Search

In New Zealand, health promotion is now expected to be an integral part of the work of a general practitioner, and in the recently implemented New Zealand Primary Health Organisation structure, specific funding is available to undertake health promotion activities in primary care. Eighteen general practitioners recruited to take part in two focus groups discussing men's health, talked extensively about health promotion. This talk was analysed through a discourse analysis. This study of the 'talk' of general practitioners suggests that there are problems in transferring the concept, which must be recognised and addressed if health promotion is going to be taken up effectively within general practice. The meaning given to health promotion in the consultation is unclear and general practitioners were unsure about its value in 'health checks' and screening. Lack of time and lack of confidence in the evidence appeared to be barriers to undertaking health promotion within general practice consultations. In the current climate general practitioners are uncertain, to the point of ambivalence, about health promotion in their work. Further work will be required to ensure this ambivalence does not result in covert resistance. Keywords: General practitioners; Health promotion; New Zealand

Objective: Assess differences in personal circumstances, risk exposure and risk-taking among female sex workers in different sectors of the New Zealand sex industry in regard to issues of sexual safety, drug use, violence and coercion. Method: A cross-sectional survey of 303 female sex workers was carried out in Christchurch, New Zealand, May-September 1999. Results: There was evidence of `segmentation': street workers were younger, had started work at a younger age and had less education than indoor workers. More street than indoor workers used money from sex work for drugs and used drugs at work. There was a high level of condom use but little `negotiation' about them with clients. High levels of violent experiences were reported, but street workers reported more, and more extreme forms of, violence than indoor workers. Implications: Although knowledge of condom use and sexual safety appears generally high and women in both sectors report taking the initiative for safer sex, drug use, violence and coercion remain of concern. While sexual safety will need ongoing health promotion and education interventions to support and ensure the uptake of safer sex practice by new workers and prevent any relapse by more experienced workers, issues of violence and coercion also require attention to the power relationships between individuals. Legislation and policy directed at these issues should encourage the control women can exert over their work practice. Reducing exposure to personal risk may require different measures in different sectors. (Aust N Z J Public Health 2001; 25: 78-83)

Aims: To estimate the prevalence of Chlamydia trachomatis among young people in Year 12 and Year 13 in Christchurch secondary schools., Methods: A cross-sectional survey on sexual behaviour was carried out in conjunction with the collection of urine samples, which were tested for C. trachomatis., Results: 1582 young people were invited to take part in the study. 72% of these students answered the questionnaire of whom 49% had experienced sexual intercourse. The mean age of the sample was 16.7 years. The prevalence of C. trachomatis among the sexually active participants who provided a urine sample was 2.0% (1.8% of males and 2.3% of females). 39% of sexually active participants had had one partner in their lifetime and 13% had had more than five partners. 51% of males and 39% of females indicated that they always used condoms and 69% of males and 57% of females reported using a condom on the last occasion of sexual intercourse., Conclusions: Our study shows that 2.0% of sexually active senior high school students have asymptomatic C. trachomatis infections. Opportunistic screening for C. trachomatis should be offered to all sexually active males and females at risk.

Aims: To investigate factors associated with patient recruitment by general practitioners (GPs) in a randomised controlled trial in primary care., Methods: Cross sectional survey of 100 GPs who had agreed to recruit patients for a randomised controlled trial. A postal questionnaire was sent to the 100 GPs to collect information on factors associated with recruitment in the randomised controlled trial., Results: The response rate to the survey was 97%. GPs who reported that practice nurses were involved in the research project were significantly more likely to recruit patients into the trial. Age, sex, membership of an independent practitioner association (IPA), number of half days worked, and the number of GPs working in a practice were not associated with recruitment., Conclusions: Involvement of practice nurses together with GPs may improve recruitment of patients in randomised controlled trials in primary care in New Zealand.