Regional and rural allied health professionals in Australia need better information services training and support for evidence-based practice.

BACKGROUND: Evidence-based practice requires health professionals to recognise situations of uncertainty in their practice, translate that uncertainty into answerable questions, and find and appraise information relevant to those questions. No research to date has explored the research-based information needs of allied health professionals (AHPs) in regional and rural Australia. OBJECTIVE: To examine the information-seeking experiences and needs of AHPs in regional and rural Australia. METHODS: A total of 80 AHPs, predominantly occupational therapists and physiotherapists, practising in regional and rural areas of Australia completed an online survey. RESULTS: Almost all respondents reported having questions requiring research evidence, but most of their questions were worded non-specifically. Respondents practising in rural areas had greater perceived difficulty in obtaining relevant evidence than their regional counterparts. Many respondents reported wanting additional support to find relevant research evidence. DISCUSSION: The findings offer insights regarding information-seeking challenges AHPs face and potential solutions, including improved training and increased health librarian support. However, due to sampling limitations, the results cannot be generalised to all allied health professions. CONCLUSION: Allied health professionals may require more training and support to engage in efficient and effective information-seeking behaviours. Health librarians have a valuable role to play in providing this training and support.

Meta-analysis of the effects of third-wave behavioural interventions on disordered eating and body image concerns: implications for eating disorder prevention.

Third-wave behavioural interventions are increasingly popular for treating and preventing mental health conditions. Recently, researchers have begun testing whether these interventions can effectively targeting eating disorder risk factors (disordered eating, body image concerns). This meta-analysis examined whether third-wave behavioural interventions (acceptance and commitment therapy; dialectical behaviour therapy; mindfulness-based interventions; compassion-focused therapy) show potential for being effective eating disorder prevention programs, by testing their effects on eating disorder risk factors in samples without an eating disorder. Twenty-four studies (13 randomized trials) were included. Most studies delivered selective prevention programs (i.e. participants who reported elevated risk factor). Third-wave interventions led to significant pre-post (g = 0.59; 95% CI = 0.43, 0.75) and follow-up (g = 0.83; 95% CI = 0.38, 1.28) improvements in disordered eating, and significant pre-post improvements in body image (g = 0.35; 95% CI = 0.13, 0.56). DBT-based interventions were associated with the largest effects. Third-wave interventions were also significantly more efficacious than wait-lists (g = 0.39; 95% CI = 0.09, 0.69) in reducing disordered eating, but did not differ to other interventions (g = 0.25; 95% CI = -0.06, 0.57). Preliminary evidence suggests that third-wave interventions may have a beneficial effect in ameliorating eating disorder risk.

Ageing well: Pilot evaluation of a dual-task training program in a rural community.

OBJECTIVE: This pilot trial examined the feasibility and effectiveness of "Ageing Well," a community-based program for improving cognitive skills and mobility of rural older people. DESIGN AND SETTING: The non-randomised, wait-list-controlled pilot trial was conducted at a regional NSW university clinic. PARTICIPANTS: Twenty-three community-dwelling adults aged 60+ who had begun to experience a decline in their physical or cognitive abilities or both. INTERVENTIONS: Dual-tasking activities simultaneously challenged participants' motor and cognitive abilities. Student facilitators encouraged participants to progress through increasing complex functional tasks in a range of contexts, including a café, supermarket and a simulated "home." MAIN OUTCOME MEASURES: The Patient Reported Evaluation of Cognitive State measured the impact of an individual's cognitive state in terms of how much they were "bothered" by problems with their cognition. Functional mobility was measured by the Timed Up-and-Go, a test of static and dynamic balance, and the Six Minute Walk Test. RESULTS: Intervention participants' Patient Reported Evaluation of Cognitive State ratings in relation to impacts on their performance of everyday skills improved substantially, whereas the control group did not change. Intervention participants walked 12% further in the Six Minute Walk Test post-intervention, while the control group distance did not change. Timed Up-and-Go time was reduced by 1 second in the intervention group. CONCLUSIONS: There is a strong interest in this dual-tasking program among older community-dwelling residents in this rural setting. The results of this pilot study support the feasibility and effectiveness of the Ageing Well program. But further trials are warranted.

Simultaneous Dual-Task Interventions That Improve Cognition in Older Adults: A Scoping Review of Implementation-Relevant Details.

Cognitive change occurs as a person ages and may result in decreased cognitive functioning in older adults (60 years and older). Simultaneous dual-task (SDT) interventions-activities that require the person to engage physically and cognitively at the same time-are effective in improving cognition in this group. This scoping review analysed published implementation-relevant details about effective SDT interventions, to assist the translation of the available evidence into various practice needs and contexts. A total of 23 databases were searched for relevant studies published between 2009 and 2020 inclusively. Randomised controlled trials (RCTs) that revealed statistically significant improvement in one or more aspects of cognitive function were appraised for methodological quality, using the Joanna Briggs Institute RCT checklist. The 14 RCTs scoring over 50% on the checklist were further analysed. Implementation-relevant data-for example, intervention nature, session length and frequency, equipment and space requirements, target group, and outcomes-were extracted, collated, and synthesised. The effective SDT interventions varied considerably in their nature and outcomes, meaning that suitable SDT interventions exist for a range of contexts. However, the resources required to implement some of the interventions either were not reported and/or may be prohibitive in some real-world practice contexts. Whilst "challenge" and "group interaction" were common features of effective SDT interventions, most studies failed to report on key implementation details required to facilitate translation into practice. It also remains unclear for how long the cognitive benefits are sustained following an effective SDT intervention. In future, more consistent publication of information about how to implement effective SDT interventions, for whom these interventions are engaging/enjoyable, and why would help to translate the available research into improved cognitive outcomes for older adults.

