Regional Australia Research Articles

Australian population norms for health-related quality of life measured using the EQ-5D–5L, and relationships with sociodemographic characteristics

BackgroundMeasuring health related quality-of-life (HRQoL) of the general population is essential to establish a reference for health outcome evaluations. This study sought to establish EQ-5D-5L population norms in Australia and to investigate the heterogeneity of HRQoL between sociodemographic variables.MethodsA cross-sectional study comprising of a representative sample of Australia’s general population (n = 9958) aged 18 or older. Recruitment quotas were set for the Australian census population by age, sex, state/territory of residence and rurality. Participants were recruited by Qualtrics through its database of over 800,000 registered panel members and asked to value their own state of health using the EQ-5D-5L domains and the EuroQol-Visual Analogue Scale (EQ-VAS). An Australian value set developed using Discreet Choice Experiment was used to calculate utility scores.ResultsThe estimated mean EQ-5D-5L index for Australia’s general population was 0.86 (standard deviation [SD] 0.19), and the EQ-VAS score was estimated as 73.2 (SD 21.7). 23.9% of the study population reported being in the best health state (11,111). Younger people, current smokers, people who are unemployed and people with more financial stress reported a lower EQ-5D-5L index score (p < 0.001). Residents in the major cities, inner regional and outer regional Australia reported higher health utility scores than those residing in remote and very remote Australia.ConclusionsThis is the first Australian study to apply the EQ-5D-5L in a nationally representative sample. The EQ-5D-5L Australian population norms obtained can be used as reference scores for future population health evaluations and comparisons. The findings facilitate a national reference for clinical, economic, and policy decision-making processes and provide a fuller understanding of the Australian population’s HRQoL.

Comparison of three modalities of teleophthalmology delivery in regional Western Australia during the COVID-19 lock-down

ABSTRACTClinical relevanceIn conjunction with local optometry services, telehealth may be used in to provide specialist care for patients living in rural areas underserved by ophthalmology.BackgroundTo combat travel restrictions for specialist outreach to regional areas during the 2020 COVID-19 lockdown, Lions Outback Vision introduced three different modalities of teleophthalmology consultations; home-based telephone, hospital-based video, and optometry-based video. This study evaluated the utility of these in providing specialist care to rural patients during the pandemic.MethodsData from patients referred during the COVID-19 lock-down period (23 March 2020 to 5 June 2020) were analysed. If sufficient clinical information and imaging were available then ophthalmologists conducted home-based telephone consultations. If further ocular imaging or examination was required, then optometry-based video or hospital-based video were used. Data were analysed using ANOVA and two-sided t tests for continuous data and Chi Square statistics for categorical data (p < 0.05).ResultsMajority of the 431 consultations were conducted via home telephone (38%) or optometry-based video (37%). Indigenous patients (p = 0.014) and patients in very remote communities (p < 0.01) were more likely to receive a home-based telephone consultation. Because sufficient clinical information had already been obtained for home-based consultations, these patients were more likely to be booked for surgery than optometry (p < 0.01).Cataracts were the predominant diagnosis in optometry consults compared to hospital (p < 0.01).ConclusionPrimary optometry and home telephone represent a new modality for providing specialist care for patients living in very remote regions and for Indigenous patients. When appropriate clinical testing has been completed, telephone-based ophthalmology may continue to be useful for certain conditions such as waitlisting patients for cataract surgery and should continue to be funded beyond the duration of the pandemic for rural patients.

Financial toxicity in men undergoing prostate cancer treatment in regional Australia.

Financial toxicity in men undergoing prostate cancer treatment in regional Australia.

Diverse Sound Practices: An exploration of experimental electronic music in regional Australia

Examining the role of arts and culture in regional Australia often focuses on economic aspects within the creative industries. However, this perspective tends to disregard the value of unconventional practices and fails to recognise the influence of regional ecological settings and the well-being advantages experienced by amateur and hobbyist musicians who explore ubiquitous methods of music creation. This article presents the results of a survey conducted among practitioners in regional Australia, exploring their utilisation of creative technology ecosystems. This project marks the first independent, evidence-based study of experimental electronic music practices in regional Australia and how local and digital resource ecosystems support those activities. Spanning the years 2021 and 2022, the study involved interviewing 11 participants from many Australian states. In this article, we share the study’s findings, outlining the diverse range of experimental electronic music practices taking place across regional Australia and how practitioners navigate the opportunities and challenges presented by their local context.

