Health and social care needs of people living with dementia: a qualitative study of dementia support in the Victorian region of Gippsland, Australia.

INTRODUCTION: There is a lack of information about the experiences of people living with dementia and their carers, especially in rural and regional areas. Understanding these experiences helps to identify gaps and unmet needs within the health system and improve quality of care and outcomes for people living with dementia. The aim of this study was to improve our knowledge of dementia support needs. This included access to health and social care services and supports for people living with dementia and those who provide informal or formal support to someone living with dementia. METHODS: Interviews were conducted with 26 participants from the Gippsland region of Victoria, Australia with knowledge of dementia care. Purposive sampling engaged people with lived experience, carers/family members and health professionals delivering dementia care and social services. Discussions centred around participants' experiences of support services, the diagnosis process and what they thought was needed to improve the services and supports offered. Thematic analysis of the data was undertaken using the framework method. RESULTS: The interview data indicated that the needs of many people living with dementia and their carers were not currently being met. The themes were limited access to services and supports, including primary and specialist care, often impacted by lack of knowledge of care options, difficulty navigating the system and funding models as a barrier, leading to delays in getting a diagnosis and accessing specialist services; lack of holistic care to enable people living with dementia to 'live well'; and stigma impacted by a lack of knowledge of dementia among professionals and in the community. Relationship-centred care was described as a way to improve the lives of people living with dementia. CONCLUSION: Key areas for improvement include increasing community awareness of dementia and available local services, more support to obtain an early dementia diagnosis, increased help to navigate the system, especially immediately after diagnosis, and easier access to appropriate home support services when they are needed. Other recommendations include person-centred care across settings - supported by funding models, more education and communication skills training for health professionals and care staff - and greater support for and increased recognition of carers.

Factors that influence family-focused practice in Chinese mental health workers: A cross-sectional survey.

INTRODUCTION: Family-focused practice has become an emerging paradigm in mental health services. However, little is known about family-focused practice and associated factors in Chinese mental health workers. AIM: To examine family-focused practice and associated factors in Chinese mental health workers. METHOD: A cross-sectional survey was conducted in a convenience sample of mental health workers (n = 515) in Beijing, China. The Family-Focused Mental Health Practice Questionnaire was used to measure family-focused practice, as well as worker, workplace and client factors that might influence family-focused practice. Multiple linear regression analysis was performed to investigate the factors associated with family-focused practice. RESULTS: On average, the participants exhibited a moderate level of engagement in family-focused practice. The factors that most significantly influenced family-focused practice in Chinese mental health workers were skill and knowledge, worker confidence and time and workload. Moreover, psychiatrists were found to engage more in family-focused practice than psychiatric nurses, and community mental health workers were more active in family-focused practice than hospital-based ones. DISCUSSION: This study provided important data concerning family-focused practice and associated factors in Chinese mental health workers. IMPLICATIONS FOR PRACTICE: The varying level of Chinese mental health workers to engage in family-focused practice has advocacy, training, research and organizational implications for mental health services in China and elsewhere.

Clinicians' and Users' Views and Experiences of a Tele-Mental Health Service Implemented Alongside the Public Mental Health System during the COVID-19 Pandemic.

A tele-mental health model called Head to Health was implemented in the state of Victoria, Australia to address the crisis caused by the COVID-19 pandemic. It was a free centralized intake service that adopted a targeted approach with several novel elements, such as stepped care and telehealth. This study examines the views and experiences of clinicians and service users of the tele-mental health service in the Gippsland region of Victoria during the COVID-19 pandemic. Data from clinicians were obtained via an online 10-item open-ended survey instrument and from service users through semi-structured interviews. Data were obtained from 66 participants, including 47 clinician surveys and 19 service user interviews. Six categories emerged from the data. They were: 'Conditions where use of tele-mental health is appropriate', 'Conditions where tele-mental health may not be useful', 'Advantages of tele-mental health', 'Challenges in using tele-mental health', 'Client outcomes with tele-mental health', and 'Recommendations for future use'. This is one of a few studies where clinicians' and service users' views and experiences have been explored together to provide a nuanced understanding of perspectives on the efficacy of tele-mental health when it was implemented alongside public mental health services.

Sociodemographic circumstances, health, and life experience shape posttraumatic distress trajectories among individuals exposed to smoke during a large-scale coal mine fire.

