Australian Journal of Rural Health最新文献

{"title":"Taking a Strengths-Based Approach to Mental Health in Rural Communities: What Is the Evidence for Harnessing Strengths?","authors":"Annika Luebbe,&nbsp;Sandra Diminic,&nbsp;Zoe Rutherford,&nbsp;Hannah Roovers,&nbsp;Mikesh Patel,&nbsp;Harvey Whiteford","doi":"10.1111/ajr.70061","DOIUrl":"https://doi.org/10.1111/ajr.70061","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study aimed to determine if rural community strengths identified in the literature have been causally linked to improved mental health and whether these strengths have been harnessed in interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A secondary analysis of a systematic review of literature from Australia, Canada and the USA identified 28 studies that proposed a conceptual relationship to improved mental health. Studies were categorised, their distribution across a socioecological framework was assessed, and evidence of causality was evaluated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among 28 studies, 24 were analytical and focused mainly on community strengths, with four interventional studies that addressed both personnel and community strengths. None established a causal relationship, including those that harnessed strengths in interventions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Although rural strengths have been associated with improved mental health, evidence on causality, effectiveness and mechanisms for harnessing remains limited. Strengthening the evidence base is critical to justify incorporating rural strengths into mental health commissioning.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70061","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144244628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Surgery During the Pandemic in a Public Hospital in South West Victoria, Australia: A Regional/Rural Perspective","authors":"Thomas J. Neerhut,&nbsp;Jacob Gordon,&nbsp;Margaret J. Rogers,&nbsp;Susan Brereton,&nbsp;Simon A. Williams","doi":"10.1111/ajr.70063","DOIUrl":"https://doi.org/10.1111/ajr.70063","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>In Victoria, the onset of COVID-19 resulted in restricted entry to metropolitan areas, and lockdowns were a common occurrence. Our health services adapted and changed procedures. Surgical services were limited to urgent cases, while staff were redirected to support COVID-19 health care. This study documents the experience of surgical services in a public hospital serving a rural and regional population in south-west Victoria.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Cohort study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All patients who had operations at University Hospital Geelong, the major regional hospital in south-west Victoria, were included in this study. Operations pre-pandemic (2019), during the pandemic (2020–2022) and late pandemic (2023) were recorded. The flow of procedures within each subspecialty, cancellations and the waiting list are reported.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>From July 2019 until June 2023, there were 76 098 operations performed with the largest number of operations by general surgery (17 610), plastics and reconstruction (10 560), obstetrics and gynaecology (10 848) and orthopaedics (8376). Emergency procedures peaked at 41% in 2020. Urology experienced the highest percentage increase for operations in 2023 (by 40%), followed by obstetrics and gynaecology (15%), general surgery (14%), otolaryngology (14%), orthopaedics (12%), ophthalmology (11%) and vascular surgery (9%). Staff not available was a reason for cancellation of surgery and the wait list increased by 121% in 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The wait list late pandemic far exceeds that of pre pandemic, increasing the potential to exacerbate regional/rural Victoria's limited access to care. The significant impact on various surgical specialties in regional hospitals requires refocus to ensure that the elective surgery waitlist is addressed.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144220094","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating and Expanding Rural Victorian Community Pharmacists Role in Providing Oral Healthcare","authors":"Erica Stelfox,&nbsp;Joseph Tucci,&nbsp;Virginia Dickson-Swift,&nbsp;Santosh Kumar Tadakamadla","doi":"10.1111/ajr.70059","DOIUrl":"https://doi.org/10.1111/ajr.70059","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To investigate rural pharmacists' perceptions of oral health services they provide in towns without dental practitioners and how to best expand their role.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Community pharmacists are well placed to provide oral health services in rural areas where oral health is poorer and access to dental care is limited. Pharmacists' views on oral health advice delivery and how to best expand their role in oral health need to be assessed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Participants were community pharmacists practicing in small rural towns without a dental practitioner in Victoria, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Eleven community pharmacists participated in semi-structured telephone interviews that were recorded and transcribed verbatim. Transcripts were thematically analysed using NVivo software.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Five overarching themes were derived from the data analysis, including confidence in delivering oral hygiene instructions, barriers and facilitators to providing oral health advice, recommendations for advertising and implementing oral health promotion, undergoing oral health training and recommendations for increased collaboration with dental practitioners. Pharmacists were confident in delivering basic oral hygiene instructions upon patient request. Most pharmacists were interested in verbally delivering oral health advice. Barriers identified included time constraints and operating as a single pharmacist. Pharmacists requested enhanced training, ideally online as continued professional development and support from pharmacy educational and regulatory bodies or dental practitioners to be able to expand their scope.