A cross-sectional survey assessing the acceptability and feasibility of self-report electronic data collection about health risks from patients attending an Aboriginal Community Controlled Health Service.

BACKGROUND: Aboriginal Australians experience significantly worse health and a higher burden of chronic disease than non-Aboriginal Australians. Electronic self-report data collection is a systematic means of collecting data about health risk factors which could help to overcome screening barriers and assist in the provision of preventive health care. Yet this approach has not been tested in an Aboriginal health care setting. Therefore, the aim of this study was to examine the acceptability and feasibility of a health risk questionnaire administered on a touch screen laptop computer for patients attending an Aboriginal Community Controlled Health Service (ACCHS). METHODS: In 2012, consecutive adult patients attending an ACCHS in rural New South Wales, Australia, were asked to complete a health risk survey on a touch screen computer. Health risk factors assessed in the questionnaire included smoking status, body mass index, and level of physical activity. The questionnaire included visual cues to improve accuracy and minimise literacy barriers and was completed while participants were waiting for their appointment. RESULTS: A total of 188 participants completed the questionnaire, with a consent rate of 71%. The mean time taken to complete the questionnaire was less than 12 minutes. Over 90% of participants agreed that: the questionnaire instructions were easy to follow; the touch screen computer was easy to use; they had enough privacy; the questions were easy to understand; they felt comfortable answering all the questions. CONCLUSIONS: Results indicate that the use of a touch screen questionnaire to collect information from patients about health risk factors affecting Aboriginal Australians is feasible and acceptable in the ACCHS setting. This approach has potential to improve identification and management of at-risk individuals, therein providing significant opportunities to reduce the burden of disease among Aboriginal Australians.

Aboriginal health: agreement between general practitioners and patients on their health risk status and screening history.

OBJECTIVE: To examine agreement between patients' self-report and general practitioners' perception of their patients' health risk status and screening history. METHODS: Patients attending an Aboriginal Community Controlled Health Service self-reported via survey their health risk status and screening history, while waiting to see their general practitioner (GP). Following the consultation the GP completed a corresponding survey. Prevalence rates and rates of agreement using the kappa statistic were calculated for both self-reported and GP-reported risk status for smoking, at-risk alcohol consumption and physical inactivity; and screening history for blood pressure, cholesterol, diabetes and cervical cancer. RESULTS: Prevalence rates of health risks were similar from self-report versus GP-reported, yet differed on screening history. Patients who identified themselves as being at risk were often not the same as those identified by GPs. Agreement between patient and doctor was substantial for smoking, yet poor for at-risk alcohol consumption and physical inactivity. Agreement was fair for cholesterol and cervical cancer screening, and slight for blood pressure and diabetes screening. CONCLUSIONS AND IMPLICATIONS: This study suggests that for effective preventive care, using self-report for some health risks may be reliable, but less so for screening history. Greater assistance is needed in primary health care settings to identify patients who are at risk.

The risk status, screening history and health concerns of Aboriginal and Torres Strait Islander people attending an Aboriginal Community Controlled Health Service.

INTRODUCTION AND AIMS: Primary health-care services need to maximise prevention activities to improve the health of Aboriginal and Torres Strait Islander people. This study determined Aboriginal and Torres Strait Islander people's risk status and screening history for cardiovascular, diabetes and cancer, and identified opportunities for prevention based on patient's health concerns. DESIGN AND METHODS: Consenting adult patients attending an Aboriginal Community Controlled Health Service completed interview surveys. Outcome measures were: patient's self-reported rates of smoking, at-risk alcohol consumption, body mass index and screening rates for cholesterol, diabetes, blood pressure, cervical and breast cancer, the proportion of patients with multiple risk factors and health information patients prioritise to receive from their doctor. RESULTS: We surveyed 587 patients giving a consent rate of 77%. Patient's self-reported being at risk due to smoking (51%), harmful alcohol consumption in both short term (10%) and long term (10%), and overweight (28%) and obese (49%) body mass index. The proportion of patients who had not been screened within the recommended guidelines was 27% for cholesterol, 24% for diabetes, 40% for blood pressure, 47% for cervical cancer and 54% for breast cancer. The majority (73%) of patients had multiple risk factors. Patients prioritised receiving health information on diabetes (45%), weight (43%) and heart disease (43%). DISCUSSION AND CONCLUSIONS: Many patients were at high risk, and were concerned about the health risks they experience. Strategies are needed to help clinic staff identify risks, and maximise prevention activities according to best-practice guidelines, particularly to patients who experience multiple risk factors.

Strategies for increasing high-quality intervention research in Aboriginal and Torres Strait Islander health: views of leading researchers.

OBJECTIVE: To identify policy strategies that are perceived by researchers active in Aboriginal and Torres Strait Islander health as effective in increasing the amount of high-quality intervention research undertaken in this field. DESIGN AND SETTING: A cross-sectional study using a web-based survey was emailed to researchers based in clinical, public health and other academic institutions. PARTICIPANTS: Researchers who had published more than once in Aboriginal health between 1 January 2005 and 1 August 2009, based on a MEDLINE search. MAIN OUTCOME MEASURES: Participants selected and weighted 17 strategies that were, in their opinion, important for increasing the amount of high-quality intervention research being conducted in Aboriginal health. RESULTS: We invited 157 researchers to complete the survey, and received 74 completed surveys. The most highly weighted strategies were: for research funding bodies to give funding priority to intervention research proposals that target Aboriginal populations (median weighted score,15%); for peak bodies representing Aboriginal communities to clearly specify intervention research priorities in a national Aboriginal health research agenda (median weighted score, 10%); for research funding bodies to fund research to develop reliable measures of health for Aboriginal people (median weighted score, 9.5%); for health care organisations to participate more in intervention research targeting Aboriginal populations (median, 8.5%); and for research review panels to accept intervention research designs other than the randomised controlled trial (median weighted score, 8%). CONCLUSIONS: Researchers who are active in Aboriginal health research perceive that improvements in funding mechanisms, priority setting and research systems are required to increase the amount of high-quality intervention research being conducted in this field. A national intervention research agenda that encourages multidisciplinary research teams and community partnerships may offer a solution.