Rosemary McKenzie

Well for Life: Evaluation and policy implications of a health promotion initiative for frail older people in aged care settings

This paper discusses the findings and policy implications of an evaluation of ‘Well for Life’, a health promotion initiative that focuses on good nutrition and physical activity for frail older people in Planned Activity Groups and residential aged care facilities.

Cancer care coordination: building a platform for the development of care coordinator roles and ongoing evaluation.

Continuity of care is integral to the quality and safety of care provided to people with cancer and their carers. Further evidence is required to examine the contribution Nurse Cancer Care Coordinator (NCCC) roles make in improving the continuity. The aim of the present study was to clarify the assumptions underpinning the NCCC roles and provide a basis for ongoing evaluation. The project comprised a literature review and a qualitative study to develop program logic. The participants who were purposively sampled included policy makers, practitioners, patient advocates, and researchers. Both the literature and participant reports found that NCCC roles are diverse and responsive to contextual influences to coordinate care at the individual (patient), organisational, and systems levels. The application of the program logic for the development of NCCC roles was explored. The conceptualisation of NCCC roles was also examined in relation to Boundary Spanning and Relational Coordination theory. Further research is required to examine how NCCCs contribute to improving equity, safety, quality and coordination of care. The project has implications for research, policy and practice, and makes explicit existing assumptions to provide a platform for further development and evaluation of these roles.

Trachoma elimination in remote Indigenous Northern Territory communities: baseline health-promotion study

Identify trachoma knowledge, attitudes and practice of staff in clinics, schools and community workplace settings to optimise trachoma-elimination health-promotion programs in the Katherine West Health Board region of the Northern Territory. Prior to the introduction of a suite of health promotion resources the Indigenous Eye Health Unit and Katherine West Health Board conducted a baseline survey of open, multi-choice and closed questions regarding knowledge, attitudes and practices in relation to trachoma with 72 staff members over a 6-month period in 2010-11. Data were analysed for differences between settings. Two significant barriers and one enabling factor were identified. One in five staff members in clinics and 29% of staff members in schools were unaware they lived and worked in a trachoma-endemic area. One-third of school staff and 38% of clinic staff considered it normal for children to have dirty faces. However, the majority of participants felt comfortable talking about hygiene issues with others. The presence of dirty faces in young Indigenous children underpins the continuing prevalence of trachoma. Increasing the awareness of the health effects of childrens nasal and ocular secretions and changing community acceptance of dirty faces as the norm will reduce the risk of trachoma and other childhood infections. Staff in clinics, schools and community work settings can play a role in trachoma elimination by actively encouraging clean faces whenever they are dirty and by including face washing in holistic hygiene and health education. Staff in schools may need additional support. Trachoma-elimination health promotion should increase awareness of trachoma prevalence and encourage all who work and live in remote Indigenous communities to take action to promote facial cleanliness and good hygiene practices.

Improving the quality of qualitative studies: do reporting guidelines have a place?

Family Practice encourages the submission and publications of qualitative studies in family practice. These studies provide invaluable information and insights regarding the processes, salience, accessibility, appropriateness and satisfaction of family practice.1 Such studies provide information superior to randomized control trials for these dimensions. RCTs in turn provide superior information concerning the effectiveness, safety and the cost-effectiveness of family practice. Given increasing demand from policy makers for research findings that guide decision-making in a complex environment, medical and health researchers have come to recognize the value of qualitative studies more generally. This manifests itself for example, in the incorporation of qualitative sub-studies within predominately quantitative research to provide contextual and in-depth understanding. It is appropriate then, to ask whether research-oriented health journals like Family Practice should require authors submitting qualitative studies to conform to reporting guidelines in accordance with expectations of more quantitative submissions. These latter reporting guidelines include CONSORT (RCTs), PRISMA (systematic reviews), STARD (diagnostic accuracy studies).2,3,4 Medical journals including Lancet, JAMA, NEJM, BMJ as well as Family Practice often require conformity to all or some of these reporting guidelines. These guidelines for qualitative research specify a minimum set of information needed for complete and clear reporting of what was found during a research study. They were introduced to overcome the well-established limitations in the reporting of scientific studies in many areas of health research. These can range from withholding publications of whole studies or pre-specified outcomes, often with negative or undesired results,to omissions of crucial information in published articles.5,6 Although there is limited evidence, it can be anticipated that problems of this nature will also occur with the reporting of qualitative studies. Reflecting an increased desire for rigour in reporting of qualitative research, some publishers (e.g. BioMed Central7) and journals (e.g. Journal of Advanced Nursing8) have now developed reporting guidelines for qualitative studies. Most importantly, the EQUATOR Network9 includes a number of guidelines for reporting qualitative research. EQUATOR is an international initiative that seeks to improve reliability and value of medical research literature by promoting transparent and accurate reporting of research studies. Its various aims, as stated in their website, include:

Patient intention and self‐reported compliance in relation to emergency department attendance after using an after hours GP helpline

To determine ED attendance and compliance with GP advice following a call to an after hours telephone triage and advice service.