Development and trialling of a tool to support a systems approach to improve social determinants of health in rural and remote Australian communities: the healthy community assessment tool

McDonald, Elizabeth; Bailie, Ross; Michel, Thomas

doi:10.1186/1475-9276-12-15

Cited by 16 publications

(22 citation statements)

References 11 publications

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“…4,5 Although it has been shown that burn injuries occur more frequently in rural areas, 17 specific differences between the pediatric populations of rural and metropolitan areas appear not to have been previously studied. 18,19 Our analysis has shown that statistically significant differences between these populations of children exist.…”

Section: Discussionmentioning

confidence: 99%

Rural and Metropolitan Pediatric Burns in New South Wales and the Australian Capital Territory

Hyland

Zeni

Harvey

et al. 2015

Journal of Burn Care & Research

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To determine if differences exist between children who sustain burns in rural areas and in metropolitan areas, an analysis of children presenting to the Burns Unit at The Children's Hospital at Westmead, from the January 1, 2008 to December 31, 2012 was performed. In all, 4326 children met the inclusion criteria, of which 21.2% came from rural regions. Just more than a quarter (26.0%) of rural children and 11.6% from metropolitan areas were Indigenous Australian (P < 0.0001). The average age of rural child was 4.5 years; metropolitan child was 3.9 years (P = 0.0001). Boys were more likely to sustain burns in both populations. Of the rural children, 40.8% sustained contact burns, 37.7% scald, and 12.5% flame. In contrast, 58.8% metropolitan children sustained scalds, 27.4% contact, and 4.5% flame. The home was the most common place for all burns to occur, but rural injuries commonly occurred outdoors. Burns were associated with risk-taking behavior in 15.3% rural and 8.7% metropolitan children (P < 0.0001). Nearly two thirds (65.9%) of children in both groups received adequate first aid (20 minutes of cool running water). Major burn injuries (≥10% Total BSA) occurred in 3.4% of rural and 2.1% metropolitan children (P = 0.02). Skin grafting was required in 28.3% rural and 16.3% metropolitan children (P = 0.0001). Nearly 32% of rural children required admission to the Burns Unit for >24 hours (15.9% metropolitan; P = 0.0001). Significant differences exist between burns sustained by rural and metropolitan children. This should be accounted for in burns prevention campaigns and the education of local health practitioners.

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Section: Discussionmentioning

confidence: 99%

Rural and Metropolitan Pediatric Burns in New South Wales and the Australian Capital Territory

Hyland

Zeni

Harvey

et al. 2015

Journal of Burn Care & Research

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“…The Healthy Community Assessment Tool (HCAT) was developed and piloted through a multi-phase and iterative process that involved a series of consultations with community members and key stakeholders in the Northern Territory (NT) of Australia [12]. The tool was then trialed in remote NT Aboriginal communities, confirming its face validity with the scoring system reportedly well understood and easily followed by Aboriginal and non-Aboriginal study participants.…”

Section: Introductionmentioning

confidence: 99%

“…The tool was then trialed in remote NT Aboriginal communities, confirming its face validity with the scoring system reportedly well understood and easily followed by Aboriginal and non-Aboriginal study participants. The original authors suggested using a facilitated small group process to reduce bias in scoring of indicators [12].…”

Section: Introductionmentioning

confidence: 99%

“…The full HCAT version 2 has 13 domains with two to six items in each domain [12]. The concepts and constructs of the HCAT were informed by the socioecological theory, The Driving force, Pressure, State, Exposure, Effect, Actions (DPSEEA) framework and the Multiple Exposure Multiple Effect Model These theories and models help with assessing and understanding the relationship of diverse personal and environmental factors in human health and illness including the exploration of policy drivers that lead to pressure and change in the environment and hence health effects.…”

Section: Introductionmentioning

confidence: 99%

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Using the Healthy Community Assessment Tool: Applicability and Adaptation in the Midwest of WA

