Australian Journal of Rural Health最新文献

{"title":"Factors That Influence Digital Health Implementation in Rural, Regional, and Remote Australia: An Overview of Reviews and Recommended Strategies","authors":"Michelle A. Krahe,&nbsp;Stephanie Baker,&nbsp;Leeanna Woods,&nbsp;Sarah L. Larkins","doi":"10.1111/ajr.70045","DOIUrl":"https://doi.org/10.1111/ajr.70045","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Digital transformation can enhance health and healthcare delivery; however, its application in rural, regional, and remote (RRR) areas presents considerable, underexplored challenges. While the benefits of digital health for underserved areas are evident, we must understand and address the challenges to fully realise its impact.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To synthesise the evidence for factors influencing the implementation of digital health in RRR Australia and recommend implementation strategies to address barriers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>An overview of existing reviews was conducted to identify relevant systematic and scoping reviews. Review quality was assessed using the AMSTAR-2 tool. Barriers and enablers to implementation were mapped using the Consolidated Framework for Implementation Research (CFIR), and strategies to address barriers were identified based on the Expert Recommendations for Implementation Change (ERIC).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Three reviews met the inclusion criteria; each was focused on telehealth and remote monitoring technologies. Influencing factors were identified across five CFIR domains, encompassing 16 barrier and 12 enabler constructs. While gaps in evidence on health outcomes were noted, the benefits of implementation, such as improved access to services, reduced travel, and enhanced patient satisfaction, were highlighted. The recommended implementation strategies involved tailoring interventions to local needs, fostering local leadership and advocacy, planning and structuring implementation, and mobilising resources.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study identified key influencing factors and recommended implementation strategies to mitigate barriers. These strategies, if employed, could facilitate the successful implementation of digital health in RRR Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Trial Registration</h3>\u0000 \u0000 <p>PROSPERO CRD42024512742</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70045","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801396","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":"Why Settle for Equity?","authors":"Timothy A. Carey","doi":"10.1111/ajr.70048","DOIUrl":"https://doi.org/10.1111/ajr.70048","url":null,"abstract":"&lt;p&gt;The rurality gradient, in which health outcomes worsen the greater the distance from metropolitan locations, is well-established and enduring. This health disparity has maintained a strong hold on the attention of many politicians, policy- and other decision-makers and has been the focus of numerous policy imperatives and program and service innovations, all aiming to close the health gap. Yet, despite the best efforts of many talented and committed people, the health inequity gap remains.&lt;/p&gt;&lt;p&gt;Sometimes, when a problem is complex, intractable, even “wicked”, it can be helpful to step back and examine the construction of the concept that defines the problem. The concept in this case is health inequity or a health “gap”. Considering this gap in some detail may be instructive.&lt;/p&gt;&lt;p&gt;While there is appropriate sensitivity to “metrocentric” approaches in which programs and services are developed in metropolitan centres and then disseminated to non-metropolitan jurisdictions with little apparent regard for the importance of context, the same sensitivity does not appear to have been applied to the health inequity gap. It seems to be the case that metropolitan standards have become the default benchmark when considering health, education, and other statistics.&lt;/p&gt;&lt;p&gt;The Australian Institute of Health and Welfare [&lt;span&gt;1&lt;/span&gt;] plays an important role in providing current statistics about rural and remote health. When reporting on age, we are informed that “On average, people living in &lt;i&gt;Inner regional&lt;/i&gt; and &lt;i&gt;Outer regional&lt;/i&gt; areas are older than those in &lt;i&gt;Major cities&lt;/i&gt;.” For education, “In 2023, people aged 20-64 living in rural and remote areas were less likely than those in &lt;i&gt;Major cities&lt;/i&gt; to have completed Year 12 or a non-school qualification.” There are also numerous health statistics in which metropolitan centres are presented as the comparison standard. In terms of chronic conditions, “people living outside &lt;i&gt;Major cities&lt;/i&gt; had higher rates of arthritis, and mental and behavioural conditions, while chronic obstructive pulmonary disease was higher in &lt;i&gt;Outer regional and remote areas&lt;/i&gt; compared with &lt;i&gt;Major cities&lt;/i&gt;” [&lt;span&gt;1&lt;/span&gt;].