Australian journal of primary health最新文献

Background Improving engagement and utilisation of Primary Health Care Services (PHCS) by Aboriginal and Torres Strait Islander males is critical to advancing current physical and mental health outcomes among the subgroup with the highest burden of disease in Australia. PHCS are a first point of contact, coordinating services essential in preventing and managing these conditions. A Men's Group was established within a South Australian Aboriginal PHCS as a strategy to address documented barriers of access to health care. This study aimed to explore participant experiences and perspectives of the Men's Group initiative to inform the program. Methods This Aboriginal and Torres Strait Islander led qualitative study used an Aboriginal Participatory Action Research (APAR) framework and a Continuous Quality Improvement approach to gather and transfer Indigenous Knowledges. Semi-structured interviews were conducted by and with Aboriginal and Torres Strait Islander men attending the Men's Group. Data were analysed using thematic network analysis. Results Thirty two participants were interviewed in total. Five global themes were identified: (1) Facilitates and strengthens social and emotional wellbeing (SEWB), (2) Acquiring health knowledge and care is valued, (3) Provide greater opportunities to strengthen connection to culture, (4) Foster individual and collective self-determination, and (5) Improve access and enhance program delivery. Conclusions This study demonstrates the effectiveness of APAR to enhance Aboriginal and Torres Strait Islander male engagement with PHCS through prioritising their voices to co-design a culturally responsive male health program. The findings illustrate profound SEWB, empowerment and health awareness outcomes, resulting from engaging in the newly established, localised Men's Group.

Background Atopic dermatitis (AD) is a chronic inflammatory skin condition that negatively impacts quality of life. Topical corticosteroids (TCS) remain the first-line management and effective TCS use is associated with improved holistic wellbeing. However, medication self-withdrawal and 'no-moisture' method discussions have emerged, and there is evidence that treatment success is influenced by caregivers' views on TCS use. The aim of this study was to understand the experiences causing parents to deviate from traditional TCS use in paediatric AD management. Methods A convenience sampling approach was used to recruit caregivers of children with AD, who subsequently participated in one-on-one semi-structured interviews following informed consent. Qualitative data were thematically analysed. Results Ten participants were interviewed, of which four were also general practitioners (GPs). The steroid phobia observed among non-healthcare participants was also evident in the views of some GPs. Mismatched expectations within therapeutic relationships lead to some participants seeking alternative therapies and non-medical information sources. Divergence in interpretations of management between primary care practitioners is associated with poor treatment adherence and lowered parent confidence. Conclusions A holistic approach to paediatric AD management can effectively support parents and caregivers, as well as reduce treatment burden. Further education for GPs,exploration of psychosocial AD management and alternative therapies may assist in improving patient outcomes.

Background Women and children who experience domestic and family violence (DFV) have complex physical and mental health needs, may be at risk of homelessness, and face substantial barriers to accessing health care. The integration of outreach primary health care delivered by a multidisciplinary team (MDT) into shelters or mobile clinics may address these issues. This rapid review sought to identify and describe outreach programs for women and children affected by DFV and/or homelessness in middle- and high-income countries. Methods Seven bibliographic databases were searched in March 2024. Included studies described a primary care MDT outreach program that was delivered in a shelter, refuge, mobile clinic or drop-in centre; were written in English; and reported results separately for women. Results Twelve publications reporting on 11 programs were included. These identified four staffing models: (1) nurse-led MDT; (2) nurse-led MDT with physician available remotely; (3) MDT with on-site physician; and (4) student-led. Model 3 offered the greatest range of services (11.5 on average), and Model 4 the least (5.5 on average). Three publications reported on two quasi-experimental studies, whereas the remainder of the studies lacked a control group. All studies reported benefits to outreach service clients for one or more of the following outcomes: service acceptability, healthcare use, health outcomes and economic outcomes. Only two studies examined the impact on health outcomes. Conclusions Few studies evaluate primary care MDT outreach programs; however, those identified in this review indicate benefits for women and children experiencing DFV and/or homelessness.

