Advancing health promotion in rural and remote Australia: Strategies for change

Smith, James A.; Canuto, Karla; Campbell, Narelle; Schmitt, Dagmar; Bonson, Jason; Smith, LA; Connolly, Paul; Bonevski, Billie; Rissel, Chris; Aitken, Robyn; Dennis, Christine; Williams, Carmel; Dyall, Danielle; Stephens, Donna

doi:10.1002/hpja.569

Cited by 8 publications

(4 citation statements)

References 28 publications

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“…The relationship between rurality and poorer health outcomes has been widely described 20–22 . This disparity also exists in diabetes‐related foot disease, of which participants in the current study were acutely aware.…”

Section: Discussionmentioning

confidence: 65%

“…18,19 The relationship between rurality and poorer health outcomes has been widely described. [20][21][22] This disparity also exists in diabetes-related foot disease, of which participants in the current study were acutely aware. The Australian Institute of Health and Welfare statistics demonstrate a 50% higher likelihood of lower limb amputation for people who reside in rural areas, 23 with similar findings demonstrated by other local studies.…”

Section: Discussionmentioning

confidence: 80%

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Experiences and impact of a rural Australian high‐risk foot service: A multiple‐methods study

Tehan,

Donnelly,

Martin

et al. 2024

Australian J Rural Health

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ObjectiveMost podiatry‐led high‐risk foot services (HRFS) in Australia are located in metropolitan areas or large regional centres. In rural areas, where there are limited specialist services, individuals with diabetes‐related foot ulceration are more likely to undergo amputation. This study aimed to explore clinicians' perceptions of a recently implemented HRFS in rural New South Wales, Australia, and compare trends of amputation and hospitalisation prior to and post‐implementation of the service.SettingRural HRFS in Tamworth, New South Wales, Australia.ParticipantsHealth professionals working within the HRFS were recruited to participate.DesignThis was a multiple‐methods study. For the qualitative arm, semi‐structured interviews were conducted, which were analysed using a reflexive thematic approach. The quantitative arm of the study utilised a retrospective analytic design which applied an interrupted time series to compare amputation and hospitalisation trends pre‐ and post‐implementation of the HRFS utilising diagnostic and procedural ICD codes.ResultsThe qualitative arm of the study derived three themes: (1) navigating the divide, (2) rural community and rural challenges and (3) professional identity. Results of the interrupted time series indicate that there was a downward trend in major amputations following implementation of the HRFS; however, this was not statistically significant.ConclusionClinicians were aware of the inequity in DFD outcomes between rural and metropolitan areas and were committed to improving outcomes, particularly with respect to First Nations peoples. Future research will explore service use and amputation rates in the longer term to further evaluate this specialised multidisciplinary care in a rural community.

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Section: Discussionmentioning

confidence: 65%

Section: Discussionmentioning

confidence: 80%

Experiences and impact of a rural Australian high‐risk foot service: A multiple‐methods study

Tehan,

Donnelly,

Martin

et al. 2024

Australian J Rural Health

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“…Rural and regional towns are known to have demographic, social, economic, and environmental features distinct from capital cities that can uniquely influence the mental health and wellbeing of residents [ 1 – 3 ]. These include an older population, higher rates of chronic disease, lower socioeconomic status and reduced access to health and social services.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated with mental health problems of psychological distress and depression among rural Victorians – analysis of cross-sectional data (Crossroads II)

