Health, access and engagement of Aboriginal young people with the Orange Aboriginal Medical Service (OAMS)
Significant inequalities exist in the health of young Aboriginal and non-Aboriginal people. Young Aboriginal people have the lowest rates of utilisation of the Orange Aboriginal Medical Service (OAMS). It is a collaborative study between Western Sydney University, Western NSW LHD, Orange Aboriginal Medical Service, University of Newcastle and the School of Rural Health. The study aims to improve access and service delivery within OAMS for Aboriginal young people by providing an evidence base for the development of an OAMS Youth Program. The study involves describing health profiles and healthcare utilisation among young people (Aboriginal and non-Aboriginal) in Orange and in Western NSW using existing datasets; and interviews of OAMS staff about factors that may promote or hinder access and delivery of services to young people.
For more infomation contact Georgina Luscombe
Associate Professor Catherine Hawke is a Chief Investigator on the ACCESS 3 study. The study is funded by the Office of Kids and Families, NSW Health to inform youth health policy, the ACCESS 3 research study will describe the experiences of young people accessing and navigating the health system in NSW, focusing on the barriers and facilitators to accessing health care for marginalised young people in NSW. The ACCESS 3 study will focus on young people aged 12-24 living in NSW who are:
- Aboriginal and/or Torres Strait Islander
- living in rural/remote areas
- homeless or at risk of homelessness
- refugee or vulnerable migrants
- identifying as gender or sexuality diverse
Aboriginal people’s stories of diabetes care in Dubbo
This study used grounded theory and participatory research methodologies to explain how Aboriginal people learn to understand and manage type 2 diabetes. It was a collaborative study between Western NSW LHD, Dubbo Aboriginal Regional Health Service, Marathon Health and the School of Rural Health. Aboriginal people with diabetes were invited to participate in one of five focus groups conducted by Aboriginal members of the research team.
Participants described colonisation and dislocation from Country and family members’ experiences with diabetes as significant historical influences which, in conjunction with the model of care experienced and they type of interaction with health services shaped how they came to understand and manage their diabetes. The study showed that patient experience of a model of care is not what influenced understanding and management of diabetes in Aboriginal people.
Our services are now working together to improve services for Aboriginal people with diabetes with a focus on improving interactions with health services and providing holistic family centred models of care.
For more information contact Emma Webster
Health professional’s perspectives on creating integrated diabetes care for Aboriginal people with type 2 diabetes in Dubbo
This research described perspectives of health professionals on creating integrated care for Aboriginal people with type 2 diabetes in Dubbo. It aimed to generate discussion and collaborative action between all services and sectors who work together in diabetes service delivery and was nested in the broader context of the Dubbo Aboriginal Health Integration- Diabetes Project. Collaborators were the Dubbo Regional Aboriginal Health Service, Western NSW PHN, Western NSW LHD and the School of Rural Health.
Interviews (n=13) with a broad range of health professionals from both private and public sector demonstrated there is both enthusiasm for and resistance to the shift to integrated care. Facilitators of integrated care included having health professionals operating with broadest professional boundaries. Facilitators for culturally appropriate care included a well-trained Aboriginal workforce, including AHW who are diabetes educators and use of visual resources, storytelling and group work.
Barriers to integrated care included payment incentives not being comprehensive enough to provide culturally appropriate care, leading to the view that Aboriginal people do not fit the business model. The payment system was seen to reward clinician activity rather than patient outcomes and pathways were regarded with suspicion as they were not considered patient centred. Poorly designed general practice management plans, team care arrangements and poor quality written information about patients were a cause of frustration for all health professionals. There was considerable variation in individual general practitioner approach to care coordination and lack of consistency of who the care coordinator was.
The lack of a diabetes network for professional education and networking was seen to be a barrier which led to a lack of confidence in other health professional’s clinical knowledge, skills and availability of services. Negative stereotypes of Aboriginal people and lower expectations of treatment outcomes for Aboriginal patients were also found.
Study findings are informing Phase 2 of the Dubbo Integrated Care Project.
For more information contact Emma Webster
Strengthening Simulation Education
The School of Rural Health is undertaking a rapid review of published literature that focuses on simulation education, stress and cognitive load theory. This work has been commissioned by NSW Health’s Health and Education and Training Unit (HETI). The results of this review will be used to inform further study designs for planned research conducted in partnership with the SRH and HETI.
For more information contact Karen Paxton
A qualitative enquiry about on-farm rules about quad bikes.
Despite quad bikes being responsible for a significant number of deaths annually in Australia, little is known regarding on-farm behaviour and use of these vehicles. This qualitative study has interviewed 8 adults and aims to interview a further 2-7 people who live or work on a farm in rural Australia to understand current on-farm rules about the use of quad bikes. Themes derived from interviews will be used to inform the development of a questionnaire relating to prevalence of on-farm rules for quad bike safety.
The research is conducted in the interest of keeping people safe in farm environments determine the types of rules and behaviours that are engaged in around quad bikes, as these can then be mapped to the types of injuries people sustain and inform the development of strategies for safer quad bikes and safer quad bike use.
For more information contact Emma Webster
Young and Well Cooperative Research Centre (YAW CRC): Exploring the role of technologies in improving young people’s mental health and wellbeing.
