Emily Saurman

Introduction: Digital technologies can significantly improve access to healthcare, education and social services. However, there is limited evidence on the extent of ownership and use of digital devices in remote Aboriginal communities. This study aimed to examine digital technology use, internet availability and use, intention to use technology for health and eHealth literacy in a very remote Aboriginal community in the Northern Territory (NT), Australia. Methods: A face‐to‐face community‐based structured survey was implemented by local Aboriginal community‐based researchers in a very remote island community of the NT. Results: Approximately 20% ( n = 46) of the community participated in the study. Seventeen respondents did not own a digital device. While 17 reported having no internet access, two‐thirds of those who had internet access ( n = 29) were using prepaid mobile data. Twenty‐three of the participants reported accessing health information online and eight reported having received a text message reminder about a health appointment. Only three individuals did not want to use a digital device for health. The mean score for eHealth literacy was 23.7; range 8–40. Overall, younger respondents (18–44 years) had higher eHealth literacy than those aged 45 and over. Conclusion: The use of digital technologies was common; however, its application for healthcare was limited, despite community members' interest in using devices to access health information. Limited use, together with low eHealth literacy scores, and gaps in internet connectivity and mobile phone ownership suggest unmet needs for more accessible community digital infrastructure (e.g., community WiFi), and greater personal access to devices.

Journal of Medical Internet Research - International Scientific Journal for Medical Research, Information and Communication on the Internet #Preprint #PeerReviewMe: Warning: This is a unreviewed preprint. Readers are warned that the document has not been peer-reviewed by expert/patient reviewers or an academic editor, may contain misleading claims, and is likely to undergo changes before final publication, if accepted, or may have been rejected/withdrawn. Readers with interest and expertise are encouraged to sign up as peer-reviewer, if the paper is within an open peer-review period. Please cite this preprint only for review purposes or for grant applications and CVs (if you are the author). Background: Background: Aboriginal and Torres Strait Islander (Indigenous) peoples living in remote Australia experience a heavy burden of ill health and multiple barriers to accessing health care. Digital health technologies (DHTs) have the potential to help overcome some of these challenges and increase access to comprehensive primary health care (CPHC), thereby improving equity of health outcomes. However, little is known about the community and provider preference of the use of digital technologies for improving health and wellness. Objective: The aim of this project is to co-design, implement, and evaluate how DHTs can improve access to CPHC in remote Indigenous communities in the Northern Territory. Methods: Methods: This multi-phased project will take a participatory action research approach to co-design and optimise digital health solutions with local community members and health services staff in two communities. Our mixed methods approach will include pre- and post-implementation focus group discussions, interviews, quantitative analysis of CPHC utilisation administrative data and surveys administered by Indigenous community-based researchers to understand the use of digital devices and connectivity, eHealth literacy, preferences for different attributes of DHTs using best-worst scaling, and consumer satisfaction and experiences with DHT interventions. Priority DHTs will be selected for implementation based on consumer and health staff preferences. Focus group discussions and interview data will explore community and health service staff preferences, experiences and satisfaction with implemented DHTs. A realist approach will be taken to identify how DHT interventions work, for whom and in what circumstances, so that understanding of why some interventions work while others do not is expanded. Economic analyses will be conducted to calculate the incremental costs and benefits of implemented DHT interventions. The scalability of digital health solutions will be tested in two additional communities. Project partners include key funding, service and support agencies in the NT and nationally. Results: As of November 2024, we have selected two implementation sites. Digital health initiatives are underway at the implementation sites, and evaluation activities are progressing. The initial findings from these sites have informed our scalability assessment in additional two sites. Conclusions: Knowledge translation is integral to the study design which involves partnering with consumers, CPHC service providers, and a range of key stakeholders to inform health service providers and policymakers about what DHTs work for which groups of consumers, and under what circumstances, to improve access to CPHC. This unique study will accommodate consumer and provider preferences regarding the use of DHTs to improve CPHC access and address the lack of knowledge about how to deploy digital solutions to best support CPHC in remote Indigenous Australia. Clinical Trial: Not applicable.

Purpose: Care after falls constitutes a substantial cost to the Australian health system. The Falls Reduction and Empathy Development Experience (FREDeX), a hybrid simulation training program, was designed in rural NSW. This paper initiates a multi-pronged evaluation of FREDeX. Methodology: Pre- and post-training survey data was collected from voluntary FREDeX trainees. Surveys included validated empathy, compassion, and person-centred-care assessment tools, as well as questions about workshop quality and open-ended response questions. Findings: There was significant improvement in trainees' empathy, compassion, and person-centred care scores. Trainees expressed positivity about FREDeX, noting facilitators and challenges of the program, and implications for professional practice. FREDeX enhanced empathy, aiding better patient understanding, communication, and personalised care. Implications: Significant evidence has emerged demonstrating the efficacy of virtual reality and other simulation training for empathy and compassion in clinical contexts. FREDeX enhances soft skills through a hybrid simulation training approach, proving to be engaging and educational. It is valuable for the delivery of person-centred care, and a compelling program based on effectiveness and ease of implementation. Originality and value: FREDeX has demonstrated implications for improving empathy and compassion in rural and urban healthcare professionals and enables more person-centred care. The positive outcomes from FREDeX suggest broader adoption of hybrid simulation training may enhance soft skills and healthcare quality, emphasising the potential of technology-driven learning for health workforce capacity. Limitations: While this evaluation demonstrates the value of FREDeX, further evaluation will seek to bridge the gap between demonstrated improvements in assessed metrics of care ability and direct improvements to patient care, by assessing fall rates, harm assessments, and clinical notes for participating facilities. This will endeavour to determine changes in fall prevalence and improvement in management and care for falls.

