Factors affecting the embedding of integrated primary-secondary care into a health district.

With the aging population, the tide of chronic disease is rising with attendant increases in health service need. Integrated care and patient-centred approaches, which established partnerships between a regional Hospital and health service (HHS), the local primary health network and local general practitioners (GPs), were identified as exemplars of an approach needed to support growing community health needs. This paper summarises the findings from a process evaluation of four GP-specialist care integration programs with the aim of identifying recommendations for embedding integrated GP-specialist care into routine practice within the HHS. The process evaluation of the integration programs drew on input from a multidisciplinary expert advisory group and data collected through face-to-face semi-structured interviews with key stakeholders, as well as surveys of participating GPs and patients. Overarching findings were identified and grouped under six themes: interdisciplinary teamwork; communication and information exchange; the use of shared care guidelines or pathways; training and education; access and accessibility; and funding. Within each theme, key challenges and enablers emerged. The findings of this study highlight benefits and challenges associated with the establishment of integrated care between primary and secondary care providers, leading to the development of key recommendations for routine integration.

How can HIV/STI testing services be more accessible and acceptable for gender and sexually diverse young people? A brief report exploring young people's perspectives in Queensland.

ISSUE ADDRESSED: Gender and sexually diverse young people (GSDYP) are an important target group for HIV/sexually transmitted infection (STI) prevention and there is an immediate need to explore ways to make testing interventions accessible and appropriate for this group. METHODS: We used a modified World Café workshop with 14 GSDYP in Brisbane Australia, to inform the development of a pilot community-based testing intervention. RESULTS: The workshop identified the key features of an ideal service, which would include multiple, accessible sites that offer holistic, affordable services and confidential care by respectful and knowledgeable providers. The service would allow young people to engage in decision-making processes, have a culturally inclusive, comfortable and friendly atmosphere, and provide free sexual and reproductive health technologies. CONCLUSION: When designing HIV/STI testing interventions for key groups, health promotion practitioners need to be cognisant of localised and nuanced expectations and ensure that services are tailored to the needs and experiences of the local population. SO WHAT?: This study provides insights into the needs and expectations of HIV/STI testing interventions for GSDYP in Australia, a key at-risk group whose perspectives are not adequately voiced in sexual health research and intervention design. SUMMARY: This study explores facilitators and current barriers to HIV/STI testing with a group of gender and sexually diverse young people in Brisbane, Australia. Outcomes provide insights into the needs and expectations of HIV/STI testing services for this group.

Using Applied Theater in Primary, Secondary, and Tertiary Prevention of Intimate Partner Violence: A Systematic Review.

There is an immediate need to advance knowledge around the effective prevention of intimate partner violence (IPV), which is responsible for significant negative health and well-being outcomes for women around the world. Creative approaches are being explored internationally-this systematic review provides a timely synthesis of applied theater interventions addressing primary, secondary, and tertiary IPV prevention. Six hundred and ten articles were identified through a comprehensive search of five cross-disciplinary databases. Eleven studies discussed in 15 quantitative and qualitative peer-reviewed articles and one book chapter met the inclusion criteria and were included in the review. Articles were appraised using a standardized quality assessment tool and were analyzed within the context of IPV prevention. Of the reviewed studies, five were classified as primary prevention, four secondary, and two focused on tertiary prevention. Specific strategies used by each of the studies included healthy relationship training, rising awareness and community advocacy, service provider training, bystander training, and working with survivors. While the paucity and quality of current literature make it difficult to determine overall efficacy, this review points to the potential of applied theater as a useful prevention strategy, particularly when interactive, participatory methods are incorporated. Further, applied theater could be an effective tool for working in culturally diverse settings as well as with minority groups. Future applied theater program planning needs to include comprehensive evaluation. More rigorous investigation, involving mixed-method research approaches, is required to fully understand the potential of applied theater as a tool in the context of IPV prevention.