ORCID Profile
0000-0003-1364-2072
Current Organisations
UNSW Sydney
,
NSW Department of Education
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Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/PY20045
Abstract: The Rohingya community living in the City of Canterbury-Bankstown in Sydney have been identified as a priority population with complex health needs. As part of ongoing work, AU$10000 was provided to the community to address important, self-determined, health priorities through the Can Get Health in Canterbury program. Program staff worked with community members to support the planning and implementation of two community-led events: a soccer (football) tournament and a picnic day. This paper explores the potential for this funding model and the effect of the project on both the community and health services. Data were qualitatively analysed using a range of data sources within the project. These included, attendance sheets, meeting minutes, qualitative field notes, staff reflections and transcripts of focus group and in idual discussions. This analysis identified that the project: (1) enabled community empowerment and collective control over funding decisions relating to their health (2) supported social connection among the Australian Rohingya community (3) built capacity in the community welfare organisation –Burmese Rohingya Community Australia and (4) enabled reflective practice and learnings. This paper presents an innovative model for engaging with refugee communities. Although this project was a pilot in the Canterbury community, it provides knowledge and learnings on the engagement of refugee communities with the health system in Australia.
Publisher: BMJ
Date: 06-2018
Publisher: CSIRO Publishing
Date: 2015
DOI: 10.1071/PY14061
Abstract: The objective of the study was to explore the feasibility of an intervention that enhances preventive care for primary care patients with low health literacy. A mixed method study was conducted in four Sydney general practices in areas of socioeconomic disadvantage. The intervention included screening for low health literacy in patients aged 40–69 years, clinical record audits of care for prevention of diabetes and cardiovascular disease, and provider training and meetings. Surveys and interviews were conducted to identify providers’ approaches to, and delivery of, preventive care for people with low health literacy. Our study found variable response rates and prevalence of low health literacy. Of the eligible patients screened, 29% had low health literacy. Providers described three approaches to preventive care, which remained largely unchanged. However, they demonstrated recognition of the importance of better communication and referral support for patients with low health literacy. Fewer patients with low health literacy were identified than expected. Despite improved awareness of the need for better communication, there was limited evidence of change in providers’ approach to providing preventive care, suggesting a need for more attention towards providers’ attitudes to support these patients.
Publisher: BMJ
Date: 12-2015
Publisher: The Sax Institute
Date: 2018
DOI: 10.17061/PHRP2821809
Abstract: Definitions of health literacy have tended to focus on the abilities of patients and communities, rather than on the ability of the health system and its services to respond to patients' different levels of health literacy. However, health literacy is increasingly being recognised as part of a dynamic, two-way relationship, affected by both organisational factors (e.g. tailoring of communication and care to patients' needs) and community factors (e.g. in iduals' ability to perceive and seek care). Developing a more comprehensive understanding of health literacy is an important step towards improving health literacy. Most health literacy interventions described in the literature tend to be small and focused on either organisational or community aspects of health literacy rather than addressing both sides. However, some good ex les can be found in Local Health Districts and Primary Health Networks in New South Wales (NSW), Australia, of health literacy interventions that are multidimensional and address both organisational and community health literacy. Although progress is being made, gaps in knowledge remain. A deeper understanding of the intersection between health literacy, culture and language is needed, as well as identification of effective communication strategies after patient comprehension has been assessed using strategies such as 'teach-back'. The teach-back method can be used to check patient understanding, but it is not a communication strategy in itself. If teach-back shows that the patient has not understood, clinicians can employ communication strategies such as limiting discussion to two or three points, or using visual aids. If these are not effective, extended family networks and the use of patient navigators may be required. These health literacy interventions address both organisational and community aspects. More work is needed to evaluate such interventions, in particular their impact on health literacy and appropriate and timely access to healthcare.
