Public Health Research & Practice最新文献

{"title":"A participatory system map of the adverse influence of urban environments on population health: integrating urban development and preventive health expertise.","authors":"Jason Prior, Rupert Legg, Erica McIntyre","doi":"10.17061/phrp3342335","DOIUrl":"https://doi.org/10.17061/phrp3342335","url":null,"abstract":"OBJECTIVES\u0000A growing number of urban development and public health professionals are developing expertise in how urban environments influence population health to support preventive health (PH) planning, implementation and outcomes. This study aimed to address the growing interest among these experts in Sydney, Australia, to move beyond silo-based approaches to PH planning and urban development by developing a preliminary mapping of the complex adaptive system. This is a network of agents and parts that collectively relate and interact, where they seek to intervene by meshing the disparate knowledge of their multidisciplinary expertise. This mapping will help experts to better integrate PH approaches by linking primordial and primary prevention within urban environments, collectively prioritising areas for intervention within the complex adaptive system, and developing a better understanding of relations between multiple factors at play within it.\u0000\u0000\u0000METHODS\u0000The system map was developed using a unique participatory system-mapping (PSM) process involving a modified Delphi technique consisting of three rounds between October 2019 and August 2020 and 15 urban development and public health experts engaged in PH in Sydney's urban environment.\u0000\u0000\u0000RESULTS\u0000The final system map encompassed features of the local environment, determinants of health and wellbeing in urban environments, pre-clinical health and wellbeing impacts, and clinical health outcomes, providing a comprehensive map of the adverse effects of urban environments on population health. There was a high level of agreement among experts on the final system map. While experts from different disciplines generally agreed on priority areas for intervention, consensus was higher among those from similar disciplinary backgrounds.\u0000\u0000\u0000CONCLUSIONS\u0000The study highlights how the collective intelligence of experts from diverse disciplines can generate PSM. Furthermore, it illustrates how using systems mapping can help experts interested in complex public health problems to take a broader view of the complex adaptive system for PH planning, support collaborative prioritisation, and offer valuable insights for targeted interventions.","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"64 43","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138594896","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":"Heat illness presentations to emergency departments in Western Sydney: surveillance for environmental, personal and behavioural risk factors.","authors":"Stephen J Conaty, Sayontonee Ghosh, Khizar Ashraf, Karin H Taylor, George Truman, Helen Noonan, Mithilesh Dronavalli, Bin Jalaludin","doi":"10.17061/phrp3342331","DOIUrl":"https://doi.org/10.17061/phrp3342331","url":null,"abstract":"OBJECTIVE\u0000To pilot surveillance to describe environmental, personal and behavioural risk factors for people presenting to hospital emergency departments (EDs) with heat illness.\u0000\u0000\u0000METHODS\u0000We conducted a retrospective case series and telephone interview study of people presenting to EDs across South Western Sydney, Western Sydney and Nepean Blue Mountains Local Health Districts with heat illness over the 2017/18 and 2018/19 summer periods (1 December to 28 February). We used the Public Health Rapid Emergency Disease Syndromic Surveillance (PHREDSS) 'heat problems' syndrome to identify people with heat illness and medical records to find contact details. We developed a detailed questionnaire instrument to guide the telephone interview.\u0000\u0000\u0000RESULTS\u0000A total of 129 individuals presented with 'heat problems' (57 in 2017/18 and 72 in 2018/19). The median age was 44 years (range 1-89 years). Most attended hospitals via the NSW Ambulance Service (58%) or private car (40%). Of the total, 53% were classified as triage category 3 (potentially life-threatening), 27% as category 4 (potentially serious) and 16% as category 2 (imminently life-threatening). The main supplementary codes were heat exhaustion (35%), heat syncope (39%), and heat stroke (30%). The majority were discharged from the emergency department after completing treatment (73%), with 21% requiring admission. A total of 38 follow-up interviews were completed (29% response rate). Almost all individuals were exposed to heat outside their home environment: 11 (29%) were engaged in paid work, 5 (13%) in outdoor housework, and 10 (26%) in outdoor recreational activities.