ORCID Profile
0000-0003-1730-2622
Current Organisation
Swinburne University of Technology
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Social Policy | Policy and Administration | Urban and Regional Studies (excl. Planning) | Community Planning | Communication Technology and Digital Media Studies | Public Policy | Social and Cultural Geography | Urban and Regional Planning | Human Geography | Counselling, Welfare and Community Services | Health Promotion | Sport and leisure management | Commercial services | Health promotion
ANZSRC Socio-Economic Objective (SEO)
Social Class and Inequalities | Public Services Policy Advice and Analysis | Regional Planning | Electronic Information Storage and Retrieval Services | Social Structure and Health | Communication not elsewhere classified | Health Education and Promotion |
Related Links
Publications
Groups or teams in health care: Finding the best fit
Publisher: Wiley
Date: 26-10-2007
DOI: 10.1111/J.1365-2753.2006.00649.X
Abstract: In the evolution of the team concept, clear distinctions between 'groups' and 'teams' were made. In this paper we argue that these distinctions were not made explicit in the translation of team structures to health care. Even though teams are appropriate for many health care settings, this paper explores the notion that when teams may not be working, it is the concept of team that may not be appropriate, not the functioning of the team itself. This paper reviews the differences between teams and groups, and identifies how these differences are expressed in health care settings using urban and rural ex les from the UK and Australia. Some suggestions about matching structures to suit the unique nature of health care provision, particularly in community health settings, are made. Instead of concentrating on improving the process of teams, the focus could be better directed to ensure that whatever structure is utilized best facilitates the necessary outcomes in the most effective way. The team approach may not always be the best approach, and sometimes referring to a number of people working together as a group is sufficient.
Effects of screw pile installation on installation requirements and in-service performance using the discrete element method
Publisher: Canadian Science Publishing
Date: 09-2021
Abstract: Existing guidance on the installation of screw piles suggest that they should be installed in a pitch-matched manner to avoid disturbance to the soil that may have a detrimental effect on the in-service performance of the pile. Recent insights from centrifuge modelling have shown that installing screw piles in this way requires large vertical compressive (or crowd) forces, which is inconsistent with the common assumption that screw piles pull themselves into the ground requiring minimal vertical compressive force. In this paper, through the use of the discrete element method (DEM), the effects of advancement ratio, i.e., the ratio between the vertical displacement per rotation to the geometric pitch of the helix of the screw pile helix, on the installation resistance and in-service capacity of a screw pile is investigated. The findings are further used to assess the applicability of empirical torque capacity correlation factors for large diameter screw piles. The results of the investigation show that it is possible to reduce the required vertical compressive installation force by 96% by reducing the advancement ratio and that although over-flighting a screw pile can decrease the subsequent compressive capacity, it appears to increase the tensile capacity significantly.
The state of health services partnering with consumers: evidence from an online survey of Australian health services
Publisher: Springer Science and Business Media LLC
Date: 10-08-2018
Evaluating alcohol intoxication management services: the EDARA mixed-methods study
Publisher: National Institute for Health and Care Research
Date: 06-2020
DOI: 10.3310/HSDR08240
Abstract: Front-line health-care services are under increased demand when acute alcohol intoxication is most common, which is in night-time environments. Cities have implemented alcohol intoxication management services to ert the intoxicated away from emergency care. To evaluate the effectiveness, cost-effectiveness and acceptability to patients and staff of alcohol intoxication management services and undertake an ethnographic study capturing front-line staff’s views on the impact of acute alcohol intoxication on their professional lives. This was a controlled mixed-methods longitudinal observational study with an ethnographic evaluation in parallel. Six cities with alcohol intoxication management services were compared with six matched control cities to determine effects on key performance indicators (e.g. number of patients in the emergency department and ambulance response times). Surveys captured the impact of alcohol intoxication management services on the quality of care for patients in six alcohol intoxication management services, six emergency departments with local alcohol intoxication management services and six emergency departments without local alcohol intoxication management services. The ethnographic study considered front-line staff perceptions in two cities with alcohol intoxication management services and one city without alcohol intoxication management services. Alcohol intoxication management services typically operated in cities in which the incidence of acute alcohol intoxication was greatest. The per-session average number of attendances across all alcohol intoxication management services was low (mean 7.3, average minimum 2.8, average maximum 11.8) compared with the average number of emergency department attendances per alcohol intoxication management services session (mean 78.8), and the number of patients erted away from emergency departments, per session, required for services to be considered cost-neutral was 8.7, falling to 3.5 when ambulance costs were included. Alcohol intoxication management services varied, from volunteer-led first aid to more clinically focused nurse practitioner services, with only the latter providing evidence for ersion from emergency departments. Qualitative and ethnographic data indicated that alcohol intoxication management services are acceptable to practitioners and patients and that they address unmet need. There was evidence that alcohol intoxication management services improve ambulance response times and reduce emergency department attendance. Effects are uncertain owing to the variation in service delivery. The evaluation focused on health service outcomes, yet evidence arose suggesting that alcohol intoxication management services provide broader societal benefits. There was no nationally agreed standard operating procedure for alcohol intoxication management services, undermining the evaluation. Routine health data outcomes exhibited considerable variance, undermining opportunities to provide an accurate appraisal of the heterogenous collection of alcohol intoxication management services. Alcohol intoxication management services are varied, multipartner endeavours and would benefit from agreed national standards. Alcohol intoxication management services are popular with and benefit front-line staff and serve as a hub facilitating partnership working. They are popular with alcohol intoxication management services patients and capture previously unmet need in night-time environments. However, acute alcohol intoxication in emergency departments remains an issue and opportunities for ersion have not been entirely realised. The nurse-led model was the most expensive service evaluated but was also the most likely to ert patients away from emergency departments, suggesting that greater clinical involvement and alignment with emergency departments is necessary. Alcohol intoxication management services should be regarded as fledgling services that require further work to realise benefit. Research could be undertaken to determine if a standardised model of alcohol intoxication management services, based on the nurse practitioner model, can be developed and implemented in different settings. Future evaluations should go beyond the health service and consider outcomes more generally, especially for the police. Future work on the management of acute alcohol intoxication in night-time environments could recognise the partnership between health-care, police and ambulance services and third-sector organisations in managing acute alcohol intoxication. Current Controlled Trials ISRCTN63096364. This project was funded by the National Institute for Health Research (NIHR) Health Services and Delivery Research programme and will be published in full in Health Services and Delivery Research Vol. 8, No. 24. See the NIHR Journals Library website for further project information.
Including the Rural Excluded: Digital Technology and Diverse Community Participation
Publisher: Elsevier
Date: 2018
Introduction
Publisher: Edward Elgar Publishing
Date: 29-06-2012
More than health: The added value of health services in remote Scotland and Australia
Publisher: Elsevier BV
Date: 11-2010
DOI: 10.1016/J.HEALTHPLACE.2010.07.005
Abstract: Health services are suggested to contribute to remote communities in the ways that extend beyond healthcare delivery. This international multiple case-study research provides qualitative evidence of the social, economic and human contributions (the 'added-value') that may be lost should remote communities lose in-situ health provision. We present a typology of added-value contributions that differentiates institutional aspects (residing in buildings, or embodied in the specific status, capabilities and skills of health professionals) and in idual aspects (attributable to health professionals' unique personalities and choices). This typology has relevance for communities, policymakers and managers when considering the impacts of potential service changes.
‘I think we're getting a bit clinical here’: A qualitative study of professionals' experiences of providing mental healthcare to young people within an Australian rural service
Publisher: Hindawi Limited
Date: 07-09-2020
DOI: 10.1111/HSC.13152
Abstract: This paper contributes to scholarship on the medicalisation of mental health support for young people through a case study of a multidisciplinary mental health service in rural Australia. All staff (n = 13) working at the service participated in semi-structured, in idual interviews. Transcripts of interview data were read and selectively coded and interpreted in relation to the overarching question of how participants view and experience mental health care provision to a erse range of young people. Following analytical reflection, codes pertaining to engagement, accessibility and care provision were re-examined using the concept of medicalisation to understand the biomedical underpinning of mental healthcare and how this plays out in the experiences and perceived challenges participants talked about in responding to the mental health concerns of erse young people. The resulting analysis is presented under five theme headings: (a) privileging clinical expertise and priorities within service provision, which was an important source of conflict for some participants (b) 'multidisciplinary' teams-a 'difficult kind of culture at times' (c) articulations of where cultural barriers lie (d) the tracks along which young people are directed to 'engage' with 'mental health' and (e) a clinical 'feel' to space. We suggest that service and system investment needs to be given to alternative ways of thinking about and approaching mental health and care provision that are cognisant of, and engage with, the inherent connections between in idual circumstance and social, place, cultural, economic and political contexts. This is particularly relevant to the provision of care in rural contexts because of limited service options and the complexities of access and providing care to a erse range of young people living in isolated environments. Interdisciplinary frameworks need to be enacted and services must acknowledge their own cultural positions for alternative ways of working to become possibilities.
Designing participation for the digital fringe
Publisher: ACM
Date: 26-06-2017
Considering the implications of place-based approaches for improving rural community wellbeing: The value of a relational lens
Publisher: Informa UK Limited
Date: 10-2014
Getting better: Health information provision in Guernsey
Publisher: Emerald
Date: 12-1995
DOI: 10.1108/03074809510099898
Abstract: Describes briefly the results of research carried out to look at the provision of health information for consumers on the Channel Island of Guernsey. The research utilized a three‐pronged survey to examine the views of the general public, recent hospital in‐patients and health professionals. These groups were asked to provide their views on the information currently available to them, the sources used and their degree of satisfaction with what was currently available. Respondents were also asked what could be done to improve health information provision on the island. Parallel to this, an independent audit of information sources on the island was carried out. Results establish a baseline on which plans for developing an island‐wide policy can be built. They show that there is a dearth of good information available. Consumers ask for more to be provided by health professionals and provide a number of ideas which can be used by policy makers to develop services. Concludes that current opinion would seem to be that policy makers are using the results to take some encouraging action.
Digital participation: Engaging diverse and marginalised communities
Publisher: ACM Press
Date: 2016
Relative professional roles in antenatal care: Results of a survey in Scottish rural general practice
Publisher: Informa UK Limited
Date: 11-2003
CONSIDERING THE IMPLICATIONS OF PLACE-BASED APPROACHES FOR IMPROVING RURAL COMMUNITY WELLBEING: THE VALUE OF A RELATIONAL LENS
Publisher: Informa UK Limited
Date: 27-06-2014
General Practitioner Involvement in Remote and Rural Maternity Care: Too Big a Challenge?
