Public Health Research & Practice最新文献

{"title":"An analysis of the legal framework influencing walking in Australia.","authors":"Tracy Nau, Adrian Bauman, William Bellew, Billie Giles-Corti, Ben J Smith","doi":"10.17061/phrp32122205","DOIUrl":"https://doi.org/10.17061/phrp32122205","url":null,"abstract":"AIM Although walking is a priority in many strategic plans in Australian cities, there is limited understanding of the statutory components for delivering this. Confusion still exists despite substantial evidence about the built environment elements that promote walking and the availability of tools to assess walkability outcomes. This paper examines the characteristics and components of the legal framework that influence the walkability of built environments in Australian states and territories. METHODS We audited the form and nature of statutory components regulating the design of the built environment and used framework analysis to identify and compare the main statutory instrument/s that address walkability design considerations in each state and territory. RESULTS Lawmaking for planning may involve the state/territory parliament, executive, ministers, government departments and/or statutory authorities. The state/territory planning Act is the primary legislation that sets out the framework for the prevailing planning systems. Its relevance to walkability arises from its planning objectives, the legal effect it confers to statutory instruments that support the Act's implementation, and any processes or mechanisms to promote high-quality design outcomes. Most states and territories have developed jurisdiction-wide statutory tools that contain relevant design considerations for walking. These instruments influence walkability through objectives set for planning zones and aspects of development, and through criteria established to achieve the goals. Many jurisdictions use a combination of outcome and rules-based standards to achieve desired design objectives. CONCLUSIONS The variability in jurisdictional approaches poses challenges, and raises uncertainty, about the scope and strength of legal support for creating walkable environments at the national level. Future policy surveillance and epidemiological analysis are needed to refine the specifications of laws that influence walking in Australia.","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"33 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9114438","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":"Filling the gap between evidence, policy and practice: are 45 and Up Study researchers planning for impact?","authors":"Tam C Ha,&nbsp;Martin McNamara,&nbsp;Luciano Melo,&nbsp;Emma K Frost,&nbsp;Gabriel M Moore","doi":"10.17061/phrp32122207","DOIUrl":"https://doi.org/10.17061/phrp32122207","url":null,"abstract":"<p><strong>Aim: </strong>To improve health outcomes, policy and practice decisions should be guided by relevant and timely evidence. High-quality, large-scale population data could play an essential role in supporting evidence-based decision making. The 45 and Up Study is a long-term, large-scale cohort study with more 250 000 participants aged 45 years and over from New South Wales (NSW), Australia. Data collected by the Study is accessible to researchers, government and non-governmental bodies. The study aimed to identify the proportion of researchers using data from the Study who intended to have an impact and achieved impact; the types of impact they intended and achieved; and the pathways through which they achieved it.</p><p><strong>Methods: </strong>Using data extracted from the application, progress and final report documents for 25 projects using 45 and Up Study data from January 2011 until December 2017, we a) determined the proportion of projects that intended to have policy or practice impact and b) described the type of policy and practice impact achieved.</p><p><strong>Results: </strong>We found that 88% (<i>n</i> = 22) of projects intended to have a policy or practice impact. Of those, 68% (<i>n</i> = 15) planned to influence or inform a policy or program, and 41% (<i>n</i> = 9) planned to share findings at conferences or in journals. Almost half of projects with intended impact (45%, <i>n</i> = 10) did not state how they planned to achieve impact. Approximately 16% of all projects (<i>n</i> = 4) reported achieving an impact on policy or services. The type of impact achieved by all four of these projects was influencing, informing or changing a policy or program. One of these four projects also achieved a change to legislation or regulation.</p><p><strong>Conclusions: </strong>Further strategies to promote a targeted approach to impact planning in research projects using datasets such as the 45 and Up Study would help guide researchers in achieving impact.