Biomedical subjects

Lynne Parkinson

Publications and source records attributed to Lynne Parkinson.

11 recordsLinked to original sources

PubMed2005

Low back pain risk factors in a large rural Australian Aboriginal community. An opportunity for managing co-morbidities?

BACKGROUND: Low back pain (LBP) is the most prevalent musculo-skeletal condition in rural and remote Australian Aboriginal communities. Smoking, physical inactivity and obesity are also prevalent amongst Indigenous people contributing to lifestyle diseases and concurrently to the high burden of low back pain. OBJECTIVES: This paper aims to examine the association between LBP and modifiable risk factors in a large rural Indigenous community as a basis for informing a musculo-skeletal and related health promotion program. METHODS: A community Advisory Group (CAG) comprising Elders, Aboriginal Health Workers, academics, nurses, a general practitioner and chiropractors assisted in the development of measures to assess self-reported musculo-skeletal conditions including LBP risk factors. The Kempsey survey included a community-based survey administered by Aboriginal Health Workers followed by a clinical assessment conducted by chiropractors. RESULTS: Age and gender characteristics of this Indigenous sample (n = 189) were comparable to those reported in previous Australian Bureau of Statistics (ABS) studies of the broader Indigenous population. A history of traumatic events was highly prevalent in the community, as were occupational risk factors. Thirty-four percent of participants reported a previous history of LBP. Sporting injuries were associated with multiple musculo-skeletal conditions, including LBP. Those reporting high levels of pain were often overweight or obese and obesity was associated with self-reported low back strain. Common barriers to medical management of LBP included an attitude of being able to cope with pain, poor health, and the lack of affordable and appropriate health care services. Though many of the modifiable risk factors known to be associated with LBP were highly prevalent in this study, none of these were statistically associated with LBP. CONCLUSION: Addressing particular modifiable risk factors associated with LBP such as smoking, physical inactivity and obesity may also present a wider opportunity to prevent and manage the high burden of illness imposed by co-morbidities such as heart disease and type-2 diabetes.

Journal Article↗

PubMed2005

Cancer patients' attitudes toward euthanasia and physician-assisted suicide: the influence of question wording and patients' own definitions on responses.

OBJECTIVES: The aims of this study were to: (1) investigate patients' views on euthanasia and physician-assisted suicide (PAS), and (2) examine the impact of question wording and patients' own definitions on their responses. DESIGN: Cross-sectional survey of consecutive patients with cancer. SETTING: Newcastle (Australia) Mater Hospital Outpatients Clinic. PARTICIPANTS: Patients over 18 years of age, attending the clinic for follow-up consultation or treatment by a medical oncologist, radiation oncologist or haematologist. MAIN OUTCOME MEASURES: Face-to-face patient interviews were conducted examining attitudes to euthanasia and PAS. RESULTS: 236 patients with cancer (24% participation rate; 87% consent rate) were interviewed. Though the majority of participants supported the idea of euthanasia, patient views varied significantly according to question wording and their own understanding of the definition of euthanasia. CONCLUSIONS: Researchers need to be circumspect about framing and interpreting questions about support of 'euthanasia', as the term can mean different things to different people, and response may depend upon the specifics of the question asked.

Adult↗

PubMed2005

Single index of multimorbidity did not predict multiple outcomes.

BACKGROUND AND OBJECTIVES: Measurement of multimorbidity and comorbidity is important in epidemiologic and health services research. The aim of this research was to derive a generic multimorbidity index based on patient self-report, incorporating severity, for predicting a range of outcomes. METHODS: The dataset was obtained from a trial including 1,541 Veterans and war widows aged 70 years and over. The survey included sociodemographics, hospital admissions, SF-36, and information on deaths was obtained. The methods of Charlson were used to derive Multimorbidity Indices. RESULTS: All indices predicted quality of life, with decreasing quality of life for each increase in multimorbidity category. Multimorbidity scores incorporating severity significantly contributed to the prediction of mortality, hospital admission, and follow-up quality of life, regardless of adjustment for baseline quality of life. CONCLUSIONS: Our results indicate that a single index cannot predict a variety of relevant outcomes. Consequently, research undertaken to assess the impact of intervention or illness on health outcomes should use an index that is valid for predicting the specific outcome of interest.

