Social and emotional wellbeing screening for Aboriginal and Torres Strait Islanders within primary health care services: A series of missed opportunities?

Erika Langham, Janya McCalman, Veronica Matthews, Roxanne Bainbridge, Barbara Nattabi, Irina Kinchin, Ross Bailie

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Social and emotional wellbeing (SEWB) is a critical determinant of health outcomes for Indigenous Australians. This study examined the extent to which primary healthcare services (PHSs) undertake SEWB screening and management of Aboriginal and Torres Strait Islander clients, and the variation in SEWB screening and management across Indigenous PHS.
Methods: Cross-sectional analysis between 2012 and 2014 of 3,407 Indigenous client records from a non-representative sample of 100 PHSs in 4 Australian states/territory was undertaken to examine variation in the documentation of: (1) SEWB screening using identified measurement instruments, (2) concern regarding SEWB, (3) actions in response to concern, and (4) follow up actions. Binary logistic regression was used to determine the factors associated with screening.
Results: The largest variation in SEWB screening occurred at the state/territory level. The mean rate of screening across the sample was 26.6%, ranging from 13.7 to 37.1%. Variation was also related to PHS characteristics. A mean prevalence of identified SEWB concern was 13% across the sample, ranging from 9 to 45.1%. For the clients where SEWB concern was noted, 25.4% had no referral or PHS action recorded. Subsequent internal PHS follow up after 1 month occurred in 54.7% of cases; and six-monthly follow up of referrals to external services occurred in 50.9% of cases.
Conclusion: Our findings suggest that the lack of a clear model or set of guidelines on best practice for screening for SEWB in Indigenous health may contribute to the wide variation in SEWB service provision. The results tell a story of missed opportunities: 73.4% of clients were not screened and no further action was taken for 25.4% for whom an SEWB concern was identified. There was no follow up for just under half of those for whom action was taken. There is a need for the development of national best practice guidelines for SEWB screening and management, accompanied by dedicated SEWB funding, and training for health service providers as well as ongoing monitoring of adherence with the guidelines. Further research on barriers to screening and follow up actions is also warranted.
Original languageEnglish
Article number159
Number of pages9
JournalFrontiers in Public Health
Volume5
DOIs
Publication statusPublished - Jul 2017

Fingerprint

Health Services
Primary Health Care
Practice Guidelines
Referral and Consultation
Guideline Adherence
Health
Social Work
Documentation
Cross-Sectional Studies
Logistic Models
Guidelines
Research

Cite this

Langham, Erika ; McCalman, Janya ; Matthews, Veronica ; Bainbridge, Roxanne ; Nattabi, Barbara ; Kinchin, Irina ; Bailie, Ross. / Social and emotional wellbeing screening for Aboriginal and Torres Strait Islanders within primary health care services: A series of missed opportunities?. In: Frontiers in Public Health. 2017 ; Vol. 5.
@article{061580af8f85442da32ee3e2d81d208b,
title = "Social and emotional wellbeing screening for Aboriginal and Torres Strait Islanders within primary health care services: A series of missed opportunities?",
abstract = "Background: Social and emotional wellbeing (SEWB) is a critical determinant of health outcomes for Indigenous Australians. This study examined the extent to which primary healthcare services (PHSs) undertake SEWB screening and management of Aboriginal and Torres Strait Islander clients, and the variation in SEWB screening and management across Indigenous PHS.Methods: Cross-sectional analysis between 2012 and 2014 of 3,407 Indigenous client records from a non-representative sample of 100 PHSs in 4 Australian states/territory was undertaken to examine variation in the documentation of: (1) SEWB screening using identified measurement instruments, (2) concern regarding SEWB, (3) actions in response to concern, and (4) follow up actions. Binary logistic regression was used to determine the factors associated with screening.Results: The largest variation in SEWB screening occurred at the state/territory level. The mean rate of screening across the sample was 26.6{\%}, ranging from 13.7 to 37.1{\%}. Variation was also related to PHS characteristics. A mean prevalence of identified SEWB concern was 13{\%} across the sample, ranging from 9 to 45.1{\%}. For the clients where SEWB concern was noted, 25.4{\%} had no referral or PHS action recorded. Subsequent internal PHS follow up after 1 month occurred in 54.7{\%} of cases; and six-monthly follow up of referrals to external services occurred in 50.9{\%} of cases.Conclusion: Our findings suggest that the lack of a clear model or set of guidelines on best practice for screening for SEWB in Indigenous health may contribute to the wide variation in SEWB service provision. The results tell a story of missed opportunities: 73.4{\%} of clients were not screened and no further action was taken for 25.4{\%} for whom an SEWB concern was identified. There was no follow up for just under half of those for whom action was taken. There is a need for the development of national best practice guidelines for SEWB screening and management, accompanied by dedicated SEWB funding, and training for health service providers as well as ongoing monitoring of adherence with the guidelines. Further research on barriers to screening and follow up actions is also warranted.",
author = "Erika Langham and Janya McCalman and Veronica Matthews and Roxanne Bainbridge and Barbara Nattabi and Irina Kinchin and Ross Bailie",
year = "2017",
month = "7",
doi = "10.3389/fpubh.2017.00159",
language = "English",
volume = "5",
journal = "Frontiers in Public Health",
issn = "2296-2565",
publisher = "Frontiers Media SA",

}

Social and emotional wellbeing screening for Aboriginal and Torres Strait Islanders within primary health care services: A series of missed opportunities? / Langham, Erika; McCalman, Janya; Matthews, Veronica; Bainbridge, Roxanne; Nattabi, Barbara; Kinchin, Irina; Bailie, Ross.