Dementia awareness, motivation and modifiable risk factors amongst older Australians in regional communities

AbstractBackgroundDementia is the second leading cause of death in regional Australia. A large body of research into modifiable dementia risk factors and awareness levels has been gathered with metropolitan communities, yet this remains unexplored within regional areas. Therefore, this study aims to 1) identify awareness of modifiable dementia risk factors; 2) identify the presence/absence of modifiable dementia risk factors; and 3) explore sociodemographic and motivation characteristics associated with modifiable dementia risk in regional areas of AustraliaMethodCross‐sectional data of dementia awareness and risk levels in 180 adults &gt;65 living in rural and remote regions within New South Wales, were collected using an online survey. Data included demographics, awareness of dementia risk factors (British Social Attitudes survey), presence/absence of modifiable dementia risk factors (LIBRA), motivation to reduce dementia risk (MCLHB‐DRR) and social connections (LSNS‐6). Descriptive analyses was used to identify awareness as well as presence/absence of risk factors and univariate associations were used to explore demographic factors and motivation characteristics, associated with dementia awareness and dementia risk.ResultParticipants had a mean age of 72.2 (SD = 5.5) years, majority were female (70%), and had less than 10 years of education (41.1%). 41.7% were from a low socio‐economic background and 97.2% were born in an English‐speaking country. A substantial proportion of participants agreed that dementia risk is modifiable (73.3%) and identified an average of 5.7 (SD = 3.1, out of 12) dementia risk factors correctly. The motivation domain of perceived susceptibility towards dementia was low (11.3 out of 20; SD = 3.4; [4‐20]), and few social connections were reported (8.2; SD = 9.3; [0‐30]).ConclusionRural and remote Australian older adults having a basic understanding that dementia is not inevitable, however, they remain unaware of more than half of the risk and protective factors for dementia. Given the consistencies in dementia risk and the inconsequential association between sociodemographic variables in regional areas, future interventions should adopt a population health approach to improve awareness and create opportunities for communities to target health risk factors contributing to dementia.

Cost-effectiveness of remote patient monitoring for First Nations peoples living with diabetes in regional Australia

The aim of this study was to determine the cost-effectiveness of remote patient monitoring (RPM) with First Nations peoples living with diabetes. This study was set at the Goondir Health Service (GHS), an Aboriginal and Torres Strait Islander Community-Controlled Health in South-West Queensland. Electronic medical records and RPM data were provided by the GHS. Clinical effectiveness was determined by comparing mean HbA1c before and after enrolment in the RPM service. Our analysis found no statistically significant effect between the mean HbA1c before and after enrolment, so this analysis focused on net-benefit and return on investment for costs from the perspective of the GHS. The 6-month RPM service for 84 clients cost AUD $67,841 to cover RPM equipment, ongoing technology costs, and a dedicated Virtual Care Manager, equating to $808 per client. There were 199 additional client–clinician interactions in the period after enrolment resulting in an additional $4797 revenue for the GHS. Therefore, the program cost the GHS $63,044 to deliver, representing a return on investment of around 7 cents for every dollar they spent. Whilst the diabetes RPM service was equally effective as usual care and resulted in increased interactions with clients, the cost for the service was substantially more than the additional revenue generated from increased interactions. This evidence highlights the need for alternative funding models for RPM services and demonstrates the need to focus future research on long-term clinical effects and the extra-clinical benefits resulting from services of this type.

First-nation Australian children’s interpretation of a pictorial questionnaire designed to assess physical literacy

