scholarly journals Scaling up sexually transmissible infections point-of-care testing in remote Aboriginal and Torres Strait Islander communities: healthcare workers’ perceptions of the barriers and facilitators

2021 ◽  
Vol 2 (1) ◽  
Author(s):  
Lise Lafferty ◽  
Kirsty Smith ◽  
Louise Causer ◽  
Kelly Andrewartha ◽  
David Whiley ◽  
...  
Keyword(s):  
Health Services ◽  
Patient Engagement ◽  
Healthcare Workers ◽  
Torres Strait Islander ◽  
Point Of Care ◽  
Scaling Up ◽  
Point Of Care Testing ◽  
Sti Testing ◽  
Sexually Transmissible Infections ◽  
Torres Strait

Abstract Background Sexually transmissible infections (STIs), such as gonorrhoea and chlamydia, are highly prevalent, particularly in remote Aboriginal and Torres Strait Islander communities in Australia. In these settings, due to distance to centralised laboratories, the return of laboratory test results can take a week or longer, and many young people do not receive treatment, or it is considerably delayed. Point-of-care testing (POCT) provides an opportunity for same day diagnosis and treatment. Molecular POC testing for STIs was available at 31 regional or remote primary health care clinic sites through the Test-Treat-And-GO (TANGO2) program. This qualitative study sought to identify barriers and facilitators to further scaling up STI POCT in remote Aboriginal communities within Australia. Methods A total of 15 healthcare workers (including nurses and Aboriginal health practitioners) and five managers (including clinic coordinators and practice managers) were recruited from remote health services involved in the TTANGO2 program to participate in semi-structured in-depth interviews. Health services’ clinics were purposively selected to include those with high or low STI POCT uptake. Personnel participants were selected via a hybrid approach including nomination by clinic managers and purposive sampling to include those in roles relevant to STI testing and treatment and those who had received TTANGO2 training for POCT technology. Milat’s scaling up guide informed the coding framework and analysis. Results Acceptability of STI POCT technology among healthcare workers and managers was predominantly influenced by self-efficacy and perceived effectiveness of POCT technology as well as perceptions of additional workload burden associated with POCT. Barriers to integration of STI POCT included retention of trained staff to conduct POCT. Patient reach (including strategies for patient engagement) was broadly considered an enabler for STI testing scale up using POCT technology. Conclusions Remote healthcare clinics should be supported by both program and clinic management throughout scaling up efforts to ensure broad acceptability of STI POCT as well as addressing local health systems’ issues and identifying and enhancing opportunities for patient engagement.

Review of the cultural safety of a national Indigenous point-of-care testing program for diabetes management

2016 ◽  
Vol 22 (4) ◽  
pp. 368 ◽  
Author(s):  
Mark Shephard ◽  
Christopher O'Brien ◽  
Anthony Burgoyne ◽  
Jody Croft ◽  
Trevor Garlett ◽  
...  
Keyword(s):  
Torres Strait Islander ◽  
Diabetes Management ◽  
Health Workers ◽  
Point Of Care ◽  
Cultural Safety ◽  
Medical Services ◽  
Indigenous Australians ◽  
Point Of Care Testing ◽  
Group Setting ◽  
Torres Strait

In Australia, Aboriginal and Torres Strait Islander people have approximately three-fold higher rates of diabetes than non-Indigenous Australians. Point-of-care testing, where pathology tests are conducted close to the patient, with results available during the patient consultation, can potentially deliver several benefits for both the Indigenous client and the health professional team involved in their care. Currently, point-of-care testing for diabetes management is being conducted in over 180 Aboriginal and Torres Strait Islander Medical Services as part of a national program called Quality Assurance for Aboriginal and Torres Strait Islander Medical Services (QAAMS). The cultural safety of the Program was reviewed by sourcing the views of the QAAMS Indigenous Leaders Team in a focus group setting and by surveying the point-of-care testing operators enrolled in QAAMS, via an electronic questionnaire. The current study confirms that QAAMS remains a culturally safe program that fills a permanent and positive niche within the Indigenous health sector. The study demonstrates that QAAMS provides a convenient and accessible ‘one-stop’ pathology service for Indigenous clients with diabetes and empowers Aboriginal Health Workers to have a direct role in the care of their diabetes clients.

scholarly journals Establishment of a sentinel surveillance network for sexually transmissible infections and blood borne viruses in Aboriginal primary care services across Australia: the ATLAS project

2020 ◽  
Author(s):  
Clare Bradley ◽  
Belinda Hengel ◽  
Katy Crawford ◽  
Salenna Elliott ◽  
Basil Donovan ◽  
...  
Keyword(s):  
Health Services ◽  
Torres Strait Islander ◽  
Clinical Care ◽  
Program Planning ◽  
National Level ◽  
Sentinel Surveillance ◽  
Future Research ◽  
Surveillance Network ◽  
Sexually Transmissible Infections ◽  
Torres Strait

