Journal of primary health care最新文献

{"title":"Newborn enrolment, engagement, and immunisation in primary care: a qualitative study of healthcare providers' perspectives.","authors":"Amber Young, Christine McIntosh, Felicity Ware, Emma Best, Nikki Turner, Nadia A Charania, Andrew Campbell, Te Atarua Davis, Samantha Marsh","doi":"10.1071/HC26025","DOIUrl":"10.1071/HC26025","url":null,"abstract":"<p><strong>Introduction: </strong>Childhood immunisation coverage in Aotearoa New Zealand (NZ) is not meeting recommended targets. Enrolment and engagement with primary care are associated with timely immunisation uptake, yet enrolment and immunisation are inequitable, with Māori and Pacific children less likely to be enrolled and receive their 6-week vaccinations on time.</p><p><strong>Aim: </strong>This study aimed to understand healthcare providers' perceptions of barriers and enablers to primary healthcare enrolment from birth and provide recommendations to support enrolment, engagement, and immunisation, particularly for Māori whānau (families).</p><p><strong>Methods: </strong>This qualitative study, guided by a Kaupapa Māori-aligned methodology, involved interviews and focus groups to explore barriers and enablers to enrolment from the perspective of people working within the NZ healthcare sector (n = 27). Analysis was undertaken using qualitative content analysis.</p><p><strong>Results: </strong>Many participants expressed that the current system was contributing to inequitable enrolment and immunisation of pēpi (infants). Four categories were constructed: health services may not be accessible or practical for whānau; perceived complexity and skill shortages; the need to prioritise communication and engagement; and services must be built on cultural safety and trust.</p><p><strong>Discussion: </strong>Reasons for inadequate enrolment include poorly designed systems, limited resourcing, and inconsistent approaches. Enrolment needs to be simplified, with integrated and automated systems to reduce administrative burden for staff. Flexible whānau-centred practices can help support enrolment, engagement, and immunisation of pēpi.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"175-184"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147774744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'We just need to make sure this vaccine gets to the right place': a qualitative study exploring vaccinators' approaches to needle-length selection for big-bodied patients.","authors":"Sally B Rose, Carmen Timu-Parata, Ashlea Gillon, George Parker, Lesley Gray","doi":"10.1071/HC25223","DOIUrl":"10.1071/HC25223","url":null,"abstract":"<p><strong>Introduction: </strong>Access to effective vaccination is an important way to protect against infectious diseases. The Aotearoa-New Zealand immunisation handbook on safe and effective vaccination practice recommends a 38-mm needle length for intramuscular deltoid injections in very large individuals, using clinical judgment to ensure needle length is appropriate to reach muscle. It is not clear how vaccinators implement this guidance in practice.</p><p><strong>Aim: </strong>This study aimed to explore vaccinators' needle-length selection practice for big-bodied people and their views on a prototype arm circumference tool to guide needle choice.</p><p><strong>Method: </strong>Vaccinators working with Māori and Pacific communities were recruited via researchers' networks to take part in one of six in-person focus groups in the Wellington region, Horowhenua district, and Tairāwhiti region (August-October 2025). Data were analysed qualitatively using a reflexive thematic approach.</p><p><strong>Results: </strong>Twenty-five primary care-based vaccinators with varied roles and experience participated. Themes identified in the discussion included prioritisation of patient-centred care, influences on decision making (familiarity with guidance, training, workflow and equipment), and strengthening practice in these areas. The prototype tool was viewed positively, with discussion highlighting its potential to improve familiarity with arm size and needle-length criteria. Practical, workflow, and patient-centred considerations were raised, with particular focus on the importance of communicating use of the tool in a sensitive manner.</p><p><strong>Discussion: </strong>Ensuring adequate supply and availability of 38-mm needles, along with clear guidance and education, are essential to support vaccinators' clinical judgement and effective vaccine delivery to big-bodied people. Use of an arm circumference assessment tool could strengthen vaccinators' decision making and help standardise needle length.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"156-164"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147973288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Views on vaccination in a New Zealand rural Pasifika community: a qualitative study.","authors":"Jo Hilder, Jane Taafaki, Maria Stubbe","doi":"10.1071/HC25139","DOIUrl":"10.1071/HC25139","url":null,"abstract":"<p><strong>Introduction: </strong>Vaccination rates for Pasifika in Aotearoa New Zealand have fallen dramatically since the COVID-19 pandemic. Although the decline in the South Island is not as great as in areas of greater Pasifika concentration, such as Auckland, rural Pasifika are under-represented in research, and it is important to investigate their perspectives.