1
|
Bailie J, Scott KM. Overcoming the challenges posed by disasters through learning, reflection and adaption. Med Educ 2024; 58:659-661. [PMID: 38317406 DOI: 10.1111/medu.15320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Accepted: 01/17/2024] [Indexed: 02/07/2024]
Abstract
Drawing on explorations of emergency responses, Bailie and Scott comment on learning through covid, highlighting influences on sense of duty, the concept of volunteering, and the importance of adaptability.
Collapse
Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, Australia
- School of Public Health, The University of Sydney, Sydney, Australia
| | - Karen M Scott
- Sydney Medical School, The University of Sydney, Sydney, Australia
| |
Collapse
|
2
|
Caltabiano P, Bailie J, Laycock A, Shea B, Dykgraaf SH, Lennox N, Ekanayake K, Bailie R. Identifying barriers and facilitators to primary care practitioners implementing health assessments for people with intellectual disability: a Theoretical Domains Framework-informed scoping review. Implement Sci Commun 2024; 5:39. [PMID: 38627849 PMCID: PMC11020327 DOI: 10.1186/s43058-024-00579-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 04/05/2024] [Indexed: 04/20/2024] Open
Abstract
INTRODUCTION People with intellectual disability experience poorer health outcomes compared with the general population, partly due to the difficulties of accessing preventive care in primary care settings. There is good evidence that structured annual health assessments can enhance quality of care for people with intellectual disability, and their use has become recommended policy in several high-income countries. However, uptake remains low. The Theoretical Domains Framework (TDF) offers a conceptual structure for understanding barriers to implementation and has been usefully applied to inform implementation of health assessments for other high-need groups, but not for people with intellectual disability. We conducted a scoping review of the literature, using the TDF, to identify barriers and facilitators influencing primary care practitioners' implementation of annual health assessments for people with intellectual disability as part of routine primary care practice. METHODS This study was conducted according to the JBI methodological approach for scoping reviews. Searches were conducted in Medline (OVID-SP), Embase (OVID-SP), PsycINFO (OVID-SP), CINHAL (EBSCO), Scopus (Elsevier) and Web of Science (Clarivate) for relevant peer-reviewed publications up to May 2023. Screening, full-text review and data extraction were completed by two independent reviewers. Data were extracted and mapped to the TDF to identify relevant barriers and facilitators. RESULTS The search yielded 1057 publications, with 21 meeting the inclusion criteria. Mapping data to the TDF, the most frequently identified domains were (a) environmental context and resources, (b) skills, (c) knowledge and (d) emotion. Predominant factors impacting on implementation included practitioners' lack of awareness about health assessments and their identified benefits; inadequate training and experience by practitioners in the delivery of health assessments for people with intellectual disability; insufficient time to provide health assessments; and practitioner burnout. CONCLUSION Using a theory-informed behavioural framework, our review aids understanding of the barriers and facilitators to improving the implementation of health assessments as part of routine care for people with intellectual disability. However, there is a clear need for further qualitative research to examine the perceptions of primary care practitioners regarding implementation barriers and facilitators to health assessments in general, including views from practitioners who are not currently undertaking health assessments.
Collapse
Affiliation(s)
- Paul Caltabiano
- School of Rural Health, The University of Sydney, Dubbo, Australia
- Sydney Medical School, The University of Sydney, Camperdown, Australia
| | - Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, Australia.
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, Australia.
| | - Alison Laycock
- University Centre for Rural Health, The University of Sydney, Lismore, Australia
| | - Bradley Shea
- Sydney Medical School, The University of Sydney, Camperdown, Australia
- University Centre for Rural Health, The University of Sydney, Lismore, Australia
| | - Sally Hall Dykgraaf
- Rural Clinical School, Australian National University, ACT, Canberra, Australia
| | - Nicholas Lennox
- Queensland Centre for Intellectual and Developmental Disability, Mater Research Institute, University of Queensland, Brisbane, Australia
| | - Kanchana Ekanayake
- University of Sydney Library, The University of Sydney, Camperdown, Australia
| | - Ross Bailie
- School of Public Health, The University of Sydney, Camperdown, Australia
| |
Collapse
|
3
|
Quilliam C, Green E, Rasiah RL, Sheepway L, Seaton C, Moore L, Bailie J, Matthews KM, Ferns J, Debenham J, Taylor C, Fitzgerald K, Ridd M. University staff perspectives on determinants of high-quality health professions student placements in regional, rural and remote Australia: protocol for a mixed-method study. BMJ Open 2024; 14:e077079. [PMID: 38448071 PMCID: PMC10916158 DOI: 10.1136/bmjopen-2023-077079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 02/13/2024] [Indexed: 03/08/2024] Open
Abstract
INTRODUCTION In rural areas, work-integrated learning in the form of health student placements has several potential benefits, including contributing to student learning, enhancing rural health service capacity and attracting future rural health workforce. Understanding what constitutes a high-quality rural placement experience is important for enhancing these outcomes. There is no current standardised definition of quality in the context of rural health placements, nor is there understanding of how this can be achieved across different rural contexts. This study is guided by one broad research question: what do university staff believe are the determinants of high-quality health professions student placements in regional, rural and remote Australia? METHODS AND ANALYSIS This study will adopt a convergent mixed-method design with two components. Component A will use explanatory sequential mixed methods. The first phase of component A will use a survey to explore determinants that contribute to the development of high-quality health student placements from the perspective of university staff who are not employed in University Departments of Rural Health and are involved in the delivery of health student education. The second phase will use semistructured interviews with the same stakeholder group (non-University Department of Rural Health university staff) to identify the determinants of high-quality health student placements. Component B will use a case study Employing COnceptUal schema for policy and Translation Engagement in Research mind mapping method to capture determinants that contribute to the development of high-quality health student placements from the perspective of University Department of Rural Health university staff. ETHICS AND DISSEMINATION The University of Melbourne Human Ethics Committee approved the study (2022-23201-33373-5). Following this, seven other Australian university human research ethics committees provided external approval to conduct the study. The results of the study will be presented in several peer-review publications and summary reports to key stakeholder groups.
Collapse
Affiliation(s)
- Claire Quilliam
- Department of Rural Health, The University of Melbourne, Shepparton, Victoria, Australia
| | - Elyce Green
- Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Rohan L Rasiah
- Western Australian Centre for Rural Health, The University of Western Australia, Karratha, Western Australia, Australia
| | - Lyndal Sheepway
- La Trobe Rural Health School, La Trobe University, Wodonga, Victoria, Australia
| | - Catherine Seaton
- Centre for Rural and Remote Health, James Cook University, Mount Isa, Queensland, Australia
| | - Leigh Moore
- Flinders University Rural and Remote Health, Flinders University, Darwin, Northern Territory, Australia
| | - Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kylie Maree Matthews
- Majarlin Kimberley Centre for Remote Health, The University of Notre Dame Australia, Broome, Western Australia, Australia
| | - Jane Ferns
- Department of Rural Health, The University of Newcastle, Taree, New South Wales, Australia
| | - James Debenham
- Majarlin Kimberley Centre for Remote Health, The University of Notre Dame Australia, Broome, Western Australia, Australia
| | - Carolyn Taylor
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Kathryn Fitzgerald
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, Western Australia, Australia
| | - Melissa Ridd
- Flinders University Rural and Remote Health, Flinders University, Darwin, Northern Territory, Australia
| |
Collapse
|
4
|
Bishop GM, Llewellyn G, Kavanagh AM, Badland H, Bailie J, Stancliffe R, Emerson E, Fortune N, Aitken Z. Disability-related inequalities in the prevalence of loneliness across the lifespan: trends from Australia, 2003 to 2020. BMC Public Health 2024; 24:621. [PMID: 38413942 PMCID: PMC10898179 DOI: 10.1186/s12889-024-17936-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 01/30/2024] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Experiencing loneliness can be distressing and increasing evidence indicates that being lonely is associated with poor physical and mental health outcomes. Cross-sectional studies have demonstrated that people with disability have increased risk of experiencing loneliness compared to people without disability. However, we do not know if these inequalities have changed over time. This study investigated the prevalence of loneliness for people with disability in Australia annually from 2003 to 2020 to examine whether disability-related inequalities in loneliness have changed over time, and disaggregated results for subgroups of people with disability by age group, sex, and disability group. METHODS We used annual data (2003-2020) from the Household, Income and Labour Dynamics in Australia Survey. Loneliness was measured by a single question assessing the subjective experience of loneliness. For each wave, we calculated population-weighted age-standardised estimates of the proportion of people experiencing loneliness for people with and without disability. We then calculated the absolute and relative inequalities in loneliness between people with and without disability for each wave. Analyses were stratified by 10-year age groups, sex, and disability group (sensory or speech, physical, intellectual or learning, psychological, brain injury or stroke, other). RESULTS From 2003 to 2020, the prevalence of loneliness was greater for people with disability, such that people with disability were 1.5 to 1.9 times more likely to experience loneliness than people without disability. While the prevalence of loneliness decreased for people without disability between 2003 and 2020, the prevalence of loneliness did not decrease for people with disability during this period. Inequalities in loneliness were more substantial for people with intellectual or learning disabilities, psychological disability, and brain injury or stroke. CONCLUSION This study confirms that people with disability have increased risk of loneliness compared to people without disability. We add to the existing evidence by demonstrating that disability-related inequalities in loneliness have persisted for two decades in Australia without improvement. Our findings indicate that addressing inequalities in loneliness for people with disability is a critical public health concern given that loneliness is associated with a wide range of poor health outcomes.
Collapse
Affiliation(s)
- Glenda M Bishop
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia.
| | - Gwynnyth Llewellyn
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Anne M Kavanagh
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Hannah Badland
- Social and Global Studies Centre, RMIT University, Melbourne, VIC, 3000, Australia
| | - Jodie Bailie
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, NSW, 2006, Australia
- University Centre for Rural Health, The University of Sydney, Lismore, NSW, 2480, Australia
| | - Roger Stancliffe
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Eric Emerson
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, NSW, 2006, Australia
- Centre for Disability Research, Faculty of Health & Medicine, Lancaster University, Lancaster, LA1 4YW, UK
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, 5042, Australia
| | - Nicola Fortune
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, NSW, 2006, Australia
| | - Zoe Aitken
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
| |
Collapse
|
5
|
Watson TPG, Tong M, Bailie J, Ekanayake K, Bailie RS. Relationship between climate change and skin cancer and implications for prevention and management: a scoping review. Public Health 2024; 227:243-249. [PMID: 38262229 DOI: 10.1016/j.puhe.2023.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 11/04/2023] [Accepted: 12/02/2023] [Indexed: 01/25/2024]
Abstract
OBJECTIVES This study aimed to explore the published research on the relationship between climate change and skin cancer and the implications for prevention, management and further research. STUDY DESIGN Scoping review. METHODS This scoping review following JBI methodology reviewed English articles identified in searches of MEDLINE, Embase, CINAHL, Web of Science and Scopus on 14 April 2023. The screening of articles was completed by two independent reviewers. Data were extracted by a single reviewer and checked by another. A causal pathway diagram was iteratively developed throughout the review and was used to categorise the findings. RESULTS The search identified 1376 papers, of which 45 were included in the final review. Nine papers reported primary research, and 36 papers were reviews, perspectives, commentaries, editorials, or essays. The papers examined climate change influencing behaviours related to ultraviolet exposure (30 papers), ambient temperature (21 papers) and air pollution (five papers) as possible risk factors; occupational, rural, and contextual factors affecting skin cancer (11 papers); and prevention and access to health care in the context of climate change (seven papers). Most papers were published in journals in subject areas other than health. CONCLUSIONS This review identified ultraviolet radiation, occupation, rising temperature, individual behaviour and air pollution as possible influences on skin cancer rates. Furthermore, it highlights the complexity and uncertainties in the relationship between climate change and skin cancer and the need for further research on this relationship, including primary epidemiological research and reviews that follow recognised review guidelines and include assessment of health services and social determinants in the causal pathways of this relationship.
