Remote Regions Of Australia Research Articles

High prevalence of antibodies against feline calicivirus in Australian feral and stray cat (Felis catus) populations.

Feline calicivirus (FCV) commonly causes upper respiratory tract, oral and ocular infections in species of the family Felidae, with high prevalence amongst domestic cat (Felis catus) populations worldwide. Detection of FCV-specific antibodies in serum provides evidence of previous infection with FCV and an indication of whether a cat may be protected against clinical FCV disease. This study describes the most extensive sampling for anti-FCV antibodies in feral and stray cat populations in Australia, and examines variation in prevalence associated with cat age, sex and location. Blood samples were opportunistically collected from 669 feral, stray or Indigenous community cats from the Northern Territory, South Australia, Victoria, south-east Tasmania and south-west New South Wales. The sera were harvested and tested for antibodies capable of neutralising the FCV vaccine strain F9 by serum-virus neutralisation assay. Of the 669 cats tested, 69.7% had detectable FCV-F9-neutralising antibodies (titres ≥5). Maturity was significantly associated with higher seroprevalence and higher antibody titres, with adult cats being more than twice as likely to have detectable FCV-neutralising antibodies than subadults. Male cats had a higher seroprevalence and slightly higher antibody titres than females. Cats living in closer proximity to humans had significantly higher seroprevalences and higher FCV-neutralising antibody titres than feral cats from more remote regions of Australia. Australian feral and stray cats have a high risk of natural exposure to and infection with FCV, with the prevalence and levels of pre-existing immunity to FCV being highest amongst adult cats living in highly modified urban, peri-urban and agricultural environments.

Australian medical practitioners: trends in demographics and regions of work 2013-2022.

ObjectiveThis study aimed to examine changes in the demographics and regions of work of Australian doctors over a period of 9years.MethodsA retrospective study of Australian Health Practitioner Regulation Agency (AHPRA) registration data was performed. Data were sourced from the Health Workforce Dataset Online Data Tool which was derived from annual registration data from AHPRA for 2013-2022. The demographic factors analysed were gender, age, and origin of qualification. Regions of work were defined using the Modified Monash (MM) model.ResultsThe number of registered doctors increased from 82,408 in 2013 to 111,908 in 2022 but mean hours worked per week decreased from 41 to 39 leading up to 2020. Trends in age and origin of qualification remained stable, but the proportion of female workers increased from 38.5% in 2013 to 44.5% in 2022. While female hours per week (~37) were consistent from 2013 to 2020, male hours per week decreased from 43 to 41. The number of registrations and total full-time equivalent (FTE) outcomes increased consistently in metropolitan (MM1) and rural (MM2-5) regions but did not increase for remote and very remote (MM6-7) regions.ConclusionThe Australian medical workforce both grew and changed between 2013 and 2022. An overall decrease in mean hours worked appears to be driven by a decline in hours worked by male workers and the increased proportion of female workers. While increased gender parity and a decrease in hours worked per week were positive outcomes, a lack of growth in the medical workforce was noted in remote and very remote regions of Australia.

Discharge against medical advice in rural and remote emergency departments: views of healthcare providers.

The aim of the study was to explore, in one remote hospital, emergency department healthcare providers' experience and perceptions of the factors surrounding a patient's decision to discharge against medical advice (DAMA). The secondary objective was to gain insight into staff experiences of the current protocols for managing DAMA cases and explore their recommendations for reducing DAMA incidence. This was a cross-sectional study involving a survey and semi-structured interviews exploring healthcare providers' (n=19) perceptions of factors perceived to be influencing DAMA, current practice for managing DAMA and recommendations for practice improvements. Health professionals (doctors, nurses, Aboriginal Health Workers) all worked in the emergency department of a remote community hospital, Queensland, Australia. Responses relating to influencing factors for DAMA were provided on a three-point rating scale from 'no influence/little influence' to 'very strong influence'. DAMA management protocol responses were a three-point rating scale from 'rarely/never' to 'always'. Semi-structured interviews were conducted after the survey and explored participants' perceptions in greater detail and current DAMA management protocol. Feedback from the total of 19 participants across the professions presented four prominent yet interconnected themes: patient, culture, health service and health provider, and health literacy and education-related factors. Factors that were perceived to have a strong influence on DAMA events included alcohol and drug abuse (100%), a lack of culturally sensitive healthcare services (94.7%), and family commitments or obligations (89.5%). Healthcare provider recommendations for preventing DAMA presented themes of right communication, culturally safe care (right place, right time) and the right staff to support DAMA prevention. The healthcare providers described the pivotal role the Indigenous Liaison Officer (ILO) plays and the importance of this position being filled. DAMA is a multifaceted issue, influenced by both personal and hospital system-related factors. Participants agreed that the presence of ILO and/or Aboriginal Health Workers in the emergency department may reduce DAMA occurrences for Indigenous Australians who are disproportionately represented in DAMA rates, particularly in rural and remote regions of Australia.

