General Australian Population Research Articles

How are socio-demographic and psycho-social factors associated with the prevalence and chronicity of severe pain in 14 different body sites? A cross-sectional population-based survey

SummaryBackgroundSevere pain and chronic pain have a high impact on individuals and society. Body location of pain is important with regard to perception, articulation, and underlying biological, mental or social causes of pain.MethodsA cross-sectional survey was performed in the general Austrian population with 15,474 personally interviewed subjects aged 15 years and older.ResultsThe 1‑year period prevalence of severe pain in any body site was 38.6% and of chronic pain 24.9%. In all, 8.1% had pain in at least three body sites. Subjects aged 65 years and older (52.2%), those with low education (43.4%), unemployed subjects (50.4%), retired subjects (52.4%), those with anxiety/depression (67.7%), and subjects with lack of social support (49.6%) were sub-populations with high pain prevalence. In multivariate analyses, depression/anxiety was associated with prevalence and chronicity of severe pain in all body sites (range of ORs 1.89–5.01), while such associations were found for lack of social support (range of ORs 1.33–1.65), female sex (range of ORs 1.38–2.34), higher age (range of ORs 1.09–1.18 for 5 year intervals), as well as low educational (range of ORs 1.47–2.06 primary vs. tertiary education) and unemployment status (range of ORs 1.50–2.62) in most body sites. Being born in non-EU or EFTA states was associated with pain in many body sites (range of ORs 1.38–2.10).ConclusionsPsychosocial factors are associated with pain presence in similar ways irrespective of location. Regarding socio-demographic factors, differences towards the magnitude and the direction in the association with pain frequency and chronicity in different body sites emerged.

Health, workforce characteristics, quality of life and intention to leave: The 'Fit for the Future' survey of Australian nurses and midwives.

To examine the quality of life of nurses and midwives in New South Wales, Australia and compare values with those of the Australian general population; to determine the influence of workforce, health and work life characteristics on quality of life and its effect on workforce intention to leave. Few studies have examined nurses' and midwives' quality of life and little is known of its effects on workforce longevity. This was a cross-sectional survey conducted in 2014-2015. The "Fit for the Future" electronic survey, delivered to nurses and midwives, examined demographic, work and health-related factors, which were compared with Australian general population normative values for physical and mental components of quality of life (the Short Form-12). Univariate and multivariate logistic regression models assessed associations with workforce intention to leave. Physical and mental component scores, calculated for 4,592 nurses and midwives, revealed significantly higher physical but lower mental component scores than the general population. Physical component scores decreased with increasing age; higher scores were seen in nurses with better health indices and behaviours. Mental well-being scores increased with increasing age; in nurses who reported job satisfaction, no work injury, sleep problems or frequent pain and non-smokers. The odds of intention to leave decreased with increasing mental well-being. Managers and decision-makers should heed study recommendations to implement health promotion strategies for nurses and midwives, aiming to improve mental health, specifically to promote workforce retention.

A content analysis of the consumer-facing online information about My Health Record: Implications for increasing knowledge and awareness to facilitate uptake and use.

Low health literacy, low levels of positive belief and privacy and security concerns have been identified as a significant barrier to personal electronic health record uptake and use. An important tool for overcoming these barriers is the consumer-facing information which accompanies the system. My Health Record (MyHR) is the Australian national e-health record system, for which a large suite of online resources exists to facilitate consumer registration and use. This study uses a number of different measures of health resource quality to assess the MyHR online consumer-facing information and identify any gaps or areas for improvement. To analyse the quality and content of the online consumer-facing resources which support the uptake and use of MyHR. Australian information resources aimed at healthcare consumers about the MyHR were included in this study. A comprehensive search using Internet search engines was conducted to locate all online consumer-facing resources about MyHR from both government and non-government sources. Readability (measured by Flesch-Kincaid grade level), year of publication/review, publishing organisation type, presentation style, linked websites, target audience, and themes were identified as important measures of health information quality, and these were recorded and reported on for each resource. Eighty resources met the inclusion criteria. The mean Flesch-Kincaid grade level was 11.8. Most resources were created by Australian government sources ( n = 55), and the most common target audience was the general public ( n = 65). Registration ( n = 51), privacy/security ( n = 49), and benefits of use ( n = 46) were the most common resource themes. The authors identified a number of gaps and areas for improvement in the provision of consumer-facing information about MyHR. Readability is too high for the general Australian population, and there are few translated resources, which means that the information provided does not cater to people with low literacy levels, communication disability, and/or difficulties in understanding written English. The target audiences for resources do not reflect priority groups that were identified during the MyHR development processes. There are also gaps in information provision about how consumers can use MyHR as a tool to meaningfully engage with health professionals and services to support their own person-centred care.

