Original Research

How primary health care staff working in rural and remote areas access skill development and expertise to support health promotion practice

AUTHORS

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Kathryn A McFarlane
1 PhD, PhD candidate *

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Jenni A Judd
2 DHSc, Professor of Health Promotion

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Hylda Wapau
3 Graduate Diploma in Indigenous Health Promotion, BNSc. RN, Team Leader Care Coordination

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Nina Nichols
4 Master of Development Studies, Team Leader - Health Promotion Program

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Kerrianne Watt
5 PhD, Associate Dean

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Susan G Devine
6 DrPH, Associate Professor ORCID logo

AFFILIATIONS

1, 5, 6 College of Public Health, Medical and Veterinary Sciences, James Cook University, Townsville, QLD 4811, Australia

2 School of Human Health and Social Sciences, Central Queensland University, Bundaberg, QLD 4670, Australia

3, 4 Apunipima Cape York Health Council, Bungalow, QLD 4870, Australia

ACCEPTED: 12 November 2017


early abstract:

Introduction: Health promotion is a key component of comprehensive primary health care. Health promotion approaches compliment health care management by enabling individuals to increase control over their health. Many primary health care staff have a role to play in health promotion practice, but their ability to integrate health promotion into practice is influenced by their previous training and experience. For primary health care staff working in rural and remote locations, access to professional development can be limited by what is locally available and prohibitive in terms of cost for travel and accommodation. This study provides insight into how staff at a large north Queensland Aboriginal Community Controlled Health Service access skill development and health promotion expertise to support their work.
Methods: A qualitative exploratory study was conducted. Small group and individual semi-structured interviews were conducted with staff at Apunipima Cape York Health Council (n=9). A purposive sampling method was used to recruit participants from a number of primary health care teams that were more likely to be involved in health promotion work. Both on-the-ground staff and managers were interviewed. All participants were asked how they access skill development and expertise in health promotion practice and what approaches they prefer for ongoing health promotion support. The interviews were transcribed verbatim and analysed thematically.
Results: All participants valued access to skill development, advice and support that would assist their health promotion practice. Skill development and expertise in health promotion was accessed from a variety of sources: conferences, workshops, mentoring or shared learning from internal and external colleagues, and access to online information and resources. With limited funds and limited access to professional development locally, participants fostered external and internal organisational relationships to seek in-kind advice and support. Irrespective of where the advice came from, it needed to be applicable to work with Aboriginal and Torres Strait Islander remote communities.
Conclusions: To improve health outcomes in rural and remote communities the focus on health promotion and prevention approaches must be strengthened. Primary health care staff require ongoing access to health promotion skill development and expertise to increase their capacity to deliver comprehensive primary health care. Practice-based evidence from staff working in the field provides a greater understanding of how skill development and advice is accessed. Many of these strategies can be formalised through organisational plans and systems which, would ensure that a skilled health promotion workforce is sustained.