Well-implemented vaccination programs can reduce infectious disease burden in an equitable and cost-effective manner. This rapid review used a strengths-based approach to identify enablers and barriers to vaccination for Aboriginal and Torres Strait Islander children aged 0-5years, and identify the characteristics of effective programs to improve vaccination coverage and timeliness. Databases and grey literature sources were searched for articles published between 2013 and 2025. Following screening, an inductive coding process informed by Braun and Clarke's reflexive thematic analysis was utilised to consolidate qualitative data. Twelve studies discussing enablers, barriers and characteristics of successful programs to increase vaccination rates were included. These studies were heterogenous in design and population. Despite variability between settings and communities, service access barriers, such as lack of adequate transport and opening hours, were commonly cited throughout the included studies, as well as lack of cultural safety. This review emphasises the value of community ownership and local responsiveness of programs aimed at increasing vaccination timeliness and coverage, and the importance of strengthening the Aboriginal and Torres Strait Islander health workforce.

In Australia, opioid use disorder is a major public health concern, and opioid agonist treatment (OAT) is an effective and evidence-based approach for treating opioid use disorder, reducing morbidity, mortality and societal cost. In Australia, 60% of OAT prescribing occurs in general practice, but significant barriers exist. This scoping review aimed to find research describing the characteristics and evaluation of different models of primary care-based OAT in Australia. Following the PRISMA guidelines for scoping reviews, a systematic search was conducted of PubMed, Embase, Scopus and CINAHL, and several grey literature databases. We conducted a narrative synthesis, and derived study themes inductively from included studies. We identified 24 relevant articles over 34years that reported primary research on general practice-based OAT. Seven studies evaluated general practice OAT; eight examined prescriber attitudes, behaviour and workforce; two described single-models of care; four investigated primary care OAT policy; and two studies examined consumer experiences. The studies showed primary care OAT was as effective as specialist care for retention in OAT; however, prescriber deficits exist, with lack of remuneration and stigma identified as common barriers. The multidisciplinary models of care all received external funding, with GPs well placed, but underfunded, to coordinate care. The limited research demonstrates research gaps in service delivery, models of care, funding and views of people who use drugs. Future research scope needs to be broadened to encompass improved national monitoring datasets, patient views, models of care, holistic support and coordination, and structural supports to recruit and retain active prescribers.

In Australia, inclusive disability legislation is in place to support people with disabilities to access health services, including dental health. Yet evidence demonstrates children with Intellectual and Developmental Disabilities (IDD) face barriers to accessing dental services. Developing an understanding of factors that contribute to these barriers, in consideration of disability legislation, is crucial to the provision of equitable dental care for this population group. Access, the ability to obtain dental services, is conceptualised to include six domains: accessibility, availability, affordability, accommodation, acceptability, and appropriateness. To understand the extent of inclusion of children with IDD in policies that guide dental services in Victoria, Australia, a structured, systematic grey literature review on dental policies in Australia was conducted. Four search strategies were incorporated: (1) grey literature database searching via Grey Literature for Health™, (2) domain-specific Google Chrome™ search engines, (3) targeted databases identified from a list on Australian dental associations, and (4) targeted databases identified from a list on Australian disability advocacy organisations' websites. Where relevant, to confirm the scope of the resources, author organisations were contacted. Inclusion criteria guided the screening of the documents yielding three documents issued at the national level, with none issued at the Victorian state level. The relative absence of children with IDD from inclusive dental policies suggests research, policy, and practice gaps that may inhibit equitable dental care access for this population group. The findings also present as a timely opportunity to address the identified gaps in the next iteration of the plans such as the Australian National Oral Health Plan 2026-2035.

