Lifestyle management of hypertension : International Society of Hypertension position paper endorsed by the World Hypertension League and European Society of Hypertension
- Charchar, Fadi, Prestes, Priscilla, Mills, Charlotte, Ching, Siew, Neupane, Dinesh, Marques, Francine, Sharman, James, Vogt, Liffert, Burrell, Louise, Korostovtseva, Lyudmila, Zec, Manja, Patil, Mansi, Schultz, Martin, Wallen, Matthew, Renna, Nicolás, Islam, Sheikh, Hiremath, Swapnil, Gyeltshen, Tshewang, Chia, Yook-Chin, Gupta, Abhinav, Schutte, Aletta, Klein, Britt, Borghi, Claudio, Browning, Colette, Czesnikiewicz-Guzik, Marta, Lee, Hae-Young, Itoh, Hiroshi, Miura, Katsuyuki, Akinnibosun, Olutope, Shane Thomas
- Authors: Charchar, Fadi , Prestes, Priscilla , Mills, Charlotte , Ching, Siew , Neupane, Dinesh , Marques, Francine , Sharman, James , Vogt, Liffert , Burrell, Louise , Korostovtseva, Lyudmila , Zec, Manja , Patil, Mansi , Schultz, Martin , Wallen, Matthew , Renna, Nicolás , Islam, Sheikh , Hiremath, Swapnil , Gyeltshen, Tshewang , Chia, Yook-Chin , Gupta, Abhinav , Schutte, Aletta , Klein, Britt , Borghi, Claudio , Browning, Colette , Czesnikiewicz-Guzik, Marta , Lee, Hae-Young , Itoh, Hiroshi , Miura, Katsuyuki , Akinnibosun, Olutope , Shane Thomas
- Date: 2024
- Type: Text , Journal article
- Relation: Journal of hypertension Vol. 42, no. 1 (2024), p. 23-49
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- Description: Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliates “Fadi Charchar, Priscilla Prestes, Britt Klein, Colette Browning, Olutope Akinnibosun and Shane Thomas” are provided in this record**
- Description: Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliates “Fadi Charchar, Priscilla Prestes, Britt Klein, Colette Browning, Olutope Akinnibossun and Shane Thomas” are provided in this record**
- Authors: Charchar, Fadi , Prestes, Priscilla , Mills, Charlotte , Ching, Siew , Neupane, Dinesh , Marques, Francine , Sharman, James , Vogt, Liffert , Burrell, Louise , Korostovtseva, Lyudmila , Zec, Manja , Patil, Mansi , Schultz, Martin , Wallen, Matthew , Renna, Nicolás , Islam, Sheikh , Hiremath, Swapnil , Gyeltshen, Tshewang , Chia, Yook-Chin , Gupta, Abhinav , Schutte, Aletta , Klein, Britt , Borghi, Claudio , Browning, Colette , Czesnikiewicz-Guzik, Marta , Lee, Hae-Young , Itoh, Hiroshi , Miura, Katsuyuki , Akinnibosun, Olutope , Shane Thomas
- Date: 2024
- Type: Text , Journal article
- Relation: Journal of hypertension Vol. 42, no. 1 (2024), p. 23-49
- Full Text:
- Reviewed:
- Description: Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliates “Fadi Charchar, Priscilla Prestes, Britt Klein, Colette Browning, Olutope Akinnibosun and Shane Thomas” are provided in this record**
- Description: Hypertension, defined as persistently elevated systolic blood pressure (SBP) >140 mmHg and/or diastolic blood pressure (DBP) at least 90 mmHg (International Society of Hypertension guidelines), affects over 1.5 billion people worldwide. Hypertension is associated with increased risk of cardiovascular disease (CVD) events (e.g. coronary heart disease, heart failure and stroke) and death. An international panel of experts convened by the International Society of Hypertension College of Experts compiled lifestyle management recommendations as first-line strategy to prevent and control hypertension in adulthood. We also recommend that lifestyle changes be continued even when blood pressure-lowering medications are prescribed. Specific recommendations based on literature evidence are summarized with advice to start these measures early in life, including maintaining a healthy body weight, increased levels of different types of physical activity, healthy eating and drinking, avoidance and cessation of smoking and alcohol use, management of stress and sleep levels. We also discuss the relevance of specific approaches including consumption of sodium, potassium, sugar, fibre, coffee, tea, intermittent fasting as well as integrated strategies to implement these recommendations using, for example, behaviour change-related technologies and digital tools. **Please note that there are multiple authors for this article therefore only the name of the first 30 including Federation University Australia affiliates “Fadi Charchar, Priscilla Prestes, Britt Klein, Colette Browning, Olutope Akinnibossun and Shane Thomas” are provided in this record**
Identifying public healthcare priorities in virtual care for older adults : a participatory research study
- Pu, Dai, Palmer, Victoria, Greenstock, Louise, Pigott, Cathie, Peeters, Anna, Sanci, Lena, Callisaya, Michele, Browning, Colette, Chapman, Wendy, Haines, Terry
- Authors: Pu, Dai , Palmer, Victoria , Greenstock, Louise , Pigott, Cathie , Peeters, Anna , Sanci, Lena , Callisaya, Michele , Browning, Colette , Chapman, Wendy , Haines, Terry
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 20, no. 5 (2023), p.
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- Description: There has been increasing adoption and implementation of virtual healthcare in recent years, especially with COVID-19 impacting the world. As a result, virtual care initiatives may not undergo stringent quality control processes to ensure that they are appropriate to their context and meet sector needs. The two objectives of this study were to identify virtual care initiatives for older adults currently in use in Victoria and virtual care challenges that could be prioritised for further investigation and scale-up and to understand why certain virtual care initiatives and challenges are prioritised over others for investigation and scale-up. Methods: This project used an Emerging Design approach. A survey of public health services in the state of Victoria in Australia was first carried out, followed by the co-production of research and healthcare priorities with key stakeholders in the areas of primary care, hospital care, consumer representation, research, and government. The survey was used to gather existing virtual care initiatives for older adults and any associated challenges. Co-production processes consisted of individual ratings of initiatives and group-based discussions to identify priority virtual care initiatives and challenges to be addressed for future scale-up. Stakeholders nominated their top three virtual initiatives following discussions. Results: Telehealth was nominated as the highest priority initiative type for scaling up, with virtual emergency department models of care nominated as the highest priority within this category. Remote monitoring was voted as a top priority for further investigations. The top virtual care challenge was data sharing across services and settings, and the user-friendliness of virtual care platforms was nominated as the top priority for further investigation. Conclusions: Stakeholders prioritised public health virtual care initiatives that are easy to adopt and address needs that are perceived to be more immediate (acute more so than chronic care). Virtual care initiatives that incorporate more technology and integrated elements are valued, but more information is needed to inform their potential scale-up. © 2023 by the authors.
