Rural Australian Communities Research Articles

Design and delivery of an innovative speech pathology service-learning program for primary school children in Far West NSW, Australia

Children growing up in Australian rural communities have more communication impairments than their urban counterparts. Communication impairments, if left unresolved in school starters, lead to long-term learning and behavioural problems. Rural communities are disadvantaged by a scarcity of health professionals. Supervised speech pathology students on rural clinical placement provided speech, language and communication screening, assessment and therapy to children starting kindergarten in Broken Hill, New South Wales, Australia. The students collected service outcome data for children in the program. Analysis of the outcome data demonstrated improvements in communication impairments for approximately one-quarter of the children. The service-learning program used in this study is designed to facilitate implementation in other locations. The model resulted in some improvement in communication impairments. It has the potential to revolutionise undergraduate student learning placements, as well as address the chronic health professional shortage in rural Australia.

Creating Feminist Culture: Australian Rural Lesbian-Separatist Communities in the 1970s and 1980s

Creating Feminist Culture: Australian Rural Lesbian-Separatist Communities in the 1970s and 1980s

Engaging rural Australian communities in National Science Week helps increase visibility for women researchers.

During a week-long celebration of science, run under the federally supported National Science Week umbrella, the Catch a Rising Star: women in Queensland research (CaRS) programme flew scientists who identify as women to nine regional and remote communities in the Australian State of Queensland. The aim of the project was twofold: first, to bring science to remote and regional communities in a large, economically diverse state; and second, to determine whether media and public engagement provides career advancement opportunities for women scientists. This paper focuses on the latter goal. The data show: (i) a substantial majority (greater than 80%) of researchers thought the training and experience provided by the programme would help develop her career as a research scientist in the future, (ii) the majority (65%) thought the programme would help relate her research to end users, industry partners or stakeholders in the future, and (iii) analytics can help create a compelling narrative around engagement metrics and help to quantify influence. During the week-long project, scientists reached 600 000 impressions on one social media platform (Twitter) using a program hashtag. The breadth and depth of the project outcomes indicate funding bodies and employers could use similar data as an informative source of metrics to support hiring and promotion decisions. Although this project focused on researchers who identify as women, the lessons learned are applicable to researchers representing a diverse range of backgrounds. Future surveys will help determine whether the CaRS programme provided long-term career advantages to participating scientists and communities.

General practitioners\u2019 experiences and perceptions of mild moderate depression management and factors influencing effective service delivery in rural Australian communities: a qualitative study

BackgroundRural communities in Australia face significant disadvantages relating to geographical isolation and limited access to mental health services. Documenting general practitioners’ (GP) experiences and perception of mental health services in rural Australia may be useful to gain insight into rural GP management of mild to moderate depression.AimsTo explore GPs’ experience and views on which factors influence access to mental health services for mild to moderate depression.MethodThis qualitative study was conducted in 2014 in the Northern Rivers, NSW, Australia. Data were obtained from semi-structured in-depth face-to-face interviews with ten GPs, and analyses were performed using a general inductive method of thematic analysis.ResultsMost GPs believed that the current services for managing mild-moderate depression were adequate, however they also identified the need for better access and more services that were free for patients. GPs had a positive perception of management of depression in a rural setting, identifying advantages including better doctor-patient relationships, continuity of care and the proximity of services. However, GPs also identified several barriers to access to mental health services in a rural setting, including long waiting-times, inadequate patient rapport with referred professionals, cost of treatment, transportation, geographical location, stigma, and lack of education about available mental health services. As a result, GPs frequently self-managed patients in addition to referring them to other community mental health service providers where possible.ConclusionOverall, GPs appeared relatively satisfied with the resources available in their communities but also identified numerous barriers to access and room for improvement. Rural GPs often self-managed patients in addition to referring patients to other mental health services providers. This should be taken into account when designing mental health policies, developing new services or re-designing current services in rural communities.

Implementation of oral health initiatives by Australian rural communities: Factors for success.

In this paper, we consider factors significant in the success of community participation in the implementation of new oral health services. Our analysis draws on data from the Rural Engaging Communities in Oral Health (Rural ECOH) study (2014-2016). We aimed to assess the Australian relevance of a Scottish community participation framework for health service development; Remote Service Futures. Internationally, community participation in planning of health initiatives is common, but less common in new service implementation. Health managers query the legitimacy of "lay" community members, whether they will persist, and whether they can act as change agents. Our data provide evidence that helps answer these queries. Six communities, located within regions covered by two large rural primary healthcare organisations (Medicare Locals), were selected in two Australian states. Two university-based facilitators worked with a group of local residents (for each community) to monitor implementation of new oral health initiatives designed through participatory processes. Data about implementation were collected through interviews with 28 key stakeholders at the beginning of implementation and 12months later. Data were coded, themed and analysed abductively. Five themes emerged; the inter-relationship between community motivation to participate with the fortunes of the oral health initiatives, having the "right" people involved, continuing involvement of sponsors and/or significant people, trusting working relationships between participants and perceiving benefits from participation. Findings provide evidence of a role for community participation in implementing new community services if solid partnerships with relevant providers can be negotiated and services are seen to be relevant and useful to the community.

