Mixed-methods evaluation of screening for hearing loss using the hearScreen™ mobile health application in Aboriginal and Torres Strait Islander children presenting to an urban primary healthcare service

Author(s):  
Geoffrey K. Spurling ◽  
Claudette ‘Sissy' Tyson ◽  
Deborah Askew ◽  
Jennifer Reath
2017 ◽  
Vol 23 (5) ◽  
pp. 446 ◽  
Author(s):  
Deborah A. Askew ◽  
Vivian J. Lyall ◽  
Shaun C. Ewen ◽  
David Paul ◽  
Melissa Wheeler

Aboriginal and Torres Strait Islander peoples continue to be pathologised in medical curriculum, leaving graduates feeling unequipped to effectively work cross-culturally. These factors create barriers to culturally safe health care for Aboriginal and Torres Strait Islander peoples. In this pilot pre-post study, the learning experiences of seven medical students and four medical registrars undertaking clinical placements at an urban Aboriginal and Torres Strait Islander primary healthcare service in 2014 were followed. Through analysis and comparison of pre- and post-placement responses to a paper-based case study of a fictitious Aboriginal patient, four learning principles for medical professionalism were identified: student exposure to nuanced, complex and positive representations of Aboriginal peoples; positive practitioner role modelling; interpersonal skills that build trust and minimise patient–practitioner relational power imbalances; and knowledge, understanding and skills for providing patient-centred, holistic care. Though not exhaustive, these principles can increase the capacity of practitioners to foster culturally safe and optimal health care for Aboriginal peoples. Furthermore, competence and effectiveness in Aboriginal health care is an essential component of medical professionalism.


2019 ◽  
Vol 25 (5) ◽  
pp. 449 ◽  
Author(s):  
Deborah A. Askew ◽  
Warren J. Jennings ◽  
Noel E. Hayman ◽  
Philip J. Schluter ◽  
Geoffrey K. Spurling

Many Aboriginal and Torres Strait Islander people live in urban areas, but epidemiological data about their health status and health needs are lacking. This knowledge is critical to informing and evaluating initiatives to improve service delivery and health outcomes. One potential data source is de-identified routinely collected clinical data. This cross-sectional study, conducted in an urban Aboriginal and Torres Strait Islander primary healthcare service, involved randomly selecting a sample of 400 patients aged ≥15 years, and manually extracting electronic health record data. In the sample, 49% of patients were aged <35 years, 56% were female and 38% were employed. Overall, 56% of females and 47% of males aged 35–54 years had depression, 26% had experienced a bereavement within the last 12 months, and while 44% were alcohol abstainers, 35% were drinking at high-risk levels. The present study cannot demonstrate causal relationships between the observed high rates of chronic disease in older people and frequent experiences of bereavement and high levels of mental ill health in young- and middle-aged adults. However, a life course approach provides a framework to understand the interconnectedness of these results, and suggests that strategies to blunt the intergenerational burden of chronic disease need to address the social and emotional wellbeing of youth.


BMJ Open ◽  
2021 ◽  
Vol 11 (4) ◽  
pp. e046459
Author(s):  
Tirritpa Ritchie ◽  
Tara Purcell ◽  
Seth Westhead ◽  
Mark Wenitong ◽  
Yvonne Cadet-James ◽  
...  

IntroductionOne-third of Australia’s Aboriginal and Torres Strait Islander population are adolescents. Recent data highlight their health needs are substantial and poorly met by existing services. To design effective models of primary healthcare, we need to understand the enablers and barriers to care for Aboriginal and Torres Strait Islander adolescents, the focus of this study.Methods and analysisThis protocol was codesigned with Apunipima Cape York Health Council that supports the delivery of primary healthcare for 11 communities in Far North Queensland. We framed our study around the WHO global standards for high-quality health services for adolescents, adding an additional standard around culturally safe care. The study is participatory and mixed methods in design and builds on the recommended WHO assessment tools. Formative qualitative research with young people and their communities (exploring concepts in the WHO recommended quantitative surveys) seeks to understand demand-side enablers and barriers to care, as well as preferences for an enhanced response. Supply-side enablers and barriers will be explored through: a retrospective audit of clinic data (to identify current reasons for access and what can be strengthened); an objective assessment of the adolescent friendliness of clinical spaces; anonymous feedback from adolescent clients around quality of care received and what can be improved; and surveys and qualitative interviews with health providers to understand their perspectives and needs to provide enhanced care. This codesigned project has been approved by Apunipima Cape York Health Council and Far North Queensland Human Research Ethics Committee.Dissemination and implicationsThe findings from this project will inform a codesigned accessible and responsive model of primary healthcare for Aboriginal and Torres Strait Islander adolescents.


Diabetes ◽  
2018 ◽  
Vol 67 (Supplement 1) ◽  
pp. 860-P
Author(s):  
PING LING ◽  
SIHUI LUO ◽  
JINHUA YAN ◽  
XUEYING ZHENG ◽  
DAIZHI YANG ◽  
...  

2020 ◽  
Author(s):  
Adriana Klein ◽  
Roseli de Deus Lopes ◽  
Rodrigo Suigh

BACKGROUND EasySeating is a mobile health (mHealth) app that supports the prescription of wheelchair and postural support devices (WPSD). It can be used by occupational therapists (OT) and physiotherapists (PT) who prescribe WPSD. The app offers a standardization of the prescription procedure, showing images, metrics and details that guide the prescriber to decide on the best equipment. It was developed with an iterative mixed-methods evaluation approach. Objective: The aim of this study was to investigate the processes involved in the prescription of WPSD and to propose, develop and evaluate a mHealth to support OT and PT prescribers. OBJECTIVE The aim of this study was to investigate the processes involved in the prescription of WPSD and to propose, develop and evaluate a mHealth to support OT and PT prescribers. METHODS This study was divided into three phases and was carried out as an iterative process composed of user consulting/testing (using a mixed-methods evaluation approach), system (re)design and software development. The first phase consisted of the collection of qualitative and quantitative data to map and understand the users requirements and of the development of the first prototype (v1) of the app. This data collection was performed through semi-structured interviews with 14 OT and PT prescribers, 5 specialized technicians and 5 WPSD users. The second phase aimed at improving the overall functionality of the app and consisted in the development, test and evaluation of the prototypes v1, v2, v3 and v4. A total of 59 prescribers tested and evaluated these prototypes by means of open interviews, semi-structured questionnaires and focus groups. The third phase focused in the usability aspects of the app. It consisted in the development and test of the prototype v5. Eight technology specialists assessed its usability through heuristics evaluation. RESULTS Data collected in phase one indicated there is a lack of standardization on the prescription of postural support devices (PSD). A divergent nomenclature for the PSDs was also found and classified in eight categories. These information guided the development of the first prototype of the EasySeating app. Phase two results pointed that the prescribers value the insertion of the app into their clinical practice, as it accelerates and increases the quality of the evaluation process and improves the organization of the prescription information. Significant suggestions for the improvement of the app were given during the users tests, including the use of images to represent the PSDs. The usability tests from the third phase revealed two strong issues that must be solved: the need of greater feedback and failures in the persistence of the input data. CONCLUSIONS This study demonstrated that there is a lack of systematization of the WPSD prescription process. The evaluation of the developed EasySeating app demonstrated that there is a potential to standardize, integrate and organize the WPSD prescription information, supporting and facilitating the decision making process of the prescribers. CLINICALTRIAL This study was approved by the Research Ethics Board of the Universidade de São Paulo (registered protocol n°53929516.6.0000.0065) URL - http://plataformabrasil.saude.gov.br/login.jsf


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