Publisher: Springer Science and Business Media LLC
Date: 17-02-2015
Publisher: CSIRO Publishing
Date: 2010
DOI: 10.1071/AH09760
Abstract: Objectives. To identify the factors that contribute to the under-resourcing of Aboriginal health and to explore the impact that funding arrangements have on the implementation of Aboriginal health policy. Design, settings and participants. Qualitative study based on 35 in-depth interviews with a purposive s le of frontline health professionals involved in health policy and service provision in the Northern Territory. Results. Participants described three factors that contributed to the under-resourcing of Aboriginal health: inefficient funding arrangements, mainstream programs being inappropriate for Aboriginal Australians, and competing interests determining the allocation of resources. Insufficient capacity within the healthcare system undermines the multilevel implementation process whereby organisations need to have the capacity to recognise new policy ideas, assess their relevance to their existing work and strategic plan and to be able to incorporate the relevant new ideas into day-to-day practice. Conclusion. Insufficient resources for Aboriginal health were found to be a barrier to implementing Aboriginal health policy. Inadequate resources result from the cumbersome allocation of funding rather than simply the amount of funding provided to Aboriginal healthcare. Monitoring government performance and ensuring the efficient allocation of funds would allow us to develop the delivery system for Aboriginal healthcare and therefore provide greater opportunities to capitalise on current interventions and future efforts. What is known about the topic? The extent to which Aboriginal health interventions are funded is variable, and the funding of the Aboriginal healthcare system is an important and topical issue. What does this paper add? The argument surrounding funding for Aboriginal health can be understood in several ways. Firstly, there is insufficient money being invested to address the need. By need we are referring to addressing community illness and injury as well as the need for a quality and accessible primary healthcare system. Secondly, there may be enough money being invested, but because of complicated and inflexible funding arrangements it is not being spent efficiently. Thirdly, there may be enough money invested, but not in effective interventions, and not in building the healthcare system, for ex le the local workforce. Finally, there may be enough money invested, but decisions about its distribution at the community level are not sufficiently in the control of communities. What are the implications for practitioners? To implement Aboriginal health policy, an effective delivery system is needed. Funding alone can be of limited value in achieving this aim over the long term unless it is used to build the capacity of a sustained delivery system for Aboriginal health care. Monitoring and facilitating government performance on how funds are invested, as well as the amount spent, is an important step towards the more effective implementation of Aboriginal health policy.
Publisher: Springer Science and Business Media LLC
Date: 25-10-2014
Publisher: MDPI AG
Date: 28-02-2020
DOI: 10.3390/JCM9030646
Abstract: Self-management (SM) includes activities that patients initiate and perform in the interest of controlling their disease and maintaining good health and well-being. This review examines the health literacy and patient activation elements of self-management interventions for Chronic Obstructive Pulmonary Diseases (COPD) patients. We investigated the effects of the intervention on health-related quality of life, self-efficacy, depression, and anxiety among people with COPD. We conducted a systematic review of studies evaluating the efficacy of self-management interventions among COPD patients that also included health literacy or patient activation as keywords. Four electronic databases Medline, EMBASE, PsycINFO, and Google Scholar, were searched to identify eligible studies. These studies were screened against predetermined inclusion criteria. Data were extracted according to the review questions. Twenty-seven studies met the criteria for inclusion. All of the included studies incorporated health literacy components and focused on COPD and self-management skills. Three studies measured health literacy two showed improvements in disease knowledge, and one reported a significant change in health-related behaviors. Seventeen studies aimed to build and measured self-efficacy, but none measured patient activation. Eleven studies with multicomponent interventions showed an improvement in quality of life. Six studies that focused on specific behavioral changes with frequent counseling and monitoring demonstrated improvement in self-efficacy. Two interventions that used psychosocial counseling and patient empowerment methods showed improvement in anxiety and depression. Most self-management interventions did not measure health literacy or patient activation as an outcome. Successful interventions were multicomponent and comprehensive in addressing self-management. There is a need to evaluate the impact of comprehensive self-management interventions that address and measure both health literacy and patient activation on health outcomes for COPD patients.
