Physiotherapy - Research Publications

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    "We are a unique breed": strategies to enhance physical activity participation for preschool-aged children born extremely preterm, a mixed-methods study
    Coulston, F ; Spittle, A ; McDonald, C ; Remedios, L ; Toovey, R ; Cheong, J ; Sellick, K (TAYLOR & FRANCIS LTD, 2023-12)
    PURPOSE: Preschool-aged children (three to five years old) born preterm participate in less physical activity (PA) than term-born children. Circus activities (a type of recreational PA) are a potential avenue to increase PA rates, but further insight into how to tailor these to address the participation gap is needed. This study investigated barriers and facilitators informing participation in recreational PA for preschool-aged children born extremely preterm and explored strategies to enhance participation in circus activities. MATERIALS AND METHODS: Sequential mixed-methods study utilizing surveys (n = 217), interviews (n = 43), and a focus group (n = 6) with key stakeholder groups (parents, coaches, and clinicians). Qualitative data (Framework Method) and quantitative data (descriptive statistics) were mixed during preliminary and final analyses. RESULTS: Five themes were developed from the mixed data: the crucial role of the coach and the need for specific training, the therapeutic role of PA and promoting outcomes beyond the physical, the impact of communication and class planning, consideration of convenience and cost, and finally, the role of clinicians. CONCLUSIONS: Barriers, facilitators, and strategies were identified which may be used to modify or co-design circus-based PA interventions to enhance participation and improve rates of PA for preschool-aged children born extremely preterm.IMPLICATIONS FOR REHABILITATIONFamilies consider recreational physical activities to be part of the therapeutic agenda for their preschool-aged children born extremely preterm.Key stakeholders feel that recreational physical activity should target outcomes beyond the physical.Coach attributes and capability impact participation of children born preterm and their families, and may be enhanced with specific training.Clinicians should be engaged in design of recreational physical activities for children born preterm.
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    Improving centre-based group exercise participation of older adults using the behaviour change wheel
    Kwok, BC ; Wong, WP ; Remedios, L (BMJ PUBLISHING GROUP, 2021-03)
    An emphasis on active ageing could help to delay the onset of frailty. In Singapore, Senior Activity Centres provide free and guided group exercise sessions for older adults. However, one such centre had very low participation rates among community-dwelling older adults despite running standardised programmes. Based on a needs analysis from a prior project, this paper reports on strategies implemented to improve the daily centre-based group exercise participation rate among community-dwelling older adults. Using the behaviour change wheel model, participant motivation domains were identified as primary gaps, while the psychological capability and physical opportunity were categorised as secondary gaps. A logic model was used to design a project to respond to these identified gaps and guide the evaluation approach. Three strategies were implemented over a 4-week period and reviewed at 6 months: (1) promotion of the exercise classes, (2) delayed rewards for participation and (3) health ambassadors. Evaluation findings highlighted that more resources were needed for the training of community-dwelling older adult healthcare ambassadors in the use of motivational interviewing. The interventions were found to be efficacious in increasing daily group exercise participation rate at the centre, from an average of three to nine participants per day over the 4 weeks. Furthermore, more than 60% of these participants achieved the WHO's weekly minimum exercise recommendation for older adults (150 min moderate-intensity physical activity). To increase the engagement of older adults in physical activity or exercise participation, we recommend the use of behaviour change wheel model and the use of community-based health ambassadors. In conclusion, the project found improved daily centre-based group physical exercise participation rates when all the domains in the behaviour change wheel model were addressed.
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    Interventions to support parents of infants at risk or with a diagnosis of neurodevelopmental disability
    Finlayson, F ; Olsen, JE ; Remedios, L ; Spittle, A (WILEY, 2021-03)
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    The use of the international classification of functioning, disability and health (ICF) in indigenous healthcare: a systematic literature review
    Alford, VM ; Remedios, LJ ; Webb, GR ; Ewen, S (BMC, 2013-05-16)
    INTRODUCTION: The International Classification of Functioning, Disability and Health (ICF) was endorsed by the World Health Organisation (WHO) in 2001 to obtain a comprehensive perspective of health and functioning of individuals and groups. Health disparities exist between Indigenous and non-Indigenous Australians and there is a need to understand the health experiences of Indigenous communities from Indigenous Australian's perspectives in order to develop and implement culturally appropriate and effective intervention strategies to improve Indigenous health. This systematic review examines the literature to identify the extent and context of use of the ICF in Indigenous healthcare, to provide the foundation on which to consider its potential use for understanding the health experiences of Indigenous communities from their perspective. METHODS: The search was conducted between May and June 2012 of five scientific and medical electronic databases: MEDLINE, Web of Science, CINAHL, Academic Search Complete and PsychInfo and six Indigenous-specific databases: AIATSIS, APAIS-health, ATSI-health, health and society, MAIS-ATSIS and RURAL. Reference lists of included papers were also searched. Articles which applied the ICF within an Indigenous context were selected. Quantitative and qualitative data were extracted and analysed by two independent reviewers. Agreement was reached by consensus. RESULTS: Five articles met the inclusion criteria however two of the articles were not exclusively in an Indigenous context. One article applied the ICF in the context of understanding the health experience and priorities of Indigenous people and a second study had a similar focus but used the revised version of the International Classification of Impairments, Disability and Handicap (ICIDH-2), the predecessor to the ICF. Four of the five papers involved Indigenous Australians, and one of the paper’s participants were Indigenous (First Nation) Canadians. CONCLUSION: Literature referring to the use of the ICF with Indigenous populations is limited. The ICF has the potential to help understand the health and functioning experience of Indigenous persons from their perspective. Further research is required to determine if the ICF is a culturally appropriate tool and whether it is able to capture the Indigenous health experience or whether modification of the framework is necessary for use with this population.