</p><p><strong>Aim: </strong>The study aimed to explore knowledge of and perspectives on childhood vaccinations of a diverse rural Pasifika community in the South Island of New Zealand, and to identify underlying reasons for the recent decline in immunisation rates.</p><p><strong>Methods: </strong>Interviews and focus groups, informed by a talanoa approach, were conducted with 12 female members of the Pasifika community in a rural NZ town with a large and growing Pasifika community. Transcripts were analysed using framework analysis followed by iterative, inductive thematic analysis.</p><p><strong>Results: </strong>Five themes were identified that underlie vaccine uptake: (1) Established norms; (2) Knowledge about vaccination; (3) Experiences of vaccination or diseases; (4) Health professionals' communication; and (5) Logistical and practical concerns. Each theme encompasses both barriers and facilitators of vaccination.</p><p><strong>Discussion: </strong>Rural Pasifika communities are disadvantaged in terms of healthcare access both by rurality and by their minority ethnic status. Empowering individuals and communities to access, understand, and use health information is vital, especially for Pasifika navigating an unfamiliar system in rural areas, and when there have been negative vaccination experiences. Every health interaction should aim to build literacy, address concerns, and foster relationships, trust, and understanding.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"185-192"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Corrigendum to: Are patients with type 2 diabetes in the Waikato District provided with adequate education and support in primary care to self-manage their condition? A qualitative study.","authors":"Rebekah Crosswell, Kimberley Norman, Shemana Cassim, Valentina Papa, Rawiri Keenan, Ryan Paul, Lynne Chepulis","doi":"10.1071/HC23141_CO","DOIUrl":"10.1071/HC23141_CO","url":null,"abstract":"","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"193"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The journey of people accessing first trimester abortion in Aotearoa New Zealand: health consumers' perspectives.","authors":"Emma Macfarlane, Helen Paterson, Michael Stitely, Pauline Dawson","doi":"10.1071/HC25011","DOIUrl":"10.1071/HC25011","url":null,"abstract":"<p><strong>Introduction: </strong>Aotearoa New Zealand (NZ) achieved abortion law reform in 2020, allowing people to choose abortion without legal restriction up to 20 weeks gestation. Abortion can now be provided by a range of health practitioners in a variety of settings. While some progress has been made, we are yet to see abortion care being provided within the full extent of the law.</p><p><strong>Aim: </strong>To describe the journey of people accessing first-trimester abortion care in NZ to identify how abortion services can be developed to deliver optimal first-trimester abortion care.</p><p><strong>Methods: </strong>This was a qualitative study informed by phenomenology. Participants were recruited via a separate national survey to participate in in-depth interviews. Analysis was undertaken using a reflexive inductive approach to identify themes.</p><p><strong>Results: </strong>Seven people were recruited. Analysis revealed four themes: (1) decision making (to have an abortion, choice of method, and coercive contraceptive decision making); (2) barriers to access (abortion service navigation, lack of access in rural areas including requirement to travel, abortion requirements); (3) abortion as a societal issue (abortion is isolating, 'slut-shaming', abortion is the taking of a life); and (4) empathy and advocacy.</p><p><strong>Discussion: </strong>Despite decriminalisation of abortion in NZ, barriers remain. Work is required to improve access to accurate and non-judgemental information to inform decision-making. People value kind, non-judgemental clinicians and supportive whanau/friends play a major role in optimising the experience. Abortion stigma persists and has a negative impact on the abortion experience. Abortion services need support to ensure they are responsive to the needs of health consumers and reduce barriers to care.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"117-123"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing an equity-focused model for early pregnancy care in general practice.","authors":"J P McMenamin, G White","doi":"10.1071/HC25071","DOIUrl":"10.1071/HC25071","url":null,"abstract":"<p><strong>Introduction: </strong>Disparities in maternal health outcomes in Aotearoa New Zealand are well documented, with Māori and Pacific women experiencing disproportionately poorer outcomes. Early pregnancy care delivered through general practice offers an opportunity to reduce these inequities. The Best Start early pregnancy assessment tool, developed by the National Hauora Coalition, was implemented across four general practices in Whanganui to support timely, culturally safe care.