Publisher: Springer Publishing Company
Date: 2011
Abstract: BACKGROUND: In the United Kingdom, general practitioner (GP) involvement in maternity care has declined significantly over the past decade. This is particularly so in remote and rural areas where midwives have stepped up and taken over units to ensure that women in these areas continue to have a service. A recent report by the King’s Fund argues for a greater role for the GP in maternity care provision however, this raises questions about whether GPs have the skills and training to provide such care. AIM: To explore the views of GPs on the skills and training required to deliver safe and appropriate local intrapartum services in remote and rural settings. METHODS : Mixed-method study consisting of qualitative interviews with a purposive s le of GPs in six remote and rural sites. To triangulate the interview findings and identify features that might have been missed in the interviews, a questionnaire was developed using initial key themes identified. FINDINGS: Maternity care accounted for less than 10% of most remote and rural GPs’ workload, yet interviewees reported that their role required them to be competent in a wide range of procedures. This was seen as a major barrier to recruitment and retention in rural areas. Although self-reported competence and confidence was high, several GPs felt de-skilled and felt that they were fighting a losing battle to maintain skills. GPs regarded isolation, need for comprehensive expertise, limited resources, and transportation difficulties as factors affecting the decline in their contribution to remote and rural maternity care. CONCLUSION: Although rural GPs and midwives might traditionally have been in competition, providing a woman-centered service in remote areas may be easier to achieve through collaborative working. However, if GPs are to play a greater role, then they will need to be prepared to make a strategic commitment to the maintenance of remote and rural maternity care. This will require innovative methods of training, special consideration of educational needs, and incentives for practitioners to settle in rural areas, but it may already be too late for GPs to have a substantial input into maternity care.
Informing debate or fuelling dispute? Media communication of reconfiguration in Scotland's rural maternity care
Publisher: Wiley
Date: 30-10-2008
Guidelines and management of mild hypertensive conditions in pregnancy in rural general practices in Scotland: Issues of appropriateness and access
Publisher: BMJ
Date: 08-2003
DOI: 10.1136/QHC.12.4.286
Abstract: To assess the diagnosis and management of mild non-proteinuric hypertension in pregnancy in rural general practices against guideline recommendations. Postal survey and telephone interview. All 174 designated rural general practices in Scotland. 171 GPs and 158 midwives responsible for antenatal care stratified by distance from a specialist maternity hospital. Accuracy of diagnosis and appropriateness of management compared with guideline. At least one respondent replied for 91% (158/174) of rural practices. Response rates were 68% (117/170) for GPs and 77% (121/158) for midwives. Both GP and midwife replied for 46% (80/174) of practices. Most GPs (80%, 87/109) and midwives (63%, 71/113) overdiagnosed the scenario. Intended management was therefore most often referral or admission to specialist hospital (59%, 132/224), both courses of action beyond guideline recommendations. There was an association between distance of practice from specialist maternity hospital and professionals' report of intended referral or admission. Explanatory factors from telephone interviews included a poor knowledge base, cautious risk assessment, and perceived inflexibility of guidelines for remote situations. There is a lack of accuracy in the diagnosis of a common antenatal problem and intended management is consistent with overdiagnosis. The results suggest that women in rural settings may experience more antenatal referrals and admissions than are clinically appropriate according to the guidelines. At a time of increasing centralisation of maternity services, this could increase inappropriate referrals and increase costs to service and patients. Quality of care may be improved by developing consensual local guidelines with rural maternity care professionals and support maintained skills and confidence in decision making.
Territorial tensions: Misaligned management and community perspectives on health services for older people in remote rural areas
Publisher: Elsevier BV
Date: 03-2010
DOI: 10.1016/J.HEALTHPLACE.2009.10.010
Abstract: This paper presents findings from a qualitative study investigating older people's health service provision in remote rural Scotland. Comparing stakeholders' perspectives, contested issues were exposed where community members, service managers and policymakers disagreed. Considering these, led to the proposal that fundamental tensions exist between community and management olicy stakeholders' perspectives and these underlie service change conflicts. While highlighting issues for older people's service design, findings suggest that impacts of the current planning process require to be understood, and aspects need to be changed, before the voice of older people can inform local service policy.
ISSPEA 2019: 1st International Symposium on Screw Piles for Energy Applications
Publisher: University of Dundee
Date: 27-05-2019
DOI: 10.20933/100001123
Nice lessons to be learned
Publisher: Cambridge University Press (CUP)
Date: 04-2001
DOI: 10.1017/S0266462300105082
Abstract: Objectives: This study examined users' perceptions of the role and value of the Scottish Health Purchasing Information Centre (SHPIC) from 1995 to 1998. Methods: Questionnaires and interviews were used to gather data from Scottish GP fundholders and health board managers at two stages. Results: Initially, purchasers sought help in identifying the most relevant information. By 1997, while some appreciated the clinical and cost-effectiveness information produced, others were critical of lack of timely production and apparent lack of cooperation between agencies. Conclusions: New U.K. agencies can learn from SHPIC's problems, specifically in producing clear, coordinated, timely, independent, and well-marketed information with implementation strategies. Policy Implications: It is important to evaluate the impact of agencies to produce and disseminate evidence-based information, even if this has to be done pragmatically rather than as an outcomes-based assessment. Evidence from evaluations can inform direction and strategy for existing and new agencies.
An Organizational Approach to Understanding How Social Enterprises Address Health Inequities: A Scoping Review
Publisher: Informa UK Limited
Date: 30-07-2020
Evaluation of physician assistants in National Health Service Scotland
Publisher: SAGE Publications
Date: 08-2011
Abstract: Physician assistants (PAs) have medical training and work supervised by a doctor. In 2006-2008 the Scottish Government piloted use of USA-trained PAs. The aim of the paper is to evaluate the impact and contribution made by PAs to delivering effective health care in National Health Service (NHS) Scotland. Mixed methods, longitudinally, including interviews, feedback forms and activity data collection. Data analysis used nVivo, SPSS and Excel. Participants were 15 USA-trained PAs, medical supervisors and team members, 20 patients, four NHS senior managers and three trade union representatives. Settings were four Scottish NHS Boards where PAs worked in primary care, out of hours clinics, emergency medicine, intermediate care and orthopaedics. Two minor patient safety issues arose. Patients were satisfied with PAs. Scope of practice did not replicate US working. Inability to prescribe was a hindrance. PAs tended to have longer consultations, but provided continuity and an educational resource. They were assessed to be mid-level practitioners approximating to nurse practitioner or generalist doctor. Valued features were generalism, medical background, confidence differential diagnosis and communication. Interviewees suggested PAs could fulfil roles currently filled by medical staff, potentially saving resources. In conclusion, there is potential for PAs to fulfil distinctive mid-level roles in the Scottish NHS adding value in continuity, communication and medical approach.
Challenges of community engagement in a rural area: The impact of flood protection and policy
Publisher: Elsevier BV
Date: 2020
Sleep and psychological wellbeing of racehorse industry workers: A survey of Australian trainers
Publisher: Informa UK Limited
Date: 06-2019
DOI: 10.1111/AJPY.12230
Do community empowerment and enabling state policies work in practice? Insights from a community development intervention in rural Scotland
Publisher: Elsevier BV
Date: 12-2018
Integration and segregation for social enterprise employees: A relational micro-geography
Publisher: Wiley
Date: 11-06-2020
DOI: 10.1111/AREA.12567
Spanning communication boundaries to address health inequalities: the role of community connectors and social media
Publisher: Informa UK Limited
Date: 21-06-2021
The Orange Declaration on rural and remote mental health
Publisher: Wiley
Date: 12-09-2019
DOI: 10.1111/AJR.12560
Abstract: Rural mental health outcomes have been persistently poorer than those in larger cities suggesting that the prevailing investments to improve matters are not working. Mental health researchers and service providers from New South Wales, Victoria, Western Australia and the Australian Capital Territory met in Orange in October 2018 to explore issues pertaining to rural mental health and well-being. The group recognised and acknowledged that rural residents experience a series of interconnected geographical, demographic, social, economic and environmental challenges which are not addressed adequately by the current mix of services. This declaration has been endorsed by those listed below and we welcome further support. We list ten interrelated problems and ten solutions. As a group, we take this declaration as an opportunity to invite discussion about how we can collectively improve the mental health of rural residents through research, service design and delivery. We invite the reader to consider endorsing this declaration. A short summary of supporting evidence is available online at www.crrmh.com.au/.
Online Mental Health Forums and Rural Resilience: Mixed Methods Study and Logic Model (Preprint)
Publisher: JMIR Publications Inc.
Date: 21-03-2023
Abstract: ural mental health is a growing area of concern internationally, and online mental health forums offer a potential response to addressing service gaps in rural communities. he objective of this study was to explore and identify pathways by which online peer support mental health forums help to build resilience for rural residents experiencing mental ill-health by contributing to overcoming their specific contextual challenges. e developed a Theoretical Resilience Framework and applied it to 3000 qualitative posts from 3 Australian online mental health forums and to data from 30 interviews with rural forum users. rawing on the findings and an abductive approach, a logic model was developed to illustrate links between the resilience resources built and enabling features of forums that make them spaces that facilitate resilience. he study demonstrated that online forums make valuable contributions to social well-being and access to a range of timely support services for rural people experiencing mental ill-health, and, while doing so, involve users in the processes of resilience building. The study provides a new way for practitioners to frame the work of and value produced by forums. It gives a logic model that can be used in evaluation and audit as it facilitates a causal framing of how forums, as an intervention, link with resilience outcomes. Ultimately, the study contributes to developing new knowledge about how rural resilience building can be conceptualized and measured while showing how forums are part of contemporary health service provision in rural places.
Taking stock: Career planning for isolated, middle-level professionals
Publisher: Emerald
Date: 06-1996
DOI: 10.1108/03074809610115672
Abstract: Middle‐level professionals working in one‐person library or information units, usually women, frequently experience obstacles to career progression, which are seen as insurmountable. Examines some of these obstacles, and suggests a possible approach to career planning incorporating a number of different strategies for change.
Identifying support needs to improve rural dementia services for people with dementia and their carers: A consultation study in Victoria, Australia
Publisher: Wiley
Date: 02-2019
DOI: 10.1111/AJR.12444
DEM study of particle scale effect on plain and rotary jacked pile behaviour in granular materials
Publisher: Elsevier BV
Date: 09-2023
Social capital, rural nursing and rural nursing theory
Publisher: Wiley
Date: 22-02-2006
DOI: 10.1111/J.1440-1800.2006.00297.X
Abstract: The notion of social capital focuses attention on social connectedness within communities and the ways that this connectedness may affect health and well-being. There are many competing definitions of social capital but most suggest that it involves trust, social networks and reciprocity within communities, not necessarily geographically defined. The usefulness of social capital and related theories that help in understanding the function of nurses in rural communities are explored in this paper. Nurses and health service planners are becoming increasingly aware of the potential contribution of community nurses in rural and/or remote areas, as evidenced in the development of nurse practitioners. Through their interrelational role and status in rural communities, nurses are often 'immersed' or 'embedded' in the social networks that make up the fabric of rural life and may therefore be important contributors to social capital. For a concept such as social capital to be useful in nursing research, it must have distinct attributes, delineated boundaries, and well-described preconditions and outcomes in multiple contexts.