The 2014 Hazelwood coal mine fire in the Latrobe Valley, Australia, distributed toxic smoke into surrounding communities over 45 days. This study investigated risk and protective factors associated with four trajectories of posttraumatic distress (resilient, recovery, delayed-onset, chronic) among exposed adults. Participants (N = 709) completed surveys in 2016-2017 and 2019-2020 assessing mine fire-related particulate matter (PM2.5 ) exposure; sociodemographic, physical, and mental health variables; and exposure to other traumatic and recent stressful events. Mine fire-related posttraumatic distress was measured using the IES-R; trajectories were determined according to established clinical significance thresholds. Relative risk ratios (RRRs) were generated from multivariate multinomial regressions. The resilient trajectory was most common (77.0%). The chronic trajectory (8.5%) was associated with loneliness, RRR = 2.59, 95% CI [1.30, 5.16], and physical health diagnoses, RRR = 2.31, 95% CI [1.32, 4.02]. The delayed-onset trajectory (9.1%) was associated with multiple recent stressful events, RRR = 2.51, 95% CI [1.37, 4.59]; mental health diagnoses, RRR = 2.30, 95% CI [1.25, 4.24]; loneliness, RRR = 2.05, 95% CI [1.09, 3.88]; and male gender, RRR = 2.01, 95% CI [1.18, 3.44]. Socioeconomic advantage protected against chronic, RRR = 0.68, 95% CI [0.53, 0.86], and delayed-onset trajectory membership, RRR = 0.68, 95% CI [0.50, 0.94]; social support protected against chronic trajectory membership, RRR = 0.67, 95% CI [0.49, 0.92]. PM2.5 exposure did not determine trajectory. These findings enhance understanding of longer-term posttraumatic responses to large-scale smoke events and can inform mental health initiatives within at-risk communities.

Mental health service users' experiences and perspectives of family involvement in their care: a systematic literature review.

BACKGROUND: The importance of engaging families in mental health care is recognised and endorsed by governments worldwide, however service users' perspectives of family involvement are not well understood. AIMS: This study sought to summarise the literature regarding how service users view the involvement of family in their engagement with services and care. METHODS: A search was conducted within the following databases for manuscripts published in the last 10 years: PsycINFO, CINAHLPlus, PubMed and Scopus. Of the 4251 eligible papers 17 met the inclusion criteria for review and were subjected to quality appraisal using the RATS (relevance, appropriateness, transparency, soundness) qualitative research review guidelines. RESULTS: Thematic analysis identified four primary themes: family involvement can be positive and negative; barriers to family involvement; family involvement is variable; and communication and collaboration among stakeholders. CONCLUSIONS: Identifying the barriers to family involvement and heterogeneity among service users' views were key findings of this review. Despite the widely reported benefits of including families in mental health care it does not always occur. A clearer and more nuanced understanding of service users' needs and preferences for family involvement is required.

The impact of a mine fire and smoke event on academic outcomes for primary and secondary school students.

OBJECTIVE: This study explored how exposure to a mine fire and smoke event influenced students' academic outcomes. METHOD: The academic results for 303 students (aged 7.8-16.2 years) were accessed and students completed the Children's Revised Impact of Events Scale to measure their level of distress resulting from the mine fire. RESULTS: The longitudinal analysis found that secondary students, who attended schools in the town most exposed to particulate matter from the mine fire, experienced an 18.5-month delay in academic progress (95% CI [13.6, 23.5]) after the mine fire, relative to the wider area. No evidence was found in academic delays related to exposure to the mine fire among primary school students. There was also no evidence of additional delays in academic progress for students with higher levels of event-related distress. CONCLUSIONS: Schools should monitor and provide academic support to students to protect them against academic decline after a disaster. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

[Family-focused practices among adult mental health professionals: A portrait of the situation in Quebec]. / Pratiques centrées sur la famille chez les professionnels en santé mentale adulte : un portrait de la situation au Québec.

Context Children living with a mentally ill parent are a vulnerable population, at higher risk of various psychosocial and mental health problems. They are overrepresented in youth mental health and child protection services. Adult mental health services that treat parents have the opportunity to identify and support children in these families. However, to date, there is still little knowledge on the extent of family-centered practices offered by professionals from different disciplinary fields in Quebec. Objective This study aims to document the family-focused practices of adult mental health professionals according to different disciplines (social work, nursing, psychoeducation, psychology, and special education). Method A total of 524 participants, from all regions of Quebec and working with adult mental health clients, responded to an online provincial survey. A subsample of 380 participants, members of a professional order or association, was retained for the present study. These come from five discipline: social work (n=127), nursing (n=99), psychoeducation (n=57), psychology (n=56) and special education (n=41) A MANCOVA analysis was performed to compare groups on the five subscales of the French version of the Family Focused Mental Health Practice (FFMHPQ-FR, Piché et al., in press), controlling for gender, years of experience working in mental health services and estimated proportion of clients with a parental role. Results Significant differences were found between social workers and psychologists in reported family-focused practices. Participants also reported very different levels of facilitating factors such as workplace support, openness to training, perceived knowledge and skills, and attitudes towards these practices. Discussion This study helps to increase knowledge on the use of family-focused practices by professionals from different disciplinary fields, in the context of adult mental health services in Quebec. The results allow to better support the adoption of such practices in mental health services.