Introduction: Interprofessional education enables allied health students to learn with, from and about each other, equipping them with the skills, values and knowledge to work collaboratively in teams and with service users. DRUMBEAT, a groupwork program, was applied as a creative tool and implemented to empower learners with knowledge and skills not consistently addressed in traditional allied health education. This paper will explore the value of using DRUMBEAT during practice placement through gaining the perspectives of allied health students and the intentions, perceptions and experiences of allied health academic facilitators. Methods: This multiple-methods qualitative inquiry used student end-of-program feedback surveys (n = 73) and academic semi-structured interviews (n = 3). Data was thematically analysed. Results: Implementing DRUMBEAT had value for students. Benefits included skill development, deeper self-reflection and self-awareness, a sense of safety, an opportunity for selfcare and shifting perspectives. DRUMBEAT also provided students with a fun escape from the stresses of placement; it became an opportunity for creative expression, fostering wellbeing and mindfulness. The academics valued DRUMBEAT for the neurobiological benefits of rhythm, its opportunity for experiential learning combined with social and emotional growth and the enjoyment of the program. Connecting and learning together allowed for holistic relationships with students and the provision of more individualised support. Conclusions: DRUMBEAT has value for interprofessional group learning. Introducing a creative psycho-educational groupwork program such as DRUMBEAT supports students’ personal and professional growth and has the potential for enhancing learning and wellbeing. These are skills necessary for mindful collaboration and reflective practice, which are known to enhance quality experiences and outcomes for service users.

Health services respond to myriad practice standards and guidelines that regulate, monitor, and improve the safety and quality of healthcare. Although important, information overload and compliance fatigue for accreditation can be burdensome for service managers and clinicians. To address this, and ultimately improve the safety and quality of care, this case study demonstrates how a mapping exercise was completed to synthesise seven practice standards and guidelines relevant to palliative care; and develop an online resource to aid accreditation efforts and improve palliative care. A working group, comprised of service managers, clinicians, and academics, mapped a state-wide blueprint to improve palliative care against seven unique practice standards and guidelines, most of which were national in scope. This project culminated with a freely available online resource to translate the standards and guidelines for accreditation – a resource that supports service managers and clinicians across public and private health sectors to readily determine whether and how they demonstrated safety and quality in the context of palliative care and pursue accreditation. By developing one matrix, there is opportunity to alleviate information overload and compliance fatigue for service managers and clinicians. Despite its focus on palliative care, this case study demonstrates how to collaboratively map distinct practice standards and guidelines and form a resource to aid accreditation efforts to improve healthcare.

Aim: We aim to promote discussion about an Indigenous Cultural Identity of Research Authors Standard (ICIRAS) for academic journal publications. Context: This is based on a gap in research publishing practice where Indigenous peoples' identity is not systematically and rigorously flagged in rural health research publications. There are widespread reforms, in different research areas, to counter the reputation of scientific research as a vehicle of racism and discrimination against the world's Indigenous peoples. Reflecting on these broader movements, the editorial teams of three rural health journals-the Australian Journal of Rural Health, the Canadian Journal of Rural Medicine, and Rural and Remote Health-recognised that Indigenous peoples' identity could be embedded in authorship details. Approach: An environmental scan (through a cultural safety lens where Indigenous cultural authority is respected, valued, and empowered) of literature was undertaken to detect the signs of inclusion of Indigenous peoples in research. This revealed many ways in which editorial boards of Journals could systematically improve their process so that there is 'nothing about Indigenous people, without Indigenous people' in rural health research publications. Conclusion: Improving the health and wellbeing of Indigenous peoples worldwide requires high quality research evidence. The philosophy of cultural safety supports the purposeful positioning of Indigenous peoples within the kaleidoscope of cultural knowledges as identified contributors and authors of research evidence. The ICIRAS is a call-to-action for research journals and institutions to rigorously improve publication governance that signals "Editing with IndigenUs and for IndigenUs".

Changes in public health profiles and moves towards inclusive models of education have led to significant number of students in mainstream schools with special health needs. Addressing these needs requires collaboration between health professionals, educators and families. Integrated models of school-based health care can facilitate this collaboration; however, there is little evidence to guide their implementation. The School-Based Primary Health Care Service (SB-PHCS) is one such service that has been established in far west New South Wales. The School-Based Primary Health Care Service embeds health district-employed registered nurses with school learning support teams to increase service access, and improve health and education outcomes for students. We conducted focus groups with nurses and learning support teams to explore their experiences of implementing the School-Based Primary Health Care Service. Focus group transcripts were analysed using framework analysis. We found that defining the role and working across systems were challenges to program implementation, whereas a collaborative culture, relationship building and flexibility in work processes facilitated the integration of nurses into the school teams. We recommend others embarking on similar initiatives involve key stakeholders early in service development, understand each other’s systems and processes, and provide clarity about the new role, but plan to adapt the role to fit the context. This study will be of interest to those involved in the implementation of integrated models of school-based health care.