Cultural safety is a key component of quality general practice for Aboriginal and Torres Strait Islander peoples; however, few tools exist to assess this from the patient's perspective. This study aimed to explore the qualities of a general practitioner (GP) that support culturally safe consultations, as described by Aboriginal and Torres Strait Islander peoples, and to examine how these align with two consultation models: the Calgary-Cambridge Guide and clinical yarning. A mixed methods approach was used, including a survey, qualitative interviews and a modified nominal group technique (mNGT). Participants were Aboriginal and Torres Strait Islander peoples who had previously engaged with general practice care. Data were both described and analysed thematically. In total, 131 Aboriginal and Torres Strait Islander peoples participated (70 in the survey and interview; 43 in mNGT to validate the findings; and 18 in three separate mNGTs to rate desirable attributes of a GP). Participants identified several qualities underpinning a safe GP consultation. Within the top five attributes in the mNGT were universal skills - clinical competence, avoidance of jargon and attentive listening - alongside welcoming patients with a greeting and avoiding stereotyping. Although there was strong emphasis on respectful, individualised care, preferences varied significantly, highlighting the limitations of a generic approach to consultation skills. Some findings challenged core assumptions regarding clinical yarning and elements of cultural safety training. We propose a refined, integrated consultation model that enhances the Calgary-Cambridge Guide with relational elements of the social yarn, particularly during initiation of the consultation. This integrated model, grounded in Aboriginal and Torres Strait Islander peoples' perspectives yet familiar to GPs and academics, offers a promising foundation for culturally safe practice and assessment, with potential applicability across other diverse populations.

Diabetes and cardiovascular disease profoundly affect rural Australians. The Care2U program was proposed to integrate rural community-based screening with general practice systems. Its innovative feature is a closed-loop communication model between outreach teams and general practitioners (GPs), enabling systematic tracking of diagnoses, management and outcomes for screening-detected medical conditions. This study explored the acceptability, feasibility and sustainability of the proposed model from healthcare providers' perspectives. A qualitative study was undertaken using a focus group. A total of 12 participants, including GPs, nurses, practice managers and health informatics professionals, took part in a 91-min discussion in April 2025. The proposed Care2U model, incorporating mobile outreach screening for diabetes and cardiovascular disease risk factors, was discussed. Transcripts were thematically analysed, with findings interpreted using the critical realism lens to account for structural, organisational and individual influences. Four overarching themes were identified: (i) strong perceived need and value of outreach services in underserved communities; (ii) strategies and challenges in identifying and engaging at-risk patients, particularly those without a regular GP; (iii) desired scope of screening, including both biomedical and lifestyle risk factors, with mixed views on feasibility of remote heart rhythm monitoring; and (iv) communication, workflow and medico-legal responsibilities in managing abnormal findings. Participants emphasised the need to integrate results directly into GP software and to establish clear responsibility for unaffiliated patients. The Care2U program was perceived as a valuable and feasible model to extend preventive care to rural communities. Its closed-loop communication system offers the potential to ensure continuity of care, strengthen GP-community integration and measure program impact. Addressing medico-legal, workflow, and sustainability challenges will be crucial for the implementation and scale-up of this initiative.

To explore barriers and enablers to implementing voluntary National Safety and Quality Primary and Community Healthcare Standards in Australian private dietetics practice. Semi-structured interviews with private practice dietitians, guided by the Consolidated Framework for Implementation Research, were conducted. Transcripts were analysed using a deductive-inductive thematic analysis informed by the theory of planned behaviour, with member checking used to refine the themes. Sixteen dietitians completed an interview. Awareness of the standards was low, with weak social norms impeding implementation. Although some dietitians valued benchmarks, business systems, care quality and staff experiences, others questioned the need for formal standards for small practices, preferring to be guided by profession-specific codes of conduct. Barriers to implementing the standards included insufficient time, resources and knowledge, identifying key areas for future intervention. No participants planned to pursue formal accreditation; however, some intended to reference the standards informally to guide their improvements. Without mandatory use or strong incentives, dietitians are unlikely to formally adopt the national quality and safety standards despite acknowledging the potential benefits. Embedding quality concepts in pre- and post-credentialing education, strengthening financial and professional incentives, and providing implementation resources may foster uptake.

