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Objective: Health research priorities are commonly identified and resourced by strategic leaders. The importance of recognising the expertise of clinician-researchers is being prioritised by a national funding shift towards applied research. There is a dearth of evidence regarding research priorities for maternity care in rural and remote health in Australia. This study aimed to develop an evidence-based consensus of maternity research priorities in regional, rural, and remote areas of Australia's largest rural health service (by land area) in Western Australia. Methods: A three-phased Delphi method was selected to achieve an interdisciplinary, evidence-based consensus on maternity research priorities within Western Australian Country Health Service. Results: Across three study phases, 432 participants responded. Representation was from seven regions and all stakeholder roles within the regions. Phase 1 included 173 responses yielding 53 concepts categorised under five domains. Phase 2 involved 161 participants who prioritised concepts under domains of (i) workforce and education; (ii) health equity; (iii) Aboriginal health; (iv) logistics and health systems; and (v) clinical. Phase 3 included 96 participants revealing 15 maternity research priorities with the top four ranked concepts: 'recruitment and retention of staff'; 'care for women and families with vulnerabilities', 'models of care offering continuity' and 'systems efficiencies'. Conclusions: The novel evidence provided in this study, in conjunction with a strong consensus on research priorities and an interdisciplinary approach, strengthens the findings of this study and amplifies the mandate of action without delay. What is known about the topic? Research priorities in health are often set by strategic leaders that are not always able to capture or reflect the views and perspectives of clinicians involved with service delivery. What does this paper add? This research delivers the first ever evidence-based consensus of maternity research priorities identified by those who deliver or coordinate maternity care in regional, rural, and remote areas of Australia's largest rural health service (by land area) in Western Australia. What are the implications for practitioners? Demand-driven research identified by those who provide maternity care in this unique setting ensures that research strategy and resourcing can be targeted with confidence and translated without delay. [ABSTRACT FROM AUTHOR]

Background: In Australia, a significant proportion of women live rurally and deliver their babies in services supported by general practitioner obstetricians (GPOs). While GPOs are known to be an important backbone in the provision of maternity care in Australia, little attention has been paid to their models of care. Aims: To describe the models of maternity care provided by GPOs across Western Australia. Materials and Methods: This was a multi‐phase mixed‐methods cross‐sectional exploratory study. We invited rural GPOs in Western Australia to complete an online survey about their models of care and a sub‐group of GPOs agreed to an interview to further explore their responses. Results: Thirty‐five GPOs completed the survey and 12 completed an interview. We found that GPOs work in a variety of models, dependent on local community needs, resources and geography. Key attributes of GPO models are continuity of care, safety, generalism, accessibility and affordability. GPO care involves continuity of care beyond the time limits of pregnancy. Conclusions: GPOs' models of care make up an essential part of rural maternity services and have evolved to meet the needs of the communities they serve. This work informs rural generalist trainees of career pathways and policymakers about rural service provision. [ABSTRACT FROM AUTHOR]

Objective: To measure satisfaction with general practitioner obstetrician‐led maternity care in Western Australia and to explore perspectives of maternity service users Design: Women were recruited at antenatal visits with their general practitioner obstetrician. Participants completed a validated three‐part survey about their satisfaction with antenatal, intrapartum and postpartum care. They were all offered a semi‐structured interview. Setting: Nine general practitioner obstetrician practices located in regional Western Australia. Participants: 155 women receiving general practitioner obstetrician‐led maternity care within the South West or Great Southern regions of Western Australia. 13 of these women also participated in an interview. Main Outcome Measures: We quantified satisfaction with aspects of antenatal, intrapartum and postpartum care using a Likert scale. Descriptive variables included demographic information and birth outcomes. Qualitative data described valued aspects of maternity care. Results: 116 women completed all 3 surveys. General practitioner obstetrician‐led care resulted in high rates of satisfaction across all 3 stages of care, with 78%‐100% agreement with positively worded satisfaction statements. Thematic analysis identified four key aspects of care women valued when receiving maternity care: the woman‐centred care experience, the skills of the general practitioner obstetrician, support from the health care team and the health care environment. Conclusion: General practitioner obstetrician‐led maternity care is a highly regarded model of maternity care, valued by rural women with high rates of satisfaction. [ABSTRACT FROM AUTHOR]