Longitudinal changes in personal wellbeing in a cohort of people who inject drugs.

AimsTo determine whether the self-reported personal wellbeing of a cohort of people who inject drugs (PWID) changes over time, and to identify longitudinal correlates of change.MethodsWe used Personal Wellbeing Index (PWI) scores reported between April 2008 and February 2015 by 757 PWID (66% male) enrolled in the Melbourne Injecting Drug Use Cohort Study (2,862 interviews; up to seven follow-up waves). A mixed-effects model was used to identify correlations between changes in temporal variables and changes in individual PWI scores while controlling for demographic variables.ResultsThe cohort’s mean PWI score did not significantly differ over time (between 54.4/100 and 56.7/100 across the first four interview waves), and was 25–28% lower than general Australian population scores (76.0/100). However, there were large variations in individuals’ PWI scores between interviews. Increased psychological distress, moving into unstable accommodation, reporting intentional overdose in the past 12 months and being the victim of assault in the past six months were associated with declines in PWI scores.ConclusionsParticipants experienced substantially lower levels of personal wellbeing than the general Australian population, influenced by experiences of psychological distress, assault, overdose and harms related to low socioeconomic status. The results of this study suggest a need to ensure referral to appropriate housing and health support services for PWID.

Efficacy of a Web-Based Guided Recommendation Service for a Curated List of Readily Available Mental Health and Well-Being Mobile Apps for Young People: Randomized Controlled Trial.

BackgroundMental disorders are highly prevalent for the people who are aged between 16 and 25 years and can permanently disrupt the development of these individuals. Easily available mobile health (mHealth) apps for mobile phones have great potential for the prevention and early intervention of mental disorders in young adults, but interventions are required that can help individuals to both identify high-quality mobile apps and use them to change health and lifestyle behavior.ObjectivesThe study aimed to assess the efficacy of a Web-based self-guided app recommendation service (“The Toolbox”) in improving the well-being of young Australians aged between 16 and 25 years. The intervention was developed in collaboration with young adults and consists of a curated list of 46 readily available health and well-being apps, assessed and rated by professionals and young people. Participants are guided by an interactive quiz and subsequently receive recommendations for particular apps to download and use based on their personal goals.MethodsThe study was a waitlist, parallel-arm, randomized controlled trial. Our primary outcome measure was change in well-being as measured by the Mental Health Continuum-Short Form (MHC-SF). We also employed ecological momentary assessments (EMAs) to track mood, energy, rest, and sleep. Participants were recruited from the general Australian population, via several Web-based and community strategies. The study was conducted through a Web-based platform consisting of a landing Web page and capabilities to administer study measures at different time points. Web-based measurements were self-assessed at baseline and 4 weeks, and EMAs were collected repeatedly at regular weekly intervals or ad hoc when participants interacted with the study platform. Primary outcomes were analyzed using linear mixed-models and intention-to-treat (ITT) analysis.ResultsA total of 387 participants completed baseline scores and were randomized into the trial. Results demonstrated no significant effect of “The Toolbox” intervention on participant well-being at 4 weeks compared with the control group (P=.66). There were also no significant differences between the intervention and control groups at 4 weeks on any of the subscales of the MHC-SF (psychological: P=.95, social: P=.42, emotional: P=.95). Repeat engagement with the study platform resulted in a significant difference in mood, energy, rest, and sleep trajectories between intervention and control groups as measured by EMAs (P<.01).ConclusionsThis was the first study to assess the effectiveness of a Web-based well-being intervention in a sample of young adults. The design of the intervention utilized expert rating of existing apps and end-user codesign approaches resulting in an app recommendation service. Our finding suggests that recommended readily available mental health and well-being apps may not lead to improvements in the well-being of a nonclinical sample of young people, but might halt a decline in mood, energy, rest, and sleep.Trial RegistrationAustralian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12614000710628; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=366145 (Archived by WebCite at http://www.webcitation.org/ 6pWDsnKme)

