Delivery of preventive health services to Indigenous adults

response to a systems-oriented primary care quality improvement intervention

Damin Si, Ross Stewart Bailie, Michelle Dowden, L O'DONOGHUE, Christine Connors, Gary Robinson, Joan Cunningham, John Condon

    Research output: Contribution to journalArticleResearchpeer-review

    Abstract

    Objective: To describe changes in delivery of preventive services among adults in Aboriginal communities that occurred in association with a systems-oriented intervention. Design, setting and participants: A quality improvement intervention with a 2-year follow-up was undertaken at 12 Aboriginal community health centres in the Northern Territory between January 2002 and December 2005. The study involved 360 well adults aged 16-49 years who had no known diagnosis of chronic disease. Intervention: Two annual cycles of assessment, feedback workshops, action planning, and implementation of system changes. Assessment included a structured review of health service systems and an audit of clinical records. Main outcome measures: Adherence to guideline-scheduled preventive services including taking basic measurements, laboratory investigations, lifestyle counselling and pneumococcal vaccination. Results: Of 12 preventive services measured, delivery of four services showed improvement over the study period: counselling on diet increased from 3% to 8% (P = 0.018); counselling on physical activity from 2% to 8% (P = 0.006); counselling on smoking from 2% to 11% (P= 0.003); and counselling on alcohol from 2% to 10% (P = 0.007). There was no improvement in important measures such as monitoring of waist circumference, blood pressure and blood glucose level, and delivery of pneumococcal vaccination. Conclusion: Our systems-oriented intervention was associated with some improvement in counselling activities, but no significant improvement in delivery of other preventive services. The main reason may be that implementation focused more on chronic illness management than preventive services for generally well adults.
    Original languageEnglish
    Pages (from-to)453-457
    Number of pages5
    JournalMedical Journal of Australia
    Volume187
    Issue number8
    Publication statusPublished - 2007

    Fingerprint

    Preventive Health Services
    Quality Improvement
    Counseling
    Primary Health Care
    Vaccination
    Chronic Disease
    Northern Territory
    Clinical Audit
    Guideline Adherence
    Community Health Centers
    Waist Circumference
    Health Services
    Blood Glucose
    Life Style
    Smoking
    Alcohols
    Outcome Assessment (Health Care)
    Diet
    Blood Pressure
    Education

    Cite this

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    title = "Delivery of preventive health services to Indigenous adults: response to a systems-oriented primary care quality improvement intervention",
    abstract = "Objective: To describe changes in delivery of preventive services among adults in Aboriginal communities that occurred in association with a systems-oriented intervention. Design, setting and participants: A quality improvement intervention with a 2-year follow-up was undertaken at 12 Aboriginal community health centres in the Northern Territory between January 2002 and December 2005. The study involved 360 well adults aged 16-49 years who had no known diagnosis of chronic disease. Intervention: Two annual cycles of assessment, feedback workshops, action planning, and implementation of system changes. Assessment included a structured review of health service systems and an audit of clinical records. Main outcome measures: Adherence to guideline-scheduled preventive services including taking basic measurements, laboratory investigations, lifestyle counselling and pneumococcal vaccination. Results: Of 12 preventive services measured, delivery of four services showed improvement over the study period: counselling on diet increased from 3{\%} to 8{\%} (P = 0.018); counselling on physical activity from 2{\%} to 8{\%} (P = 0.006); counselling on smoking from 2{\%} to 11{\%} (P= 0.003); and counselling on alcohol from 2{\%} to 10{\%} (P = 0.007). There was no improvement in important measures such as monitoring of waist circumference, blood pressure and blood glucose level, and delivery of pneumococcal vaccination. Conclusion: Our systems-oriented intervention was associated with some improvement in counselling activities, but no significant improvement in delivery of other preventive services. The main reason may be that implementation focused more on chronic illness management than preventive services for generally well adults.",
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    Delivery of preventive health services to Indigenous adults : response to a systems-oriented primary care quality improvement intervention. / Si, Damin; Bailie, Ross Stewart; Dowden, Michelle; O'DONOGHUE, L; Connors, Christine; Robinson, Gary; Cunningham, Joan; Condon, John.

    In: Medical Journal of Australia, Vol. 187, No. 8, 2007, p. 453-457.

    Research output: Contribution to journalArticleResearchpeer-review

    TY - JOUR

    T1 - Delivery of preventive health services to Indigenous adults

    T2 - response to a systems-oriented primary care quality improvement intervention

    AU - Si, Damin

    AU - Bailie, Ross Stewart

    AU - Dowden, Michelle

    AU - O'DONOGHUE, L

    AU - Connors, Christine

    AU - Robinson, Gary

    AU - Cunningham, Joan

    AU - Condon, John

    PY - 2007

    Y1 - 2007

    N2 - Objective: To describe changes in delivery of preventive services among adults in Aboriginal communities that occurred in association with a systems-oriented intervention. Design, setting and participants: A quality improvement intervention with a 2-year follow-up was undertaken at 12 Aboriginal community health centres in the Northern Territory between January 2002 and December 2005. The study involved 360 well adults aged 16-49 years who had no known diagnosis of chronic disease. Intervention: Two annual cycles of assessment, feedback workshops, action planning, and implementation of system changes. Assessment included a structured review of health service systems and an audit of clinical records. Main outcome measures: Adherence to guideline-scheduled preventive services including taking basic measurements, laboratory investigations, lifestyle counselling and pneumococcal vaccination. Results: Of 12 preventive services measured, delivery of four services showed improvement over the study period: counselling on diet increased from 3% to 8% (P = 0.018); counselling on physical activity from 2% to 8% (P = 0.006); counselling on smoking from 2% to 11% (P= 0.003); and counselling on alcohol from 2% to 10% (P = 0.007). There was no improvement in important measures such as monitoring of waist circumference, blood pressure and blood glucose level, and delivery of pneumococcal vaccination. Conclusion: Our systems-oriented intervention was associated with some improvement in counselling activities, but no significant improvement in delivery of other preventive services. The main reason may be that implementation focused more on chronic illness management than preventive services for generally well adults.

    AB - Objective: To describe changes in delivery of preventive services among adults in Aboriginal communities that occurred in association with a systems-oriented intervention. Design, setting and participants: A quality improvement intervention with a 2-year follow-up was undertaken at 12 Aboriginal community health centres in the Northern Territory between January 2002 and December 2005. The study involved 360 well adults aged 16-49 years who had no known diagnosis of chronic disease. Intervention: Two annual cycles of assessment, feedback workshops, action planning, and implementation of system changes. Assessment included a structured review of health service systems and an audit of clinical records. Main outcome measures: Adherence to guideline-scheduled preventive services including taking basic measurements, laboratory investigations, lifestyle counselling and pneumococcal vaccination. Results: Of 12 preventive services measured, delivery of four services showed improvement over the study period: counselling on diet increased from 3% to 8% (P = 0.018); counselling on physical activity from 2% to 8% (P = 0.006); counselling on smoking from 2% to 11% (P= 0.003); and counselling on alcohol from 2% to 10% (P = 0.007). There was no improvement in important measures such as monitoring of waist circumference, blood pressure and blood glucose level, and delivery of pneumococcal vaccination. Conclusion: Our systems-oriented intervention was associated with some improvement in counselling activities, but no significant improvement in delivery of other preventive services. The main reason may be that implementation focused more on chronic illness management than preventive services for generally well adults.

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