Collapse
Affiliation(s)
- T P G Watson
- Sydney Medical School, The University of Sydney, Camperdown, New South Wales, 2050, Australia; University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, 2480, Australia
| | - M Tong
- National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australian Capital Territory, 2601, Australia
| | - J Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, 2480, Australia; School of Public Health, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - K Ekanayake
- University of Sydney Library, The University of Sydney, Camperdown, New South Wales, 2050, Australia
| | - R S Bailie
- School of Public Health, The University of Sydney, Camperdown, New South Wales, 2050, Australia.
| |
Collapse
|
6
|
Bailie J, Disney G, Quilliam C, Kavanagh AM. The NDIS at ten years: designing an equitable scheme for the next decade. Med J Aust 2024; 220:54. [PMID: 38009556 DOI: 10.5694/mja2.52173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 10/17/2023] [Indexed: 11/29/2023]
Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health, University of Sydney, Lismore, NSW
- Centre for Disability Research and Policy, University of Sydney, Lismore, NSW
| | - George Disney
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
| | - Claire Quilliam
- Department of Rural Health, University of Melbourne, Shepparton, VIC
| | - Anne M Kavanagh
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC
| |
Collapse
|
7
|
Warner S, Cheung D, Condon A, Cunningham J, Bailie J, Minc A, Herbert S, Edmiston N. Communication and coordination of care for people living with HIV: a qualitative study of the patient perspective. BMC Prim Care 2024; 25:19. [PMID: 38200444 PMCID: PMC10777490 DOI: 10.1186/s12875-023-02243-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 12/12/2023] [Indexed: 01/12/2024]
Abstract
BACKGROUND There is growing consensus that primary health care (PHC) providers have an important role in providing holistic, preventative care for people living with human immunodeficiency virus (PLHIV). In regional Australia, HIV care is primarily delivered through specialist services, thus adequate coordination and communication between specialist and PHC professionals is crucial. This study aimed to explore patient experiences of the coordination of care and health care professional communication for PLHIV in regional Australia. METHODS Semi-structured interviews with PLHIV in a regional area of Australia were conducted in March to April 2022. Interviews were conducted via video conferencing, face-to-face, or via telephone call. Interviews were audio-recorded and manually transcribed. Transcripts were coded inductively and thematic analysis was conducted to explore perspectives on communication and coordination. RESULTS Thirteen participants were interviewed. Most participants were male, aged 50-70, were diagnosed with HIV more than ten years ago, and had been living in regional Australia long-term. Through qualitative analysis, themes emerged in the following areas: (1) Patient perception of care coordination; (2) Patient understanding of modality of communication; (3) Positive attitudes towards communication between healthcare professionals; and (4) Concerns for information sharing between healthcare professionals. Many participants highlighted lack of clarity around care coordination as a key issue in their healthcare, with some citing themselves as the primary care coordinator. Participants identified that coordination and communication between PHC professionals and specialist services are essential in the delivery of their health care, but some were hesitant for this to occur. Hesitancy was entrenched in some patients' distrust of healthcare due to previous experiences of confidentiality breaches and stigma. CONCLUSION This study identifies the need for clarity in coordination between health care professionals to deliver safe and effective HIV care, which may occur through care plans. Patient support for communication between healthcare providers may be strengthened by ensuring trust in the people and systems involved. Eliminating stigma in healthcare as well as building more trustworthy electronic-based communication technologies are essential components to trust-building between PLHIV and healthcare systems.
Collapse
Affiliation(s)
- Sherridan Warner
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Daniel Cheung
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ashleigh Condon
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Juliet Cunningham
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jodie Bailie
- University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia
- School of Public Health, The University of Sydney, Sydney, Australia
| | - Ariane Minc
- North Coast Sexual Health Service, Mid North Coast New South Wales Local Health District, Lismore, Australia
| | - Simone Herbert
- North Coast Sexual Health Service, Mid North Coast New South Wales Local Health District, Lismore, Australia
| | - Natalie Edmiston
- University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia.
- School of Medicine, Western Sydney University, Campbelltown, Australia.
| |
Collapse
|
8
|
Conte KP, Laycock A, Bailie J, Walke E, Onnis LA, Feeney L, Langham E, Cunningham F, Matthews V, Bailie R. Producing knowledge together: a participatory approach to synthesising research across a large-scale collaboration in Aboriginal and Torres Strait Islander health. Health Res Policy Syst 2024; 22:3. [PMID: 38172892 PMCID: PMC10765661 DOI: 10.1186/s12961-023-01087-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
BACKGROUND Despite that stakeholder participation in evidence synthesis could result in more useful outcomes, there are few examples of processes that actively involve them in synthesis work. Techniques are needed that engage diverse stakeholders as equal partners in knowledge co-production. The aims of this paper are to describe an innovative participatory process of synthesising a large body of academic research products and compare the findings of the participatory process against two traditional approaches to synthesis: a rapid review and a structured review. METHODS First, a rapid synthesis of all research outputs (n = 86) was conducted by researchers with in-depth knowledge of the collaboration's research. Second, a team of researchers and service providers conducted a structured synthesis of seventy-eight peer-reviewed articles and reports generated by the collaboration. Fifty-five publications were brought forward for further synthesis in part three, a facilitated participatory synthesis. Finally, we explored the value added by the participatory method by comparing findings generated across the three synthesis approaches. RESULTS Twelve researchers and 11 service providers/policy partners-8 self-identified as Aboriginal and/or Torres Strait Islander-participated in two facilitated workshops (totalling 4 h). Workshop activities engaged participants in reviewing publication summaries, identifying key findings, and evoked review, discussion and refinement. The process explicitly linked experiential knowledge to citations of academic research, clearly connecting the two knowledge types. In comparing the findings generated across all three methods we found mostly consistencies; the few discrepancies did not contradict but gave deeper insights into statements created by the other methods. The participatory synthesis generated the most, detailed, and unique findings, and contextual insights about the relevance of the key messages for practice. CONCLUSION The participatory synthesis engaged stakeholders with diverse backgrounds and skillsets in synthesising a large body of evidence in a relatively short time. The participatory approach produced findings comparable to traditional synthesis methods while extending knowledge and identifying lessons most relevant for the participants who, ultimately, are the end users of the research. This process will interest other large-scale research collaborations seeking to engage stakeholders in evidence synthesis.
Collapse
Affiliation(s)
- Kathleen P Conte
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia.
- Oregon Health Sciences University-Portland State University School of Public Health, Portland State University, Portland, USA.
| | - Alison Laycock
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
| | - Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
- School of Public Health, The University of Sydney, Camperdown, Australia
| | - Emma Walke
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
| | - Leigh-Ann Onnis
- College of Business, Law and Governance, James Cook University, Cairns, Australia
| | - Lynette Feeney
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
| | - Erika Langham
- Poche Centre for Indigenous Health, University of Queensland, Brisbane, Australia
| | - Frances Cunningham
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, Camperdown, Australia
| | - Ross Bailie
- Sydney Medical School, The University of Sydney, Camperdown, Australia
| |
Collapse
|
9
|
Emerson E, Stancliffe RJ, Aitken Z, Bailie J, Bishop GM, Badland H, Llewellyn G, Kavanagh AM. Disability and loneliness in the United Kingdom: cross-sectional and longitudinal analyses of trends and transitions. BMC Public Health 2023; 23:2537. [PMID: 38114963 PMCID: PMC10729364 DOI: 10.1186/s12889-023-17481-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 12/13/2023] [Indexed: 12/21/2023] Open
Abstract
BACKGROUND Loneliness can have a detrimental impact on health, yet little is known about the association between disability and loneliness. METHODS Secondary analysis of three waves of data collected between 2017 and 2020 by the UK's annual household panel study, Understanding Society. Direct age-standardisation was used to compare the prevalence of loneliness at each wave and the persistence of loneliness across all three waves for participants with/without disabilities aged 16-65 years. Transitional probabilities for the stability of loneliness, the stability of non-loneliness, the onset of loneliness and the offset of loneliness between consecutive waves were also estimated. RESULTS At each wave, the prevalence of loneliness was significantly higher among respondents with disabilities than respondents without disabilities; these inequalities persisted with no evidence of change over time. The prevalence of persistent loneliness was 46% for respondents with disabilities compared with 22% for respondents without disabilities. Risk factors for the likelihood of persistent loneliness included disability, financial stress, not living as a couple, living in rented accommodation, being female and not being employed. The probability of the onset and stability of loneliness between successive waves were markedly higher for people with disabilities compared with people without disabilities. CONCLUSION Adults with disabilities were more likely to experience loneliness, become lonely and remain lonely over time than their peers. Policies and interventions aimed at reducing loneliness should ensure that they are accessible and effective for people with disabilities. Further research is needed to explore the health outcomes of persistent loneliness among people with/without disabilities.
Collapse
Affiliation(s)
- Eric Emerson
- Centre for Disability Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK.
- Centre for Disability Research and Policy, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia.
- College of Nursing and Health Sciences, Flinders University, Bedford Park, SA, 5042, Australia.
| | - Roger J Stancliffe
- Centre for Disability Research and Policy, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Zoe Aitken
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Jodie Bailie
- Centre for Disability Research and Policy, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
- University Centre for Rural Health, University of Sydney, Camperdown, NSW, 2006, Australia
- School of Public Health, University of Sydney, Camperdown, NSW, 2006, Australia
| | - Glenda M Bishop
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Hannah Badland
- Social and Global Studies Centre, RMIT University, Melbourne, VIC, 3001, Australia
| | - Gwynnyth Llewellyn
- Centre for Disability Research and Policy, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, 2006, Australia
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
| | - Anne M Kavanagh
- Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC, 3010, Australia
| |
Collapse
|
10
|
Bailie J, Bishop GM, Badland H, Emerson E, Aitken Z, Stancliffe R, Ekanayake K, Llewellyn G. Health and wellbeing outcomes associated with loneliness for people with disability: a scoping review. BMC Public Health 2023; 23:2361. [PMID: 38031029 PMCID: PMC10685646 DOI: 10.1186/s12889-023-17101-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 10/30/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Loneliness is a significant public health concern due to its detrimental impact on health and wellbeing. Despite people with disability reporting higher levels of loneliness than the general population, there has been little research into how this is affecting their health and wellbeing. In light of this, the aim of our study was to scope both the existing evidence about the health and wellbeing outcomes associated with loneliness for people with disability, as well as the conceptual frameworks and measures utilised in this field of research. METHODS To conduct this scoping review, we followed the methodology outlined by JBI and searched MEDLINE, Scopus, Informit, Embase, and Web of Science for peer-reviewed, English-language articles published between 1 January 2000 and 8 February 2023. Two independent reviewers completed screening, full-text review and data extraction, with consensus sought at each stage. Data were analysed using content analysis and presented both numerically and narratively. RESULTS Out of the initial 1602 publications identified in the scoping review, only nine were included after duplicate removal, title and abstract screening, and full-text review. This limited number of studies, with the earliest study one published in 2015, represents a key finding. Eight of the nine studies were quantitative, and all were conducted in high income countries. Most of these studies utilised a version of the University of Los Angles Loneliness Scale to measure loneliness and addressed specific impairment groups. Notably, most of the studies identified associations between loneliness and health and wellbeing outcomes for people with disability. CONCLUSIONS This scoping review highlights the current scarcity of studies examining the effect that loneliness has on the health and wellbeing outcomes of people with disability. As most of the reviewed studies relied on loneliness measures designed for individuals without disability, they potentially overlook the unique life experiences of people with disability. Given that loneliness is an international public health concern, it is imperative that people with disability are not left behind or overlooked in efforts to address the impact of loneliness on health and wellbeing.
Collapse
Affiliation(s)
- Jodie Bailie
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, NSW, 2006, Australia.
- University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia.
| | - Glenda M Bishop
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Hannah Badland
- Social and Global Studies Centre, RMIT University, Melbourne, VIC, 3000, Australia
| | - Eric Emerson
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, NSW, 2006, Australia
- Centre for Disability Research, Faculty of Health & Medicine, Lancaster University, Lancaster, LA1 4YW, UK
| | - Zoe Aitken
- Melbourne School of Population and Global Health, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Roger Stancliffe
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, NSW, 2006, Australia
| | | | - Gwynnyth Llewellyn
- Centre for Disability Research and Policy, The University of Sydney, Camperdown, NSW, 2006, Australia
| |
Collapse
|
11
|
Cunningham J, Bailie J, Warner S, Condon A, Cheung D, Minc A, Herbert S, Edmiston N. Determinants of access to general practice in a shared care model for people living with HIV: a qualitive study of patients' perspectives in an Australian rural community. BMC Prim Care 2023; 24:179. [PMID: 37674116 PMCID: PMC10483738 DOI: 10.1186/s12875-023-02142-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 08/29/2023] [Indexed: 09/08/2023]
Abstract
BACKGROUND Improved management of human immunodeficiency virus (HIV) has resulted in improved life expectancy for people living with HIV and an ageing population with a significant comorbidity burden. Shared care models, involving the co-ordinated liaison between general practitioners and specialist physicians, have been advocated for in Australia to provide comprehensive care. People living with HIV in rural areas have reduced access to general practice and therefore shared care. This study explores the perspectives of people living with HIV on the barriers and enablers to accessing shared care in an Australian rural setting. METHODS In this qualitative study, semi-structured interviews were conducted with adults living with HIV who either resided in or accessed care in a rural area of Australia. Interviews were conducted via video conferencing, phone or face-to-face. Transcripts were imported into NVivo, coded and analysed in alignment with a conceptual framework of healthcare access defined by Levesque and colleagues. RESULTS Thirteen interviews were conducted in total. Participants' narratives demonstrated the substantial influence of accessibility to general practice on their ability to engage in effective shared care. Challenges included the perception that general practitioners would not provide additive value to participants' care, which restricted the ability to both seek and engage in the shared care model. Healthcare beliefs, expectations and experiences with stigma led participants to prioritise the perceived interpersonal qualities of specialist care above a shared care system. Access to shared care was facilitated by continuity of care in general practice but logistical factors such as affordability, transport and availability impacted the ability to access regular high-quality healthcare. CONCLUSIONS Navigating patient priorities and anticipated stigma in general practice within the resource limitations of rural healthcare were barriers to effective shared care. General practitioners' ability to build rapport and long-term relationships with participants was instrumental in the perception of valuable care. Strategies are required to secure continuity of care with interpersonally skilled general practitioners to ensure provision of quality primary care for people living with HIV, which can be supported by specialist physicians in a shared care model.
Collapse
Affiliation(s)
- Juliet Cunningham
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, Australia
- School of Public Health, The University of Sydney, Sydney, Australia
| | - Sherridan Warner
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ashleigh Condon
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Daniel Cheung
- Faculty of Medicine and Health, The University of Sydney, Sydney, Australia
| | - Ariane Minc
- Northern New South Wales Sexual Health Service, North Coast Public Health, Mid North Coast Local Health District, Lismore, Australia
| | - Simone Herbert
- Northern New South Wales Sexual Health Service, North Coast Public Health, Mid North Coast Local Health District, Lismore, Australia
| | - Natalie Edmiston
- University Centre for Rural Health, The University of Sydney, Lismore, Australia.