ABSTRACT Background The Physical Literacy in Children Questionnaire (PL-C Quest) is a pictorial tool designed to measure children’s self-reported physical literacy. It measures 30 elements within the four domains (physical, psychological, cognitive, and social) of the Australian Physical Literacy Framework (APLF). The development study of the PL-C Quest only included children from non-Indigenous backgrounds living in a metropolitan city. Hence, little is known about how Indigenous children living in regional and rural areas understand and engage with the items. Purpose The study aims to determine if Indigenous children living in regional and rural areas in Australia understand the items in the PL-C Quest (test content) and if they cognitively engaged with the items (response processes) as intended by the APLF definitions. Methods The study followed a qualitative descriptive approach. The PL-C Quest includes an orange cartoon bunny carrying out 30 scenarios with accompanying statements. Each scenario has one bunny rabbit doing the activity well and the other bunny not so well. Cognitive interviews were conducted based on verbal probing using Tourangeau’s four-stage cognitive model (comprehension, retrieval, judgment, and response). In the regional town, nine Indigenous children were interviewed one on one in after-school sessions. In the rural town, 12 Indigenous children enrolled in the school programme of a sports provider were interviewed in pairs or small groups. All individual and group interviews were audio recorded and transcribed verbatim. All transcripts were coded using the NVivo12 software. Each cognitive action of Tourangeau’s model, comprehension, retrieval, judgment, and response, became a coding category. Responses coded into each category were further categorised into sub-categories. For instance, ‘Understood as intended’, ‘Partially understood’, and ‘Misunderstood’ were subcategories for comprehension; ‘skills’ and ‘past events and experiences’ were for retrieval; ‘confident and unconfident’ were for judgement; and ‘justify’ and ‘unable to justify’ were subcategories for response category. Once the first author completed the analysis of the children’s responses to items, the other two authors’ part of the data collection confirmed the accuracy of the coding. Findings Overall, children in both sites understood most of the content of the items as intended. In addition, they could retrieve relevant information when responding to the items. For example, a few children reflected on their ability to play a ball-throwing Indigenous game and carry younger siblings when responding to the items, ‘Object Manipulation’ and ‘Strength’, respectively. Also, most children confidently selected the bunny that represented them more in all 30 items and were able to justify their responses. Conclusion The study is the first to generate validity evidence for the PL-C Quest when used with Indigenous children in regional and rural Australia. The findings demonstrate that this pictorial scale may be a suitable tool to collect data about the physical literacy of Indigenous children living in regional and rural areas – subject to further testing with a larger population. Future research may provide evidence on other sources of validity. For instance, whether these domains uphold the measured construct, physical literacy (internal structure), with Indigenous children.

'There is no other option': Exploring health care providers' experiences implementing regional multisite midwifery model of care in South Australia.

In the past 30 years, 60% of South Australia's rural maternity units have closed. Evidence demonstrates midwifery models of care offer regional Australia sustainable birthing services. Five birthing sites within the York and Northern Region of South Australia, designed in collaboration with key stakeholders, offered a new all-risk midwifery continuity of care model (MMoC). All pregnant women in the region were allocated to a known midwife once pregnancy was confirmed. In July 2019, the pilot program was implemented and an evaluation undertaken. The study aimed to evaluate the effectiveness, acceptability, and sustainability of the new midwifery model of care from the perspective of health care providers. The evaluation utilised a mixed methods design using focus groups and surveys to explore experiences of health care providers impacted by the implementation of the MMoC. This paper reports on midwives, doctors and nurses experiences at different time points, to gain insight into the model of care from the care providers impacted by the change to services. The first round of focus groups included 14 midwives, 6 hospital nurses/midwives and 5 doctors with the overarching theme that the 'MMoC was working well.' The second round of focus groups were undertaken across the five sites with 10 midwives, 9 hospital nurses/midwives and 5 doctors. The overarching theme captured all participants commitment to the MMoC, with agreement that 'there is no other option - it has to work'. All participants reported positive outcomes and a strong commitment to navigate the changes required to implement the new model of care. Collaboration and communication was expressed as key elements for success. Specific challenges and complexities were evident including a need to clarify expectations and the workload for midwives, and for nurses who were accustomed to having midwives 24 hours a day in hospitals. This innovative model responds to challenges in providing rural maternity care and offers a sustainable model for maternity services and workforce. There is an overwhelming commitment and consensus that there is 'no other option-it has to work'.

Outback Quit Pack: Feasibility trial of outreach smoking cessation for people in rural, regional, and remote Australia.