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/AH13005
Abstract: Objective. To examine the effectiveness of telephone-based coaching services for the management of patients with chronic diseases. Methods. A rapid scoping review of the published peer reviewed literature, using Medline, Embase, CINAHL, PsychNet and Scopus. We included studies involving people aged 18 years or over with one or more of the following chronic conditions: type 2 diabetes, congestive cardiac failure, coronary artery disease, chronic obstructive pulmonary disease and hypertension. Patients were identified as having multi-morbidity if they had an index chronic condition plus one or more other chronic condition. To be included in this review, the telephone coaching had to involve two-way conversations by telephone or video phone between a patient and a provider. Behaviour change, goal setting and empowerment are essential features of coaching. Results. The review found 1756 papers, which was reduced to 30 after screening and relevance checks. Most coaching services were planned, as opposed to reactive, and targeted patients with complex needs who had one or more chronic disease. Several studies reported improvements in health behaviour, self-efficacy, health status and satisfaction with the service. More than one-third of the papers targeted vulnerable people and telephone coaching was found to be effective for these people. Conclusions. Telephone coaching for people with chronic conditions can improve health behaviour, self-efficacy and health status. This is especially true for vulnerable populations who had difficulty accessing health services. There is less evidence for improvements in quality of life and patient satisfaction with the service. The evidence for improvements in health service use was limited. This rapid scoping review found that telephone-based coaching can enhance the management of chronic disease, especially for vulnerable groups. Further work is needed to identify what models of telephone coaching are most effective according to patients’ level of risk and co-morbidity. What is known about the topic? With the increasing prevalence of chronic diseases more demands are being made of limited health services and resources. Telephone health coaching for people with or at risk of chronic diseases is seen as a means of supporting people to manage their health and reducing the burden on the healthcare system. What does this paper add? Telephone coaching interventions were effective for vulnerable people with chronic disease(s). Often the vulnerable populations had worse control of their chronic condition at baseline and demonstrated the greatest improvement compared with those with better control at baseline. Planned (i.e. weekly or monthly telephone calls to support the patients with chronic disease) and unscripted telephone coaching interventions appear to be most effective for improving self-management skills in people from vulnerable groups: the planned telephone coaching services had the advantage of regular contact and helping people develop their skills over time, whereas the unscripted aspect allowed the coach to tailor support to the patient’s in idual needs What are the implications for practitioners? Telephone coaching is an effective means of supporting people with chronic diseases to manage their own health. Further work is needed to embed telephone coaching within existing services. Good linkages with the patient’s general practitioner are important. This might be a regular report, updates via the patient e-health record, or provision for contact if a problem is identified or linking to the patient e-health record.
Publisher: CSIRO Publishing
Date: 2014
DOI: 10.1071/PY12078
Abstract: Significant gaps remain between recommendations of evidence-based guidelines and primary health care practice in Australia. This paper aims to evaluate factors associated with the use of guidelines reported by Australian GPs. Secondary analysis was performed on a survey of primary care practitioners which was conducted by the Commonwealth Fund in 2009: 1016 general practitioners responded in Australia (response rate 52%). Two-thirds of Australian GPs reported that they routinely used evidence-based treatment guidelines for the management of four conditions: diabetes, depression, asthma or chronic obstructive pulmonary disease and hypertension – a higher proportion than in most other countries. Having non-medical staff educating patients about self-management, and a system of GP reminders to provide patients with test results or guideline-based intervention or screening tests, were associated with a higher probability of guidelines use. Older GP age was associated with lower probability of guideline usage. The negative association with age of the doctor may reflect a tendency to rely on experience rather than evidence-based guidelines. The association with greater use of reminders and self-management is consistent with the chronic illness model.
Publisher: SAGE Publications
Date: 26-12-2019
Abstract: Current evidence indicates that although they are correlated, health literacy (HL) and patient activation (PA) are distinct. This article describes how HL, PA and their determinants intersect and erge and how these concepts might inform the development of self-management interventions. The concepts of HL and PA contribute to self-management interventions in different ways. HL includes the skills and confidence required for self-management while PA focuses more on motivation and ability to take action. In this light, communication of concepts on HL and PA needs to be more widely understood by academics, researchers and policy experts as each of them plays a unique role in promoting self-management for long-term conditions such as chronic obstructive pulmonary disease.
