Community nurses have often been 'touted' as potential major contributors to health promotion. Critical literature, however, often states that this has not been the case. Furthermore, most studies examining nurses' role and function have occurred mainly in hospital settings. This is a sequential mixed-methods study of two groups of community nurses from a Sydney urban area (n = 100) and from rural and remote areas (n = 49) within New South Wales, Australia. A piloted questionnaire survey was developed based on the five action areas of the Ottawa Charter for Health Promotion. Following this, 10 qualitative interviews were conducted for both groups, plus a focus group to support or refute survey results. Findings showed that rural and remote nurses had more positive attitudes towards health promotion and its clinical implementation. Survey and interview data confirmed that urban community nurses had a narrower focus on caring for individuals rather than groups, agreeing that time constraints impacted on their limited health promotion role. There was agreement about lack of resources (material and people) to update health promotion knowledge and skills. Rural and remote nurses were more likely to have limited educational opportunities. All nurses undertook more development of personal skills (DPS, health education) than any other action area. The findings highlight the need for more education and resources for community nurses to assist their understanding of health promotion concepts. It is hoped that community nurse leaders will collectively become more effective health promoters and contribute to healthy reform in primary health care sectors.

In order to facilitate the transition to renal replacement therapy, renal clinicians have a responsibility to more fully understand the patient journey during the predialysis stages of chronic kidney disease. A clearer understanding of patients' perceptions and decision-making experiences creates a space for mutual understanding. This is essential for the future development and implementation of collaborative, person-centred educational strategies and long-term renal healthcare outcomes.

Identifying pathways to diagnosis and referral can raise awareness of the challenges kidney health consumers face in their participation within the primary health care arena. Using consumer meaningful language improves the capacity of these consumers to engage in their own primary health care agenda.