- Authors: Pu, Dai , Palmer, Victoria , Greenstock, Louise , Pigott, Cathie , Peeters, Anna , Sanci, Lena , Callisaya, Michele , Browning, Colette , Chapman, Wendy , Haines, Terry
- Date: 2023
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 20, no. 5 (2023), p.
- Full Text:
- Reviewed:
- Description: There has been increasing adoption and implementation of virtual healthcare in recent years, especially with COVID-19 impacting the world. As a result, virtual care initiatives may not undergo stringent quality control processes to ensure that they are appropriate to their context and meet sector needs. The two objectives of this study were to identify virtual care initiatives for older adults currently in use in Victoria and virtual care challenges that could be prioritised for further investigation and scale-up and to understand why certain virtual care initiatives and challenges are prioritised over others for investigation and scale-up. Methods: This project used an Emerging Design approach. A survey of public health services in the state of Victoria in Australia was first carried out, followed by the co-production of research and healthcare priorities with key stakeholders in the areas of primary care, hospital care, consumer representation, research, and government. The survey was used to gather existing virtual care initiatives for older adults and any associated challenges. Co-production processes consisted of individual ratings of initiatives and group-based discussions to identify priority virtual care initiatives and challenges to be addressed for future scale-up. Stakeholders nominated their top three virtual initiatives following discussions. Results: Telehealth was nominated as the highest priority initiative type for scaling up, with virtual emergency department models of care nominated as the highest priority within this category. Remote monitoring was voted as a top priority for further investigations. The top virtual care challenge was data sharing across services and settings, and the user-friendliness of virtual care platforms was nominated as the top priority for further investigation. Conclusions: Stakeholders prioritised public health virtual care initiatives that are easy to adopt and address needs that are perceived to be more immediate (acute more so than chronic care). Virtual care initiatives that incorporate more technology and integrated elements are valued, but more information is needed to inform their potential scale-up. © 2023 by the authors.
Virtual care initiatives for older adults in Australia : scoping review
- Savira, Feby, Gupta, Adyya, Gilbert, Cecily, Huggins, Catherine, Browning, Colette, Chapman, Wendy, Haines, Terry, Peeters, Anna
- Authors: Savira, Feby , Gupta, Adyya , Gilbert, Cecily , Huggins, Catherine , Browning, Colette , Chapman, Wendy , Haines, Terry , Peeters, Anna
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Journal of Medical Internet Research Vol. 25, no. (2023), p.
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- Description: Background: There has been a rapid shift toward the adoption of virtual health care services in Australia. It is unknown how widely virtual care has been implemented or evaluated for the care of older adults in Australia. Objective: We aimed to review the literature evaluating virtual care initiatives for older adults across a wide range of health conditions and modalities and identify key challenges and opportunities for wider adoption at both patient and system levels in Australia. Methods: A scoping review of the literature was conducted. We searched MEDLINE, Embase, PsycINFO, CINAHL, AgeLine, and gray literature (January 1, 2011, to March 8, 2021) to identify virtual care initiatives for older Australians (aged
- Authors: Savira, Feby , Gupta, Adyya , Gilbert, Cecily , Huggins, Catherine , Browning, Colette , Chapman, Wendy , Haines, Terry , Peeters, Anna
- Date: 2023
- Type: Text , Journal article , Review
- Relation: Journal of Medical Internet Research Vol. 25, no. (2023), p.
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- Description: Background: There has been a rapid shift toward the adoption of virtual health care services in Australia. It is unknown how widely virtual care has been implemented or evaluated for the care of older adults in Australia. Objective: We aimed to review the literature evaluating virtual care initiatives for older adults across a wide range of health conditions and modalities and identify key challenges and opportunities for wider adoption at both patient and system levels in Australia. Methods: A scoping review of the literature was conducted. We searched MEDLINE, Embase, PsycINFO, CINAHL, AgeLine, and gray literature (January 1, 2011, to March 8, 2021) to identify virtual care initiatives for older Australians (aged
Boundary crossers : how providers facilitate ethnic minority families' access to dementia services
- Brijnath, Bianca, Gilbert, Andrew, Antoniades, Josefine, Croy, Samantha, Kent, Mike, Ellis, Katie, Browning, Colette, Goeman, Dianne, Adams, Jon
- Authors: Brijnath, Bianca , Gilbert, Andrew , Antoniades, Josefine , Croy, Samantha , Kent, Mike , Ellis, Katie , Browning, Colette , Goeman, Dianne , Adams, Jon
- Date: 2022
- Type: Text , Journal article
- Relation: Journals of Gerontology - Series B Psychological Sciences and Social Sciences Vol. 77, no. 2 (2022), p. 396-406
- Full Text: false
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- Description: Objectives: Providers who work closely with ethnic minority people with dementia and their families are pivotal in helping them access services. However, few studies have examined how these providers actually do this work. Using the concept of "boundary crossers,"this article investigates the strategies applied by these providers to facilitate access to dementia services for ethnic minority people with dementia and their families. Methods: Between 2017 and 2020, in-depth video-recorded interviews were conducted with 27 health, aged care, and community service providers working with ethnic minority people living with dementia across Australia. Interviews were conducted in one of seven languages and/or in English, then translated and transcribed verbatim into English. The data were analyzed thematically. Results: Family and community stigma associated with dementia and extra-familial care were significant barriers to families engaging with services. To overcome these barriers, participants worked at the boundaries of culture and dementia, community and systems, strategically using English and other vernaculars, clinical and cultural terminology, building trust and rapport, and assisting with service navigation to improve access. Concurrently, they were cognizant of familial boundaries and were careful to provide services that were culturally appropriate without supplanting the families' role. Discussion: In negotiating cultural, social, and professional boundaries, providers undertake multidimensional and complex work that involves education, advocacy, negotiation, navigation, creativity, and emotional engagement. This work is largely undervalued but offers a model of care that facilitates social and community development as well as service integration across health, aged care, and social services. © 2021 The Author(s) 2021. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved.