&lt;/p&gt;&lt;p&gt;How has the narrative arisen that metropolitan standards are those to which non-metropolitan areas should aspire? Comparisons similar to those prepared by the AIHW are offered in Queensland (QLD) Health's (2022) &lt;i&gt;Rural and Remote Health &amp; Wellbeing Strategy 2022-2027&lt;/i&gt;. For example, Queenslanders living outside metropolitan areas have one to 3 years less life expectancy than metropolitan residents and, in 2020, daily smoking prevalence was higher outside major cities [&lt;span&gt;2&lt;/span&gt;]. A gap, however, necessarily has two sides. If some catastrophic city-based event were to occur so that people living in major cities started dying at a younger age, the life expectancy gap would close. Conversely, if the gap was flipped so that, due to a series of fortunate events, country pe","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70048","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143801540","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":"Reframing Nurse Education in Rural Australia: Implications for Advancing Longitudinal Integrated Placements","authors":"Debra Jones,&nbsp;Giti Haddadan,&nbsp;Moira Dunsmore,&nbsp;Anna Williams,&nbsp;Danielle White,&nbsp;Jackie Hanniver,&nbsp;Corey Sclater,&nbsp;Tracy Robinson,&nbsp;Sue Randall","doi":"10.1111/ajr.70041","DOIUrl":"https://doi.org/10.1111/ajr.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To explore the experiences of final-year pre-registration nursing students undertaking a longitudinal integrated placement in rural Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>Rural primary health care settings in far west NSW and northwest Victoria, Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Thirteen final year pre-registration nursing students comprised two pilot cohorts undertaking the placement in semester one (<i>n</i> = 7) and two (<i>n</i> = 6) of 2022.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A descriptive qualitative study design using semi-structured individual interviews with transcripts analysed using reflexive thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three themes were generated from the data: Experiencing comprehensive care, Making connections and Engaging with complexity. The subtheme of rural curriculum is described for each theme.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Findings highlight the importance of longitudinal integrated placements for student nurse exposure to comprehensive care, mitigating previous experiences of episodic and fragmented care associated with short duration placements across multiple settings. Placement duration enabled students to establish connections with their peers, health care teams, and the communities in which placements were undertaken. Student exposure to complexity-informed practice extended their capacity to interpret and respond to the broader inequities experienced and complexity as it relates to nursing practice in rural contexts. There is an imperative to reframe Australia's commitments to national nursing workforce policy, curriculum and clinical education to transform nursing education and maximise the full potential of our nursing workforce. These reforms must include consideration for the design, implementation, and scalability of rurally embedded longitudinal integrated placements, informed by rural curriculum, to enable the development of a competent future rural nursing workforce to address critical workforce shortages.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70041","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143793299","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":"Investigating the Prevalence and Level of Pain Experienced by Australian Farmers","authors":"Indika Koralegedera,&nbsp;Gemma Skaczkowski,&nbsp;G. Lorimer Moseley,&nbsp;Kate M. Gunn","doi":"10.1111/ajr.70039","DOIUrl":"https://doi.org/10.1111/ajr.70039","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objectives</h3>\u0000 \u0000 <p>This study evaluated the prevalence and level of pain in Australian farmers and how these compare to the general working population. We also explored factors related to the interference of pain on farmers' work.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Logistic regressions were used to examine the prevalence of chronic pain and pain interference with normal work among farmers compared to the general working population, and also to examine the factors associated with pain interference in farmers. A multinomial logistic regression model was used to examine the level of bodily pain among farmers compared to the general working population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>The nationally representative HILDA (Household, Income, and Labour Dynamics Australia) survey data (wave 21) was used.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>The final sample included 168 (1.6%) farmers and 10 318 (98.4%) people in the general working population.