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There is a need for additional training, resources and support for rural pharmacists to deliver this expanded role in oral health to improve oral health outcomes for rural people.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70059","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rural Health Pro—A Digital Platform Connecting Rural People, Organisations, and Communities","authors":"Robyn Ramsden,&nbsp;Sara-Jane Pappas,&nbsp;Jessica Rostas,&nbsp;Md Irteja Islam,&nbsp;Alexandra Martiniuk,&nbsp;Yann Guisard","doi":"10.1111/ajr.70050","DOIUrl":"https://doi.org/10.1111/ajr.70050","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Rural areas face persistent health disparities exacerbated by workforce shortages and the geographical isolation of health professionals. Innovative approaches are needed to mitigate professional isolation and enhance access to continuous professional development. This paper explores how health professionals perceive and utilise Rural Health Pro, analysing its potential to support professional needs, enhance capability, and improve workforce retention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore rural health professionals' experiences and perceptions of the Rural Health Pro focusing on its functionality, support for professional needs, enhancement of capability, and contribution to workforce retention.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative study utilising thematic analysis of semi-structured interviews with 12 allied health professionals working in rural practice, examining their experiences and perceptions of the utility of the Rural Health Pro platform. They are independent of the Rural Doctors Network.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Participants reported that the Rural Health Pro platform supported their capability through professional development, peer connectivity, reducing feelings of professional isolation, and leadership development. Challenges included the need for more structured support in mentoring and professional development.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Rural Health Pro facilitates resource sharing, knowledge exchange, and access to professional connectivity, enabling rural health professionals to access relevant information and support. While it enhanced users' sense of capability and reduced professional isolation, further evidence is needed to evaluate its broader impact on workforce retention and quality of care in rural health.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144206354","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Health Care and Health Information Access by Parents With Young Children in Regional Queensland","authors":"Catherine McCosker,&nbsp;Gavin Beccaria,&nbsp;Lisa Beccaria,&nbsp;Tanya Machin","doi":"10.1111/ajr.70060","DOIUrl":"https://doi.org/10.1111/ajr.70060","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The effects of childhood health, education and experiences can have long-term impacts on adult health and wellbeing. Access to health services and information can be complex especially in regional and rural areas of Australia. This research aimed to: (1) investigate how and where parents living in regional and rural Australia with young children search for health information and (2) explore how parents decide what is appropriate health information to enable them to meet the health needs of their families.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Regional and rural areas of Southern Queensland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Parents with a child under the age of 5 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A convergent mixed methods design was utilised. Parents participated in an online survey and were invited to in-depth semi-structured telephone interviews about their health information search methods. Inductive content analysis was applied to the transcripts.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The 11 interviewees searched for health information when their child was unwell, using the internet, family and friends and GPs and medical services. Websites were used for health information, whereas social media sites provided support and connection. The internet helped determine when to seek medical advice, and a preference was shown for Australian, hospital and government websites and websites recommended by GPs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The results may inform the development of targeted hospital and government websites to ensure all parents have easy access to evidence-based children's health information. GPs may also play a role in discussing internet-sourced health information with parents.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70060","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144171876","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When One Size Does not Fit All—Artificial Intelligence in Australian Rural Health","authors":"Lewis Hains,&nbsp;Joshua G. Kovoor,&nbsp;Brandon Stretton,&nbsp;Aashray K. Gupta,&nbsp;Ammar Zaka,&nbsp;Gavin Carmichael,&nbsp;John M. Kefalianos,&nbsp;Win Le Shwe Sin Ei,&nbsp;Alasdair Leslie,&nbsp;Andrew Booth,&nbsp;Shrirajh Satheakeerthy,&nbsp;Alexander Beath,&nbsp;Yasser Arafat,&nbsp;Mathew O. Jacob,&nbsp;Martin Bruening,&nbsp;Weng Onn Chan,&nbsp;Stephen Bacchi","doi":"10.1111/ajr.70037","DOIUrl":"https://doi.org/10.1111/ajr.70037","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>Artificial intelligence (AI) is having an increasing impact on many aspects of our day-to-day lives. This change is also true in healthcare, with various tools being developed to hasten burdensome administrative tasks and increase overall healthcare efficiency, particularly in metropolitan centres.