Research highlights a child's environment and experiences during the first 2000days has a lasting impact on their health, development and wellbeing. In NSW, it is recommended that all children under 5years of age have free routine health and developmental checks, promoting optimal childhood development and shaping future health outcomes. There appears to be a strong indication that parents do not return for their checks. Between 2019 and 2020, a qualitative study was undertaken aiming to identify and better understand the key factors driving parents' disengagement from child family health nursing (CFHN) services after contact in their baby's first year. Moreover, having a greater understanding of key factors driving parents' early service disengagement may help to reshape service delivery. During the study period, parents of infants who had received the 1-4-week health check with CFHN services were informed about the study and invited to participate. A total of 104 families gave consent to take part in phone interviews. These interviews were transcribed and analysed using straightforward thematic analysis. Qualitative data were gathered to explore families' experiences with the CFHN services. Less than 35% of families utilised CFHN services, whereas >62% visited their general practitioners. Barriers identified included the presence of multiple services, established relationships with current health professionals, limited accessibility, convenience factors and parents' lack of knowledge regarding CFHN services. On a positive note, half of the participants reported experiencing no barriers. This study emphasises the need for better awareness and accessibility to CFHN services. The findings are concerning, because children missing health screenings may experience delays in early identification and intervention before starting school.

Background Primary care provides comprehensive whole-of-person patient-centred care with important responsibilities in prevention among cancer survivors. This includes cancer surveillance, the management of other chronic diseases, health promotion and preventative care. However, there is inconsistent application of prevention activities. We explored the experiences of Australian general practitioners (GPs) and practice nurses to: (1) understand the delivery of prevention activities for cancer survivors; and (2) identify determinants to optimise disease prevention activities within the current general practice context. Colorectal cancer is the fourth most common cancer in Australia. However, each GP will likely diagnose only one new case of colorectal cancer per year. Colorectal cancer survivorship care was provided as an example to prompt discussion on the delivery of prevention activities for cancer survivors and determinants to optimise prevention. Methods A qualitative study using semi-structured interviews with GPs and practice nurses from New South Wales and Queensland, Australia. Interviews were conducted between June 2021 and February 2022. Transcripts were reflexively analysed and mapped to the Functional Resonance Analysis Method framework. Results We conducted 15 interviews with GPs (n =11) and practice nurses (n =4) from 12 practices. Three potential activities fundamental to disease prevention for cancer survivors were identified: risk assessment, partnering with the patient and co-planning prevention activities. Conclusions Primary care is a complex and adaptive system. The Functional Resonance Analysis Method approach, by visualising the dynamic interactions and interdependencies between people, resources, time and system conditions involved in prevention activities, offers a pragmatic guide to develop acceptable, scalable and adaptable interventions for promoting disease risk estimation (cancer and other chronic diseases), therapeutic partnerships and co-planning activities within the socio-technological constraints of the system studied using the resources available. This approach represents a key paradigm shift in health system innovation for cancer survivors.

Background Despite improvements in children's oral health, disparities persist, particularly among children with special needs. This study compares oral health risks between children attending schools for specific purposes (SSPs) and their mainstream school (MS) peers to inform targeted interventions. Methods A retrospective cross-sectional analysis was conducted using data from school-based oral health assessments and caregiver questionnaires. Descriptive statistics, Chi-squared test and logistic regression were applied. Results Data from 610 students (320 SSPs, 290 MS), aged 5-19years, were analysed. Chi-squared analyses revealed MS students were more likely to consume sweet snacks several times a week (χ 2 =20.06, P χ 2 =8.6, P =0.003). Logistic regression indicated that SSPs students were less likely to visit a dentist in the past year (OR0.56, P P P P Conclusion Incorporating occupational therapists and speech pathologists into SSPs and school nurses in MS schools, through collaboration with oral health professionals, can enhance access to dental care and promote healthy oral care routines. For SSPs students, strategies should address sensory sensitivities, fine and oral-motor challenges and sugar drink consumption. For MS students, incorporating oral health into school health programs can identify at-risk children, facilitate referrals and strengthen connections to dental services, reducing disparities and improving well-being.

