Rural Health - Research Publications
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ItemNotwithstanding High Prevalence of Overweight and Obesity, Smoking Remains the Most Important Factor in Poor Self-rated Health and Hospital Use in an Australian Regional Community(AMER INST MATHEMATICAL SCIENCES-AIMS, 2017)OBJECTIVE: To classify a rural community sample by their modifiable health behaviours and identify the prevalence of chronic conditions, poor self-rated health, obesity and hospital use. METHOD: Secondary analysis of a cross- sectional self-report questionnaire in the Hume region of Victoria, Australia. Cluster analysis using the two-step method was applied to responses to health behaviour items. RESULTS: 1,259 questionnaires were completed. Overall 63% were overweight or obese. Three groups were identified: 'Healthy Lifestyle' (63%), 'Non Smoking, Unhealthy Lifestyle' (25%) and 'Smokers' (12%). 'Healthy lifestyle' were older and more highly educated than the other two groups while 'Non Smoking, Unhealthy Lifestyle' were more likely to be obese. 'Smokers' had the highest rate of poor self-rated health. Prevalence of chronic conditions was similar in each group (>20%). 'Smokers' were twice as likely to have had two or more visits to hospital in the preceding year even after adjustment for age, gender and education. CONCLUSION: High rates of overweight and obesity were identified but 'Smokers' were at the greatest risk for poor self-rated health and hospitalisation. IMPLICATIONS FOR PUBLIC HEALTH: Within an environment of high rates of chronic ill health and obesity, primary care clinicians and public health policy makers must maintain their vigilance in encouraging people to quit smoking.
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ItemWhy Australia needs to define obesity as a chronic condition(BMC, 2017-05-23)BACKGROUND: In Australia people with a diagnosed chronic condition can be managed on unique funded care plans that allow the recruitment of a multidisciplinary team to assist in setting treatment goals and adequate follow up. In contrast to the World Health Organisation, the North American and European Medical Associations, the Australian Medical Association does not recognise obesity as a chronic condition, therefore excluding a diagnosis of obesity from qualifying for a structured and funded treatment plan. BODY: The Australian guidelines for management of Obesity in adults in Primary Care are structured around a five step process -the '5As': Ask & Assess, Advise, Assist and Arrange'. This article aims to identify the key challenges and successes associated with the '5As' approach, to better understand the reasons for the gap between the high Australian prevalence of overweight and obesity and an actual diagnosis and treatment plan for managing obesity. It argues that until the Australian health system follows the international lead and defines obesity as a chronic condition, the capacity for Australian doctors to diagnose and initiate structured treatment plans will remain limited and ineffective. CONCLUSION: Australian General Practitioners are limited in their ability manage obesity, as the current treatment guidelines only recognise obesity as a risk factor rather than a chronic condition.
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ItemNo Preview AvailableSexuality education delivery in Australian regional secondary schools: A qualitative case study(SAGE PUBLICATIONS LTD, 2017-06)Background: Factors affecting the delivery of sexuality education to school students include government policy, school leadership and teacher confidence. Objective: The aim of this paper was to understand, from the perspective of regional education, health and welfare sector professionals, what is needed to support good sexual health for secondary school students. Methods: A qualitative study that took place in ‘Fairview’, a regional location in Victoria, Australia. Five focus groups, totalling 37 participants, were conducted in 2015. An inductive analysis was used to identify key themes. Findings: The main theme was the inconsistent presence and delivery of sexuality education curriculum in Fairview schools. This was attributed to factors such as perceived lack of commitment at government level to sexuality education, lack of importance in comparison with other subjects and variation in inclusion across year levels. Teachers and the delivery of sexuality education and the role of school leadership in supporting sexuality education were the two sub-themes present within the broader narrative. Teacher capacity to deliver sexuality education was ascribed to lack of training. Perceptions concerning the use of external providers to deliver sexuality education differed, as did opinions about the role of school leadership in supporting sexuality education. Conclusion: Sexuality education in schools could be improved through clearer government policy direction. This would signal the importance of sexuality education to school leaders and, if supported via resources such as training for teachers, could assist in achieving the aim of improving students’ sexual health and well-being.