Disability workforce and the NDIS planning process in regional, rural and remote regions of Australia: Scoping review.

The Australian geographically rural and remote disability workforce has historically demonstrated difficulties to keep up with the demand for quality services and supports for people with disability. In 2013, the National Disability Insurance Scheme (NDIS) was launched to provide individualised disability support packages to meet people's needs. To receive funding, people with disability are required to develop a NDIS plan. That plan is then funded by the National Disability Insurance Agency (NDIA), the government agency responsible for managing the NDIS. Although the NDIS has been operating for almost 10 years, there is limited research into the planning experiences of the workforce in regional, rural and remote regions of Australia. This review aims to ascertain the level of scholarly investigation into workers' experiences of NDIS planning. Research publication databases were searched using a specific search string to identify publications that included reference to the workforce's experiences of the NDIS planning process in regional, rural and remote regions of Australia. The Mixed Methods Appraisal Tool (MMAT) was adopted to appraise the quality of the research publications. Research publications that focused on those working with Aboriginal and Torres Strait Islander people were also appraised using the Aboriginal and Torres Strait Islander Quality Appraisal Tool developed by the Centre for Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange. A thematic synthesis of the publications was undertaken to ascertain disability and health workforce experiences of the NDIS planning process. Seven papers met the selection criteria. Two papers were policy reviews and reported the improvements of the NDIS planning process since its inception. These studies reported four reoccurring themes: (1) cultural/socioeconomic and geographical factors; (2) administrative burden and bureaucracy; (3) values, culture and geography; and (4) burden on allied health workers. The NDIS planning process has developed and progressed since its rollout in 2013. There are limited research papers available that describe the workforce's experience of the planning process in regional, rural and remote regions. More research in this area is needed to identify the experiences of the disability workforce in relation to the NDIS planning process.

The role of heritage sites and other influential factors in domestic tourism inflow to Australian states: a gravity model approach

ABSTRACT Domestic tourism plays a crucial role in the Australian economy, generating revenue, creating employment opportunities, fostering cultural identity, and facilitating tourism growth and development. The remote regions of Australia are particularly reliant on domestic inbound tourism to stimulate their local economies. This study investigates the influence of heritage sites and various factors on domestic tourism inflows to eight states in the Australia between 1998–2021. The gravity method and random effect model are employed for the empirical analysis. The results indicate that the macro determinants, including population of origin state, gross state product per capita, infrastructural development, shared border between states, and the number of heritage sites, have significant and positive impact on domestic tourism inflow. Conversely, the consumer price index, distance, and pandemic outbreak have a negative influence on domestic tourism inflow. These findings hold important practical implications. Given Australia’s geographical remoteness, promoting domestic tourism becomes imperative to boost the tourism industry and local economies. Therefore, it is recommended that authorities prioritize domestic tourism flows and invest in infrastructure, preserve heritage sites, stabilize prices, implement effective marketing strategies, and respond swiftly to public emergencies such as the Covid-19 pandemic.

Restoring Human Dignity: Some Reflections on the Right to Repair & Medical Devices and Assistive Technologies

The Right to Repair movement, defined broadly as the ability to have products repaired at a competitive price using repairers of choice, gained even more support from the community during the COVID-19 pandemic as hospitals worldwide reported issues with the ongoing maintenance of crucial medical equipment. The ability to keep lifesaving medical equipment operational is not only relevant in hospital settings but is fundamentally important for those individuals in our community, particularly those in remote regions of Australia, who need to rely upon medical devices in their day-to-day lives. This article examines these complex issues in light of the findings of the Australian Productivity Commission’s Right to Repair inquiry that barriers currently do exist to medical device repair and that a review be conducted of the medical device market and current regulations.

