Aspire2Health and COVID-19: the impact of the pandemic on outcomes from an outreach program to increase high school student interest in rural health careers.

INTRODUCTION: Rural health career outreach programs promote health careers to secondary school students and aim to address rural health workforce shortages. This study analyses student feedback data from Aspire2Health, a multidisciplinary rural health career outreach program conducted in Queensland Australia before COVID in 2019, and during COVID lockdown and isolation periods during 2020-2021. The study aims were to assess the suitability of the program and its elements, the program's short-term impact on students' interest in health careers and whether COVID restrictions on program delivery affected students' program experience and outcomes. METHODS: We conducted statistical and semantic analysis of data collected pre- and peri-COVID from participating secondary school students living in regional, rural and remote Australian communities. Data validity was established by triangulating quantitative results from items using a five-point Likert scales, qualitative themes from short-response items and frequency analysis of themes. Data were collected pre-COVID (2019, n=125) and peri-COVID (2020-21, n=248). RESULTS: Student responses to the program remained extremely positive despite COVID-imposed restrictions. Feedback scores indicated quite strong agreement in pre- and peri-COVID periods that the program motivated students to pursue a career in health (mean (M)=4.6 pre-COVID v M=4.5 peri-COVID) and that students would recommend the program to a friend (M=4.8 pre-COVID v M=4.7 peri-COVID). Overall ratings of the event were high, although a drop occurred during the peri-COVID period (M=4.8 pre-COVID v M=4.7 peri-COVID; p=0.043). Activity interest rankings indicated that, irrespective of the pandemic, clinical skills sessions, meeting health professionals and watching the emergency scenario were more interesting to students than ambulance and hospital tours (p<0.001). Four themes were generated from analysing qualitative data. In response to the item 'What did you enjoy the most?' the themes were 'clinical skills' (n=203, 55% of respondents) and 'interacting with professionals' (n=146, 39% of respondents). Responses to 'Is there anything we could do differently?' produced the themes 'no changes required' (n=158, 58% of respondents) and 'variety and duration' (n=40, 11% of respondents). 'Variety and duration' described students' desire for more variety, more professionals and more time to engage in activities. The themes and their frequency among student responses indicate strong support for the validity of the results. CONCLUSION: This study found that the Aspire2Heath program continued to motivate rural students to pursue health careers during the COVID-19 pandemic and that student interest is greatest during activities with hands-on clinical skills and student-professional interactions. These results suggests that rural health career outreach programs can be run under challenging social circumstances with confidence that students can be successfully encouraged to pursue health careers. Furthermore, program design should emphasise hands-on clinical skills and interactions with professions. These findings have practical implications for rural health career outreach programs, particularly those faced with restricted financing or external circumstances that limit their access to external healthcare resources.

Identifying predictors of the reasons women give for choosing to breastfeed.

The aims of this article are to outline the reasons Australian women give for initiating breastfeeding, identify unique predictors for these reasons, and use principal components factor analysis to determine factors that influence a woman's decision to breastfeed. Data were collected as part of a large longitudinal study investigating the breastfeeding behaviors and supports of women in Southern Queensland, Australia. The most common reason women (N = 562) gave for deciding to breastfeed was breast milk is better for my baby (95.5%). Reasons related to the mother such as breastfeeding is more convenient (84.3%) were also popular. Four significant components-mother-related reasons, health effects for the infant, moral and family influences, and advice from others-were determined after principal components factor analysis. As well as health benefits for the infant, convenience and other reasons related to the mother appear to be important factors in an Australian woman's decision to breastfeed.

An evaluation of a telephone-based postnatal support intervention for infant feeding in a regional Australian city.

BACKGROUND: Postnatal breastfeeding support in the form of home visits is difficult to accommodate in regional Australia, where hospitals often deal with harsh economic constraints in a context where they are required to provide services to geographically dispersed consumers. This study evaluated a predominantly telephone-based support service called the Infant Feeding Support Service. METHODS: A prospective cohort design was used to compare data for 696 women giving birth in two regional hospitals (one public, one private) and participating in the support service between January and July 2003 with data from a cohort of 625 women who gave birth in those hospitals before the introduction of the support service. Each mother participating in the support service was assigned a lactation consultant. First contact occurred 48 hours after discharge, and approximately weekly thereafter for 4 weeks. Breastfeeding duration was measured at 3 months postpartum. RESULTS: For women from the private hospital, the support service improved exclusive breastfeeding duration to 4.5 weeks postpartum, but these improvements were not evident at 3 months postpartum. No effects were observed for mothers from the public hospital. Quantitative and qualitative data demonstrated high levels of client satisfaction with the support service. CONCLUSIONS: This small-scale, predominantly telephone-based intervention provided significant, although apparently context-sensitive, improvements to exclusive breastfeeding duration.