- Northern New South Wales Sexual Health Service, North Coast Public Health, Mid North Coast Local Health District, Lismore, Australia.
- School of Medicine, Western Sydney University, Campbelltown, Australia.
| |
Collapse
|
12
|
Bailie J, Reed K, Matthews V, Scott KM, Ahern C, Bailie R. Volunteering as prosocial behaviour by medical students following a flooding disaster and impacts on their mental health: A mixed-methods study. Med Educ 2023. [PMID: 37661656 DOI: 10.1111/medu.15199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 07/31/2023] [Accepted: 08/14/2023] [Indexed: 09/05/2023]
Abstract
BACKGROUND Volunteering is a form of prosocial behaviour that has a been recognised as having positive benefits for medical students. However, there is a lack of research on what influences students to volunteer during and after weather-related disasters. Our study (1) explores factors related to medical students' willingness and readiness to volunteer, and (2) describes mental health impacts of the flood events on students. METHODS We conducted a mixed-methods study of medical students on rural clinical placements in a regional area of Australia, 2 to 6 weeks after two major flooding events in 2022. Data were collected through survey and focus groups. Summary statistics were generated from the survey data, and Fisher's exact test was used to determine associations between student experience of the flood and self-rated well-being. Qualitative data were deductively analysed using Byrne and colleagues' theory of prosocial behaviour during an emergency. RESULTS The 36 students who participated in focus groups (including the 34 who completed the survey) (response rates 84% and 79%, respectively) demonstrated high levels of prosocial behaviours and were willing to volunteer. A sense of moral obligation was the primary reason for volunteering, whereas concerns for their physical and psychological safety, and missing key aspects of their training, were the strongest reasons for not continuing to volunteer. Students reported personal stress, anxiety and trauma during this period, with significant associations between self-rated impacts on their well-being and feelings of being terrified, helpless and hopeless during the flooding events and of still being distressed weeks later (p < .05). CONCLUSIONS This study expands on prosocial behaviour theory by applying Byrne and colleagues elaborated model in the context of medical student volunteering during the 2022 major flooding events in Australia. Modifiable barriers to prosocial behaviour are identified along with proposed strategies to address these barriers.
Collapse
Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Krista Reed
- School of Medicine, Western Sydney University, Sydney, New South Wales, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Karen M Scott
- Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Christine Ahern
- University Centre for Rural Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Ross Bailie
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
13
|
Bailie J, Matous P, Bailie R, Passey ME. Patterns of collaboration and knowledge generated by an Australian rural research centre over 20 years: a co-authorship network analysis. Health Res Policy Syst 2023; 21:87. [PMID: 37649071 PMCID: PMC10466867 DOI: 10.1186/s12961-023-01029-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/06/2023] [Indexed: 09/01/2023] Open
Abstract
BACKGROUND People living in rural areas have poorer health than their urban counterparts. Although rural health research centres have been promoted as vehicles for improving rural health by contributing evidence to address rural health disadvantage and building research capacity, their characteristics and evolution are poorly understood. Collaboration is known to have an important positive influence on research outputs and research quality. In this study we examine publication outputs from an Australian rural research centre to evaluate how researchers have engaged in research collaboration over a two-decade period. METHODS A retrospective longitudinal study of publications in peer-reviewed journals from a rural research centre-University Centre for Rural Health (UCRH) -between January 2002 and December 2021. Organisational co-author networks across four periods (2002-2006; 2007-2011; 2012-2016; 2017-2021) were constructed based on author organisational affiliations and examined using social network analysis methods. Descriptive characteristics included organisation types, study design, region of study focus, thematic research trends, Aboriginal and Torres Strait Islander and female authorship, and journal characteristics. RESULTS We identified 577 publications with 130 different UCRH-affiliated authors. Publications and the co-author network increased in number and diversity over each period, with an acceleration and a consolidation of the network in the final period. Over time there was an increase in publications related to Aboriginal and Torres Strait Islander health, coupled with an increase in Aboriginal and Torres Strait Islander authorship and collaborations with Aboriginal and Torres Strait Islander organisations; rise in female senior authorship and publication in quartile 1 journals. About two-thirds of publications make no reference to regional or remote populations. CONCLUSION Collaboration in publications increased, expanded, and consolidated, which coincided with an increase in the number and diversity of both co-authoring organisations and UCRH-affiliated authors in the final period. The findings highlight the value of collaborations (including urban and international) in building and strengthening rural health research capacity. With increased capacity and consolidation of the network it is now imperative that research becomes more focussed on understanding and addressing rural health inequities.
Collapse
Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia.
- School of Public Health, The University of Sydney, Camperdown, Australia.
| | - Petr Matous
- School of Project Management, Faculty of Engineering, The University of Sydney, Camperdown, Australia
| | - Ross Bailie
- School of Public Health, The University of Sydney, Camperdown, Australia
| | - Megan E Passey
- University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia
| |
Collapse
|
14
|
Fortune N, Bailie J, Gordon J, Plunkett K, Hargrave J, Madden R, Llewellyn G. Developing self-report disability questions for a voluntary patient registration form for general practice in Australia. Aust N Z J Public Health 2023; 47:100032. [PMID: 37001218 DOI: 10.1016/j.anzjph.2023.100032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 10/25/2022] [Accepted: 11/03/2022] [Indexed: 03/31/2023] Open
Abstract
OBJECTIVE This article reports on research undertaken to develop self-report disability questions for a patient registration form that may be implemented in general practices across Australia as part of a voluntary patient registration program. METHODS There were four research components: rapid review of approaches for capturing disability information; expert informant interviews (n=19); stakeholder consultation via virtual focus groups (n=65); and online survey (n=35). Findings from each component informed development of materials for subsequent components in an iterative research process. RESULTS Three disability questions were developed: two alternative questions for identifying disability, conceptually aligned with the operational definition of disability in Australia's national disability survey; one question to determine the patient's disability group/s. CONCLUSIONS Knowledge and perspectives from a variety of sources informed the development of self-report questions to identify patients with disability. Implementing these questions represents an opportunity to test new ways of capturing disability information suited to mainstream service provision contexts. It will be essential to evaluate the quality of the data produced during the initial period of implementation. IMPLICATIONS FOR PUBLIC HEALTH The collection of self-report patient disability information within general practice, using standard and conceptually-sound questions, has the potential to support improved provision of health care to patients with disability.
Collapse
|
15
|
Bailie J, Fortune N, Plunkett K, Gordon J, Llewellyn G. A call to action for more disability-inclusive health policy and systems research. BMJ Glob Health 2023; 8:bmjgh-2022-011561. [PMID: 36958749 PMCID: PMC10040021 DOI: 10.1136/bmjgh-2022-011561] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 02/27/2023] [Indexed: 03/25/2023] Open
Abstract
To date, the exclusion of people with disability participating in research has limited the evidence base informing health system strengthening policy and practice more generally, and addressing disability-related inequalities in access to health services and better health outcomes more particularly. Given that more than 1 billion people, or 16% of the world's population, have a disability, we may fail to respond to the needs of a large proportion of the population unless we are purposeful with inclusion. Our research in this area indicates that online qualitative methods can be effective in engaging under-represented groups and are essential to ensure their input into health policy and systems research. This has important implications for researchers whose responsibility it is to make all health research disability inclusive, for ethical and methodological reasons, so they do not perpetuate the under-representation of people with disability in health policy and systems research. Our paper puts forward several recommendations to facilitate more people with disability participating in health policy and systems research. By critically reflecting on a health system strengthening research project, in which we purposefully aimed to support the participation of people with disability, we identify lessons learnt and issues to consider when planning and conducting accessible research. We also propose a set of actions for moving the agenda forward.
Collapse
Affiliation(s)
- Jodie Bailie
- Centre for Disability Research and Policy, The University of Sydney, Sydney, New South Wales, Australia
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Nicola Fortune
- Centre for Disability Research and Policy, The University of Sydney, Sydney, New South Wales, Australia
- Centre of Research Excellence in Disability and Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Karleen Plunkett
- Centre for Disability Research and Policy, The University of Sydney, Sydney, New South Wales, Australia
| | - Julie Gordon
- Centre for Disability Research and Policy, The University of Sydney, Sydney, New South Wales, Australia
| | - Gwynnyth Llewellyn
- Centre for Disability Research and Policy, The University of Sydney, Sydney, New South Wales, Australia
- Centre of Research Excellence in Disability and Health, The University of Melbourne, Melbourne, Victoria, Australia
| |
Collapse
|
16
|
Sheepway L, Jessup B, Podubinski T, Heaney S, Bailie J, Hoang H, Bourke L. A qualitative exploration of health student perspectives of rural and remote placements during the early stages of the COVID-19 pandemic. Aust J Rural Health 2022; 31:294-307. [PMID: 36444653 PMCID: PMC9878096 DOI: 10.1111/ajr.12952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/01/2022] [Accepted: 11/16/2022] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE To explore health student perspectives of rural and remote placements during the early stages of the COVID-19 pandemic. SETTING Australia. PARTICIPANTS Allied health, nursing and medical students with a planned rural or remote placement between February and October 2020. DESIGN Semi-structured interviews (n = 29) with data thematically analysed. RESULTS Five main themes emerged from student experiences: (1) 'Do we go? Don't we go? Like how much risk is involved?' related to student concerns regarding acquiring and transmitting COVID-19 on placement; (2) 'We are sort of just standing at the door trying to watch' encompassed student perceptions of missed clinical learning opportunities in response to health and safety measures related to COVID-19; (3) 'I, as a student, sort of fell under the radar' related to student perceptions of suboptimal supervision; (4) 'It was a bit more difficult to engage with that wider community' recognised student feelings of social disconnection and their lack of opportunity for community immersion; and (5) 'We felt like we got something that is more than we expected' emerged from student reflections on training during the pandemic and alternative placements (virtual, simulated and non-clinical) that exceeded expectations for learning. CONCLUSIONS Although most students were willing and able to undertake their rural or remote placement in some form during the early stages of the pandemic and identified unanticipated learning benefits, students recognised lost opportunities to build clinical skills, become culturally aware and connect with rural communities. It remains unknown how these rural and remote placement experiences will impact rural intention and in turn, rural workforce development.
Collapse
Affiliation(s)
- Lyndal Sheepway
- La Trobe Rural Health SchoolLa Trobe UniversityWodongaVictoriaAustralia
| | - Belinda Jessup
- Centre for Rural HealthThe University of TasmaniaLauncestonTasmaniaAustralia
| | - Tegan Podubinski
- Department of Rural HealthThe University of MelbourneSheppartonVictoriaAustralia
| | - Susan Heaney
- The University of Newcastle Department of Rural HealthThe University of NewcastlePort MacquarieNew South WalesAustralia
| | - Jodie Bailie
- University Centre for Rural HealthThe University of SydneyLismoreNew South WalesAustralia
| | - Ha Hoang
- Centre for Rural HealthThe University of TasmaniaLauncestonTasmaniaAustralia
| | - Lisa Bourke
- Department of Rural HealthThe University of MelbourneSheppartonVictoriaAustralia
| |
Collapse
|
17
|
Shea B, Bailie J, Dykgraaf SH, Fortune N, Lennox N, Bailie R. Access to general practice for people with intellectual disability in Australia: a systematic scoping review. BMC Prim Care 2022; 23:306. [PMID: 36447186 PMCID: PMC9707181 DOI: 10.1186/s12875-022-01917-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022]
Abstract
BACKGROUND People with intellectual disability experience inadequate access to general practice and poorer health outcomes than the general population. While some access barriers have been identified for this population, these studies have often used narrow definitions of access, which may not encompass the multiple dimensions that influence access to general practice. To address this gap, we conducted a scoping review to identify factors impacting access to general practice for people with intellectual disability in Australia, using a holistic framework of access conceptualised by Levesque and colleagues. METHODS This scoping review followed Joanna Briggs Institute methodology and was guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. Medline (Ovid), Scopus, CINAHL, Informit and PsycINFO databases were searched. Screening, full-text review and data extraction were completed by two independent reviewers, with consensus reached at each stage of the study. Data were extracted, coded and synthesised through deductive qualitative analysis - using the five corresponding conceptual dimensions within Levesque and colleagues' theoretical framework of access, which incorporate both supply-side features of health systems and services, and demand-side characteristics of consumers and populations. RESULTS The search identified 1364 publications. After duplicate removal, title and abstract screening and full-text review, 44 publications were included. Supply-side factors were more commonly reported than demand-side factors, with the following issues frequently identified as impacting access to general practice: limited general practitioner education about, and/or experience of, people with intellectual disability; communication difficulties; and inadequate continuity of care. Less frequently included were factors such as the health literacy levels, promotion of general practice services and availability of complete medical records. CONCLUSIONS This is the first scoping review to assess access barriers for people with intellectual disability using a comprehensive conceptualisation of access. The findings highlight the need for increased efforts to address demand-side dimensions of access to general practice and offer a basis for a balanced portfolio of strategies that can support recent policy initiatives to enhance access to care for people with intellectual disability.
