ORCID Profile
0000-0002-9013-1068
Current Organisation
The University of Canberra
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Publisher: BMJ
Date: 12-2020
DOI: 10.1136/BMJOPEN-2020-040479
Abstract: Cardiac rehabilitation (CR) is recommended for secondary prevention of cardiovascular disease and reducing the risk of repeat cardiac events. Physical activity is a core component of CR however, studies show that participants remain largely sedentary. Sedentary behaviour is an independent risk factor for all-cause mortality. Strategies to encourage sedentary behaviour change are needed. This study will explore the effectiveness and costs of a smartphone application (Vire) and an in idualised online behaviour change program (ToDo-CR) in reducing sedentary behaviour, all-cause hospital admissions and emergency department visits over 12 months after commencing CR. A multicentre, assessor-blind parallel randomised controlled trial will be conducted with 144 participants (18+ years). Participants will be recruited from three phase-II CR centres. They will be assessed on admission to CR and randomly assigned (1:1) to one of two groups: CR plus the ToDo-CR 6-month programme or usual care CR. Both groups will be re-assessed at 6 months and 12 months for the primary outcome of all-cause hospital admissions and presentations to the emergency department. Accelerometer-measured changes in sedentary behaviour and physical activity will also be assessed. Logistic regression models will be used for the primary outcome of hospital admissions and emergency department visits. Methods for repeated measures analysis will be used for all other outcomes. A cost-effectiveness analysis will be conducted to evaluate the effects of the intervention on the rates of hospital admissions and emergency department visits within the 12 months post commencing CR. This study received ethical approval from the Australian Capital Territory Health (2019.ETH.00162), Calvary Public Hospital Bruce (20–2019) and the University of Canberra (HREC-2325) Human Research Ethics Committees (HREC). Results will be disseminated through peer-reviewed academic journals. Results will be made available to participants on request. ACTRN12619001223123.
Publisher: Emerald
Date: 13-04-2015
DOI: 10.1108/IGDR-03-2014-0008
Abstract: – This paper aims to analyse factors that influence child schooling outcomes in India, specifically the role of gender. – This paper uses data from the nationally representative Indian National Family Health Surveys 1995-1996 and 2005-2006 and estimates Heckman s le selection, cluster fixed-effects and household fixed-effects econometric models. The dependent variables are the child’s enrolment status and conditional on enrolment child’s years of schooling. – This analysis finds statistically significant evidence of male advantage both in schooling enrolment as well as years of schooling. However, using a cluster fixed-effects model, our analysis finds that within a village, conditional on being enrolled, girls spend more years in school relative to boys. Other results show that parental schooling has a positive and statistically significant impact on child schooling. There is statistically significant wealth effect, community effect and regional disparities between states in India. – The large s le size and the range of questions available in this data set, allows us to explore the influence of in idual, household and village level social, economic and cultural factors on child schooling. The role of gender on child schooling within a village, intrahousehold resource allocation for schooling and regional gender differences in schooling are important issues in India, where education outcomes remain poor for large segments of the population.
Publisher: Springer Science and Business Media LLC
Date: 04-2017
Publisher: Springer Science and Business Media LLC
Date: 31-05-2023
DOI: 10.1007/S11764-023-01401-5
Abstract: To critically synthesise qualitative research to understand experiences of supportive care in people affected by brain cancer and their informal caregivers. A qualitative systematic review was conducted according to the Joanna Briggs methodology and has been reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) Guidelines. Electronic databases were searched by an expert systematic review librarian for all qualitative studies irrespective of research design. All publications were double screened by two reviewers using a pre-determined exclusion and inclusion criteria. The review was managed using Covidence systematic review software. Methodological quality assessment and data extraction were performed. Qualitative findings accompanied by illustrative quotes from included studies were extracted and grouped into categories, which created the overall synthesised findings. A total of 33 studies were included which represented a total s le of 671 participants inclusive of 303 patients and 368 informal caregivers. There was a total of 220 in idual findings included in this review, which were synthesised into two findings (1) caregivers and patients perceived supports which would have been helpful and (2) caregiver and patient experiences of unmet supportive care needs. This review highlighted the suffering and distress caused by brain cancer and associated treatments. Both patients and their informal caregivers experienced disconnect from themselves in renegotiating roles, and a profound sense of loneliness as the physical deterioration of the disease progressed. Both patients and informal caregivers reported similar unmet needs within the current service provision for brain cancer. However, what is apparent is that current cancer services are provided solely for patients, with little or no consideration to the support needs of both the patient and their informal caregiver. Service re-design is needed to improve care coordination with in idualised informational support, implementation of holistic needs assessments for both the patients and their caregivers, better community support provision, improved opportunities for emotional care with early referral for palliative care services. It is recommended that members of the multidisciplinary brain cancer team reflect on these findings to target holistic needs assessments and develop shared self-management care plans for both the patient and the informal caregiver.