</p>","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"33 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9114469","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":"Lung cancer screening: the hidden public health emergency.","authors":"Emily Stone,&nbsp;Rachael H Dodd,&nbsp;Henry Marshall,&nbsp;Billie Bonevski,&nbsp;Nicole M Rankin","doi":"10.17061/phrp3312302","DOIUrl":"https://doi.org/10.17061/phrp3312302","url":null,"abstract":"<p><p>Lung cancer causes nearly 2 million deaths per year worldwide, and cases continue to rise. Most lung cancer is diagnosed at late, incurable stages, and the five-year survival is a fraction of that for other common cancers, including breast, prostate, melanoma and colorectal cancer. Lung cancer screening (LCS) in high-risk populations using low-dose computed tomography (LDCT) could potentially save thousands of lives per year by shifting the stage at diagnosis to early curable disease. Although an LCS program has not yet started in Australia, two trials have provided local data on the feasibility, selection criteria and outcomes. A government-commissioned report has detailed a potential national program, and Federal Budget funding has been committed to early feasibility projects that include population-specific consultations with, for example, Aboriginal and Torres Strait Islander communities who are at higher risk of lung cancer due to high smoking rates. Effective recruitment to LCS, embedded smoking cessation and the provision of subsequent lung cancer care to all at-risk Australians remain key priorities for any future LCS program.</p>","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"33 1","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-03-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9121465","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":"Healthcare costs following falls and cataract surgery in older adults using Australian linked health data from 2012-2019","authors":"Jessie Huang-Lung, Kam Chun Ho, Thomas Lung, Anna Palagyi, Peter McCluskey, Andrew White, Soufiane Boufous, Lisa Keay","doi":"10.17061/phrp33342311","DOIUrl":"https://doi.org/10.17061/phrp33342311","url":null,"abstract":"OBJECTIVES\u0000To investigate publicly funded healthcare costs according to faller status and the periods pre- and post-cataract surgeries, and identify factors associated with higher monthly costs in older people with bilateral cataract.\u0000\u0000\u0000METHODS\u0000This prospective cohort study included community-dwelling older people aged 65 and over (between 2012 and 2019); at baseline participants had bilateral cataract and were waiting for cataract surgery in New South Wales (NSW) public hospitals. Participants were followed for 24 months. The study used self-reported and linked data (Medicare Benefits Schedule, Pharmaceutical Benefits Scheme, NSW Admitted Patient and Emergency Department Data Collections) to identify falls, cataract surgeries and healthcare costs incurred by the Australian and NSW Governments, all costs were inflated to 2018-19 Australian dollars (AUD). Median monthly healthcare costs were calculated for faller status (non-faller, non-medically treated faller, medically treated faller) and surgery periods (pre-surgery, post-first surgery, post-second surgery). Costs in the 30 days following a medically treated fall were estimated. A generalised linear model was used to investigate predictors of healthcare costs.\u0000\u0000\u0000RESULTS\u0000During the median follow-up period of 24 months, 274 participants suffered 448 falls, with 95 falls requiring medical treatment. For medically treated falls, the mean cost in the 30 days after treatment was A$3779 (95% confidence interval $2485, $5074). Higher monthly healthcare costs were associated with a higher number of medications, being of the male sex, having one or more medically treated falls and having bilateral cataract surgery. After excluding the cost of cataract surgery, there were no significant differences in healthcare costs between the pre-cataract surgery, post-first eye cataract surgery and post-second eye cataract surgery periods.\u0000\u0000\u0000CONCLUSIONS\u0000To our knowledge, this is the first study investigating publicly funded costs related to falls and cataract surgery in older people with bilateral cataract. This information enhances our understanding of healthcare costs in this group. The patterns in costs associated with falls can guide future government healthcare expenditure on falls treatment and prevention, including timely cataract surgery.","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"43 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135612126","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":"45 and Up COVID Insights: a dynamic and collaborative approach to evidence-making during the COVID-19 pandemic.","authors":"Greer Dawson,&nbsp;Kerrin Bleicher,&nbsp;Sarah Blaynes,&nbsp;Catherine D'Este,&nbsp;Julia Steinberg,&nbsp;Marianne F Weber,&nbsp;Jill Newby,&nbsp;Ding Ding,&nbsp;Bette Liu,&nbsp;Barry Edwards,&nbsp;Andrew Milat,&nbsp;Martin McNamara","doi":"10.17061/phrp32232214","DOIUrl":"https://doi.org/10.17061/phrp32232214","url":null,"abstract":"<p><strong>Objectives: </strong>In response to the coronavirus 2019 (COVID-19) pandemic, a research project was developed with a cohort of 45 and Up Study participants to generate timely, relevant evidence to guide policy, practice and planning. This paper describes the research model, the cohort establishment and characteristics, and some findings.</p><p><strong>Methods: </strong>A subgroup of 45 and Up Study participants was invited to enrol in 45 and Up COVID Insights -a series of five online surveys conducted during 2020-22. The model involved a close collaborative partnership with the New South Wales Ministry of Health and a panel of scientific advisers, an agile data collection methodology and rapid dissemination of findings. Frequent, iterative engagement with stakeholders provided a framework for identifying survey themes and questions and ensured wide dissemination of findings. Themes included healthcare use, attitudes toward and uptake of COVID-19 prevention measures, and the impact of the pandemic on mental health, loneliness, and lifestyle behaviours.