Getting the FACS: A Protocol for Developing a Survey Instrument to Measure Carer and Family Engagement with Mental Health Services.

Government policies recommend, and all stakeholders benefit, when mental health services meaningfully engage with carers and family. However, health service engagement with carers is inadequate, and often non-existent with children whose parents are service users. There are seven fundamental ways that carers and families want to be integrated with and engaged by health services but current survey instruments do not capture these seven engagement practices. This protocol describes the development of two closely aligned Family and Carer Surveys (FACS) to measure engagement of service users in mental health services. The new measures are based on the seven engagement themes and a conceptual distinction between the carer and family, with particular focus on where the service user is a parent. The instruments will be developed in five stages; (1) item generation (2) Cognitive pretesting of survey (3) preliminary item content quantitative assessment (4) psychometric analysis of a large data collection and (5) selection of items for short form instruments. These steps will operationalise the seven fundamental ways that families and carers want to be engaged with mental health services, thereby providing valid and reliable measures for use in research and benchmarking of carer and family engagement.

It Takes a Village to Raise a Child: Understanding and Expanding the Concept of the "Village".

This perspective article defines and discusses the concept of the "village" when working with families who are experiencing multiple adversities. The article starts with a discussion on what is meant generally by a village approach, followed by a historical overview of how families living in adversity have been defined and positioned. The need to move past a siloed, professional centric approach when working with families is then presented. Using a model of social connections, based on Bronfenbrenner's ecological theory, we then identify who the "villagers" might be. Some potential principles for how the village might work with families living with adversity are presented, along with two case studies, to demonstrate how these principles might be enacted. This perspective article provides an overview and discussion of "the village" concept, rather than present a definitive set of guidelines or recommendations.

Clinical Implementation and Evaluation of Three Implementation Interventions for a Family-Oriented Care for Children of Mentally Ill Parents (ci-chimps): Study Protocol for a Randomized Controlled Multicenter Trial.

Background: In Germany, approximately three million children under the age of eighteen have a mentally ill parent. These children are at an increased risk of developing a mental illness themselves (1) as well as a physical illness (2). While research has identified numerous evidence-based family-oriented interventions, little is known about how to implement such interventions effectively and efficiently in clinical practice in Germany. This implementation study (ci-chimps) evaluates three clinical implementation projects with three different implementation interventions for the optimal implementation of the tailored family-oriented preventive and therapeutic interventions in the CHIMPS-NET (children of mentally ill parents-research network) with an implementation model for children of mentally ill parents. Methods: A two-group randomized controlled multicenter trial will examine changes in family-oriented practice and aspects of implementation at baseline as well as at 12- and 24-months follow-up. The CHIMPS-Network consists of 20 clinical centers. The centers in the intervention group receive the support of all of the three implementation interventions: (1) optimal pathways to care, (2) education and a training program for professionals, and (3) systematic screening for children. The centers in the control group do not receive this specific implementation support. Discussion: While we know that children of mentally ill parents are an important target group to be addressed by preventive and therapeutic interventions, there is often a lack of structured implementation of family-oriented interventions in clinical practice in Germany. Using a randomized controlled multicenter trial design with a large and wide-ranging sample (clinics for adult psychiatry and clinics for child and adolescent psychiatry, university clinics and clinics at the real health care) will provide a robust understanding of implementing family-oriented changes in German clinical practice. Trial Registration: The CHIMPS-NET-study was registered with the German Clinical Trials Register on 2019-12-19 (DRKS00020380) and with Clinical Trials on 2020-4-30 (NCT04369625), the ci-chimps-study was registered with the German Clinical Trials Register (DRKS00026217) on 2021-08-27, the Clinical Trials registration is in review process.

An exploration of the trajectory of psychological distress associated with exposure to smoke during the 2014 Hazelwood coal mine fire.