Publisher: Public Library of Science (PLoS)
Date: 19-11-2021
DOI: 10.1371/JOURNAL.PONE.0260265
Abstract: Stunting is still a major public health problem in low- and middle-income countries, including Indonesia. Previous studies have reported the complexities associated with understanding the determinants of stunting. This study aimed to examine the household-, subdistrict- and province-level determinants of stunting in Indonesia using a multilevel hierarchical mixed effects model. We analyzed data for 8045 children taken from the 2007 and 2014 waves of the Indonesian Family and Life Surveys (IFLS). We included in idual-, family-/household- and community-level variables in the analyses. A multilevel mixed effects model was employed to take into account the hierarchical structure of the data. Moreover, the model captured the effect of unobserved household-, subdistrict- and province-level characteristics on the probability of children being stunted. Our findings showed that the odds of childhood stunting vary significantly not only by in idual child- and household-level characteristics but also by province- and subdistrict-level characteristics. Among the child-level covariates included in our model, dietary habits, neonatal weight, a history of infection, and sex significantly affected the risk of stunting. Household wealth status and parental education are significant household-level covariates associated with a higher risk of stunting. Finally, the risk of stunting is higher for children living in communities without access to water, sanitation and hygiene. Stunting is associated with not only child-level characteristics but also family- and community-level characteristics. Hence, interventions to reduce stunting should also take into account family and community characteristics to achieve effective outcomes.
Publisher: MDPI AG
Date: 2023
Abstract: Globally, depression and anxiety are major public health concerns with onset during adolescence. While rural Australia experiences overall lower health outcomes, variation in mental health prevalence rates between rural and urban Australia is unclear. The aim of this paper was to estimate the pooled prevalence rates for depression and anxiety among young Australians aged between 10 and 24 years. Selected studies from a systematic literature search were assessed for risk of bias. Random effects model using DerSimonian and Laird method with Freeman–Tukey Double Arcsine Transformation was fitted. Sensitivity analyses were performed. Prevalence estimates were stratified by region and disorder. The overall pooled prevalence of depression and anxiety was 25.3% (95% CI, 19.9–31.0%). In subgroup analysis, anxiety prevalence was 29.9% (95% CI, 21.6–39.0%) depression: 21.3% (95% CI, 14.9–28.5%) and depression or anxiety: 27.2% (95% CI, 20.3–34.6%). Depression and anxiety prevalence were higher in urban 26.1% (95% CI, 17.3–35.9%) compared to rural areas 24.9% (95% CI, 17.5–33%), although the difference was not statistically significant. The heterogeneity was high with an I2 score of 95.8%. There is need for further research on healthcare access, mental health literacy and help-seeking attitude in Australia.
Publisher: Public Library of Science (PLoS)
Date: 06-05-2016
Publisher: Public Library of Science (PLoS)
Date: 07-02-2023
DOI: 10.1371/JOURNAL.PONE.0281539
Abstract: In this paper, we examine whether access to treatment for major morbidity conditions is determined by the social class of the person who needs treatment. Secondly, we assess whether health insurance coverage and the presence of a PHC have any significant impact on the utilisation of health services, either public or private, for treatment and, more importantly, whether the presence of health insurance and PHC modify the treatment use behaviour for the two excluded communities of interest namely Indigenous communities and older widows using data from two rounds (2005 and 2012) of the nationally representative India Human Development Survey (IHDS). We estimated a multilevel mixed effects model with treatment for major morbidity as the outcome variable and social groups, older widows, the presence of a PHC and the survey wave as the main explanatory variables. The results confirmed access to treatment for major morbidity was affected by social class with Indigenous communities and older widows less likely to access treatment. Health insurance coverage did not have an effect that was large enough to induce a positive change in the likelihood of accessing treatment. The presence of a functional PHC increased the likelihood of treatment for all social groups except Indigenous communities. This is not surprising as Indigenous communities generally live in locations where the terrain is more challenging and decentralised healthcare up to the PHC might not work as effectively as it does for others. The social class to which one belongs has a significant impact on the ability of a person to access healthcare. Efforts to address inequity needs to take this into account and design interventions that are decentralised and planned with the involvement of local communities to be effective. Merely addressing one or two barriers to access in an isolated fashion will not lead to equitable access.
Publisher: Informa UK Limited
Date: 02-01-2023
Publisher: Public Library of Science (PLoS)
Date: 13-03-2018
Publisher: Wiley
Date: 26-06-2023
DOI: 10.1111/DPR.12706
Abstract: Much of the world's population still lacks access to safe drinking water and sanitation, particularly people living in poverty and in rural areas. The literature suggests that lack of access to water, sanitation, and hygiene (WASH) contributes to poor development of young children. That further leads to inadequate cognitive stimulation, stunting, iodine and iron deficiency, and lower productivity. We aim to study the status of early childhood health in Indonesia by measuring an Early Childhood Health Index and to examine the role of access to safe water, sanitation, and hygiene in improving children's health using the national representative data of Indonesian Family Life Survey (IFLS) waves 4 (in 2007) and 5 (in 2014). Our methodological approach consisted of two steps. First, we developed WASH Index and Early Childhood Health Index using polychoric Principal Component Analysis (PCA), then assessed the association between the two indices using Ordinary Least Squares (OLS) regression. Overall, we found significant associations between the WASH Index and children's health status and nutritional status. The results also show that several important indicators of WASH (in particular, quality of drinking water, washing and bathing water, and sanitation) improved between 2007 and 2014. Children's access to health care and several children's health indicators also got better. Nevertheless, we still observed stable conditions or even worsening conditions in other components, namely an increase in stunting and children's morbidity. This study provides evidence that access to safe drinking water, sanitation, and hygiene is essential to improve children's health status. In accordance with Government Regulation of the Republic of Indonesia number 185 from 2014, the government at the national, provincial, and district levels must accelerate the development of public infrastructure to ensure access to safe drinking water, sanitation, and hygiene for the entire population as this investment is essential to improve young children's health and reduce the prevalence of stunting in Indonesia.
