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11. Prevalence and characteristics of overweight and obesity in indigenous Australian children: A systematic review

Author

Dyer, Suzanne M, Gomersall, Judith Streak, Smithers, Lisa, Davy, Carol, Coleman, Dylan, Street, Jacqueline M, Dyer, Suzanne M, Gomersall, Judith Streak, Smithers, Lisa, Davy, Carol, Coleman, Dylan, and Street, Jacqueline M

Abstract

Evidence-based profiling of obesity and overweight in Indigenous Australian children has been poor. This study systematically reviewed evidence of the prevalence and patterns of obesity/overweight, with respect to gender, age, remoteness, and birth weight, in Indigenous Australian children, 0-18 years (PROSPERO CRD42014007626). Study quality and risk of bias were assessed. Twenty-five publications (21 studies) met inclusion criteria, with large variations in prevalence for obesity or overweight (11 to 54%) reported. A high degree of heterogeneity in study design was observed, few studies (6/21) were representative of the target population, and few appropriately recruited Indigenous children (8/21). Variability in study design, conduct, and small sample sizes mean that it is not possible to derive a single estimate for prevalence although two high-quality studies indicate at least one in four Indigenous Australian children are overweight or obese. Four of six studies reporting on gender, found overweight/obesity higher in girls and eight studies reporting on overweight/obesity by age suggest prevalence increases with age with one high quality large national study reporting total overweight/obesity as 22.4% of children aged 2-4 years, 27.5% of those aged 5-9, 38.5% aged 10-14, and 36.3% aged 15-17. Three of four studies, reporting obesity/overweight by region, found lower rates for children living in more remote areas than urban areas.

Published
2017

12. The CREATE Critical Appraisal Tool: Establishing The Validity, Reliability And Feasibility Of A Tool To Appraise Research From Aboriginal And Torres Strait Islander Perspective

Author

Harfield, Stephen, Gibson, O, Morey, Kathryn Anne, Kite, Elaine, Canuto, Karla, Glover, K, Gomersall, Judith Streak, Davy, Carol, Carter, D, Aromataris, Edoardo, Braunack-Mayer, Annette J, Harfield, Stephen, Gibson, O, Morey, Kathryn Anne, Kite, Elaine, Canuto, Karla, Glover, K, Gomersall, Judith Streak, Davy, Carol, Carter, D, Aromataris, Edoardo, and Braunack-Mayer, Annette J

Abstract

presented at the Global Evidence Summit: Using evidence. Improving lives, 13-16 September 2017, Cape Town, South Africa

Published
2017

15. Client and facility level determinants of quality of care in family planning services in Ethiopia: Multilevel modelling.

Author

Mahmood, Mohammad Afzal, Gomersall, Judith Streak, Laurence, Caroline O., Tessema, Gizachew Assefa, Assefa, Yibeltal, Zemedu, Theodros Getachew, and Kifle, Mengistu

Subjects
*FAMILY planning services, *QUALITY of service, *MEDICAL care, *CONTRACEPTIVES, *BIRTH control, *MULTILEVEL models
Abstract

Introduction: Over the last two decades, while contraceptive use has improved in Ethiopia, the contraceptive prevalence rate remains low. In addition to socio-demographic and cultural factors, the quality of care in Family Planning (FP) services is an important determining factor of FP utilization. However, little research exists on the determinants of quality of care in FP services in Ethiopia. This study aims to identify the client and facility level determinants of quality of care in FP services in Ethiopia. Methods: This study was based on the first Ethiopian Services Provision Assessment Plus (ESPA+) survey conducted in 2014. A total of 1247 clients nested in 374 health facilities were included in the analysis. Multilevel mixed-effects logistic regression modelling was conducted. The outcome variable, client satisfaction, was created using polychoric principal component analysis using eleven facets that reflect client satisfaction. Results: The results showed that both client-level and facility-level factors were associated with quality of care in FP services in Ethiopia. At the client-level; provision of information on potential side effects of contraceptive method (AOR = 5.22, 95% CI: 2.13–12.80), and number of history and physical assessments (AOR = 1.19, 95% CI: 1.03–1.34) were positively associated with client satisfaction, whereas waiting times of 30 minutes to two hours (AOR = 0.11, 95% CI: 0.03–0.33) was negatively associated with client satisfaction. At the facility-level; urban location (AOR = 4.61, 95% CI: 1.04–20.58), and availability of FP guidelines/protocols for providers (AOR = 4.90, 95% CI: 1.19–20.19) had positive significant effect on client satisfaction. Conclusion: Quality improvement programs in FP services in Ethiopia should focus on shortening waiting times and provision of information about the potential side effects of contraceptive methods. It is also important to improve health providers’ skills in thorough client history taking and physical assessment. Further distribution and implementation of best practice guidelines for providers working in the FP services must be a priority. [ABSTRACT FROM AUTHOR]

Published
2017
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16. What Indigenous Australian clients value about primary health care: a systematic review of qualitative evidence

Author

Judith Streak Gomersall, Odette Gibson, Edoardo Aromataris, Alex Brown, Judith Dwyer, Kim O'Donnell, Matthew Stephenson, Kootsy Canuto, Zachary Munn, Drew Carter, Gomersall, Judith Streak, Gibson, Odette, Dwyer, Judith, O'Donnell, Kim, Stephenson, Matthew, Carter, Drew, Canuto, Kootsy, Munn, Zachary, Aromataris, Edoardo, and Brown, Alex

Subjects
Male, Value (ethics), Health Knowledge, Attitudes, Practice, medicine.medical_specialty, Native Hawaiian or Other Pacific Islander, Indigenous Australians, Qualitative evidence, media_common.quotation_subject, community control, Primary health care, Indigenous, 03 medical and health sciences, 0302 clinical medicine, Nursing, Health care, Health Services, Indigenous, Humans, Mainstream, Medicine, Quality (business), 030212 general & internal medicine, Qualitative Research, media_common, 030505 public health, Primary Health Care, business.industry, lcsh:Public aspects of medicine, Public health, Australia, Public Health, Environmental and Occupational Health, lcsh:RA1-1270, accessibility, culturally safe care, primary health care, client perspectives, Patient Satisfaction, Female, 0305 other medical science, business
Abstract

Objective: To synthesise client perceptions of the unique characteristics and value of care provided in Aboriginal Community Controlled Health Organisations (ACCHOs) compared to mainstream/general practitioner services, and implications for improving access to quality, appropriate primary health care for Indigenous Australians. Method: Standardised systematic review methods with modification informed by ethical and methodological considerations in research involving Indigenous Australians. Results: Perceived unique valued characteristics of ACCHOs were: 1) accessibility, facilitated by ACCHOs welcoming social spaces and additional services; 2) culturally safe care; and 3) appropriate care, responsive to holistic needs. Conclusion: Provider-client relationships characterised by shared understanding of clients' needs, Indigenous staff, and relationships between clients who share the same culture, are central to ACCHO clients' perceptions of ACCHOs' unique value. The client perceptions provide insights about how ACCHOs address socio-economic factors that contribute to high levels of chronic disease in Indigenous communities, why mainstream PHC provider care cannot substitute for ACCHO care, and how to improve accessibility and quality of care in mainstream providers. Implications for public health: To increase utilisation of PHC services in Indigenous Australian communities, and help close the gaps between the health status of Indigenous and non-Indigenous Australians, Indigenous community leaders and Australian governments should prioritise implementing effective initiatives to support quality health care provision by ACCHOs. Refereed/Peer-reviewed

Published
2017

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