</p><p><strong>Aim: </strong>To implement and evaluate an equity-focused model of early pregnancy care in general practice using the Best Start assessment tool, with the goal of improving timely, culturally responsive support for pregnant Māori and Pacific women.</p><p><strong>Methods: </strong>An iterative, co-designed implementation was carried out across a Very Low Cost Access clinic, an iwi health provider, and two general practices. The project was structured in three modules: (1) co-design with hapū māmā (pregnant Māori women), (2) clinical implementation, and (3) integration of wrap-around services. Mixed methods were used, including practice management data queries, clinical audits, and qualitative insights from community hui.</p><p><strong>Results: </strong>In the lead practice, 85% of estimated pregnancies were identified, with 84% identified in the first trimester. Of these, 79% received a Best Start assessment (74% of Māori pregnancies). Mental health concerns were the most common referral need (18%), while low attendance at external stop smoking services highlighted persistent barriers. Community feedback led to system improvements, including warm handovers (in-person referrals) and protected appointment slots.</p><p><strong>Discussion: </strong>The Best Start model demonstrates that early pregnancy care in general practice can be redesigned to better support equity, provided it is culturally responsive, co-designed with māmā, and supported by systemic change. Ongoing investment is needed to sustain and scale the model, especially for Māori and Pacific women.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"97-101"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary health care utilisation in Aotearoa New Zealand: a descriptive study of trends from 2008 to 2023.","authors":"Mona Jeffreys, Maite Irurzun Lopez, Claire O'Loughlin, Tessa Senior, Jacqueline Cumming","doi":"10.1071/HC25035","DOIUrl":"10.1071/HC25035","url":null,"abstract":"<p><strong>Introduction: </strong>The New Zealand Primary Health Care Strategy (2001) and subsequent government health policy have aimed to improve access to and expand the role of nurses in primary health care. Measuring primary healthcare utilisation is one way to assess the success of such policies.</p><p><strong>Aim: </strong>This study aimed to describe trends from 2008 to 2023 in average annual general practitioner (GP) and nurse consultations, by gender, age, ethnicity, and area-level deprivation.</p><p><strong>Methods: </strong>Primary health care service utilisation data were obtained from the Ministry of Health.</p><p><strong>Results: </strong>Average GP consultations per enrolled patient per year showed little change over the study period, with increases from 2.9 in 2008 to 3.1 in 2022, and a dip in 2020 and 2021 during the COVID-19 pandemic. In 2023, GP consultations were the lowest in the study period (2.8). Nurse consultations rose steadily from 0.4 in 2008 to 1.0 in 2023 and did not show a marked COVID-19-related dip. Māori had consistently lower rates of GP consultations and higher rates of nurse consultations than New Zealand Europeans. Utilisation of primary health care, particularly that provided by GPs, was low in 2023.</p><p><strong>Discussion: </strong>Possible reasons for Māori and older people consulting with nurses at higher rates should be investigated. These may be artefactual, due to our inability to age-standardise the data. Other possible reasons include nurse management of chronic conditions and barriers to accessing GP care. The fall in primary healthcare utilisation in 2023 will likely increase secondary care need.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"102-109"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The long and short of it: a qualitative descriptive analysis of self-identifying fat people's experiences of Aotearoa New Zealand's COVID-19 vaccination centres.","authors":"Erica Stolte, George Parker, Lesley Gray","doi":"10.1071/HC25007","DOIUrl":"10.1071/HC25007","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare systems historically fail to deliver adequate and appropriate size- inclusive health care to the fat community with implications for fat people's health and human rights. The COVID-19 vaccination rollout was, and continues to be, an important part of Aotearoa New Zealand's (NZ) response to the COVID-19 pandemic. People with high body mass were identified as a priority group for early vaccination.</p><p><strong>Aim: </strong>To investigate self-identified fat people's experiences of COVID-19 vaccination centres in NZ.</p><p><strong>Methods: </strong>Qualitative descriptive analysis of free-text responses provided by self-identified fat people residing in NZ as part of a international online survey implemented during the COVID-19 pandemic.</p><p><strong>Results: </strong>Of the 761 NZ survey respondents, 210 respondents provided open-ended and free-text comments about their first COVID-19 vaccination, 169 commented on their experiences of second or subsequent vaccination, and 198 commented on their overall experiences concerning COVID-19 vaccination. Two themes were identified: Navigating challenges in the vaccination centre environment and Advocating for the use of long needles.