Publisher: Public Library of Science (PLoS)
Date: 12-12-2016
Publisher: Cambridge University Press (CUP)
Date: 29-07-2021
DOI: 10.1017/S0144686X21001100
Abstract: The feminisation of ageing observed across the world is a significant challenge in many societies. Women's greater longevity is associated with the increased likelihood of age-related disability and morbidity. Furthermore, gendered disadvantage and poverty can make access to health care increasingly problematic in later years. Among the Indian states, Kerala has the highest number of residents above the age of 60 and many are older widows. Given this context, this paper explores what promotes access to health care for older widows living alone in the south Indian state of Kerala. Thirty-two in-depth interviews, eight focus group discussions and eight units of participant observation were carried out among widows, health-care providers and key informants. Applying a reflexive inductive approach to our analysis, the main barriers to access that emerged were altered family structures and loneliness, whilst enablers included good social networks and access to neighbourhood clinics. Our participants’ social networks were drawn from three levels: family, neighbourhood and the wider community. The ability to form a personal community from their social networks and the quality of relationships within this community strongly predicted the capacity to access health care. Efforts to improve access to health care for older widows requires a response that is rooted in the socio-cultural context of the community. Comprehensive social protection policies that promote initiatives to engender social capital among the older population, decentralised primary health-care services, and the training and sensitisation of health service staff would be key to promote equitable access for older widows.
Publisher: Cambridge University Press
Date: 2017
Publisher: Public Library of Science (PLoS)
Date: 22-02-2023
DOI: 10.1371/JOURNAL.PONE.0266576
Abstract: A large proportion of the older population in India constitutes an undeniable share of workforce after the retirement age. This stresses the need to understand the implications of working at older ages on health outcomes. The main objective of this study is to examine the variations in health outcomes by formal/informal sector of employment of older workers using the first wave of the Longitudinal Ageing Study in India. Using binary logistic regression models, the results of this study affirm that type of work does play a significant role in determining health outcomes even after controlling socio-economic, demographic, life-style behaviour, childhood health and work characteristics. The risk of Poor Cognitive Functioning (PCF) is high among informal workers, while formal workers suffer greatly from Chronic Health Conditions (CHC) and Functional Limitations (FL). Moreover, the risk of PCF and/or FL among formal workers increases with the increase in risk of CHC. Therefore, the present research study underscores the relevance of policies focusing on providing health and healthcare benefits by respective economic activity and socio-economic position of older workers.
Publisher: Springer Science and Business Media LLC
Date: 23-01-2021
DOI: 10.1186/S12884-021-03563-5
Abstract: Maternal mortality can be prevented in low-income settings through early health care seeking during maternity complications. While health system reforms in India prioritised institutional deliveries, inadequate antenatal and postnatal services limit the knowledge of danger signs of obstetric complications to women, which delays the recognition of complications and seeking appropriate health care. Recently, a novel rapidly scalable community-based program combining maternal health literacy delivery through microfinance-based women-only self-help groups (SHG) was implemented in rural India. This study evaluates the impact of the integrated microfinance and health literacy (IMFHL) program on the knowledge of maternal danger signs in marginalised women from one of India’s most populated and poorer states - Uttar Pradesh. Additionally, the study evaluates the presence of a diffusion effect of the knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. Secondary data from the IMFHL program comprising 17,232 women from SHG and non-member households in rural Uttar Pradesh was included. Multivariate logistic regression models were used to identify the program’s effects on the knowledge of maternal danger signs adjusting for a comprehensive range of confounders at the in idual, household, and community level. SHG member women receiving health literacy were 27% more likely to know all danger signs as compared with SHG members only. Moreover, the results showed that the SHG network facilitates diffusion of knowledge of maternal danger signs from SHG members receiving health literacy to non-members in program villages. The study found that the magnitude of the program impact on outcome remained stable even after controlling for other confounding effects suggesting that the health message delivered through the program reaches all women uniformly irrespective of their socioeconomic and health system characteristics. The findings can guide community health programs and policy that seek to impact maternal health outcomes in low resource settings by demonstrating the differential impact of SHG alone and SHG plus health literacy on maternal danger sign knowledge.
Publisher: Research Square Platform LLC
Date: 17-01-2020
Abstract: Background Inequity in access to healthcare services is a constant concern. While advances in healthcare have progressed in the last several decades, thereby significantly improving the prevention and treatment of disease, these benefits have not been shared equally. Excluded communities such as Indigenous communities typically face a lack of access to healthcare services that others do not. This study seeks to understand why the indigenous community in Attapadi continues to experience poor access to healthcare in spite of both financial protection and adequate coverage of health services Methods Ethnographic fieldwork was carried out among the various stakeholders living in Attapadi . A total of 52 in-depth interviews and 5 focus group discussions were conducted amongst the indigenous community, the healthcare providers and key informants. The data was coded utilising a reflexive and inductive approach leading to the development of the key categories and themes Results The health system provided a comprehensive financial protection package in addition to a host of healthcare facilities for the indigenous community to avail services. In spite of this, the community resisted the attempts of the health system to improve their access. The failure to provide culturally respectful care, the discrimination of the community at healthcare facilities, the centralisation of the delivery of services as well as the lack of power among the indigenous community to negotiate with the health system for services that were less disruptive to their lives were barriers to improving healthcare access. Power differentials between the community and the health system stakeholders also ensured that meaningful involvement of the community in the local health system did not occur. Conclusion Improving access to health care for indigenous communities would require UHC interventions to be culturally safe, locally relevant and promote active involvement of the community at all stages of the intervention. Structural power imbalances that affect access to resources and prevent meaningful involvement of indigenous communities also need to be addressed.