Practice nurses’ communication with people living with type 2 diabetes : a scoping review
- Hills, Sharon, Terry, Daniel, Gazula, Swapnali, Browning, Colette
- Authors: Hills, Sharon , Terry, Daniel , Gazula, Swapnali , Browning, Colette
- Date: 2022
- Type: Text , Journal article , Review
- Relation: Patient Education and Counseling Vol. 105, no. 8 (2022), p. 2664-2670
- Full Text: false
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- Description: Objective: To identify the key characteristics of practice nurses’ communication with people living with Type 2 Diabetes (T2D) where lifestyle activities are discussed. Methods: A scoping review of the peer-reviewed literature was conducted. Reflexive thematic analysis was used to identify key themes that emerged. The PRISMA-ScR checklist was followed. Results: 25 studies were retained in the final review. Nurses who were committed to engaging in lifestyle discussions created supportive environments and built rapport to enable change conversations. However, this was present in just 20% of the studies. In most studies, (60%) nurses continued to use traditional health education communication styles, had little understanding of behaviour change theories, lacked skills in behaviour change counselling and were reluctant to engage in behaviour change discussions with people with T2D. Conclusions: Nurses require a deeper understanding of behavioural change theories and skills in behavioural counselling. Practice implications: Practice nurses have a unique opportunity to facilitate T2D remission by engaging in evidence-based behaviour change communication. A behaviour change training intervention is needed that recognises the environment of practice nurse consultations. It needs to be pragmatic and fully consider the enablers and barriers to addressing behaviour change in both the nurse and the person with T2D. © 2022
The experience of structural burden for culturally and linguistically diverse family carers of people living with dementia in Australia
- Gilbert, Andrew, Antoniades, Josefine, Croy, Samantha, Thodis, Antonia, Adams, Jon, Goeman, Dianne, Browning, Colette, Kent, Mike, Ellis, Katie, Brijnath, Bianca
- Authors: Gilbert, Andrew , Antoniades, Josefine , Croy, Samantha , Thodis, Antonia , Adams, Jon , Goeman, Dianne , Browning, Colette , Kent, Mike , Ellis, Katie , Brijnath, Bianca
- Date: 2022
- Type: Text , Journal article
- Relation: Health and Social Care in the community Vol. 30, no. 6 (2022), p. e4492-e4503
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- Description: Evidence suggests that family carers of culturally and linguistically diverse (CALD) people living with dementia experience higher stress and unmet need than the general Australian population. These disparities are often framed as the result of CALD communities failing to seek formal support. Challenging this, we draw on the concept of ‘structural burden’ to explore how the complexity of health and aged systems contribute to the burden that CALD carers experience. We conducted semi‐structured interviews with 104 family carers for CALD people with dementia in Australia, followed by thematic analysis of transcripts. Additional to structural burdens encountered by the general older population, CALD carers faced challenges understanding Australia's Anglo‐centric aged care system, locating culturally appropriate care and were required to translate the languages and operations of health and aged care systems into terms their family members understood. This burden was mitigated by the presence of ethno‐specific organisations and other navigation support. Australia's aged care system has moved towards centralised governance and consumer‐directed care provision. This system involves a confusing array of different programmes and levels, bureaucratic applications and long waiting times. Carers' encounters with these systems demonstrates how some CALD people are being left behind by the current aged care system. While ethno‐specific services can reduce this burden, not all CALD groups are represented. Consequently, improving access to dementia care among CALD populations requires entry point and navigation support that is culturally appropriate and linguistically accessible.
- Authors: Gilbert, Andrew , Antoniades, Josefine , Croy, Samantha , Thodis, Antonia , Adams, Jon , Goeman, Dianne , Browning, Colette , Kent, Mike , Ellis, Katie , Brijnath, Bianca
- Date: 2022
- Type: Text , Journal article
- Relation: Health and Social Care in the community Vol. 30, no. 6 (2022), p. e4492-e4503
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- Description: Evidence suggests that family carers of culturally and linguistically diverse (CALD) people living with dementia experience higher stress and unmet need than the general Australian population. These disparities are often framed as the result of CALD communities failing to seek formal support. Challenging this, we draw on the concept of ‘structural burden’ to explore how the complexity of health and aged systems contribute to the burden that CALD carers experience. We conducted semi‐structured interviews with 104 family carers for CALD people with dementia in Australia, followed by thematic analysis of transcripts. Additional to structural burdens encountered by the general older population, CALD carers faced challenges understanding Australia's Anglo‐centric aged care system, locating culturally appropriate care and were required to translate the languages and operations of health and aged care systems into terms their family members understood. This burden was mitigated by the presence of ethno‐specific organisations and other navigation support. Australia's aged care system has moved towards centralised governance and consumer‐directed care provision. This system involves a confusing array of different programmes and levels, bureaucratic applications and long waiting times. Carers' encounters with these systems demonstrates how some CALD people are being left behind by the current aged care system. While ethno‐specific services can reduce this burden, not all CALD groups are represented. Consequently, improving access to dementia care among CALD populations requires entry point and navigation support that is culturally appropriate and linguistically accessible.
The relationship between diabetes distress, medication taking, glycaemic control and self-management
- Alzubaidi, Hamzah, Sulieman, Hana, Mc Namara, Kevin, Samorinha, Catarina, Browning, Colette
- Authors: Alzubaidi, Hamzah , Sulieman, Hana , Mc Namara, Kevin , Samorinha, Catarina , Browning, Colette
- Date: 2022
- Type: Text , Journal article
- Relation: International Journal of Clinical Pharmacy Vol. 44, no. 1 (2022), p. 127-137
- Full Text: false
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- Description: Background Diabetes distress (DD) has broad-ranging effects on type 2 diabetes (T2DM) management and outcomes. DD research is scarce among ethnic minority groups, particularly Arabic-speaking immigrant communities. To improve outcomes for these vulnerable groups, healthcare providers, including pharmacists, need to understand modifiable predictors of DD. Aim To assess and compare DD and its association with medication-taking behaviours, glycaemic control, self-management, and psychosocial factors among first-generation Arabic-speaking immigrants and English-speaking patients of Anglo-Celtic background with diabetes, and determine DD predictors. Setting Various healthcare settings in Australia. Method A multicentre cross-sectional study was conducted. Adults with T2DM completed a survey comprised of validated tools. Glycated haemoglobin, blood pressure, and lipid profile were gathered from medical records. Multiple linear regression models were computed to assess the DD predictors. Main outcome measure Diabetes distress level. Results Data was analysed for 696 participants: 56.3% Arabic-speaking immigrants and 43.7% English-speaking patients. Compared with English-speaking patients, Arabic-speaking immigrants had higher DD, lower medication adherence, worse self-management and glycaemic control, and poorer health and clinical profile. The regression analysis demonstrated that higher DD in Arabic-speaking immigrants was associated with cost-related medication underuse and lower adherence to exercise, younger age, lower education level, unemployment, lower self-efficacy, and inadequate glycaemic control. Whereas among English-speaking patients, higher DD was associated with both cost- and non-cost-related underuse of medication and lower dietary adherence. Conclusion Results provided new insights to guide healthcare providers on reducing the apparent excess burden of DD among Arabic-speaking immigrants and potentially improve medication adherence, glycaemic control, and self-management. © 2021, The Author(s), under exclusive licence to Springer Nature Switzerland AG.