Tobacco smoking rates are higher in rural, regional, and remote (RRR) areas in Australia, and strategies to improve access to quit supports are required. This pilot study examined the feasibility of a smoking cessation intervention for people in RRR areas who smoke with the intention of using this data to design a powered effectiveness trial. A randomised controlled trial (RCT) of the feasibility of a 12-week 'Outback Quit Pack' intervention consisting of mailout combination nicotine replacement therapy (NRT) and a proactive referral to Quitline, compared with a minimal support control (1-page smoking cessation support information mailout) was conducted between January and October 2021. Participants recruited via mailed invitation or Facebook advertising, were adults who smoked tobacco (≥10 cigarettes/day) and resided in RRR areas of New South Wales, Australia. Participants completed baseline and 12-week follow-up telephone surveys. Outcomes were feasibility of trial procedures (recruitment method; retention; biochemical verification) and acceptability of intervention (engagement with Quitline; uptake and use of NRT). Facebook advertising accounted for 97% of participant expressions of interest in the study (N = 100). Retention was similarly high among intervention (39/51) and control (36/49) participants. The intervention was highly acceptable: 80% of the intervention group had ≥1 completed call with Quitline, whilst Quitline made 3.7 outbound calls/participant (mean 14:05 mins duration). Most of the intervention group requested NRT refills (78%). No differences between groups in self-reported cessation outcomes. Biochemical verification using expired air breath testing was not feasible in this study. The Outback Quit Pack intervention was feasible and acceptable. Alternative methods for remote biochemical verification need further study. SO WHAT?: A powered RCT to test the effectiveness of the intervention to improve access to evidence-based smoking cessation support to people residing in RRR areas is warranted.

Factors Associated With Transition From Community to Permanent Residential Aged Care Following Stroke: A Linked Registry Data Study.

Understanding factors that influence the transition to permanent residential aged care following a stroke or transient ischemic attack may inform strategies to support people to live at home longer. We aimed to identify the demographic, clinical, and system factors that may influence the transition from living in the community to permanent residential care in the 6 to 18 months following stroke/transient ischemic attack. Linked data cohort analysis of adults from Queensland and Victoria aged ≥65 years and registered in the Australian Stroke Clinical Registry (2012-2016) with a clinical diagnosis of stroke/transient ischemic attack and living in the community in the first 6 months post-hospital discharge. Participant data were linked with primary care, pharmaceutical, aged care, death, and hospital data. Multivariable survival analysis was performed to determine demographic, clinical, and system factors associated with the transition to permanent residential care in the 6 to 18 months following stroke, with death modeled as a competing risk. Of 11 176 included registrants (median age, 77.2 years; 44% female), 520 (5%) transitioned to permanent residential care between 6 and 18 months. Factors most associated with transition included the history of urinary tract infections (subhazard ratio [SHR], 1.41 [95% CI, 1.16-1.71]), dementia (SHR, 1.66 [95% CI, 1.14-2.42]), increasing age (65-74 versus 85+ years; SHR, 1.75 [95% CI, 1.31-2.34]), living in regional Australia (SHR, 31 [95% CI, 1.08-1.60]), and aged care service approvals: respite (SHR, 4.54 [95% CI, 3.51-5.85]) and high-level home support (SHR, 1.80 [95% CI, 1.30-2.48]). Protective factors included being dispensed antihypertensive medications (SHR, 0.68 [95% CI, 0.53-0.87]), seeing a cardiologist (SHR, 0.72 [95% CI, 0.57-0.91]) following stroke, and less severe stroke (SHR, 0.71 [95% CI, 0.58-0.88]). Our findings provide an improved understanding of factors that influence the transition from community to permanent residential care following stroke and can inform future strategies designed to delay this transition.

The mice plague and the assemblage of beastly landscapes in regional and rural Australia

AbstractBeginning in the spring of 2020, a mouse and rat plague spread across the rural grain belt in New South Wales, Australia. Lasting for almost 10 months, the plague was described by the local media as a ‘horror’ which ‘terrorised’ farmers and ‘ravaged’ farms. Focusing predominantly on news media reporting of the plague, this article shows how the mice and rats were constructed as abject matter out of place. This construction reveals how the interspecies dynamics of managing pests render rural landscapes vulnerable and unsettle colonial imaginaries regarding the management of the Australian environment. The plague signals a disturbance of the ‘natural’ order of things where the landscape is ‘normally’ anthropocentrically managed for monocultural farming. Drawing on Chris Philo and Chris Wilbert's identification of ‘beastly spaces’, this article explores the plague as facilitating a beastly landscape that radically de‐centres human control and investment in the environment.

