BackgroundNon-communicable chronic diseases in Australia contribute to approximately 85% of the total burden of disease; this proportion is greater for Aboriginal communities. The Get Healthy Service (GHS) is effective at reducing lifestyle-based chronic disease risk factors among adults and was enhanced to facilitate accessibility and ensure Aboriginal cultural appropriateness. The purpose of this study is to detail how formative research with Aboriginal communities was applied to guide the development and refinement of the GHS and referral pathways; and to assess the reach and impact of the GHS (and the Aboriginal specific program) on the lifestyle risk factors of Aboriginal participants.MethodsFormative research included interviews with Aboriginal participants, leaders and community members, healthcare professionals and service providers to examine acceptability of the GHS; and contributed to the redesign of the GHS Aboriginal program. A quantitative analysis employing a pre-post evaluation design examined anthropometric measures, physical activity and fruit and vegetable consumption of Aboriginal participants using descriptive and chi square analyses, t-tests and Wilcoxon signed-rank tests.ResultsWhilst feedback from the formative research was positive, Aboriginal people identified areas for service enhancement, including improving program content, delivery and service promotion as well as ensuring culturally appropriate referral pathways. Once these changes were implemented, the proportion of Aboriginal participants increased significantly (3.2 to 6.4%). There were significant improvements across a number of risk factors assessed after six months (average weight loss: 3.3 kg and waist circumference reduction: 6.2 cm) for Aboriginal participants completing the program.ConclusionsWorking in partnership with Aboriginal people, Elders, communities and peak bodies to enhance the GHS for Aboriginal people resulted in an enhanced culturally acceptable and tailored program which significantly reduced chronic disease risk factors for Aboriginal participants. Mainstream telephone based services can be modified and enhanced to meet the needs of Aboriginal communities through a process of consultation, community engagement, partnership and governance.
Blood lead level (BPbL) was determined in forty-five traffic controllers working on Alexandria road intersections. Central nervous system dysfunction in the subjects studied was investigated by means of performance tests. Biochemical indicators related to lead exposure such as delta-aminolevulinic acid dehydratase and hemoglobin in their blood were also determined. Results indicated that most of the subjects studied have a comparably high BPbL. They also showed significantly poorer performance scores than that obtained in a previous study with a group of textile workers of the same age and educational levels. The mean of the BPbL in the traffic controllers was found to be 68.28 +/- 13.22 micrograms/dl. This is a very high level compared to an acceptable level of 30.00 micrograms/dl. All neurobehavioral symptoms demonstrated in the traffic controllers could be attributed to a high level of lead exposure.
The free, telephone-based Get Healthy Information and Coaching Service (GHS) has made sustained improvements in healthy behaviours and weight change in the Australian population, but there is poor uptake of the GHS by culturally and linguistically diverse communities. This formative research study explored the Australian-Chinese community's awareness, perceptions and experiences of the GHS and their knowledge and cultural beliefs about healthy lifestyles. Conducted in Sydney, Australia, the research included 16 Chinese community-stakeholder interviews, a cross-sectional survey of 253 Chinese community members; and a review of Chinese participant GHS data. The study revealed poor uptake (<1%) and awareness (16%) of the GHS, but good intent (86%) to use it. The need for culturally appropriate and relevant information on healthy eating and physical activity was identified. Employment of a bilingual, bicultural coach, redesign and translation of written resources and targeted promotion in partnership with community organisations were recommended.
The aim of the present paper was to explore how social networks enable dissemination of health information within two Aboriginal communities in New South Wales. The study design was modelled on a social network analysis socio-centric model. Data collection was conducted primarily by Aboriginal community members who were trained as community researchers. Participants reported on their patterns of interaction and who they provided or received health information from, and awareness of the Aboriginal Enhancement of the Get Healthy Information and Coaching Service. In total, 122 participants across two sites participated in the study. Aboriginal Community Controlled Health Services (ACCHSs) and Aboriginal Community Controlled Health Organisations (ACCHOs) were cited as the main provider of health information in both sites. Between-ness, degree and closeness centrality showed that certain community members, ACCHS and ACCHO within the two communities in the present study were considerable enablers [actors] in enhancing the reach and flow of health information to their respective Aboriginal community. There is potential for future health-promotion activities to be increasingly targeted and effective in terms of reach and influence, if guided by local Aboriginal organisations and by key Aboriginal community members within and across family networks and communities.
Risky alcohol use has significant individual health and social impacts, and is related to short-and long-term harm, including injuries, accidents, liver diseases, some cancers, cardiovascular diseases and alcohol dependence. The Get Healthy Information & Coaching Service (GHS) is a free telephone coaching service supporting adults 16 years or older to reduce weight, improve nutrition and increase physical activity. Tailored programs are available for Aboriginal people, pregnant women and people at risk of type 2 diabetes. The GHS provides an opportunity to implement a specific program for participants wishing to reduce or cease their alcohol consumption. This paper describes the processes used to develop an Alcohol Program for the GHS. It outlines the contributions from clinical and program experts, the evidence base for the program's development, clinical screening tools, training for health coaches and referral processes for participants. The Alcohol Program has the potential to provide effective coaching to adults to voluntarily reduce short-and long-term risky alcohol consumption. BackgroundThe Australian guidelines to reduce health risks from drinking alcohol (2009) recommend that, for healthy women and men, drinking no more than two standard drinks of alcohol on any given day reduces the lifetime risk of harm from alcohol-related injury or disease (Guideline 1). To reduce the likelihood of risk from a single occasion of drinking, the guidelines recommend consuming four or fewer standard drinks (Guideline 2).1 Alcohol consumption has been associated with a range of health-related harms, as well as a high economic cost arising from alcohol misuse.2 Collins and Lapsley calculated that the total cost to Australia from alcohol-related harm was $15.3 billion in 2004-05. 3 The New South Wales (NSW) Auditor-General estimated the cost of alcohol-related abuse to NSW Government services at $1.03 billion in 2010. 4 The NSW state health plan: towards 2021 has a stated target of reducing drinking at levels posing lifetime risk (Guideline 1) to below 25% by 2015.
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