Fate and redistribution of perfluoroalkyl acids through AFFF-impacted groundwater

Leaching of perfluoroalkyl acids (PFAAs) from a local point source, a fire-fighting training area, has led to extensive contamination of a groundwater aquifer which has spread underneath part of a nearby town, Oakey, situated in the State of Queensland, Australia. Groundwater is extracted by residents from privately owned wells for daily activities such as watering livestock and garden beds. The concentration of 10 PFAAs in environmental and biological samples (water, soil, grass, chicken egg yolk, serum of horses, cattle and sheep), as well as human serum was investigated to determine the extent of contamination in the town and discuss fate and redistribution of PFAAs. Perfluorooctane sulfonate (PFOS) was the dominant PFAA in all matrices investigated, followed by perfluorohexane sulfonate (PFHxS). PFOS concentrations measured in water ranged between <0.17–14μg/L, concentrations of PFHxS measured between <0.07–6μg/L. PFAAs were detected in backyards (soil, grass), livestock and chicken egg yolk. Significant differences (p<0.01) in PFOS and PFHxS concentrations in two groups of cattle were found, one held within the contamination plume, the other in the vicinity but outside of the contamination plume. In human serum PFOS concentrations ranged from 38 to 381μg/L, while PFHxS ranged from 39 to 214μg/L. Highest PFOS concentrations measured in human serum were >30-fold higher compared to the general Australian population. Through use of contaminated groundwater secondary sources of PFAA contamination are created on private property, leading to further redistribution of contamination and creation of additional human exposure pathways.

Muslims in the Military

Australian Muslims rarely join the Australian Defence Force. There is no evidence this statistic is changing, no sign it is likely to change in the near future, and meanwhile the Australian Muslim population continues to grow faster than the general Australian population. If statistical trends continue, at best the situation will become far more noticeable, and at worst it will become an issue of national security and societal cohesion. This paper discusses the risks of long-term segregation of Australian Muslims from the nation’s defence forces, and considers them alongside the risks of acting to deliberately increase in numbers of Muslims serving in the ADF. Muslim jurists face a dilemma, where the scholar who is against Islamic service in the ADF risks being perceived as not supportive of Australia’s efforts to fight ISIS, et al, and the scholar who comes out in support of ADF service risks being perceived by their own community as endorsing Western imperialism and the collateral damage suffered by innocent Muslims in the same geographical areas. Similar dilemmas for ADF leadership also exist and are the cause of app

Sex Offspring Ratio and Radiofrequency Radiation Exposure

Radiofrequency (RF) radiation is a silent and invisible hazard for both high-access window cleaners and telecommunications riggers that can heat body tissue, resulting in injury. In this study, a total of 68 high-access window cleaners were interviewed to establish their sex offspring ratio. Results indicated that there was no significant variance to that of the general Australian population.&#x0D; The high-access window cleaning industry has a lower awareness of this hazard than the telecommunications industry. This study compares and contrasts its outcomes against a similar study within the telecommunications industry (n = 68), which also identified no significant variance.&#x0D; As mobile telecommunication networks expand, the risk for high-access window cleaners will increase. Therefore, the study recommended that high-access window cleaning companies should revise their safety systems to ensure this hazard is addressed. A further recommendation was that this study should be repeated in the future to determine if expanding telecommunications networks and increased potential exposure has affected sex offspring ratios.