Accessing voluntary assisted dying in regional Western Australia: early reflections from key stakeholders.

Most Australian jurisdictions have passed voluntary assisted dying (VAD) laws, with some regimes already in operation. Inequitable access to assisted dying in regional communities has been described internationally. Although regional access to VAD has been identified as a concern in Australia, to date it has been understudied empirically. Western Australia (WA) was the second Australian jurisdiction to pass and implement VAD laws. Due to the vast geography of WA (and the potential for such geography to exacerbate regional access inequities) several initiatives were introduced to try to mitigate such inequities. This article aims to explore the effectiveness of these initiatives, and report on regional provision of VAD in WA more generally, by drawing on the early experiences and reflections of key stakeholders. A total of 27 semi-structured interviews were conducted with 29 participants belonging to four main stakeholder groups: patients and families, health practitioners, regulators and VAD system personnel, and health and professional organisation representatives. Interviews were transcribed verbatim and analysed using inductive thematic analysis. Data analysis led to the description of four main themes: the importance of the Regional Access Support Scheme, the need for local providers, the role of telehealth in VAD provision and the impact of distance. Early experiences and reflections of key stakeholders suggest that while many of the regional initiatives implemented by WA are largely effective in addressing regional access inequities, challenges for regional VAD provision and access remain.

Alcohol consumption and health-related quality of life in regional, rural and metropolitan Australia: analysis of cross-sectional data from the Community Health and Rural/Regional Medicine (CHARM) study

BackgroundRelationships between alcohol consumption and health are complex and vary between countries, regions, and genders. Previous research in Australia has focused on estimating the effect of alcohol consumption on mortality. However, little is known about the relationships between alcohol consumption and health-related quality of life (QoL) in Australia. This study aimed to investigate the levels of alcohol intake and QoL in males and females in rural, regional and metropolitan areas of Australia.MethodParticipants (n = 1717 Australian adults) completed an online cross-sectional study. Males and females were compared on measures including the AUDIT-C and WHOQOL-BREF. Data were stratified into risk of alcohol use disorder (AUD) and associations were examined between alcohol consumption and QoL, adjusting for sociodemographic variables.ResultsMales had higher alcohol consumption and were at greater risk of AUD than females (20% vs 8%). Relationships between alcohol consumption and QoL were positive or non-significant for low–moderate AUD risk categories and negative in the severe AUD risk category. Males in regional communities reported higher alcohol consumption (AUDIT-C score 6.6 vs 4.1, p < 0.01) than metropolitan areas. Regression analyses identified that after adjusting for sociodemographic variables, alcohol consumption was positively related to overall, environmental, and physical QoL and general health.ConclusionThe results indicate that alcohol consumption is negatively related to QoL only in those with severe risk of AUD. Males in regional areas reported higher alcohol consumption than those in metropolitan areas. These results provide further information about relationships between alcohol intake and health in Australia that can help inform prevention, screening and delivery of interventions.

The Relationship Between Masculinity and Help-Seeking Among Australian Men Living in Non-urban Areas

This study explores how traditional masculine norms affect mental health help-seeking attitudes in men residing in regional, rural, and remote Australia. Participants ( N = 271) were men living outside of major cities of Australia. Analyses of survey data found increasing endorsement of masculine norms was predictive of more negative attitudes toward help-seeking. Perceived barriers to help seeking partially mediated relationships between masculine norms and help seeking. Full mediation was present for gender role conflict through perceived barriers and help seeking. These findings suggest efforts to improve mental health of men from non-urban communities may consider the way health messages could be targeted to optimise help seeking. Increasing engagement with stakeholders, such as clinicians, community groups, government agencies, and mental health organisations is warranted when engaging men living in non-urban areas.