Abstract Background: Sexually transmissible infection (STI) and blood-borne virus (BBV) diagnoses data are a core component of the Australian National Notifiable Diseases Surveillance System (NNDSS). However, the NNDSS data alone is not enough to understand STI and BBV burden among priority population groups, like Aboriginal and Torres Strait Islander people, because it lacks testing, treatment and management data. Here, we describe the processes involved in establishing a STI and BBV sentinel surveillance network representative of Aboriginal Community-Controlled Health Services (ACCHS)—known as the ATLAS network—to augment the NNDSS and to help us understand the burden of disease due to STI and BBV among Aboriginal and Torres Strait Islander peoples. Methods: Researchers invited participation from ACCHS in urban, regional and remote areas clustered in five clinical hubs across four Australian jurisdictions. Participation agreements were developed for each clinical hub and individual ACCHS. Deidentified electronic medical record (EMR) data relating to STI and BBV testing, treatment and management are collected passively from each ACCHS via the GRHANITE tm data extraction tool. These data are analysed centrally to inform 12 performance measures which are included in regular surveillance reports generated for each ACCHS and clinical hub. Results: The ATLAS network currently includes 29 ACCHS. Regular reports are provided to ACCHS to assess clinical practice and drive continuous quality improvement initiatives internally. Data is also aggregated at the hub, jurisdictional and national level and will be used to inform clinical guidelines and to guide future research questions. The ATLAS infrastructure can be expanded to include other health services and potentially linked to other data sources using GRHANITE. Conclusions: The ATLAS network is an established national surveillance network specific to Aboriginal and Torres Strait Islander peoples. The data collected through the ATLAS network augments the NNDSS and will contribute to improved STI and BBV clinical care, guidelines and policy program-planning.

Exploring Leave Events for Aboriginal and Torres Strait Islander People From Australian Tertiary Services: A Systematic Literature Review

2020 ◽  
Author(s):  
Julieann Coombes ◽  
Syazlin Sazali ◽  
Tamara Mackean ◽  
Margaret Banks ◽  
Nilva Egana ◽  
...  
Keyword(s):  
Health Services ◽  
Torres Strait Islander ◽  
Primary Objective ◽  
Google Scholar ◽  
Evidence Based ◽  
Torres Strait Islander People ◽  
Policy Document ◽  
Manual Search ◽  
Preventative Measures ◽  
Torres Strait

Abstract Objective The primary objective of this systematic review was to identify contributing causes to leave events from health services for Australian patients. The second objective was to identify evidence based preventative measures for effectively reducing leave events, which could be implemented. Study design Articles published in Australia were included if they reported on Aboriginal and/or Torres Strait Islander people and other Australians who leave health services prior to being seen or discharged by a medical professional. Two researchers screened each abstract and independently reviewed full text articles. Study quality was assessed, and data were extracted with standardised tools.Data sources MEDLINE and Google Scholar were searched for relevant publications from May 27th to June 30th, 2020. The search returned 30 relevant records. Nine additional records were identified by manual search in Google Scholar. References of included articles were searched. From these articles, 11 met the inclusion criteria. Of these 5 were from New South Wales, 2 from Western Australia, 1 each from Queensland and Northern Territory, two were conducted nationally. Data synthesis Four studies used a retrospective cohort method, one included patient interviews,(1) Four cohort studies and two systematic reviews were included. Two government reports and one health policy document were included in this review. All studies were from Australia using mixed methods.Conclusions This review identified causes for, and evidence based preventative measures that have been or could be implemented to reduce Leave Events and describes additional terms and definitions used for Leave Events.

scholarly journals Formulating Design Recommendations for the Acceptance of the Use and Results of Point-of-Care Testing in Low- and Middle-Income Countries: A Literature Review

2019 ◽  
Vol 1 (1) ◽  
pp. 2795-2804
Author(s):  
Yvonne Jolanda Melanie Licher ◽  
Jan Simon Visser ◽  
G-Young Van ◽  
Jan Carel Diehl
Keyword(s):  
Healthcare Workers ◽  
Point Of Care ◽  
Waiting Times ◽  
Point Of Care Testing ◽  
Middle Income ◽  
Future Design ◽  
Middle Income Countries ◽  
Barriers And Opportunities ◽  
Point Of Care Tests ◽  
Low And Middle Income

AbstractIn low- and middle-income countries (LMIC), diagnostics are not always available in remote areas. Hospitals and healthcare centres are often too far from the community, and waiting times are up to a few hours even for relatively simple procedures. Moreover, travelling to the healthcare centre and taking the diagnostic test is frequently unaffordable. Point of Care Tests (POCTs) can improve the availability, accessibility and affordability of the diagnostics by providing the test at the time and place of patient care. Although many POCTs have been developed already, there remain challenges to enable the healthcare workers (HCW) and the patients to use the device in practice. In this paper, we aim to provide a systemic overview of the barriers and opportunities for the adoption of use and acceptance of the results of POCTs based on the literature. The barriers and opportunities were clustered into six themes and used to draw out recommendations for the future design.

