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: Objective: To assess the use of Medicare‐subsidised health services by women with and without dementia. Methods: Data from women of the 1921–26 birth cohort of the Australian Longitudinal Study on Women's Health were linked to various administrative datasets to ascertain dementia diagnosis. The use of subsidised general practitioner (GP) services (75+ health assessments [HAs], chronic disease management meetings [CDMs], multidisciplinary case conferences [MCCs]) and specialist and allied health services between 2000 and 2013 for these women was analysed using longitudinal GEE models. Results: A total of 9,683 women were included with 1,444 (15%) women identified as having dementia. Compared to women with no dementia indication, women with dementia had more yearly non‐emergency GP attendances (short [30 minutes] IRR=1.11 [1.04, 1.19]) and fewer specialist attendances (IRR=0.91 [0.85, 0.97]) and were more likely to have an emergency GP attendance (OR=2.29 [2.05, 2.57]). There were no significant differences in the odds of having either a HA or CDM or using allied health services for women with and without dementia indicators. Conclusions: The overall use of services designed to improve the prevention and coordination of the care of older people with chronic conditions was low. Women with dementia were no more likely to access these services. Implications for public health: There is underuse of some primary and allied healthcare services designed for people with complex chronic conditions. These could be better used by women with dementia to improve the management of complex comorbidities (e.g. CDMs), to prevent the onset of disability (e.g. physiotherapy), and enhance needs assessment and service access (e.g. HAs)., The Australian Institute of Health and Welfare estimates that dementia affects almost 1 in 10 (8.8%) people aged 65 and over,[sup.1] and research shows it is increasingly prevalent as populations [...]

: Objective: To examine general practitioners’ views about how health assessments for older people should be conducted. Methods: General practitioners were randomly sampled from a national database of medical practitioners and invited to complete a survey. Survey items explored general practitioners’ views about essential components of a 75+ Health Assessment and who should assess each component, consultation time, use of standardised templates and tools, and home visits. Results: Overall, 185 (19.2%) general practitioners participated. Of 61 items presented, 24 were rated ‘essential’ by ≥70% of practitioners, with an average estimated consultation time of 65 minutes. Of the 24 essential items, it was perceived that 21 could be assessed by either a general practitioner or clinic nurse. Most practitioners indicated a standardised template (86%) and standardised tools for complex issues (79%) should be used, and home visits conducted (75%). Conclusions: General practitioners agreed on 24 items as essential for every health assessment, with assessments estimated to take more than one hour. Implications for public health: Increases to remuneration for prolonged assessments or mechanisms for improving efficiency and quality of assessments are needed. Acceptable mechanisms may include standardised patient‐reported tools, standardised templates and the use of non‐medical staff to assist with assessments., Globally, many countries are projected to experience ageing populations.[sup.1] In Australia, approximately 15% of the population was aged 65 or older in 2017, with this figure expected to rise to [...]

Objective: This study examines the effectiveness and costs of follow-up phone calls in improving response rates to a community survey. Methods: Non-responders to a postal survey were randomly allocated to receive a phone call or no phone call. The resources used for the development and implementation of the survey were documented. The response rates and cost per level of follow-up contact examined. Results: Follow-up phone calls led to a statistical significant increase in the number of responses to a community-wide survey, relative to no phone call. This relative increase in responses (n=62 for the follow-up phone call group versus n=l for controls), did not increase the absolute survey response rate sufficiently (from 38.5% for two mailed surveys to 39.8% for two mailed surveys plus a phone call) to justify the phone call costs. Scenario analyses show increasing the initial response rate by 10% and conducting a second mailed survey achieves greater marginal cost savings than increasing the response rate to the second mailout or the follow-up phone calls. Conclusions: These results suggest a follow-up phone call was not cost effective. Survey research ought to primarily focus on obtaining optimal initial response rates by using strategies identified in a Cochrane meta-analytic review. Key words: response rate, non-response, survey, follow-up, cost, randomised controlled trial. Aust NZ J Public Health. 2010; 34:508-12 doi: 10.1111/j.1753-6405.2010.00598.x

Objectives: To determine the level of support by licensees, police and the general public for interventions to reduce alcohol-related harm associated with licensed premises and to identify differences between the three groups. Methods: Participants were 108 licensees of premises licensed to sell alcohol; 132 police officers; 200 members of the public. Questionnaires were administered either through work settings or by mail. Respondents' levels of agreement with interventions to reduce alcohol-related harm associated with licensed premises: responsible service of alcohol; security and crowd control; policing; patron transport; and linking of alcohol-related harm to licensed premises and communication. Results: Police and members of the public were significantly more likely than licensees to agree with strategies under licensee control, such as subsidising patron transport and training staff to deal with intoxicated patrons. Police were more likely than licensees and members of the public to agree with strategies requiring community action and changes to liquor licensing laws. Licensees had significantly lower levels of agreement than the other groups about licensees' responsibility to reduce alcohol-related harm as a consequence of drinking at their premises. Conclusions: While there was good agreement between police officers and members of the public about strategies for reducing alcohol-related harm at licensed premises, licensees held divergent views about strategies within their control. Licensees were less likely than police and members of the public to agree they were responsible for reducing alcohol-related harm resulting from drinking at their premises. Key words: licensed premises, alcohol, alcohol-related harm, police, responsible service of alcohol.