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There was a higher prevalence of chronic pain (<i>p</i> &lt; 0.001), higher levels of bodily pain (<i>p</i> &lt; 0.001), and pain interference with normal work (<i>p</i> &lt; 0.001) in farmers than in the general working population. Age, gender, Body Mass Index (BMI), education level, remoteness, and personal social cohesion were not associated with pain interference with normal work in farmers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>The prevalence of chronic pain, level of bodily pain, and pain interference with normal work in Australian farmers is higher than the general working population. However, information is lacking on the factors that influence pain for this unique group. Further exploration is needed into why factors that are commonly associated with pain are not associated with pain in the farming population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70039","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143778120","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":"Telehealth and Collaboratively Delivered Dialectical Behaviour Therapy: An Opportunity for Increasing Access to Effective Treatment for People With Borderline Personality Disorder Living in Rural Areas","authors":"Carla J. Walton,&nbsp;Sharleen Gonzalez,&nbsp;Anna Dunbar,&nbsp;Katie McGill","doi":"10.1111/ajr.70036","DOIUrl":"https://doi.org/10.1111/ajr.70036","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>The aim of this commentary is to consider how telehealth and a collaborative model of service delivery may offer a way of making Dialectical Behaviour Therapy available in rural areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Dialectical Behaviour Therapy (DBT) is an effective treatment for Borderline Personality Disorder (BPD). However, there are many barriers to making this sort of therapy available within routine care, particularly in rural areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>This commentary provides a summary of the literature relevant to the role that telehealth could play in increasing access to DBT. A new model of care could utilise telehealth services to deliver comprehensive DBT treatment to people with BPD living in rural areas in partnership with community mental health services.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Telehealth and collaborative models of Dialectical Behaviour Therapy delivery should be further investigated, especially to meet the needs of rural mental health care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70036","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143761913","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":"Reducing Health Inequity for Children and Young People in Rural Australia: Are Digital Interventions a Panacea? A Rural Generalist's Commentary","authors":"Corin Miller,&nbsp;Hayley Smithers-Sheedy,&nbsp;Nan Hu,&nbsp;David Schmidt,&nbsp;Annemarie Christie,&nbsp;Tammy Morris,&nbsp;Lena Sanci,&nbsp;Raghu Lingam","doi":"10.1111/ajr.70015","DOIUrl":"https://doi.org/10.1111/ajr.70015","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Aims</h3>\u0000 \u0000 <p>To explore the role of digital interventions in improving health equity for children and young people (CYP) in rural Australia from a rural generalist's perspective.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Rural Australian CYP experience worse health outcomes than their urban peers and have insufficient access to early intervention and support. Rural paediatric outpatient waiting times as long as 6 years have been reported, with some regions having no services. Digital interventions have expanded since the COVID pandemic, providing new opportunities to improve quality and access to care for CYP in rural settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>Here we provide a synthesis of the literature and health policy, from the perspective of a clinician working in rural Australian paediatric care, to describe the role and limitations of digital interventions to support CYP in rural areas.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Digital interventions such as telephone and video consultations, online tools, child-friendly robot ward rounds, and digital GP-paediatrician co-consulting models show great promise in helping to bridge the gap in health outcomes for rural Australian CYP. Models of care that utilise digital components can provide care closer to home for rural families; however, research to evaluate the effectiveness of these models in the Australian context is lacking. Infrastructure challenges, cultural considerations, and patient preferences limit the utility of digital interventions for some populations. A panacea? Unfortunately, not; however, these technologies herald an exciting new phase in healthcare for rural Australian CYP, and digital interventions are likely to play an increasingly important role in increasing access to care for this population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143717128","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":"Community Warriors: Development and Validation of a Social and Emotional Well-Being Tool for Aboriginal and Torres Strait Islander Children and Youth","authors":"Gustavo Hermes Soares,&nbsp;Pedro Henrique Ribeiro Santiago,&nbsp;Brianna Poirier,&nbsp;Sneha Sethi,&nbsp;Dandara Haag,&nbsp;Madison Cachagee,&nbsp;Emma Flanagan,&nbsp;Yvonne Cadet-James,&nbsp;Joanne Hedges,&nbsp;Lisa Jamieson","doi":"10.1111/ajr.70035","DOIUrl":"https://doi.org/10.1111/ajr.70035","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>To develop and validate two age-specific, strength-based measures of social and emotional well-being (SEWB) for Aboriginal and Torres Strait Islander children and youth.