\u0000\u0000\u0000CONCLUSION\u0000Our pilot surveillance study successfully collected home, local environment and behavioural risk factors on a small cohort presenting with 'heat problems' to EDs in Western Sydney during the summer months. Most were exposed to heat outdoors while engaged in work or recreation outside the home, and were preventable.","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"60 6","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138597308","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":"Urban environmental exposures during the first 2000 days of life as a foundation for health across the life-course: a scoping review.","authors":"Erica McIntyre, Jason Prior, Christine Catling, Rupert Legg, Dwan Vilcins, Jane Frawley, Clare Perry, Amanda Henry, Christina Rojas, Valsamma Eapen","doi":"10.17061/phrp3342334","DOIUrl":"10.17061/phrp3342334","url":null,"abstract":"<p><strong>Objectives: </strong>By 2030, 60% of the global population is expected to live in urban areas. Exposure to urban environments during the first 2000 days of life can have positive or negative health outcomes across the life course. Understanding the types of urban exposures that influence health outcomes is needed to guide research priorities for public health and urban planning. This review aims to summarise the published research examining the health outcomes of all urban environmental exposures during the first 2000 days of life, identify the quantity and characteristics of research in this area, methods used, and knowledge gaps.</p><p><strong>Methods: </strong>We conducted a scoping review using the JBI methodology for scoping reviews. Eight databases were searched for peer-reviewed primary studies. Inclusion criteria were studies that measured maternal, infant and child exposure to everyday urban environment features and conditions in cities/metropolitan areas during the first 2000 days of life and reported offspring health outcomes across the life course, including embryo, fetal/newborn, infant, child, adolescent, and adult outcomes. We used Covidence software for data screening and extraction. Study characteristics and findings were summarised using tables and narrative synthesis.</p><p><strong>Results: </strong>We reviewed 235 articles, which included studies conducted across 41 countries, the majority in the US (n = 63). A broad range of environmental exposures were studied, spanning seven categories: air pollution; energy-based pollution; atmosphere, chemical and metal exposure; neighbourhood-built and natural environment features; neighbourhood community conditions; and residential living conditions. Air pollution was the most studied exposure type (n = 153 studies). Health outcomes were reported for all life stages except adults, with fetal/newborn outcomes the most studied life stage (n = 137).</p><p><strong>Conclusions: </strong>We found that most research investigating urban environmental exposures in the first 2000 days and health outcomes across the life course focused on air pollution exposures and fetal/newborn health outcomes, using correlational retrospective cohort designs. Few studies included multiple environmental exposures. There is a clear need for more longitudinal research to determine the health impacts of multiple urban environmental exposures across the life course. This will assist in developing urban design and planning strategies and population health to mitigate health risks across the life course.</p>","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"33 4","pages":""},"PeriodicalIF":2.5,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488749","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":"Assessing tenant health amid social housing redevelopment: lessons from a pilot project.","authors":"Christopher M Standen, Erica McIntyre, Hazel Easthope, Jennifer Green, Fiona Haigh","doi":"10.17061/phrp3342337","DOIUrl":"10.17061/phrp3342337","url":null,"abstract":"<p><strong>Objectives: </strong>To trial methods for a future longitudinal study to: a) assess how the redevelopment of a large social housing estate affects the health of tenants; and b) act on health needs identified throughout the redevelopment. Type of program or service: Self-reported health assessment with referral to community-based link worker.</p><p><strong>Methods: </strong>Participants recruited from the tenant population completed (online or face-to-face) a health questionnaire covering self-reported health status and behaviours, housing conditions, sense of community, and demographics. Those identified as being at moderate/high risk of psychological distress and/or alcohol use disorder were contacted by a community-based link worker, who connected them with health/human services as appropriate.</p><p><strong>Results: </strong>A total of 24 tenants were recruited for the pilot study against a target sample size of 50. The health questionnaire and referral process worked as expected, with no issues reported.</p><p><strong>Lessons learnt: </strong>This pilot study successfully trialled methods for: a) assessing tenants' health; and b) referring those identified as being likely to have unmet health service needs to a community-based link worker, leveraging existing collaborations between academics, the local health district and community groups. Fewer tenants than expected, and none aged younger than 35 years, participated in the survey. Furthermore, the substantial number of suspicious/fraudulent responses was not anticipated. Recruitment and data collection approaches must be reviewed to address these issues if this study is to be scaled up. Although only a pilot project, we connected several tenants who had unmet health needs with a health service. While it is impossible to generalise from our small sample, the number of referrals (one-quarter of participants) indicates a potentially large unmet need for health services in the community. It highlights the importance of link workers or other person-centred integrated care interventions in social housing populations.