Undergraduate nursing students' course expectations, actual experiences, and associated satisfaction levels: A mixed methods survey.

BACKGROUND: Student satisfaction is related to experiences and expectations. It is challenging for educational administrators to deliver quality experiences without student expectation insight. Without this insight, student satisfaction is at risk. AIM: This study aims to develop a better understanding of the gaps that exist between student expectations and student experiences in a nursing program to inform and potentially improve student satisfaction in undergraduate nursing programs. METHODS: This research was a mixed methods survey undertaken at an Australian regional university. A total of 82 nursing students completed the survey, which contained open and closed questions addressing various domains of course experience. The questions were mostly categorical (respondents selected from predetermined ordinal options), with opportunities to elaborate on some questions. FINDINGS: The survey responses showed that flexibility in subject requirements, the helpfulness of academic/teaching staff (lecturers and tutors), and clarity of teacher communications correlated strongly with satisfaction in those respective areas. Expectation-experience discrepancy correlated strongly with satisfaction in these areas: support to navigate university systems, the timing of subject availability, the helpfulness of academic staff, and timetable suitability. The strongest predictor of students' overall satisfaction with their course was the extent to which they felt "supported to navigate university systems." CONCLUSION: The findings indicate that a better understanding of student course expectations can lead to better student satisfaction and, as such, educational administrators should work to innovate methods to discover and address student expectations.

Development of a Measure of Barriers to Laparoscopic Adjustable Gastric Banding (LAGB) Aftercare Attendance.

BACKGROUND: Regular aftercare attendance following laparoscopic adjustable gastric banding (LAGB) is associated with greater weight loss and fewer post-surgical complications. Despite high reported rates of attrition from LAGB aftercare, the reasons for non-attendance have not been thoroughly explored. The aim of the current study was to describe the scale development, explore the factor structure and evaluate the psychometric properties of the Gastric Banding Aftercare Attendance Questionnaire (GBAAQ)-a tool that measures barriers to aftercare attendance in LAGB patients. METHODS: One hundred and eighty-three participants completed the GBAAQ; 107 regular attendees and 76 non-attendees. RESULTS: A factor analysis identified four factors (Treatment Approach, Time Constraints, Stress and Pressures, Uncomfortable Participating) that demonstrated good known-groups validity and internal consistency. CONCLUSIONS: Although further validation is needed, the results of the present study provide preliminary support for the validity of the GBAAQ. Knowledge about the barriers to LAGB aftercare attendance can be used to identify those most at risk of non-attendance and can inform strategies aimed at reducing non-attendance.

Designs and methods used in published Australian health promotion evaluations 1992-2011.

OBJECTIVE: To describe the designs and methods used in published Australian health promotion evaluation articles between 1992 and 2011. METHODS: Using a content analysis approach, we reviewed 157 articles to analyse patterns and trends in designs and methods in Australian health promotion evaluation articles. The purpose was to provide empirical evidence about the types of designs and methods used. RESULTS: The most common type of evaluation conducted was impact evaluation. Quantitative designs were used exclusively in more than half of the articles analysed. Almost half the evaluations utilised only one data collection method. Surveys were the most common data collection method used. Few articles referred explicitly to an intended evaluation outcome or benefit and references to published evaluation models or frameworks were rare. CONCLUSION: This is the first time Australian-published health promotion evaluation articles have been empirically investigated in relation to designs and methods. There appears to be little change in the purposes, overall designs and methods of published evaluations since 1992. IMPLICATIONS: More methodologically transparent and sophisticated published evaluation articles might be instructional, and even motivational, for improving evaluation practice and result in better public health interventions and outcomes.

Laparoscopic Adjustable Gastric Banding (LAGB) Aftercare Attendance and Attrition.

BACKGROUND: Regular aftercare attendance following laparoscopic adjustable gastric banding (LAGB) is associated with greater weight loss and fewer post-surgical complications. Despite high reported rates of attrition from LAGB aftercare, the reasons for non-attendance have not been previously explored. The present study aimed to explore patient-reported barriers to LAGB aftercare attendance, and the perceived helpfulness of potential attrition-reducing strategies, in both regular attendees and non-attendees of aftercare. METHODS: One hundred and seventy-nine participants (107 regular attendees and 72 non-attendees) completed a semi-structured questionnaire, assessing barriers to attrition (101 items) and usefulness of attrition prevention strategies (14 items). RESULTS: Findings indicate that both regular attendees and non-attendees experience multiple barriers to aftercare attendance. Non-attendees generally reported that barriers had a greater impact on their aftercare attendance. There was evidence for some level of acceptability for attrition-reducing strategies suggesting that LAGB patients may be receptive to such strategies. CONCLUSIONS: Current findings highlight the importance of assessing barriers to treatment in both attendees and non-attendees. It is proposed that addressing barriers that differentiate non-attendees from attendees may be most effective in reducing attrition from aftercare.

Adolescent girls' responses to warning signs of abuse in romantic relationships: implications for youth-targeted relationship violence prevention.

This study explored adolescent girls' experiences of, and responses to, seven domains of partner behavior that are considered to be early warning signs of relationship abuse. Girls (N = 146) aged 14 to 18 years, attending schools in a semirural area, completed a purpose-built questionnaire, providing measures of self-reported exposure, perceived seriousness, and proposed response protectiveness in relation to each domain. Substantial proportions of girls (a) reported exposure to each of the domains, (b) lacked awareness particularly of the risks associated with jealous/possessive partner behaviors, and (c) regardless of their level of risk awareness, lacked knowledge of behavioral responses that might discourage continued warning-sign behaviors by their partners in all domains except for social restriction tactics. The implications of these findings for youth-targeted relationship abuse prevention are discussed.