Project 2000 and Nursing College Libraries in Scotland: The experience of development and implementation for the first wave of project 2000 students
Publisher: Emerald
Date: 05-1993
Abstract: Sets out to examine the \\ill\\ of how nursing college libraries in Scotland developed \\ill\\ services to cope with the new demands implied in the \\ill\\ 2000 curriculum. Looks at the experience for libraries \\ill\\ with the first wave of Project 2000 students. Seeks \\ill\\ whether many of the problems experienced in England \\ill\\ repeated in Scotland or whether lessons have \\ill\\ . A postal survey of nursing college libraries in \\ill\\ was conducted followed by in‐depth interviews with a \\ill\\ of libraries. Observes issues such as funding, \\ill\\ with other institutions, use of stock, etc. Results see\\ill\\ that Scottish nursing college libraries have coped \\ill\\ changes for a number of reasons including professional \\ill\\ and involvement in planning. However, the study \\ill\\ possible ongoing or future strategic and organiza\\ill\\ which may militate against a satisfactory \\ill\\ scenario.
Conceptualizing the everyday life application components: A scoping review of technology mediated experience
Publisher: ACM
Date: 04-12-2018
Processes of community-led social enterprise development: learning from the rural context
Publisher: Oxford University Press (OUP)
Date: 14-11-2014
DOI: 10.1093/CDJ/BSU055
Attitudes to LIS education and academic-practitioner liaison: results of a survey of members of the Library Association Health Libraries Group.
Publisher: Wiley
Date: 06-1998
DOI: 10.1046/J.1365-2532.1998.1520097.X
Abstract: A questionnaire survey was conducted by the Library Association Health Libraries Group in October-December 1996. Information practitioners in the health care sector were asked what they considered were the education and research needs of the profession, their opinion of Library and Information Sciences education, and their views on practitioner input to education and research. They were also asked whether they would be prepared to give talks to students and to offer student placements. The results show that there is still a considerable gulf between academics and practitioners, and that although practitioners are enthusiastic about getting more involved in liaison, they are constrained by lack of time and resources. Practical solutions need to be found to encourage greater understanding and closer working relationships, to achieve the benefits of academic-practitioner liaison.
Decision-making by health purchasing organisations in Scotland: The role and influence of evidence from the research literature
Publisher: SAGE Publications
Date: 02-1997
DOI: 10.1177/016555159702300105
Abstract: Evidence-based health care is currently receiving much attention in the health service. The movement is of particular interest to health information professionals, as it is a chance for them to show their skills and achieve credibility after years in the wilderness. However, to what extent is managers’ use of research findings in the purchasing and provision of health care merely so much rhetoric? The research reported here is the first phase of a study which aims to look at the impact of the Scottish Health Purchasing Information Centre (SHPIC) in providing information intended to change purchasing and providing behaviour. This phase of the project involved a survey of Scottish purchasers, which examined use of evidence from research in making purchasing decisions. Findings from the study seem to indicate that, although most are aware of the movement towards evidence-based health care and agree with its ethos, there are several very real barriers to change.
Engage, participate, empower: Modelling power transfer in disadvantaged rural communities
Publisher: SAGE Publications
Date: 06-04-2017
Abstract: Abstract This article explores a process meant to empower disadvantaged communities that have not previously engaged in government-instigated civic projects. Drawing on a large exploratory study of an empowerment project in seven Scottish rural communities, findings include that empowering communities should harness community development techniques that use both external actors and sources of support (i.e. exogenous practices), and those that utilise assets from within the community (i.e. endogenous practices). The paper presents the Engagement-Participation-Empowerment Model showing stages in transferring power from external actors to local communities. The paper highlights that the process of community empowerment starts with engagement and follows with participation – both representing a precondition of community empowerment. The paper indicates that there are limits to which community members are capable of embracing current community empowerment policies and showing that even targeted ‘well-tailored’ community empowerment programmes might fail. Implications of the study for further research and policy are identified.
The Social Enterprise as a Space of Wellbeing:
Publisher: Emerald
Date: 02-11-2015
Abstract: – The purpose of this paper is to present an Australian case study and to explore how social enterprises may be conceptualised as spaces of well-being, that is the ways in which social enterprises, not explicitly delivering health services, may be producing health and well-being benefits for those who come into contact with them. – A case study in Australia is used to explore in depth the mechanisms of well-being production. Data were collected using ethnographic observation, focus groups and walking interviews. Data were analysed using thematic analysis, GIS and the lens of therapeutic assemblage. – The case study social enterprise produces well-being as integration, capability, security and therapy. The social enterprise acts as a therapeutic assemblage with well-being “spoken”, “practiced” and “felt” within the social enterprise. The ways in which well-being is generated are often linked to the productive element of enterprise – and have the potential to contribute to tackling several contemporary health challenges and inequalities relating to, for ex le, a lack of physical activity and levels of social isolation. – This paper draws on a single Australian case study but points to the need for further in-depth work in the area of social enterprise and health. – The paper advances our understanding of how social enterprises may be linked to health and well-being. It goes beyond quantification of, for ex le, number of clients helped, to consider the wider experience of well-being for those who come into contact with social enterprises.
Information professionals, CPD and transferable skills
Publisher: Emerald
Date: 05-1997
DOI: 10.1108/01435129710166446
Abstract: Argues that the workplace of today is in a state of perpetual change and that in iduals across the professions are faced with economic cutbacks, managerial reorganization and staff downsizing. In order to cope with/adapt to these changes, professionals have been forced to consider the issue of continuing professional development (CPD). Reports on a questionnaire survey sent out UK‐wide to 175 information professionals in the health and energy/oil sectors. The survey was designed to gain a flavour of these professionals’ attitudes to CPD and to identify their transferable skills. Addresses the problems of a changing workplace, the difficulties attached to career progression for information professionals and the growing need for CPD.
Evaluating community participation: A comparison of participatory approaches in the planning and implementation of new primary health‐care services in northern Australia
Publisher: Wiley
Date: 15-04-2018
DOI: 10.1002/HPM.2523
Abstract: Community participation is increasingly seen as a prerequisite for more acceptable and sustainable health services. It is difficult to evaluate the extent of participation in health planning and implementation of services, and there are limited tools available to assist in evaluating such processes. Our paper reports on community participation as part of the implementation of 2 primary health programs in regional north Queensland, Australia. We define community participation as collective involvement of people, including consultation, from a community of place or interest in aspects of health service development. We pragmatically evaluate and compare the extent of participation by using a framework developed by Rifkin and colleagues in 1988 and subsequently refined. Data collected from the implementation of each program were analyzed and ranked on a spidergram against 5 process indicators: needs assessment, leadership, resource mobilization, management, and organization. Community participation was found to vary across the programs but was most extensive in both programs in identifying need and potential solutions. Both programs demonstrated high levels of integration of the implementation of health programs with preexisting community structures. Involving local communities in genuine opportunities in managing the programs and mobilizing resources was more challenging. Key differences emerged in the people involved in the programs, the settings and frameworks used to facilitate implementation. We conclude that Rifkin's process indicators are a useful starting point for assessing community participation, particularly for health planners who are required to include participatory approaches when planning and implementing services. We suggest areas that require further consideration.
Web-Based Technologies to Support Carers of People Living With Dementia: Protocol for a Mixed Methods Stepped-Wedge Cluster Randomized Controlled Trial (Preprint)
Publisher: JMIR Publications Inc.
Date: 18-08-2021
Abstract: nformal carers play a significant role in supporting people living with dementia however, carers in rural areas are often isolated, with limited access to support services. Although dementia-friendly communities provide valued support for carers, access to them is limited as they are few and geographically dispersed. his study’s aim was to increase support and services for rural informal carers of people living with dementia by using information and communication technologies accessed through an integrated website and mobile app—the Verily Connect app. The objective of this protocol is to detail the research design used in a complex study that was situated in a challenging real-world setting integrating web-based and on-ground technology and communication. Therefore, it is anticipated that this protocol will strengthen the research of others exploring similar complex concepts. stepped-wedge, open-cohort cluster randomized controlled trial was conducted to implement Verily Connect across 12 rural Australian communities. The Verily Connect intervention delivered web-based, curated information about dementia, a localized directory of dementia services and support, group and in idual chat forums, and peer support through videoconference. During the implementation phase of 32 weeks, Verily Connect was progressively implemented in four 8-weekly waves of 3 communities per wave. Usual care, used as a comparator, was available to carers throughout the study period. Participants and researchers were unblinded to the intervention. There were 3 cohorts of participants: carers, volunteers, and staff participants were recruited from their communities. The primary outcome measure was perceived carer social support measured using the Medical Outcomes Study-Social Support Survey. Volunteers and staff provided feedback on their participation in Verily Connect as qualitative data. Qualitative data were collected from all cohorts of participants through interviews and focus groups. Process evaluation data were collected through interviews and memos written by research staff. Data on the costs of implementing Verily Connect were collected by the research team members and evaluated by a health economist. etween August 2018 and September 2019, a total of 113 participants were recruited. There were 37 (32.7%) carers, 39 (34.5%) volunteers, and 37 (32.7%) health service staff. The study was complex because of the involvement of multiple and varied communities of carers, volunteers, health service staff, and research team members originating from 5 universities. Web-based technologies were used as intervention strategies to support carers and facilitate the process of undertaking the study. he Verily Connect trial enabled the testing and further development of a web-based approach to increasing support for carers of people living with dementia across a erse rural landscape in Australia. This protocol provides an ex le of how to conduct a pragmatic evaluation of a complex and co-designed intervention involving multiple stakeholders. ustralian New Zealand Clinical Trials Registry ACTRN12618001213235 rjvrasf R1-10.2196/33023
Applying social innovation theory to examine how community co-designed health services develop: using a case study approach and mixed methods
Publisher: Springer Science and Business Media LLC
Date: 31-01-2018
Social media for social good? A thematic, spatial and visual analysis of humanitarian action on Instagram
Publisher: Informa UK Limited
Date: 20-04-2021
An exploration of the longer-term impacts of community participation in rural health services design
Publisher: Elsevier BV
Date: 09-2015
DOI: 10.1016/J.SOCSCIMED.2015.07.021
Abstract: This article explores what happened, over the longer term, after a community participation exercise to design future rural service delivery models, and considers perceptions of why more follow-up actions did or did not happen. The study, which took place in 2014, revisits three Scottish communities that engaged in a community participation research method (2008-2010) intended to design rural health services. Interviews were conducted with 22 citizens, healthcare practitioners, managers and policymakers all of whom were involved in, or knew about, the original project. Only one direct sustained service change was found - introduction of a volunteer first responder scheme in one community. Sustained changes in knowledge were found. The Health Authority that part-funded development of the community participation method, through the original project, had not adopted the new method. Community members tended to attribute lack of further impact to low participation and methods insufficiently attuned to the social nuances of very small rural communities. Managers tended to blame insufficient embedding in the healthcare system and issues around power over service change and budgets. In the absence of convincing formal community governance mechanisms for health issues, rural health practitioners tended to act as conduits between citizens and the Health Authority. The study provides new knowledge about what happens after community participation and highlights a need for more exploration.