Weight in the First Year of Life: Associations with Maternal Prepregnancy Body Mass Index and Gestational Weight Gain-Findings from a Longitudinal Pregnancy Cohort.

Objective To investigate the obesogenic influence of maternal prepregnancy body mass index (BMI) and gestational weight gain (GWG) on infant weight at birth and 12 months postpartum in an Australian general population sample. Methods Data on 1,305 pregnant women were collected on prepregnancy BMI and GWG through maternal interview, on infant weight at birth through hospital records, and on infant weight 12 months postbirth through direct measurement. Relationships between prepregnancy, gestational weight exposures, and infant weight outcomes were assessed with and without adjustment for potential confounding. Results We observed a 14 to 24 g increase in infant birth weight for every 1 kg increase in maternal weight (infant birth weight: β(BMI) = 0.014, p < 0.000; β(GWG) = 0.012, p < 0.000; and 12 months: β(BMI) = 0.018, p < 0.000; β(GWG) = 0.024, p < 0.000). Effects remained after adjustment for potential confounders (infant birth weight: β(BMI) = 0.014, p < 0.000; β(GWG) = 0.012, p < 0.001; and 12 months: β(BMI)= 0.017, p ≤ 0.033; β(GWG) = 0.023, p = 0.001). However, the effects observed were small, and there was no evidence that GWG mediated relationships between preconception BMI and infant weight. Conclusion In a general population sample, there is a significant but not substantial observed relationship between maternal prepregnancy BMI and GWG and infant weight outcomes, suggesting a minor role for these factors at a population level.

P392 Comparison of dietary nutrient and food additive intake between patients with moderately active ulcerative colitis, healthy stool donors and the general Australian population

P392 Comparison of dietary nutrient and food additive intake between patients with moderately active ulcerative colitis, healthy stool donors and the general Australian population

The personal cancer screening behaviours of nurses and midwives.

The aim of this study was to identify the personal cancer screening behaviours of nurses and midwives in New South Wales, Australia, and identify factors predictive of cancer screening uptake. The nursing workforce may have a higher risk for some cancers and is ageing. In Australia, more than 40% are over 50years - an age where cancer incidence rises rapidly, but when screening may reduce cancer mortality. Nurses and midwives are important health role models for the population, but their engagement in cancer screening is unknown. A cross-sectional survey conducted in 2014-2015. Data were obtained from the 'Fit for the Future' study on 5041 working nurses and midwives in New South Wales, Australia and analyses were conducted on subsets of age-eligible respondents. Demographic, geographical and occupational data were analysed in relation to population-based screening for breast, cervical and bowel cancers and opportunistic screening for prostate and skin cancer screening participation, in line with Australian recommendations. Nurses' and midwives' recent screening rates were higher than the Australian general population across relevant age groups. Compared with full-time nurses and midwives, part-time/casual/pool workers were significantly more likely to undertake cervical, breast and bowel screening. Compared with those working office hours, shift workers were significantly less likely to undertake breast and bowel screening, but more likely to undertake skin screening. Disparities in reported screening prevalence and factors predictive of screening uptake indicate opportunities for targeted strategies to inform and/or promote workforce engagement with screening programmes and protect the health of this ageing workforce.

Heart failure and multimorbidity in Australian general practice.

BackgroundHeart failure (HF) is a serious condition that mostly affects older people. Despite the ageing population experiencing an increased prevalence of many chronic conditions, current guidelines focus on isolated management of HF.ObjectiveTo describe the burden of multimorbidity in patients with HF being managed in general practice in Australia.DesignData from the Bettering the Evaluation And Care of Health (BEACH) programme were used to determine (i) the prevalence of HF, (ii) the number of co-existing long-term conditions, and (iii) the most common disease combinations in patients with HF. The study was undertaken over fifteen, 5-week recording periods between November 2012 and March 2016.ResultsThe dataset included a total of 25,790 general practitioner (GP) encounters with patients aged ≥45 years, collected by 1,445 GPs. HF had been diagnosed in 1,119 of these patients, a prevalence of 4.34% (95% confidence interval [CI] 3.99–4.68) among patients at GP encounters, and 2.08% (95% CI 1.87–2.29) when applied to the general Australian population overall. HF rarely occurred in isolation, with 99.1% of patients having at least one and 53.4% having six or more other chronic illnesses. The most common pair of comorbidities among active patients with HF was hypertension and osteoarthritis (43.4%).ConclusionOverall, one in every 20–25 GP encounters with patients aged ≥45 years in Australia is with a patient with HF. Multimorbidity is a typical presentation among this patient group and guidelines for general practice must take this into account.