Could point-of-care testing be effective for reducing the prevalence of trichomoniasis in remote Aboriginal communities?

Sexual Health ◽  
2014 ◽  
Vol 11 (4) ◽  
pp. 370
Author(s):  
Ben B. Hui ◽  
James Ward ◽  
Louise Causer ◽  
Rebecca J. Guy ◽  
Matthew G. Law ◽  
...  
Keyword(s):  
Mathematical Modelling ◽  
Older Women ◽  
Point Of Care ◽  
Indigenous Communities ◽  
Treatment Programs ◽  
Point Of Care Testing ◽  
Aboriginal Communities ◽  
Sexually Transmissible Infections ◽  
High Prevalence ◽  
The Impact

High prevalence of trichomoniasis is reported for many remote Indigenous communities despite intensive screening and treatment programs. Mathematical modelling has previously been used to show that point-of-care (POC) testing for gonorrhoea and chlamydia has the potential to increase the impact of screening in reducing the prevalence of these sexually transmissible infections. The study was extended to estimate the impact of a rapid POC test for trichomoniasis. The results suggest that POC testing in place of conventional testing will also provide additional reductions in trichomoniasis prevalence. However, more emphasis should be placed on testing for trichomoniasis in older women due to the high prevalence observed in this group.

Gonorrhoea testing and positivity in non-remote Aboriginal Community Controlled Health Services

Sexual Health ◽  
2017 ◽  
Vol 14 (4) ◽  
pp. 320 ◽  
Author(s):  
Mary Ellen Harrod ◽  
Sophia Couzos ◽  
James Ward ◽  
Mark Saunders ◽  
Basil Donovan ◽  
...  
Keyword(s):  
Health Services ◽  
Torres Strait Islander ◽  
Clinical Encounter ◽  
Current Approach ◽  
Research Network ◽  
Torres Strait Islander People ◽  
Remote Communities ◽  
Aboriginal Community ◽  
Torres Strait ◽  
Concurrent Testing

Background Gonorrhoea occurs at high levels in young Aboriginal and Torres Strait Islander people living in remote communities, but there are limited data on urban and regional settings. An analysis was undertaken of gonorrhoea testing and positivity at four non-remote Aboriginal Community Controlled Health Services participating in a collaborative research network. Methods: This was a retrospective analysis of clinical encounter data derived from electronic medical records at participating services. Data were extracted using the GRHANITE program for all patients aged 15–54 years from 2009 to 2013. Demographic characteristics and testing and positivity for gonorrhoea were calculated for each year. Results: A total of 2971 patients (2571 Aboriginal and/or Torres Strait Islander) were tested for gonorrhoea during the study period. Among Aboriginal and/or Torres Strait Islander patients, 40 (1.6%) tested positive. Gonorrhoea positivity was associated with clinic location (higher in the regional clinic) and having had a positive chlamydia test. By year, the proportion of patients aged 15–29 years tested for gonorrhoea increased in both men (7.4% in 2009 to 15.9% in 2013) and women (14.8% in 2009 to 25.3% in 2013). Concurrent testing for chlamydia was performed on 86.3% of testing occasions, increasing from 75% in 2009 to 92% in 2013. Factors related to concurrent testing were sex and year of test. Conclusions: The prevalence of gonorrhoea among young Aboriginal and/or Torres Strait Islander people in non-remote settings suggests that the current approach of duplex testing for chlamydia and gonorrhoea simultaneously is justified, particularly for women.

What constitutes ‘support’ for the role of the Aboriginal and Torres Strait Islander child health workforce?

2013 ◽  
Vol 37 (1) ◽  
pp. 112 ◽  
Author(s):  
Karen Watson ◽  
Jeanine Young ◽  
Margaret Barnes
Keyword(s):  
Child Health ◽  
Health Services ◽  
Cultural Awareness ◽  
Torres Strait Islander ◽  
Health Workers ◽  
Overall Acceptability ◽  
Torres Strait ◽  
Use Of Health Services ◽  
Torres Strait Islander Health

As well as providing primary health care services, Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services through their role of cultural brokerage in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this vulnerable population. This study sought to identify key areas that both Aboriginal and Torres Strait Islander and non-Indigenous health professionals working within Indigenous communities felt were important in providing support for their roles. This group of workers require support within their roles particularly in relation to cultural awareness and capability, resource provision, educational opportunities, collaboration with colleagues and peers, and professional mentorship. What is known about the topic? Aboriginal and Torres Strait Islander health workers are known to significantly contribute to the overall acceptability, access and use of health services in the communities within which they work. As such they are uniquely positioned to positively influence health improvements for this population. What does this paper add? Through consultation with a sample of Indigenous child health workers and child health workers key areas necessary to provide support for the individuals working in these roles have been identified. What are the implications for practitioners? The findings from this study will inform policy and program development in order to more comprehensively support health workers in the community and contribute towards workforce development and satisfaction, recruitment and retention.

Sign in / Sign up

Export Citation Format

Share Document