Predictors of dental visits among primary school children in the rural Australian community of Lithgow

BackgroundRegular dental attendance is significant in maintaining and improving children’s oral health and well-being. This study aims to determine the factors that predict and influence dental visits in primary school children residing in the rural community of Lithgow, New South Wales (NSW), Australia.MethodsAll six primary schools of Lithgow were approached to participate in a cross-sectional survey prior to implementing water fluoridation in 2014. Children aged 6–13 years (n = 667) were clinically examined for their oral health status and parents were requested to complete a questionnaire on fluoride history, diet, last dental visit, and socio-demographic characteristics. Multiple logistic regression analyses were employed to examine the independent predictors of a 6-monthly and a yearly dental visit.ResultsOverall, 53% of children visited a dentist within six months and 77% within twelve months. In multiple logistic regression analyses, age of the child and private health insurance coverage were significantly associated with both 6-monthly and twelve-month dental visits. In addition, each serve of chocolate consumption was significantly associated with a 27% higher odds (OR = 1.27, 95% CI: 1.05-1.54) of a 6-monthly dental visit.ConclusionIt is imperative that the socio-demographic and dietary factors that influence child oral health must be effectively addressed when developing the oral health promotion policies to ensure better oral health outcomes.

When the social meets health in rural Australia: confronting the disconnect

ABSTRACTWhat happens in contemporary rural Australian communities when health consumers, health practitioners and health services intersect is the focus of this article. Using a hypothetical case of intimate partner violence, we analyse the power relations within what we call the ‘intersecting space’ to examine how each of these three central and ‘typical’ actors – rural consumers, health practitioners and rural services – is positioned. Drawing on Foucault’s concepts of power and discourse, we deconstruct dominant discourses of sameness and neutrality which (i) marginalise the perspectives and needs of rural health consumers, (ii) immobilise the ability of health practitioners to connect the social to health and (iii) restrict the flexibility of rural health services to address the social as part of health need. We argue that these discourses of sameness and neutrality have generated a longstanding disconnect that constrains social and health care systems, thwarting the production of client-centred care. We suggest that system-level change is required to provide client-centred, integrated and inclusive rural health care that recognises and addresses the social as a fundamental part of health.

An Approach for Enhancing Adoption, Use and Utility of Shared Digital Health Records in Rural Australian Communities.

Internationally, shared digital health records are considered an important addition to improving modern health care provision. Australia launched its version, My Health Record (MyHR), in 2012 but has experienced low adoption and challenges in practical implementation and evaluation. Individuals living with complex and chronic conditions in rural and remote communities often experience challenges in obtaining equitable access to health care provision. They are also supposed to face additional barriers to adopting and using eHealth services. This paper reports on research investigating adoption, use and utility of MyHR, in rural remote Australian community settings. Based on this research an approach for improving national roll out of MyHR is presented. The approach highlights a means to understand and engage communities with complex care needs, to support their adoption and use of digital tools. It also draws attention to holistic methods for evaluating and assessing impact at individual, community and health care provision levels.

Re-turning feelings that matter using reflexivity and diffraction to think with and through a moment of rupture in activist work

Over the past three decades, calls for alternative forms of qualitative research that require of the researcher to think deeply, differently, disruptively and diffractively have been gathering momentum. This article adds to a growing bank of possibilities for this type of work by re-turning feelings that emerged while doing insider activist work related to issues of gender in an isolated rural Australian community. The original five-year study drew on emancipatory, poststructural feminist and critical research paradigms; however, this paper takes a paradigmatic leap to fold in posthumanist and new materialist thinking as it re-turns feelings that mattered and were produced as part of the mangle of doing activist research. The paper foregrounds a different way of knowing by embracing a researcher identity that is an assemblage of shifting feelings, thoughts, physical realities, identities, temporalities, speech acts and practices. This postmodern paradox is a superposition of knowings and unknowings; certainties and uncertainties; power and powerlessness; an entanglement of relations and productions that are troubled and troubling, determined and indeterminate, comfortable and uncomfortable.

