Fit4YAMs: Structuring a Lifestyle Intervention for Rural Overweight and Obese Young Adult Males Using Participatory Design.

PURPOSE: Young adult males (YAMs) are understudied with respect to lifestyle interventions to address overweight and obesity in this group. This study reports on the participatory design of the structure and delivery of the Fit4YAMs text message-based lifestyle intervention for 18- to 25-year-old rural YAMs in Australia. METHODS: Two semi-structured focus group discussions were held with six overweight or obese YAMs. Sessions explored their preferences for the structure and delivery of a weight loss intervention. Focus groups were recorded, and the contents transcribed verbatim for thematic analysis. RESULTS: The YAMs were unanimous in their preference for a highly personalized intervention program, complete with personalized goal setting, personalized motivation and engagement strategies, and personalized text message content. A text message frequency of three-four messages per week was deemed optimal for this group. Minimal direct contact by the intervention team was requested, but with clear guidelines and reminders of key contacts whom they could contact should they require help and guidance. The YAMs also agreed that a comprehensive goal setting session and personalization session prior to commencement of the intervention would be best. CONCLUSIONS: To engage rural YAMs in lifestyle interventions, a high degree of personalization of the program appears important. Although initially more time and resource intensive than a less personalized approach, it is essential to identify strategies to prevent and reverse weight gain in this hard to engage group. Maximizing their engagement using a more personalized approach could be the key to promoting long-term health outcomes in this group.

Communicating diabetes in Australian print media: a change in language use between 2010 and 2014?

OBJECTIVE: To assess if language used by Australian print media has changed in accordance with the 2011 Diabetes Australia position statement: a new language for diabetes. METHODS: Five prominent Australian newspapers were reviewed to retrieve articles from 2010 and 2014 that focused on diabetes or discussed diabetes in detail. Individual terms or phrases used within each article were categorised as preferred language, neutral language or language to avoid. RESULTS: 111 and 79 diabetes-specific articles were retrieved for 2010 and 2014, respectively. A significant decrease (p<0.05) was observed in diabetes articles using language to avoid in 2014 (45.6%) compared to 2010 (70.3%); accompanied by a significant increase (p<0.05) in diabetes articles using preferred language. There was no significant increase in articles that only used preferred language with or without neutral language, indicating that most articles commonly use both preferred language and language to avoid. CONCLUSIONS AND IMPLICATIONS: The Australian print news media has increased use of preferred language when communicating about diabetes, but have not eliminated the use of language to avoid. To realise the goals of the language position statement, continued championing of the recommendations by the health community is needed to ensure awareness and adoption.

2014 Rural Clinical School Training and Support Program Snapshot survey.

INTRODUCTION: The Rural Clinical Training and Support (RCTS) program is an Australian Government initiative to address the shortage of medical practitioners within rural and remote Australia. There is a large amount of published information about the RCTS program and rural medical student cohorts who have undertaken short- and long-term rotations. However, very little is known about the academic and professional staff involved in the program, a knowledge gap that may impact workforce and succession planning. To address this, the Federation of Rural Australian Medical Educators (FRAME) initiated the pilot 2014 RCTS Snapshot survey to obtain data on the current RCTS workforce. METHODS: All professional, academic and clinical academic staff (fixed-term and continuing, regardless of fraction) employed through the RCTS program were invited to complete a short, web-based survey. The survey was conducted from March to June 2014. The quantitative variables in the survey included demographics (age and gender), rural background and exposure, employment history in rural/regional areas and at rural clinical schools (RCS), experience and expertise, reasons for working at RCS, and future employment intentions. The last three questions also were of a qualitative open-ended format to allow respondents to provide additional details regarding their reasons for working at RCSs and their future intentions. RESULTS: The estimated total RCTS workforce was 970. A total of 413 responses were received and 316 (40.9%) complete responses analysed. The majority of respondents were female (71%), the 40-60-year age group was predominant (28%), and professional staff constituted the majority (62%). The below 40-year age group had more professionals than academics (21% vs 12%) and more than 62% of academics were aged above 50 years. Notably, there were no academics aged less than 30 years. The percentage of professional staff with a rural background was higher (62%) than that of academics with a rural background (42%). However, more than 70% of academics had previous exposure to a rural area as an adult and 32% had an exposure as a part of university or the TAFE (technical and further education) system. More than half (62%) of RCTS academics were aged more than 50 years and thus approaching retirement age. The implementation of a FRAME-sponsored leadership and succession program was considered by most staff (84%) as one strategy that could be used to prevent a future shortage of academics. Lifestyle reasons for working at an RCS were common to both academic (54%) and professional (63%) staff. A passion for rural health and building capacity within the rural health workforce were other central themes to emerge from the qualitative data. Uncertainty around contract renewal and future funding were dominant themes to emerge from respondents regarding their future employment intentions within the RCTS program. CONCLUSIONS: This study has provided valuable insights into the professional and academic staff's views and aspirations about the RCTS program. These data on the current RCTS workforce provide a benchmark to which future surveys of the workforce can be compared to monitor trends in turnover or predict future shortages due to cohort ageing.

A decade of Rural Clinical School research: a PubMed review.

INTRODUCTION: One parameter of the operational framework of the Australian Rural Clinical Training & Support Program (RCTS) is rural health research, yet there are no published reports of the research outcomes generated by these hallmarks of Australian rural medical education. To assess the contribution of RCTS to rural health research, their MEDLINE-indexed research publications over the last decade was analysed, using a bibliometric method. METHODS: MEDLINE-indexed RCTS publications from 2004 to 2013 were retrieved using validated PubMed queries. Two authors independently checked all retrieved RCTS publications for validity. Australian rural health (ARH) publications from RCTS were selectively enumerated and their proportion among all Australian rural health publications in each year was determined. ARH publications were defined as Australian publications that explore issues relevant to the health of the regional, rural or remote Australian population.RCTS publications related to medical education, Indigenous health, rural service areas, National Health Priority Areas (NHPA), and National Rural Health Alliance Priority Areas (NRHAPA) were analysed. Frequency of publication in different journals was also compared. RESULTS: A total of 280 RCTS publications were retrieved, increasing from 10 in 2004 to 49 in 2013. ARH topics dominated (177 articles; 67%). RCTS rural health publications increased as a proportion of all ARH publications from 3.4% in 2004 to 7.7% in 2013. Other RCTS publications increased from 2 (20% of total) in 2004 to 19 (39% of total) in 2013, and covered topics such as mental health, cancer, diabetes, obesity and asthma. RCTS medical education publications increased from 3 in 2004 to 14 in 2013. In total, 81 articles were retrieved comprising 28.9% of all RCTS publications. Indigenous health (18; 6%), rural populations (37; 13%) and rural health services (83; 29%) were the other important categories relevant to the RCTS funding parameters. RCTS publications also included NHPA (57; 20%) and NRHAPA (61; 22%). The main journals publishing RCTS research in this time period were Rural and Remote Health (16%), Australian Journal of Rural Health (13%) and Australian Family Physician (9%). RESULTS: This first study to report on the research efforts of RCTS researchers has shown that they are making a valuable contribution to rural health research and increasingly so within the research parameters indicated. These data represent a benchmark of research strengths and highlight research areas that should be strengthened with targeted research to best promote the health of rural Australians.