- Brijnath, Bianca, Gilbert, Andrew, Kent, Mike, Ellis, Katie, Browning, Colette
- Authors: Brijnath, Bianca , Gilbert, Andrew , Kent, Mike , Ellis, Katie , Browning, Colette
- Date: 2021
- Type: Text , Journal article
- Relation: Dementia Vol. 20, no. 6 (2021), p. 1910-1924
- Full Text: false
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- Description: The ‘family crisis’ narrative is frequently used in dementia studies to explain ethnic minority families’ pathways to health and aged care and why there is delayed dementia diagnoses in ethnic minority communities. Such narratives may obscure the family carers’ agency in negotiating services and managing personal, social and structural burdens in the lead up to diagnosis. To illuminate agency, this article describes ethnic minority families’ pathways to a dementia diagnosis using the concept of sense-making. Three case studies were drawn from 56 video interviews with family carers of older adults with dementia from Chinese, Arab and Indian backgrounds. Interviews were conducted across Australia from February to August 2018, then translated, transcribed and thematically analysed. Findings suggest families did not enter into formal care because of a crisis, instead navigating fragmented systems and conflicting advice to obtain a dementia diagnosis and access to relevant care. This experience was driven by sense-making (a search for plausible explanations) that involved family carers interpreting discrepant cues in changes to the behaviour of the person with dementia over time, managing conflicting (medical) advice about these discrepancies and reinterpreting their relationships with hindsight. The sense-making concept offers a more constructive hermeneutic than the ‘family crisis’ narrative as it illuminates the agency of carers’ in understanding changed behaviours, negotiating services and managing personal, social and structural barriers pre-diagnosis. The concept also demonstrates the need for a multimodal approach to promoting timely diagnosis of dementia in ethnic minority communities through dementia awareness and literacy campaigns as well as initiatives that address structural inequities. © The Author(s) 2020. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Colette Browning” is provided in this record**
Use of medical services by older Australian women with dementia : a longitudinal cohort study
- Byles, Julie, Cavenagh, Dominica, Bryant, Jamie, Mazza, Danielle, Browning, Colette, O'Loughlin,Sally
- Authors: Byles, Julie , Cavenagh, Dominica , Bryant, Jamie , Mazza, Danielle , Browning, Colette , O'Loughlin,Sally
- Date: 2021
- Type: Text , Journal article
- Relation: Australian and New Zealand Journal of Public Health Vol. 45, no. 5 (2021), p. 497-503
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- Description: Objective: To assess the use of Medicare-subsidised health services by women with and without dementia. Methods: Data from women of the 1921–26 birth cohort of the Australian Longitudinal Study on Women's Health were linked to various administrative datasets to ascertain dementia diagnosis. The use of subsidised general practitioner (GP) services (75+ health assessments [HAs], chronic disease management meetings [CDMs], multidisciplinary case conferences [MCCs]) and specialist and allied health services between 2000 and 2013 for these women was analysed using longitudinal GEE models. Results: A total of 9,683 women were included with 1,444 (15%) women identified as having dementia. Compared to women with no dementia indication, women with dementia had more yearly non-emergency GP attendances (short [<30 minutes] IRR=1.11 [1.07, 1.13]; long [>30 minutes] IRR=1.11 [1.04, 1.19]) and fewer specialist attendances (IRR=0.91 [0.85, 0.97]) and were more likely to have an emergency GP attendance (OR=2.29 [2.05, 2.57]). There were no significant differences in the odds of having either a HA or CDM or using allied health services for women with and without dementia indicators. Conclusions: The overall use of services designed to improve the prevention and coordination of the care of older people with chronic conditions was low. Women with dementia were no more likely to access these services. Implications for public health: There is underuse of some primary and allied healthcare services designed for people with complex chronic conditions. These could be better used by women with dementia to improve the management of complex comorbidities (e.g. CDMs), to prevent the onset of disability (e.g. physiotherapy), and enhance needs assessment and service access (e.g. HAs). © 2021 The Authors. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Colette Browning” is provided in this record**
- Authors: Byles, Julie , Cavenagh, Dominica , Bryant, Jamie , Mazza, Danielle , Browning, Colette , O'Loughlin,Sally
- Date: 2021
- Type: Text , Journal article
- Relation: Australian and New Zealand Journal of Public Health Vol. 45, no. 5 (2021), p. 497-503
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- Description: Objective: To assess the use of Medicare-subsidised health services by women with and without dementia. Methods: Data from women of the 1921–26 birth cohort of the Australian Longitudinal Study on Women's Health were linked to various administrative datasets to ascertain dementia diagnosis. The use of subsidised general practitioner (GP) services (75+ health assessments [HAs], chronic disease management meetings [CDMs], multidisciplinary case conferences [MCCs]) and specialist and allied health services between 2000 and 2013 for these women was analysed using longitudinal GEE models. Results: A total of 9,683 women were included with 1,444 (15%) women identified as having dementia. Compared to women with no dementia indication, women with dementia had more yearly non-emergency GP attendances (short [<30 minutes] IRR=1.11 [1.07, 1.13]; long [>30 minutes] IRR=1.11 [1.04, 1.19]) and fewer specialist attendances (IRR=0.91 [0.85, 0.97]) and were more likely to have an emergency GP attendance (OR=2.29 [2.05, 2.57]). There were no significant differences in the odds of having either a HA or CDM or using allied health services for women with and without dementia indicators. Conclusions: The overall use of services designed to improve the prevention and coordination of the care of older people with chronic conditions was low. Women with dementia were no more likely to access these services. Implications for public health: There is underuse of some primary and allied healthcare services designed for people with complex chronic conditions. These could be better used by women with dementia to improve the management of complex comorbidities (e.g. CDMs), to prevent the onset of disability (e.g. physiotherapy), and enhance needs assessment and service access (e.g. HAs). © 2021 The Authors. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Colette Browning” is provided in this record**
Older women in australia : facing the challenges of dual sensory loss
- Heine, Chyrisse, Gong, Cathy, Feldman, Susan, Browning, Colette
- Authors: Heine, Chyrisse , Gong, Cathy , Feldman, Susan , Browning, Colette
- Date: 2020
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 17, no. 1 (2020), p.
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- Description: With the increase in longevity, the number of women living into old age is rising and higher than that of men. Data was derived from the Melbourne Longitudinal Studies on Healthy Ageing Program, which included 533 women and 467 men aged 65 years and older, in Australia, over 10 years. Logistic regression modeling was used to investigate the prevalence of dual sensory loss and the unmet needs for vision and hearing devices in older women (compared to men) over time, as well as its impacts on self-reported general health, depression, perceived social activities, community service use and ageing in place. Results suggested that the prevalence of dual sensory loss increased for women from the age of 75 years and over. Dual sensory loss was higher for older women and men who were living alone, with government benefits as their main income source or were divorced, separated or widowed. Dual sensory loss had significant impacts on poor general health, perceived inadequate social activities and community service use for women and men and on depression for women only. Early identification of dual sensory loss is essential to minimize its effects, ensuring continued well-being for this population. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.