Due to climate change, catastrophic events such as landscape fires are increasing in frequency and severity. However, relatively little is known about the longer-term mental health outcomes of such events. Follow-up was conducted of 709 adults exposed to smoke from the 2014 Hazelwood mine fire in Morwell, Victoria, Australia. Participants completed two surveys evaluating posttraumatic distress, measured using the Impact of Events Scale-Revised (IES-R), three and six years after the mine fire. Mixed-effects regression models were used to evaluate longitudinal changes in distress. IES-R total scores increased on average by 2.6 points (95%CI: 1.2 to 3.9 points) between the two survey rounds, with increases across all three posttraumatic distress symptom clusters, particularly intrusive symptoms. This increase in distress was evident across all levels of fine particulate matter (PM2.5) exposure to the mine fire smoke. Age was an effect modifier between mine fire PM2.5 exposure and posttraumatic distress, with younger adults impacted more by exposure to the mine fire. Greater exposure to PM2.5 from the mine fire was still associated with increased psychological distress some six years later, with the overall level of distress increasing between the two survey rounds. The follow-up survey coincided with the Black Summer bushfire season in south-eastern Australia and exposure to this new smoke event may have triggered distress sensitivities stemming from exposure to the earlier mine fire. Public health responses to disaster events should take into consideration prior exposures and vulnerable groups, particularly younger adults.

What shapes research and research capacity building in rural health services? Context matters.

OBJECTIVE: To determine the contextual factors influencing research and research capacity building in rural health settings. DESIGN: Qualitative study using semi-structured telephone interviews to collect data regarding health professionals' research education and capacity building. Analysis involved inductive coding using Braun and Clark's thematic analysis; and deductive mapping to the Consolidated Framework for Implementation Research (CFIR). SETTING: Victorian rural health services and university campuses. PARTICIPANTS: Twenty senior rural health managers, academics and/or research coordinators. Participants had at least three years' experience in rural public health, health-related research or health education settings. MAIN OUTCOME MEASURES: Contextual factors influencing the operationalisation and prioritisation of research capacity building in rural health services. RESULTS: Findings reflected the CFIR domains and constructs: intervention characteristics (relative advantage); outer setting (cosmopolitanism, external policies and incentives); inner setting (implementation climate, readiness for implementation); characteristics of individuals (self-efficacy); and process (planning, engaging). Findings illustrated the implementation context and the complex contextual tensions, which either prevent or enhance research capacity building in rural health services. CONCLUSIONS: Realising the Australian Government's vision for improved health service provision and health outcomes in rural areas requires a strong culture of research and research capacity building in rural health services. Low levels of rural research funding, chronic workforce shortages and the tension between undertaking research and delivering health care, all significantly impact the operationalisation and prioritisation of research capacity building in rural health services. Effective policy and investment addressing these contextual factors is crucial for the success of research capacity building in rural health services.

An online intervention for 18-25-year-old youth whose parents have a mental illness and/or substance use disorder: A pilot randomized controlled trial.

AIM: Young adults aged 18-25 whose parents have a mental illness or substance use problem can be vulnerable to multiple difficulties in adulthood. There are, however, few available interventions designed for this group. This study evaluated a 6 week online intervention (mi. spot; mental illness: supported, preventative, online, targeted) specifically designed for this population. The intervention aims to improve mental health and wellbeing. METHODS: Forty-one young people, recruited from the community, participated in a two-arm parallel randomized controlled trial where participants were randomized to mi. spot (n = 22) or a wait list control group (n = 19). They were assessed at baseline, immediately post intervention and at six weeks post intervention with measures covering depression, anxiety and stress, wellbeing, coping, general self-efficacy, help seeking and social connectedness. RESULTS: Intervention participants reported significantly improved psychological wellbeing, coping, general self-efficacy, and a reduction in anxiety. Participants in the control group reported significant improvements in emotional wellbeing and help seeking and a reduction in self-blame. CONCLUSION: This pilot controlled trial supported previous findings and shows preliminary evidence that mi.spot is effective for young adults who grew up with parents who have a mental illness or substance use problem. A large-scale, randomized controlled trial with a diverse group of young people is needed.

Approaches Used to Describe, Measure, and Analyze Place of Practice in Dentistry, Medical, Nursing, and Allied Health Rural Graduate Workforce Research in Australia: A Systematic Scoping Review.