Understanding the planning and preparation for diabetes self-management of grey nomads when travelling in rural and remote Australia: An exploratory survey.

Many older Australians with chronic health conditions, including diabetes, are taking to the road in a recreational vehicle following retirement and are colloquially known as grey nomads. This exploratory online survey aimed to ascertain the issues on the road for grey nomads with diabetes and their experiences of self-management of their diabetes whilst in rural and remote regions of Australia. Following ethical approval and piloting, an online survey was distributed through social media sites used by grey nomads and those with diabetes. From the closed and open-ended responses from travelers with diabetes in rural and remote areas, the demographics of this cohort were explored, as well as their self-management of diabetes. A total of 103 grey nomads with diabetes responded and 81 completed all survey questions. There was wide variation in the respondents' answers in regard to their self-management including their preparation for travel; their knowledge of diabetes and accessing health-care services; their management of illness; and their experiences whilst travelling including the effects of COVID-19. It was identified that there was a need for an increase in preparation prior to travel, and several important checks were identified for this planning specific to rural and remote areas of Australia, including the expectations of health services in these regions. A pretravel checklist for travellers with diabetes is recommended to contribute to better self-management of grey nomads with diabetes on the road in order to alleviate the issues identified.

Surveying the changing climate of Northern Territory medical workforce retention.

Low retention is a significant contributor to medical workforce shortages in rural and remote regions of Australia, including in the Northern Territory (NT). Many of these areas are susceptible to climate change, which could exacerbate workforce retention problems. To examine factors influencing medical workforce retention in the NT, including the potential impact of climate change. Cross sectional online survey of NT medical professionals, distributed via email through professional networks. Predominantly quantitative mixed methods (descriptive statistics, multivariate logistic regression, thematic analysis). Main 2 outcome measures reported were proportion of respondents intending to leave the NT, timeframe of intention to leave and motivating factors. Of 1407 registered practising medical professionals in the NT, 362 responded who met inclusion criteria (26% estimated response rate) and 351 completed all questions. Of the latter, 143 (41%) intended to leave the NT, 102 (29%) were unsure, and 106 (30%) did not intend to leave. Among doctors in training (DITs) 67 (55%) intended to leave and 29 (24%) were unsure. The best multivariable predictive model included only practice type (with general practitioners/rural generalists and non-GP specialists significantly less likely to intend to leave compared to DITs), and location of primary medical degree (with non-NT training non-significantly associated with greater intention to leave). Of those intending to leave 94 (66%) reported planning to do so within two years. Training and career development opportunities, job dissatisfaction, moving to a preferred location and family-related factors were all important motivators. Of those considering leaving, 58 (24%) identified climate change as a motivating factor. Retention remains a key challenge in addressing rural workforce shortages. In addition to established factors, climate change is an important driver that has the potential to worsen workforce shortages in susceptible regions.

The dialectical relation of real and digital Conceptual PlayWorlds in Family Day Care

ABSTRACT Play acts as the source of children’s development in the preschool period. Yet, the global pandemic has changed children’s play conditions in ways that are not yet fully understood. With movement restrictions, families have struggled to find ways of bringing children together for play. We studied how family day care (FDC) educators across a remote region of Australia used a digital platform to collectively play in a Conceptual PlayWorld. The central question was: How do the dialectical digital and real world conditions of play create developmental opportunities for children? To answer this, we researched how family day care educators, their leaders (n = 7) and the children (n = 38) from their respective FDC homes, simultaneously played at home and remotely using a zoom platform with a storyteller-player. 797.46 min of digital data were generated and analysed using the Vygotskian conception of the dialectical relation between rudimentary/real and ideal/mature forms of play. In drawing on previous cultural-historical theorisations of digital play, this paper discusses the new developmental conditions created in this real world and virtual context of FDC. We introduce new concepts for explaining the developmental processes and outcomes for these children.

Poorer first aid after burn is associated with remoteness in Australia: Where to from here?

Early intervention with appropriate first aid following burn injury improves clinical outcomes. Previous evidence suggests geographic remoteness may be a barrier to receiving appropriate burns first aid. This study investigated the prevalence of gold standard first aid in patients managed in Australian burn services and whether geographic remoteness was associated with receiving gold standard first aid. Registry-based cohort study. Binational clinical quality registry. Burn-injured patients admitted to a specialist Australian burn service. Receiving gold standard first aid following a burn injury. Approximately two-thirds of patients received gold standard first aid. Patients whose burns were sustained in very remote regions had a greater risk of receiving no first aid, compared to gold standard first aid, relative to patients who sustained their burn injuries in major cities. Nearly two-thirds of patients received gold standard burns first aid following injury. However, patients who were injured in the most remote regions of Australia were at an increased risk of not receiving gold standard first aid treatment within 3hours of injury. Further examination of factors contributing to poorer first aid standards in remote areas is required.

