The Northern Australia Research Network: Building evidence-informed services for Functioning, Disability and Health in northern Australia.

Mrs Kylie Stothers2, A/Prof. Ruth Barker1, Mr Andrew McGraw3, Mrs Jennifer Chamberlain-Salaun1, Ms Jennifer Carr1, Ms Renae Moore4

1James Cook University, Smithfield, Australia, 2Indigenous Allied Health Australia, Katherine, Australia, 3WA Country PHN, Broome, Australia, 4Top End Health Service, Darwin, Australia

Abstract:

The Northern Australia Research Network (NARN) was established in 2016 to conduct collaborative research in the area of Functioning, Disability and Health, to inform delivery of rehabilitation and lifestyle services in regional, rural and remote Northern Australia. Recognising the cultural and diverse needs, beliefs, practices and authority of Aboriginal and Torres Strait Islander peoples in northern Australia, in 2017 NARN partnered with Indigenous Allied Health Australia.

NARN is a small cross-jurisdictional collaborative network of researchers, clinicians, health managers, Primary Health Network managers and consumers from the Northern Territory, Western Australia and Queensland. Allied health professionals form the majority of the NARN membership with a range of other members who contribute to delivery of rehabilitation and lifestyle services. A Leadership Group and an Expert Research Advisory Group guide the following five Research Working Groups:
• Community engagement
• People-centred health care
• Skilled and responsive workforce
• Evidence-informed practice
• Evidence-informed investment
The objectives of NARN are to:
• Build an evidence base for services in the area of Functioning, Disability and Health in northern Australia.
• Respond to the needs of Northern Australians, particularly Aboriginal and Torres Strait Islander peoples.
• Build research capacity – community research partners, clinicians, student and early career researchers.
• Embed allied health professionals into the broader health research arena.
• Work with stakeholders across the health sector to identify needs, partnerships and resources.

This presentation will consist of an overview of NARN within the changing landscape of northern Australia and of the Disability sector.


Biography:

Kylie Stothers and Ruth Barker are the co-chairs of the Northern Australia Research Network.

Kylie Stothers is a Jawoyn woman, born and raised in Katherine within a large extended family with strong ties in Katherine and surrounding communities. She is a Social Worker and Workforce Development Manager for Indigenous Allied Health Australia (IAHA), the national peak body representing Aboriginal and Torres Strait Islander allied health professionals and students. Kylie has a central role in training allied health professionals on the IAHA Cultural Responsiveness Framework.

Ruth Barker is a physiotherapist and researcher with expertise in stroke rehabilitation and innovative models of service delivery for rural, remote and Indigenous communities of northern Australia. Over the past decade, Ruth has attracted funding of more than $16 million to design, pilot, implement and evaluate community rehabilitation services in Townsville and Mt Isa with outreach services to surrounding communities. In her current position, Ruth is focused on building research capacity across Allied Health disciplines by supporting, mentoring and advising a raft of PhD students and clinician researchers across the health professions.

“Balancing health and farming: How farmers understand, maintain and make decisions about their health”

Miss Alexandra Humphrys1, Professor Megan Smith1, Associate Professor  Rylee Dionigi1

1Charles Sturt University, Albury, Australia

Abstract:

Farmers experience a lower standard of health than the general population, and are a consumer group with specific requirements of health services. This study provided new insights into how farmers understand, maintain and make decisions about their health. This knowledge enables better collaboration between farmers and rural and remote allied health professionals.
In-depth interviews were conducted with seven farmers in the Riverina, recruited by trusted referral. Data was analysed using inductive content analysis to generate new insights into the health values, maintenance behaviours, and decision-making processes of farmers.
The findings of this study were captured in three themes: farmers understand their health in relation to their role as a farmer, farmers actively aim to maintain health, and farmers base their health decisions on the values of productivity and self-sufficiency. It was found that farmers do not refrain from seeking the help of practitioners, however they have different triggers for help-seeking compared to other consumer groups.
What this means for allied health professionals is that farmers as a consumer group may use consultations for advice and maintenance strategies for multiple issues, rather than presenting with one specific issue. It also provides evidence that improving functionality at work, which is within the scope of physiotherapists and occupational therapists in particular, is the key to providing allied health services that address the specific needs of farmers as a consumer group.