Objective: To describe and critique methodological aspects of school-based interventions that involve a broader community initiative. Methods: An electronic search of 11 databases and manual search of references for intervention studies published in peer-reviewed journals from January 2000 to August 2004. To be included in the review, alcohol needed to be a primary focus of the study, the intervention to be school based and include grades between five and 12, and the intervention needed to involve the community. Results: Sixteen articles were selected for inclusion in the review. Methodologically, several studies excluded reporting important details (e.g. follow-up periods unclear), process measures were ignored by some studies (e.g. exposure to intervention), and some employed less than optimal outcome measures (such as attitudes and knowledge). Student education, some form of parental involvement and researchers providing resources to the school, were the most frequently employed intervention strategies. Conclusions: There is a clear need to conduct more rigorous evaluation studies and to increase reporting standards for school-based interventions. There is also tentative scope to include the community more broadly, rather than focus on established relationships within the school environment. Implications: As evidence suggests, there is limited effectiveness in school-based interventions. It may be beneficial to do lowest-cost interventions that have some evidence for effect, complemented by strategies identified by expert opinion, until further rigorous evidence arises.

Objective: To assess the prevalence and predictors of perceived unmet needs among women diagnosed with breast cancer, with a particular focus on the impact of location (rural/urban). Method: A random sample of women in NSW diagnosed with breast cancer was surveyed during 1995-96. The Breast Cancer Patients' Needs Questionnaire (BR-CPNQ) explores patients' perceived needs across five domains: psychological, health information, physical/daily living, patient care/support and interpersonal communication. Items assessing breast cancer specific needs and access to services and resources were included. Of 235 eligible rural women, 134 (57%) consented to participate and 129 (55%) returned completed surveys. Of 196 eligible urban women, 102 (52%) consented to participate and 100 (51%) returned completed surveys. Results: For 12 of the 52 items, at least one-third of the sample reported ever having a moderate/high need for help. Of the 15 highest moderate or high unmet needs, 10 related to health information and three to psychological needs. There were few differences in the prevalence of needs reported by rural and urban women. Only in the physical/daily living domain were rural women more likely than urban women to report some need for help (OR=2.59, 95% CI 1.21-5.52). Conclusions: Unmet needs, particularly in the information and psycho-social domains, are reported by both rural and urban women with breast cancer, with sub-groups experiencing different types of needs. Implications: There is a need to develop and trial targeted and innovative strategies to meet the health information and psychological needs of women with breast cancer, and the physical/daily living needs of rural women diagnosed with breast cancer.

A study was conducted in NSW, Australia, to examine the type of antenatal services available and to examine the views of midwives and obstetricians about who can provide adequate antenatal care. The results showed that NSW hospitals have general practitioners (GP) providing care, but midwives' clinics and independent midwives were less available. While obstetricians and midwives hold similar beliefs about GPs, they differ about the midwives role.

Results of a study suggest a growing inequity exists in Australia in the spending on anti-smoking activities vs revenues from cigarette sales to minors. The research was to determine whether changes in government revenue from sale of cigarettes to minors and the proportion of the revenue spent in an effort to prevent adolescents from taking up the habit, 1990-93. One who starts smoking at 14 or before is five times as likely to die of lung cancer as one who starts at 24 or later and 15 times as likely to die of lung cancer as never-smokers.

Self-report data on whether a woman had had a Pap test in the past two years from 2498 women in 19 rural towns of NSW in Australia was compared to Health Insurance Commission (HIC) data. The goal of the study was to compare data types. After adjustment for possible sources of confounding factors, self-report estimates were significantly higher than HIC estimates in 18 of the 19 towns. Discrepancies ran 13%-29%.

Interventions with retailers to cut down on cigarette sales to minors in Australia have been studied in a randomized controlled trial. Neither intervention achieved significant improvements for the two key behavioral outcomes, which were requiring proof of age and displaying a warning sign. Knowing about the law was not shown to have an intervention effect. Interventions may have been partly successful in modifying attitudes of retailers. One group received an educational letter and the other received a threat of enforcement of laws followed by a visit from a public health officer.

Print materials are common tools for public health education in New South Wales, but their effectiveness is rarely evaluated. A survey of sample materials showed the most cost-effective means to develop such materials were not commonly used, and their effectiveness was unreported. Health educators and administrators will need to note these results.

Objectives: To assess the prevalence, type, location of and injuries from home accidents, including falls and other accidents, and to explore whether variables including socio-demographic characteristics, medication use and home hazards were associated with all home accidents and falls. Method: 657 older people were interviewed about accidents in the previous four weeks. For a subsample (n=425), a home hazard check was completed. Results: Of the 10.1 accidents reported, 51% (n=51) were falls and 50% (n=50) were other accidents. The most common location for all accidents was outside (30%). Most resulted in minor injury to the legs (43%) or arms (39%). Medical treatment was sought for 14% of accidents. Having more than five hazards and infrequent home visits by healthcare providers were associated with having at least one accident and at least one fall. Use of a walking aid was also associated with falling. Conclusion: Rates of falls and other accidents are considerable. Implications: Work is required to confirm the importance of the relationships suggested and to provide data on the burden of injury associated with non-fall accidents. (Aust N Z J Public Health 2000; 24: 633-6)

The article examines ways to evaluate general practitioners' strategies for opportunistic recruitment of women for cervical cancer screening, and cautions that reliance on the accuracy of women's recall of such strategies will be needed until other measures have been validated, noting that likely bias will intrude.