Delivering behaviour support to children and adolescents with autism via telepractice: a narrative review

Access to timely behaviour support services for children and adolescents with a disability in rural and remote regions of Australia is problematic due to the inadequate supply of specialised staff providing complex behaviour support in their local area. Technology has the potential to provide a timely, quality, low-cost option that extends access to behaviour support services for these children and their support teams in rural and remote areas. The purpose of this narrative review was to explore policy and practice guidelines on the delivery of behaviour support via telepractice for children and adolescents with a disability in Australia, and more specifically for those on the autism spectrum. Secondly, the review aimed to establish the evidence base of this model of service for children and adolescents with autism, in order to reflect on how it aligns with current Australian policy and practice. Practice and policy documents were drawn from selected websites relevant to the delivery of behaviour support via telepractice in Australia. Peer-reviewed literature (2004–2019) on the delivery of behaviour support via telepractice was sourced via four databases. While telepractice appears to have promising utility for the provision of support for children and adolescents with autism who present with challenging behaviour, there was very little policy documentation or guidelines found that related specifically to the delivery of this support. There is a need for further rigorous research to inform policy, establish efficacy, and develop practice guidelines that ensure delivery of high quality telepractice behaviour supports under the National Disability Insurance Scheme.

The use of clozapine in a rural and remote region of Australia.

Clozapine is the most effective antipsychotic available for treatment-resistant schizophrenia. Unfortunately, it is often underutilised or administered late in the treatment course, if at all. This issue is further augmented in rural and remote regions where access to treatment is sparse. This study is the first of its kind to investigate the use of clozapine in a remote and regional area of Australia with a high proportion of Aboriginal and/or Torres Strait Islander individuals. This study includes all individuals who were commenced on clozapine between June 2013 and June 2018. Relevant clinical information was sourced from electronic medical records and descriptive statistical analysis performed. A total of 3850 patients with psychotic disorders were reviewed over 5 years, of whom 63 were commenced on clozapine. The majority were male (n = 50, 79.4%) with a mean age of 33.9 years (standard deviation 11.0). A total of 34.9% (n = 22) identified as Aboriginal and/or Torres Strait Islander. The mean length of time between diagnosis and commencement of clozapine was 7.2 years (standard deviation ±4.6 years), while the mean number of antipsychotic medications tried prior to clozapine was 4.2 (standard deviation ±1.6 antipsychotics). Clozapine was discontinued in 57.1% of the individuals in this study (41% within the first 12 months). The most common cause for cessation was poor compliance (n = 19, 30.2%). While clozapine remains the most effective antipsychotic treatment, it is often commenced late in the treatment or ceased prematurely. Further work is required, particularly in remote and regional populations, to ensure treatment adherence for optimal patient outcomes.

Five years of dermatological disease requiring specialist care in the Kimberley region of Western Australia.

Epidemiological studies that document the burden of skin diseases in rural and remote regions of Australia are vital in ensuring proper health-care planning and management. The purpose of this study was to establish the burden of skin disease requiring specialist dermatology input for both the Aboriginal and non-Aboriginal communities in the Kimberley. A retrospective audit of all outpatient encounters with the primary Country Health Service visiting dermatology specialist in the Kimberley region between January 2012 and January 2017. A total of 2281 encounters were recorded with 1459 unique patients seen. The most common disease categories seen in the general population were premalignant and malignant skin disease (40%), eczema and dermatitis (17%) and benign skin neoplasms (12%). Among Aboriginal patients, the most common conditions were eczema and dermatitis (19%), autoimmune connective tissue disease/rheumatological and autoinflammatory syndromes (17%), adnexal diseases (10%), pigmentary disorders (7%) and benign skin neoplasms (7%). These findings can be used to enhance, direct and plan dermatological services for both the Aboriginal and non-Aboriginal populations in the Kimberley region.