Bone health in rural Australia: a mixed methods study of consumer needs

SummaryThis mixed methods study explores osteoporosis among adults living in a regional area of Victoria, Australia. Three major themes emerged from interviews, which reflected the findings of surveys, concerns regarding the adequacy of care in rural areas, a desire for tailored, local care, and a desire for hybrid telemedicine or in-person services.PurposeOsteoporosis or osteopenia affects over half of adults aged over 50 years. People living outside major cities in Australia have higher hip fracture rates than people living in cities, along with reduced access to bone densitometry and osteoporosis specialists. This study explores osteoporosis risk factors, knowledge, experiences of and preferences for care in people living in a regional area, to inform development of osteoporosis care programs.MethodsAdults living in a large non-metropolitan region of Australia were invited to participate in a mixed methods study: a survey (phase 1) followed by semi-structured interviews (phase 2) with triangulation of results. Data collected included osteoporosis diagnosis, risk factors, management, knowledge, preferences for care and experience using telemedicine. Surveys were analysed quantitatively, with linear and logistic regression used to assess factors related to osteoporosis knowledge or satisfaction with telemedicine. Interview transcripts were analysed using thematic analysis by two researchers, with in-depth discussion to identify themes.ResultsSixty-two participants completed the survey, and 15 completed interviews. The mean (SD) age of survey participants was 62.2 (14.1) years, 57% had a screening test for osteoporosis, and 12 (19%) had a diagnosis of osteoporosis. The mean osteoporosis knowledge score was 8.4 / 19 and did not differ with age, education, or history of osteoporosis. The majority wanted access to more information about osteoporosis but preferred method differed, and the majority preferred in-person medical consultations to telemedicine. Interview participants were aged between 57 and 87 years, and included 8 with osteoporosis or osteopenia. Three major themes emerged: concerns regarding the adequacy of care in rural areas, a desire for tailored local car and a desire for hybrid telemedicine or in-person services.ConclusionGaps exist in rural osteoporosis care, including knowledge, screening and management. People have differing experiences of care, access to services and preferences for care. High-quality care, tailored to their needs, was preferred. Improving osteoporosis services for regional Australia will require a flexible, multi-faceted approach, addressing needs of the local community and providers.

A qualitative exploration of young people’s mental health needs in rural and regional Australia: engagement, empowerment and integration

BackgroundAustralian rural and regional communities are marked by geographic isolation and increasingly frequent and severe natural disasters such as drought, bushfires and floods. These circumstances strain the mental health of their inhabitants and jeopardise the healthy mental and emotional development of their adolescent populations. Professional mental health care in these communities is often inconsistent and un-coordinated. While substantial research has examined the barriers of young people’s mental health and help-seeking behaviours in these communities, there is a lack of research exploring what adolescents in rural and regional areas view as facilitators to their mental health and to seeking help when it is needed. This study aims to establish an in-depth understanding of those young people’s experiences and needs regarding mental health, what facilitates their help-seeking, and what kind of mental health education and support they want and find useful.MethodWe conducted a qualitative study in 11 drought-affected rural and regional communities of New South Wales, Australia. Seventeen semi-structured (14 group; 3 individual) interviews were held with 42 year 9 and 10 high school students, 14 high school staff, and 2 parents, exploring participants’ experiences of how geographical isolation and natural disasters impacted their mental health. We further examined participants’ understandings and needs regarding locally available mental health support resources and their views and experiences regarding mental illness, stigma and help-seeking.ResultsThematic analysis highlighted that, through the lens of participants, young people’s mental health and help-seeking needs would best be enabled by a well-coordinated multi-pronged community approach consisting of mental health education and support services that are locally available, free of charge, engaging, and empowering. Participants also highlighted the need to integrate young people’s existing mental health supporters such as teachers, parents and school counselling services into such a community approach, recognising their strengths, limitations and own education and support needs.ConclusionsWe propose a three-dimensional Engagement, Empowerment, Integration model to strengthen young people’s mental health development which comprises: 1) maximising young people’s emotional investment (engagement); 2) developing young people’s mental health self-management skills (empowerment); and, 3) integrating mental health education and support programs into existing community and school structures and resources (integration).

Working toward a place-based online pedagogy

ABSTRACT Online learner engagement research has risen internationally due to the COVID-19 pandemic, especially in relation to experiential learning. However, this research has focused on the use of technology to access learning about a particular place rather than consider the pedagogical potential of the places in which the learner is located. This study therefore considers the question: What is the pedagogical potential of place for online learners? The aim of the study is to scrutinise pedagogical practices that facilitate applied understanding of course concepts in a way that enables learners to contextualise learning in their unique locations. This paper analyzes recounts of experiences with place-based inquiry with online students in an initial teacher education course offered in regional Australia. The evidence presented suggests that place-based pedagogy enables students to see learning concepts at work in context, beyond the abstract. Further, contrary to expectations that the experience of place-based learning is diminished in an online environment, there might be advantages for the preparation of pre-service teachers in experiencing place-based inquiry in their own locales.

