Tracy Cheffins

A 12-week lifestyle intervention for middle-aged, overweight men who are supporters of local sporting clubs

Abstract Objective: To evaluate the effectiveness of a 12-week lifestyle program for changes in healthy lifestyle knowledge, health perceptions and body composition of middle-aged, overweight men. Methods: A participatory, action-based experimental design was employed with a convenience sample (n = 24) of middle-aged men who were supporters of either a local rugby league or rugby union club. Participants attended an introductory session and baseline testing in week one, participated in once-weekly group circuit exercise and lifestyle education sessions for 10 weeks and attended post-testing and project evaluation in week 12. Results: Fourteen participants completed the project. Healthy lifestyle knowledge did not improve significantly. As a combined group there were significant improvements in both physical and mental components of the SF12 questionnaire and in waist girth. The rugby league cohort achieved significant improvement in the SF12 physical component, weight, BMI and waist girth. The rugby union cohort achieved significant improvement in the SF12 mental component and waist girth. Participants reported a variety of health improvement and lifestyle changes following the project and reported appreciation at the involvement of the sporting club. Conclusions: The men’s lifestyle program resulted in significant improvement in body composition, resulting in a reduction in obesity-related disease risk in some participants.

Randomised controlled trial of an in-home monitoring intervention to improve health outcomes for type 2 diabetes: study protocol

Type 2 diabetes is a leading cause of death and morbidity and is a health priority in Australia. This randomised controlled trial will explore whether remote access to clinical care, supported by telehealth technologies over high speed broadband, leads to improved diabetes control in a way that benefits patients, carers and clinicians and improves the overall health system. People in the intervention arm of the trial will receive additional diabetes care from a care coordinator nurse via an in-home broadband communication device that can capture clinical measures, provide regular health assessments and videoconference with other health professionals when required. Patients in the control arm of the trial will receive usual care from their GP and participate in the clinical measurement and quality of life components of the evaluation. The trial evaluation will include biomedical, psychological, self-management and quality of life measures. Data on utilisation rates and satisfaction with the technology will be collected and cost -effectiveness analyses undertaken. The role of this technology in health care reform will be explored.

Evaluating the use of Enhanced Primary Care Health Assessments by general practices in north Queensland

The Enhanced Primary Care (EPC) program funds GPs to provide preventative health assessments through a specific set of Medicare item numbers. The study aimed to show whether patients completing these health assessments had better recorded screening rates than those receiving usual care. A retrospective clinical record audit was undertaken in north Queensland general practices by practice nurses from the North Queensland Practice Based Research Network. Comparisons were made between the recorded screening test rates for patients who completed an over-75-years health assessment with those who did not. A questionnaire was also completed by practice nurses and practice principals. Screening tests were recorded more frequently in patients with a completed health assessment: notably urinalysis, visual acuity and faecal occult blood test/colonoscopy. Blood pressure was the most frequently recorded test with or without a health assessment. The questionnaires provided useful information on how health assessments are implemented and whether GPs believe they are useful.

At work or play: a comparison of private property vehicle crashes with those occurring on public roads in north Queensland.

OBJECTIVE To define characteristics of vehicle crashes occurring on rural private property in north Queensland with an exploration of associated risk factors. DESIGN Descriptive analysis of private property crash data collected by the Rural and Remote Road Safety Study. SETTING Rural and remote north Queensland. PARTICIPANTS A total of 305 vehicle controllers aged 16 years or over hospitalised at Atherton, Cairns, Mount Isa or Townsville for at least 24 hours as a result of a vehicle crash. MAIN OUTCOME MEASURE A structured questionnaire completed by participants covering crash details, lifestyle and demographic characteristics, driving history, medical history, alcohol and drug use and attitudes to road use. RESULTS Overall, 27.9% of interviewees crashed on private property, with the highest proportion of private road crashes occurring in the North West Statistical Division (45%). Risk factors shown to be associated with private property crashes included male sex, riding off-road motorcycle or all-terrain vehicle, first-time driving at that site, lack of licence for vehicle type, recreational use and not wearing a helmet or seatbelt. CONCLUSIONS Considerable trauma results from vehicle crashes on rural private property. These crashes are not included in most crash data sets, which are limited to public road crashes. Legislation and regulations applicable to private property vehicle use are largely focused on workplace health and safety, yet work-related crashes represent a minority of private property crashes in north Queensland.

Young driver restrictions: Does the evidence support them?

OBJECTIVE To assess the suitability of Queenslands graduated licensing system in the context of rural and remote Queensland. DESIGN Age-based comparison of crash data collected by the Rural and Remote Road Safety Study (RRRSS). SETTING Rural and remote North Queensland. PARTICIPANTS A total of 367 vehicle controllers aged 16 years or over hospitalised at Townsville, Cairns or Mount Isa for at least 24 hours, or killed, as a result of a vehicle crash. MEASUREMENTS Specific RRRSS variables are assessed in relation to Queenslands graduated licensing program, including rates of unlicensed driving/riding, late night crashes, crashes with multiple passengers, contributing factors in crashes and vehicle types involved. RESULTS While people between 16 and 24 years of age comprise 16% of the target population, 25% of crashes meeting RRRSS criteria involved a vehicle controller in that age group. 12.8% of all cases involved an unlicensed driver/rider, within which 66% were below 25 years of age. Young drivers/riders were represented in 50% of crashes occurring between 11:00 p.m. and 5:00 a.m., and 33% of crashes in vehicles with multiple passengers. Motorcyclists represented about 40% of cases in both age groups. There were no significant differences between age groups in vehicle types used, or circumstances that contributed to crashes. CONCLUSIONS The general overrepresentation of young drivers/riders in rural and remote North Queensland supports tailored interventions, such as graduated licensing. However, while some measures in the legislation are well supported, problems surrounding unlicensed driving/riding might be exacerbated.

Mapping access to health services as a strategy for planning: access to primary care for older people in regional Queensland

Australia has seen a significant increase in people aged over 65 years accessing general practice services over the last decade. Although people aged 65 years and over comprise 14% of the total population, this age demographic accounts for the largest proportion of general practitioner (GP)-patient encounters. Access to general practice is important for older Australians as the burden of chronic disease increases with age. A geographic information system, ArcGIS, was used to assess geographic access to general practice for older people residing in the regional Queensland towns of Mackay, Townsville and Cairns. Geographic units with high proportions of over 65-year-old people were spatially analysed in relation to proximity to geomapped general practices with a 2-km buffer zone. Modelling of changes in access was performed with the strategic location of a new general practice where gaps existed. Geographic access to general practice for the older population was poorest in Cairns despite a high population density. Addition of a single, strategically placed general practice in Cairns markedly improved access. Socioeconomic analysis suggested that general practices were appropriately located in areas of greatest need. Geographic information systems provide a means to map population characteristics against service locations to assist in strategic development and location of future health services.