Introduction: The COVID-19 pandemic has necessitated the rapid transition of many face-to-face health services to alternate modes of service delivery. The objective of this study was to explore the benefits, challenges and perceived quality of a telehealth service delivery model from the perspective of clients and students. Further, students’ perceptions relating to the quality of the educational experience were also explored. Methods: The study was set in a student-led interprofessional health and wellness clinic in rural Queensland, Australia. A qualitative case study design was used, including semi-structured student interviews and client open-response survey data. Participants were nursing and allied health students who completed a student-led interprofessional clinic placement and adults with low to rising risk of chronic disease who attended the clinic for telehealth delivered services. Results: Themes identified following analysis included: new or adapted skills needed for success; challenges, limitations and the need for resources, training and support; quality interprofessional education experiences can be achieved in telehealth; coming away with a new set of skills; the important role of the client for success; and benefits and disadvantages of telehealth for clients. Conclusions: The findings support that telehealth-based service-learning models are a feasible way to deliver health and wellness services from the perspective of students and clients and provide students with important skills for rural health service delivery.

Objective To explore the impact of providing nursing and midwifery student placements from the perspective of regional, rural and remote health service staff involved in hosting students. Setting Hospital and health services across regional, rural and remote southern Queensland. Participants Thirty-six nursing and midwifery staff working in clinical and/or management roles who were direct clinical supervisors of students or in leadership positions with responsibility for overseeing and supporting clinical placements. Design Semi-structured interviews exploring the experiences and perspectives of nursing and midwifery health service staff who support student placements. Data were subject to thematic analysis. Results Five key themes were identified as follows: (a) bringing new ideas and perspectives, (b) opportunities for development, (c) supporting the future rural workforce (d) impacts on workload and productivity and (e) strategies for balancing supervision. Conclusion The results indicate that there are a range of perceived benefits and challenges of providing nursing and midwifery student placements within regional, rural and remote settings. The findings also indicate that there are opportunities to further support rural health services to optimise the positive impacts and mitigate the challenges of providing placements. To do so requires collaboration between health services and education providers to allocate students appropriately to health services and support health service staff.

Background: Positive rural clinical experiences strongly correlate with future rural health career intention. It is therefore important to understand the factors which contribute to positive rural clinical placement experiences. Aims: To understand the benefits and challenges of rural nursing and midwifery placements for students, and to explore factors which influence positive clinical placement experiences. Methods: Semi-structured interviews were undertaken to explore the experiences and perspectives of nursing and midwifery students (n=17) and staff working at health services where students are placed (n=36). Data were subject to thematic analysis. Results: Five themes were identified: variety of experiences in a rural health context; supervision and support; engaging with a rural community; placement type and duration influence on rural placement experience; and inspiring, reaffirming or challenging future rural career intentions. Conclusion: This study reiterates the importance of ensuring that students are actively engaged and supported during rural clinical placements to encourage students to consider future rural career pathways. The findings highlight the important role of education providers and health services in supporting student placement experiences to enable positive rural career intentions.

Healthcare workers (HCWs) play a crucial role in the delivery of much-needed healthcare services globally. Outside major metropolitan centres (i.e., non-metropolitan areas including regional, rural, remote, and very remote), recruiting and retaining HCWs continues to be a challenge. Rural Australia already faces significant healthcare challenges and inequities. Stabilizing the healthcare workforce in these underserved areas is a national priority. This study aimed to examine median retention timeframes across medicine, nursing, midwifery, and allied health professions in the public health sector in rural southern Queensland (Australia). Further, it also aimed to understand the demographic, employment, and geographical variables that influence retention of the rural healthcare workforce. A 12-year administrative dataset from two public health services, servicing rural Queensland in Australia were examined. De-identified data were analyzed through descriptive statistical tests, survival analyses, and Andersen-Gill Cox proportional hazards regression. Data from 6651 records linked to 5527 employees were included in the analysis. Sampled employees were predominately female (70.4%), employed permanently (86.3%), in a clinical role (97.6%), and in the public hospital sector (87.5%). The overall median survival time (i.e., time employed in one location) was 1.46 years [95% CI, 1.35–1.52 years], with 41% of employees remaining in employment in location after two years. Compared to those in nursing and midwifery, those employed in medical (HR: 1.91, 95% CI: 1.75–2.09) and allied health (HR: 1.38, 95% CI: 1.26–1.51) streams were at greater risk of leaving location. This effect was relatively small, though, compared to: (a) geographic location of employment, where, compared to those working in the regional city, there was greater risk of leaving location if working in rural (HR: 1.79, 95% CI: 1.66–1.94) or remote communities (HR: 2.64, 95% CI: 2.40–2.91); and (b) employment type, where compared to being employed in permanent part-time roles, there was greater risk of leaving location if employed in casual (HR: 1.76, 95% CI: 1.56–1.99), full-time (HR: 1.65, 95% CI: 1.51–1.79) or temporary roles (HR: 2.13, 95% CI: 1.78–2.55). Understanding retention patterns of the healthcare workforce is crucial to developing and implementing supportive interventions to enhance HCW retention in rural areas. Our findings show that the overall retention rate in this population is comparable to international evidence and may be slightly better than some previously reported rates from other Australian studies. Our findings suggest that profession, employment type, sector type, age, and geographical remoteness influenced employee retention. Further research is needed to fully explore and understand the reasons for HCWs leaving their roles and supportive measures that enable reasonable HCW retention rates.