A scoping review of the barriers and facilitators to accessing and utilising mental health services across regional, rural, and remote Australia

BackgroundInadequate healthcare access and utilisation are implicated in the mental health burden experienced by those living in regional, rural, and remote Australia. Facilitators that better enable access and utilisation are also reported in the literature. To date, a synthesis on both the barriers and facilitators to accessing and utilising mental health services within the rural Australian context has not been undertaken. This scoping review aims to (1) synthesise the barriers and facilitators to accessing and utilising mental health services in regional, rural, and remote Australia, as identified using the Modified Monash Model; and (2) better understand the relationship between barriers and facilitators and their geographical context.MethodsA systematic search of Medline Complete, EMBASE, PsycINFO, Scopus, and CINAHL was undertaken to identify peer-reviewed literature. Grey literature was collated from relevant websites. Study characteristics, including barriers and facilitators, and location were extracted. A descriptive synthesis of results was conducted.ResultsFifty-three articles were included in this scoping review. Prominent barriers to access and utilisation included: limited resources; system complexity and navigation; attitudinal and social matters; technological limitations; distance to services; insufficient culturally-sensitive practice; and lack of awareness. Facilitators included person-centred and collaborative care; technological facilitation; environment and ease of access; community supports; mental health literacy and culturally-sensitive practice. The variability of the included studies precluded the geographical analysis from being completed.ConclusionBoth healthcare providers and service users considered a number of barriers and facilitators to mental health service access and utilisation in the regional, rural, and remote Australian context. Barriers and facilitators should be considered when re-designing services, particularly in light of the findings and recommendations from the Royal Commission into Victoria’s Mental Health System, which may be relevant to other areas of Australia. Additional research generated from rural Australia is needed to better understand the geographical context in which specific barriers and facilitators occur.

Understanding the Skills and Roles of Social Media Manager in Improving Job-Related Performance among SMEs in Australia

One of the biggest challenges that Small and Medium Enterprises (SMEs) confront is coming up with the best business plan, which is made possible by a strong social media adoption of modern soft and hard skills. Due to the high rate of failures among SMEs, there has been a substantial investment in research to pinpoint the crucial elements that will ultimately lead to a more successful journey. Several models have also been developed to evaluate the profound impact of the social media manager. However, there is a gap in determining how prepared an SME is to successfully boost performance, and the gap is considerably larger when considering it from the perspective of the absence of intervention from social media managers skills (SMM). The current research suggests a model for evaluating such readiness by interrogating SMM skills. In order to help SMEs to better grasp the foundations that must be laid in order to successfully enhance performance, organisational readiness is introduced as a mediator. From the viewpoint of an employee, this paper suggests a model to position the role of SMEs for upcoming challenges. The organisational readiness evaluation seeks to give SMEs in regional Australia a better understanding of the foundations that must be laid in order to successfully achieve the required increase in performance for SMEs.

Changing conversations about family violence in regional Western Australia: A primary prevention communication case study

ObjectiveTo illuminate the enablers and challenges of implementing a communication strategy designed to support Community, Respect, Equality (CRE) and a family and domestic violence (FDV) primary prevention plan in a regional Western Australian town. MethodThis research draws on documentation and interviews with members of Leading Lights, an advocacy group arising from a collaboration of local organisations to communicate the goals and priorities of the CRE action plan. Interviews explored how primary prevention messages were promoted to foster supportive community attitudes toward addressing the drivers of FDV. ResultsThe initiative fostered a learning community that coordinated public messaging about the drivers of FDV for organisations pledged to the CRE values. The diffusion of messaging was affected over time by inconsistent staffing, discontinuities in resourcing and individual organisational commitment, and concerns about gender equality messaging. ConclusionThe communications strategy increased awareness of the drivers of FDV among the members of the Leading Lights. In turn, this group produced media content that made visible each organisation’s commitment to addressing the attitudes and behaviours that enable FDV. Implications for public healthCommunity collaborations need time, resourcing, and coordination to sustainably prompt changes in social norms that underpin violence.