Theory in rural health
Publisher: Wiley
Date: 25-07-2012
DOI: 10.1111/J.1440-1584.2012.01286.X
Abstract: This paper offers theories to explain persistent rural health challenges and describes their application to rural health and research. Review of theories from several disciplines. Key issues in rural health are poorer health status and access to health care, staff shortages, relationship-based health provision and the role of health services in community sustainability. These could be fruitfully addressed by applying theory and findings around social determinants of health, economic sociology, the role of culture and capitals approaches to measuring assets. In particular, the concept of rural health might be a barrier to progressing knowledge and relational approaches, common in geography, offer a more useful conceptual framework for studying health and place. To move beyond its current stage, rural health needs to look to other disciplines' theories and ideas particularly, it needs a more contemporary understanding of what place means so that health status and service provision can be improved by more thoughtful research.
Anchor geotechnics for floating offshore wind: Current technologies and future innovations
Publisher: Elsevier BV
Date: 07-2023
Boundary spanning practices of community connectors for engaging ‘hardly reached’ people in health services
Publisher: Elsevier BV
Date: 07-2019
Organisational processes and the policy-practice gap
Publisher: Edward Elgar Publishing
Date: 29-06-2012
A qualitative study in rural and urban areas on whether – and how – to consult during routine and out of hours
Publisher: Springer Science and Business Media LLC
Date: 26-04-2006
Abstract: Patients vary widely when making decisions to consult primary care. Some present frequently with trivial illness: others delay with serious disease. Differences in health service provision may play a part in this. We aimed to explore whether and how patients' consulting intentions take account of their perceptions of health service provision. Four focus groups and 51 semi-structured interviews with 78 participants (45 to 64 years) in eight urban and rural general practices in Northeast and Southwest Scotland. We used vignettes to stimulate discussion about what to do and why. Inductive analysis identified themes and explored the influence of their perceptions of health service provision on decision-making processes. Anticipated waiting times for appointments affected consulting intentions, especially when the severity of symptoms was uncertain. Strategies were used to deal with this, however: in cities, these included booking early just in case, being assertive, demanding visits, or calling out-of-hours in rural areas, participants used relationships with primary care staff, and believed that being perceived as undemanding was advantageous. Out-of-hours, decisions to consult were influenced by opinions regarding out-of-hours services. Some preferred to attend nearby emergency departments or call 999. In rural areas, participants tended to delay until their own doctor was available, or might contact them even when not on call. Perceived barriers to health service access affect decisions to consult, but some patients develop strategies to get round them. Current changes in UK primary care are unlikely to reduce differences in consulting behaviour and may increase delays by some patients, especially in rural areas.
Rural social enterprise – Evidence to date, and a research agenda
Publisher: Elsevier BV
Date: 08-2019
Conclusion
Publisher: Edward Elgar Publishing
Date: 29-06-2012
Information for trained nurses in remote areas: doelectronically networked resources provide an answer?
Publisher: Wiley
Date: 06-1997
Semi-Automatic Creation of Resilience Dictionary for Strengths-based Text Analysis of Online Mental Health Forums (Preprint)
Publisher: JMIR Publications Inc.
Date: 25-04-2022
Abstract: esilience is an accepted strengths-based concept responding to change, adversity and crisis that involves a range of environmental, social and personal adaptive factors. The concept underpins both personal and community-based preventative approaches to mental health issues and has shaped digital interventions. Online peer-support mental health forums have played a prominent role in enhancing resilience by providing accessible places for sharing lived experiences of mental issues and finding support. Despite the significance and viability of such forums for complementing mental health care, there has been little research on whether and how resilience is realised, hindering service providers’ ability to demonstrate impact. his paper aims to create a resilience dictionary that reflects the characteristics and realisation of resilience within online mental health peer-support forums. The findings can be used to guide further analysis and inform strengths-based moderation and management of mental health forums. semi-automatic approach to creating a resilience dictionary is proposed using topic modelling and qualitative content analysis. We present a systematic four-phase analysis pipeline that pre-processes raw forum posts, discovers main themes being discussed in the posts, conceptualises resilience indicators, and resilience dictionary creation. Our approach is applied to online peer-support mental health forums from 2018 to 2020 in SANE Australia, where 70,179 forum post data used by 2,357 users were collected and explored in this study. he resilience dictionary and taxonomy developed in this study, reveal: (1) how resilience indicators (i.e., “social capital”, “belonging”, “learning”, “adaptive capacity”, and “self-efficacy”) are characterised by themes commonly discussed on the forums (2) each theme’s top-10 most relevant descriptive terms and their synonyms and (3) the relatedness of resilience, reflecting a taxonomy of indicators that are more comprehensive (or compound) and indicators that are more likely to facilitate the realisation of others. The study also presents the four-phase analysis pipeline that constructs a resilience dictionary from new forum datasets. Further, this study identifies the resilience indicators “learning”, “belonging” and “social capital” are more commonly realised resilience indicators, and "learning" and "belonging" serve as foundations for the realisation of “self-efficacy” and “adaptive capacity” across the two-year study period. his paper presents a resilience dictionary that improves our understanding of how aspects of resilience are realised in online mental health forums. The dictionary provides novel guidance on how to improve training to support and enhance automated systems for moderating mental health forum discussions.
Using micro-geography to understand the realisation of wellbeing: A qualitative GIS study of three social enterprises
Publisher: Elsevier BV
Date: 03-2020
Measuring the value of social organisations as rural service providers
Publisher: Edward Elgar Publishing
Date: 29-06-2012
Competencies and skills for remote and rural maternity care: a review of the literature
Publisher: Wiley
Date: 04-2007
DOI: 10.1111/J.1365-2648.2007.04246.X
Abstract: This paper reports a review of the literature on skills, competencies and continuing professional development necessary for sustainable remote and rural maternity care. There is a general sense that maternity care providers in rural areas need specific skills and competencies. However, how these differ from generic skills and competencies is often unclear. Approaches used to access the research studies included a comprehensive search in relevant electronic databases using relevant keywords (e.g. 'remote', 'midwifery', 'obstetrics', 'nurse-midwives', education', 'hospitals', 'skills', 'competencies', etc.). Experts were approached for (un-)published literature, and books and journals known to the authors were also used. Key journals were hand searched and references were followed up. The original search was conducted in 2004 and updated in 2006. Little published literature exists on professional education, training or continuous professional development in maternity care in remote and rural settings. Although we found a large literature on competency, little was specific to competencies for rural practice or for maternity care. 'Hands-on' skills courses such as Advanced Life Support in Obstetrics and the Neonatal Resuscitation Programme increase confidence in practice, but no published evidence of effectiveness of such courses exists. Educators need to be aware of the barriers facing rural practitioners, and there is potential for increasing distant learning facilitated by videoconferencing or Internet access. They should also consider other assessment methods than portfolios. More research is needed on the levels of skills and competencies required for maternity care professionals practising in remote and rural areas.
Models of intrapartum care and women’s trade‐offs in remote and rural Scotland: a mixed‐methods study
Publisher: Wiley
Date: 28-09-2007
DOI: 10.1111/J.1471-0528.2007.01516.X
Abstract: To explore women's preferences for, and trade-offs between, key attributes of intrapartum care models. Mixed-methods study using discrete choice experiments (DCEs) and focus groups. The North of Scotland. Women from the catchment areas of eight rural maternity units in the North of Scotland. Based on current policy, 'model of care' and 'time travelled' were selected as key attributes of intrapartum care in remote and rural settings. A DCE questionnaire explored women's preferences for and trade-offs between these attributes. Focus groups validated the DCE attributes and provided valuable information about the drivers of women's preferences for place of delivery. Preferences for attributes of intrapartum care. Eight focus groups were conducted, and 877 eligible women completed the questionnaire. Overall, the DCE results found women preferred delivery in a unit to home birth and consultant-led care (CLC) to midwife-managed care (MMC). Women preferring CLC associated it with covering every eventuality and increased safety. Although women preferred shorter travel times, trade-offs indicated a willingness to travel for approximately 2 hours to get one's preferred choice. Focus group findings and subgroup DCE analysis showed heterogeneity of preferences related to experience, risk status, geographic location, perception of care and family circumstances. In contrast to service redesign offering local midwife-managed intrapartum care, most rural women in our study expressed a preference to give birth in hospital and have CLC because they felt safer. Women were willing to travel for this but within limits. Qualitative results showed that women's preferences were influenced by their home and family context, beliefs and previous pregnancy experiences. Challenges for service redesign are to provide comprehensive obstetric services within acceptable travel time, while responding to the heterogeneity of women's preferences.
A framework of the transferable skills of information professionals
Publisher: Emerald
Date: 08-1998
DOI: 10.1108/01435129810218375
Abstract: Describes a research project for the British Library Research and Innovation Centre which identified and analysed the generic skills and competences of information professionals in the healthcare and oil industry sectors. The study and its findings are described in a pack which is included with this issue of Library Management .
Culture and rural health
Publisher: Wiley
Date: 23-09-2012
‘Housing risk’ and the neoliberal discourse of responsibilisation in Victoria
Publisher: SAGE Publications
Date: 03-06-2015
Abstract: The article examines the representation of housing risk in contemporary Australian policy discourse through a critical analysis of two policy texts from the recent Victorian Coalition government (2010–2014). Drawing on governmentality theory and contemporary debates on neoliberalism, it examines how these policy texts perpetuate a discourse in which ‘housing risk’ is primarily understood as an issue for in iduals to manage, rather than as an issue with predominantly structural roots. It then explores how this particular neoliberal representation of ‘housing risk’ supports policy solutions that ultimately responsibilise in iduals through a narrow focus on education and employment as the pathways to independence in the private housing market. The article argues that this situation is problematic in a context of increasing rates of homelessness and diminished access to affordable housing across Australia.
Workload pressures in rural general practice: a qualitative investigation
Publisher: Informa UK Limited
Date: 2002
DOI: 10.1080/028134302760234573
Abstract: To examine whether there are workload pressures, as reported by healthcare professionals, which are unique to rural general practice. Semi-structured face-to-face interviews with staff from general practice teams located in different geographical areas. The north-east of Scotland (Gr ian). 16 GPs, 14 practice nurses, 9 practice managers and 14 administrative staff from 14 general practice teams. Recurrent themes were identified by the systematic analysis of interview transcripts. Workload pressures experienced at aDl locations included continual change, increased volumes of administration and dealing with rising patient expectations. Workload pressures particular to rural areas were long periods on-call and difficulties in taking time off from the practice, the "specialist-generalist" role of rural practitioners and feelings of responsibility, including a pastoral role within the community. Although some workload pressures exist regardless of location, rural practices appear to have some unique difficulties. Solutions which help practices cope with change and demand will be useful to both rural and urban practices. Staff from rural practices, however, also need location-specific solutions, such as those for reducing stress from being on-call for prolonged periods.