Publisher: Informa UK Limited
Date: 02-01-2015
Publisher: Wiley
Date: 04-2016
Publisher: BMJ
Date: 02-2022
DOI: 10.1136/BMJOPEN-2021-054318
Abstract: Recently, a novel community health programme—the integrated microfinance and health literacy (IMFHL) programme was implemented through microfinance-based women’s only self-help groups (SHGs) in India to promote birth preparedness and complication readiness (BPCR) to improve maternal health. The study evaluated the impact of the IMFHL programme on BPCR practice by women in one of India’s poorest states—Uttar Pradesh—adjusting for the community, household and in idual variables. The paper also examined for any diffusion of knowledge of BPCR from SHG members receiving the health literacy intervention to non-members in programme villages. Quasi-experimental study using cross-sectional survey data. Secondary survey data from the IMFHL programme were used. Survey data were collected from 17 244 women in households with SHG member and non-member households in rural India. Multivariable logistic regression was used to estimate main and adjusted IMFHL programme effects on maternal BPCR practice in their last pregnancy. Membership in SHGs alone is positively associated with BPCR practice, with 17% higher odds (OR=1.17, 95% CI 1.07 to 1.29, p .01) of these women practising BPCR compared with women in villages without the programmes. Furthermore, the odds of practising complete BPCR increase to almost 50% (OR=1.48, 95% CI 1.35 to 1.63, p .01) when a maternal health literacy component is added to the SHGs. A diffusion effect was found for BPCR practice from SHG members to non-members when the health literacy component was integrated into the SHG model. The results suggest that SHG membership exerts a positive impact on planned health behaviour and a diffusion effect of BPCR practice from members to non-members when SHGs are enriched with a health literacy component. The study provides evidence to guide the implementation of community health programmes seeking to promote BPCR practise in low resource settings.
Publisher: Elsevier BV
Date: 11-2021
Publisher: E.U. European Publishing
Date: 05-08-2021
DOI: 10.18332/TPC/138951
Publisher: Springer Science and Business Media LLC
Date: 22-11-2022
DOI: 10.1186/S12913-022-08797-3
Abstract: Internationally, stroke and cardiac rehabilitation clinicians agree that current cardiac rehabilitation models are a suitable secondary prevention program for people following a transient ischaemic attack (TIA) or mild stroke. There is strong evidence for exercise-based cardiac rehabilitation in people with heart disease, however, the evidence for cardiac rehabilitation post-TIA or stroke is limited. Here we will explore the effectiveness and implementation of an integrated (TIA, mild stroke, heart disease) traditional exercise-based cardiovascular rehabilitation (CVR) program for people with TIA or mild stroke over 6-months. This type 1 effectiveness-implementation hybrid study will use a 2-arm single-centre assessor-blind randomised controlled trial design, recruiting 140 participants. Adults who have had a TIA or mild stroke in the last 12-months will be recruited by health professionals from hospital and primary healthcare services. Participants will be assessed and randomly allocated (1:1) to the 6-week CVR program or the usual care 6-month wait-list control group. Distance completed in the 6-min walk test will be the primary effectiveness outcome, with outcomes collected at baseline, 6-weeks (complete CVR) and 6-months in both groups. Other effectiveness outcome measures include unplanned cardiovascular disease-related emergency department and hospital admissions, daily minutes of accelerometer moderate-to-vigorous physical activity, body mass index, waist circumference, blood pressure, quality of life, anxiety and depression. Implementation outcomes will be assessed using the Reach, Effectiveness, Adoption, Implementation, Maintenance (RE-AIM) framework, including a cost-effectiveness analysis. Semi-structured interviews will be conducted with participants and CVR program health professionals, investigating the acceptability, value, and impact of the CVR program. Qualitative analyses will be guided by the Consolidated Framework for Implementation Research. Few studies have assessed the effectiveness of cardiac rehabilitation for people with TIA and mild stroke, and no studies appear to have investigated the cost-effectiveness or implementation determinants of such programs. If successful, the CVR program will improve health outcomes and quality of life of people who have had a TIA or mild stroke, guiding future research, policy, and clinical practice, reducing the risk of repeat heart attacks and strokes for this population. Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12621001586808 , Registered 19 November 2021.
Publisher: Research Square Platform LLC
Date: 13-08-2019
Abstract: Background The study investigates the self-assessed mental and general health status of informal carers in Australia. It evaluates the influence of carer’s health behaviours, namely: physical activity, smoking and drinking status along with their social connectedness and workforce engagement on their health status. Methods The study uses a retrospective longitudinal design using data from the Household Income and Labour Dynamics of Australia survey, waves 5-15 (2005-2015). It includes in iduals aged 15 years and older from Australian households surveyed over a period of 11 years. The s le consists of 23,251 in iduals. The outcome measures include: Mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire, a widely used multi-dimensional measure of health-related quality of life. Using fixed effects regression, the analysis takes care of the issue of in iduals self-selecting themselves as carers due to some predisposing factors such as age, poor health, socioeconomic status and sedentary behaviour. Results Informal carers suffer from poor mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes compared to non-carers in Australia. Increasing age has a modifying impact on carers’ mental and general health outcomes. The older carers are coping better with their caregiving status than the younger ones. Moreover, physical activities have a positive influence on both mental and general health for non-cares, with more activities generating better health outcomes. Also, physical activities have a modifying impact on carers’ mental health compared to non-carers. Furthermore, the study finds that moderate levels of social drinking have beneficial modifying impact on carers’ mental and general health. Conclusion Findings suggest that some targeted support programs for young carers and, in general, carer focused community physical activities programs, could help to improve the poor health profiles of carers. Moreover, improved informal carer’s health would help to reduce the institutional demand for carers and could bridge the gap in carers’ demand and supply. Finally, the study identified a link between moderate levels of social drinking and carer health that needs to be further explored with more targeted future research.