Stroke incidence and subtypes in Aboriginal people in remote Australia: a healthcare network population-based study

ObjectivesWe aimed to compare the incidence, subtypes and aetiology of stroke, and in-hospital death due to stroke, between Aboriginal and non-Aboriginal people in Central Australia, a remote region of Australia...

Finding a pathway and making it strong: Learning from Yolŋu about meaningful health education in a remote Indigenous Australian context.

Access to meaningful health information is limited in remote regions of Australia where Indigenous languages and culture are strong but the prevalence of chronic conditions is extremely high. This qualitative study aimed to support and understand the evolution of an educational approach to improve communication about chronic conditions for Yolŋu (Aboriginal people of Northeast Arnhem Land). Within a culturally responsive research design, data were gathered through participant observation and semi-structured interviews with educators and community members. An iterative and continuous process of data collection and inductive analysis, exploring key elements of the process as it evolved, supported the Project Team to modify and refine their approach as the project progressed. A high level of community participation and control was a critical element of the project. Collaboration between Yolŋu educators and community experts, with culturally competent support from others, enabled Yolŋu to share health information in ways that could not be achieved by outsiders. Yolŋu and biomedical knowledges were integrated to build and share meaningful, in-depth (not simplified or directive) oral explanations in local languages using culturally responsive communication processes. The urgent need for ongoing, sufficient and meaningful health education was a consistent and recurring theme in this context where chronic conditions are having a devastating impact. Sustained and equitable access to meaningful information, using a culturally responsive approach led by community educators, is crucial to improve health literacy and to enable genuinely informed decisions in prevention and management of chronic conditions. Long-term funding is needed to support ongoing programs. These findings may have relevance for others who do not share the culture and language of the majority population. SO WHAT?: Equity of access to meaningful health information through sustained support for community-led education processes is essential to improve First Nations health outcomes.

Rural clinical school dental graduates views on rural and metropolitan employment.

There is a maldistribution of dental professionals working in rural and remote regions of Australia. This study investigates dental graduates from a newly established rural clinical school (RCS) at Charles Sturt University (CSU), New South Wales, Australia, and records graduates' workforce locations and views on working in both metropolitan and rural practice. In late 2015 to early 2016, CSU graduates of 2013 and 2014 were asked to complete a telephone interview related to their employment choices. Thirty-nine interviews (68% of contactable graduates) were completed. Qualitative framework analysis was applied to identify trends and themes. More than half of the graduates were working rurally, with 67% working full-time and 77% in private practice. Key influencing factors on graduates related to rural employment were as follows: family and personal relationships, developing clinical skills, rural community, lifestyle, professional support, mentorship, job availability, full-time employment and financial incentives. Key barriers to working rurally included leaving family and friends, small patient base, low salary, partner factors, and professional and personal isolation. More than half of the CSU graduates were working in rural communities, demonstrating initially positive rural workforce outcomes. Reasons for choosing to work rurally were complex and spanned a broad spectrum of social, personal, professional development and support, community, economic, environmental and lifestyle factors. Future workforce strategies should apply a broad multifactorial approach to consider the complex interrelated employment factors. Furthermore, increased evaluation is required of the CSU programme, with increased workforce outcomes and exploration of employment retention factors.

Understanding the Roles of Remoteness and Indigenous Status in Rural and Remote Road Trauma in North Queensland: Using a Mixed-Methods Approach.

Road trauma is a significant health problem in rural and remote regions of Australia, particularly for Indigenous communities. This study aims to identify and compare the circumstances leading to (proximal causation) and social determinants of (distal causation) crashes of Indigenous and non-Indigenous people in these regions and their relation to remoteness. This is a topic seriously under-researched in Australia. Modelled on an earlier study, 229 persons injured in crashes were recruited from local health facilities in rural and remote North Queensland and interviewed, mainly by telephone, according to a fixed protocol which included a detailed narrative of the circumstances of the crash. A qualitative analysis of these narratives identified several core themes, further explored statistically in this sample, supplemented by participants in the earlier study with compatible questionnaire data, designed to determine which factors were more closely associated with Indigenous status and which with remoteness. Indigenous participants were less often vehicle controllers, more likely to have recently been a drink driver or passenger thereof; to be unemployed, unlicensed, distracted or fatigued before the crash, alcohol dependent and have lower perceived social, but not personal, locus of control in a traffic crash than non-Indigenous persons. Differences between Indigenous and non-Indigenous participants are largely ascribable to hardship and transport disadvantage due to lack of access to licensing and associated limitations on employment opportunities. Based on these findings, a number of policy recommendations relating to educational, enforcement and engineering issues have been made.