Collapse
Affiliation(s)
- Bradley Shea
- grid.1013.30000 0004 1936 834XSydney Medical School, The University of Sydney, Sydney, NSW Australia
| | - Jodie Bailie
- grid.1013.30000 0004 1936 834XUniversity Centre for Rural Health, The University of Sydney, Lismore, NSW Australia ,grid.1013.30000 0004 1936 834XCentre for Disability Research and Policy, The University of Sydney, Sydney, NSW Australia
| | - Sally Hall Dykgraaf
- grid.1001.00000 0001 2180 7477Rural Clinical School, Australian National University, Canberra, ACT Australia
| | - Nicola Fortune
- grid.1013.30000 0004 1936 834XCentre for Disability Research and Policy, The University of Sydney, Sydney, NSW Australia ,grid.1008.90000 0001 2179 088XCentre of Research Excellence in Disability and Health, University of Melbourne, Carlton, VIC Australia
| | - Nicholas Lennox
- grid.1003.20000 0000 9320 7537Queensland Centre for Intellectual and Developmental Disability, University of Queensland, Brisbane, QLD Australia
| | - Ross Bailie
- grid.1013.30000 0004 1936 834XSydney Medical School, The University of Sydney, Sydney, NSW Australia
| |
Collapse
|
18
|
Cunningham FC, Potts BA, Ramanathan SA, Bailie J, Bainbridge RG, Searles A, Laycock AF, Bailie RS. Network evaluation of an innovation platform in continuous quality improvement in Australian Indigenous primary healthcare. Health Res Policy Syst 2022; 20:119. [PMID: 36316678 PMCID: PMC9620635 DOI: 10.1186/s12961-022-00909-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Accepted: 09/13/2022] [Indexed: 11/04/2022] Open
Abstract
Background From 2014 to 2019, the Centre for Research Excellence in Integrated Quality Improvement (CRE-IQI) was evaluated as an innovation platform focusing on continuous quality improvement in Indigenous Australian primary healthcare. Although social network analysis (SNA) is a recognized method for evaluating the functioning, collaboration and effectiveness of innovation platforms, applied research is limited. This study applies SNA to evaluate the CRE-IQI’s functioning as an innovation platform. Methods Two surveys (2017, 2019) were conducted using social survey and network methods. Survey items covered respondent characteristics, their perceptions of the CRE-IQI’s performance, and its impact and sociometric relationships. Members’ relationship information was captured for the CRE-IQI at three time points, namely start (retrospectively), midpoint and final year, on three network types (knew, shared information, collaborated). SNA software was used to compute standard network metrics including diameter, density and centrality, and to develop visualizations. Survey and network results were addressed in a workshop held by members to develop improvement strategies. Results The response rate was 80% in 2017 and 65% in 2019 (n = 49 and 47, respectively). Between 2017 and 2019, respondents’ mean ratings of the CRE-IQI’s functioning and achievements in meeting its goals were sustained. They perceived the CRE-IQI as multidisciplinary, having effective management and governance, and incorporating Indigenous research leadership, representation and ways of working. Respondents recognized high levels of trust amongst members, rated “good communication and coordination with participants” highly, and “facilitating collaboration” as the CRE’s most strongly recognized achievement. In collaboration and information-sharing networks, average path length remained low in 2017 and 2019, indicating good small-world network properties for relaying information. On average, respondents shared information and collaborated with more CRE members in 2017 than 2019. However, in both 2017 and 2019 there were new collaborations and information-sharing outside of direct collaborations. CRE-IQI outcomes included: evidence generation; knowledge transfer and skills development in quality improvement; research capacity-building, career development; mentoring; grant support; development of new projects; health service support; and policy impact. Conclusions This study shows the utility of network analysis in evaluating the functioning, and collaboration, at the individual, organizational and health system levels, of an innovation platform, and adds to our understanding of factors enabling successful innovation platforms. Supplementary Information The online version contains supplementary material available at 10.1186/s12961-022-00909-z.
Collapse
Affiliation(s)
- Frances Clare Cunningham
- grid.271089.50000 0000 8523 7955Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Brisbane, QLD Australia
| | - Boyd Alexander Potts
- grid.271089.50000 0000 8523 7955Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Brisbane, QLD Australia
| | - Shanthi Ann Ramanathan
- grid.413648.cHealth Research Economics, Hunter Medical Research Institute, Newcastle, NSW Australia ,grid.266842.c0000 0000 8831 109XCollege of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW Australia
| | - Jodie Bailie
- grid.1013.30000 0004 1936 834XUniversity Centre for Rural Health, The University of Sydney, Lismore, NSW Australia ,grid.1013.30000 0004 1936 834XSchool of Public Health, The University of Sydney, Sydney, NSW Australia
| | - Roxanne Gwendalyn Bainbridge
- grid.1003.20000 0000 9320 7537Poche Centre for Indigenous Health, The University of Queensland, Toowong, QLD Australia
| | - Andrew Searles
- grid.413648.cHealth Research Economics, Hunter Medical Research Institute, Newcastle, NSW Australia ,grid.266842.c0000 0000 8831 109XCollege of Health, Medicine and Wellbeing, The University of Newcastle, Newcastle, NSW Australia
| | - Alison Frances Laycock
- grid.1013.30000 0004 1936 834XUniversity Centre for Rural Health, The University of Sydney, Lismore, NSW Australia
| | - Ross Stewart Bailie
- grid.1013.30000 0004 1936 834XFaculty of Medicine and Health, The University of Sydney, Sydney, NSW Australia
| |
Collapse
|
19
|
Fortune N, Bailie J, Llewellyn G. The need for improved Australian data on social determinants of health inequities. Med J Aust 2022; 217:325. [DOI: 10.5694/mja2.51698] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2022] [Accepted: 06/29/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Nicola Fortune
- Centre for Disability Research and Policy University of Sydney Sydney NSW
- Centre of Research Excellence in Disability and Health University of Melbourne Melbourne VIC
| | - Jodie Bailie
- Centre of Research Excellence in Disability and Health University of Melbourne Melbourne VIC
- University Centre for Rural Health University of Sydney Lismore NSW
- Centre for Disability Research and Policy University of Sydney Sydney NSW
| | - Gwynnyth Llewellyn
- Centre for Disability Research and Policy University of Sydney Sydney NSW
- Centre of Research Excellence in Disability and Health University of Melbourne Melbourne VIC
| |
Collapse
|
20
|
Bailie J, Fortune N, Gordon J, Madden RC, Llewellyn G. Making everyone count: it is time to improve the visibility of people with disability in primary care. Med J Aust 2022; 217:173-175. [PMID: 35908261 PMCID: PMC9543419 DOI: 10.5694/mja2.51650] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Revised: 03/22/2022] [Accepted: 03/22/2022] [Indexed: 11/21/2022]
Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health University of Sydney Lismore NSW
- Centre for Disability Research and Policy University of Sydney Sydney NSW
| | - Nicola Fortune
- Centre for Disability Research and Policy University of Sydney Sydney NSW
- Centre of Research Excellence in Disability and Health University of Melbourne Melbourne VIC
| | - Julie Gordon
- WHO Collaborating Centre for Strengthening Rehabilitation Capacity in Health Systems University of Sydney Sydney NSW
| | - Richard C Madden
- Centre for Disability Research and Policy University of Sydney Sydney NSW
| | - Gwynnyth Llewellyn
- Centre for Disability Research and Policy University of Sydney Sydney NSW
- Centre of Research Excellence in Disability and Health University of Melbourne Melbourne VIC
| |
Collapse
|
21
|
Bailie J, Matthews V, Bailie R, Villeneuve M, Longman J. Exposure to risk and experiences of river flooding for people with disability and carers in rural Australia: a cross-sectional survey. BMJ Open 2022; 12:e056210. [PMID: 35918120 PMCID: PMC9252212 DOI: 10.1136/bmjopen-2021-056210] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES In this paper, we explore the exposure to risk and experiences of people with disability and carers during a flooding event and the subsequent mental health impacts. DESIGN A cross-sectional survey between September and November 2017. Binary logistic regression models were used to investigate associations between the mental health of people with disability and carers and their exposure to the flood. Inductive content analysis was used to analyse qualitative data. SETTING Flood-affected communities in the rural area of Northern Rivers, New South Wales, Australia, 6 months after river flooding in 2017. PARTICIPANTS People over 16 years and a resident in the Northern Rivers at the time of the flood were invited to participate. Using a purposive, snowballing sampling technique participants were drawn from a wide range of socioeconomic backgrounds and had experienced different degrees of flood exposure. RESULTS Of 2252 respondents, there were 164 people with disability and 91 carers. Both groups had increased odds of having their home flooded (people with a disability: OR 2.41 95% CI 1.71 to 3.39; carers: OR 1.76 95% CI 1.10 to 2.84). On evacuation, respondents reported inaccessible, conflicting and confusing information regarding flood warnings. Essential services such as healthcare and social services were disrupted (people with a disability: OR 3.98 95% CI 2.82 to 5.60; carers 2.17 95% CI 1.33 to 3.54) and access to safe and mould free housing post flood event was limited. After taking sociodemographic factors into account, respondents with a disability and carers had greater odds of probable post-traumatic stress disorder compared with other respondents (people with a disability: 3.32 95% CI 2.22 to 4.96; carers: 1.87 95% CI 1.10 to 3.19). CONCLUSION Our findings show the profound impact and systemic neglect experienced by people with disability and carers during and after the 2017 flood event in the Northern Rivers. As people with disability will take longer to recover, they will require longer-term tailored supports and purposeful inclusion in flood preparedness and recovery efforts.
Collapse
Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
- Centre for Disability Research and Policy, The University of Sydney, Sydney, New South Wales, Australia
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Ross Bailie
- Faculty of Medicine and Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Michelle Villeneuve
- Centre for Disability Research and Policy, The University of Sydney, Sydney, New South Wales, Australia
| | - Jo Longman
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| |
Collapse
|
22
|
Bailie J, Matthews V, Bailie RS. Uncontrolled blood pressure in Australia: a call to action. Med J Aust 2022; 216:487-488. [DOI: 10.5694/mja2.51503] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 02/09/2022] [Accepted: 02/28/2022] [Indexed: 11/17/2022]
Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health University of Sydney Lismore NSW
- University of Sydney Sydney NSW
| | | | - Ross S Bailie
- University Centre for Rural Health University of Sydney Lismore NSW
| |
Collapse
|
23
|
Green E, Quilliam C, Sheepway L, Hays CA, Moore L, Rasiah RL, Bailie J, Howard C, Hyde S, Inyang I, Matthews K, Ferns J, Brown LJ, Jones S, Collett M. Identifying features of quality in rural placements for health students: scoping review. BMJ Open 2022; 12:e057074. [PMID: 35396299 PMCID: PMC8995951 DOI: 10.1136/bmjopen-2021-057074] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVES To explore and synthesise the evidence relating to features of quality in rural health student placements. DESIGN Scoping review. DATA SOURCES MEDLINE, CINAHL, Embase, ProQuest, Informit, Scopus, ERIC and several grey literature data sources (1 January 2005 to 13 October 2020). STUDY SELECTION The review included peer-reviewed and grey literature from Organisation for Economic Co-operation and Development listed countries that focused on quality of health student placements in regional, rural and remote areas. DATA EXTRACTION Data were extracted regarding the methodological and design characteristics of each data source, and the features suggested to contribute to student placement quality under five categories based on a work-integrated learning framework. RESULTS Of 2866 resulting papers, 101 were included for data charting and content analysis. The literature was dominated by medicine and nursing student placement research. No literature explicitly defined quality in rural health student placements, although proxy indicators for quality such as satisfaction, positive experiences, overall effectiveness and perceived value were identified. Content analysis resulted in four overarching domains pertaining to features of rural health student placement quality: (1) learning and teaching in a rural context, (2) rural student placement characteristics, (3) key relationships and (4) required infrastructure. CONCLUSION The findings suggest that quality in rural health student placements hinges on contextually specific features. Further research is required to explore these findings and ways in which these features can be measured during rural health student placements.