Objective: To investigate coronavirus disease 2019 community transmission concerns and adherence to social distancing and hygiene practices across metropolitan, regional, rural and remote areas in Australia.Design: Cross‐sectional online survey of Australian adults conducted between April and May 2020 through convenience snowball sampling.Setting: A range of locations across all states and territories of Australia.Participants: Six hundred and seventy‐seven Australian adults, of which 78.8% lived outside of a metropolitan area.Main outcome measures: Perceived threat of coronavirus disease 2019; social distancing guidelines and adherence; infection concerns; hygiene practices; frequency of leaving the house; impact of coronavirus disease 2019 on day‐to‐day life.Results: Almost all respondents perceived the threat of the coronavirus disease 2019 pandemic was serious. There were high levels of support for the Australian Government's social distancing guidelines, although the perception that social distancing guidelines in participants’ communities were ‘too strict’ increased with remoteness area classification. Most respondents reported adherence with Australian Government social distancing guidelines. There was an association between remoteness and risk perception, with non‐metropolitan respondents more likely to feel safe when leaving the house. However, there was no association between geographical remoteness and self‐reported adherence with Australian Government social distancing guidelines.Conclusions: This study provides an important initial insight into Australian perceptions and behaviours relating to the coronavirus disease 2019 pandemic, and how perceptions and behaviours varied by geographical remoteness. The geographical remoteness of communities should be considered by policy makers to ensure effective communication with the Australian public regarding coronavirus disease 2019 and ongoing adherence with preventative health behaviours.

Background: There is increasing recognition of the importance of the preconception period for addressing reproductive and intergenerational health inequities and supporting improved maternal and child health outcomes. This study aimed to understand the extent and type of evidence that exists in relation to preconception health for Indigenous peoples living in high-income countries with similar experiences of colonisation, namely, Australia, New Zealand, Canada, and the United States. Methods: This review was conducted as per the JBI methodology and PRISMA Extension for Scoping Reviews. A comprehensive search of PubMed, CINAHL [EBSCO], Ovid Embase, Scopus, and the Wiley Cochrane Library was conducted using keywords and index terms. We included research in English published between January 2010 and June 2023 on quantitative and qualitative primary studies. Data were extracted using a standardised tool, and the analysis included quantitative descriptions and qualitative content analysis. Results: We identified 360 potential studies and included 57 articles in the review. Most studies were from the United States (n = 36, 63.2%) and Australia (n = 13, 22.8%), and they commonly reported associations between preconception health risk factors and maternal or child health outcomes (n = 27, 48.2%) or described the development, implementation, or evaluation of preconception health interventions (n = 26, 46.4%). Common preconception health areas were pre-pregnancy body mass index or weight (n = 34), alcohol (n = 16), diet (n = 14), physical activity (n = 12), and diabetes (n = 11). Most studies focused exclusively on women (n = 46, 80.7%), and very few included men (n = 3, 5.3%). The study populations were mostly urban and rural (n = 25, 43.9%) or rural only (n = 14, 24.6%); however, the geographical remoteness was often unclear (n = 14, 24.6%). Conclusions: While there was some research relating to the preconception health of Indigenous peoples, this review identified considerable research gaps. There is a need for dedicated research into preconception health risk factors and reproductive health outcomes, attitudes and awareness of preconception health, and preconception health interventions for Indigenous peoples.