Redressing the maldistribution of the health workforce in regional, rural, and remote geographical areas is a global issue and crucial to improving the accessibility of primary health care and specialist services. Geographical classification systems are important as they provide an objective and quantifiable measure of access and can have direct policy relevance, yet they are not always consistently applied in rural health research. It is unclear how research focusing on the graduate health workforce in Australia has described, measured, and analyzed place of practice. To examine approaches used, this review systematically scopes Australian rural studies focusing on dentistry, medicine, nursing, and allied health graduates that have included place of practice as an outcome measure. The Joanna Brigg's Institute Scoping Review Methodology was used to guide the review. Database searches retrieved 1130 unique citations, which were screened, resulting in 62 studies for inclusion. Included studies were observational, with most focusing on the practice locations of medical graduates and predicators of rural practice. Variations in the use of geographical classification approaches to define rurality were identified and included the use of systems that no longer have policy relevance, as well as adaptations of existing systems that make future comparisons between studies challenging. It is recommended that research examining the geographical distribution of the rural health workforce use uniform definitions of rurality that are aligned with current government policy.

Promoting Self-Determination in Parents With Mental Illness in Adult Mental Health Settings.

This article reports a strengths-based intervention to support parents with mental illness and their children in adult mental health settings: "Let's Talk About Children" (LTC) intervention. A qualitative methodology was adopted with parent participants receiving LTC in adult mental health and family services. The benefits for parents receiving LTC were described through in-depth interviews with 25 parents following the delivery of the program. Interview data identified an impact on parental self-regulation-mainly through a change in a sense of agency as a parent-and skill building, once a clearer picture of their child's everyday life was understood. This study outlines the benefits of talking with parents about the strengths and vulnerabilities of their children during routine mental health treatment. The role for self-determination of parents in preventive interventions for children is an important consideration for mental health recovery, and it also helps to break the cycle of transgenerational mental illness within families.

Editorial Perspective: Prato Research Collaborative for change in parent and child mental health - principles and recommendations for working with children and parents living with parental mental illness.

Children whose parents have mental illnesses are among the most vulnerable in our communities. There is however, much that can be done to prevent or mitigate the impact of a parent's illness on children. Notwithstanding the availability of several evidence-based interventions, efforts to support these children have been limited by a lack of adequate support structures. Major service reorientation is required to better meet the needs of these children and their families. This editorial provides recommendations for practice, organisational, and systems change.

Associations between self-reported respiratory symptoms and non-specific psychological distress following exposure to a prolonged landscape fire.

We investigated the association between respiratory symptoms and psychological distress in the context of a prolonged smoke event, and evaluated whether smoke exposure, or pre-existing respiratory and mental health conditions, influenced the association. Three thousand ninety-six residents of a rural town heavily exposed to smoke from the 6-week Hazelwood coal mine fire, and 960 residents of a nearby unexposed town, completed Kessler's psychological distress questionnaire (K10) and a modified European Community Respiratory Health Survey. Logistic regression models evaluated associations between distress and respiratory symptoms, with interactions fitted to evaluate effect modification. Smoke exposed participants reported higher levels of distress than those unexposed, and participants reporting respiratory symptoms recorded higher levels of distress than participants without respiratory symptoms, irrespective of exposure. 5-unit increments in K10 scores were associated with 21%-48% increases in the odds of reporting respiratory symptoms. There were significant interactions with pre-existing asthma, chronic obstructive pulmonary disease and mental health conditions, but not with smoke exposure. Although participants with pre-existing conditions were more likely to report respiratory symptoms, increasing distress was most strongly associated with respiratory symptoms among those without pre-existing conditions. Communities exposed to landscape fire smoke could benefit from interventions to reduce both psychological and respiratory distress.

An online intervention for vulnerable young adults: identifying mechanisms of change using a grounded theory approach.

PURPOSE: The purpose of this study is to qualitatively identify the mechanisms of change as young adults, whose parents have a mental illness and/or substance use issue, navigate their way through a 6-week, moderated online intervention. METHODS: Using a qualitative, grounded theory approach, data were collected and triangulated for analysis from participants before, during, and after engaging in the intervention. First, 31 young people's motivations for enrolling in the intervention were identified from one open ended question on an online survey. Second, online chat sessions were analysed to identify those topics the 31 participants engaged in throughout the intervention. Finally, 19 interviews were conducted 2 weeks post-intervention, to ascertain participants' perceptions of the impacts of the intervention and how the intervention promoted changes. RESULTS: The main storyline was that of participants "making sense" of their parents, themselves and other relationships, in collaboration with peers, in a safe online space. This storyline of "making sense" drove their motivation to join the intervention and was the focus of the online chats. After the intervention, some were closer to having "made sense" of their families while others struggled differentiating themselves away from their families. An anonymous, professionally moderated online site afforded participants opportunities to think about who they were and for some, who they wanted to be. CONCLUSION: Generating an explanatory theory of how vulnerable young people navigate their way through an online intervention provides important information that can be used to inform future services, interventions, and research.