The epidemiology of regional and widespread musculoskeletal pain in rural versus urban settings in those ≥55 years
Publisher: SAGE Publications
Date: 02-04-2014
Abstract: To examine whether the prevalence of regional and chronic widespread pain (CWP) varies with rurality and to determine the characteristics of persons in rural locations in whom pain is found to be in excess. Participants, aged ≥55 years, from participating general practices in seven different geographical locations in Scotland were sent a postal questionnaire. The 1-month prevalence of 10 regional pain conditions plus CWP was identified using body manikins. Differences in the prevalence of pain with differing rurality were examined using Chi 2 test for trend. Thereafter, among the rural population, the relationships between pain and putative risk factors were examined using Poisson regression. Thus, results are described as risk ratios. There was some evidence to suggest that the prevalence of CWP increased with increasing rurality, although the magnitude of this was slight. No large or significant differences were observed with any regional pain conditions. Factors associated with the reporting of CWP included poor general health, feeling downhearted most of the time and selected measures of social contact. Factors independently associated with CWP included female gender (risk ratio: 1.24 95% confidence interval (CI): 0.997–1.55), poor self-rated health (risk ratio: 3.50 95% CI: 1.92–6.39) and low mood (risk ratio: 1.54 95% CI: 1.07–2.20). Also, having fewer than 10 people to turn to in a crisis was associated with a decrease in the risk of CWP – risk ratio: 0.68 (95% CI: 0.50–0.93) and 0.78 (95% CI: 0.60–1.02) for those with 5–10 and people, respectively. This study provides no evidence that the prevalence of regional musculoskeletal pain is increased in rural settings, although there is some evidence of a modest increase in CWP. Risk factors for CWP are similar to those seen in the urban setting, including markers of general health, mental health and also aspects of social contact. It may be, however, that social networks are more difficult to maintain in rural settings, and clinicians should be aware of the negative effect of perceived social isolation on pain in rural areas.
How and why do participatory women’s groups (PWGs) improve the quality of maternal and child health (MCH) care? A systematic review protocol
Publisher: BMJ
Date: 09-2019
DOI: 10.1136/BMJOPEN-2019-030461
Abstract: Community-based Participatory Women’s Groups (PWGs) have proven to be an effective intervention to improve maternal and child health (MCH) outcomes in low/middle-income countries (LMICs). Less is known about how PWGs exert their effects in LMICs and virtually nothing is known about the contextual issues, processes and power relationships that affect PWG outcomes in high resource settings. The aim of this systematic review is to synthesise and critically analyse the current evidence on how and why PWGs improve the quality of MCH care. We aim to demonstrate how PWGs function and why PWG interventions contribute to social and health outcomes. The protocol will follow Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols guidelines. The databases Medline (Ovid): Cumulative Index to Nursing and Allied Health Literature (Ebsco) Informit health suite Scopus, Australian HealthInfoNet, the Cochrane Library and other sources will be searched under broad categories: intervention, context and outcomes to 30 June 2019. As only secondary data will be analysed ethical approval is not required. The review will be disseminated to relevant organisations and presented in peer-reviewed papers and at conferences. This will be the first attempt to summarise the current available evidence on the characteristics, contextual influences and mechanisms that are associated with the outcomes and effectiveness of PWGs. CRD42019126533.
Dr. John has gone: Assessing health professionals' contribution to remote rural community sustainability in the UK
Publisher: Elsevier BV
Date: 08-2003
DOI: 10.1016/S0277-9536(02)00410-0
Abstract: Due mainly to increasing difficulties in recruiting and retaining health professionals to work in remote and peripheral areas of Scotland, there is discussion of the need to implement new models of primary health care provision. However, innovative service models may imply a reduction in the number of health professionals who live and work in remote communities. Currently decisions about remodelling service provision are being taken by National Health Service stakeholders, apparently with little consideration of the wider social and economic impacts of change. This paper aims to argue that health professionals contribute to the fabric of rural life in a number of ways and that decisions about health service redesign need to take this into account. As well as fulfilling a wide health and social care role for patients, the authors seek to show that health professionals are important to the social sustainability of rural communities as, due to their unique position, they are often at the heart of networks within and between communities. The wider economic contribution of health services in remote communities is important, but often underplayed. The authors propose that theories of capital, principally the concept of social capital, could help in investigating the wider contribution of health professionals to their local communities. Ultimately, it is proposed that health services, as embodied in nurses, doctors and others, could be highly important to the ongoing livelihood and social infrastructure of fragile remote communities. Since this area is poorly understood, there is a need for prospective primary research and evaluation of service redesign initiatives.
Urban versus rural populations' views of health care in Scotland
Publisher: SAGE Publications
Date: 10-2005
DOI: 10.1258/135581905774414240
Abstract: Objectives: To compare satisfaction with, and expectations of, health care of people in rural and urban areas of Scotland. Methods: Questions were included in the 2002 Scottish Social Attitudes Survey (SSAS). The Scottish House-hold Survey urban-rural classification was used to categorize locations. A random s le of 2707 people was contacted to participate in a face-to-face interview and a self-completion questionnaire survey. SPSS (v.10) was used to analyse the data. Relationships between location category and responses were explored using logistic regression analysis. Results: In all, 1665 (61.5%) interviews were conducted and 1507 (56.0%) respondents returned self-completion questionnaires. Satisfaction with local doctors and hospital services was higher in rural locations. While around 40% of those living in remote areas thought A& E services too distant, this did not rank as a top priority for health service improvement. This could be due to expectations that general practitioners would assist in out-of-hours emergencies. Most Scots thought services should be good in rural areas even if this was costly, and that older people should not be discouraged from moving to rural areas because of their likely health care needs. In all, 79% of respondents thought that care should be as good in rural as urban areas. Responses to many questions were independently significantly affected by rural/urban location. Conclusions: Most Scots want rural health care to continue to be good, but the new UK National Health Service (NHS) general practitioner contract and service redesign will impact on provision. Current high satisfaction, likely to be due to access and expectations about local help, could be affected. This study provides baseline data on attitudes and expectations before potential service redesign, which should be monitored at intervals in future.
Participation in rural community groups and links with psychological well-being and resilience: A cross-sectional community-based study
Publisher: Springer Science and Business Media LLC
Date: 08-04-2016
Social enterprises and regional cities: working together for mutual benefit
Publisher: Informa UK Limited
Date: 23-03-2021
Community participation in rural health: a scoping review
Publisher: Springer Science and Business Media LLC
Date: 18-02-2013
From passive welfare to community governance: Youth NGOs in Australia and Scotland
Publisher: Elsevier BV
Date: 03-2010
How Work Integration Social Enterprises Help to Realize Capability: A Comparison of Three Australian Settings
Publisher: Informa UK Limited
Date: 18-10-2021
Comparing needs with available resources: A study of the use of drug information by rheumatology patients
Publisher: SAGE Publications
Date: 12-1996
DOI: 10.1177/096100069602800405
Abstract: Reports results of a British Library funded project to examine the information needs of a group of rheumatology outpatients about the drugs they are taking and to carry out an audit of available information sources. The study was conducted between October 1994 and September 1995 and involved in-depth interviews with a s le of 40 patients attending a clinic in Aberdeen, Scotland. The aim was to assess how well current information resources matched patients' needs and to recommend improvements. Potential information sources included: Arthritis Care Newsletter television programmes newspapers and magazines family and friends health professionals (including community pharmacists) other patients public libraries and purchased books. Further work involved a questionnaire survey of 37 pharmaceutical companies and 230 rheumatology clinics in the UK regarding their information provision to patients. Concludes that many patients are not aware of a need for further information about their drugs and for these patients the presentation of more information might encourage them to think about evaluating their information requirements in future. Helpful models for rheumatology departments might include interdisciplinary teams, involving nurses and pharmacists, who can provide information tailored to in idual needs. Full results and recommendations of this project are published in the British Library Research and Development Department report 6227, 1995 (LISA ref. 9603034).
Evaluating the outcomes of rural health policy
Publisher: Wiley
Date: 21-01-2009
DOI: 10.1111/J.1440-1584.2008.01038.X
Abstract: With the development of policies specifically relating to rural health and health care provision, it seems apposite to consider evaluating their outcomes. Although little has apparently been done that specifically studies policy or processes, much of rural health research implicitly 'measures' policy effects for ex le, study of the effects of rural medical education. Given what is known about the policy-making process, rural health researchers should beware of thinking that policy outcome evaluation might be straightforward or that evidence produced from evaluation will seamlessly influence future or evolving policy. Nonetheless, as rural health research and policy mature, it is worth adopting some of the complex approaches to health policy outcome measurement and applying them to understand our field--to find out the extent that policy, and indeed our role and research, have effects on rural health and care provision. In this paper, we identify some of the quirks of policy and policy evaluation and provide ex les.
Implementing computerised workload data collection in rural primary health care
Publisher: Wiley
Date: 16-01-2004
DOI: 10.1111/J.1440-1584.2004.00547.X
Abstract: Describes the implementation of a computerised information system to collect workload data and discusses feedback from staff evaluation of use and value. Feedback interviews following service implementation. Remote rural primary health care, Scotland. Thirty-three primary health care staff. Not relevant, as the study was service development with qualitative evaluation. Findings of evaluation interviews indicate a number of themes common to remote rural practice that make implementing a computerised information system problematical. These include: logistical problems caused by small practice teams and wide areas covered inadequate allowance for recording of blurred roles and the wide range of non-clinical duties carried out lack of local contextual and cultural information, which is necessary to make sense of data collected. Remote rural health professionals found reports from the system of limited value as they felt they already had good knowledge of local activities and had few opportunities, due to small teams, to use data for service redesign. Remote rural primary care is underpinned by a number of organisational and philosophical features that require understanding when considering the implementation of initiatives developed in an urban working environment.
Possibility and risk in encounter between people with and without intellectual disability
Publisher: Informa UK Limited
Date: 29-10-2021
Resilience in Web-Based Mental Health Communities: Building a Resilience Dictionary With Semiautomatic Text Analysis
Publisher: JMIR Publications Inc.