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ItemDo Not "Let Them Eat Cake": Correlation of Food-Consumption Patterns among Rural Primary School Children from Welfare and Non-Welfare Households(MDPI, 2017-01)Physical and financial access impacts food choice and consumption, while educational attainment, employment, income, gender, and socioeconomic status are also influential. Within this context, the aim of the paper is to examine the association between various foods consumed and eating patterns of children between low and higher income households. A paper-based survey was completed by parents/carers of children in 41 primary schools in rural and regional areas of Victoria. Data collected included demographics and the consumption of fruit, vegetable, and other foods including drinks. Ordinal data were analysed using Spearman's rank-order correlation. The main findings were that children who consumed more fruit and vegetables tended to have a higher intake of healthy drinks (plain milk and water) as well as a lower intake of unhealthy snacks and drinks (sugar sweetened drinks). Those who perceived that fruit and vegetables cost too much reported greater consumption of unhealthy snacks and sugar-sweetened beverages, which was more prominent in low-income households. Changing food consumption behaviours requires a complex systems-based approach that addresses more than just individual issues variables. A participatory approach that works with local communities and seeks to build an understanding of unique challenges within sub-groups has potential for embedding long-lasting and meaningful change in eating behaviours.
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ItemNo Preview AvailableStrategic English Learning and Proficiency among Vietnamese Tertiary Learners: Beyond Passive Stereotypes(Common Ground Research Networks, 2017)Practitioners and researchers worldwide have enthusiastically undertaken research on language learning strategies (LLS) since the early 1970s. They have since established solid evidence on LLS as an influential factor in determining success in second/foreign language learning. However, in the context of Vietnam, there is a dearth of evidence regarding LLS and successful second/foreign language learning. The purpose of this study was to examine the frequency and pattern of LLS use among Vietnamese students undertaking English as a foreign language (EFL) at the tertiary (university) level. Secondly, it sought to investigate the relationship between LLS use and self-rated English proficiency. Quantitative data were collected from 564 students through a researcher-generated questionnaire, the English Language Learning Strategy Questionnaire (ELLSQ), which had been pretested to ensure validity and reliability. Findings revealed that the students were moderate users of learning strategies, and frequency of strategy use was positively correlated with self-reported English proficiency.
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ItemNo Preview AvailableDeveloping sustainable social programmes for rural ethnic seniors: perspectives of community stakeholders(WILEY, 2017-05)This qualitative study explores barriers to delivering sustainable rural community programmes to increase social participation among Australian ethnic seniors. In 2013, in-depth interviews were conducted with 14 stakeholders across eight rural/regional organisations that had received state government funding to provide social participation initiatives for ethnic seniors. Within interviews, participants were asked to outline factors that had enhanced or hindered their capacity to deliver the funded projects, and their plans for sustainability. Data were analysed thematically in accordance with Shediac-Rizkallah and Bone's (1998) tripartite programme sustainability framework (project design and implementation, organisational setting and broader community environment). Findings indicate that in the context of resource and staffing constraints and a lack of ethnic critical mass, programme sustainability reflected the increased capacity of rural ethnic seniors to integrate into existing community groups and maintain their own groups and activities. However, this is dependent on the ability of mainstream government, health and social care services to cater for diverse cultural needs and preferences, the ability of rural organisations to support ethnic seniors to manage their own cultural groups and activities, and the capacity of funding bodies, rural community and policy structures to maintain cultural sensitivity while compensating for the rural premium. In addition to identifying some key learnings for rural governments, health and community organisations, this research highlights the precarious nature of rural programme sustainability for ethnic seniors in the context of wider community, organisational and policy constraints.