Collapse
Affiliation(s)
- Elyce Green
- Three Rivers University Department of Rural Health, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Claire Quilliam
- Department of Rural Health, The University of Melbourne, Shepparton, Victoria, Australia
| | - Lyndal Sheepway
- La Trobe Rural Health School, La Trobe University, Wodonga, Victoria, Australia
| | - Catherine A Hays
- Centre for Rural and Remote Health, James Cook University, Mount Isa, Queensland, Australia
| | - Leigh Moore
- Rural and Remote Health, Flinders University, Darwin, Northern Territory, Australia
| | - Rohan L Rasiah
- Western Australian Centre for Rural Health, The University of Western Australia, Karratha, Western Australia, Australia
| | - Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Christine Howard
- Three Rivers University Department of Rural Health, Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Sarah Hyde
- Joint Program in Medicine School of Rural Medicine, Charles Sturt University, Orange, New South Wales, Australia
| | - Imo Inyang
- Centre for Rural Health, University of Tasmania, Launceston, Tasmania, Australia
| | - Kylie Matthews
- Majarlin Kimberley Centre for Remote Health, The University of Notre Dame, Broome, Western Australia, Australia
| | - Jane Ferns
- Department of Rural Health, The University of Newcastle, Taree, New South Wales, Australia
| | - Leanne J Brown
- Department of Rural Health, The University of Newcastle, Taree, New South Wales, Australia
| | - Sara Jones
- Department of Rural Health, University of South Australia, Whyalla, South Australia, Australia
| | - Marjorie Collett
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, Western Australia, Australia
| |
Collapse
|
24
|
Bailie J, Laycock A, Bailie RS. Introducing general practice enrolment in Australia: the devil is in the detail. Med J Aust 2022; 216:158. [DOI: 10.5694/mja2.51399] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Revised: 07/13/2021] [Accepted: 07/15/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health University of Sydney Lismore NSW
- University of Sydney Sydney NSW
| | - Alison Laycock
- University Centre for Rural Health University of Sydney Lismore NSW
| | - Ross S Bailie
- University Centre for Rural Health University of Sydney Lismore NSW
| |
Collapse
|
25
|
Bailie J, Cunningham F, Abimbola S, Laycock A, Bainbridge R, Bailie R, Conte K, Passey M, Peiris D. Methodological pluralism for better evaluations of complex interventions: lessons from evaluating an innovation platform in Australia. Health Res Policy Syst 2022; 20:14. [PMID: 35090472 PMCID: PMC8796351 DOI: 10.1186/s12961-022-00814-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 01/10/2022] [Indexed: 11/10/2022] Open
Abstract
Complex interventions, such as innovation platforms, pose challenges for evaluators. A variety of methodological approaches are often required to build a more complete and comprehensive understanding of how complex interventions work. In this paper, we outline and critically appraise a methodologically pluralist evaluation of an innovation platform to strengthen primary care for Aboriginal and Torres Strait Islander Australians. In doing so, we aim to identify lessons learned from the approach taken and add to existing literature on implementing evaluations in complex settings, such as innovation platforms. The pluralist design used four evaluation approaches-developmental evaluation, principles-focused evaluation, network analysis, and framework analysis-with differing strengths and challenges. Taken together, the multiple evaluation approaches yielded a detailed description and nuanced understanding of the formation, functioning and outcomes of the innovation platform that would be difficult to achieve with any single evaluation method. While a methodologically pluralist design may place additional pressure on logistical and analytic resources available, it enables a deeper understanding of the mechanisms that underlie complex interventions.
Collapse
Affiliation(s)
- J Bailie
- The University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia.
- The School of Public Health, The University of Sydney, Sydney, Australia.
| | - F Cunningham
- Menzies School of Health Research, Charles Darwin University, Brisbane, Australia
| | - S Abimbola
- The School of Public Health, The University of Sydney, Sydney, Australia
- The George Institute for Global Health, The University of New South Wales, Sydney, Australia
| | - A Laycock
- The University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia
| | - R Bainbridge
- School of Health, Medical and Applied Sciences, Central Queensland University, Cairns, Australia
| | - R Bailie
- The University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia
| | - K Conte
- The University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia
- The School of Public Health, De Paul University, Chicago, USA
| | - M Passey
- The University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia
| | - D Peiris
- The School of Public Health, The University of Sydney, Sydney, Australia
- The George Institute for Global Health, The University of New South Wales, Sydney, Australia
| |
Collapse
|
26
|
Bailie J, Peiris D, Cunningham FC, Laycock A, Bailie R, Matthews V, Conte KP, Bainbridge RG, Passey ME, Abimbola S. Utility of the AHRQ Learning Collaboratives Taxonomy for Analyzing Innovations from an Australian Collaborative. Jt Comm J Qual Patient Saf 2021; 47:711-722. [PMID: 34538583 DOI: 10.1016/j.jcjq.2021.08.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Despite the proliferation of learning collaborations such as innovation platforms, the factors contributing to their success or failure are rarely documented. The Agency for Healthcare Research and Quality learning collaboratives taxonomy provides a framework for understanding how such collaborations work in different settings according to four primary elements: innovation, communication, time, and social systems. This study applied the taxonomy to assess an innovation platform and the utility of applying the taxonomy. METHODS The study focus was a five-year national research collaboration operating as an innovation platform to strengthen primary health care quality improvement efforts for Indigenous Australians. The study team analyzed project records, reports and publications, and interviews that were conducted with 35 stakeholders. Data were mapped retrospectively against the taxonomy domains and thematically analyzed. RESULTS The taxonomy proved useful in understanding how and why the innovation platform generated innovations. It revealed that time was particularly important, both to see innovations through and to establish a social system that enabled interconnectivity between members. However, the taxonomy did not provide useful guidance on identifying the types of innovations from the collaboration or the importance of a culture of continuous adaptation and learning. The study also found that the primary and secondary elements of the taxonomy were not discrete, which meant that it was difficult to align themes with only one element. CONCLUSION To improve the utility of the taxonomy, several elaborations are proposed, including reconfiguring it to a more dynamic form that recognizes the interconnections and links between the elements.
Collapse
|
27
|
Bailie J, Laycock A, Matthews V, Bailie RS. Increasing health assessments for people living with an intellectual disability: lessons from experience of Indigenous-specific health assessments. Med J Aust 2021; 215:16-18.e1. [PMID: 34080698 DOI: 10.5694/mja2.51124] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health, University of Sydney, Lismore, NSW
| | - Alison Laycock
- University Centre for Rural Health, University of Sydney, Lismore, NSW
| | - Veronica Matthews
- University Centre for Rural Health, University of Sydney, Lismore, NSW
| | - Ross S Bailie
- University Centre for Rural Health, University of Sydney, Lismore, NSW
| |
Collapse
|
28
|
Bailie J, Potts BA, Laycock AF, Abimbola S, Bailie RS, Cunningham FC, Matthews V, Bainbridge RG, Conte KP, Passey ME, Peiris D. Collaboration and knowledge generation in an 18-year quality improvement research programme in Australian Indigenous primary healthcare: a coauthorship network analysis. BMJ Open 2021; 11:e045101. [PMID: 33958341 PMCID: PMC8103942 DOI: 10.1136/bmjopen-2020-045101] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVES Though multidisciplinary research networks support the practice and effectiveness of continuous quality improvement (CQI) programmes, their characteristics and development are poorly understood. In this study, we examine publication outputs from a research network in Australian Indigenous primary healthcare (PHC) to assess to what extent the research network changed over time. SETTING Australian CQI research network in Indigenous PHC from 2002 to 2019. PARTICIPANTS Authors from peer-reviewed journal articles and books published by the network. DESIGN Coauthor networks across four phases of the network (2002-2004; 2005-2009; 2010-2014; 2015-2019) were constructed based on author affiliations and examined using social network analysis methods. Descriptive characteristics included organisation types, Indigenous representation, gender, student authorship and thematic research trends. RESULTS We identified 128 publications written by 308 individual authors from 79 different organisations. Publications increased in number and diversity over each funding phase. During the final phase, publication outputs accelerated for organisations, students, project officers, Indigenous and female authors. Over time there was also a shift in research themes to encompass new clinical areas and social, environmental or behavioural determinants of health. Average degree (8.1), clustering (0.81) and diameter (3) indicated a well-connected network, with a core-periphery structure in each phase (p≤0.03) rather than a single central organisation (degree centralisation=0.55-0.65). Academic organisations dominated the core structure in all funding phases. CONCLUSION Collaboration in publications increased with network consolidation and expansion. Increased productivity was associated with increased authorship diversity and a decentralised network, suggesting these may be important factors in enhancing research impact and advancing the knowledge and practice of CQI in PHC. Publication diversity and growth occurred mainly in the fourth phase, suggesting long-term relationship building among diverse partners is required to facilitate participatory research in CQI. Despite improvements, further work is needed to address inequities in female authorship and Indigenous authorship.
Collapse
Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Boyd Alexander Potts
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Alison Frances Laycock
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Seye Abimbola
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Ross Stewart Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | | | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | | | - Kathleen Parker Conte
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
- School of Public Health, DePaul University, Chicago, Illinois, USA
| | - Megan Elizabeth Passey
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - David Peiris
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
29
|
Bailie J, Laycock AF, Conte KP, Matthews V, Peiris D, Bailie RS, Abimbola S, Passey ME, Cunningham FC, Harkin K, Bainbridge RG. Principles guiding ethical research in a collaboration to strengthen Indigenous primary healthcare in Australia: learning from experience. BMJ Glob Health 2021; 6:e003852. [PMID: 33441334 PMCID: PMC7812086 DOI: 10.1136/bmjgh-2020-003852] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Revised: 11/25/2020] [Accepted: 12/17/2020] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION Indigenous communities worldwide are leading calls for all research involving Indigenous people to be underpinned by values and principles articulated by them. Many researchers are explicitly adopting these principles to guide what, where, how and when research is undertaken with Indigenous people. With critical reflection to support the implementation of such principles largely absent from published literature, this paper explores both the implementation of, and the outcomes from a set of guiding principles used in a large-scale Australian research collaboration to improve Indigenous health. METHODS In this inductive qualitative study, we adopted a principles-focused evaluation approach. Based on interviews with 35 actors in the collaboration and a review of project documents, we generated themes that were then iteratively discussed, refined and categorised into (1) 'strategies'-activities by which implementation of our guiding principles were recognised; (2) 'outcomes'-results seen from implementing the principles and (3) 'conditions'-aspects of the context that facilitated and constrained implementation of the principles. RESULTS Respondents found it difficult to articulate how the guiding principles were actually implemented, and frequently referred to them as part of the fabric of the collaboration. They viewed the set of principles as mutually reinforcing, and as providing a rudder for navigating complexity and conflict. Implementation of the principles occurred through five strategies-honouring the principles; being dynamic and adaptable; sharing and dispersing leadership; collaborating purposefully and adopting a culture of mutual learning. Outcomes included increased Indigenous leadership and participation; the ability to attract principled and values-driven researchers and stakeholders, and the development of trusting and respectful relationships. The conditions that facilitated the implementation of the principles were collaborating over time; an increasing number of Indigenous researchers and taking an 'innovation platform' approach. CONCLUSION Our findings show that principles guiding collaborations are valuable in providing a focus, direction and a way of working together when they are collaboratively developed, hold genuine meaning for all members and are implemented within a culture of continuous critical reflection, learning and adaptation, with ongoing reinterpretation of the principles over time.
Collapse
Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
- The School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Alison Frances Laycock
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Kathleen Parker Conte
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
- School of Public Health, DePaul University, Chicago, Illinois, USA
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - David Peiris
- The School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Ross Stewart Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | - Seye Abimbola
- The School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Megan Elizabeth Passey
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | | | - Kerryn Harkin
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
| | | |
Collapse
|
30
|
Bailie J, Laycock AF, Peiris D, Bainbridge RG, Matthews V, Cunningham FC, Conte KP, Abimbola S, Passey ME, Bailie RS. Using developmental evaluation to enhance continuous reflection, learning and adaptation of an innovation platform in Australian Indigenous primary healthcare. Health Res Policy Syst 2020; 18:45. [PMID: 32398136 PMCID: PMC7218558 DOI: 10.1186/s12961-020-00562-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Accepted: 04/08/2020] [Indexed: 12/21/2022] Open
Abstract
Effective efforts to strengthen health systems need diverse, multi-stakeholder networks working together on complex or 'wicked' problems such as prevention and control of chronic diseases, solutions to which go beyond the role and capability of one organisation. The contextual complexities inherent in 'wicked' problems mean that solutions warrant a systems approach that encompasses innovation and new ways of thinking about, facilitating and implementing collective decision-making processes and change practices.Innovation platforms are a mechanism for facilitating communication and collaboration among diverse stakeholders, promoting joint action and stimulating innovation. Developmental evaluation is an approach that is increasingly being used to evaluate innovative and emergent programmes and projects, as it enables evaluators to provide real-time feedback so that evaluation findings can be used to guide development and adaptations. Developmental evaluation emphasises learning and adaptation, and aligns well with the implementation of innovation platforms that have continuous reflection, learning and adaptation as a specific design principle.Here, we outline our rationale for applying a developmental evaluation to enhance the formation, functioning and outcomes of an innovation platform aimed at accelerating and strengthening large-scale quality improvement efforts in Australian Aboriginal and Torres Strait Islander primary healthcare. We provide examples to explain how the developmental evaluation findings were used for adaptation of the innovation platform and assess to what extent our application of developmental evaluation was consistent with, and reflective of, its essential principles.Our evaluation aligned strongly with the principles of developmental evaluation, and the approach we took was well suited to situations with a developmental purpose, innovation niche and complexity such as innovation platforms. As a result, along with the increasing interest in multi-stakeholder platforms (e.g. innovation platforms) and the inherent challenges with evaluating these complex networks, we anticipate our use of this approach being of interest globally.