Biography:

Alexandra Humphrys is a new graduate physiotherapist, who conducted this research as part of her Honours degree under the guidance of co-authors, Professor Megan Smith and Associate Professor Rylee Dionigi. Alexandra grew up in Echuca, and has always been interested in rural health, having travelled extensively in the Australian outback. She is inspired by rural practitioners, and aspires do her best to improve the health of rural communities.
Professor Megan Smith is a director of Three Rivers University Department of Rural Health. She has previously been the Head of School of the School of Community Health, physiotherapy course leader, Sub Dean of Workplace Learning for the Faculty of Science, and Acting Associate Dean for the Faculty of Science. Her current research interests are in the area of developing a future rural health workforce that can meet the health needs of rural communities, and she supervises PhD, Professional Doctorate, Masters and Honours students.
Associate Professor Rylee Dionigi is widely published in the fields of sport sociology, ageing and physical activity, health, exercise psychology and leisure studies. She has extensive expertise in qualitative research methodologies, and her research is recognised both nationally and internationally. In addition to her work at Charles Sturt University, she has ongoing external research collaborations in Canada, the United Kingdom and Australia.

Talking about tucker – developing a culturally responsive dysphagia resource

Ms Alexandra  Hogan2, Ms Jaimee Dutton1, Mrs Leah Curran3, Ms Jane  Warburton4

1Top End Health Service, Tiwi, Australia, 2Office Of Disability – Top End Remote, Department of Health, Casuarina, Australia, 3Top End Health Service, Tiwi, Australia, 4Office Of Disability – Top End Remote, Department of Health, Casuarina, Australia

Abstract:

Eating and drinking is an essential part of people’s lives. It is underpinned by social and cultural norms that not only shape how we view ourselves but also how we relate to others and engage in certain roles in society. In Indigenous culture, eating and drinking are engrained in traditional practices around hunting and ceremony. Difficulty with eating and drinking, referred to as dysphagia, is a complex concept regardless of a person’s health literacy levels. The abstract terms used to explain the concept of dysphagia are not easily translated or understood by people from different cultural and linguistic backgrounds.

The aim of this study is to develop a culturally and linguistically responsive dysphagia resource for use across the continuum of care within the Top End Indigenous population. A participatory action research approach will be utilised to engage patients and key stakeholders in the resource development. This resource will support patient understanding of dysphagia and in turn facilitate engagement with health services and informed decision making regarding dysphagia management options. Potential future implications of this study are development of an Indigenous dysphagia goal setting tool and patient centred outcome measures.


Biography:

Alexandra Hogan is Speech Pathologist at the Royal Darwin Hospital who works in a generalist role but has a special interest in Head and Neck cancer.
Jaimee Dutton is Speech Pathologist for the Office of Disability Top End Remote Team who works as a remote generalists.
The Royal Darwin Hospital and the Office of Disability teams provide speech pathology services across the lifespan for Indigenous clients from across the Top End. The teams work closely to link hospital and community services for remote clients to ensure quality and continuity of care.

 

Perceptions of health practitioners and service managers of disability services in their community.

Mr David Wellman1  Dean Selby1, Sarah Venn1

1Health Workforce Queensland, Brisbane, Australia

Abstract:

Introduction:Almost one in five Australians live with a disability. Allied health professionals play an important role in providing care and support for people with disability. Those who live in rural and remote areas face many challenges in accessing services. The disability sector is currently undergoing major reform with the roll out of the National Disability Insurance Scheme.

Aim:The aim of this study was to investigate rural and remote health practitioner and manager perceptions of disability services in their community.

Methods:In 2017-18, Health Workforce Queensland undertook an online survey as part of a Health Workforce Needs Assessment. Among other items there were two questions concerning disability services. The first asked participants to rate their level of agreement with the following statement: There is a serious gap in disability services in my community. The second asked: Please describe any difficulties you or your practice/hospital has assisting clients with a disability and their families? The survey targeted general practitioners, practice managers, primary health care nurses, Aboriginal and Torres Strait Islander Health Workers and allied health professionals working in ASGC Remoteness Areas (RA) 2-5 classifications in Queensland.