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>AI has remained comparatively clear of rural, regional and remote Australian hospitals, where it has the potential to provide significant benefits. Like previous health technology implementations, rural workforce requirements for AI maintenance and support may hinder AI deployment in these areas. While AI has been implemented successfully in metropolitan areas, these models may have limited translatability to rural health settings with significantly different administrative and healthcare systems.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>AI may assist with key issues in rural centres such as resource allocation and timely patient transfer for higher level care. While the potential benefits of AI in rural centres are clear, one must consider key factors in rural centres that may limit the success of AI in these hospitals. Smaller rural populations may limit the ability to train location-specific models, and connectivity issues may impede their effective use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Specific efforts are required to realise potential benefits of medical AI for rural Australia; addressing connectivity and workforce issues in rural areas is vital to allow for AI and large language models to help benefit rural centres.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70037","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144172004","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cost Comparison From a Health Service Perspective of Three Allied Health Models of Care for Remote Australia: Student-Assisted Services, Fly-In Fly-Out Services and Services Provided by a Resident Clinician","authors":"Narelle Campbell,&nbsp;Jackie Roseleur,&nbsp;Jon Karnon,&nbsp;Chris Hince,&nbsp;Alice Cairns,&nbsp;Kylie Stothers,&nbsp;Chris Rissel","doi":"10.1111/ajr.70012","DOIUrl":"https://doi.org/10.1111/ajr.70012","url":null,"abstract":"&lt;div&gt;\u0000 \u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Objectives&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The objective of this paper is to compare the costs of an allied health student-assisted model of care with Fly-In-Fly-Out (FIFO) and resident clinician models of care from a health system perspective.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Methods&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;A descriptive cost analysis was conducted to understand the costs of an allied health student-assisted model of care. Scenarios were developed for the two remaining service models to determine their costs from a health service perspective.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Design&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;An observed and modelled costing study.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Setting&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Northern Territory, Australia.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Participants&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;Allied health professionals and students.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Main Outcome Measure(s)&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The cost of providing a student-assisted model of care from a health service perspective.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Results&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The students provided an average of 5 h of service time per client to 50 clients at a cost of $2363 per client. Three resident clinician and FIFO scenarios were modelled. The first scenario was based on time with clients across all three student cohorts. The second scenario applied the time spent with clients by the third cohort, reflecting the increase in time spent with clients as the program matured. In the third scenario, we increased the time in scenario 2 by 25% to account for the potential under-recording of client time. The resident clinician results for the three scenarios were $915, $987, and $1178, respectively. The FIFO results for the three scenarios were $1502, $1575, and $1922, respectively.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 \u0000 &lt;section&gt;\u0000 \u0000 &lt;h3&gt; Conclusions&lt;/h3&gt;\u0000 \u0000 &lt;p&gt;The student-assisted model was more expensive per client seen than the FIFO and resident clinician models, but significant intangible benefits were identified that positively impact both clients and students. These include training health professionals for remote communities in a culturally responsive model, greater cultural understanding, and increased care coordination provided by the students.&lt;/p&gt;\u0000 &lt;/section&gt;\u0000 ","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70012","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085401","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Double-Edged Sword of Translational Research: Stakeholder Perspectives of the Enablers and Challenges Implementing Anorexia Nervosa Treatment in Rural Health Settings","authors":"Ashlea Hambleton,&nbsp;Verusha Kandar,&nbsp;Jane Miskovic-Wheatley,&nbsp;Sabina Vatter,&nbsp;Daniel Le Grange,&nbsp;Stephen Touyz,&nbsp;Sarah Maguire","doi":"10.1111/ajr.70043","DOIUrl":"https://doi.org/10.1111/ajr.70043","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the translational research processes that emerged at the early phase of the implementation of telehealth-delivered family-based therapy (FBT) for young people with anorexia nervosa (AN) attending Australian rural health services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Commencing mid-2019, five rural health districts across New South Wales (NSW) participated in the study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Nine stakeholders, including study coordinators, clinicians and eating disorder coordinators, participated in a semi-structured interview during the early implementation of telehealth-delivered FBT.