https://www.rrh.org.au Rural and Remote Health is an open-access international academic journal serving rural and remote communities and publishing articles by rural health practitioners, educators, researchers and policy makers. en-gb Tue, 20 May 25 11:15:30 +0000 Papir Journal Platform melissa.storey@rrh.org.au (Melissa Storey) webmaster@commonline.com.au (Webmaster) https://www.rrh.org.au/images/rrh_og_branding.jpg https://www.rrh.org.au https://www.rrh.org.au/journal/article/9626 https://www.rrh.org.au/journal/article/9626 Rural populations face inequitable access to primary healthcare services and are increasingly challenged to sustain a sufficient healthcare workforce. In addition, in the USA, the rural physician workforce is expected to decrease by 23% by 2030. Despite this, there are encouraging trends in the rapidly increasing numbers of nurse practitioner (NP) graduates. NPs have advanced clinical education, are qualified to provide primary care services, and are more likely to practice in rural communities than their physician colleagues. This Integrative Review synthesizes the scholarly literature about the early career experiences of NPs in rural health care and identifies the gaps in the literature for future research. Tue, 20 May 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/9269 https://www.rrh.org.au/journal/article/9269 Intimate partner violence (IPV), any behaviour within an intimate relationship that causes physical, sexual or psychological harm, is a major public health concern worldwide. While the violence prevention research landscape is still evolving, only in the past two decades has it started to become a high priority for practitioners and researchers to devote resources into conducting more primary prevention research. Community-based interventions, particularly community mobilisation interventions, can transform attitudes towards social norms and reduce IPV behaviours when rigorously planned, have a robust theory of change and are rooted in knowledge of local context. This Original Research study assessed the effect of a community mobilisation intervention on attitudes supportive of physical IPV, women's experiences of IPV and men's perpetration of IPV in rural communities of South West Nigeria. Thu, 15 May 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/9618 https://www.rrh.org.au/journal/article/9618 While incarcerated, women experience multiple barriers to accessing primary and specialty health care. When women are released from prison, they face barriers to timely access to primary health care, substance use disorder support and treatment, and mental health services, compounded by the need to navigate a complex web of services and systems to access housing and food, reconnect with children and access parenting supports. This Scoping Review identifies what is known about the health outcomes and health experiences of women and gender-diverse people who are currently incarcerated or recently released from prison into rural areas. Wed, 30 Apr 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/9103 https://www.rrh.org.au/journal/article/9103 Multiple international studies have shown that farming is one of the occupations in which workers have the lowest mental health scores. Farmers are exposed to unfavorable working conditions, such as long working hours and great physical demands, and may be more reluctant to seek help regarding their mental health than other occupational groups. This exploratory study investigates which facilitators and barriers farmers perceive as important in their everyday lives regarding their mental wellbeing. Mon, 28 Apr 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/9536 https://www.rrh.org.au/journal/article/9536 People co-using opioids and methamphetamines are more likely to be homeless, have comorbid severe psychiatric illness and be infected by sexually transmissible infections, and are at higher risk of overdose causing death. Moreover, although medications for opioid use disorder (MOUD) are effective at preventing opioid withdrawal, use, and overdose, research suggests that concomitant methamphetamine use negatively impacts treatment retention and opioid abstinence over time. As opioid and methamphetamine co-use continues to rise in rural counties of the US, the need to understand the prognostic effects of methamphetamine use among individuals initiating MOUD in rural community treatment settings is paramount. This Original Research article examines whether positive methamphetamine urinalysis results predict worse treatment outcomes in four rural US clinics. Thu, 24 Apr 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/9549 https://www.rrh.org.au/journal/article/9549 Ultrasonography is increasingly used across medical specialties, including family medicine, where it could reduce diagnostic delays, improve accuracy, and lower healthcare costs but ultrasonography training is not standardized in the family medicine curriculum. This Research Letter reports on the the feasibility and perceived usefulness of a one-day introductory ultrasonography course for family medicine interns at the Brest School of Medicine, France. Fri, 11 Apr 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/8686 https://www.rrh.org.au/journal/article/8686 Australian guidelines for initial management of migraine (an episodic, debilitating form of headache characterised by pain, nausea and aura causing significant personal morbidity), include aspirin, NSAIDs or paracetamol, followed by dopamine antagonists and serotonin receptor agonists, avoiding opioids unless as a last resort. Despite these guidelines, recent Australian studies have shown inconsistency in emergency department prescribing patterns. This Short Communication looks at patterns of prescriber intervention in a rural hospital to hypothesise how rural health barriers and enablers may impact prescription decisions. Wed, 02 Apr 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/8984 https://www.rrh.org.au/journal/article/8984 Health justice partnerships (HJPs) are integrated service models established to mitigate the impacts on health from issues that have a legal origin and that, if left unattended, can be detrimental to the health of individuals. Evidence from HJPs demonstrates the positive contribution of legal services on the mental health of program recipients, including improvements in depression, stress, anxiety and wellbeing upon delivery of legal assistance. This Project Report adds to the limited available research literature about HJPs for youth by presenting the perceptions of regional young people and workers about the impact of legal matters on health and wellbeing and the role of an HJP in the health of young people in regional Victoria, Australia. Sun, 30 Mar 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/9490 https://www.rrh.org.au/journal/article/9490 This exploratory study presents self-reported dietary supplement use among peri-menopausal women in rural Hawaiʻi. Regular use of supplements was notably higher in this population compared with results reported in communities in other nations and different geographic regions of the US. As the majority of respondents reported receiving supplement information from a clinician, healthcare providers are encouraged to engage in thoughtful discussion with their patients regarding supplement use.   