- Authors: Heine, Chyrisse , Gong, Cathy , Feldman, Susan , Browning, Colette
- Date: 2020
- Type: Text , Journal article
- Relation: International Journal of Environmental Research and Public Health Vol. 17, no. 1 (2020), p.
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- Description: With the increase in longevity, the number of women living into old age is rising and higher than that of men. Data was derived from the Melbourne Longitudinal Studies on Healthy Ageing Program, which included 533 women and 467 men aged 65 years and older, in Australia, over 10 years. Logistic regression modeling was used to investigate the prevalence of dual sensory loss and the unmet needs for vision and hearing devices in older women (compared to men) over time, as well as its impacts on self-reported general health, depression, perceived social activities, community service use and ageing in place. Results suggested that the prevalence of dual sensory loss increased for women from the age of 75 years and over. Dual sensory loss was higher for older women and men who were living alone, with government benefits as their main income source or were divorced, separated or widowed. Dual sensory loss had significant impacts on poor general health, perceived inadequate social activities and community service use for women and men and on depression for women only. Early identification of dual sensory loss is essential to minimize its effects, ensuring continued well-being for this population. © 2019 by the authors. Licensee MDPI, Basel, Switzerland.
- Mariño, Rodrigo, Enticott, Joanne, Browning, Colette, Elsamman, Mahmoud, Etzion, Rachel, Ferooz, Maryam, Fujihara, Ryuun, Hancock, Hugo, He, Julian, Kendig, Hal
- Authors: Mariño, Rodrigo , Enticott, Joanne , Browning, Colette , Elsamman, Mahmoud , Etzion, Rachel , Ferooz, Maryam , Fujihara, Ryuun , Hancock, Hugo , He, Julian , Kendig, Hal
- Date: 2020
- Type: Text , Journal article
- Relation: Journal of Public Health Dentistry Vol. 80, no. 3 (2020), p. 177-185
- Full Text: false
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- Description: Objectives: This study aimed to investigate oral health-related factors affecting the self-assessed psychological well-being (PW) and depressive symptoms of independent-living Australians aged 79 years and over living in the community in metropolitan Melbourne. Methods: The Melbourne Longitudinal Studies on Healthy Aging (MELSHA) program was used as the data source in this study and includes data on the health and well-being of older participants. The MELSHA baseline data collection occurred in 1994, the current study used data from the 2008 data collection and included 201 participants, who remained in the study. Data were analyzed using multiple linear regression (MLR) analysis with a stepwise procedure to identify the variables that accounted for a significant proportion of the variance in the participants' PW scores. Results: Present findings indicate that oral health may play a significant mediating role in PW through maintaining a presentable and acceptable physical appearance. Some 16.4 percent of participants reported feeling concerned about their dental appearance, either “Sometimes,” “Often,” or “Very often.” Multivariate analysis showed significantly influences on PW positive and negative affect scores (P ' 0.0001); and depressive symptoms (P ' 0.0001) by participants' dentition status, enjoyment of meals, self-reported feeling of concern about the appearance of the mouth, social activity and self-assessment of general health. Final models explained 17.8, 20.1, and 24.6 percent of the variance of PW positive, negative affect scores, and depressive symptoms, respectively. Conclusions: Oral health, specifically the appearance of the mouth and dentition, plays a significant role in the PW of older Melbournians. Future cross-sectional and longitudinal studies are indicated to raise awareness on the changes required to improve the quality of life of the older population. © 2020 American Association of Public Health Dentistry
- Description: Funding details: National Health and Medical Research Council, NHMRC, 148625, 219295
The development of a competency assessment standard for general practitioners in China
- Rao, Xin, Lai, Jinming, Wu, Hua, Li, Yang, Xu, Xingzhi, Browning, Colette, Thomas, Shane
- Authors: Rao, Xin , Lai, Jinming , Wu, Hua , Li, Yang , Xu, Xingzhi , Browning, Colette , Thomas, Shane
- Date: 2020
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 8, no. (2020), p.
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- Description: This paper describes the development of a competency assessment standard for General Practitioners in Shenzhen, China. The standard is to be used for developing and delivering the training curriculum for General Practitioners and to enable rigorous assessment of the mastery of the standards by GP trainees. The requirement for the training of General Practitioners in China is mandated by government policy requires an international standard curriculum to meet the needs of patients and the community. A modified Delphi process was employed to arrive at a curriculum consensus. An expert panel and 14 expert working groups derived from the expert panel were established to review and evaluate national and international competency standards for General Practice and develop a set of standards, through a modified Delphi methodology. Forty three experts were involved in the project. The project resulted in a detailed curriculum statement. The curriculum was then used in 2017 and 2018 where pilot examinations of GP trainees (n = 298 and n = 315, respectively) were conducted to assess the trainee's competencies against the Standards. The examination included two modules, a written test (Module A) and a practical test (Module B). The success rate for participants was relatively low with the majority not successfully completing the assessments. The assessments will be further refined in subsequent work. The project achieved its goal of developing a rigorously evaluated standard to support clinical practice and the training and assessment of GPs. © Copyright © 2020 Rao, Lai, Wu, Li, Xu, Browning and Thomas.
- Authors: Rao, Xin , Lai, Jinming , Wu, Hua , Li, Yang , Xu, Xingzhi , Browning, Colette , Thomas, Shane
- Date: 2020
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 8, no. (2020), p.
- Full Text:
- Reviewed:
- Description: This paper describes the development of a competency assessment standard for General Practitioners in Shenzhen, China. The standard is to be used for developing and delivering the training curriculum for General Practitioners and to enable rigorous assessment of the mastery of the standards by GP trainees. The requirement for the training of General Practitioners in China is mandated by government policy requires an international standard curriculum to meet the needs of patients and the community. A modified Delphi process was employed to arrive at a curriculum consensus. An expert panel and 14 expert working groups derived from the expert panel were established to review and evaluate national and international competency standards for General Practice and develop a set of standards, through a modified Delphi methodology. Forty three experts were involved in the project. The project resulted in a detailed curriculum statement. The curriculum was then used in 2017 and 2018 where pilot examinations of GP trainees (n = 298 and n = 315, respectively) were conducted to assess the trainee's competencies against the Standards. The examination included two modules, a written test (Module A) and a practical test (Module B). The success rate for participants was relatively low with the majority not successfully completing the assessments. The assessments will be further refined in subsequent work. The project achieved its goal of developing a rigorously evaluated standard to support clinical practice and the training and assessment of GPs. © Copyright © 2020 Rao, Lai, Wu, Li, Xu, Browning and Thomas.
