Health research is important for innovation and assessment of health status and health interventions, and maintaining a strong, engaged cohort of rural health researchers is essential for the ongoing improvement of the health of rural populations. Ethical guidelines and processes ensure research is undertaken in a way that protects and, where possible, empowers participants. We set out to systematically examine and document the challenges posed by ethics and governance processes for rural health researchers in Western Australia (WA) and the impact on the research undertaken. In this qualitative study, fifteen WA-based rural health researchers were interviewed. The identified challenges included inefficient systems, gatekeeping, apparent resistance to research and the lack of research experience of those involved in approval processes. For researchers seeking to conduct studies to improve rural and Aboriginal health, extended delays in approvals can hold up and impede research, ultimately changing the nature of the research undertaken and constraining the willingness of practitioners and researchers to undertake health research. Unwieldy ethics processes were seen to have a particularly onerous impact on rural research pertaining to service delivery, multiple sites, and research involving Aboriginal people, impeding innovation and inquiry in areas where it is much needed.
Aboriginal and Torres Strait Islander Australians suffer higher rates of cancer and poorer outcomes than the wider population. These disparities are exacerbated by rurality and remoteness due to reduced access and limited engagement with health services. This study explored the cancer journeys of Aboriginal patients and carers, and their views on the establishment of an Aboriginal Patient Navigator role within the Western Australian healthcare system to support cancer patients and their families. Sixteen Aboriginal participants were interviewed either face to face, by telephone, or via video conferencing platforms. The interviews were then recorded, transcribed, and thematically analyzed using standard qualitative techniques. Close consultation within the research team enhanced the rigour and robustness of the study findings. Patients and carers identified many gaps in cancer service delivery that made their experiences stressful and unnecessarily complex. Challenges included a lack of stable accommodation, financial burdens, constant travel, being “off-Country”, and miscommunication with health professionals. Key sources of support and strength were the centrality of family and ongoing cultural connectedness. All participants were supportive of an Aboriginal Patient Navigator role that could address shortfalls in cancer service delivery, especially for patients from rural and remote communities. A culturally safe model of support has the potential to increase access, reduce anxiety and improve health outcomes.
It is imperative that universities continue to explore innovations that support staff and student learning and pursue their mission to promote social responsibility and community service. Communities of Practice have been used to facilitate innovation and regenerate teaching and learning in tertiary contexts, including interdisciplinary collaborations around complex problems. This study describes the challenges and achievements of the first year of an interdisciplinary Community of Practice which aimed to create innovative approaches to teaching and learning about family and domestic violence, a complex social issue, inherently gendered, which receives little attention across the University discipline areas, despite the centrality of this issue in much of the future work of University graduates within a range of professional areas. We interviewed engaged members to explore the value gained from their first year of involvement in the Community of Practice. This initiative brought members substantial value while recognising the need for long-term engagement and commitment from the senior University leadership to embed innovation. A key lesson was that developing an innovative curriculum to address critical and ongoing social and public health issues requires much more senior leadership, responsibilities shared across faculty, and commitment of dedicated resources and staff time. The findings provide valuable learning for other Communities of Practice attempting to engage with complex problems and create innovative interdisciplinary approaches to teaching, learning, and research.
Community efforts at the primary prevention of family violence (FV) involve changing values, structures and norms that support gender inequality. This study examines the attitudes of a group of highly engaged community leaders and service providers involved in FV primary prevention in Geraldton, a small city in regional Western Australia. The outcomes of focus group discussions were mapped against a readiness for change model. Despite considerable involvement in discussions of FV prevention over time, the readiness level of these engaged community members for taking leadership roles in the prevention strategy were between pre-planning and preparation stages, although some individuals’ understanding of the drivers of FV and readiness for implementing change was higher. Key areas for further education are the role of gender inequality as the primary driver of FV, particularly rigid gender roles and men’s control of decision making, and the role of alcohol and drugs as reinforcers but not primary drivers of FV.
In the Midwest region of Western Australia, rates of intimate partner and family violence (IPV/FV) are high. We undertook research into social workers’ knowledge, attitudes, and skills as part of addressing this significant public health issue. Social workers come into contact with people experiencing IPV/FV in multiple settings, so their understandings and responses are critical to the prevention and interventions related to violence against women. The goal of the research was to determine the issues that the social workers in this region needed to be addressed that could assist in tackling the problem of IPV/FV. A questionnaire included open-ended questions to capture information on respondents’ profiles, knowledge, attitudes, practices, and education around IPV/FV, with 29 of 37 social workers working in the region responding. We also elicited respondents' recommendations related to training and service delivery. Despite working in many settings, most social workers had contact with people experiencing IPV/FV and had reasonable confidence and knowledge that showed an understanding of the complexity of FV, including why women stay in violent relationships. This paper identified social workers’ need for more education, including during their university training, resources, and service coordination to support best practice delivery of services to people affected by IPV/FV. Training to develop skills for conversations about IPV/FV with clients, around safety planning, and greater access to safe alternative accommodation for those leaving FV were identified priorities.
In response to the high burden of family and domestic violence (FDV), The Australian National Plan to End Violence Against Women and Children has established that primary prevention measures are necessary to reduce FDV’s harmful impacts on health. The Community, Respect, and Equality (CRE) project is a primary prevention initiative aimed towards changing harmful social norms and practices that enable FDV in Geraldton, Western Australia. Organizations affiliated with the CRE are required to promote gender equality and a respectful work environment. However, there is a gap in the literature regarding the impact and effectiveness of such interventions, especially in rural/regional areas. As such, this study served to evaluate the project’s effectiveness in a CRE-certified workspace, a local non-profit social services provider. Investigators conducted interviews to learn how the organization had implemented the CRE, and whether the CRE had had an impact on social norms and practices within the work environment. Findings indicated that the project had largely failed to permeate workplace culture due to a lack of effective promotion, low perceived benefits, and low resources. Future interventions must take persuasive measures, even for organizations perceived to be receptive to change.