Publisher: Wiley
Date: 17-01-2023
DOI: 10.1111/HEX.13701
Abstract: Sharing research findings with participants is recognized as an ethical imperative for the research community. However, most discourse on this topic in mainstream public health takes a paternalistic approach, with researchers retaining the power to choose if, when, and how research findings are shared. Fieldwork took place from August 2018 to January 2019 and again from August 2019 to December 2019 among two communities in the south Indian state of Kerala. We integrated participant engagement with study findings into the research protocol, using various collaborative strategies identified during the design stage, forming partnerships with participants and determining appropriate forms of dissemination for different participant groups during fieldwork. Findings from previous research projects undertaken with these communities by other researchers had not been shared with them. This was interpreted by the communities as researchers not being interested in making a difference to their situation. In the current study, building reciprocal relationships that minimized power disparities, and providing outputs in tailored formats that promoted active engagement were key factors that enabled participants to engage with results. This engagement added value by enabling us to co‐develop study recommendations. This process also enabled the community to have ownership of the results and use them to advocate for health system change to improve access to health care. Research should be transformative for participating communities. Participants have a right to know the results of the research they participate in since their knowledge provides the research data which can in turn promote community change. Operationalising this requires researchers to build partnerships with participants and their communities from the outset. The role of participants must be reimagined, and adequate resources should be built into the research process. This is both socially responsible and ethical, but also improves the impact and legitimacy of research for the participants and the communities that they represent. Participants of our research contributed to the design of various aspects of the engagement processes including the venue, the formats used for engagement, interpretation of the findings and recommendations from our research.
Publisher: Public Library of Science (PLoS)
Date: 18-08-2020
Publisher: Research Square Platform LLC
Date: 18-10-2019
Abstract: Background: The study investigated the self-assessed mental and general health status of informal carers in Australia. It evaluated the influence of carer’s health behaviours, namely: physical activity, smoking and drinking status along with their social connectedness and workforce engagement on their health status. Methods: The study used a retrospective longitudinal design using data from the Household Income and Labour Dynamics of Australia survey, waves 5-15 (2005-2015). It included in iduals aged 15 years and older from Australian households surveyed over a period of 11 years. The s le consisted of 23,251 in iduals. The outcome measures included: Mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire , a widely used multi-dimensional measure of health-related quality of life. Using fixed effects regression and following in iduals over time, the analysis took care of the issue of in iduals self-selecting themselves as carers due to some predisposing factors such as age, poor health, socioeconomic status and sedentary behaviour. Results: There were statistically significant carer-noncarer status differences in mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes. Aging had a modifying impact on carers’ mental and general health outcomes. Older carers coped better with their caregiving responsibilities than younger ones. Moreover, while physical activities had a positive influence on both mental and general health for non-carers, with more activities generating better health outcomes, it only had a modifying impact on carers’ mental health. Furthermore, the study found that moderate levels of social drinking had beneficial modifying impact on carers’ mental and general health. Conclusion: This study added value to the literature on informal carers’ mental and general health in Australia by identifying some of the protective and risk factors. The study found the modifying effects of carers’ age, health behaviours such as physical activity, smoking and drinking status on their health. Finally, the study identified an apparent beneficial link between moderate levels of social drinking and carer health that needs to be further explored with more targeted future research.
Publisher: Research Square Platform LLC
Date: 15-10-2019
Abstract: Background: The study investigated the self-assessed mental and general health status of informal carers in Australia. It evaluated the influence of carer’s health behaviours, namely: physical activity, smoking and drinking status along with their social connectedness and workforce engagement on their health status. Methods: The study used a retrospective longitudinal design using data from the Household Income and Labour Dynamics of Australia survey, waves 5-15 (2005-2015). It included in iduals aged 15 years and older from Australian households surveyed over a period of 11 years. The s le consisted of 23,251 in iduals. The outcome measures included: Mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire, a widely used multi-dimensional measure of health-related quality of life. Using fixed effects regression and following in iduals over time, the analysis took care of the issue of in iduals self-selecting themselves as carers due to some predisposing factors such as age, poor health, socioeconomic status and sedentary behaviour. Results: There were statistically significant carer-noncarer status differences in mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes. Aging had a modifying impact on carers’ mental and general health outcomes. Older carers coped better with their caregiving responsibilities than younger ones. Moreover, while physical activities had a positive influence on both mental and general health for non-carers, with more activities generating better health outcomes, it only had a modifying impact on carers’ mental health. Furthermore, the study found that moderate levels of social drinking had beneficial modifying impact on carers’ mental and general health. Conclusion: This study added value to the literature on informal carers’ mental and general health in Australia by identifying some of the protective and risk factors. The study found the modifying effects of carers’ age, health behaviours such as physical activity, smoking and drinking status on their health. Finally, the study identified an apparent beneficial link between moderate levels of social drinking and carer health that needs to be further explored with more targeted future research.