</p>","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"33 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488733","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":"Developing a climate change inequality health impact assessment for health services.","authors":"Fiona Haigh, Alana Crimeen, Liz Green, Holger Moeller, Stephen J Conaty, Jason H Prior, Ben Harris-Roxas","doi":"10.17061/phrp3342336","DOIUrl":"10.17061/phrp3342336","url":null,"abstract":"<p><strong>Objectives: </strong>To develop a Climate Change Inequality Health Impact Assessment (CCIHIA) framework for health services; to provide a systematic process for assessing potential unequal health impacts of climate change on vulnerable and marginalised populations and places; to support effective planning to address these impacts; and to develop contextually appropriate local strategies. Type of program: A collaborative interdisciplinary scoping research project involving two universities and two local health districts (LHDs) in New South Wales (NSW) to develop a CCIHIA framework. This work builds upon the health impact assessment (HIA) approach, which systematically assesses proposals' potential health and equity impacts by involving stakeholders in developing responses.</p><p><strong>Methods: </strong>The project involved four main activities: understanding stakeholder requirements; conceptualising climate change vulnerability; considering the role of health services; and integrating findings into a conceptual framework.</p><p><strong>Results: </strong>Stakeholders identified key functions that should be addressed across the framing, process and utility of the CCIHIA framework. The resulting conceptual framework outlines contexts and social stratification, the differential impacts of climate change (including factors influencing unequal impacts) and the health system's position, and also identifies key potential points of intervention.</p><p><strong>Lessons learnt: </strong>The challenge of addressing the complexity of factors and resulting health impacts is reflected within the CCIHIA framework. While there are many intervention points within this framework for health services to address, many factors influencing unequal impacts are created outside the health sector's direct control. The framework's development process reflected the focus on collaboration and the interdisciplinary nature of climate change response. Ultimately, the CCIHIA framework is an assessment tool and an approach for prioritising inclusive, cross-cutting, multisector working, and problem-solving.</p>","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"33 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488734","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 impact of community-based food access strategies in high-income countries: a systematic review of randomised controlled trials.","authors":"Sandra Marjanovic, Katherine Kent, Nicky Morrison, Jason Wu, Catharine Fleming, Kathy Trieu, Kate McBride, David Simmons, Uchechukwu Osuagwu, Freya MacMillan","doi":"10.17061/phrp3342333","DOIUrl":"10.17061/phrp3342333","url":null,"abstract":"<p><strong>Objectives: </strong>Some geographic regions in high-income countries (HIC), including Australia, have poor healthy food access and a high burden of diet-related chronic disease. Scalable and sustainable strategies to strengthen community food systems have the potential to address these inequities. To inform future interventions in regions with poor healthy food access in Sydney, Australia, and beyond, we systematically reviewed randomised controlled trials of community-based food access interventions in HIC, to identify effects on dietary behaviours and health outcomes.</p><p><strong>Methods: </strong>Four electronic databases were searched. Studies involving community-based healthy food access strategies (solely or combined with education/behaviour change) and measuring effects on dietary behaviours and/or health outcomes were identified. Data on dietary behaviours, health outcomes and intervention descriptions were extracted, and the risk of bias was assessed.</p><p><strong>Results: </strong>Seven studies met inclusion criteria, with most conducted in the US (n = 6). Intervention strategies included food pantry-based interventions (n = 2), mobile produce markets (n = 2) and community farms (n = 3). Most interventions (n = 6, 85%) incorporated educational and/or behavioural change aspects. All studies measured fruit and vegetable (F&V) intake, with nearly all (n =6, 85%) reporting significant beneficial effects.