Dashputre,

Agho,

Piya

et al. 2023

BMC Psychiatry

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Background Research suggests that rates of mental illness are similar in rural and urban Australia, although there are significant workforce shortages in rural regions along with higher rates of chronic disease and obesity and lower levels of socioeconomic status. However, there are variations across rural Australia and limited local data on mental health prevalence, risk, service use and protective factors. This study describes the prevalence of self-reported mental health problems of psychological distress and depression, in a rural region in Australia and aims to identify the factors associated with these problems. Methods The Crossroads II study was a large-scale cross-sectional study undertaken in the Goulburn Valley region of Victoria, Australia in 2016–18. Data were collected from randomly selected households across four rural and regional towns and then screening clinics from individuals from these households. The main outcome measures were self-reported mental health problems of psychological distress assessed by the Kessler 10 and depression assessed by Patient Health Questionnaire-9. Unadjusted odd ratios and 95% confidence intervals of factors associated with the two mental health problems were calculated using simple logistic regression with multiple logistic regression using hierarchical modelling to adjust for the potential confounders. Results Of the 741 adult participants (55.6% females), 67.4% were aged ≥ 55 years. Based on the questionnaires, 16.2% and 13.6% had threshold-level psychological distress and depression, respectively. Of those with threshold-level K-10 scores, 19.0% and 10.5% had seen a psychologist or a psychiatrist respectively while 24.2% and 9.5% of those experiencing depression had seen a psychologist or a psychiatrist, respectively in the past year. Factors such as being unmarried, current smoker, obesity, were significantly associated with a higher prevalence of mental health problems whereas physical activity, and community participation reduced the risk of mental health problems. Compared to rural towns, the regional town had higher risk of depression which was non-significant after adjusting for community participation and health conditions. Conclusions The high prevalence of psychological distress and depression in this rural population was consistent with other rural studies. Personal and lifestyle factors were more relevant to mental health problems than degree of rurality in Victoria. Targeted lifestyle interventions could assist in reducing mental illness risk and preventing further distress.

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“…Implications for health organisations and professionals based in isolated Aboriginal and Torres Strait Islander settings are discussed. This strengths‐based health promotion discourse is critical for ameliorating the ongoing marginalisation remote Aboriginal and Torres Strait Islander males face 4–9 …”

Section: Introductionmentioning

confidence: 99%

Strengthening health promotion development with Aboriginal and Torres Strait Islander males in remote Australia: A Northern Territory perspective

Souter

Smith

Canuto

et al. 2022

Australian J Rural Health

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AimsTo elucidate key considerations for effective health promotion with Aboriginal and Torres Strait Islander males in remote Northern Territory.ContextDespite the significant disparities in health outcomes amongst Aboriginal and Torres Strait Islander males, particularly in remote Northern Territory, investment in health promotion policy and practice has been inadequate. Progressing towards self‐determination with Aboriginal and Torres Strait Islander males, and to meet the unique health and well‐being needs of this marginalised demographic, consideration for staff retention and training, strengths‐based approaches, and implications of divergent masculinities must be considered when devising and delivering culturally responsive and appropriate health promotion interventions. Health promotion needs to be conducted in a collaborative manner, and in less conventional settings, to better engage Aboriginal and Torres Strait Islander males.ApproachThis commentary draws on the author's reflections about working in remote Aboriginal and Torres Strait Islander health policy, practice and research contexts in Northern Australia. It brings together diffuse strands of scholarship about Aboriginal and Torres Strait Islander male health; Aboriginal and Torres Strait Islander health promotion; and health promotion in rural and remote contexts. In doing so, we identify and discuss strategies that have potential to strengthen Aboriginal and Torres Strait Islander male health promotion in rural and remote Australia.ConclusionHealth services and professionals in remote Northern Territory must leverage the inherent strengths of Aboriginal and Torres Strait Islander males to imbue service delivery with both meaning and capacity for self‐determination. In doing so, this might ultimately help to alleviate the marginalisation of this demographic.

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Advancing health promotion in rural and remote Australia: Strategies for change

Cited by 8 publications

References 28 publications

Experiences and impact of a rural Australian high‐risk foot service: A multiple‐methods study

Experiences and impact of a rural Australian high‐risk foot service: A multiple‐methods study

Prevalence and factors associated with mental health problems of psychological distress and depression among rural Victorians – analysis of cross-sectional data (Crossroads II)

Strengthening health promotion development with Aboriginal and Torres Strait Islander males in remote Australia: A Northern Territory perspective

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