Grey nomads with diabetes: the experience of rural and remote diabetes educators in South Australia.

The phenomenon of grey nomads travelling in rural and remote regions of Australia is on the increase, and as this cohort is an older age group, they are often travelling with chronic conditions, such as diabetes. Seven rural and remote diabetes educators were interviewed about their experiences of grey nomad travellers with diabetes, to whom they provided services. The findings revealed problems associated with grey nomads with diabetes, including maintenance of equipment, medications, self-management, glycaemic control and unpredictable events. The problems highlighted by the participants were exacerbated when travelling long distances for extended periods, often with changes to their usual regime of self-management. The isolation and remoteness of some areas was a factor for the travellers who were often not prepared and often turned to pharmacists for help. The participants were able to enhance the care and self-management of the travellers with diabetes and identified several pathways travellers may undertake if they needed services related to their diabetes. The diabetes educators' capacity to provide services for travellers was stretched at times; however, this was viewed as positive in that it added diversity to their normal practice. Recommendations included a preparation checklist and information for travellers with diabetes and further education for pharmacists.

Elevated sodium concentrations in Australian drinking water supplies

Salt in the drinking water of many Australian water supplies could be adversely contributing to the ill-health of many people. Health care professionals often recommend low-sodium diets for patients with kidney disease, heart disease and cardiovascular disease. It is recommended that people on a low-sodium diet drink water with less than 20 mg/L of sodium. The sodium concentration of water supplies in many regional and remote regions of Australia often had water with elevated sodium (more than 20 mg/L) in their water supplies. In NSW 17 of the 21 regional water supplies tested had higher than 20 mg/L sodium. The issue of elevated sodium in many Australian drinking water supplies needs to be recognised more prominently. Sodium needs to be sampled more frequently and the results shared openly with consumers and health professionals. All water authorities that provide drinking water with sodium concentrations higher than 20 mg/L should be advising their customers of this fact as a high priority. People on low-sodium diets that have >20 mg/L sodium in their water supply should consider options to obtain low-sodium water.

Coverage of cancer services in Australia and providers\u2019 views on service gaps: findings from a national cross-sectional survey

BackgroundIn response to the increasing cancer prevalence and the evolving health service landscape across the public and private health sectors in Australia, this study aimed to map cancer services and identify factors associated with service provision and important service gaps.MethodsA prospective, cross-sectional survey was conducted throughout 2016. Extensive search strategies identified Government or privately-owned, hospital or community-based healthcare organisations with dedicated cancer services. One nominated staff member from each organisation answered a purpose specific online/paper questionnaire. Descriptive statistics, standardised rates, and single level and multilevel multinomial logistic regression were used to analyse the data. Analysis was augmented with a qualitative descriptive analysis of open-ended questions.ResultsFrom the 295 eligible organisations with a cancer service in Australia, 93.2% participated in the survey. After adjusting for remoteness, for-profit companies were significantly more likely than Government operated services to provide only one or two types of cancer services (e.g. radiotherapy) in a limited range of settings (e.g. day hospital with no in-patient or home care) (p < 0.001) and less likely to provide comprehensive cancer services (p < 0.001). After adjusting for ownership and the respondent’s role in the organisation, respondents located in remote regions of Australia were more likely to identify cancer services that are dependent upon specialist medical practitioners as the most important service gaps in their region (p = 0.003). Despite 76.0% of organisations across Australia offering some type of supportive care or survivorship services, providers identified this group of services as the most pressing service gaps in major cities, rural and remote regions alike (standardised rate: 47.9% (95%CI: 43.6–57.4%); p < .000). This included the need for improved integration, outreach and affordability.ConclusionsThe broad range of cancer services, settings and ownership identified by this survey highlights the complexity of the Australian healthcare system that cancer survivors must navigate and the challenges of providing comprehensive cancer care particularly in rural and remote regions. Whilst the significant role of supportive care and survivorship services are increasingly being recognised, the findings from this survey support calls for innovative service models and funding mechanisms that expand the focus from preventing and treating cancer to supporting cancer survivors throughout the cancer continuum and promoting the delivery of integrated and equitable cancer care across the public and private sectors.