Publisher: JMIR Publications Inc.
Date: 28-04-2023
Publisher: Springer Science and Business Media LLC
Date: 26-11-2020
DOI: 10.1186/S12889-020-09874-0
Abstract: Informal carers suffer from worse health outcomes than non-carers due to their caregiving role. Yet, in a society carers health is as important as that of their care recipients. This study investigated the self-assessed mental and general health outcomes of informal carers in Australia. It evaluated the influence of carers’ personal social capital- a logically linked sequence of their social behaviour such as community participation, social support and trust in others- on their health outcomes. The study estimated the magnitude of small area level variation at Statistical Area Level 1 (SA1) along with in idual level variation in carers’ health outcomes. The study used a multilevel mixed effects cross-sectional design using data from the Household Income and Labour Dynamics of Australia survey, wave 14. It included Australians aged 15 years and older that were surveyed in the year 2014. The s le consisted of 12,767 in iduals and 5004 SA1s. The outcome measures included- mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire , a widely used multi-dimensional measure of health-related quality of life. Informal carers suffered from poor mental (Beta = − 0.587, p = 0.003) and general health (Beta = − 0.670, p = 0.001) outcomes compared to non-carers in Australia. These health outcomes exhibited significant variation acrossSA1s in Australia, with 12–13% variation in general and mental health. However, within small local areas, differences at the in idual level, accounted for most of the variation in outcomes. Moreover, levels of community participation, personal social connection and trust, as perceived by in iduals in the communities, had a positive influence on both mental and general health of carers and non-carers, and were more beneficial for carers compared to non-carers. It seems that the positive influence of social capital for carers helps them in coping with the negative impact of their caregiving duty on health outcomes. Findings suggested that some targeted community support programs for carers to build on their personal social cohesion and trust in their community could help in improving their poor health profiles. Moreover, improved informal carers’ health may help the health system in better managing their resources.
Publisher: Springer Science and Business Media LLC
Date: 11-2019
DOI: 10.1186/S12889-019-7816-8
Abstract: The study investigated the self-assessed mental and general health status of informal carers in Australia. It evaluated the influence of carer’s health behaviours, namely physical activity, smoking and drinking status, along with their social connectedness and workforce engagement on their health status. The study used a retrospective longitudinal design using data from the Household Income and Labour Dynamics of Australia survey, waves 5–15 (2005–2015). It included in iduals aged 15 years and older from Australian households surveyed over a period of 11 years. The s le consisted of 23,251 in iduals. The outcome measures included: mental health, general health and physical functioning domains of the Short Form 36 Questionnaire , a widely used multi-dimensional measure of health-related quality of life. Using fixed effects regression and following in iduals over time, the analysis took care of the issue of in iduals self-selecting themselves as carers due to some predisposing factors such as age, poor health, socioeconomic status and sedentary behaviour. There were statistically significant carer-noncarer status differences in mental (Beta = − 0.587, p = 0.003) and general health (Beta = − 0.670, p = 0.001) outcomes. Aging had a modifying impact on carers’ mental and general health outcomes. Older carers coped better with their caregiving responsibilities than younger ones. Moreover, while physical activities had a positive influence on both mental and general health for non-carers, with more activities generating better health outcomes, it only had a modifying impact on carers’ mental health. Furthermore, the study found that moderate levels of social drinking had beneficial modifying impact on carers’ mental and general health. This study added value to the literature on informal carers’ mental and general health in Australia by identifying some of the protective and risk factors. The study found the modifying effects of carers’ age, health behaviours such as physical activity, smoking and drinking status on their health. Finally, the study identified an apparent beneficial link between moderate levels of social drinking and carer health that needs to be further explored with more targeted future research.
Publisher: Research Square Platform LLC
Date: 18-06-2020
DOI: 10.21203/RS.3.RS-21182/V2
Abstract: Background: Informal carers suffer from worse health outcomes than non-carers due to their caregiving role. Yet, in a society carers health is as important as that of their care recipients. This study investigated the self-assessed mental and general health outcomes of informal carers in Australia. It evaluated the influence of carers’ personal social capital- a logically linked sequence of their social behaviour such as community participation, social support and trust in others- on their health outcomes. The study estimated the magnitude of small local area (SA1) level variation along with in idual level variation in carers’ health outcomes. Methods: The study used a multilevel mixed effects cross-sectional design using data from the Household Income and Labour Dynamics of Australia survey, wave 14. It included Australians aged 15 years and older that were surveyed in the year 2014. The s le consisted of 12,767 in iduals and 5004 SA1s. The outcome measures included- mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire , a widely used multi-dimensional measure of health-related quality of life. Results: Informal carers suffered from poor mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes compared to non-carers in Australia. These health outcomes exhibited significant variation across small areas (SA1s) in Australia, with 12-13% variation in general and mental health. However, within small local areas, differences at the in idual level, accounted for most of the variation in outcomes. Moreover, levels of community participation, personal social connection and trust, as perceived by in iduals in the communities, had a positive influence on both mental and general health of carers and non-carers, and were more beneficial for carers compared to non-carers. Conclusion: It seems that the positive influence of social capital for carers helps them in coping with the negative impact of their caregiving duty on health outcomes. Findings suggested that some targeted community support programs for carers to build on their personal social cohesion and trust in their community could help in improving their poor health profiles. Moreover, improved informal carers’ health may help the health system in better managing their resources.