The inter-relationship of diversity principles for the enhanced participation of older people in their care : a qualitative study
- Ogrin, Rajna, Meyer, Claudia, Appannah, Arti, McMillan, Sally, Browning, Colette
- Authors: Ogrin, Rajna , Meyer, Claudia , Appannah, Arti , McMillan, Sally , Browning, Colette
- Date: 2020
- Type: Text , Journal article
- Relation: International Journal for Equity in Health Vol. 19, no. 1 (2020), p.
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- Description: Background: The health and aged care workforce must understand and support the diverse needs of older people to enhance their care experience. We previously identified five principles of diversity training for this workforce: awareness of unconscious bias and prejudice; promotion of inclusion; access and equity; appropriate engagement; and intersectionality. This study aims to explore how these principles are considered from the perspectives of older Australians. Methods: Older people (≥65 years) receiving home care and nursing services based in Victoria, Australia were invited to participate in a home-based semi-structured interview about their experience of, or with, diversity. Interviews were thematically analysed using a priori categories based on our previous work on principles of diversity training, and themes were interpreted and expanded upon based on the participants' experiences and understanding of diversity concepts and their care needs. Results: Fifteen older people (seven female, eight male), mean age 76 years (range 71-85 years), were interviewed. Five themes were drawn from the data. It was found that human connection through building (1) trust and rapport was highly valued as an approach by older people, crucial as a first step to understanding what is important to the older person. Identifying with (2) intersectionality, that is, the different intersecting aspects of who they are and their experiences was understood by the participants as an important framework to meet their needs. The participants were aware of (3) unconscious bias and prejudice by health professionals and its impact on their care. Participants also noted that (4) promotion of inclusion through language was important to for a positive relationship with the healthcare worker. The participants understood that to facilitate human connection, these four principles of human interaction were critical, underpinned by (5) access and equity of the system. A model articulating these relationships was developed. Conclusion: Health and aged care training should incorporate the five diversity principles to support older people to participate in their own care. © 2020 The Author(s).
- Authors: Ogrin, Rajna , Meyer, Claudia , Appannah, Arti , McMillan, Sally , Browning, Colette
- Date: 2020
- Type: Text , Journal article
- Relation: International Journal for Equity in Health Vol. 19, no. 1 (2020), p.
- Full Text:
- Reviewed:
- Description: Background: The health and aged care workforce must understand and support the diverse needs of older people to enhance their care experience. We previously identified five principles of diversity training for this workforce: awareness of unconscious bias and prejudice; promotion of inclusion; access and equity; appropriate engagement; and intersectionality. This study aims to explore how these principles are considered from the perspectives of older Australians. Methods: Older people (≥65 years) receiving home care and nursing services based in Victoria, Australia were invited to participate in a home-based semi-structured interview about their experience of, or with, diversity. Interviews were thematically analysed using a priori categories based on our previous work on principles of diversity training, and themes were interpreted and expanded upon based on the participants' experiences and understanding of diversity concepts and their care needs. Results: Fifteen older people (seven female, eight male), mean age 76 years (range 71-85 years), were interviewed. Five themes were drawn from the data. It was found that human connection through building (1) trust and rapport was highly valued as an approach by older people, crucial as a first step to understanding what is important to the older person. Identifying with (2) intersectionality, that is, the different intersecting aspects of who they are and their experiences was understood by the participants as an important framework to meet their needs. The participants were aware of (3) unconscious bias and prejudice by health professionals and its impact on their care. Participants also noted that (4) promotion of inclusion through language was important to for a positive relationship with the healthcare worker. The participants understood that to facilitate human connection, these four principles of human interaction were critical, underpinned by (5) access and equity of the system. A model articulating these relationships was developed. Conclusion: Health and aged care training should incorporate the five diversity principles to support older people to participate in their own care. © 2020 The Author(s).
Food, eating, and happy aging : the perceptions of older Chinese people
- Browning, Colette, Qiu, Zeqi, Yang, Hui, Zhang, Touhong, Thomas, Shane
- Authors: Browning, Colette , Qiu, Zeqi , Yang, Hui , Zhang, Touhong , Thomas, Shane
- Date: 2019
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 7, no. APR (2019), p.
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- Description: China's government and its people have for a long time focused on food security for its population as one of the most important issues in economic and social development. Many older people in China have lived in times when food security was not stable. Thus, while food has a central position in Chinese culture for all Chinese people, it is of particular pertinence to older people. In this paper we explore the meaning of food and eating in the lives of older Chinese people in China and how it contributes to healthy, thus happy aging. Focus groups and qualitative interviews were used in this study. Participants were recruited from the rural Yongfu Province of Southwest China, and the urban Fangzhuang and Haidan districts in Beijing. Forty-two participants were recruited aged 62-83 years of age. All focus groups and interviews were conducted in Mandarin and audiotaped with the participants' permission. Audio-tapes were transcribed by a Chinese speaking researcher and then were translated into English. Data were analyzed continuously and comparatively, transcripts were coded, and themes and sub-themes were identified. The initial analysis and interpretation were then presented and discussed at a workshop with all the authors. Two major themes emerged-the quantity of food and the quality of food required to have a happy old age. Participants discussed the desire to eat "until you are full" because of their experiences of famine during childhood. However, they also believed that as an older person they should eat less for their health, particularly less high fat foods. The importance of the food quality and food affordability was also discussed. Grain and meat were characterized as "good" foods and important in their diets for a happy old age. The participants, especially those from urban areas, were concerned with food safety. The high cultural importance of food for older Chinese in China was confirmed in this study. Social and economic lifespan experiences continue to impact on the food and eating attitudes and practices of older Chinese. The food related life experiences of older Chinese in China are quite different from younger Chinese and health promotion messaging needs to be informed by these unique perspectives in order to maximize its effectiveness. © 2019 Browning, Qiu, Yang, Zhang and Thomas.
- Authors: Browning, Colette , Qiu, Zeqi , Yang, Hui , Zhang, Touhong , Thomas, Shane
- Date: 2019
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 7, no. APR (2019), p.