Differences in, and Frames of Reference of, Indigenous Australians' Self-rated General and Oral Health.

To compare general and oral health perceptions between Indigenous and non-Indigenous Australians and to quantify Indigenous Australian health-related frames of reference. A mixed-methods approach was used. The quantitative component comprised data from four convenience studies of Indigenous oral health and one national oral health survey stratified by Indigenous status. Qualitative data with questions pertaining to frames of reference were collected from 19 Indigenous Australian interviews. Among the Indigenous studies, deficits in perceptions of excellent, very good, or good general health and excellent, very good, or good oral health ranged from 10.5% to 43.8%. Among the non-Indigenous population, the deficit was 5%. Frames of reference appeared to underpin a biomedical conceptual outlook. The deficit in perceived oral health compared with general health was far greater among Indigenous Australians. The frame of reference underpinning Indigenous Australian's perceptions of health reflect those of the general Australian population.

Closing the gap: Longitudinal changes in employment for Australians with multiple sclerosis

Background and objectives: Previous studies have documented far lower employment participation rates for people with multiple sclerosis (PwMS) compared to the general population. In a large national sample of PwMS, we examined employment status, longitudinal changes in employment and the provision of modifications to work role/environment from 2010 to 2013. Methods: Employment data were collected through the Australian MS Longitudinal Study from 2010 to 2013, with 1260 people responding to all four surveys. Employment rates were compared with the Australian general population. The survey included questions on the provision of modifications to employees’ work role and work environment. Results: Employment (full- and part-time) increased from 48.8% in 2010 to 57.8% in 2013, mainly due to increases in male full-time employment. The employment gap between PwMS and the general population fell from 14.3% in 2010 to 3.5% in 2013. Male employment rates, however, remain significantly lower than the general population. The majority of PwMS who required adjustments to either their work role or environment received them. Conclusion: The gap in employment between PwMS and the general population has substantially reduced from 2010 to 2013, with organisations responding positively to requests for work role/environment adjustments.

Cardiovascular risk profiles of world masters games participants.

Increasing evidence indicates adherence to exercise throughout life is concurrent with improved health. World masters games (WMG) have more participants than any other international sporting competition and is under investigated, particularly with regard to indices of cardiovascular disease risk. Therefore, we chose to investigate selected cardiovascular risk factors in WMG participants. This was a cross-sectional, observational study which utilized a web-based questionnaire to survey cardiovascular risk factors of WMG participants. The survey consisted of three sections: basic demographics, medical history and physiological parameters which included Body Mass Index (BMI), waist circumference (WC), resting blood pressure (BP) and lipids (total cholesterol [TC], high density lipoprotein [HDL] and low density lipoprotein [LDL]). A total of 1435 participants, 872 male, aged 27-91 years (mean age 54.99 years) participated in the study. Key findings included significant differences (P<0.05) between genders in BMI (17.7%, P<0.001), WC (10.6%, P<0.001), resting SBP (5.8%, P<0.001) and resting DBP (4.8%, P<0.001). Significant differences were also found between genders in HDLs (15.2%, P<0.001), TC:HDL ratio (17.2%, P<0.001) and LDL:HDL ratio (19.0%, P<0.001). Significant differences (P<0.001) were also identified when comparing WMG lipid results to the Australian general population (TC P<0.001; HDLs P<0.001; LDLs P<0.001). A high percentage of WMG participants demonstrated optimal values in a number of cardiovascular disease (CVD) risk factors when compared to the general population, female WMG participants had better values as compared to males. This reflected a decreased CVD in WMG participants and supports our hypothesis of enhanced health characteristics in an active, but aged cohort.