Publisher: Springer Science and Business Media LLC
Date: 18-01-2013
Publisher: Public Library of Science (PLoS)
Date: 11-04-2018
Publisher: SAGE Publications
Date: 2009
DOI: 10.1258/JHSRP.2008.008002
Abstract: This article explores the role of professional values and the culture of the Australian health care system in facilitating and constraining the implementation of an Aboriginal health policy. Thirty-five semi-structured in-depth interviews were conducted in a case study on the implementation of the Northern Territory Preventable Chronic Disease Strategy (PCDS). PCDS included three major evidence-based components - primary prevention, early detection and better management. The research revealed that PCDS changed as it was implemented. The values of the medical and nursing professions favoured the implementation of the clinically-based component of PCDS - better management. But there was dissonance between the values of these dominant professional groups and the values and expertise in public health that were necessary to implement fully the primary prevention component of PCDS. While Aboriginal health workers have valuable knowledge and skills in this area, they were not accorded sufficient power and training to influence decision-making on priorities and resources, and were able to exercise only limited influence on the components of the PCDS that were implemented. The findings highlight the role that a myriad of values play in influencing which aspects of a policy are implemented by organizations and their agents. Comprehensive and equitable implementation of policy requires an investigation and awareness of different professional values, and an examination of whose voices will be privileged in the decision-making process. If the advances in developing evidence-based, culturally-appropriate and inclusive policy are to be translated into practice, then care needs to be taken to monitor and influence whose values are being included at what point in the policy implementation process.
Publisher: Wiley
Date: 13-11-2017
DOI: 10.1111/AJR.12396
Abstract: The objective of this review was to synthesise evidence on the health and social support needs of Aboriginal and Torres Strait Islander people leaving prison and on programs which aid successful community re-entry. A systematic literature review was undertaken of peer-reviewed and grey literature published between 2001 and 2013, focusing on the post-release needs of Aboriginal and Torres Strait Islander adults and pre- and post-release programs. Aboriginal and Torres Strait Islander people have high health and social support needs on leaving prison. There is little literature evidence that re-entry programs commonly consider health needs, support linkages with primary care or Aboriginal Medical Services, or are designed in consideration of the particular needs of Aboriginal and Torres Strait Islander people. In the absence of evaluative evidence on re-entry programs in this group, we have synthesised the best practice recommendations. Re-entry programs must be culturally competent in design and delivery, holistic, take a long-term view, involve families and communities, demonstrate interagency coordination and promote linkages between prison and community-based services. There is an urgent need for accessible pre- and post-release programs which meet the particular needs of Aboriginal and Torres Strait Islander people, including their health needs. Programs must be flexible, comprehensive and accessible to those on remand or with short sentences. Stronger linkage with primary care and Aboriginal and Torres Strait Islander community controlled health organisations is recommended.
Publisher: CSIRO Publishing
Date: 2008
DOI: 10.1071/AH080174
Abstract: Thirty-five interviews were conducted in a case study on the implementation of the Northern Territory Preventable Chronic Disease Strategy (PCDS) to explore the role of the health workforce in the implementation of Aboriginal health policy. There was a tendency for the workforce to implement those aspects of the policy that drew on existing skills in treatment and management and to avoid or delay implementation that required the acquisition of new skills in primary prevention. Factors that facilitated the implementation of the PCDS included the addition of new resources, employment of additional staff, training, increased commitment from managers, and the creation of dedicated chronic disease positions. Factors impeding implementation included insufficient numbers of service providers, too little support for current Aboriginal Health Workers, and high staff turnover.
Publisher: Public Library of Science (PLoS)
Date: 29-05-2020
Publisher: Springer Science and Business Media LLC
Date: 04-05-2016
Publisher: Springer Science and Business Media LLC
Date: 05-01-2017
Publisher: Springer Science and Business Media LLC
Date: 22-07-2015
No related grants have been discovered for Jane Lloyd.