Whānau-centredness is core to Māori wellbeing. Western models of health, in contrast, tend to be deficit-framed and individualistic, although a more collective model can be seen in the concept of syndemics: conditions that cluster in populations and are amplified by health inequities. Through the voices of whānau and key informants, we investigated how a whānau-ora approach can inform the management of syndemics of long-term conditions and infectious diseases within primary health care. The study team was gifted the Māori name Pūriri [a medicinal tree] by a community leader, enabling the concept of syndemics to be considered in a Te Ao Māori context. We undertook a qualitative kaupapa Māori study, conducting focus groups and interviews with purposively selected participants. We utilised descriptive and inductive thematic analysis. We identified several themes to guide appropriate management of syndemic conditions in primary care. Participants stressed the importance of whakawhanaungatanga and strengths-based practices when working with whānau; culturally appropriate services that are grounded in Māori worldviews; whānau engagement in care; and whakawhanaungatanga, which is also vital at the Provider level. This paper reports findings from a Māori-led study, building on existing research focused on whānau-centred care and established approaches to Māori health. Building trusting, respectful connections through whakawhanaungatanga was seen as a central practice for engaging with Māori. Grounded in the symbolism of the Pūriri, these findings highlight pathways for primary health care to partner with whānau and communities in a whānau-ora approach to create enduring and equitable solutions to syndemics.

Rural workforce maldistribution persists, and short rural immersions that embed students in community life may strengthen rural intentions and deepen understanding of social determinants. This study examined a community-engaged, therapeutic gardening immersion as a novel place-based rural learning context in two Western Australian Wheatbelt towns. A mixed-methods design was used. A pre-placement survey of Year 3 medical students (n=22) captured baseline intentions and preferences. Post-placement, semi-structured interviews were conducted with students (n=22) and community members (n=10). Interviews were analysed manually using reflexive thematic analysis. Most students reported high baseline rural interest (20/22 likely or very likely to pursue Rural Clinical School/rural electives), typically favouring regional or larger rural centres. Qualitative findings indicated that shared practical work rapidly dissolved social distance and fostered belonging; students described clearer insight into rural contexts and social determinants, and reflected on professional identity and rural career pathways, alongside generally positive personal growth. Community members reported visible outputs in a short time, students as social catalysts for renewed engagement, and a need for planning, materials and recurring cycles to sustain gains. A brief, garden-centred immersion appears feasible and educationally valuable: it supports relationship-building, situated learning about determinants of health and professional identity work while delivering tangible community benefit. Programs should co-design tasks with hosts, plan logistics early and build ongoing partnerships; future work should track longitudinal student outcomes and community-level indicators to assess durability.

Australia has commenced implementing the resupply and prescribing of contraception by community pharmacists. This is to improve equitable opportunities when accessing contraceptive methods in community pharmacy settings. The aim of this study was to investigate women participants' acceptability of the resupply and prescribing of hormonal contraceptive by community pharmacists. Participants (n=22) were women who had visited the pharmacy for the emergency contraceptive pill or with a prescription for medical abortion medicines, and were recruited to this study using convenience sampling. Semi-structured interviews were conducted to understand participants' perspectives on hormonal contraceptive resupply and prescribing by community pharmacists. Participants endorsed the acceptability of the resupply service by highlighting its benefits including: convenience, cost-effectiveness, time-effectiveness, improved access and a reliable alternative when it is not possible to see a general practitioner (GP). Participants also acknowledged the value of GPs initially prescribing contraceptive methods, particularly due to pharmacists' lack of access to comprehensive medical histories. Participant confidence in pharmacist prescribing of contraceptive methods was low. However, they were more inclined to support pharmacist prescribing of contraceptive methods if they knew that they had received appropriate upskilling and training, especially in the case where a contraceptive method was being prescribed for the first time. Although pharmacist-led resupply is seen as an acceptable service, ongoing research is needed to explore its sustainability, feasibility and long-term impact on patient outcomes. Further research is required to understand the acceptability of autonomous pharmacist prescribing.