Sustainable primary care - caring for people and the planet 11-12 August 2025, Deakin University, Waterfront Campus, Geelong, Australia The Australasian Association for Academic Primary Care (AAAPC) held its Annual Research Conference from 11 to 12 August at Deakin University's Waterfront Campus in Geelong. The Conference provided an important opportunity to: Showcase Australasia's leading primary care research; Nurture research excellence; Promote multidisciplinary research networks and collaborations; Support the translation of evidence into policy and practice; Strengthen the impact of primary care research; and Promote opportunities for networking. To cite the full set of abstracts: (2025) Abstracts of the Australasian Association for Academic Primary Care (AAAPC) Annual Research Conference. Australian Journal of Primary Health31, PYv31n4abs. doi:10.1071/PYv31n4abs To cite individual abstracts use the following format: Abbott P et al. (2025) 1. Difficult and shameful - a scoping review of menstruation experiences among women in prison [Conference abstract]. Australian Journal of Primary Health31, PYv31n4abs.

Background Strong partnerships are the cornerstone for effectively co-planning primary healthcare models that meet community needs, however, there are few examples specifically for rural areas where smaller health services cover a dispersed population and wide geography with limited resources (thin markets). This study aimed to explore the partnership factors enabling the co-planning of sustainable rural health models in thin markets. Methods A qualitative study drawing upon in-depth focus groups with eight partnership members covering a combined estimated resident population of 24,620 people across three local government areas with small rural towns ( Results The overarching theme was that the partnership was valued and should continue. Four sub-themes included: the importance of the skilled and independent project lead to coordinate co-planning, the leadership and commitment of rural health service executives, strength and fragility of the project in the face of limited resources and staffing changes, and the importance of trust and relationships. Conclusions The research suggested that partnerships for co-planning of sustainable rural health models in rural thin markets are important. Independent and skilled leadership can assist small rural health services to engage with co-planning. This context also relies on committed rural health service executives who pay attention to building relationships and trust. Partnerships within this context are likely to be dynamic and require executives to spend time together to understand the range of problems and potential solutions as conditions change. With attention to these partnership factors, work on sustainable rural health models can be maintained.

Background People with prediabetes are at high risk of developing type 2 diabetes; therefore, diagnosing and managing this condition is critical. This qualitative study aimed to explore perspectives of health professionals with experience in prediabetes management in a rural setting about prediabetes diagnostic and management practices, to inform recommendations to improve type 2 diabetes prevention strategies and programs. Methods The study adopted a critical realist methodology. Nineteen health professionals from northern New South Wales, Australia, who were responsible for diagnosing and/or managing people with prediabetes were interviewed. Data were thematically analysed using a critical realist lens, then context-mechanism-outcome statements were generated and confirmed by co-authors using a discussion and reflection process. Results Five themes were generated from the semi-structured interviews: (1) the diagnostic dilemma; (2) care coordination and referral processes; (3) diabetes 'waiting room'; (4) the spectrum of prediabetes management; and (5) blueprint for type 2 diabetes prevention. Conclusions Prediabetes is a complex condition requiring diagnosis and management by a multidisciplinary team of health professionals to delay and/or prevent progression to type 2 diabetes. Establishing clear roles and responsibilities for diagnosing and managing prediabetes, and development of strategies to improve referral to and engagement in type 2 diabetes prevention programs will improve prediabetes care and diabetes prevention in rural settings.

Background Australia's health system combines federal and state roles, with Primary Health Networks supporting primary care. Digital health infrastructure exists, but meaningful use and maturity are limited across general practices. Methods Digital health maturity was assessed across six domains: infrastructure, meaningful use, readiness, digital literacy, data literacy, and clinical leadership using a cross-sectional survey design. Between August 2020 and July 2024, 1164 general practices from 10 PHN regions were surveyed out of the 2255 practices invited to respond (31.3% of general practice clinics in Australia), this represented a 51.6% response rate. Results On average, none of the general practice clinics scored above 80 out of 100 in any of the digital health maturity domains, suggesting a trend towards lower maturity. We found that low overall digital health maturity in practices is related to lower scores in meaningful use, digital health and data literacy, and clinical leadership domains. Discussion Digital health infrastructure alone is not enough. Targeted support is essential for digital adoption. Enhancing digital health and data literacy, leadership, and tailored change management can strengthen digital adoption in practices, potentially improving care quality and digital transformation nationally.