A co-operative inquiry about love using narrative, performative and visual methods

Participatory researchers advocate using presentational arts-based methods to collectively inquire into a social phenomenon. In a co-operative inquiry in an Australian rural community, ten community workers inquired into the ‘love ethic’ in their community work practice using narrative, performative and visual methods to gather, analyse and interpret data within cycles of reflection and action. Group members collectively and democratically chose to use presentational inquiry tools such as storytelling, dialogical performance, gift-giving, drawing and other non-traditional approaches to explore the topic and generate collaborative knowledge. These methods were engaging and empowering, and supported group members to develop a love-based framework of community practice. The group’s final collective drawing depicts the roots, trunk, fruit and saplings of a tree representing the values, process, outcomes and cyclical nature of the love ethic in community work.

Understanding the Social Experience of Education from Adult Learners in South Australian Rural Communities

This article offers a preliminary overview of a study that investigates the experiences of adult learners residing in rural communities in the state of South Australia. Online delivery of adult education is growing, allowing more individuals who are remote from learning sites to engage with further education. Increased educational opportunity to participate in learning as well as social policy developments with an emphasis on continuing education offers a chance in research to understand the developments generated by adult education. The work presented here shows a way of investigating social engagement offered through education, especially those that allow rural students to enhance their chances across the life course. It does so through engaging with the reports from adult students. Understanding the role of education through the social experiences of adult students in rural communities highlights the role of education in the areas of personal, social and community development.

Unveiling the Male Corset

Contemporary sociological research indicates rural men face increasing pressure to comply with hegemonic masculine gender norms. Adopting Butler’s poststructural theory of gender performativity, this study presents findings from qualitative interviews with twenty-five self-identified male Goths living in rural Australia, revealing how participants enacted masculinity and how rurality shaped gender performance. Despite participants’ believing their Goth identity transcended geographic location, Goth self-expression of counternormative masculinity was met with societal pressure. Rural Australian communities were presented as strongly upholding normative, traditional gender expectations as most participants experienced adverse responses, namely, homophobic hostility, employment discrimination, bullying, and/or physical assault, which necessitated modification of gender performance for individual safety and well-being. Participants largely attributed negative reactions to rural communities’ “closed-mindedness” in contrast with the “open-mindedness” they experienced in urban communities. Overall, participants believed urban communities in Australia and beyond displayed greater acceptance of diverse gender performances than rural Australia.

Compositional, Contextual, and Collective Community Factors in Mental Health and Well-Being in Australian Rural Communities.

There are disproportionately higher and inconsistently distributed rates of recorded suicides in rural areas. Patterns of rural suicide are well documented, but they remain poorly understood. Geographic variations in physical and mental health can be understood through the combination of compositional, contextual, and collective factors pertaining to particular places. The aim of this study was to explore the role of “place” contributing to suicide rates in rural communities. Seventeen mental health professionals participated in semi-structured in-depth interviews. Principles of grounded theory were used to guide the analysis. Compositional themes were demographics and perceived mental health issues; contextual themes were physical environment, employment, housing, and mental health services; and collective themes were town identity, community values, social cohesion, perceptions of safety, and attitudes to mental illness. It is proposed that connectedness may be the underlying mechanism by which compositional, contextual, and collective factors influence mental health and well-being in rural communities.

A Journey Toward Cultural Competence: The Role of Researcher Reflexivity in Indigenous Research.

This article highlights the personal journey of reflective development that a non-Aboriginal White researcher and health professional underwent to be "fully positioned" in the everyday lives of a rural Australian Aboriginal community in Western Australia. The article explains the researcher's personal development in areas important to building respect, building relationships, and ensuring reciprocity while undertaking Aboriginal research. The researcher reports on the reflective evaluation of her worldview. Understanding that judgment is a natural tendency, the researcher used reflexivity as a tool to examine and contextualize her judgments, presumptions, and preconceptions, which positioned her to be open to differing viewpoints and actively explore alternate perspectives. The researcher explores her evolutionary understanding that cultural competence is not a destination but a continual journey, and she details her knowledge development regarding the Aboriginal research paradigm, which requires that all the learning, sharing, and growth taking place is reciprocal and engages all parties actively.

Factors affecting rural volunteering in palliative care - an integrated review.