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    Chinese students' groupwork practices and experiences in China
    Li, D ; Remedios, L ; Clarke, D (SPRINGER, 2014-08)
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    Exploring learning goals and assessment approaches for Indigenous health education: a qualitative study in Australia and New Zealand
    Delany, C ; Doughney, L ; Bandler, L ; Harms, L ; Andrews, S ; Nicholson, P ; Remedios, L ; Edmondson, W ; Kosta, L ; Ewen, S (Springer (part of Springer Nature), 2018-02-01)
    In higher education, assessment is key to student learning. Assessments which promote critical thinking necessary for sustained learning beyond university are highly valued. However, the design of assessment tasks to achieve these types of thinking skills and dispositions to act in professional practice has received little attention. This research examines how academics design assessment to achieve these learning goals in Indigenous health education. Indigenous health education is an important area of learning for health practitioners to help address worldwide patterns of health inequities that exist for Indigenous people. We used a constructivist qualitative methodology to (i) explore learning goals and assessment strategies used in Indigenous health tertiary education and (ii) examine how they relate to higher education assessment ideals. Forty-one academics (from nine health disciplines) involved in teaching Indigenous health content participated in a semi-structured interview. Thematic analysis revealed learning goals to transform students’ perspectives and capacities to think critically and creatively about their role in Indigenous health. In contrast, assessment tasks encouraged more narrowly bounded thinking to analyse information about historical and socio-cultural factors contributing to Indigenous health. To transform students to be critical health practitioners capable of working and collaborating with Indigenous people to advance their health and well-being, the findings suggest that assessment may need to be nested across many aspects of the curriculum using a programmatic approach, and with a focus on learning to think and act for future practice. These findings accord with more recent calls for transformation of learning and assessment in health education.
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    Health professional workforce education in the Asia Pacific
    Lees, J ; Webb, G ; Coulston, F ; Smart, A ; Remedios, L (SAGE PUBLICATIONS INC, 2016)
    OBJECTIVE: To design and implement an international and interprofessional Global Learning Partnership Model, which involves shared learning between academics and students from Universitas 21 network with other universities with United Nations Millennium Development Goal needs. DESIGN: Two literature reviews were conducted to inform ethical aspects and curriculum design of the GLP model. Feedback from conference presentations and consultation with experts in education and public health has been incorporated to inform the current iteration of the GLP model. INTERVENTION: The pilot group of 25 students from U21 universities and Kathmandu University, representing six health disciplines will meet in Nepal in April 2016 for a shared learning experience, including a one week university based workshop and three week community based experience. OUTCOME MEASURES: A multi-phase, mixed method design was selected for the evaluation of the GLP model, utilising a combination of focus groups and questionnaires to evaluate the efficacy of the placement through student experience and learning outcomes in cultural competency, UN SDG knowledge, community engagement and health promotion skills. RESULTS: The literature review demonstrated that cultural awareness and cultural knowledge were improved through participation in cultural immersion programs that incorporated preparatory workshops and clinical experiences. Data will be gathered in April 2006 and the results of the evaluation will be published in the future. CONCLUSIONS: The GLP model proposes a project around the fundamental concept of engagement and sharing between students and academics across universities and cultural contexts to build capacity through education, while capitalising on strengths of existing global health placements. Further the inclusion of host-country students and academics in this learning exchange will promote the establishment of an international and interprofessional network for ongoing health promotion. Significance for public healthThe Global Learning Partnership model aims to contribute to the capacity building of a health workforce that is capable of working effectively in cross cultural and interprofessional health care teams. A shared public health focused global placement has the potential to catalyse collaborative relationships between educational institutions in the Asia Pacific region.
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    CULTURAL ORIGINS OF PATTERNS OF PARTICIPATION IN MULTI-CULTURAL CLASSROOMS
    Remedios, L ; Clarke, D (Sense Publishers, 2019-01-01)