</p><p><strong>Conclusion: </strong>Preliminary evidence in our synthesis demonstrates that multicomponent community-based food system interventions promise to improve F&V intake in regions of HICs. Recommendations for improving future evaluations are identified to build evidence for policymakers and urban planners to enact upstream and downstream strategies to strengthen community healthy food, particularly in geographic regions with the greatest health inequities.</p>","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"33 4","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488736","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":"Community engagement programs on radiation and health: addressing public concerns.","authors":"Christopher Brzozek,&nbsp;Ken Karipidis","doi":"10.17061/phrpp3332325","DOIUrl":"https://doi.org/10.17061/phrpp3332325","url":null,"abstract":"<p><strong>Objective: </strong>Due to the negative connotations around radiation, there is a great deal of angst in the community regarding radiation exposure and health; especially electromagnetic radiation (EMR) sources such as powerlines, mobile phone towers and the rollout of the 5G network. As such, it is important for health authorities to provide the public with information and assurances regarding radiation safety. The Australian Radiation Protection and Nuclear Safety Agency (ARPANSA) set up community engagement programs to address community concerns. Type of program or service: From 2003 until April 2022, ARPANSA operated a Health Complaints Register, which collected reports of health complaints from members of the public related to possible EMR exposures.</p><p><strong>Methods: </strong>Collected data was used to produce annual statistical summaries on the nature and level of complaints received. Since 2016, ARPANSA has also run the Talk to a Scientist program, which allows the public to communicate directly with scientists on issues about radiation exposure, health and protection in Australia. Data is collected on the type of radiation and radiation source.</p><p><strong>Results: </strong>There was a low level of interest in the Register, with only 180 reports received over the duration of its operation. Smart meters were the most common source of EMR exposure reported to be responsible for adverse health effects. The most common adverse health effect reported was headaches. The Register was closed in April 2022 due to a lack of interest. In contrast, the Talk to a Scientist program has responded to 6546 enquiries since 2016, most of which have been on EMR sources and the success of the Talk to a Scientist program, which rendered the Register obsolete.</p><p><strong>Lessons learnt: </strong>The EMR Health Complaints Register never received much interest from the public, potentially due to a perceived lack of engagement with authorities. The Talk to a Scientist program, which facilitated direct interaction with subject matter experts, has been much more successful in engaging with the public and addressing community concerns on radiation safety.</p>","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"33 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10229876","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":"Enhanced self-harm presentation reporting using additional ICD-10 codes and free text in NSW emergency departments.","authors":"Grant E Sara,&nbsp;Jianyun Wu","doi":"10.17061/phrp33012303","DOIUrl":"https://doi.org/10.17061/phrp33012303","url":null,"abstract":"<p><strong>Objectives: </strong>Understanding and responding to emergency department (ED) presentations for suicide and self-harm is a major health system priority. Reporting using routinely collected ED diagnoses or presenting problem codes leads to significant underestimation of rates. We aimed to implement an enhanced method for reporting ED self-harm presentations in New South Wales (NSW), Australia.</p><p><strong>Methods: </strong>An enhanced method was developed based on a literature review and clinical consultation. For NSW ED data collection records from 2005-2020, presenting problem codes were mapped to International Classification of Diseases version 10 (ICD-10). Self-harm codes (ICD-10 X60-84, Y87.0) were combined with additional codes for poisoning with medications commonly used in overdose and automated keyword searching of presenting problem text. Enhanced ED diagnoses were validated against hospital diagnoses for presentations resulting in hospital admission.</p><p><strong>Results & discussion: </strong>Core ICD-10 self-harm codes identified 21 797 suicide and self-harm-related presentations per year to NSW EDs, of which 79% were for suicide-related ideation (R45.81). The enhanced method increased estimated annual presentations to 51 822 and increased sensitivity for suicide-related behaviours from 12.2% to 73.9%, while retaining high specificity (99.4%). Results matched known demographics of ED self-harm, and revised estimates were consistent with population rates reported by other jurisdictions. Service feedback and data sharing during the coronavirus disease 2019 (COVID-19) pandemic suggest that estimates from the enhanced method are plausible and sensitive to change.