Results:A total of 344 responses to agreement ratings were received along with 66 comments. Thematic analysis identified several key themes which included issues such as service access, navigation and understanding. Mean agreement ratings and differences across areas will also be discussed.

Discussion:Identifying issues facing those delivering disability services can assist in informing the development of improved service delivery and workforce models.


Biography:

David has been actively involved in public health research since 2001 and has authorship of papers covering a wide variety of community health topics from improving community health and wellbeing in a low SES area to sexuality for people with dementia. Much of the David’s research output has a focus on psychosocial aspects of care for people living in the community. Since joining Health Workforce Queensland, in 2014, the main focus of his output has been on investigating recruitment and retention of health workforce professionals to remote and rural locations. David also seeks to identify emerging issues impacting the primary health care workforce in rural and remote Qld communities.

Bariatric Specialist Multi-Disciplinary Consultancy Service (Phone B-A-R-I)

Mr Peter Young1, Miss Natalie Papallo1

1Western NSW Local Health District, Orange, Australia

Abstract:

Orange Health Service (OHS) is reasonably well equipped with specialised equipment, yet this pool is poorly managed, stored and maintained, resulting in inefficiencies, inappropriate prescriptions and unnecessary hiring of external equipment.

Planned and unplanned admissions of bariatric patients are becoming more prevalent, representing an increased risk to the organisation in terms of staff and patient injury, equipment acquisition and maintenance, and cost of service (increased staffing, increased length of stay, greater need for specialised training).

In 2017, a Bariatric Interest Group was formed via expression of interest to staff with 12 members and an executive sponsor.

This group is currently being transformed into a Specialist Multi-Disciplinary Consultancy Service which will provide individualised assessments and recommendations regarding the appropriate manual handling and equipment needs of all bariatric patients entering OHS. This service is accessed via a referral hotline (alpha numeric phone number is B-A-R-I or 2274) and backed up overnight and weekends by clear guidelines around the handling and equipment needs of new patients until a formal assessment by the team is performed.

There is potential for this consultancy service to be replicated in the other two base hospital facilities within Western NSW Local Health District, with peripheral facilities to be supported via Telehealth. A common loan pool of specialised equipment is also being investigated which will accessible by all facilities. These strategies will ensure that patients with specialised needs will be assessed, treated and handled in a more consistent and equitable manner across the District.


Biography:

Peter Young is the Physiotherapy Head of Department at Orange Health Service. Starting his career at Bathurst Base Hospital in 1998, he relocated to work in London and Cardiff for five years, before returning to the Central West of NSW in 2005. Peter was the Physiotherapist – Senior Clinician in Acute Care for 8 years, before becoming the Head of Department in 2014. He has an interest in bariatrics and early mobilisation in ICU. Peter is currently participating in the Executive Clinical Leadership Program with the CEC.

Natalie Papallo started her career as a new graduate rotational physiotherapist at Orange Health Service in 2014, and became the Physiotherapist – Senior Clinician in Acute Care in 2017. Natalie has a keen interest student education, orthopaedics and early mobilisation in ICU

South Australian rural women’s perspectives and experiences of being physically active – different landscapes, shared experiences?

Miss Jessica Muller1, Associate Professor Gaynor Parfitt1, Dr Katja Siefken1, Associate Professor James Dollman1

1Health Sciences Division, University Of South Australia, Adelaide, Australia

Abstract:

Background: We know non-communicable disease (NCD) rates are highest for those living outside major cities in Australia and lifestyle behaviours such as participating in adequate physical activity are key to reducing NCD risk factors. But more specifically, why is it that rural women are less likely to participate in physical activity? And what needs to change to engage them in the sustained uptake of physical activity?

Purpose: Previous research suggests a lack of social support within the home environment and discomfort experienced within exercise environments can limit women’s participation in physical activity. Interestingly, no such patterns were identified among men. Further research is required to understand the social conditions that support or inhibit internalisation and integration of extrinsically motivated behaviours amongst rural Australian women in relation to the adoption and maintenance of habitual physical activity.