Publisher: Springer Science and Business Media LLC
Date: 25-02-2022
DOI: 10.1186/S12884-022-04441-4
Abstract: The introduction of Janani Suraksha Yojana (JSY) in India, a conditional cash transfer program which incentivized women to deliver at institutions, resulted in a significant increase in institutional births. Another major health policy reform, which could have affected maternal and child health care (MCH) utilization, was the public health insurance scheme (RSBY) launched in 2008. However, there is a noticeable lack of studies that examine how RSBY had impacted on MCH utilization in India. We used data from a cohort of mothers whose delivery had been captured in both the 2005 and 2011/12 rounds of the Indian Human Development Survey (IHDS) to study the impact of health insurance (in particular, the public insurance scheme versus private insurance) on MCH access. We also investigated whether maternal empowerment was a significant correlate that affects MCH utilization. We used the multilevel mixed-effects ordered logistic regression model to account for the clustered nature of our data. We derived indexes for women’s empowerment using Principal component analysis (PCA) technique applied to various indicators of women’s autonomy and socio-economic status. Our results indicated that the odds of mothers’ MCH utilization levels vary by district, community and mother over time. The effect of the public insurance scheme (RSBY) on MCH utilization was not as strong as privately available insurance. However, health insurance was only significant in models that did not control for household and mother level predictors. Our findings indicated that maternal empowerment indicators – in particular, maternal ability to go out of the house and complete chores and economic empowerment—were associated with higher utilization of MCH services. Among control variables, maternal age and education were significant correlates that increase MCH service utilization over time. Household wealth quintile was another significant factor with mothers belonging to upper quintiles more likely to access and utilize MCH services. Change in women’s and societal attitude towards maternal care may have played a significant role in increasing MCH utilization over the study period. There might be a need to increase the coverage of the public insurance scheme given the finding that it was less effective in increasing MCH utilization. Importantly, policies that aim to improve health services for women need to take maternal autonomy and empowerment into consideration.
Publisher: JMIR Publications Inc.
Date: 03-10-2023
DOI: 10.2196/48229
Publisher: Research Square Platform LLC
Date: 14-04-2020
DOI: 10.21203/RS.3.RS-21182/V1
Abstract: Background: This study investigated the self-assessed mental and general health outcomes of informal carers in Australia. It evaluated the influence of carers’ personal social capital- a logically linked sequence of their social behaviour such as community participation, social support and trust in others- on their health outcomes while controlling for socio-demographic, physical activity level and other economic confounders. More importantly, the study estimated the magnitude of small local area (SA1) level variation along with in idual level variation in informal carers’ health outcomes.Methods: The study used a multilevel mixed effects cross-sectional study using data from the Household Income and Labour Dynamics of Australia survey, wave 14 (2014). It included Australians aged 15 years and older that are surveyed in the year 2014. The s le consisted of 12,767 in iduals and 5004 small local areas (SA1) in Australia. The outcome measures included- mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire, a widely used multi-dimensional measure of health-related quality of life.Results: Informal carers suffered from poor mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes compared to non-carers in Australia. The health outcome measures exhibited significant variation across small areas (SA1s) in Australia, with 12-13% variation in general and mental health. However, within small local areas, differences at the in idual level, accounted for most of the variation in health. Moreover, levels of community participation, personal social connection and trust, as perceived by in iduals in the communities, had a positive influence on both mental and general health of carers and non-carers, and even more beneficial for carers compared to non-carers.Conclusion: It seems the positive influence of social capital for carers, helps them in coping with the negative impact of their caregiving on health outcomes. Findings suggested that some targeted community support programs for carers to build on their personal social cohesion and trust in their community could help in improving their poor health profiles. Moreover, improved informal carers’ health may help the health system in better managing their resources.
Publisher: Springer Science and Business Media LLC
Date: 26-06-2020
DOI: 10.1186/S12939-020-01216-1
Abstract: Inequity in access to healthcare services is a constant concern. While advances in healthcare have progressed in the last several decades, thereby significantly improving the prevention and treatment of disease, these benefits have not been shared equally. Excluded communities such as Indigenous communities typically face a lack of access to healthcare services that others do not. This study seeks to understand why the indigenous communities in Attapadi continue to experience poor access to healthcare in spite of both financial protection and adequate coverage of health services. Ethnographic fieldwork was carried out among the various stakeholders living in Attapadi . A total of 47 in-depth interviews and 6 focus group discussions were conducted amongst the indigenous community, the healthcare providers and key informants. The data was coded utilising a reflexive and inductive approach leading to the development of the key categories and themes. The health system provided a comprehensive financial protection package in addition to a host of healthcare facilities for the indigenous communities to avail services. In spite of this, they resisted attempts by the health system to improve their access. The failure to provide culturally respectful care, the discrimination of the community at healthcare facilities, the centralisation of the delivery of services as well as the lack of power on the part of the indigenous community to negotiate with the health system for services that were less disruptive for their lives were identified as the barriers to improving healthcare access. The existing power differentials between the community and the health system stakeholders also ensured that meaningful involvement of the community in the local health system did not occur. Improving access to health care for indigenous communities would require UHC interventions to be culturally safe, locally relevant and promote active involvement of the community at all stages of the intervention. Continuing structural power imbalances that affect access to resources and prevent meaningful involvement of indigenous communities also need to be addressed.