Tsou¹,

Green²,

Gray³

et al. 2018

Preprint

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Population based studies have associated poor living conditions with the persistent disparity in the health of Aboriginal and non-Aboriginal Australians. This project assesses the applicability of the Health Community Assessment Tool and its role in improving the environment of a small community in the Midwest of WA. The action research cycles started with the initial reflection on the suitability of the HCAT version 2 for the local community context and whether it was fit-for-purpose. The researcher provided ‘critical companionship’, while the participants of the study were invited to be co-researchers (the Assessors) who critically examined the HCAT and assess the community. The relevant domains to the serviced town (an outer regional community) were pest control and animal management; healthy housing; food supply; community vibrancy, pride and safety; reducing environmental tobacco smoke; and promoting physical activity. The Assessors found the HCAT descriptors mostly aligned with their community context but found some of the items difficult to apply. Based on participant’s suggestions, some of the original scoring scales were reformatted. School attendance and illicit drug use were identified as a key outcome indicator for youth but were missing from the HCAT. The HCAT domains applied helped streamlining core business of agencies in the local community. The face validity of HCAT items were confirmed in this research with minor adjustments to reflect local context. Youth engagement to education is of high community concern and the development of an item would create similar interagency collaborative dialogues.

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“…A consortium of the leading maternity care and rural organizations in Australia released a National Consensus Framework for Rural Maternity Services in 2010 that is built on principles which include “to ensure that rural maternity services are equitable in terms of distribution and access” [18]. However, this in not reflected in outcomes [19].…”

Section: Introductionmentioning

confidence: 99%

The distribution of maternity services across rural and remote Australia: does it reflect population need?

Rolfe

Donoghue

Longman

et al. 2017

BMC Health Serv Res

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BackgroundAustralia has a universal health care system and a comprehensive safety net. Despite this, outcomes for Australians living in rural and remote areas are worse than those living in cities. This study will examine the current state of equity of access to birthing services for women living in small communities in rural and remote Australia from a population perspective and investigates whether services are distributed according to need.MethodsHealth facilities in Australia were identified and a service catchment was determined around each using a one-hour road travel time from that facility. Catchment exclusions: metropolitan areas, populations above 25,000 or below 1,000, and a non-birthing facility within the catchment of one with birthing. Catchments were attributed with population-based characteristics representing need: population size, births, demographic factors, socio-economic status, and a proxy for isolation - the time to the nearest facility providing a caesarean section (C-section). Facilities were dichotomised by service level – those providing birthing services (birthing) or not (no birthing). Birthing services were then divided by C-section provision (C-section vs no C-section birthing). Analysis used two-stage univariable and multivariable logistic regression.ResultsThere were 259 health facilities identified after exclusions. Comparing services with birthing to no birthing, a population is more likely to have a birthing service if they have more births, (adjusted Odds Ratio (aOR): 1.50 for every 10 births, 95% Confidence Interval (CI) [1.33-1.69]), and a service offering C-sections 1 to 2 h drive away (aOR: 28.7, 95% CI [5.59-148]). Comparing the birthing services categorised by C-section vs no C-section, the likelihood of a facility having a C-section was again positively associated with increasing catchment births and with travel time to another service offering C-sections. Both models demonstrated significant associations with jurisdiction but not socio-economic status.ConclusionsOur investigation of current birthing services in rural and remote Australia identified disparities in their distribution. Population factors relating to vulnerability and isolation did not increase the likelihood of a local birthing facility, and very remote communities were less likely to have any service. In addition, services are influenced by jurisdictions.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2084-8) contains supplementary material, which is available to authorized users.

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Development and trialling of a tool to support a systems approach to improve social determinants of health in rural and remote Australian communities: the healthy community assessment tool

Cited by 16 publications

References 11 publications

Rural and Metropolitan Pediatric Burns in New South Wales and the Australian Capital Territory

Rural and Metropolitan Pediatric Burns in New South Wales and the Australian Capital Territory

Using the Healthy Community Assessment Tool: Applicability and Adaptation in the Midwest of WA

The distribution of maternity services across rural and remote Australia: does it reflect population need?

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