Method: Qualitative descriptive methodology underpinned by phenomenological and feminist approaches has been applied to gain a rich description of the lived experiences of women within two diverse rural South Australian contexts. Combined with a maximum variation sampling strategy, semi-structured interviews were conducted and prepared for thematic analysis.

Results: Thematic analysis is currently in progress and will be finalised by 30 July 2018.

Conclusion: This study contributes to our understanding of the social conditions and influences that facilitate or inhibit physical activity behaviour amongst rural women and concomitantly provides direction for local strategic planning. Importantly, it validates and contextualises the unique experiences specific to the changing landscapes in which rural South Australian women reside.


Biography:

Jessica is a fourth year occupational therapy honours student studying a the University of South Australia. Jessica has actively sought opportunities throughout her undergraduate degree to gain experience within the rural health sector and is passionate about applying her occupational therapy skill set to meaningfully engage with individuals and communities to further understand and work towards addressing determinants of health.

“Exploring the Occupational Experiences of Livestock Farmers during Drought: A Narrative Inquiry”

Miss Kirsty Healing1, Mr Daniel Lowrie

1Royal Brisbane Women’s Hospital, Albion, Australia

Abstract:

Introduction: For much of the 21st century, Australia has endured the most prolonged and severe drought since records began. This drought has been found to have negative and long-lasting consequences upon both the physical and mental wellbeing of farmers and their families. To date, however, no research has explored the experience of drought through an occupational lens. This project, thus aims to explore the way in which drought shapes the occupational experiences of farmers and associated sense of meaning within the farming role.

Methods: Narrative inquiry and thematic analysis were used to explore the experiences of drought among six farming men and four farming women from Northern Queensland.

Findings: Analysis of the participants’ interviews led to the development of four key, inter-related themes. These being: ‘Entry into the Farming Role – Rites of Passage’; ‘Farmers as Guardians’; ‘Drought as Siege’ and; ‘Connectedness to the Outside World’.  Each of these themes offer insights into the way in which drought comes to be understood by farmers and, in turn, experienced and responded to.

Conclusion: By better understanding the occupational experiences of farmers during drought, resources can be more effectively targeted towards promoting occupational balance and wellbeing. Interventions aimed at reframing the way in which the farming role is conceptualised from a young age and supporting occupations beyond farming as bridges to the outside world may be effective in achieving positive outcomes during drought.


Biography:

Kirsty Healing is a new graduate occupational therapist with a strong passion for working with the elderly population, neurological disorders and rural and remote health, having grown up on a cattle property herself. She is currently working as an OT at the Royal Brisbane and Women’s hospital, but eventually hopes to return, with her skills to work in a rural area. Kirsty undertook a 2year research project during her undergraduate degree in OT at James Cook University, focusing on farming men and women and the impact their surroundings had on their identity and livelihood. Kirsty is very passionate about shaping healthcare to better address the needs of rural and remote population, including increasing access and changing attitudes.

Who is the Tooth Fairy’s best friend?

Mrs Cathryn Carboon1

1Dental Hygienists Association of Australia, Wangaratta North, Australia

Abstract:

Who is the tooth fairy’s best friend and what is fluoride magic? Both of these questions can be answered when you combine oral health literacy with a social responsibility project which has been nominated to represent Australia at the International Federation of Dental Hygienists global Social Responsibility Program.  Fluoride is important for good oral health as it strengthens teeth and  prevents tooth decay. Poor oral health literacy is linked to a decrease in fluoride demand and usage across the world.   The Carevan Foundation Sun Smiles program in partnership with the Dental Hygienists Association of Australia has  published a children’s picture book which provides an oral health literacy resource which is changing the lives of many disadvantaged Australian primary school children – one smile at a time! Low levels of health literacy is a significant problem in Australia. All allied health professionals should look at this model of delivering health information  to see whether they could also have a positive impact on the health literacy of the nation.