Date: 22-09-2022
DOI: 10.2196/39013
Abstract: Resilience is an accepted strengths-based concept that responds to change, adversity, and crises. This concept underpins both personal and community-based preventive approaches to mental health issues and shapes digital interventions. Online mental health peer-support forums have played a prominent role in enhancing resilience by providing accessible places for sharing lived experiences of mental issues and finding support. However, little research has been conducted on whether and how resilience is realized, hindering service providers’ ability to optimize resilience outcomes. This study aimed to create a resilience dictionary that reflects the characteristics and realization of resilience within online mental health peer-support forums. The findings can be used to guide further analysis and improve resilience outcomes in mental health forums through targeted moderation and management. A semiautomatic approach to creating a resilience dictionary was proposed using topic modeling and qualitative content analysis. We present a systematic 4-phase analysis pipeline that preprocesses raw forum posts, discovers core themes, conceptualizes resilience indicators, and generates a resilience dictionary. Our approach was applied to a mental health forum run by SANE (Schizophrenia: A National Emergency) Australia, with 70,179 forum posts between 2018 and 2020 by 2357 users being analyzed. The resilience dictionary and taxonomy developed in this study, reveal how resilience indicators (ie, “social capital,” “belonging,” “learning,” “adaptive capacity,” and “self-efficacy”) are characterized by themes commonly discussed in the forums each theme’s top 10 most relevant descriptive terms and their synonyms and the relatedness of resilience, reflecting a taxonomy of indicators that are more comprehensive (or compound) and more likely to facilitate the realization of others. The study showed that the resilience indicators “learning,” “belonging,” and “social capital” were more commonly realized, and “belonging” and “learning” served as foundations for “social capital” and “adaptive capacity” across the 2-year study period. This study presents a resilience dictionary that improves our understanding of how aspects of resilience are realized in web-based mental health forums. The dictionary provides novel guidance on how to improve training to support and enhance automated systems for moderating mental health forum discussions.
Rural/urban differences in accounts of patients’ initial decisions to consult primary care
Publisher: Elsevier BV
Date: 06-2006
DOI: 10.1016/J.HEALTHPLACE.2004.11.007
Abstract: In the UK, patients in urban areas consult primary health care more than rural patients for both trivial and serious conditions. This study, involving focus groups and interviews, examined rural/urban differences in accounts of patients' intentions around initial decisions to consult general practice. Findings suggest 'relationships' between doctors and patients and easier access to appointments could affect consulting in rural areas, while decision-making for urban patients tended to be more consumerist. Perceptions about access to different health services meant rural patients' decision-making in out-of-hours emergencies was complex. Rural/urban differences in demand could be affected by change in UK primary care provision.
Social Enterprise and Wellbeing in Community Life
Publisher: Emerald
Date: 08-2016
Abstract: This paper aims to explore the well-being impacts of social enterprise, beyond a social enterprise per se , in everyday community life. An exploratory case study was used. The study’s underpinning theory is from relational geography, including Spaces of Wellbeing Theory and therapeutic assemblage. These theories underpin data collection methods. Nine social enterprise participants were engaged in mental mapping and walking interviews. Four other informants with “boundary-spanning” roles involving knowledge of the social enterprise and the community were interviewed. Data were managed using NVivo, and analysed thematically. Well-being realised from “being inside” a social enterprise organisation was further developed for participants, in the community, through positive interactions with people, material objects, stories and performances of well-being that occurred in everyday community life. Boundary spanning community members had roles in referring participants to social enterprise, mediating between participants and structures of community life and normalising social enterprise in the community. They also gained benefit from social enterprise involvement. This paper uses relational geography and aligned methods to reveal the intricate connections between social enterprise and well-being realisation in community life. There is potential to pursue this research on a larger scale to provide needed evidence about how well-being is realised in social enterprises and then extends into communities.
A scoping review of the association between rural medical education and rural practice location
Publisher: Springer Science and Business Media LLC
Date: 06-05-2015
The power of stories to persuade: The storying of midwives and the financial narratives of central policy makers
Publisher: Cambridge University Press (CUP)
Date: 03-2011
DOI: 10.5172/JMO.2011.17.2.146
Abstract: The power of stories to persuade in infl uencing the process of change is the focus of this article. Attention is given to the importance of stories in making sense of past experience, of unifying groups, and in presenting options for future engagement and action. Unlike the narrative concern with sequencing, coherence and the need for a beginning, middle and end, it is argued that stories are often partial and ongoing, occur at multiple levels compete, complement and redefine positions. The plurality and political nature of stories are illustrated in an analysis of data drawn from a longitudinal study of six health care sites in remote and rural Scotland. The study concludes by arguing that stories are a powerful political vehicle in influencing sense-making and a critical component in maintaining choice and defl ecting the imposition of a single simple solution (hegemonic influence) over various interpretations of what are complex context-based issues.
Maternity care models in a remote and rural network: assessing clinical appropriateness and outcome indicators
Publisher: BMJ
Date: 29-03-2010
Abstract: Little is known about performance of small rural maternity units, including stand-alone midwife units. To describe the proportions of women delivering locally, clinical appropriateness of model of care at delivery and outcome indicators for three rural staffing models of care. Case note review. Remote and rural maternity units in NHS North of Scotland Region. 1400 deliveries to women from the catchments of eight rural units (stratified by staffing model) included those in local rural units and in associated distant referral units. Descriptive analysis examined women's risk, clinical appropriateness of model of care at delivery and outcomes aggregated by local catchment unit type and delivery unit type. Local deliveries by staffing model were 31% (214/697) in midwife stand-alone units, 70% (236/336) in midwife units alongside non-obstetric medical support and 86% (317/367) in small obstetric-led units. Model of care at delivery was generally appropriate according to risk. Judged inappropriate were 3% (22/696) of women with complications delivering in midwife stand-alone units and of referral unit deliveries, 6% (37/632) with suspected complications unconfirmed, plus 5% (31/633) discharged undelivered by referral hospital at >36 weeks' gestation. Risk profiles of catchment s les were similar, but caesarean section rates appeared lower and neonatal unit admissions higher for women from stand-alone midwife units. Rural women were generally referred appropriately for specialist care. These stand-alone midwife units provided intrapartum care for approximately one-third of rural women who remained without complications. Further evidence is needed about outcomes by staffing models of care.
A modified Continuous Quality Improvement approach to improve culturally and socially inclusive care within rural health services
Publisher: Wiley
Date: 23-03-2018
DOI: 10.1111/AJR.12409
Abstract: The sickest Australians are often those belonging to non-privileged groups, including Indigenous Australians, gay, lesbian, bisexual, transsexual, intersex and queer people, people from culturally and linguistically erse backgrounds, socioeconomically disadvantaged groups, and people with disabilities and low English literacy. These consumers are not always engaged by, or included within, mainstream health services, particularly in rural Australia where health services are limited in number and tend to be generalist in nature. The aim of this study was to present a new approach for improving the sociocultural inclusivity of mainstream, generalist, rural, health care organisations. This approach combines a modified Continuous Quality Improvement framework with Participatory Action Research principles and Foucault's concepts of power, discourse and resistance to develop a change process that deconstructs the power relations that currently exclude marginalised rural health consumers from mainstream health services. It sets up processes for continuous learning and consumer responsiveness. The approach proposed could provide a Continuous Quality Improvement process for creating more inclusive mainstream health institutions and fostering better engagement with many marginalised groups in rural communities to improve their access to health care. The approach to improving cultural inclusion in mainstream rural health services presented in this article builds on existing initiatives. This approach focuses on engaging on-the-ground staff in the need for change and preparing the service for genuine community consultation and responsive change. It is currently being trialled and evaluated.
Assessing the value of rural community health services
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/PY17125
Abstract: Rural health services are challenging to manage, a situation perhaps exacerbated by necessity to comply with one-size-fits-all performance frameworks designed for larger services. This raises the questions: do we know what rural health services are doing that is valuable and how should that be evaluated? Twenty-eight qualitative interviews with CEOs and staff of seven Victorian rural health services were conducted, exploring what they value about their ‘best practice’. Themes emergent from analysis were compared with 19 government-produced health planning and performance documents. It was found that most dimensions of rural services value aligned with current performance frameworks, but a significant theme about ‘community’ was missing. Highlighting the relevance of this theme, achieving community-oriented goals accounted for one-third of best practice case studies identified by health services personnel. It is concluded that generating community outcomes is a significant area of value aimed for by rural health services that is missing from current performance measurement frameworks applied to Victorian health services. In this study, a new Evaluative Framework is outlined and further steps needed are suggested.
Collaboration with community connectors to improve primary care access for hardly reached people: a case comparison of rural Ireland and Australia
Publisher: Springer Science and Business Media LLC
Date: 06-03-2020
DOI: 10.1186/S12913-020-4984-2
Abstract: This study presents a way for health services to improve service access for hardly reached people through an exploration of how staff can find and collaborate with citizens (referred to as connectors) who span socio-cultural boundaries in their community. The study explored the local socio-cultural contexts of connectors’ boundary spanning activities and if they are health related boundary spanning occurring between connectors and health professionals at the interface of health systems and community and the opportunities and barriers to actively seeking out and collaborating with community connectors to access marginalised and hardly reached people. We conducted a qualitative case comparison from rural Ireland and Australia. Following purposive snow-ball s ling techniques to recruit participants, semi-structured interviews were conducted with 34 community informants, 21 healthcare staff and 32 connectors. Transcripts were coded and analysed using an inductive approach to ascertain categories and overall themes. We found a erse s le of connectors relating to heterogenous, small and locally distinct groups of hardly reached people. Overall 26 connectors were active at the interface between health services and the community, with variation in how this occurred between cases. The majority (21) described one or more health related activities with hardly reached people. All connectors expressed a willingness to develop a relationship with local health services on issues they identified as relevant. Barriers to collaborations between connectors and health services related to bureaucracy, workload, and burnout. Collaborating with connectors has potential as one strategy to improve access to health services for hardly reached people. To enact this, health staff need to identify local socio-cultural boundaries and associated connectors, facilitate two-way connections at the boundary between health services and community and enable collaboration by attending to activities in the community, at the interface between health services and community, and within the health system.
Community participation for rural health: a review of challenges
Publisher: Wiley
Date: 03-12-2015
DOI: 10.1111/HEX.12314
Are rural health professionals also social entrepreneurs?
Publisher: Elsevier BV
Date: 12-2009
DOI: 10.1016/J.SOCSCIMED.2009.09.003
Abstract: Social entrepreneurs formally or informally generate community associations and networking that produces social outcomes. Social entrepreneurship is a relatively new and poorly understood concept. Policy promotes generating community activity, particularly in rural areas, for health and social benefits and 'community resilience'. Rural health professionals might be well placed to generate community activity due to their status and networks. This exploratory study, conducted in rural Tasmania and the Highlands and Islands of Scotland considered whether rural health professionals act as social entrepreneurs. We investigated activities generated and processes of production. Thirty-eight interviews were conducted with general practitioners, community nurses, primary healthcare managers and allied health professionals living and working rurally. Interviewees were self-selecting responders to an invitation for rural health professionals who were 'formally or informally generating community associations or networking that produced social outcomes'. We found that rural health professionals initiated many community activities with social outcomes, most related to health. Their identification of opportunities related to knowledge of health needs and ex les of initiatives seen elsewhere. Health professionals described ready access to useful people and financial resources. In building activities, health professionals could simultaneously utilise skills and knowledge from professional, community member and personal dimensions. Outcomes included social and health benefits, personal 'buzz' and community capacity. Health professionals' actions could be described as social entrepreneurship: identifying opportunities, utilising resources and making 'deals'. They also align with community development. Health professionals use contextual knowledge to envisage and grow activities, indicating that, as social entrepreneurs, they do not explicitly choose a social mission, rather they act within their known world-view. Policymakers could consider ways to engage rural health professionals as social entrepreneurs, in helping to produce resilient communities.