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Inductive thematic analysis methodology was used to identify key research factors that enabled and challenged the implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The translational research improved patient access to evidence-based care, afforded health services access to clinical expertise, workforce training and supervision and assisted with meeting government directives of improving care pathways. However, the study and intervention implementation were challenged by research-related factors, including ethical and clinical dilemmas, the burden of stakeholders holding multiple roles and general challenges associated with integrating research into non-academic health services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>To optimise implementation and to bridge the access gaps particularly felt by rural families and health settings, translational studies ought to consider the enablers and challenges identified by the stakeholders.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>ACTRN12620001107910</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70043","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergence of a New Post-Professional Allied Health Workforce to Address Complex Healthcare Needs of Rural Patients: A Qualitative Exploratory Study","authors":"Anna Moran,&nbsp;Olivia King,&nbsp;Catherine Cosgrave,&nbsp;Christina Malatzky,&nbsp;Rosalie Boyce","doi":"10.1111/ajr.70056","DOIUrl":"https://doi.org/10.1111/ajr.70056","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the nature and key functions of emerging allied health post-professional roles and to identify the contextual factors that continue to shape their development and operationalisation in rural public healthcare settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A qualitative exploratory study design utilising Ritchie and Spencer's team-based five-stage framework and Nancarrow's six principles to enhance workforce flexibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Victoria and New South Wales, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Semi-structured individual and group interviews were undertaken with allied health professionals working in post-professional roles and their managers/directors from four teams across multiple regional and rural areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Four key themes were identified, two of which related to the nature of the allied health post-professional role: (1) Allied health post-professionals meet clients ‘where they are at’ and (2) Hidden healthcare heroes. Two further themes described the factors that shape allied health post-professional roles in rural health settings: (3) Allied health post-professionals stretch and grow their skillset and the (4) Social construction of allied health post-professional roles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The post-professional workforce exemplifies the six principles of a ‘flexible workforce’ and may play a key role in addressing many system challenges that make client-centred care in rural settings difficult to achieve. However, the ongoing evolution and advancement of this workforce is limited by macro and meso-level constraints. It is thus critical that the value of post-professional roles is structurally supported through macro-level policy levers as well as at an organisational and individual profession level.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of a Hub-And-Spoke Model of Care for the Delivery of Sleep Disorder Services to a Remote Australian Community Using the RE-AIM Framework: A Controlled Before-And-After Implementation Outcome Study","authors":"Irene Szollosi,&nbsp;Sophia Worley,&nbsp;Sameera Senanayake,&nbsp;Sanjeewa Kularatna,&nbsp;Deanne Curtin","doi":"10.1111/ajr.70057","DOIUrl":"https://doi.org/10.1111/ajr.70057","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>To evaluate a Hub-and-Spoke design for providing sleep disorder services in a very remote community. The health service re-design aimed to provide unattended polysomnography at the Spoke site with access to attended laboratory studies at the Hub when clinically indicated.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Summative evaluation using the RE-AIM Framework including all adult patients referred for diagnosis and management of a suspected sleep disorder from Remote Health Service to Metropolitan Health Service 2 years pre-implementation and 1 year post-implementation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Controlled before-and-after implementation outcome study.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Public hospital in metropolitan South-East Queensland with a comprehensive accredited sleep disorder service (Hub), networked to a Community Health Centre (Spoke), located in a very remote region defined by the Modified Monash Model in central Queensland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcomes Measures</h3>\u0000 \u0000 <p>Referral numbers (Reach), travel avoidance and consumer satisfaction (Effectiveness), number of referrers (Adoption), unattended sleep study data quality, timeliness to testing, health service costs (Implementation), and referral numbers beyond initial 12-month pilot (Maintenance).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The Hub-and-Spoke model increased adoption five-fold by local referrers and resulted in a nine-fold increase in reach. Effectiveness was demonstrated through high levels of consumer satisfaction, and all implementation aims were met, including providing services at a lower cost. Sustainability was demonstrated through ongoing referrals and the transition of the model of care to business as usual.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Hub-and-Spoke designs for public sleep disorder services are effective at both the individual and organisational levels. Services can be delivered at a lower cost and, importantly, improve access to specialist services in remote and very remote communities.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 3","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144085365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}