Aged↗

PubMed2005

Pressing the key pad: trial of a novel approach to health promotion advice.

BACKGROUND: A relatively simple procedure, the Pap test, is effective in detecting early changes in the cervix; however, many at-risk women, even in developed countries, do not have regular Pap tests. METHODS: A randomized controlled trial of an interactive voice response (IVR) cervical screening brief advice involving 17,008 households is described. The IVR system automatically made calls to households and explained the nature of the call; selected one eligible woman aged 18-69 years; determined her screening status; delivered a message appropriate to her screening status; offered additional messages to counter common barriers; offered additional information on cervical screening and cancer; offered additional contact numbers; and offered to arrange for someone to call back. Cervical screening rate data were obtained from the Australian Health Insurance Commission (HIC) for 6 months before and following the intervention. RESULTS: The cervical screening rate was found to have increased by 0.43% in intervention compared to the control postcodes, and the increase was greater for older women at 1.34%. CONCLUSIONS: The overall conclusion was that IVR technology was a feasible means to contact women to deliver brief interventions aimed at increasing cervical screening rates and could economically target at-risk groups. The potential for linking IVR to centralized Pap test Registers to issue Pap test reminders should be explored.

Adolescent↗

PubMed2005

A community-based sports massage course for Aboriginal health workers.

OBJECTIVE: To pilot a community-based and owned sports massage course for Aboriginal health workers (AHWs). DESIGN: Descriptive, pilot educational intervention study. SETTING: Rural, Indigenous Australian community. SUBJECTS: AHWs working in a rural community. MAIN OUTCOME MEASURES: Cultural and logistical acceptability of the program to AHWs. RESULTS: The course was delivered within a culturally acceptable framework with applicability for the evaluation of sports massage skills and knowledge changes in a larger sample. CONCLUSION: The sports massage course demonstrated its applicability in this rural Aboriginal community and it has the potential to be adapted and adopted in other similar settings.

Adult↗

PubMed2005

Pilot of a novel cervical screening intervention: interactive voice response.

OBJECTIVE: This paper describes the pilot of an interactive voice response (IVR) cervical screening brief advice interface. METHOD: In September 2000, 5,000 households within Cessnock, New South Wales, were contacted by an IVR system. The system randomly selected eligible women aged 18-69, assessed their cervical screening status and provided a tailored message about cervical screening. A computer-assisted telephone interview (CATI) evaluated intervention acceptability. Participation rates, participant demographics, IVR use by women, and IVR costs were also examined. RESULTS: 549 (12%) women listened to the IVR call and 587 (59%) completed the CATI interview. IVR listeners under-represented younger and older women, and over-represented women who were married, and of Aboriginal descent. The majority of women (98%) found IVR easy to answer and 90% agreed IVR reminders were a good idea. Unscreened and older women used the system more than screened or younger women. CONCLUSIONS: The IVR call was successfully used by a large number of women to obtain information on cervical cancer screening, with higher use by recognised risk groups. IMPLICATIONS: These results suggest that an IVR reminder might be useful to increase cervical screening rates since those most at risk also used IVR the most. The potential for linking IVR to a database to issue reminders in the same manner as Pap Test Register postal reminders needs to be explored.

Adult↗

PubMed2004

An evaluation of three community-based projects to improve care for incontinence.

The Australian National Continence Management Strategy commissioned the implementation and evaluation of three community-based projects designed to improve care for people with incontinence by improving the detection and treatment of urinary incontinence. Projects were located in demographically diverse areas, overseen by co-operating professional groups with an interest in continence and aimed at facilitating a pathway of care for those with incontinence. Project activities focused on health care provider training and improving local referral networks, as well as raising public awareness. Multifaceted evaluation of each project was designed to inform principles for a national approach to continence care. The evaluation indicated that providers involved in each project became more confident in their ability to manage incontinence, had significantly increased knowledge of issues around incontinence and became more aware of local options for referral. However, there was little evidence that projects achieved an increase in seeking professional help among those with incontinence. From the evaluation, six principles were developed to guide future models of community-based continence care.