</p><p><strong>Conclusions: </strong>In NSW ED data, standard presenting problem codes recorded by clinicians detect less than half of presentations for self-harm or suicidal ideas. An enhanced method using additional codes and free text searching is computationally simple and increases sensitivity for monitoring trends and service performance. The method will continue to be refined as new data items become available.</p>","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"33 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10227981","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":"Testing campaign slogans designed to motivate older people to be more physically active.","authors":"Simone Pettigrew,&nbsp;Michelle I Jongenelis,&nbsp;Liyuwork M Dana,&nbsp;Rajni Rai,&nbsp;Ben Jackson,&nbsp;Robert U Newton","doi":"10.17061/phrpp3332323","DOIUrl":"https://doi.org/10.17061/phrpp3332323","url":null,"abstract":"<p><p>Objectives and importance of study: Being physically active is critical for healthy ageing, yet many older people do not meet physical activity guidelines. The aim of this study was to test the relative effectiveness of five previously identified campaign slogans designed to encourage older people to be more physically active: 'Be active 30-60 minutes a day to stay fit and well'; 'Move more, live longer'; 'Stay fit to stay functional'; 'This is your time - enjoy being strong and active'; and 'Use it or lose it'.</p><p><strong>Study type: </strong>Online experiment Methods: A total of 1200 Australians aged 50 years and older (50% female, mean age 65 years) were recruited to complete an online survey, with respondents randomised to answer a series of questions on a video featuring one of the five slogan conditions. One-way ANOVAs with Tukey's post-hoc tests were used to identify differences in outcomes between slogans.</p><p><strong>Results: </strong>Overall, the slogans were assessed favourably, suggesting older adults may be receptive to messages about increasing their physical activity. 'Use it or lose it 'performed best across the outcome measures of internal and external motivation, perceived effectiveness, liking, believability, and personal relevance.</p><p><strong>Conclusion: </strong>Efforts to encourage physical activity among older Australians could use the slogan 'Use it or lose it' as an evidence-based tagline.</p>","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"33 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10596774","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 delivery of safe and effective test result communication, management and follow-up.","authors":"Andrew Georgiou,&nbsp;Julie Li,&nbsp;Judith Thomas,&nbsp;Rita Horvath,&nbsp;Robert Lindeman,&nbsp;Johanna Westbrook","doi":"10.17061/phrpp3332324","DOIUrl":"https://doi.org/10.17061/phrpp3332324","url":null,"abstract":"<p><strong>Objectives: </strong>This paper reports on a program of research funded by a National Health and Medical Research Council (NHRMC) partnership grant (2015-2021) entitled \"Delivering safe and effective test result communication, management and follow-up\". The project's objectives were to: 1) improve the effectiveness and safety of test-result management through the establishment of clear governance processes of communication, responsibility, and accountability; 2) harness health information technology to inform and monitor test-result management; and 3) enhance consumer contribution to the establishment of safe and effective test-result management systems. Type of program: The partnership project addressed its key objectives through: i) the development of a consumer-driven approach; ii) using diagnostic stewardship and digital health to enhance safety and quality; iii) identifying clinical workflows that can lead to timely and meaningful communication; and iv) contributing to the Royal College of Pathologists of Australasia and Australasian Association for Clinical Biochemistry and Laboratory Medicine's work on nationally harmonised alert thresholds for critical laboratory results.</p><p><strong>Methods: </strong>The project employed a convergent mixed-methods approach using multistage studies across hospitals in South Eastern Sydney and Illawarra and Shoalhaven Local Health Districts. A consumer-centred approach, including patient reference groups and community forums, was used to identify mechanisms to enhance consumers' role in test-management governance processes and inform the direction of the research and interpretation of findings. Results and lessons learnt: The body of evidence generated by the project highlights the multilayered and interconnected components required to achieve safe and effective test results management. Addressing the significant patient safety risk associated with the failure to follow-up test results must include consideration of diagnostic clinical work tasks (involving multiple people across numerous clinical settings) and embrace patient-centred and digital health strategies for shared information and timely and meaningful communication.</p>","PeriodicalId":45898,"journal":{"name":"Public Health Research & Practice","volume":"33 3","pages":""},"PeriodicalIF":4.4,"publicationDate":"2023-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10229875","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}