格式接收数据集，然后对数据集进行标准化、丰富化、链接、质量保证和去标识化处理，最后提供给分析机构。结论疫苗安全健康链接的监测设计是对现有疫苗安全监测方法的补充。在使用疫苗安全健康链接过程中遇到的挑战和吸取的经验教训将使全球的链接项目受益。如果没有疫苗安全健康链接，就不可能对这些情况进行研究。疫苗安全健康链接 "还与 "全球疫苗数据网络"（Global Vaccine Data Network™）合作，开展已获批准的合作研究，研究对象总人数超过 3 亿。

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引用次数: 0

Estimating levels of mental health service need by small geographic area: A case study for Aboriginal and Torres Strait Islander adults living in South East Queensland 按小型地理区域估算心理健康服务需求水平：针对居住在昆士兰东南部的土著居民和托雷斯海峡岛民成年人的案例研究。

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-09-05 DOI: 10.1016/j.anzjph.2024.100185

Imogen S. Page , Claudia Pagliaro , Alize J. Ferrari , Harvey Whiteford , Sandra Diminic

Objective

The objective of this study was to determine regional variation in need for mental health care for Aboriginal and Torres Strait Islander adults (18+ years).

Methods

Three Australian Indigenous health surveys were analysed, and prevalence rates of high/very high psychological distress (as per the Kessler-5 tool) by the Index of Relative Socio-economic Disadvantage were computed and combined via meta-analysis. These estimates were applied to census population data to estimate regional needs and summed to geographic planning regions. Final estimates were assessed for face validity by comparing with other existing estimates of mental health need.

Results

The Index of Relative Socioeconomic Disadvantage had a dose–response relationship with high/very high psychological distress, whereby the more disadvantaged an area, the greater the levels of reported distress. This methodology resulted in varying levels of need within South East Queensland.

Conclusions

The approach was found to have good face validity and provides a data-driven method to determine relative levels of need.

Implications for Public Health

To ensure equity of mental health service provision, planners should account for variation in levels of need within a catchment. This method may be used throughout Australia to determine regional variation in need for care where other data are lacking to ensure evidence-based investment planning decisions at the local level.

研究目的本研究旨在确定土著居民和托雷斯海峡岛民成年人（18 岁以上）在心理保健需求方面的地区差异：方法：对三项澳大利亚原住民健康调查进行了分析，并按相对社会经济劣势指数（Index of Relative Socio-economic Disadvantage）计算出了高/极高心理压力流行率（根据凯斯勒-5工具），然后通过荟萃分析进行了合并。将这些估算值应用于人口普查数据，以估算地区需求，并汇总到地理规划区域。通过与其他现有的心理健康需求估计值进行比较，对最终估计值的表面有效性进行了评估：结果：相对社会经济劣势指数与高/极高心理压力之间存在剂量-反应关系，即一个地区越是劣势，报告的心理压力水平就越高。这种方法导致昆士兰东南部地区的需求水平各不相同：结论：该方法具有良好的表面效度，为确定相对需求水平提供了一种数据驱动方法：对公共卫生的启示：为确保心理健康服务的公平性，规划者应考虑到服务范围内需求水平的差异。这种方法可在澳大利亚全国范围内使用，以确定缺乏其他数据的地区在医疗需求方面的差异，从而确保在地方层面做出以证据为基础的投资规划决策。

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引用次数: 0

Identifying Service, Research and Policy priorities for preventing the impacts of family adversity on children’s mental health: An Australian national resource allocation study with professional and lived experience experts 确定预防家庭逆境对儿童心理健康影响的服务、研究和政策优先事项：与专业和生活经验专家共同开展的澳大利亚全国资源分配研究

IF 2.6 3区医学 Q2 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH

Australian and New Zealand Journal of Public Health

Pub Date : 2024-08-31 DOI: 10.1016/j.anzjph.2024.100184

Harriet Hiscock , Ashraful Kabir , Suzy Honisett , Tamara Morris , Leanne Constable , Suzie Forell , Sue Woolfenden , Sharon Goldfeld , Anthony Jorm

Objectives

The objective of this study was to develop Service, Research and Policy priorities to prevent the impact of family adversity on child mental health and determine comparative priorities of diverse stakeholders to those with lived experience of adversity.

Methods

Value-weighting approach conducted in a staged process: (i) professionals and experts with lived experience from health, education, justice and social care sectors attended a national symposium to identify priorities for family adversity and mental health and (ii) a subsequent resource allocation survey gathered views from participants and external experts on symposium priorities.

Results

Consensus was reached on priorities. Service priorities included establishing intersectoral hubs for children and families and early childhood nurse home-visiting programs. Research priorities included scaling up evidence-based interventions and evaluating cross-sector, flexible funding models for services addressing childhood adversity. Policy priorities included developing evidence-based policies with evaluation and implementation plans and flexible funding models to support integrated care.

Conclusions

Our results provide detailed and actionable clarity on next steps to address family adversities.

Implications for Public Health

The priorities call for a focus on cross-sectoral approaches to preventing or mitigating the effects of family adversity. The current Australian policy environment provides a timely opportunity to action the proposed interventions.

本研究的目的是制定服务、研究和政策方面的优先事项，以预防家庭逆境对儿童心理健康的影响，并确定不同利益相关者与有逆境生活经验者的优先事项比较。方法：(i) 来自卫生、教育、司法和社会关怀部门的专业人士和有生活经验的专家参加全国研讨会，以确定家庭逆境和心理健康方面的优先事项；(ii) 随后进行资源分配调查，收集与会者和外部专家对研讨会优先事项的意见。服务优先事项包括建立儿童和家庭跨部门中心以及幼儿护士家访计划。研究优先事项包括推广循证干预措施，评估跨部门、灵活的筹资模式，以提供解决儿童逆境问题的服务。政策优先事项包括制定有评估和实施计划的循证政策以及灵活的资助模式，以支持综合护理。我们的研究结果为解决家庭逆境问题的下一步措施提供了详细而可行的说明。澳大利亚当前的政策环境为采取建议的干预措施提供了一个及时的机会。

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