Collapse
Affiliation(s)
- Jodie Bailie
- The University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia. .,The School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia.
| | - Alison Frances Laycock
- The University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia.,Menzies School of Health Research, Charles Darwin University, Casuarina, Australia
| | - David Peiris
- The School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia.,The George Institute for Global Health, The University of New South Wales, Sydney, Australia
| | | | - Veronica Matthews
- The University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia
| | | | - Kathleen Parker Conte
- The University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia
| | - Seye Abimbola
- The School of Public Health, The University of Sydney, Sydney, NSW, 2006, Australia.,The George Institute for Global Health, The University of New South Wales, Sydney, Australia
| | - Megan Elizabeth Passey
- The University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia
| | - Ross Stewart Bailie
- The University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW, 2480, Australia
| |
Collapse
|
31
|
Dzidowska M, Lee KSK, Wylie C, Bailie J, Percival N, Conigrave JH, Hayman N, Conigrave KM. A systematic review of approaches to improve practice, detection and treatment of unhealthy alcohol use in primary health care: a role for continuous quality improvement. BMC Fam Pract 2020; 21:33. [PMID: 32054450 PMCID: PMC7020510 DOI: 10.1186/s12875-020-1101-x] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 01/29/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND Unhealthy alcohol use involves a spectrum from hazardous use (exceeding guidelines but no harms) through to alcohol dependence. Evidence-based management of unhealthy alcohol use in primary health care has been recommended since 1979. However, sustained and systematic implementation has proven challenging. The Continuing Quality Improvement (CQI) process is designed to enable services to detect barriers, then devise and implement changes, resulting in service improvements. METHODS We conducted a systematic review of literature reporting on strategies to improve implementation of screening and interventions for unhealthy alcohol use in primary care (MEDLINE EMBASE, PsycINFO, CINAHL, the Australian Indigenous Health InfoNet). Additional inclusion criteria were: (1) pragmatic setting; (2) reporting original data; (3) quantitative outcomes related to provision of service or change in practice. We investigate the extent to which the three essential elements of CQI are being used (data-guided activities, considering local conditions; iterative development). We compare characteristics of programs that include these three elements with those that do not. We describe the types, organizational levels (e.g. health service, practice, clinician), duration of strategies, and their outcomes. RESULTS Fifty-six papers representing 45 projects were included. Of these, 24 papers were randomized controlled trials, 12 controlled studies and 20 before/after and other designs. Most reported on strategies for improving implementation of screening and brief intervention. Only six addressed relapse prevention pharmacotherapies. Only five reported on patient outcomes and none showed significant improvement. The three essential CQI elements were clearly identifiable in 12 reports. More studies with three essential CQI elements had implementation and follow-up durations above the median; utilised multifaceted designs; targeted both practice and health system levels; improved screening and brief intervention than studies without the CQI elements. CONCLUSION Utilizing CQI methods in implementation research would appear to be well-suited to drive improvements in service delivery for unhealthy alcohol use. However, the body of literature describing such studies is still small. More well-designed research, including hybrid studies of both implementation and patient outcomes, will be needed to draw clearer conclusions on the optimal approach for implementing screening and treatment for unhealthy alcohol use. (PROSPERO registration ID: CRD42018110475).
Collapse
Affiliation(s)
- Monika Dzidowska
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Lev 6, King George V Building (C39), The University of Sydney, NSW 2006 Australia
| | - K. S. Kylie Lee
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Lev 6, King George V Building (C39), The University of Sydney, NSW 2006 Australia
- Centre for Alcohol Policy Research, La Trobe University, Level 5, HS2, Bundoora, VIC 3086 Australia
| | - Claire Wylie
- Faculty of Medicine and Health, Translational Australian Clinical Toxicology Program, The University of Sydney, Lev3, 1-3 Ross Street (K06), The University of Sydney, NSW 2006 Australia
| | - Jodie Bailie
- The University of Sydney, Faculty of Medicine and Health, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW 2480 Australia
| | - Nikki Percival
- Faculty of Health, Australian Centre for Public and Population Health Research, University of Technology Sydney, UTS Building 10, 235-253 Jones Street, Ultimo, NSW 2007 Australia
| | - James H. Conigrave
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Lev 6, King George V Building (C39), The University of Sydney, NSW 2006 Australia
| | - Noel Hayman
- Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (Inala Indigenous Health Service), 37 Wirraway Parade, Inala, QLD 4077 Australia
- School of Medicine, Griffith University, Griffith Health Centre (G40), Gold Coast campus, Gold Coast, QLD 4222 Australia
- School of Medicine, University of Queensland, Herston Road, Herston, QLD 4006 Australia
| | - Katherine M. Conigrave
- Faculty of Medicine and Health, Discipline of Addiction Medicine, NHMRC Centre of Research Excellence in Indigenous Health and Alcohol, The University of Sydney, Lev 6, King George V Building (C39), The University of Sydney, NSW 2006 Australia
- Sydney Local Health District, Royal Prince Alfred Hospital, Drug Health Service, King George V Building, 83-117 Missenden Road, Camperdown, NSW 2050 Australia
| |
Collapse
|
32
|
Bailie J, Laycock A, Matthews V, Peiris D, Bailie R. Emerging evidence of the value of health assessments for Aboriginal and Torres Strait Islander people in the primary healthcare setting. Aust J Prim Health 2019; 25:1-5. [PMID: 30636669 DOI: 10.1071/py18088] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 10/06/2018] [Indexed: 11/23/2022]
Abstract
The launch of the third edition of the National guide to preventive health assessment for Aboriginal and Torres Strait Islander people in March 2018 heralds a renewed commitment to improving the delivery of preventive care, and should reinvigorate discussions on the effectiveness of Indigenous-specific health assessments and how best to implement them. A substantial body of evidence on adherence to guideline-recommended care has been generated through a research-based continuous quality improvement (CQI) initiative conducted between 2010 and 2014. The research, which involved clinical audits of more than 17000 client records and 119 systems assessments relating to preventive care in 137 Indigenous primary healthcare centres across Australia, shows that a structured CQI program can improve the delivery of preventive health assessments and use of evidence-based guidelines. However, program implementation has also seen the emergence of new challenges. This paper reflects on four major lessons from this collaborative program of applied research that will lead to more effective delivery of preventive care.
Collapse
Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW 2480, Australia; and Corresponding author.
| | - Alison Laycock
- University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW 2480, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW 2480, Australia
| | - David Peiris
- The George Institute for Global Health, UNSW Sydney, Sydney, NSW 2000, Australia
| | - Ross Bailie
- University Centre for Rural Health, The University of Sydney, 61 Uralba Street, Lismore, NSW 2480, Australia
| |
Collapse
|
33
|
Diaz A, Vo B, Baade PD, Matthews V, Nattabi B, Bailie J, Whop LJ, Bailie R, Garvey G. Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia. Int J Environ Res Public Health 2019; 16:ijerph16193630. [PMID: 31569670 PMCID: PMC6801551 DOI: 10.3390/ijerph16193630] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Accepted: 09/23/2019] [Indexed: 12/02/2022]
Abstract
Aboriginal and Torres Strait Islander women have significantly higher cervical cancer incidence and mortality than other Australian women. In this study, we assessed the documented delivery of cervical screening for women attending Indigenous Primary Health Care (PHC) centres across Australia and identified service-level factors associated with between-centre variation in screening coverage. We analysed 3801 clinical audit records for PHC clients aged 20–64 years from 135 Indigenous PHC centres participating in the Audit for Best Practice in Chronic Disease (ABCD) continuous quality improvement (CQI) program across five Australian states/territories during 2005 to 2014. Multilevel logistic regression models were used to identify service-level factors associated with screening, while accounting for differences in client-level factors. There was substantial variation in the proportion of clients who had a documented cervical screen in the previous two years across the participating PHC centres (median 50%, interquartile range (IQR): 29–67%), persisting over years and audit cycle. Centre-level factors explained 40% of the variation; client-level factors did not reduce the between-centre variation. Screening coverage was associated with longer time enrolled in the CQI program and very remote location. Indigenous PHC centres play an important role in providing cervical screening to Aboriginal and Torres Strait Islander women. Thus, their leadership is essential to ensure that Australia’s public health commitment to the elimination of cervical cancer includes Aboriginal and Torres Strait Islander women. A sustained commitment to CQI may improve PHC centres delivery of cervical screening; however, factors that may impact on service delivery, such as organisational, geographical and environmental factors, warrant further investigation.
Collapse
Affiliation(s)
- Abbey Diaz
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Casuarina 0810, Australia.
| | - Brenda Vo
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Casuarina 0810, Australia.
| | - Peter D Baade
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Casuarina 0810, Australia.
- Cancer Research Centre, Cancer Council Queensland, Herston 4006, Australia.
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, Lismore 2480, Australia.
| | - Barbara Nattabi
- School of Population and Global Health, The University of Western Australia, Crawley 6009, Australia.
| | - Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Lismore 2480, Australia.
| | - Lisa J Whop
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Casuarina 0810, Australia.
| | - Ross Bailie
- University Centre for Rural Health, The University of Sydney, Lismore 2480, Australia.
| | - Gail Garvey
- Wellbeing and Preventable Chronic Disease Division, Menzies School of Health Research, Casuarina 0810, Australia.
| |
Collapse
|
34
|
Lange R, French L, Lippa S, Bailie J, Brickell T. B-57 Post-traumatic Stress Disorder is a Stronger Predictor of Long-term Neurobehavioral Outcome than Traumatic Brain Injury Severity in U.S. Military Service Members. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz034.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Objective
The purpose of this study was to examine long-term neurobehavioral outcome in SMVs with versus without PTSD following TBI of all severities.
Methods
Participants were 536 SMVs recruited into three experimental groups (TBI, injured controls [IC], non-injured controls [NIC]). Participants completed the PTSD Checklist and the TBI-Quality of Life (TBI-QOL). Participants were divided into six subgroups based on the three experimental categories, two PTSD categories (i.e., present/absent), and two broad TBI severity categories (i.e., ‘unMTBI’ [includes uncomplicated mild TBI]; and ‘smcTBI’ [includes severe TBI, moderate TBI, and complicated mild TBI): (1) NIC/PTSD-Absent, (2) IC/PTSD-Absent, (3) unMTBI/PTSD-Absent, (4) unMTBI/PTSD-Present, (5) smcTBI/PTSD-Absent, and (6) smcTBI/PTSD-Present.
Results
There were significant main effects across the six groups for all TBI-QOL measures (p < .001). Select pairwise comparisons revealed significantly worse scores (p < .001) on all TBI-QOL measures in all PTSD-Present groups compared to the PTSD-Absent groups (i.e., Group 3v4 and 5v6; d = 0.90 to 2.11). In contrast, when controlling for PTSD, there were no significant differences between the TBI severity groups for all TBI-QOL measures (i.e., Group 3v5 and 4v6). In the TBI sample, a series of step-wise regression analyses revealed that PTSD, but not TBI severity, was consistently a strong predictor of all TBI-QOL scales (all p’s < .001), accounting for up to 64% of the variance.
Conclusions
These results provide support for the very strong influence of PTSD, but not TBI severity, on long-term neurobehavioral outcome following TBI. Concurrent PTSD and TBI of all severities should be considered a risk factor for poor long-term neurobehavioral outcome that requires ongoing monitoring.
Collapse
|
35
|
Babakhanyan I, Jensen M, Kim D, West H, Morrissy E, Powell B, Sargent P, Bailie J. Computerized Cognitive Rehabilitation verses Clinician Directed Therapy in mTBI. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz035.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Cognitive problems following mTBI are common and typically managed with one-on-one clinician directed treatment (CDT); however, this is time and labor intensive. Computerized cognitive rehabilitation (CCR) programs overcome these limitation but the comparable efficacy is not well understood in mTBI.
Method
A randomized controlled trial included 13 active duty service members with a history of mTBI and persistent cognitive complaints. Participants received either CCR (N = 6) or CDT (N = 7) during the initial phase of this study. Treatments were one hour, 3 times a week for 4 weeks. Average age was 32.77 (SD = 7.96). Average intelligence estimated by word reading was average (WTAR M = 107.46, SD = 9.32). Specific measures for attention included Symbol Digit Modality Test (SDMT), Paced Auditory Serial Addition Test (PASAT), Conners Continuous Performance Test (CPT-3), as well as Digit Forward (DF), Digit Backward, and Driving from the Neuropsychological Assessment Battery (NAB). Standard scores corrected for age were analyzed. Change scores were computed between pre and post intervention.
Results
There was a significant difference for SDMT (p = 0.034, d = 1.342) and DF (p = 0.0015, d = 2.33), where those who received CDT showed greater improvement. The groups did not differ on Driving, PASAT, CPT-3, and DB (p’s > 0.62).
Conclusions
Preliminary analysis of data suggests that clinician directed treatment was superior to a computerized intervention matched for time and intensity in treating patients with persistent cognitive complaints following mTBI. Large effects were observed on measures of processing speed and focused attention. This may suggest computerized treatment alone is less effective though further data is needed.
Collapse
|
36
|
Bailie J, Remigio-Baker R, Cole W, Stuessi K, Ettenhofer M, West T, Qashu F, Gregory E. Outcome Following Concussion: Prospective Investigation into the Cumulative Effects of a Prior History of Brain Injury and a History of Repeated Sub-Concussive Injuries on Recovery. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz035.20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Objective
To investigate the impact of patient history of repeated head injury (RHI) and mild traumatic brain injury (mTBI) on recovery from an acute concussion.
Methods
There were 64 participants from 3 military installations treated for an acute concussion ( < 72 hours) and monitored at < 72 hours, 1 week, 1 month, 3 months, and 6 months. Participants had no concussion in the last year and no history of moderate/severe TBI. TBI history was based on the Ohio State University TBI Identification Method and limited to mTBI with loss of consciousness. Primary outcome was symptoms evaluated using the Neurobehavioral Symptom Inventory. A total of 33 participants completed the study.
Results
Participants were as follows: n = 12 TBI(-)/RHI(-); n = 6 TBI(+)/RHI(-); n = 9 TBI(-)/RHI(+); n = 6 TBI(+)/RHI(+). A multivariate ANOVA examining TBI/RHI group effect on symptoms was significant (F = 2.31, p = 0.010), whereby the TBI(+)/RHI(+) had higher symptom scores than other groups at < 72 hours, 1 week, and 6 months. At 1 month, TBI(+)/RHI(+) had more symptoms than the TBI(-)/RHI(+). At 3 months, the TBI(+)/RHI(+) had higher symptom scores than the TBI(-)/RHI(-) and the TBI(-)/RHI(+). The TBI(-)/RHI(+) did not differ from TBI(-)/RHI(-) except at 1 week where they had lower overall symptoms.