- Full Text:
- Reviewed:
- Description: China's government and its people have for a long time focused on food security for its population as one of the most important issues in economic and social development. Many older people in China have lived in times when food security was not stable. Thus, while food has a central position in Chinese culture for all Chinese people, it is of particular pertinence to older people. In this paper we explore the meaning of food and eating in the lives of older Chinese people in China and how it contributes to healthy, thus happy aging. Focus groups and qualitative interviews were used in this study. Participants were recruited from the rural Yongfu Province of Southwest China, and the urban Fangzhuang and Haidan districts in Beijing. Forty-two participants were recruited aged 62-83 years of age. All focus groups and interviews were conducted in Mandarin and audiotaped with the participants' permission. Audio-tapes were transcribed by a Chinese speaking researcher and then were translated into English. Data were analyzed continuously and comparatively, transcripts were coded, and themes and sub-themes were identified. The initial analysis and interpretation were then presented and discussed at a workshop with all the authors. Two major themes emerged-the quantity of food and the quality of food required to have a happy old age. Participants discussed the desire to eat "until you are full" because of their experiences of famine during childhood. However, they also believed that as an older person they should eat less for their health, particularly less high fat foods. The importance of the food quality and food affordability was also discussed. Grain and meat were characterized as "good" foods and important in their diets for a happy old age. The participants, especially those from urban areas, were concerned with food safety. The high cultural importance of food for older Chinese in China was confirmed in this study. Social and economic lifespan experiences continue to impact on the food and eating attitudes and practices of older Chinese. The food related life experiences of older Chinese in China are quite different from younger Chinese and health promotion messaging needs to be informed by these unique perspectives in order to maximize its effectiveness. © 2019 Browning, Qiu, Yang, Zhang and Thomas.
Non-communicable diseases and cognitive impairment : pathways and shared behavioral risk factors among older Chinese
- Yiengprugsawan, Vasoontara, Browning, Colette
- Authors: Yiengprugsawan, Vasoontara , Browning, Colette
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Frontiers in Public Health Vol. 7, no. (Oct 2019), p. 7
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- Description: Population aging has brought about a number of challenges to public health and primary health care systems due to increases in the prevalence of non-communicable diseases (NCDs). As a country with one of the largest populations globally, China is confronting a rising number of chronic NCDs including cardiometabolic related conditions. This mini-review investigates the link between NCDs and cognitive impairment through common risk factors. Identifying risk factors is important for the prevention and management of these chronic conditions. In addition, this review also identifies the role of primary health care services in reducing behavioral risk factors for NCDs and cognitive impairment. Addressing shared determinants and pathways is important in the design of public health interventions and primary health care services in China. Monitoring and management of NCD biomarkers and behavioral risk factors may also be beneficial for cognitive health among older Chinese.
- Authors: Yiengprugsawan, Vasoontara , Browning, Colette
- Date: 2019
- Type: Text , Journal article , Review
- Relation: Frontiers in Public Health Vol. 7, no. (Oct 2019), p. 7
- Full Text:
- Reviewed:
- Description: Population aging has brought about a number of challenges to public health and primary health care systems due to increases in the prevalence of non-communicable diseases (NCDs). As a country with one of the largest populations globally, China is confronting a rising number of chronic NCDs including cardiometabolic related conditions. This mini-review investigates the link between NCDs and cognitive impairment through common risk factors. Identifying risk factors is important for the prevention and management of these chronic conditions. In addition, this review also identifies the role of primary health care services in reducing behavioral risk factors for NCDs and cognitive impairment. Addressing shared determinants and pathways is important in the design of public health interventions and primary health care services in China. Monitoring and management of NCD biomarkers and behavioral risk factors may also be beneficial for cognitive health among older Chinese.
Perspectives on the training of Chinese Primary Health Care Physicians to reduce chronic illnesses and their burden
- Sun, Wenmin, Li, Yang, Hu, Yitting, Rao, Xin, Xu, Xingzhi, Browning, Colette, Thomas, Shane
- Authors: Sun, Wenmin , Li, Yang , Hu, Yitting , Rao, Xin , Xu, Xingzhi , Browning, Colette , Thomas, Shane
- Date: 2019
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 7, no. (2019), p. 1-7
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- Description: This paper is a commentary on the training of Chinese Primary Health Care Doctors to reduce chronic illness and its burden. First, we will consider the policy position of the Chinese government concerning the development of a competent and enlarged primary physician workforce to deliver the proposed primary health care system reforms. We then turn to a review of the drivers of the high burden of chronic illnesses especially in older people in China. We argue that the curriculum for the training of primary health care medical practitioners should match the demonstrated high prevalence chronic illnesses and their risk factors and that there needs to specific competencies in prevention and mitigation of the diseases and their risk factors.
- Authors: Sun, Wenmin , Li, Yang , Hu, Yitting , Rao, Xin , Xu, Xingzhi , Browning, Colette , Thomas, Shane
- Date: 2019
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 7, no. (2019), p. 1-7
- Full Text:
- Reviewed:
- Description: This paper is a commentary on the training of Chinese Primary Health Care Doctors to reduce chronic illness and its burden. First, we will consider the policy position of the Chinese government concerning the development of a competent and enlarged primary physician workforce to deliver the proposed primary health care system reforms. We then turn to a review of the drivers of the high burden of chronic illnesses especially in older people in China. We argue that the curriculum for the training of primary health care medical practitioners should match the demonstrated high prevalence chronic illnesses and their risk factors and that there needs to specific competencies in prevention and mitigation of the diseases and their risk factors.
Effect of a health coach intervention for the management of individuals with type 2 diabetes mellitus in China : a pragmatic cluster randomized controlled trial
- Chapman, Anna, Browning, Colette, Enticott, Joanne, Yang, Hui, Liu, Shuo, Zhang, Tuohong, Thomas, Shane
- Authors: Chapman, Anna , Browning, Colette , Enticott, Joanne , Yang, Hui , Liu, Shuo , Zhang, Tuohong , Thomas, Shane
- Date: 2018
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 6, (2018)
- Full Text:
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- Description: Aim: To determine the effect of a health coach intervention for the management of glycemic control, as well as physiological, psychological and self-care outcomes of patients with type 2 diabetes mellitus (T2DM), compared with usual care. Methods:This pragmatic cluster RCT was conducted in the Fengtai district of Beijing from August 2011 to December 2013. Forty-one community health stations (CHSs) were cluster randomized (stratified geographically, 1:1 ratio) and eligible, randomly selected T2DM patients were sequentially contacted by CHSs. Control participants received usual care according to the Chinese Guideline for Diabetes Prevention and Management. Intervention participants received 18-months of health coaching based on principles of Motivational Interviewing (MI) plus usual care. Medical and pathology fees were waived for both groups. Outcome assessment was performed at baseline, 6, 12, and 18-months. The primary outcome was glycated hemoglobin (HbA1c); secondary outcomes encompassed a suite of physiological, psychological and self-care measures. Results:No differential treatment effect was found at 18-months for HbA1c (adj. difference -0.07, 95% CI -0.53 to 0.39, p = 0.769) or any specified secondary outcomes. Interestingly, both groups displayed a statistically and clinically significant within-group improvement of the same magnitude at 18-months for HbA1c (intervention: mean change -3.65, 95% CI -3.92 to -3.37; control: mean change -3.38, 95% CI -3.67 to -3.08). Conclusions:The lack of differential treatment effects observed indicate that it may be premature to recommend the routine delivery of health coach interventions based on MI principles for the management of T2DM in China. However, the large, comparable within-group improvement in mean HbA1c promotes the establishment of free, regular clinical health assessments for individuals with T2DM in China. © 2018 Chapman, Browning, Enticott, Yang, Liu, Zhang and Thomas.