Publisher: Research Square Platform LLC
Date: 05-11-2020
DOI: 10.21203/RS.3.RS-21182/V4
Abstract: Background: Informal carers suffer from worse health outcomes than non-carers due to their caregiving role. Yet, in a society carers health is as important as that of their care recipients. This study investigated the self-assessed mental and general health outcomes of informal carers in Australia. It evaluated the influence of carers’ personal social capital- a logically linked sequence of their social behaviour such as community participation, social support and trust in others- on their health outcomes. The study estimated the magnitude of small area level variation at Statistical Area Level 1 (SA1) along with in idual level variation in carers’ health outcomes. Methods: The study used a multilevel mixed effects cross-sectional design using data from the Household Income and Labour Dynamics of Australia survey, wave 14. It included Australians aged 15 years and older that were surveyed in the year 2014. The s le consisted of 12,767 in iduals and 5004 SA1s. The outcome measures included- mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire , a widely used multi-dimensional measure of health-related quality of life. Results: Informal carers suffered from poor mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes compared to non-carers in Australia. These health outcomes exhibited significant variation acrossSA1s in Australia, with 12-13% variation in general and mental health. However, within small local areas, differences at the in idual level, accounted for most of the variation in outcomes. Moreover, levels of community participation, personal social connection and trust, as perceived by in iduals in the communities, had a positive influence on both mental and general health of carers and non-carers, and were more beneficial for carers compared to non-carers. Conclusion: It seems that the positive influence of social capital for carers helps them in coping with the negative impact of their caregiving duty on health outcomes. Findings suggested that some targeted community support programs for carers to build on their personal social cohesion and trust in their community could help in improving their poor health profiles. Moreover, improved informal carers’ health may help the health system in better managing their resources.
Publisher: Research Square Platform LLC
Date: 24-09-2020
DOI: 10.21203/RS.3.RS-21182/V3
Abstract: Background: Informal carers suffer from worse health outcomes than non-carers due to their caregiving role. Yet, in a society carers health is as important as that of their care recipients. This study investigated the self-assessed mental and general health outcomes of informal carers in Australia. It evaluated the influence of carers’ personal social capital- a logically linked sequence of their social behaviour such as community participation, social support and trust in others- on their health outcomes. The study estimated the magnitude of small area level variation at Statistical Area Level 1 (SA1) along with in idual level variation in carers’ health outcomes. Methods: The study used a multilevel mixed effects cross-sectional design using data from the Household Income and Labour Dynamics of Australia survey, wave 14. It included Australians aged 15 years and older that were surveyed in the year 2014. The s le consisted of 12,767 in iduals and 5004 SA1s. The outcome measures included- mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire , a widely used multi-dimensional measure of health-related quality of life. Results: Informal carers suffered from poor mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes compared to non-carers in Australia. These health outcomes exhibited significant variation acrossSA1s in Australia, with 12-13% variation in general and mental health. However, within small local areas, differences at the in idual level, accounted for most of the variation in outcomes. Moreover, levels of community participation, personal social connection and trust, as perceived by in iduals in the communities, had a positive influence on both mental and general health of carers and non-carers, and were more beneficial for carers compared to non-carers. Conclusion: It seems that the positive influence of social capital for carers helps them in coping with the negative impact of their caregiving duty on health outcomes. Findings suggested that some targeted community support programs for carers to build on their personal social cohesion and trust in their community could help in improving their poor health profiles. Moreover, improved informal carers’ health may help the health system in better managing their resources.
Publisher: Research Square Platform LLC
Date: 18-11-2020
DOI: 10.21203/RS.3.RS-21182/V5
Abstract: Background: Informal carers suffer from worse health outcomes than non-carers due to their caregiving role. Yet, in a society carers health is as important as that of their care recipients. This study investigated the self-assessed mental and general health outcomes of informal carers in Australia. It evaluated the influence of carers’ personal social capital- a logically linked sequence of their social behaviour such as community participation, social support and trust in others- on their health outcomes. The study estimated the magnitude of small area level variation at Statistical Area Level 1 (SA1) along with in idual level variation in carers’ health outcomes.Methods: The study used a multilevel mixed effects cross-sectional design using data from the Household Income and Labour Dynamics of Australia survey, wave 14. It included Australians aged 15 years and older that were surveyed in the year 2014. The s le consisted of 12,767 in iduals and 5004 SA1s. The outcome measures included- mental health, general health and physical functioning, domains of the Short Form 36 Questionnaire , a widely used multi-dimensional measure of health-related quality of life.Results: Informal carers suffered from poor mental (Beta = -0.587, p=0.003) and general health (Beta = -0.670, p=0.001) outcomes compared to non-carers in Australia. These health outcomes exhibited significant variation acrossSA1s in Australia, with 12-13% variation in general and mental health. However, within small local areas, differences at the in idual level, accounted for most of the variation in outcomes. Moreover, levels of community participation, personal social connection and trust, as perceived by in iduals in the communities, had a positive influence on both mental and general health of carers and non-carers, and were more beneficial for carers compared to non-carers. Conclusion: It seems that the positive influence of social capital for carers helps them in coping with the negative impact of their caregiving duty on health outcomes. Findings suggested that some targeted community support programs for carers to build on their personal social cohesion and trust in their community could help in improving their poor health profiles. Moreover, improved informal carers’ health may help the health system in better managing their resources.
Location: United States of America
No related grants have been discovered for ITISMITA MOHANTY.