Longitudinal changes in psychological distress in a cohort of people who inject drugs in Melbourne, Australia

BackgroundPrevious research into psychological distress among people who inject drugs (PWID) is predominantly cross-sectional; we determined longitudinal predictors of change in psychological distress among a cohort of PWID. MethodWe examined Kessler Psychological Distress Scale (K10) scores from 564 PWID (66% male) enrolled in the Melbourne Injecting Drug User Cohort Study. Gender-stratified linear models with fixed effects for each participant were used to examine correlates of change in individual K10 scores. Further linear regressions of adjusted K10 scores were used to measure correlations between demographic variables. ResultsParticipants reported higher K10 scores (higher psychological distress) than the general Australian population (mean K10 scores 23.4 (95%CI 22.6–24.2) and 14.5 (95%CI 14.3–14.7) respectively). The cohort’s mean K10 score did not significantly differ over time, but individual variations were common. Women reported higher K10 scores than men (mean baseline K10 scores 25.2 (95%CI 23.9–26.6) and 22.4 (95%CI 21.5–23.3) respectively), however no significant differences remained after controlling for temporal factors. Key predictors of increases in K10 scores were being the victim of an assault in the past six months (P<0.001 for women and men) and intentionally overdosing in the past 12 months (P=.010 for women and P<0.001 for men). ConclusionsPWID experience higher levels of psychological distress than the general population. Temporal rather than individual factors may account for the higher levels of psychological distress reported among women. Interventions to reduce rates of assault and/or intentional overdose should be explored to reduce high levels of psychological distress among PWID.

Who consults chiropractors in Victoria, Australia?: Reasons for attending, general health and lifestyle habits of chiropractic patients.

BackgroundCOAST (Chiropractic Observational and Analysis STudy) reported the clinical practices of chiropractors. The aims of this study were to: 1) describe the chiropractic patient demographic and health characteristics; 2) describe patient-stated reasons for visiting a chiropractor; 3) describe chiropractic patient lifestyle characteristics; 4) compare, where possible, chiropractic patient characteristics to the general Australian population.MethodsFifty-two chiropractors in Victoria, Australia, provided information for up to 100 consecutive encounters. If patients attended more than once during the 100 encounters, only data from their first encounter were included in this study. Where possible patient characteristics were compared with the general Australian population.ResultsData were collected from December 2010 to September 2012. Data were provided for 4464 encounters, representing 3287 unique individuals. The majority of chiropractic encounters were for musculoskeletal conditions or for wellness/maintenance. The majority of patient comorbidities were musculoskeletal, circulatory or endocrine/metabolic in nature. Eight hundred chiropractic patients (57 %, 95 % CI: 53–61) described their self-reported health as excellent or very good and 138 patients (10 %, 95 % CI: 8–12) as fair or poor. Seventy-one percent of adult male patients (18 years and older), and 53 % of adult female patients, were overweight or obese. Fourteen percent (n = 188, 95 % CI: 12–16) were current smokers and 27 % (n = 359, 95 % CI: 24–31) did not meet Australian alcohol consumption guidelines. Less than half of the chiropractic patients participated in vigorous exercise at least twice per week. Approximately 20 % ate one serving of vegetables or less each day, and approximately 50 % ate one serve of fruit or less each day. Compared to the general Australian population, chiropractic patients were less likely to smoke, less likely to be obese and more likely to describe their health in positive terms. However, many patients were less likely to meet alcohol consumption guidelines, drinking more than is recommended.ConclusionsIn general, chiropractic patients had more positive health and lifestyle characteristics than the Australian population. However, there were a significant proportion of chiropractic patients who did not meet guideline recommendations about lifestyle habits and there is an opportunity for chiropractors to reinforce public health messages with their patients.

Self-reported physical and mental health of Australian carers: a cross-sectional study

ObjectiveTo report on self-reported physical and mental health of informal carers in rural regions of New South Wales, Australia.MethodsA cross-sectional community-based sample (n=222) of carers completed a questionnaire incorporating self-reported...