Objective: For more than 20 years, the FOODcents adult nutrition education programme has been delivered to Western Australians. The aim of the programme is to provide disadvantaged individuals with the knowledge, skills and motivation to buy healthy foods on a limited budget. The present study evaluated whether the FOODcents curriculum and the way it is delivered are effective in improving participants' nutrition-related knowledge and behaviours.Design: Evaluation data were collected via in-session pre-post questionnaires and a post-course online questionnaire.Setting: Western Australia.Subjects: Data were collected from participants attending just over one-half (54 %) of the FOODcents courses conducted over the two-year evaluation period. In total, 927 course participants provided usable data.Results: After exposure to the course, respondents demonstrated an improved ability to: (i) categorize foods according to the frequency with which they should be consumed and the proportion of the food budget that should be allocated to them; (ii) correctly interpret nutrition labels on food products; and (iii) appreciate the link between diet/obesity and a range of diseases. Improvements in the latter were especially pronounced among participants of low socio-economic status. In terms of behaviour change, significant improvements in fruit and vegetable consumption were reported, along with reductions in the consumption of fast food. Participants of low socio-economic status reported the greatest changes.Conclusions: The results indicate that the FOODcents nutrition education programme improves participants' nutrition-related knowledge and behaviours. [ABSTRACT FROM AUTHOR]

Objectives To compare clinical outcomes and mortality rates between Kimberley Indigenous, other Indigenous and non- Indigenous Australian patients on peritoneal dialysis ( PD). Design and participants Patients commencing renal replacement therapy ( RRT) with PD for the first time from 1 January 2003 to 31 December 2009 were retrospectively identified. Secondary data from medical records and the Australian and New Zealand Dialysis and Transplant Registry from 1 January 2003 to 31 December 2010 were used to compare outcomes between patients. Main outcome measures Time to first peritonitis; failure and death rates per 100 patient-years, hazard ratios, unadjusted and adjusted (for age, sex, comorbid conditions, PD not the first RRT modality used). Comparison of the two PD systems used in the Kimberley. Results Kimberley patients had significantly shorter median time to first peritonitis (11.2 versus 21.5 months), higher technique failure (46.0 versus 25.2 per 100 patient-years) and shorter median survival on PD (17.5 versus 22.4 months) but similar adjusted mortality (hazard ratio 1.32; 95% CI, 0.76-2.29) as non- Indigenous patients. They also had a significantly higher technique failure rate than other Indigenous patients (46.0 versus 31.4 per 100 patient-years) and nearly double the average peritonitis episodes previously reported for Indigenous Australians (2.0 versus 1.15 per patient-year). Conclusions PD can bring patients closer to home; however, it is relatively short term and potentially hazardous. PD remains an important therapy for suitable remote patients to get closer to home, providing they are fully informed of the options. The current expansion of safer Kimberley haemodialysis options needs to continue. [ABSTRACT FROM AUTHOR]

Background and Objectives: This study explored attitudes toward two food guides currently being widely used in Australia: the Healthy Eating Pyramid and the Australian Guide to Healthy Eating Plate.Methods and Study Design: Ten focus groups were conducted with adults (aged 18+ years) and children (aged 10-17 years) across various locations in Perth, Western Australia. The discussions focused on liked and disliked aspects of each food guide and the implications for participants' perceptions of their relative usefulness.Results: When asked to state their preference, a large majority of participants nominated the plate as their preferred nutrition guide. The style of presentation used for the plate was reportedly clearer and more aesthetically pleasing. The plate was also perceived to be more complex while the pyramid was considered by adults to be more child-friendly.Conclusions: This study provides information on consumers' reactions to different food guides and the implications for perceived relevance and utility. [ABSTRACT FROM AUTHOR]