Mental health service engagement with family and carers: what practices are fundamental?

BACKGROUND: Substantial and important benefits flow to all stakeholders, including the service user, when mental health services meaningfully engage with carers and family members. Government policies around the world clearly supports inclusiveness however health service engagement with family and carers remains sporadic, possibly because how best to engage is unclear. A synthesis of currently used surveys, relevant research and audit tools indicates seven core ways that families and carers might be engaged by health services. This study sought to confirm, from the perspective of family and carers, the importance of these seven health service engagement practices. METHODS: In a mixed method online survey, 134 family members and carers were asked what they received and what they wanted from mental health services. Participants also quantified the importance of each of the seven core practices on a 0-100 point likert scale. RESULTS: Almost 250 verbatim responses were deductively matched against the seven themes, with additional unaligned responses inductively categorised. The findings triangulate with multiple diverse literatures to confirm seven fundamental engagement practices that carers and family want from health services. Conceptually, the seven practices are represented by two broad overarching practice themes of (i) meeting the needs of the family member and (ii) addressing the needs of the service user. CONCLUSION: Policy, clinical practice, training and future research might encompass the seven core practices along with consideration of the intertwined relationship of family, carers and the service user suggested by the two broader concepts.

Rationale and protocol for the Nursing and Allied Health Graduate Outcomes Tracking (NAHGOT) study: a large-scale longitudinal investigation of graduate practice destinations.

INTRODUCTION: Inequitable distribution of health workforce limits access to healthcare services and contributes to adverse health outcomes. WHO recommends tracking health professionals from their points of entry into university and over their careers for the purpose of workforce development and planning. Previous research has focused on medical students and graduates' choice of practice location. Few studies have targeted nursing and allied health graduates' practice intentions and destinations. The Nursing and Allied Health Graduate Outcomes Tracking (NAHGOT) study is investigating factors affecting Australian nursing and allied health students and graduates' choice of graduate practice location over the course of their studies and up to 10 years after graduation by linking multiple data sources, including routinely collected university administrative and professional placement data, surveys of students and graduates, and professional registration data. METHODS: By using a prospective cohort study design, each year a new cohort of about 2000 students at each participating university (Deakin University, Monash University and the University of Newcastle) is tracked throughout their courses and for 10 years after graduation. Disciplines include medical radiation practice, nursing and midwifery, occupational therapy, optometry, paramedicine, pharmacy, physiotherapy, podiatry and psychology. University enrolment data are collected at admission and professional placement data are collected annually. Students' practice destination intentions are collected via questions added into the national Student Experience Survey (SES). Data pertaining to graduates' practice destination, intentions and factors influencing choice of practice location are collected in the first and third years after graduation via questions added to the Australian Graduate Outcomes Survey (GOS). Additionally, participants may volunteer to receive a NAHGOT survey in the second and fourth-to-tenth years after graduation. Principal place of practice data are accessed via the Australian Health Practitioner Regulation Agency (Ahpra) annually. Linked data are aggregated and analysed to test hypotheses comparing associations between multiple variables and graduate practice location. RESULTS: This study seeks to add to the limited empirical evidence about factors that lead to rural practice in the nursing and allied health professions. This prospective large-scale, comprehensive study tracks participants from eight different health professions across three universities through their pre-registration education and into their postgraduate careers, an approach not previously reported in Australia. To achieve this, the NAHGOT study links data drawn from university enrolment and professional placement data, the SES, the GOS, online NAHGOT graduate surveys, and Ahpra data. The prospective cohort study design enables the use of both comparative analysis and hypothesis testing. The flexible and inclusive study design is intended to enable other universities, as well as those allied health professions not regulated by Ahpra, to join the study over time. CONCLUSION: The study demonstrates how the systematic, institutional tracking and research approach advocated by the WHO can be applied to the nursing and allied health workforce in Australia. It is expected that this large-scale, longitudinal, multifactorial, multicentre study will help inform future nursing and allied health university admission, graduate pathways and health workforce planning. Furthermore, the project could be expanded to explore health workforce attrition and thereby influence health workforce planning overall.