</p><p><strong>Discussion: </strong>Findings highlighted healthcare inequities experienced by fat people when accessing COVID-19 vaccination centres and thin privilege at structural and interactional levels, despite identified priorities for vaccinating people with high body mass.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"149-155"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145355221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities to flip the narrative from burden to action for young women joining the National Cervical Screening Programme in Aotearoa New Zealand: a Kaupapa Māori qualitative exploration of experiences and knowledge of cervical screening for 18-30 year olds.","authors":"Tania Slater, Kendall Stevenson, Anna Adcock, Mary-Ann Clueard, Koha Aperahama, Carissa Thompson, Charles Lambert, E Jane MacDonald, Melanie Gibson, Stacie Geller, Matthew Bennett, Maxine Schmidt, Varsha Parag, Jo-Ann Stanton, Alison Carlin, Kristy Wolff, Merilyn Hibma, Peter Sykes, Marion Saville, David Hawkes, Bev Lawton","doi":"10.1071/HC25151","DOIUrl":"10.1071/HC25151","url":null,"abstract":"<p><strong>Introduction: </strong>Aotearoa New Zealand's National Cervical Screening Programme uses human papillomavirus (HPV) self-testing. It is important for 25-year-olds to join the cervical screening programme so that cervical cancer can be prevented, detected, and ultimately eliminated, but screening uptake by younger women is low.</p><p><strong>Aim: </strong>The study aimed to hear young women's thoughts, experiences, and knowledge of cervical screening, including their ideas for encouraging participation in the cervical screening programme.</p><p><strong>Methods: </strong>The study was part of a wider mixed-methods implementation trial based in Te Tai Tokerau. This qualitative component was grounded in a Kaupapa Māori methodology, by, for, and with Māori, involving a structural analysis of inequities and hearing from participants via semi-structured interviews. Interviews with 24 women aged between 18 and 30 and one whānau (family) were undertaken.</p><p><strong>Results: </strong>Data were organised into four pou (pillars): Rangatiratanga (self-determination, autonomy, sovereignty), Manaaki (support, encouragement, whanaungatanga), Kura (education, public health campaigns), and Mana Taurite (equity, access issues, system issues).</p><p><strong>Discussion: </strong>The empowering and easy elements of the HPV self-test, and playing an active part in cervical cancer elimination, encourage young women to participate in cervical screening, but cost is the greatest barrier to screening access. General practice also plays a critical role in championing cervical screening. This has implications for better primary care resourcing to connect and support young women to screening. HPV self-testing in the National Cervical Screening Programme has the opportunity to flip the narrative of cervical screening from burden to action.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":" ","pages":"141-148"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145781096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The seen and unseen work of general practice: a national diary study of New Zealand General Practitioners.","authors":"Luke Bradford, Simon Wright, Jordan Schulde, Samantha Murton","doi":"10.1071/HC25195","DOIUrl":"10.1071/HC25195","url":null,"abstract":"<p><strong>Introduction: </strong>General practitioner (GP) work is mostly recognised and funded according to time spent with a patient. However, substantial work occurs outside of patient contacts. This has significant implications for workforce planning and wellbeing, models of care, and resourcing.</p><p><strong>Aim: </strong>This study analysed the range of activities of GPs in daily practice. It aimed to identify patient-facing and non-patient facing clinical work as well as other activities that are required to deliver comprehensive, continuous, primary health care in the community.</p><p><strong>Methods: </strong>GPs were invited to participate in two daily diary studies, allocating their activities to six categories. Diaries were completed for 2 weeks in summer (late 2023) and 1 week in winter (mid 2024). Data were analysed to identify the volume of patient-facing work and the range of non-patient-facing clinical and non-clinical activities.</p><p><strong>Results: </strong>A total of 566 individual GPs completed the diary studies: 417 in summer, 303 in winter, with 154 across both periods. Fifty-six percent of a GP's time was spent on patient consultations, 31% was spent on non-contact clinical work, 7% on training and education, and 7% on clinical governance and running the organisation.</p><p><strong>Discussion: </strong>Although it is recognised that patient contact time is not the only activity that GPs perform in the course of their work, this study provides details of the range and volume of work undertaken by GPs. A 40-h week in general practice cannot only recognise patient contact time. Consideration of all other unseen hours must be factored into resourcing and models of care.</p>","PeriodicalId":16855,"journal":{"name":"Journal of primary health care","volume":"18 2","pages":"110-116"},"PeriodicalIF":1.1,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148330516","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}