To review factors shaping volunteering in palliative care in Australian rural communities using Australian and International literature. Identify gaps in the palliative care literature and make recommendations for future research. A comprehensive literature search was conducted using Proquest, Scopus, Sage Premier, Wiley online, Ovid, Cochran, Google Scholar, CINAHL and Informit Health Collection. The literature was synthesised and presented in an integrated thematic narrative. Australian Rural communities. While Australia, Canada, the United States (US) and the United Kingdom (UK) are leaders in palliative care volunteer research, limited research specifically focuses on volunteers in rural communities with the least occurring in Australia. Several interrelated factors influence rural palliative care provision, in particular an increasingly ageing population which includes an ageing volunteer and health professional workforce. Also current and models of palliative care practice fail to recognise the innumerable variables between and within rural communities such as distance, isolation, lack of privacy, limited health care services and infrastructure, and workforce shortages. These issues impact palliative care provision and are significant for health professionals, volunteers, patients and caregivers. The three key themes of this integrated review include: (i) Geography, ageing rural populations in palliative care practice, (ii) Psychosocial impact of end-end-of life care in rural communities and (iii) Palliative care models of practice and volunteering in rural communities. The invisibility of volunteers in rural palliative care research is a concern in understanding the issues affecting the sustainability of quality palliative care provision in rural communities. Recommendations for future Australian research includes examination of the suitability of current models of palliative care practice in addressing the needs of rural communities; the recruitment, training, ongoing education and support of volunteers in rural palliative care provision to ensure equitable care for all communities in Australia regardless of location.

Heat adaptation and place: experiences in South Australian rural communities

Exposure to extreme heat is a familiar seasonal experience for many rural communities across Australia, which is projected to increase in frequency and intensity with climate change. This has wide-ranging implications for community health and well-being, livelihoods, recreation, and the natural and built environments. In this study, we have examined how rural and remote communities in South Australia experience and respond to extreme heat, and how this is influenced by physical, social and psychological aspects of place. Interviews with participants across different climatic regions of South Australia were analysed using a broad thematic framework that included physical aspects of place, human activities, social and community aspects, and relationships with place; providing a descriptive account of heat impacts and responses. We further suggest that some narratives expressed the construction of a rural or remote identity, with climate being a part of this relationship; suggesting that place identity may be a subjective aspect underpinning appraisals of extreme heat. We discuss the implications for adaptation choices in a warming climate.

Organizational Responsibility for Age-Friendly Social Participation: Views of Australian Rural Community Stakeholders

ABSTRACTThis qualitative study critically explores the barriers experienced by diverse rural community stakeholders in facilitating environments that enable age-friendly social participation. Twenty-six semi-structured interviews were conducted across two rural Australian communities with stakeholders from local government, health, social care, and community organizations. Findings identify that rural community stakeholders face significant difficulties in securing resources for groups and activities catering to older adults, which subsequently impacts their capacity to undertake outreach to older adults. However, in discussing these issues, questions were raised in relation to whose responsibility it is to provide resources for community groups and organizations providing social initiatives and whose responsibility it is to engage isolated seniors. These findings provide a much-needed critical perspective on current age-friendly research by acknowledging the responsibilities of various macro-level social structures—different community-level organizations, local government, and policy in fostering environments to enable participation of diverse rural older adults.

Drilling into community perceptions of coal seam gas in Roma, Australia

Coal seam gas (CSG) extraction and its conversion into liquefied natural gas (LNG) for overseas export is a recent phenomenon in Australia. These activities have, not surprisingly, attracted significant attention because of their perceived impacts on the environment and communities. However, community and stakeholder perceptions of these impacts, particularly for local development, have gone virtually unexamined in the literature. This paper aims to bridge this gap by exploring local perceptions of CSG extraction in a rural Australian community. In doing so, the research determines the efficacy of using social representation theory (SRT) and social exchange theory (SET) to assess community perceptions of mining-induced change. Findings reveal that the community perceives CSG extraction to provide positive economic impacts but is concerned about its ability to facilitate long-term economic growth and development. Long-term residents considered regional development to be targeted towards satisfying the needs of mining companies and ‘new' migrants to the region. A lack of information about the impacts of CSG extraction has led to heightened apprehension among long-term residents.

Non-dental primary care providers’ views on challenges in providing oral health services and strategies to improve oral health in Australian rural and remote communities: a qualitative study

ObjectivesTo investigate the challenges of providing oral health advice/treatment as experienced by non-dental primary care providers in rural and remote areas with no resident dentist, and their views on ways...

Sudanese young people building capital in rural Australia: the role of mothers and community

This article draws on an ethnographic study that consisted of in-depth case studies of eight Sudanese young people of refugee background living in rural Australia. Prompted by concern over deficit views of young refugees that pervade educational literature, we aimed to understand what facilitates their successful resettlement into Australian rural communities. We were particularly interested in understanding the strengths, resources and capital they draw upon and generate through their participation in out-of-school social and learning contexts, as well as within family and community networks. Here, we focus on one of the study's participants, Samir. We highlight how his mother was instrumental in providing a safe and secure home environment where significant bonding capital was generated, as well as how she facilitated her son's participation in community and ethnic networks, thus enabling him to acquire bridging and linking social capital. We conclude by discussing the implications for schools and for research.