</p><p><strong>Results: </strong>45 and Up COVID Insights achieved strong stakeholder engagement through extensive consultation and rapid reporting of results. The project recruited a diverse cohort of 32 115 participants: median age 68 years (range: 56-100+); 8% from outer regional/remote areas; 12% from the most socioeconomically disadvantaged communities; and 9% from culturally and linguistically diverse backgrounds. The first four surveys found that the impact of the pandemic varied across populations and stages of the pandemic. Between February-April (survey 2) 2021, 10% reported missed healthcare in the past month because of the pandemic, rising to 26% by September-November 2021 (survey 4). Quality of life remained high (>90% good-excellent across the surveys). As the pandemic progressed, the proportion reporting worsened mental health as a result increased from 29% (July-December 2020, survey 1) to 46% (survey 4). In survey 2 (February-April 2021), 89% intended to get the COVID-19 vaccine, with 8% unsure. By late 2021, vaccination uptake was high, with 98% of respondents having received at least one vaccination.</p><p><strong>Conclusion: </strong>There is great value in harnessing a large longitudinal, well-described, and diverse cohort study to generate evidence in a changing context with evolving information needs. The collaborative model enhanced the value and relevance of the data to inform decisions.</p>","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"32 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10690876","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 45 and Up Study: reflecting on contributions to global evidence using case studies on cardiovascular disease and smoking.","authors":"Ellie Paige,&nbsp;Jennifer Welsh,&nbsp;Grace Joshy,&nbsp;Marianne F Weber,&nbsp;Emily Banks","doi":"10.17061/phrp3242233","DOIUrl":"https://doi.org/10.17061/phrp3242233","url":null,"abstract":"<p><strong>Background/objective: </strong>To describe the attributes that have underscored the success of the 45 and Up Study (the Study) and demonstrate its value by reflecting on two case studies: our research on socioeconomic inequalities in cardiovascular disease; and the harms of smoking. Type of program or service: The Study is the largest study of healthy ageing in Australia, and one of the biggest in the world; it recruited 267 357 participants aged 45 years and older from NSW, Australia from 2005 to 2009. For more than 15 years, it has provided high-quality evidence on a broad range of public health related issues. We reflect on its value using two research case studies.</p><p><strong>Results: </strong>Four key attributes have enabled the success of the Study: its establishment as a collaborative resource, including early and ongoing engagement with researchers and policy and practice partners; its large scale, which makes it ideally suited to quantify associations between risk factors and health outcomes, including for high priority populations; high quality self-reported survey data; and linkage to routinely collected administrative data, including specialised data. Novel Australian findings on cardiovascular disease (CVD) and smoking illustrate how the Study has contributed to national and international evidence, informing policy and practice. Results on CVD demonstrated individual-level education-related inequalities in CVD incidence and mortality, and greater use of pharmacotherapy for secondary prevention of CVD, in people with low versus high socioeconomic status. In terms of smoking, Study data showed that current smokers have around three times the mortality of never-smokers; that even \"light\" smoking of <14 cigarettes per day doubles mortality; that quitting is beneficial at any age; that smoking increases the risk of multiple cancer types; and that smoking causes half of deaths in Aboriginal and Torres Strait Islander adults aged 45 years and over and more than one-third of all deaths in the population. This evidence has been used by more than 50 government and non-government organisations, including contributing to legislation, policy and national and international monitoring and reporting.</p><p><strong>Lessons learnt: </strong>The Study has fulfilled a vital role in public health research and practice in Australia, providing locally relevant data to enable research on health issues of importance, including health inequity. Through ongoing partnerships, the Study's data has contributed to international scientific evidence and been used to inform public health policy and practice. It has also been used as a focus for collaboration and capacity building.</p>","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"32 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10330790","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":"Reflecting on the '45 and Up Study' after 15 years: learnings, impact and future opportunities from a large-scale cohort study.","authors":"Martin McNamara,&nbsp;Karen Canfell","doi":"10.17061/phrp3242229","DOIUrl":"https://doi.org/10.17061/phrp3242229","url":null,"abstract":"","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"32 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10385698","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":"Knowledge, attitudes and practices regarding influenza vaccination among parents of infants hospitalised for acute respiratory infection in Australia.","authors":"Samantha J Carlson,&nbsp;Jocelynne McRae,&nbsp;Kerrie Wiley,&nbsp;Julie Leask,&nbsp;Kristine