First national survey: rural versus metropolitan comparisons
Dr Jane Burns (YAW CRC), Prof Ian Hickie (BMRI, University of Sydney), Prof Helen Christensen (Black Dog Institute), Tracey Davenport (Academic Research and Statistical Consulting), Dr Georgina Luscombe
The Young and Well Cooperative Research Centre is a national body, funded by the Australian Government, with 70 partner organisations. The organisation is primarily concerned with exploring the role of technologies in improving young people’s mental health and wellbeing.
The recently conducted YAW CRC first national survey includes information on the following:
- Demographics including information about occupation, highest level of education of respondent and household, living status and receipt of government benefits.
- General health and wellbeing.
- Health, happiness and resilience.
- Health perceptions of Australian youth.
- Eating behaviours and body image.
- Internet use by young people.
The School of Rural Health has been granted access to the computer assisted telephone interview (CATI) survey which comprises 1,400 youth aged 16-25 years (420 of whom are rural), and will examine differences between rural and metropolitan-based youth in terms of mental health and wellbeing, and use of information and communication technologies.
Occupational Health and Safety – Human exposure to Zinc Phosphide during the on-farm preparation of mouse baits
A/Prof Tony Brown, A/Prof Anthony Lower (Australian Centre for Agricultural Health & Safety, University of Sydney), A/Prof Dino Pisaniello (Occupational and Environmental Hygiene Laboratory, University of Adelaide)
In times of mouse plagues, grain growers require rapid access to effective baits to control vermin. Commercial supplies of Zinc Phosphide bait may be limited, but it is possible for farmers to produce their own. In collaboration with the Australian Centre for Agricultural Health and Safety and the Occupational and Environmental Health Laboratory, we are investigating the safe on-farm production of Zinc phosphide mouse bait, to allow formal regulatory approval for this process.
School of Rural Health Students Outcomes
The School of Rural Health is funded by the Australian Commonwealth Government under what is now the Rural Clinical Training and Support (RCTS) Program. The rationale for the program has been to increase the number of doctors practising rurally. The hypothesis has been that long-term rural placements will increase the likelihood that medical students will ultimately choose a rural career. The scheme is underpinned by sound evidence for the association between rural exposure and rural medical career uptake. We are keenly tracking our alumni in their medical careers, particularly their choice of location to practice. In addition to our own records, the School of Rural Health encourages its students to participate in the Medical Students Outcomes Database (MSOD) surveys, as well as the Federation of Rural and Medical Educators (FRAME) surveys. These combined databases are yielding insights into where our students go and what is motivating their career choices.
Working with the Office of Medical Education in the Sydney Medical School, we have tracked former University of Sydney medical students, using the Medical Students Outcomes Database (MSOD). For the graduating years of 2008-2010, we have found a significant association between taking an extended rural placement at the School of Rural Health and both the intention to and actual uptake of a rural internship; a much stronger association than rural background in this group (PMID: 24329657).
For further information contact Anthony Brown
Vibrio infections: antibiotic treatment and patient health outcomes (COVIS CDC data)
Dr Kam Cheong Wong, Dr Kumara Mendis, A/Prof Tony Brown, Dr Hazel Dalton, Shin Jie Wong, Dr Georgina Luscombe
Vibrio infections caused by V. cholera and other Vibrio such as V. parahaemolyticus are critical causes of morbidity and mortality in the world. Access to the USA Centre for Disease Control and Prevention (CDC) Cholera and other Vibrio Illness Surveillance (COVIS) data for the period 1990-2010 has been granted.
This project aims to describe the cumulative Vibrio isolates and associated morbidities and mortality rates over different epochs of time, to analyse the proportion of patients who took antibiotics as treatment of the illness and explore patient outcomes e.g. hospitalisation, morbidity. In addition it will be possible to analyse the effect of different types of antibiotics on patient outcomes.
Royal Flying Doctor Service (RFDS) - evaluating health outcomes
Dr Gerald Chitsunge (RFDS), Dr Peter Brendt (RFDS) and Dr Marc Schnekenburger (RFDS), Mrs Karen Paxton, A/Prof Tony Brown, Dr Kumara Mendis
In collaboration with the RFDS South Eastern Section, the School of Rural Health are evaluating health outcomes as result of fixed-wing air medical retrieval. This work has included endotracheal tube cuff pressure before, during, and after fixed-wing air medical retrieval (PMID: 23252881). The group is now focussed on cardiac retrievals.
The development of a population health program in a regional Aboriginal Community Controlled Health Service
Dr Matthew Day, A/Prof Catherine Hawke, A/Prof Wendy Stevens (UWS), Ms Tegan Edwards (UWS), Mr Jamie Newman and all staff at the Orange Aboriginal Medical Service (OAMS), Dr Georgina Luscombe
The aims of the current research project are:
- To document and assess the development of a Population Health Program at Orange Aboriginal Medical Service (OAMS).
- To evaluate specific initiatives developed as a result of the Population Health Program.
The group has been awarded an Evidence to Practice grant from the Cancer Institute NSW for "Tobacco control in Central Western NSW Aboriginal communities: developing a consistent patient journey through promoting health services integration". The long term vision of this project is for Aboriginal people to have a consistent patient journey and seamless access to tobacco control services, follow up and support, regardless of the health provider through which they access the system. The School of Rural Health is assisting OAMS with the development and evaluation of the project.