In: Frontiers in Public Health, Vol. 5, 159, 07.2017.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Social and emotional wellbeing screening for Aboriginal and Torres Strait Islanders within primary health care services: A series of missed opportunities?

AU - Langham, Erika

AU - McCalman, Janya

AU - Matthews, Veronica

AU - Bainbridge, Roxanne

AU - Nattabi, Barbara

AU - Kinchin, Irina

AU - Bailie, Ross

PY - 2017/7

Y1 - 2017/7

N2 - Background: Social and emotional wellbeing (SEWB) is a critical determinant of health outcomes for Indigenous Australians. This study examined the extent to which primary healthcare services (PHSs) undertake SEWB screening and management of Aboriginal and Torres Strait Islander clients, and the variation in SEWB screening and management across Indigenous PHS.Methods: Cross-sectional analysis between 2012 and 2014 of 3,407 Indigenous client records from a non-representative sample of 100 PHSs in 4 Australian states/territory was undertaken to examine variation in the documentation of: (1) SEWB screening using identified measurement instruments, (2) concern regarding SEWB, (3) actions in response to concern, and (4) follow up actions. Binary logistic regression was used to determine the factors associated with screening.Results: The largest variation in SEWB screening occurred at the state/territory level. The mean rate of screening across the sample was 26.6%, ranging from 13.7 to 37.1%. Variation was also related to PHS characteristics. A mean prevalence of identified SEWB concern was 13% across the sample, ranging from 9 to 45.1%. For the clients where SEWB concern was noted, 25.4% had no referral or PHS action recorded. Subsequent internal PHS follow up after 1 month occurred in 54.7% of cases; and six-monthly follow up of referrals to external services occurred in 50.9% of cases.Conclusion: Our findings suggest that the lack of a clear model or set of guidelines on best practice for screening for SEWB in Indigenous health may contribute to the wide variation in SEWB service provision. The results tell a story of missed opportunities: 73.4% of clients were not screened and no further action was taken for 25.4% for whom an SEWB concern was identified. There was no follow up for just under half of those for whom action was taken. There is a need for the development of national best practice guidelines for SEWB screening and management, accompanied by dedicated SEWB funding, and training for health service providers as well as ongoing monitoring of adherence with the guidelines. Further research on barriers to screening and follow up actions is also warranted.

AB - Background: Social and emotional wellbeing (SEWB) is a critical determinant of health outcomes for Indigenous Australians. This study examined the extent to which primary healthcare services (PHSs) undertake SEWB screening and management of Aboriginal and Torres Strait Islander clients, and the variation in SEWB screening and management across Indigenous PHS.Methods: Cross-sectional analysis between 2012 and 2014 of 3,407 Indigenous client records from a non-representative sample of 100 PHSs in 4 Australian states/territory was undertaken to examine variation in the documentation of: (1) SEWB screening using identified measurement instruments, (2) concern regarding SEWB, (3) actions in response to concern, and (4) follow up actions. Binary logistic regression was used to determine the factors associated with screening.Results: The largest variation in SEWB screening occurred at the state/territory level. The mean rate of screening across the sample was 26.6%, ranging from 13.7 to 37.1%. Variation was also related to PHS characteristics. A mean prevalence of identified SEWB concern was 13% across the sample, ranging from 9 to 45.1%. For the clients where SEWB concern was noted, 25.4% had no referral or PHS action recorded. Subsequent internal PHS follow up after 1 month occurred in 54.7% of cases; and six-monthly follow up of referrals to external services occurred in 50.9% of cases.Conclusion: Our findings suggest that the lack of a clear model or set of guidelines on best practice for screening for SEWB in Indigenous health may contribute to the wide variation in SEWB service provision. The results tell a story of missed opportunities: 73.4% of clients were not screened and no further action was taken for 25.4% for whom an SEWB concern was identified. There was no follow up for just under half of those for whom action was taken. There is a need for the development of national best practice guidelines for SEWB screening and management, accompanied by dedicated SEWB funding, and training for health service providers as well as ongoing monitoring of adherence with the guidelines. Further research on barriers to screening and follow up actions is also warranted.

U2 - 10.3389/fpubh.2017.00159

DO - 10.3389/fpubh.2017.00159

M3 - Article

VL - 5

JO - Frontiers in Public Health

JF - Frontiers in Public Health

SN - 2296-2565

M1 - 159

ER -