The buck stops here: Midwives and maternity care in rural Scotland
Publisher: Elsevier BV
Date: 06-2011
DOI: 10.1016/J.MIDW.2010.10.007
Abstract: To explore and understand what it means to provide midwifery care in remote and rural Scotland. Qualitative interviews with 72 staff from 10 maternity units, analysed via a case study approach. Remote and rural areas of Scotland. Predominantly midwives, with some additional interviews with paramedics, general surgeons, anaesthetists and GPs. Remote and rural maternity care includes a range of settings and models of care. However, the impact of rural geographies on decision-making and risk assessment is common to all settings. Making decisions and dealing with the implications of these decisions is, in many cases, done without onsite specialist support. This has implications for the skills and competencies that are needed to practice midwifery in remote and rural settings. Whereas most rural midwives reported that their skills in risk assessment and decisions to transfer were well developed and appropriate to practising in their particular settings, they perceived these decisions to be under scrutiny by urban-based colleagues and felt the need to stress their competence in the face of what they imagined to be stereotypes of rural incompetence. This study shows that skills in risk assessment and decision-making are central to high quality remote and rural midwifery care. However, linked to different perspectives on care, there is a risk that these skills can be undermined by contact with colleagues in large urban units, particularly when staff do not know each other well. There is a need to develop a professional understanding between midwives in different locations. It is important for the good working relationships between urban and rural maternity units that all midwives understand the importance of contextual knowledge in both decisions to transfer from rural locations and the position of midwives in receiving units. Multiprofessional CPD courses have been effective in bringing together teams around obstetric emergencies we suggest that a similar format may be required in considering issues of transfer.
Is a global rural and remote health research agenda desirable or is context supreme?
Publisher: Wiley
Date: 06-2010
DOI: 10.1111/J.1440-1584.2010.01140.X
Abstract: This paper proposes that there is value in international comparison of rural and remote health-care service delivery models because of practical reasons - to find ideas, models and lessons to address 'local' delivery challenges and for theoretical reasons - to derive a conceptual framework for international comparison. Literature review and commentary. There are significant challenges to international comparative research that have been highlighted generically for ex le, equivalence of terminology, datasets and indicators. Context supremacy has been raised as a reason why models and research findings might not be transferable. This paper proposes that there is insufficient knowledge about how rural contexts in relation to health service delivery are similar or different internationally. Investigating contexts in different countries and identifying the dimensions on which service delivery might differ is an important stimulus for study. The paper suggests, for discussion, dimensions on which rural service delivery might differ between countries and regions, including physical geographical factors, social interaction with rurality, policies of service provision and the politics and operation of health care. The paper asks whether, given the need to develop models suitable for rural areas and for theory on rural health to extend, international comparative research is an imperative or an indulgence.
Involving rural older people in service co-production: Is there an untapped pool of potential participants?
Publisher: Elsevier BV
Date: 04-2014
Web-Based Technologies to Support Carers of People Living With Dementia: Protocol for a Mixed Methods Stepped-Wedge Cluster Randomized Controlled Trial
Publisher: JMIR Publications Inc.
Date: 19-05-2022
DOI: 10.2196/33023
Abstract: Informal carers play a significant role in supporting people living with dementia however, carers in rural areas are often isolated, with limited access to support services. Although dementia-friendly communities provide valued support for carers, access to them is limited as they are few and geographically dispersed. This study’s aim was to increase support and services for rural informal carers of people living with dementia by using information and communication technologies accessed through an integrated website and mobile app—the Verily Connect app. The objective of this protocol is to detail the research design used in a complex study that was situated in a challenging real-world setting integrating web-based and on-ground technology and communication. Therefore, it is anticipated that this protocol will strengthen the research of others exploring similar complex concepts. A stepped-wedge, open-cohort cluster randomized controlled trial was conducted to implement Verily Connect across 12 rural Australian communities. The Verily Connect intervention delivered web-based, curated information about dementia, a localized directory of dementia services and support, group and in idual chat forums, and peer support through videoconference. During the implementation phase of 32 weeks, Verily Connect was progressively implemented in four 8-weekly waves of 3 communities per wave. Usual care, used as a comparator, was available to carers throughout the study period. Participants and researchers were unblinded to the intervention. There were 3 cohorts of participants: carers, volunteers, and staff participants were recruited from their communities. The primary outcome measure was perceived carer social support measured using the Medical Outcomes Study-Social Support Survey. Volunteers and staff provided feedback on their participation in Verily Connect as qualitative data. Qualitative data were collected from all cohorts of participants through interviews and focus groups. Process evaluation data were collected through interviews and memos written by research staff. Data on the costs of implementing Verily Connect were collected by the research team members and evaluated by a health economist. Between August 2018 and September 2019, a total of 113 participants were recruited. There were 37 (32.7%) carers, 39 (34.5%) volunteers, and 37 (32.7%) health service staff. The study was complex because of the involvement of multiple and varied communities of carers, volunteers, health service staff, and research team members originating from 5 universities. Web-based technologies were used as intervention strategies to support carers and facilitate the process of undertaking the study. The Verily Connect trial enabled the testing and further development of a web-based approach to increasing support for carers of people living with dementia across a erse rural landscape in Australia. This protocol provides an ex le of how to conduct a pragmatic evaluation of a complex and co-designed intervention involving multiple stakeholders. Australian New Zealand Clinical Trials Registry ACTRN12618001213235 rjvrasf RR1-10.2196/33023
Information for enterprise: The scottish enterprise network and the provision of business information
Publisher: Emerald
Date: 07-1993
DOI: 10.1108/EB051326
Abstract: Scottish Enterprise was established by the Secretary of State for Scotland on 1 April 1991 by bringing together the functions of the Scottish Development Agency and the Training Agency. Its overall role is to encourage and aid economic development on behalf of the Scottish Office. Part of this role is the provision of business information and advice services to companies in Scotland, particularly smaller companies. This paper aims, firstly, to examine the structure of the Scottish Enterprise network, looking at the roles played by Local Enterprise Companies (LECs) and Local Enterprise Trusts (LETs). It then goes on to look at how Enterprise provides information for businesses in two distinctly different areas of Scotland‐Gr ian and Ayrshire. The paper concludes with an overview of current and possible future developments, such as One Stop Shops, and their impact on the provision and uptake of business information.
Starting social enterprises in remote and rural Scotland: best or worst of circumstances?
Publisher: Inderscience Publishers
Date: 2008
Online Mental Health Forums and Rural Resilience: Mixed Methods Study and Logic Model
Publisher: JMIR Publications Inc.
Date: 28-06-2023
DOI: 10.2196/47459
Abstract: Rural mental health is a growing area of concern internationally, and online mental health forums offer a potential response to addressing service gaps in rural communities. The objective of this study was to explore and identify pathways by which online peer support mental health forums help to build resilience for rural residents experiencing mental ill-health by contributing to overcoming their specific contextual challenges. We developed a Theoretical Resilience Framework and applied it to 3000 qualitative posts from 3 Australian online mental health forums and to data from 30 interviews with rural forum users. Drawing on the findings and an abductive approach, a logic model was developed to illustrate links between the resilience resources built and enabling features of forums that make them spaces that facilitate resilience. The study demonstrated that online forums make valuable contributions to social well-being and access to a range of timely support services for rural people experiencing mental ill-health, and, while doing so, involve users in the processes of resilience building. The study provides a new way for practitioners to frame the work of and value produced by forums. It gives a logic model that can be used in evaluation and audit as it facilitates a causal framing of how forums, as an intervention, link with resilience outcomes. Ultimately, the study contributes to developing new knowledge about how rural resilience building can be conceptualized and measured while showing how forums are part of contemporary health service provision in rural places.
Social enterprises developing capability and well-being through work-based learning
Publisher: Informa UK Limited
Date: 15-05-2022
Rurality, remoteness and the change process: Evidence from a study of maternity services in the north of Scotland
Publisher: SAGE Publications
Date: 02-2007
DOI: 10.1258/095148407779614963
Abstract: There is a wealth of material on 'how to do' change plus empirical work revealing change process complexity. In health care, the relevance of context is highlighted, but studies of rural health-care change have focused on community impacts. There is little to inform health-care managers of how remoteness and rurality impact upon change processes. This study considered Scottish maternity units and aimed to identify issues in the change process associated with rurality and remoteness. Six units were purposively selected and 131 interviews were conducted with managers, staff and community members over 15 months. Analysis induced themes pertinent to remoteness and rurality. These included: perceived 'distance' between senior managers imposing change and the wider community of staff and residents perceptions of community vulnerability and tensions arising from working in small teams and living in small communities. The study provides useful insights for rural managers at a time of considerable service reconfiguration.
Geographic distribution of primary care physicians in Japan and Britain
Publisher: Elsevier BV
Date: 2010
DOI: 10.1016/J.HEALTHPLACE.2009.07.005
Abstract: Geographic distributions of primary care physicians in Japan and Britain were compared with each other. Regional variation in the number of primary care physicians per unit population was larger in Japan than in Britain. The Gini coefficient of primary care physicians against population in Japan (0.1755) was more than twice that observed for Britain (0.0837), indicating a substantially less equal distribution in Japan. The results can probably be explained by differences in the primary care systems of the two countries.