Conclusions
Participants with an acute mTBI had more severe symptoms if they had RHI and a prior remote mTBI. The combination of these two factors had a negative impact on recovery for up to 6 months. RHI in the absence of TBI did not impact recovery.
Collapse
|
37
|
Remigio-Baker R, Gregory E, Cole W, Ettenhofer M, Mullins L, Bailie J. Treatment using the Progressive Return to Activity Clinical Recommendation may return individuals with elevated symptomatology to normal levels at an expedited rate. Arch Clin Neuropsychol 2019. [DOI: 10.1093/arclin/acz035.17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Objective
To determine whether the use of a clinical recommendation (CR) for activity progression to treat concussion will benefit symptom profile months post-injury beyond what is seen with usual care.
Methods
This study included 58 individuals who participated in the Defense and Veterans Brain Injury Center Progressive Return to Activity (PRA) Study. Eligibility included sustaining a concussion within 72 hours of study enrollment and no previous concussion within 12 months of injury. Poisson regression with robust error variance was used to evaluate the relationship between treatment group assignment (usual care versus PRA-CR) and having normal symptomatology (Neurobehavioral Symptom Inventory score below the upper 10th percentile) at the 1-, 3-, and 6-month follow-up. Participants with normal symptomatology within 72 hours post-injury were excluded from analyses.
Results
Among participants with abnormal symptoms within 72 hours post-concussion, those receiving the PRA-CR to treat concussion had a 70% (CI = 1.06, 2.72) greater prevalence of normal symptomatology by 1 month post-injury, and a 39% (CI = 1.04, 1.87) greater prevalence of normal symptomatology by 3 months post-injury compared to those receiving usual care. By 6 months post-injury, there was no difference in the prevalence of having normal symptoms between groups.
Conclusion
The findings of this study show that participants with abnormal symptomatology decreased in symptom level to normal at a faster rate among those receiving the PRA-CR compared to those receiving usual care, providing evidence for the use of the PRA-CR as a means to enhance treatment of patients with concussion.
Collapse
|
38
|
Laycock A, Bailie J, Matthews V, Bailie R. Using developmental evaluation to support knowledge translation: reflections from a large-scale quality improvement project in Indigenous primary healthcare. Health Res Policy Syst 2019; 17:70. [PMID: 31324251 PMCID: PMC6642555 DOI: 10.1186/s12961-019-0474-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Accepted: 07/02/2019] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Developmental evaluation is a growing area of evaluation practice, advocated for informing the adaptive development of change initiatives in complex social environments. The utilisation focus, complexity perspective and systems thinking of developmental evaluation suggest suitability for evaluating knowledge translation initiatives in primary healthcare. However, there are few examples in the literature to guide its use in these contexts and in Indigenous settings. In this paper, we reflect on our experience of using developmental evaluation to implement a large-scale knowledge translation research project in Australian Aboriginal and Torres Strait Islander primary healthcare. Drawing on principles of knowledge translation and key features of developmental evaluation, we debate the key benefits and challenges of applying this approach to engage diverse stakeholders in using aggregated quality improvement data to identify and address persistent gaps in care delivery. DISCUSSION The developmental evaluation enabled the team to respond to stakeholder feedback and apply learning in real-time to successfully refine theory-informed research and engagement processes, tailor the presentation of findings to stakeholders and context, and support the project's dissemination and knowledge co-production aim. It thereby contributed to the production of robust, useable research findings for informing policy and system change. The use of developmental evaluation appeared to positively influence stakeholders' use of the project reports and their responses to the findings. Challenges included managing a high volume of evaluation data and multiple evaluation purposes, balancing facilitative sense-making processes and change with task-focused project management, and lack of experience in using this evaluation approach. Use of an embedded evaluator with facilitation skills and background knowledge of the project helped to overcome these challenges, as did similarities observed between features of developmental evaluation and continuous quality improvement. CONCLUSION Our experience of developmental evaluation confirmed our expectations of the potential value of this approach for strengthening improvement interventions and implementation research, and particularly for adapting healthcare innovations in Indigenous settings. In our project, developmental evaluation successfully encompassed evaluation, project adaptation, capacity development and knowledge translation. Further work is warranted to apply this approach more widely to improve primary healthcare initiatives and outcomes, and to evaluate implementation research.
Collapse
Affiliation(s)
- Alison Laycock
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Casuarina, Darwin, NT, 0811, Australia. .,The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW, 2480, Australia.
| | - Jodie Bailie
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW, 2480, Australia
| | - Veronica Matthews
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW, 2480, Australia
| | - Ross Bailie
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW, 2480, Australia
| |
Collapse
|
39
|
Bailie J, Matthews V, Laycock A, Connors C, Bailie R. Rigorous follow-up systems for abnormal results are essential to improve health outcomes for Aboriginal and Torres Strait Islander people. Aust J Prim Health 2019; 24:1-3. [PMID: 29362025 DOI: 10.1071/py17103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Accepted: 12/19/2017] [Indexed: 11/23/2022]
Affiliation(s)
- Jodie Bailie
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW 2480, Australia
| | - Veronica Matthews
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW 2480, Australia
| | - Alison Laycock
- Charles Darwin University, Menzies School of Health Research, Level 1, 147 Wharf Street, Brisbane, Qld 4000, Australia
| | - Christine Connors
- Northern Territory Department of Health, 87 Mitchell Street, Darwin, NT 0800, Australia
| | - Ross Bailie
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW 2480, Australia
| |
Collapse
|
40
|
Laycock AF, Bailie J, Percival NA, Matthews V, Cunningham FC, Harvey G, Copley K, Patel L, Bailie R. Wide-Scale Continuous Quality Improvement: A Study of Stakeholders' Use of Quality of Care Reports at Various System Levels, and Factors Mediating Use. Front Public Health 2019; 6:378. [PMID: 30687690 PMCID: PMC6338065 DOI: 10.3389/fpubh.2018.00378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2018] [Accepted: 12/19/2018] [Indexed: 01/25/2023] Open
Abstract
Introduction: Increasing the use of evidence in healthcare policy and practice requires greater understanding of how stakeholders use evidence to inform policy, refine systems and change practice. Drawing on implementation theory, we have used system-focused participatory research to engage diverse stakeholders in using aggregated continuous quality improvement (CQI) data from Australian Indigenous primary health care settings to identify priority evidence-practice gaps, barriers/enablers and strategies for improvement. This article reports stakeholders' use or intended use of evidence at various levels of the system, and factors mediating use. Material and Methods: Interviews were undertaken with a purposeful sample of 30 healthcare stakeholders in different roles, organization types and settings in one Australian jurisdiction and with national participants, as part of the project's developmental evaluation. Qualitative data were analyzed to identify themes and categories relating to use of evidence. Results: Context-specific aggregated CQI data that were relatable to the diverse professional roles and practices provided an effective starting point for sharing perspectives, generating practice-based evidence and mobilizing evidence-use. Interviewees perceived the co-produced findings as applicable at different levels and useful for planning, policy development, supporting best practice and reflection, capacity strengthening and developing new research. Factors mediating use were commitment to best practice; the credibility of the evidence and its perceived relevance to work roles, contexts and decision needs; report format and language; facilitation and communication; competing work pressures and the organizational environment for change. Conclusions: This study found that primary health care stakeholders used evidence on quality of care for a variety of purposes. This could be linked to the interactive research processes used to engage stakeholders in different roles and settings in interpreting data, sharing and generating knowledge. Findings indicate that system-based participatory research using CQI data and iterative, interactive and systematic CQI-based methods can be applied at scale to support concurrent action for healthcare improvement at different system levels. Factors known to influence implementation should be addressed within the research design to optimize evidence use. Further research is needed to explore the utility of interactive dissemination for engaging healthcare stakeholders in informing policy and system change.
Collapse
Affiliation(s)
- Alison F Laycock
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Sydney, NSW, Australia
| | - Nikki A Percival
- The Australian Centre for Public and Population Health Research, University of Technology Sydney, Sydney, NSW, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, Sydney, NSW, Australia
| | - Frances C Cunningham
- Menzies School of Health Research, Charles Darwin University, Darwin, NT, Australia
| | - Gillian Harvey
- Adelaide Nursing School, The University of Adelaide, Adelaide, SA, Australia
| | - Kerry Copley
- Aboriginal Medical Services Alliance Northern Territory, Darwin, NT, Australia
| | - Louise Patel
- Aboriginal Medical Services Alliance Northern Territory, Darwin, NT, Australia
| | - Ross Bailie
- University Centre for Rural Health, The University of Sydney, Sydney, NSW, Australia
| |
Collapse
|
41
|
Laycock A, Harvey G, Percival N, Cunningham F, Bailie J, Matthews V, Copley K, Patel L, Bailie R. Application of the i-PARIHS framework for enhancing understanding of interactive dissemination to achieve wide-scale improvement in Indigenous primary healthcare. Health Res Policy Syst 2018; 16:117. [PMID: 30497480 PMCID: PMC6267798 DOI: 10.1186/s12961-018-0392-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2018] [Accepted: 11/08/2018] [Indexed: 12/15/2022] Open
Abstract
Background Participatory research approaches improve the use of evidence in policy, programmes and practice. Few studies have addressed ways to scale up participatory research for wider system improvement or the intensity of effort required. We used the integrated Promoting Action on Research Implementation in Health Services (i-PARIHS) framework to analyse implementation of an interactive dissemination process engaging stakeholders with continuous quality improvement (CQI) data from Australian Indigenous primary healthcare centres. This paper reports lessons learnt about scaling knowledge translation research, facilitating engagement at a system level and applying the i-PARIHS framework to a system-level intervention. Methods Drawing on a developmental evaluation of our dissemination process, we conducted a post-hoc analysis of data from project records and interviews with 30 stakeholders working in Indigenous health in different roles, organisation types and settings in one Australian jurisdiction and with national participants. Content-analysed data were mapped onto the i-PARIHS framework constructs to examine factors contributing to the success (or otherwise) of the process. Results The dissemination process achieved wide reach, with stakeholders using aggregated CQI data to identify system-wide priority evidence–practice gaps, barriers and strategies for improvement across the scope of care. Innovation characteristics influencing success were credible data, online dissemination and recruitment through established networks, research goals aligned with stakeholders’ interest in knowledge-sharing and motivation to improve care, and iterative phases of reporting and feedback. The policy environment and infrastructure for CQI, as well as manager support, influenced participation. Stakeholders who actively facilitated organisational- and local-level engagement were important for connecting others with the data and with the externally located research team. Developmental evaluation was facilitative in that it supported real-time adaptation and tailoring to stakeholders and context. Conclusions A participatory research process was successfully implemented at scale without intense facilitation efforts. These findings broaden the notion of facilitation and support the utility of the i-PARIHS framework for planning participatory knowledge translation research at a system level. Researchers planning similar interventions should work through established networks and identify organisational- or local-level facilitators within the research design. Further research exploring facilitation in system-level interventions and the use of interactive dissemination processes in other settings is needed. Electronic supplementary material The online version of this article (10.1186/s12961-018-0392-z) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Alison Laycock
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Darwin, Casuarina Northern Territory, 0811, Australia.