- Authors: Chapman, Anna , Browning, Colette , Enticott, Joanne , Yang, Hui , Liu, Shuo , Zhang, Tuohong , Thomas, Shane
- Date: 2018
- Type: Text , Journal article
- Relation: Frontiers in Public Health Vol. 6, (2018)
- Full Text:
- Reviewed:
- Description: Aim: To determine the effect of a health coach intervention for the management of glycemic control, as well as physiological, psychological and self-care outcomes of patients with type 2 diabetes mellitus (T2DM), compared with usual care. Methods:This pragmatic cluster RCT was conducted in the Fengtai district of Beijing from August 2011 to December 2013. Forty-one community health stations (CHSs) were cluster randomized (stratified geographically, 1:1 ratio) and eligible, randomly selected T2DM patients were sequentially contacted by CHSs. Control participants received usual care according to the Chinese Guideline for Diabetes Prevention and Management. Intervention participants received 18-months of health coaching based on principles of Motivational Interviewing (MI) plus usual care. Medical and pathology fees were waived for both groups. Outcome assessment was performed at baseline, 6, 12, and 18-months. The primary outcome was glycated hemoglobin (HbA1c); secondary outcomes encompassed a suite of physiological, psychological and self-care measures. Results:No differential treatment effect was found at 18-months for HbA1c (adj. difference -0.07, 95% CI -0.53 to 0.39, p = 0.769) or any specified secondary outcomes. Interestingly, both groups displayed a statistically and clinically significant within-group improvement of the same magnitude at 18-months for HbA1c (intervention: mean change -3.65, 95% CI -3.92 to -3.37; control: mean change -3.38, 95% CI -3.67 to -3.08). Conclusions:The lack of differential treatment effects observed indicate that it may be premature to recommend the routine delivery of health coach interventions based on MI principles for the management of T2DM in China. However, the large, comparable within-group improvement in mean HbA1c promotes the establishment of free, regular clinical health assessments for individuals with T2DM in China. © 2018 Chapman, Browning, Enticott, Yang, Liu, Zhang and Thomas.
Trajectories of ageing well among older Australians : a 16-year longitudinal study
- Browning, Colette, Enticott, Joanne, Thomas, Shane, Kendig, Hal
- Authors: Browning, Colette , Enticott, Joanne , Thomas, Shane , Kendig, Hal
- Date: 2018
- Type: Text , Journal article
- Relation: Ageing and Society Vol. 38, no. 8 (2018), p. 1581-1602
- Full Text: false
- Reviewed:
- Description: In this study we used individual differences concepts and analyses to examine whether older people achieve different ageing-well states universally or whether there are identifiable key groups that achieve them to different extents. The data used in the modelling were from a prospective 16-year longitudinal study of 1,000 older Australians. We examined predictors of trajectories for ageing well using self-rated health, psychological wellbeing and independence in daily living as joint indicators of ageing well in people aged over 65 years at baseline. We used group-trajectory modelling and multivariate regression to identify characteristics predicting 'ageing well'. The results showed three distinct and sizeable ageing trajectory groups: (a) 'stable-good ageing well' (classified as ageing well in all longitudinal study waves; which was achieved by 30.2% of women and 28.0% of men); (b) 'initially ageing well then deteriorating' (50.5% women and 47.6% men); and (c) 'stable-poor' (not ageing well in any wave; 19.3% women and 24.4% men). Significant gender differences were found in membership in different ageing-well states. In the stable-poor groups there were 103/533 females which was significantly lower than 114/467 men (z-statistic = -2.6, p = 0.005); women had a 'zero' probability of progressing to a better ageing-well classification in later years, whilst males had a one-in-five probability of actually improving. Robust final state outcome predictors at baseline were lower age and fewer medical conditions for both genders; restful sleep and Australian-born for women; and good nutrition, decreased strain, non-smoker and good social support for men. These results support that ageing-well trajectories are influenced by modifiable factors. Findings will assist better targeting of health-promoting activities for older people. © Cambridge University Press 2017.
Ageing in Australia - Challenges and Opportunities
- O'Loughlin, Kate, Browning, Colette, Kendig, Hal
- Authors: O'Loughlin, Kate , Browning, Colette , Kendig, Hal
- Date: 2017
- Type: Text , Book
- Full Text: false
- Reviewed:
- Description: This stimulating volume examines the many faces of Australias ageing population, the social and health issues they contend with, and the steps being takenand many that should be takento help ensure a more positive and productive later life. Individual and societal ageing are conceptualized as developmental in nature, socially diverse, and marked by daily life challenges stemming from the countrys economic structures, attitudes, geography, political landscape, and infrastructure. Wide-ranging coverage (e.g., health, inequalities, employment, transportation) assesses options available to older people, and the role of families, employers, service providers, government agencies, and others in promoting or expanding those choices. The books double emphasis on challenges in older peoples lives and opportunities for enhancing their quality of life is on clear display as case studies examine policy issuesand propose solutionsin a societal and individual context. Included in the coverage: · Australian developments in ageing: issues and history · Cultural diversity, health, and ageing · Indigenous Australians and ageing: responding to diversity in policy and practice · Enhancing the health and employment participation of older workers · Housing and the environments of ageing · Health services and care for older people The rich examples in Ageing in Australia contain a depth of understanding and evidence for sociologists, gerontologists and psychologists studying ageing, health care professionals providing care to older people, and policy analysts assessing areas for improvement.
- Thomas, Shane, Browning, Colette
- Authors: Thomas, Shane , Browning, Colette
- Date: 2017
- Type: Text , Book chapter
- Relation: Encyclopedia of Geropsychology p.
- Full Text: false
- Reviewed:
- Description: Burden of disease (BoD) is a population measure of the effects of a specific disease or health problem. It is usually measured by Disability-Adjusted Life Years (DALYs) and/or by the related concept of Quality-Adjusted Life Years (QALYs). A DALY is a year of healthy life that is “lost” because of a specific condition. When the DALYs associated with a condition within a population are summed, this is the burden of disease (BoD). The burden of disease is the number of healthy years lost in a population compared to full health. The QALY is the person’s length of life multiplied by a valuation of their health-related quality of life. QALY measures are frequently used in the economic evaluation of health interventions. The World Health Organization coordinates a major ongoing global study of BoD, the Global Burden of Disease Study.