Mon, 24 Mar 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/8852 https://www.rrh.org.au/journal/article/8852 Rural doctors practising in resource-limited settings display courage when they are required to work at the limits of their scope of practice to provide the medical care that is required by their community. Although courage can be an integral part of clinical practice, the underlying attributes of clinical courage are not well described in the literature. This Original Research article contributes to the study of clinical courage in rural doctors by reporting on testing of a recently developed questionnaire. Better understanding of clinical courage may contribute to training, support and retention strategies for rural healthcare professionals. Thu, 20 Mar 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/9083 https://www.rrh.org.au/journal/article/9083 Advanced Skills Training (AST) is an opportunity for GPs to further refine their skills across one or more medical specialties. Rural training pathways have evolved to suit the needs of rural communities, trainees, trainers, health services and medical colleges. However, current rural training opportunities may be missing the mark on bridging the gap between urban and rural health and the demands on GPs have expanded beyond traditional boundaries, necessitating a re-evaluation of the skills and competencies required to address the complex and multifaceted health needs of diverse patient populations. This Review article examines the current value and fitness for purpose of AST for rural clinical practice. Tue, 18 Mar 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/8916 https://www.rrh.org.au/journal/article/8916 A holistic definition of wellbeing includes the physical, social, emotional, cultural and ecological dimensions of both the individual and the community. While some research has been conducted on persons with disabilities in rural settings in South Africa, there is limited research into inclusion of persons with disabilities in cultural rituals. This Original Research study explores the experiences of persons with disabilities in Xhosa rituals and traditions in rural South Africa and how these experiences contribute to health and wellbeing. Mon, 17 Mar 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/8894 https://www.rrh.org.au/journal/article/8894 The KidsFirst North program is a maternal-child health support program in rural northern Saskatchewan, Canada. The program serves both Indigenous and non-Indigenous families, and the majority of participants in the study are Indigenous. This Original Research article takes a community-based participatory research approach to investigate factors of success and barriers, from the perspectives of families, frontline workers, and administrators alike. Thu, 13 Mar 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/9725 https://www.rrh.org.au/journal/article/9725 Professional education for community physicians is essential but there are challenges in balancing educational responsibilities with the practical demands of clinical work. This Research Letter examines the stressors and buffers for community-attending physicians accessing professional education. These insights will be useful in ensuring the sustainability and efficacy of professional educational practices. Wed, 12 Mar 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/8506 https://www.rrh.org.au/journal/article/8506 A lack of appropriate and sustainable resources (including workforce and supplies), inadequate infrastructure (including unreliable internet connectivity) and lack of funding and governance impact the sustainability and feasibility of healthcare delivery in isolated areas. A telehealth model or mobile model of care may be most appropriate for these isolated regions but, paradoxically, these regions are the least likely to have infrastructure and resources to support the model. This Original Research article reports on the results of a needs assessment of healthcare services in Far East Gippsland, Victoria, Australia, and outlines feasible and sustainable services as suggested by the people that live there. Tue, 11 Mar 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/9522 https://www.rrh.org.au/journal/article/9522 This cross-sectional study examines the impacts of health promotion workshops led by a multidisciplinary student team. Results suggest these workshops are associated with positive gains in health knowledge by participants, and satisfaction by partnering agencies. Further development of similar initiatives may prove useful in extending health literacy in rural communities. Tue, 04 Mar 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/8961 https://www.rrh.org.au/journal/article/8961 South Africa has a history of mental health care provided primarily at tertiary level in institutions. However, in line with World Health Organization guidance, attempts have been made to decentralise and streamline the integration of public mental health care into general health care systems at primary and secondary levels. The currently implemented Mental Health Care Act 17 of 2002 serves as the national guideline to implement policy into practice, thereby increasing access and the quality of care to service users. This, of course, has implications for the roles workers and facilities are now called upon to play. This Original Research article presents data from a project that investigated issues regarding access and provision of mental health care in the Eastern Cape province of South Africa. The authors studied the experiences of public health care workers at PHC clinics and the associated referral hospitals, focusing mainly on exploring their views on the ability and readiness for access to and provision of mental health care to state health service users in the area. Sun, 02 Mar 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/9323 https://www.rrh.org.au/journal/article/9323 Research on caring for children with disabilities in sub-Saharan African contexts has primarily focused on female caregivers, leaving male caregivers understudied. This Original Research article reports on a study exploring the journeys of male caregivers in rural Kenya as they navigate the complex landscape of health care for their children with disabilities. The authors uncover valuable lessons that can inform the development of better support services and make a positive impact on the lives of children with disabilities in rural settings by improving access to quality health care. Mon, 24 Feb 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/8745 https://www.rrh.org.au/journal/article/8745 The learning environment has proved important for medical students' wellbeing, satisfaction and academic results. Although complex and multifactorial, positive initiatives include integration of learners as active members of communities of practice and tailored guidance by teachers to aid learners' development. Decentralized curricular models are potentially vulnerable for learning environment deterioration due to their remote location and limited student numbers. Prior investigations of learning environments in decentralized medical curricula describe inconsistent results, and are limited to certain geographical areas. This Original Research article compares learning environment perceptions of students in a decentralized curricular model in Norway with those of their urban counterparts, and with students in international medical curricula. Wed, 19 Feb 25 00:00:00 +0000 https://www.rrh.org.au/journal/article/9217 https://www.rrh.org.au/journal/article/9217 Living in a rural or remote area should not limit access to healthcare services or compromise quality of health care. However, the reality is that individuals in rural and remote regions often face significant barriers to appropriate health care, leading to poorer health outcomes and exacerbation of existing health disparities. This Letter to the Editor draws attention to innovative strategies for improving access to quality care for residents of rural and remote areas, including blockchain technology for health records, drone technology for medical supply delivery, and mobile health applications (mHealth). Fri, 14 Feb 25 00:00:00 +0000