Macartney","doi":"10.17061/phrp32012202","DOIUrl":"https://doi.org/10.17061/phrp32012202","url":null,"abstract":"","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"32 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10751882","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":"Lessons from billed telepsychiatry in Australia during the COVID-19 pandemic: rapid adaptation to increase specialist psychiatric care.","authors":"Jeffrey Cl Looi,&nbsp;Tarun Bastiampillai,&nbsp;William Pring,&nbsp;Rebecca E Reay,&nbsp;Stephen R Kisely,&nbsp;Stephen Allison","doi":"10.17061/phrp3242238","DOIUrl":"https://doi.org/10.17061/phrp3242238","url":null,"abstract":"<p><strong>Objective: </strong>To summarise and comment upon research regarding the service delivery impact of the introduction of COVID-19 pandemic Medicare Benefits Schedule (MBS) psychiatrist telehealth services in Australia in 2020-2021. Type of program or service: Privately-billed, MBS-reimbursed, face-to-face and telehealth consultations with a specialist psychiatrist during the first year of the COVID-19 pandemic.</p><p><strong>Methods: </strong>This paper draws on analyses of previously published papers. MBS-item-consultation data were extracted for video, telephone and face-to-face consultations with a psychiatrist for April-September 2020 in Victoria, and compared to face-to-face consultations in the same period of 2019 and for all of Australia. We also extracted MBS-item-consultation data for all of Australia from April 2020-April 2021, and compared this to face-to-face consultations for April 2018-April 2019.</p><p><strong>Results: </strong>Although face-to-face consultations with psychiatrists waned following nationwide lockdowns, the introduction of MBS billing items for video and telephone telehealth meant that overall consultations were 13% higher in April 2020-April 2021, compared to the pre-pandemic year prior. A lockdown restricted to Victoria was associated with a 19% increase in consultations from April-September 2020, compared to the corresponding period in 2019.</p><p><strong>Lessons learnt: </strong>Telehealth has been an integral component of Australia's relatively successful mental health response to COVID-19. The public availability of MBS data makes it possible to accurately assess change in psychiatric practice. The Australian Federal Government subsidises MBS telepsychiatry care by a patient rebate per consultation, illustrating that government-subsidised services can rapidly provide additional care. Rapid and substantial provision of telepsychiatry in Australia indicates that it may be a useful substitute or adjunct to face-to-face care during future pandemics and natural disasters.</p>","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"32 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10330788","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 Australian moratorium on genetics and life insurance: evaluating policy compared to Parliamentary recommendations regarding genetic discrimination.","authors":"Jane Tiller,&nbsp;Paul Lacaze,&nbsp;Margaret Otlowski","doi":"10.17061/phrp3242235","DOIUrl":"https://doi.org/10.17061/phrp3242235","url":null,"abstract":"<p><p>Objectives and importance of study: Genetic discrimination is a health policy issue of international concern to clinicians, patients, researchers, and policy makers, and threatens the success of genomic medicine. In Australia, genetic discrimination in life insurance is legal and leads to public health harms, including deterring at-risk individuals from clinically indicated testing. In 2018, a Parliamentary Joint Committee recommended an urgent ban on the use of predictive genetic test results in life insurance underwriting in Australia, to be implemented in a form similar to the UK Code on genetic testing and life insurance. In 2019, the insurance industry, through the Financial Services Council (FSC), introduced a self-regulated moratorium that applies until 2024, but only to life insurance policies up to certain financial limits. The FSC moratorium will be reviewed in late 2022, but has no government oversight.</p><p><strong>Study type: </strong>Policy implementation evaluation Methods: We used policy evaluation methods to 1) summarise the key recommendations of the 2018 Parliamentary Committee that are directed towards practical aspects of policy development and content; and 2) assess the level of disparity between the implemented moratorium and the recommendations of the Committee.</p><p><strong>Results: </strong>There is a substantial disparity between the Australian moratorium and the Parliamentary Committee recommendations across key areas, including addressing self-regulation, co-development of policy, protection of tests taken during its term, and similarity with the UK Code. The FSC moratorium offers less protection to consumers than the UK Code on a number of measures, including the level of financial coverage, the involvement of government, certainty provided to individuals who have genetic testing, and the treatment of research results.</p><p><strong>Conclusions: </strong>The FSC moratorium is a step forward for Australia, but falls short of the Parliamentary recommendations. Further regulation by the Australian Government may be required to achieve the aims of the Parliamentary recommendations and ensure the intended level of consumer protection.</p>","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"32 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2022-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10338724","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}