Biography:

Cathryn Carboon is a dental hygienist with over 30 years’ experience and a Master of Health Promotion. She was the oral health network co-ordinator on the SARRAH Advisory Committee for over a decade. Cathryn has been a member of the Dental Hygienists Association of Australia for 30 years, currently serving as the Chair of the Rural and Remote Health Special Interest Group. Cathryn is a board member of the Carevan Foundation and manages the Carevan Sun Smiles school fluoride varnish program.  She works in private practice in rural Victoria and is a Colgate Professional Educator at undergraduate dentistry and oral health therapy programs at 5 Universities.  She is also a published children’s picture book author and mother of 3 wonderful children.

Experiences of navigating the aged care landscape in Far North Queensland; a carers perspective.

Mrs Rachel Quigley1,2, Professor Michele Foster2, Dr Desley Harvey1, Dr Carolyn  Ehrlich2

1Cairns and Hinterland Hospital and Health Service, Cairns, Australia, 2Griffith University, Brisbane, Australia

Abstract:

Aims: The move towards older people being managed for longer in the community puts the onus on informal carers to navigate, negotiate and manage care. This study explores the experiences and perspectives of informal carers of older community dwelling adults, to investigate the systemic work they undertake, and the expectations and assumptions made of them, in order to elicit how they make sense of the work associated with care of the older person.
Methods: A qualitative study using descriptive phenomenological methodology was used. Semi-structured interviews were conducted with a diverse range of carers residing in Far North Queensland. An inductive process of thematic analysis was used to generate a representation of the caring experience and meaning of the systemic work.
Results: Preliminary findings suggest systemic challenges exist when interfacing with aged and health care systems. These challenges relate to navigating multiple, often complex, multilayered organisations for access to support and information, and dealing with repeated assessment processes. Findings indicate that in some instances, participants draw on skills developed through professional careers to manage the systemic work associated with their caring role.
Discussion/recommendations: It is assumed carers are willing, prepared, and capable of taking on the responsibilities expected of them in the care of older people with complex health and support needs. Systemic tasks are time consuming, yet many carers have the capacity through their ability or readiness to address demands, to persevere despite significant workloads. Findings assist clinicians to better to support carers by understanding their experiences and challenges.


Biography:

Rachel Quigley is a physiotherapist with an interest in aged care. She has worked in the UK, Saudi Arabia, Bahrain and Australia. She holds a clinical role in Cairns Hospital, as the Older Persons Liaison Advanced Clinician and a position with James Cook University as part of the Health Ageing Research Team on projects involved with dementia and ageing targeted in Aboriginal and Torres Strait Islander populations in Far North Queensland. She is currently undertaking a MPhil through Griffith University focusing on carer experiences and has received funding support from a NAHSSS scholarship through SARRAH.

From Rural Generalist to Women’s Health …. An occupational therapists journey towards helping occupational therapists to “Birth Well”.

Mrs Sarah Rheinberger1

1Empowered Space, , Australia

Abstract:

After seven years of working as a generalist in remote western Australian I reluctantly moved to the big smoke where I was faced with the prospect of having to “choose” an area in which to work.

By the time I had 2 baby’s I had found my passion. I wanted to work with women in the perinatal period supporting their empowerment and wellbeing as they navigated pregnancy, birthing and the transition into motherhood.

The perinatal period is a time of immense transition and change; physical and emotional challenges of growing, birthing and feeding a baby and recovering from birth, the disempowerment of our medicalised health system and the identity, role and occupation transitions all of which are normal and don’t account for issues that occur when things don’t go well. I was also surrounded by women who had experienced traumatic birth, postnatal depression and anxiety and fear of birth.

With the support of a growing community of occupational therapists working in women’s health world wide and some additional training, I started an online business. I am providing perinatal clinical consultations and gearing up to launch my first online course called Birth Well, an evidenced based, practical and holistic approach to birthing well for occupational therapists.

My passion for rural health, my profession and belief that women need support, knowledge and nurturing during this time has led me to find my brand of occupational therapy and fill a gap that can impact wellness for women, families and communities.


Biography:

Sarah supports women in navigating the mind-body challenges, environmental barriers and occupational difficulties that often occur during pregnancy, birth and postpartum recovery. Sarah’s innovative services are delivered both in person and online, supporting rural women and occupational therapists in their mothering journey.

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