| | - Gillian Harvey
- Adelaide Nursing School, The University of Adelaide, North Tce, Adelaide, SA, 5000, Australia
| | - Nikki Percival
- The Australian Centre for Public and Population Health Research, University of Technology Sydney, PO Box 123, Broadway, Ultimo, NSW, 2007, Australia
| | - Frances Cunningham
- Menzies School of Health Research, Charles Darwin University, PO Box 41096, Darwin, Casuarina Northern Territory, 0811, Australia
| | - Jodie Bailie
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW, 2480, Australia
| | - Veronica Matthews
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW, 2480, Australia
| | - Kerry Copley
- Aboriginal Medical Services Alliance Northern Territory, GPO Box 1624, Darwin, Northern Territory, 0801, Australia
| | - Louise Patel
- Aboriginal Medical Services Alliance Northern Territory, GPO Box 1624, Darwin, Northern Territory, 0801, Australia
| | - Ross Bailie
- The University of Sydney, University Centre for Rural Health, 61 Uralba Street, Lismore, NSW, 2480, Australia
| |
Collapse
|
42
|
Bailie J, Remigio-Baker R, Cole W, McCulloch K, Ettenhofer M, West T, Cecchini A, Mullins L, Steussi K, Qashu F, Gregory E. Adult Concussion - 2
Changes in Activity Level and Symptom Recovery from Acute Mild Traumatic Brain Injury. Arch Clin Neuropsychol 2018. [DOI: 10.1093/arclin/acy060.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
|
43
|
Lange R, Lippa S, French L, Gartner R, Driscoll A, Wright M, Bailie J, Nora D, Sullivan J, Varbedian N, Camelo-Lopez V, Cheselka J, Bellini P, Holzinger J, Walker H, Brandler B, Freud J, Schaper A, Reese M, Barnhart E, Casey K, Ndege V, Ramin D, Eshera Y, Robinson G, Brickell T. A - 60Ten Year Neurobehavioral Outcome Following Mild, Moderate, Severe, and Penetrating Traumatic Brain Injury in U.S. Military Service Members. Arch Clin Neuropsychol 2018. [DOI: 10.1093/arclin/acy061.60] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
44
|
Brickell T, Lippa S, French L, Gartner R, Driscoll A, Wright M, Bailie J, Nora D, Sullivan J, Varbedian N, Camelo-Lopez V, Cheselka J, Bellini P, Holzinger J, Walker H, Brandler B, Freud J, Schaper A, Reese M, Barnhart E, Casey K, Ndege V, Ramin D, Eshera Y, Robinson G, Lange R. A - 46Post-Concussion Symptom Reporting within the First 5-Years of the Recovery Trajectory Following Uncomplicated Mild Traumatic Brain Injury: A Cross-Sectional Perspective. Arch Clin Neuropsychol 2018. [DOI: 10.1093/arclin/acy061.46] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
|
45
|
Cunningham FC, Matthews V, Sheahan A, Bailie J, Bailie RS. Assessing Collaboration in a National Research Partnership in Quality Improvement in Indigenous Primary Health Care: A Network Approach. Front Public Health 2018; 6:182. [PMID: 29988543 PMCID: PMC6026655 DOI: 10.3389/fpubh.2018.00182] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 06/04/2018] [Indexed: 11/23/2022] Open
Abstract
Background: The ABCD National Research Partnership was formed in mid-2010 as a collaboration to harness the expertise, experiences and resources of Aboriginal and Torres Strait Islander community-controlled peak bodies, government and research organisations to improve the quality of Indigenous primary health care. The aim of this study was to apply social network methods to assess collaboration and functioning of the Partnership at two time-points. Methods: A social network analysis (SNA) survey was conducted in early 2013, with a follow-up survey in mid-2014. In the two survey rounds, online surveys were emailed to one senior person of the organisation participating in the Partnership (2013: 14 organisations; 2014: 11 organisations). The surveys collected data on respondent perceptions of the Partnership as well as social network relationship data. Social network methods were used to apply standardised metrics to assess how well the partnership was functioning as a collaborative three years into its operation, and in its fourth year. Results: Most respondents rated the Partnership as successful in progressing toward its goals. Network density and centrality scores show a well-connected partnership spanning different organisational types and states/territories (Northern Territory, Queensland, Western Australia, South Australia, and Far-West New South Wales). High centrality scores reflect high connectivity between key hubs in the network, contributing toward the shared goal of improved Indigenous primary health care. Network diagrams show key structural positions by organisational type, the frequency and intensity of interactions and the strengths and potential vulnerabilities in the partnership network, with comparisons at two time points for the partnership. Conclusions: The study found that the Partnership was effective in securing collaboration across its partners. Partners' contribution of resources reflected their active involvement. There was a high level of agreement on the achievement of the key goals of the Partnership, showing shared sense-making amongst partners. SNA tools assisted with monitoring the network over time to develop strategies supporting connections between partners for sustaining collaborative learning. Study findings identify successful approaches for a research partnership to improve quality of care in Indigenous primary health care and provide encouragement for wider applications for research partnerships and collaborations in Australia and internationally.
Collapse
Affiliation(s)
- Frances C Cunningham
- Wellbeing and Preventable Chronic Diseases Division, Menzies School of Health Research, Charles Darwin University, Spring Hill, QLD, Australia
| | - Veronica Matthews
- University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - Anna Sheahan
- Queensland Aboriginal and Islander Health Council, South Brisbane, QLD, Australia
| | - Jodie Bailie
- University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| | - Ross S Bailie
- University of Sydney, University Centre for Rural Health, Lismore, NSW, Australia
| |
Collapse
|
46
|
Bailie J, Boyle JA, Bailie RS. Population attributable fractions of perinatal outcomes for nulliparous women associated with overweight and obesity, 1990-2014. Med J Aust 2018; 208:505-506. [PMID: 29902411 DOI: 10.5694/mja18.00263] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 03/27/2018] [Indexed: 11/17/2022]
Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health, Lismore, NSW
| | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, Monash University, Melbourne, VIC
| | | |
Collapse
|
47
|
Bailie J, Cunningham FC, Bainbridge RG, Passey ME, Laycock AF, Bailie RS, Larkins SL, Brands JSM, Ramanathan S, Abimbola S, Peiris D. Comparing and contrasting 'innovation platforms' with other forms of professional networks for strengthening primary healthcare systems for Indigenous Australians. BMJ Glob Health 2018; 3:e000683. [PMID: 29862056 PMCID: PMC5969724 DOI: 10.1136/bmjgh-2017-000683] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Revised: 04/23/2018] [Accepted: 04/27/2018] [Indexed: 11/16/2022] Open
Abstract
Efforts to strengthen health systems require the engagement of diverse, multidisciplinary stakeholder networks. Networks provide a forum for experimentation and knowledge creation, information exchange and the spread of good ideas and practice. They might be useful in addressing complex issues or ‘wicked’ problems, the solutions to which go beyond the control and scope of any one agency. Innovation platforms are proposed as a novel type of network because of their diverse stakeholder composition and focus on problem solving within complex systems. Thus, they have potential applicability to health systems strengthening initiatives, even though they have been predominantly applied in the international agricultural development sector. In this paper, we compare and contrast the concept of innovation platforms with other types of networks that can be used in efforts to strengthen primary healthcare systems, such as communities of practice, practice-based research networks and quality improvement collaboratives. We reflect on our ongoing research programme that applies innovation platform concepts to drive large-scale quality improvement in primary healthcare for Aboriginal and Torres Strait Islander Australians and outline our plans for evaluation. Lessons from our experience will find resonance with others working on similar initiatives in global health.
Collapse
Affiliation(s)
- Jodie Bailie
- University Centre for Rural Health, University of Sydney, Sydney, New South Wales, Australia
| | | | | | - Megan E Passey
- University Centre for Rural Health, University of Sydney, Sydney, New South Wales, Australia
| | - Alison Frances Laycock
- Centre for Indigenous Health Equity Research, Central Queensland University, Brisbane, Queensland, Australia
| | - Ross Stewart Bailie
- University Centre for Rural Health, University of Sydney, Sydney, New South Wales, Australia
| | - Sarah L Larkins
- College of Medicine and Dentistry, James Cook University, Townsville, Queensland, Australia
| | - Jenny S M Brands
- Centre for Indigenous Health Equity Research, Central Queensland University, Brisbane, Queensland, Australia
| | - Shanthi Ramanathan
- Hunter Research Medical Institute, University of Newcastle, Newcastle, New South Wales, Australia
| | - Seye Abimbola
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - David Peiris
- The George Institute for Global Health, University of New South Wales, Sydney, New South Wales, Australia
| |
Collapse
|
48
|
McPhail-Bell K, Matthews V, Bainbridge R, Redman-MacLaren ML, Askew D, Ramanathan S, Bailie J, Bailie R. An "All Teach, All Learn" Approach to Research Capacity Strengthening in Indigenous Primary Health Care Continuous Quality Improvement. Front Public Health 2018; 6:107. [PMID: 29761095 PMCID: PMC5936797 DOI: 10.3389/fpubh.2018.00107] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 04/03/2018] [Indexed: 11/13/2022] Open
Abstract
In Australia, Indigenous people experience poor access to health care and the highest rates of morbidity and mortality of any population group. Despite modest improvements in recent years, concerns remains that Indigenous people have been over-researched without corresponding health improvements. Embedding Indigenous leadership, participation, and priorities in health research is an essential strategy for meaningful change for Indigenous people. To centralize Indigenous perspectives in research processes, a transformative shift away from traditional approaches that have benefited researchers and non-Indigenous agendas is required. This shift must involve concomitant strengthening of the research capacity of Indigenous and non-Indigenous researchers and research translators-all must teach and all must learn. However, there is limited evidence about how to strengthen systems and stakeholder capacity to participate in and lead continuous quality improvement (CQI) research in Indigenous primary health care, to the benefit of Indigenous people. This paper describes the collaborative development of, and principles underpinning, a research capacity strengthening (RCS) model in a national Indigenous primary health care CQI research network. The development process identified the need to address power imbalances, cultural contexts, relationships, systems requirements and existing knowledge, skills, and experience of all parties. Taking a strengths-based perspective, we harnessed existing knowledge, skills and experiences; hence our emphasis on capacity "strengthening". New insights are provided into the complex processes of RCS within the context of CQI in Indigenous primary health care.
Collapse
Affiliation(s)
- Karen McPhail-Bell
- Poche Centre for Indigenous Health, Sydney Medical School, The University of Sydney, Camperdown, NSW, Australia.,University Centre for Rural Health, The University of Sydney, Lismore, NSW, Australia
| | - Veronica Matthews
- University Centre for Rural Health, The University of Sydney, Lismore, NSW, Australia
| | - Roxanne Bainbridge
- Centre for Indigenous Health Equity Research, CQUniversity, Cairns, QLD, Australia
| | - Michelle Louise Redman-MacLaren
- Centre for Indigenous Health Equity Research, CQUniversity, Cairns, QLD, Australia.,College of Medicine and Dentistry, James Cook University, Cairns, QLD, Australia
| | - Deborah Askew
- Primary Care Clinical Unit, The University of Queensland, Herston, QLD, Australia.,Southern Queensland Centre of Excellence in Aboriginal and Torres Strait Islander Primary Health Care (Inala Indigenous Health Service), Queensland Health, Inala, QLD, Australia
| | - Shanthi Ramanathan
- Hunter Medical Research Institute, University of Newcastle, Newcastle, NSW, Australia
| | - Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, NSW, Australia
| | - Ross Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, NSW, Australia
| | | |
Collapse
|
49
|
Ramanathan S, Reeves P, Deeming S, Bailie RS, Bailie J, Bainbridge R, Cunningham F, Doran C, McPhail Bell K, Searles A. Encouraging translation and assessing impact of the Centre for Research Excellence in Integrated Quality Improvement: rationale and protocol for a research impact assessment. BMJ Open 2017; 7:e018572. [PMID: 29208619 PMCID: PMC5719272 DOI: 10.1136/bmjopen-2017-018572] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
INTRODUCTION There is growing recognition among health researchers and funders that the wider benefits of research such as economic, social and health impacts ought to be assessed and valued alongside academic outputs such as peer-reviewed papers. Research translation needs to increase and the pathways to impact ought to be more transparent. These processes are particularly pertinent to the Indigenous health sector given continued concerns that Indigenous communities are over-researched with little corresponding improvement in health outcomes. This paper describes the research protocol of a mixed methods study to apply FAIT (Framework to Assess the Impact from Translational health research) to the Centre for Research Excellence in Integrated Quality Improvement (CRE-IQI). FAIT will be applied to five selected CRE-IQI Flagship projects to encourage research translation and assess the wider impact of that research. METHODS AND ANALYSIS Phase I will develop a modified programme logic model for each Flagship project including identifying process, output and impact metrics so progress can be monitored. A scoping review will inform potential benefits. In phase II, programme logic models will be updated to account for changes in the research pathways over time. Audit and feedback will be used to encourage research translation and collect evidence of achievement of any process, output and interim impacts. In phase III, three proven methodologies for measuring research impact-Payback, economic assessment and narratives-will be applied. Data on the application of FAIT will be collected and analysed to inform and improve FAIT's performance. ETHICS AND DISSEMINATION This study is funded by a nationally competitive grant (ID 1078927) from the Australian National Health and Medical Research Council. Ethics approval was obtained from the University of Newcastle's Human Research Ethics Committee (ID: H-2017-0026). The results from the study will be presented in several peer-reviewed publications, through conference presentations and via social media.
Collapse
Affiliation(s)
- Shanthi Ramanathan
- Health Research Economics, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Penny Reeves
- Health Research Economics, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Simon Deeming
- Health Research Economics, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| | - Ross Stewart Bailie
- The University of Sydney, University Centre for Rural Health, Lismore, New South Wales, Australia
| | - Jodie Bailie
- The University of Sydney, University Centre for Rural Health, Lismore, New South Wales, Australia
| | - Roxanne Bainbridge
- Centre for Indigenous Health Equity Research, School of Health Medical and Applied Sciences, Central Queensland University, Brisbane, Queensland, Australia
- The Cairns Institute, James Cook University, Cairns, Queensland, Australia
| | - Frances Cunningham
- Menzies School of Health Research, Charles Darwin University, Brisbane, Queensland, Australia
| | - Christopher Doran
- Centre for Indigenous Health Equity Research, School of Health Medical and Applied Sciences, Central Queensland University, Brisbane, Queensland, Australia
| | - Karen McPhail Bell
- The University of Sydney, University Centre for Rural Health, Lismore, New South Wales, Australia
| | - Andrew Searles
- Health Research Economics, Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Newcastle, New South Wales, Australia
| |
Collapse
|
50
|
Bailie R, Bailie J, Larkins S, Broughton E. Editorial: Continuous Quality Improvement (CQI)-Advancing Understanding of Design, Application, Impact, and Evaluation of CQI Approaches. Front Public Health 2017; 5:306. [PMID: 29218305 PMCID: PMC5703697 DOI: 10.3389/fpubh.2017.00306] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2017] [Accepted: 11/03/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Ross Bailie
- The University of Sydney, The University Centre for Rural Health, Lismore, NSW, Australia
| | - Jodie Bailie
- The University of Sydney, The University Centre for Rural Health, Lismore, NSW, Australia
| | - Sarah Larkins
- James Cook University, College of Medicine and Dentistry, Townsville, QLD, Australia
| | | |
Collapse
|