Diabetes MILES Youth-Australia: methods and sample characteristics of a national survey of the psychological aspects of living with type 1 diabetes in Australian youth and their parents.

BackgroundType 1 diabetes is a complex and demanding condition, which places a substantial behavioural and psychological burden on young people and their families. Around one-third of adolescents with type 1 diabetes need mental health support. Parents of a child with type 1 diabetes are also at increased risk of psychological distress. A better understanding of the motivators, behaviours and psychological well-being of young people with diabetes and their parents will inform improvement of resources for supporting self-management and reducing the burden of diabetes. The Diabetes MILES (Management and Impact for Long-term Empowerment and Success) Youth–Australia Study is the first large-scale, national survey of the impact of diabetes on the psychosocial outcomes of Australian adolescents with type 1 diabetes and their parents.Methods/designThe survey was web-based to enable a large-scale, national survey to be undertaken. Recruitment involved multiple strategies: postal invitations; articles in consumer magazines; advertising in diabetes clinics; social media (e.g. Facebook, Twitter). Recruitment began in August 2014 and the survey was available online for approximately 8 weeks. A total of 781 young people (aged 10–19 years) with type 1 diabetes and 826 parents completed the survey. Both genders, all ages within the relevant range, and all Australian states and territories were represented, although compared to the general Australian population of youth with type 1 diabetes, respondents were from a relatively advantaged socioeconomic background.DiscussionThe online survey format was a successful and economical approach for engaging young people with type 1 diabetes and their parents. This rich quantitative and qualitative dataset focuses not only on diabetes management and healthcare access but also on important psychosocial factors (e.g. social support, general emotional well-being, and diabetes distress). Analysis of the Diabetes MILES Youth–Australia Study data is ongoing, and will provide further insights into the psychosocial problems facing young people with type 1 diabetes and their parents. These will inform future research and support services to meet the needs of young Australians with type 1 diabetes and their families.Electronic supplementary materialThe online version of this article (doi:10.1186/s40359-016-0149-9) contains supplementary material, which is available to authorized users.

Investigating the preferences of older people for telehealth as a new model of health care service delivery: A discrete choice experiment

Introduction Telehealth approaches to health care delivery can potentially improve quality of care and clinical outcomes, reduce mortality and hospital utilisation, and complement conventional treatments. However, substantial research into the potential for integrating telehealth within health care in Australia, particularly in the provision of services relevant to older people, including palliative care, aged care and rehabilitation, is lacking. Furthermore, to date, no discrete choice experiment (DCE) studies internationally have sought the views and preferences of older people about the basic features that should make up a telehealth approach to these services. Methods Using a DCE, we investigated the relative importance of six salient features of telehealth (what aspects of care are to be pursued during telehealth sessions, distance to the nearest hospital or clinic, clinicians’ attitude to telehealth, patients’ experience of using technology, what types of assessments should be conducted face-to-face versus via telehealth sessions and the costs associated with receiving telehealth). Data were obtained from an online panel of older people aged 65 years and above, drawn from the Australian general population. Results The mean age for 330 study participants was 69 years. In general, individuals expressed strong preferences for telehealth services that offered all aspects of care, were relatively inexpensive and targeted specifically at individuals living in remote regions without easy access to a hospital or clinic. Participants also preferred telehealth services to be offered to individuals with some prior experience of using technology, provided by clinicians who were positive about telehealth but wanted all or some pre-telehealth health assessments to take place in a hospital or clinic. Preferences only differed by gender. Additionally, respondents did not feel that telehealth led to loss of privacy and confidentiality. Discussion Our findings indicate a preference amongst respondents for face-to-face pre-telehealth health assessments and, thereafter, a comprehensive telehealth model (in terms of services offered) targeted at those with some technological know-how as a substitute for attendance at hospitals and clinics, especially where these health facilities were far away from older people’s homes. The findings may be usefully incorporated into the design of future telehealth models of service delivery for older people.