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following development of a conceptual framework comprising six domains of SEWB and identification of existing SEWB tools, an iterative process of item refinement took place. Items were assigned to corresponding SEWB domains, and their content validity and face validity were examined. Community-Controlled Health Services provided expert feedback. Statistical analyses were conducted to assess floor and ceiling effects, item redundancy, network structure, item stability, model fit and reliability. An ant colony optimisation (ACO) algorithm was employed to identify a reduced number of items with adequate model fit.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>Data on SEWB were generated as part of the baseline assessment for a national study involving Aboriginal and Torres Strait Islander Communities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>11 Aboriginal and Torres Strait Islander Communities from six states and territories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Aboriginal and Torres Strait Islander children and youth aged 2–18 years.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Network structure, item stability, model fit and reliability and reduced scales.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Different sets of items were developed to accommodate the needs of different age groups. A total of 235 participants and 162 guardians answered the self-report and the carer-report tool, respectively. A unidimensional structure was identified for both scales. Adequate item stability, model fit and reliability were obtained.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The short versions of the SEWB tools offer a friendly, age-appropriate and time-efficient approach while capturing all relevant domains of SEWB.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70035","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143707371","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":"Allied Health Student-Led Clinics: An Opportunity for Workforce Development","authors":"Taegen Pascoe,&nbsp;Asmita Mudholkar,&nbsp;Stephanie Burke,&nbsp;Kehinde Obamiro,&nbsp;Ines Zuchowski","doi":"10.1111/ajr.70034","DOIUrl":"https://doi.org/10.1111/ajr.70034","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>The project evaluated multidisciplinary allied health student placements co-located within a rural general practice clinic.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Occupational therapy, social work and speech pathology placement students under discipline-specific supervision led an allied health clinic model servicing clients with diverse health needs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A cross-sectional survey design recording interventions, student and stakeholder experiences and client satisfaction was applied.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>General Practice clinics in MMM 4–6 regions in Queensland.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Participants</h3>\u0000 \u0000 <p>Between February and July 2024, 10 students completed placements within the student-led clinic, working with clients.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcomes Measure</h3>\u0000 \u0000 <p>Descriptive statistics were used to summarise clients' demographics, satisfaction and the services provided using SPSS version 29.0. Qualitative survey responses were analysed using Nvivo.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Student-led allied health services co-located within a general practice clinic benefited rural communities by providing increased access to allied health services and a holistic approach to health care. Student-led allied health services alleviated the work burden for general practitioners (GPs) in a rural health care setting.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Multidisciplinary allied health student placements within a rural GP clinic benefited rural and remote communities through increased access to allied health services. Further research is needed to investigate interdisciplinary models of care and sustainable funding streams.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70034","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143699007","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":"Barriers and Facilitators of Digital Mental Health Use in Regional, Rural, and Remote Australia: A Comparison of Clinician and Consumer Perspectives","authors":"Jenny T. Le,&nbsp;Alison E. J. Mahoney,&nbsp;Jay L. Court,&nbsp;Christine T. Shiner","doi":"10.1111/ajr.70011","DOIUrl":"https://doi.org/10.1111/ajr.70011","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Consumers living in regional, rural, and remote areas of Australia face significant barriers to accessing mental healthcare. Digital mental health interventions (DMHIs) are a promising avenue to improve access to mental health treatment in these areas, but uptake has yet to reach its full potential.