Revisiting the ability of Australian primary healthcare services to respond to health inequity.

Equity of access and reducing health inequities are key objectives of comprehensive primary health care. However, the supports required to target equity are fragile and vulnerable to changes in the fiscal and political environment. Six Australian primary healthcare services, five in South Australia and one in the Northern Territory, were followed over 5 years (2009-2013) of considerable change.

Factors shaping intersectoral action in primary health care services.

Objective: To examine case studies of good practice in intersectoral action for health as one part of evaluating comprehensive primary health care in six sites in South Australia and the Northern Territory.

Methods: Interviews with primary health care workers, collaborating agency staff and service users (Total N=33); augmented by relevant documents from the services and collaborating partners.

Results: The value of intersectoral action for health and the importance of partner relationships to primary health care services were both strongly endorsed.

Health policy in South Australia 2003-10: primary health care workforce perceptions of the impact of policy change on health promotion.

Issue Addressed: This paper examines recent Australian health reform policies and considers how the primary health care (PHC) workforce experiences subsequent change and perceives its impact on health promotion practice.

Methods: Health policy documents were analysed to determine their intended impact on health promotion. Interviews were conducted with 39 respondents from four State-funded PHC services to gain their perceptions of the impact of policy change on health promotion.

Cultural respect strategies in Australian Aboriginal primary health care services: beyond education and training of practitioners.

Objective: There is little literature on health-service-level strategies for culturally respectful care to Aboriginal and Torres Strait Islander Australians. We conducted two case studies, which involved one Aboriginal community controlled health care service and one state government-managed primary health care service, to examine cultural respect strategies, client experiences and barriers to cultural respect.

Methods: Data were drawn from 22 interviews with staff from both services and four community assessment workshops, with a total of 21 clients.

A longitudinal study of the mental health impacts of job loss: the role of socioeconomic, sociodemographic, and social capital factors.

Objectives: To examine the role of socioeconomic, sociodemographic, and social capital factors in buffering or exacerbating the mental health impacts of job loss.

Methods: A 2-year longitudinal cohort study of 300 workers experiencing job loss from a motoring manufacturer in Adelaide, South Australia. Data were collected on mental health (12-item version of the General Health Questionnaire) and socioeconomic, sociodemographic, and social capital factors.

Developing a good practice model to evaluate the effectiveness of comprehensive primary health care in local communities.

Background: This paper describes the development of a model of Comprehensive Primary Health Care (CPHC) applicable to the Australian context. CPHC holds promise as an effective model of health system organization able to improve population health and increase health equity. However, there is little literature that describes and evaluates CPHC as a whole, with most evaluation focusing on specific programs.

Community assessment workshops: a group method for gathering client experiences of health services.

Community assessment workshops were developed to gather client experiences of primary health care services in Australia. Primary health care services are particularly concerned with working with disadvantaged populations, for whom traditional client survey methods such as written surveys may not be inclusive and accessible. Service staff at six Australian primary health care services, including two Aboriginal-specific services, invited participants to attend workshops in 2011-2012.

Health promotion in Australian multi-disciplinary primary health care services: case studies from South Australia and the Northern Territory.

This paper reports on the health promotion and disease prevention conducted at Australian multi-disciplinary primary health care (PHC) services and considers the ways in which the organizational environment affects the extent and type of health promotion and disease prevention activity. The study involves five PHC services in Adelaide and one in Alice Springs. Four are managed by a state health department and two by boards of governance.

Reaching those with the greatest need: how Australian primary health care service managers, practitioners and funders understand and respond to health inequity.

Equity of access to services and in health outcomes are key goals of primary health care. This study considers understandings of equity and perceptions of current performance in relation to equity among primary health care service staff, health service executives and funders. Semi-structured interviews were conducted with managers, practitioners and administration staff at five primary health care services in Adelaide and one in Alice Springs, as well as with South Australian funders and regional health service executives (n = 68).

Framework and tools for planning and evaluating community participation, collaborative partnerships and equity in health promotion.

Issue Addressed: This paper reports on the development of a planning and evaluation framework and tools to assess key principles of primary health care/health promotion: community participation, collaborative partnerships and a focus on equity. The focus of the tools is on planning and process evaluation with some outcome questions included.

Methods: Following a scan of literature, the framework and tools for each component were developed.

Building an evidence base for community health: a review of the quality of program evaluations.

An assessment of the quality of program evaluations conducted in South Australian community health services investigated how effective evaluation reporting is in producing an evidence base for community health. Evaluation reports were assessed by a team of reviewers. Practitioner workshops allowed an understanding of the uses of evaluation and what promotes or acts as a barrier to undertaking evaluations.

The Eat Well SA project: an evaluation-based case study in building capacity for promoting healthy eating.

The term 'capacity building' is used in the health promotion literature to mean investing in communities, organizations and structures to enhance access to knowledge, skills and resources needed to conduct effective health programs. The Eat Well SA project aimed to increase consumption of healthy food by children, young people and their families in South Australia. The project evaluation demonstrated that awareness about healthy eating among stakeholders across a range of sectors, coalitions and partnerships to promote healthy eating and sustainable programs had been developed.