Aged↗

PubMed2004

Generalized Electronic Interviewing System (GEIS): a program and scripting method for conducting interviews in multiple modes.

A program called the Generalized Electronic Interviewing System (GEIS) was developed for conducting interviews, using computer-assisted telephone interview (CATI) and interactive voice response (IVR) modes without the need for a programmed interface. GEIS questionnaires were prepared using a common script syntax in all supported modes. Scripted development allowed for rapid interview development without the need for programming. A GEIS script specified the following: question texts, including variable texts; answer option texts; numeric codes for answers; range check information; logical question-branching information; interview status information; do-loop information; and IVR information, such as key codes and voice messages. GEIS thoroughly checked scripts for logical or syntactical errors. GEIS required SAS Version 8.0, and survey data were accumulated within SAS data sets. An application of GEIS to conduct a survey involving CATI, IVR, and a combined hybrid method is described. The CATI results deviated in the direction expected for sensitive questions, whereas IVR obtained a small sample size, rendering the results unreliable. However, the hybrid method was found to provide more accurate telephone survey data on alcohol consumption than did CATI alone. The program may be downloaded from the Psychonomic Society Web archive at www.psychonomic.org/archive/.

Electronics↗

PubMed2003

Health promotion in childcare centres: a survey of sun protection policy and practice.

OBJECTIVES: To describe sun protection policy and practice in child care centres in the Hunter region of New South Wales (NSW) and examine differences in sun protection policy and practice between those who attended a NSW Cancer Council SunSmart workshop and those who did not. METHOD: One hundred and seventy-seven Hunter child care centres completed a CATI interview (95% consent rate). RESULTS: Ninety seven per cent of centres reported having a written sun protection policy (only 5% deemed comprehensive by review). Sun protection policy components were reported more often than sun protection practices. There were no significant differences in policy or practice according to workshop attendance. CONCLUSIONS: Having a sun protection policy in place does not necessarily translate to sun protection practice at child care centres.

Child Day Care Centers↗

PubMed2002

Interactive voice response: review of studies 1989-2000.

A systematic review of the use of interactive voice response (IVR) was conducted. IVR is a telephone interviewing technique in which the human speaker is replaced by a high-quality recorded interactive script to which the respondent provides answers by pressing the keys of a touch telephone (touchphone). IVR has numerous advantages, including economy, autonomy, confidentiality, access to certain population groups, improved data quality, standardized interviewing, multilingual interfaces, and detailed longitudinal assessments. Despite this, there have been few applications of IVR. Previous studies have been in the areas of information services, reminder calls, monitoring, assessment, experimentation, interventions, and surveys. Areas that have received little attention have been the systematic evaluation of voice, multilingual interfaces, touchphone prevalence, survey response rates, use by the elderly, and acceptability.

Humans↗

PubMed2002

A comparison of four computer-based telephone interviewing methods: getting answers to sensitive questions.

Interactive voice response (IVR) technology presents a new and promising approach by which to collect accurate data on sensitive topics by telephone interviews. In a national survey of 2,880 households of alcohol and drug consumption, we compared computer-assisted telephone interviewing (CATT) and IVR with two hybrid methods that combine IVR with CATI. The principal hypothesis was that the self-report rates of sensitive behaviors would be higher for the hybrid and IVR methods owing to greater perceived confidentiality than with CATI. All the methods obtained similar sample demographic compositions. Response rates did not differ significantly between the CATI and the hybrid methods; however, the response rate with IVR was significantly lower. The hybrid and IVR methods obtained significantly higher self-report consumption rates for alcohol and marijuana and significantly higher hazardous drinking scores, as measured by the Alcohol Use Disorders Identification Test (AUDIT).

Humans↗