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study evaluated the perceived barriers and facilitators of engagement with DMHIs for clinicians and consumers in regional, rural, and remote Australia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods, Design, and Participants</h3>\u0000 \u0000 <p>We surveyed consumers (<i>n</i> = 896) and clinicians (<i>n</i> = 104) using cross-sectional surveys to examine perceived barriers and facilitators of DMHI use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Setting</h3>\u0000 \u0000 <p>This study was conducted within the context of an established digital mental health service, THIS WAY UP.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Survey responses were mapped onto the Capability, Opportunity, Motivation, Behaviour (COM-B) model, and quantitative analyses of response frequencies partitioned the influence of each factor on engagement with DMHIs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Clinicians and consumers familiar with DMHIs reported barriers that spanned capability, opportunity, and motivation domains. Lack of consumer motivation was the most frequent barrier perceived by clinicians (51%) and reported by consumers (27%). Consumers valued many accessibility benefits of DMHIs and frequently endorsed the importance of clinicians in facilitating their use of DMHIs by supporting knowledge and motivation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>DMHIs have the potential to alleviate service-related barriers to mental healthcare in regional/remote areas, and successful implementation must consider both clinician and consumer perspectives. Our findings underscore several capability, opportunity, and motivational targets for improving consumer and clinician engagement with DMHI in these areas.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70011","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689913","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":"Changes in Mental and Physical Health Outcomes Following One Day a Week Cardiopulmonary Rehabilitation in Regional New South Wales","authors":"Nnamdi Mgbemena,&nbsp;Jane Thompson,&nbsp;Uchechukwu Levi Osuagwu","doi":"10.1111/ajr.70033","DOIUrl":"https://doi.org/10.1111/ajr.70033","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Cardiopulmonary rehabilitation participation rates in regional Australia remain poor, with outcomes further worsened by the limited number of cardiopulmonary rehabilitation professionals in these settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Objective</h3>\u0000 \u0000 <p>This study investigated the role of cardiopulmonary rehabilitation in improving physical and mental health outcomes of participants with heart or lung diseases in a regional NSW centre.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Design</h3>\u0000 \u0000 <p>A retrospective study of adults who attended a 1-h session per week cardiac or pulmonary rehabilitation programme at Bathurst Hospital between January 2021 and December 2023.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Main Outcome Measures</h3>\u0000 \u0000 <p>Pre- and post-rehabilitation assessments were conducted, which included heart rate, blood pressure, oxygen saturation, waist circumference, rating of perceived exertion, 5-sit-to-stand test (5-STS), 6-min walk test (6MWT), and the patient health questionnaire-9 for assessment of depression (PHQ-9 score ≥ 10 = major depression).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Data for eligible participants (<i>n</i> = 186, mostly males 57.5%), aged 69 ± 12 years, were analysed. There were statistically significant improvements (pre vs. post) in mean PHQ-9 scores (6.3 vs. 4.2, <i>p</i> &lt; 0.001), 5-STS (15.8 vs. 12.5 s, <i>p</i> &lt; 0.001), 6MWT (328.6 vs. 377.9 m, <i>p</i> &lt; 0.001) and waist circumference (104.7 vs. 103.9 cm, <i>p</i> &lt; 0.03) post-rehabilitation. Compared with pre-rehabilitation measures, the overall proportion with major depression was significantly lower by 50% (25.3% vs. 12.4%, <i>p</i> &lt; 0.05) post-rehabilitation. This decrease was significant for the cardiac (11.6% decrease) and pulmonary (15.4% decrease) rehabilitation participants.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Despite the limiting structure of one session per week for the cardiopulmonary rehabilitation programme at this regional centre, participants showed significant improvements in their mental and physical health at the end of the programme. Funding such organic programmes will yield a greater positive impact on the health of people in this region.</p>\u0000 </section>\u0000 </div>","PeriodicalId":55421,"journal":{"name":"Australian Journal of Rural Health","volume":"33 2","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/ajr.70033","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689676","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}