How and why do women’s groups (WGs) improve the quality of maternal and child health (MCH) care? A systematic review of the literature
Publisher: BMJ
Date: 02-2022
DOI: 10.1136/BMJOPEN-2021-055756
Abstract: This systematic review was undertaken to assist the implementation of the WOmen’s action for Mums and Bubs (WOMB) project which explores Aboriginal and Torres Strait Islander community women’s group (WG) action to improve maternal and child health (MCH) outcomes. There is now considerable international evidence that WGs improve MCH outcomes, and we were interested in understanding how and why this occurs. The following questions guided the review: (1) What are the characteristics, contextual influences and group processes associated with the MCH outcomes of WGs? (2) What are the theoretical and conceptual approaches to WGs? (3) What are the implications likely to inform Aboriginal and Torres Strait Islander WGs? We systematically searched electronic databases (MEDLINE (Ovid) CINAHL (Ebsco) Informit health suite, Scopus, Emcare (Ovid) and the Cochrane Library and Informit), online search registers and grey literature using the terms mother, child, group, participatory and community and their variations during all time periods to January 2021. The inclusion criteria were: (1) Population: studies involving community WGs in any country. (2) Intervention: a program/intervention involving any aspect of community WGs planning, acting, learning and reviewing MCH improvements. (3) Outcome: studies with WGs reported a component of: (i) MCH outcomes or (ii) improvements in the quality of MCH care or (iii) improvements in socioemotional well-being of mothers and/or children. (4) Context: the primary focus of initiatives must be in community-based or primary health care settings. (5) Process: includes some description of the process of WGs or any factors influencing the process. (6) Language: English. (7) Study design: all types of quantitative and qualitative study designs involving primary research and data collection. Data were extracted under 14 headings and a narrative synthesis identified group characteristics and analysed the conceptual approach to community participation, the use of theory and group processes. An Australian typology of community participation, concepts from Aboriginal and Torres Strait Islander group work and an adapted framework of Cohen and Uphoff were used to synthesise results. Risk of bias was assessed using Joanna Briggs Institute Critical Appraisal Tools. Thirty-five (35) documents were included with studies conducted in 19 countries. Fifteen WGs used participatory learning and action cycles and the remainder used cultural learning, community development or group health education. Group activities, structure and who facilitated groups was usually identified. Intergroup relationships and decision-making were less often described as were important concepts from an Aboriginal or Torres Strait Islander perspective (the primacy of culture, relationships and respect). All but two documents used an explicit theoretical approach. Using the typology of community participation, WGs were identified as predominantly developmental (22), instrumental (10), empowerment (2) and one was unclear. A framework to categorise links between contextual factors operating at micro, meso and macro levels, group processes and MCH improvements is required. Currently, despite a wealth of information about WGs, it was difficult to determine the methods through which they achieved their outcomes. This review adds to existing systematic reviews about the functioning of WGs in MCH improvement in that it covers WGs in both high-income and low-income settings, identifies the theory underpinning the WGs and classifies the conceptual approach to participation. It also introduces an Australian Indigenous perspective into analysis of WGs used to improve MCH. CRD42019126533.
Community boundary spanners as an addition to the health workforce to reach marginalised people: a scoping review of the literature
Publisher: Springer Science and Business Media LLC
Date: 10-09-2018
The power of stories to persuade: The storying of midwives and the financial narratives of central policy makers
Publisher: Cambridge University Press (CUP)
Date: 03-2011
DOI: 10.1017/S1833367200001589
Abstract: The power of stories to persuade in infl uencing the process of change is the focus of this article. Attention is given to the importance of stories in making sense of past experience, of unifying groups, and in presenting options for future engagement and action. Unlike the narrative concern with sequencing, coherence and the need for a beginning, middle and end, it is argued that stories are often partial and ongoing, occur at multiple levels compete, complement and redefine positions. The plurality and political nature of stories are illustrated in an analysis of data drawn from a longitudinal study of six health care sites in remote and rural Scotland. The study concludes by arguing that stories are a powerful political vehicle in influencing sense-making and a critical component in maintaining choice and defl ecting the imposition of a single simple solution (hegemonic influence) over various interpretations of what are complex context-based issues.
Exploratory scoping of the literature on factors that influence oral health workforce planning and management in developing countries
Publisher: Wiley
Date: 12-12-2017
DOI: 10.1111/IDH.12260
Abstract: The purpose of this study was to scope the literature that exists about factors influencing oral health workforce planning and management in developing countries (DCs). The Arksey and O'Malley method for conducting a scoping review was used. A replicable search strategy was applied, using three databases. Factors influencing oral health workforce planning and management in DCs identified in the eligible articles were charted. Four thousand citations were identified 41 papers were included for review. Most included papers were situational analyses. Factors identified were as follows: lack of data, focus on the restorative rather than preventive care in practitioner education, recent increase in number of dental schools (mostly private) and dentistry students, privatization of dental care services which has little impact on care maldistribution, and debates about skill mix and scope of practice. Oral health workforce management in the eligible studies has a bias towards dentist-led systems. Due to a lack of country-specific oral health related data in developing or least developed countries (LDCs), oral health workforce planning often relies on data and modelling from other countries. Approaches to oral health workforce management and planning in developing or LDCs are often characterized by approaches to increase numbers of dentists, thus not ameliorating maldistribution of service accessibility. Governments appear to be reducing support for public and preventative oral healthcare, favouring growth in privatized dental services. Changes to professional education are necessary to trigger a paradigm shift to the preventive approach and to improve relationships between different oral healthcare provider roles. This needs to be premised on greater appreciation of preventive care in health systems and funding models.
Primary health-care teams as adaptive organizations: Exploring and explaining work variation using case studies in rural and urban Scotland
Publisher: SAGE Publications
Date: 08-2005
Abstract: It is acknowledged, internationally, that health-care practitioners' work differs between rural and urban areas. While several factors affect in idual teams' activities, there is little understanding about how patterns of work evolve. Consideration of work in relation to local circumstances is important for training, devising contracts and redesigning services. Six case studies centred on Scottish rural and urban general practices were used to examine, in-depth, the activity of primary health-care teams. Quantitative workload data about patient contacts were collected over 24 months. Interviews and diaries revealed insightful qualitative data. Findings revealed that rural general practitioners and district nurses tended to conduct more consultations per practice patient compared with their urban counterparts. Conditions seen and work tasks varied between case study teams. Qualitative data suggested that the key reasons for variation were: local needs and circumstances choices made about deployment of available time, team composition and the extent of access to other services. Primary care teams might be viewed as adaptive organizations, with co-evolution of services produced by health professionals and local people. The study highlights limitations in the application of workload data and suggests that understanding the nature of work in relation to local circumstances is important in service redesign.
Being rural in rural health research
Publisher: Elsevier BV
Date: 09-2012
Sustainable maternity services in remote and rural Scotland? A qualitative survey of staff views on required skills, competencies and training
Publisher: BMJ
Date: 02-2005
A theory of how rural health services contribute to community sustainability
Publisher: Elsevier BV
Date: 11-2012
Implementation of oral health initiatives by Australian rural communities: Factors for success
Publisher: Hindawi Limited
Date: 16-07-2018
DOI: 10.1111/HSC.12483
Abstract: In this paper, we consider factors significant in the success of community participation in the implementation of new oral health services. Our analysis draws on data from the Rural Engaging Communities in Oral Health (Rural ECOH) study (2014-2016). We aimed to assess the Australian relevance of a Scottish community participation framework for health service development Remote Service Futures. Internationally, community participation in planning of health initiatives is common, but less common in new service implementation. Health managers query the legitimacy of "lay" community members, whether they will persist, and whether they can act as change agents. Our data provide evidence that helps answer these queries. Six communities, located within regions covered by two large rural primary healthcare organisations (Medicare Locals), were selected in two Australian states. Two university-based facilitators worked with a group of local residents (for each community) to monitor implementation of new oral health initiatives designed through participatory processes. Data about implementation were collected through interviews with 28 key stakeholders at the beginning of implementation and 12 months later. Data were coded, themed and analysed abductively. Five themes emerged the inter-relationship between community motivation to participate with the fortunes of the oral health initiatives, having the "right" people involved, continuing involvement of sponsors and/or significant people, trusting working relationships between participants and perceiving benefits from participation. Findings provide evidence of a role for community participation in implementing new community services if solid partnerships with relevant providers can be negotiated and services are seen to be relevant and useful to the community.
Measuring oral health literacy: a scoping review of existing tools
Publisher: Springer Science and Business Media LLC
Date: 12-2014
CPT-Based Design Method for Helical Piles in Sand
Publisher: Canadian Science Publishing
Date: 10-05-2023
Coupled relaxation channels of excitons in monolayer MoSe
Publisher: Royal Society of Chemistry (RSC)
Date: 2017
DOI: 10.1039/C7NR05174C
Abstract: Using ultrafast degenerate pump-probe spectroscopy, we have investigated the ultrafast exciton dynamics of monolayer MoSe
Citizen participation in health services co-production: a roadmap for navigating participation types and outcomes
Publisher: CSIRO Publishing
Date: 2017
DOI: 10.1071/PY16133
Abstract: Primary healthcare managers are required to include citizens in service co-design and co-production. Health policy guidance appears deceptively simple and largely outlines how people could participate in a range of health services activities. Policy tends to neglect outcomes assessment, and a multidisciplinary academic literature corpus is large and complex to navigate for practical, time-poor managers. In this paper, we set out to provide a summary ‘map’ of key concepts in participation to assist managers in aligning participants, activities, expected outcomes and outcome indicators, and to consider contextual factors that could affect participation processes and outcomes. The intention is a practical tool for planning and evaluation of participation. The map is built drawing on policy guidance, literature and authors’ experiences of implementing and researching health services participation.
Improving access to information for nursing staff in remote areas: The potential of the internet and other networked information resources
Publisher: Elsevier BV
Date: 02-1999
Documentation note: Drug information for patients: Do we know the answer?
Publisher: Emerald
Date: 04-1994
DOI: 10.1108/EB026937
Abstract: Under the Patient's Charter, The National Health Service has an obligation to become more responsive to the needs of patients. These needs have been shown by research to include the provision of good quality information, both oral and written, about patients' drugs. The provision of such information has been shown to increase compliance, patient satisfaction and confidence of patients in coping with their illness, drugs and any side‐effects. The information in this article was gathered as a preliminary to further research. It combines a review of the literature with information from a series of informal interviews with members of the local healthcare team. The article looks at where patients get drug information from, then moves on to examine the value of providing such information. Issues arising in the provision of drug information are considered and recommendations are provided which indicate long term concerns and approaches for further work.
Community co-production: Social enterprise in remote and rural communities
Publisher: Edward Elgar Publishing
Date: 29-06-2012
Health care management: models for evidence‐based practice
Publisher: Emerald
Date: 08-2001
DOI: 10.1108/02689230110403777
Abstract: Presents models suggesting how research evidence can best be operationalised within health care commissioning. Models were derived from data gathered from surveys of Scottish health board managers and GP fundholders regarding the use of information in commissioning from 1995 to 1997. Feedback on the models was obtained subsequently from practitioners in 1998. Two models, one for health board managers and the other for GPs, are presented. These include critical success factors in achieving evidence‐based commissioning and factors that are likely to predispose and precipitate evidence‐based practice. Given a culture demanding transparency, accountability and continuing improvement, the models provide tools for reflection, evaluation and planning. In addition, they identify a pragmatic role for managers in evidence‐based commissioning and provide a framework for audit.
Nepalese dental hygiene and dental students’ career choice motivation and plans after graduation: a descriptive cross-sectional comparison
Publisher: Springer Science and Business Media LLC
Date: 12-2015
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