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Health literacy is a major issue for improving health outcomes of clients. In rural Victoria, Australia, the Gippsland Health Literacy Project (GHLP) educated local health services staff about health literacy and provided tools and techniques for health literacy implementation in services. This paper reports the outcomes of this project. Participants' change in knowledge was measured through pre- and post-project surveys and interviews. Descriptive analysis of survey data and analysis of interviews using qualitative description enabled exploration of individual and organisational shifts in health literacy perspectives. Healthcare professionals' knowledge of health literacy has improved as a result of the health literacy education. Health service organisations are also taking greater responsibility for health literacy responsiveness in their services. Systematic changes to policy and procedures that support health literacy are required. Although health literacy education provides more accessible health care for consumers, where projects had executive-level support the changes implemented were more likely to be successful and sustainable. What is known about this topic?: Low health literacy is a strong predictor of health status and it is important for health organisations to ensure they provide health care and information in a way that can be understood, interpreted and acted on by all clients, regardless of their health literacy levels. What does this paper add?: This paper presents findings on staff training and resources that can effectively support staff to improve health literacy practices. What are the implications for practitioners?: Addressing health literacy issues appears to result in more accessible health care for consumers. Executive support and health literacy champions are key requirements to successfully address health literacy issues. [ABSTRACT FROM AUTHOR]

Objective: Completion rates in vocational education are typically poor for Aboriginal students (<30%). A scholarship program was designed for Australian Aboriginal students using five enablers of success previously identified for Aboriginal preregistration tertiary nursing students. The purpose of this study was to evaluate whether the five enablers contributed to the success of Aboriginal students in vocational education and whether there were any other enablers. Methods: Semistructured interviews were conducted with two groups of Aboriginal students in Certificate III and IV Dental Assisting and Certificate IV in Allied Health Assistance, and their teaching and support staff. The data were initially coded inductively. Initial codes were then categorised according to the five enablers identified to contribute to the success of Bachelor of Nursing students. New categories were created for data not assigned to the enablers. Results: Twenty students (64.5% of the cohort) and six staff (75%) consented to participate. The five enablers were perceived to have contributed to the success of the scholarship recipients and two additional enablers were identified. A completion rate of 96.8% was achieved by the scholarship recipients (30 completions of 31 enrolments). Conclusions: In contrast with the state average, a completion rate of 96.8% was achieved using seven enablers in this study. To improve completion rates for Aboriginal students, vocational education programs need to be customised to cultural, family and community context. The seven enablers in this study should be subject to a larger study to inform policy, funding, design and delivery of vocational training for Aboriginal students. What is known about the topic?: It is well established in the literature that Aboriginal students have poorer educational outcomes than other students. What does this paper add?: This paper validates five previously identified enablers to improve outcomes for Aboriginal students and an additional two for vocational education. These enablers may also be applicable to other types of education. What are the implications for practitioners?: Practitioners can use the enablers in this study to design and implement vocational education programs and improve educational outcomes for Aboriginal students. [ABSTRACT FROM AUTHOR]

This study evaluated a program arising from the Commonwealth policy of regionalised training for general practice with regard to the outcomes for the region investing in the training program. A complete operational audit was performed of the outcomes of a training provider of the Commonwealth program, evaluating workforce contribution and retention in the region during and after training, stratified for the effects of locally contextualising, advanced skill training and origin of trainee. The local regional workforce contribution during training peaked at 130 full-time equivalents in 2015. Cumulatively, 53% of alumni remained in the region, but over 40% moved to practice in metropolitan south-east Queensland and other Australian capital cities. Local contextualising of training, completing additional advanced skills training and being an Australian graduate were associated with increased retention in the region. A regional training program is a significant local asset introducing potential general practitioners (GPs) to the region. However, this regional area has become a 'rural' training ground for GPs into metropolitan practice rather than local investment translating as comprehensively as possible into long-term local workforce. The Commonwealth program should focus on local workforce outcomes as an evaluation metric rather than the proportion of trainees in rural training. What is known about the topic?: Retention in regional areas following the Australian General Practice Training (AGPT) program measured on a national basis is greater following regional-based training. What does this paper add?: Local workforce return on investment for training providers in GP is substantial. Contextualised local rural training, Australian graduates and trainees completing advanced rural training improve local return on training investment. A significant proportion of this rural local training program investment provides GPs for metropolitan southeast Queensland. What are the implications for practitioners?: National and regional investment in the AGPT should recognise that despite the lesser supervisory medical workforce and resources, regional training still supports metropolitan GP workforce development. Australian graduates are more likely to remain in a region following local training, as are those who have additionally completed advanced rural skill training. [ABSTRACT FROM AUTHOR]

Objective: To examine the impact and cost associated with mental illness. Methods: A rapid review of the literature from Australia, New Zealand, UK and Canada was undertaken. The review included literature pertaining to the cost-of-illness and impact of mental illness as well as any modelling studies. Included studies were categorised according to impact on education, labour force engagement, earlier retirement or welfare dependency. The well-accepted Drummond 10-point economic appraisal checklist was used to assess the quality of the studies. Results: A total of 45 methodologically diverse studies were included. The studies highlight the significant burden mental illness places on all facets of society, including individuals, families, workplaces and the wider economy. Mental illness results in a greater chance of leaving school early, a lower probability of gaining full-time employment and a reduced quality of life. Research from Canada suggests that the total economic costs associated with mental illness will increase six-fold over the next 30 years with costs likely to exceed A$2.8 trillion (based on 2015 Australian dollars). Conclusions: Mental illness is associated with a high economic burden. Further research is required to develop a better understanding of the trajectory and burden of mental illness so that resources can be directed towards cost-effective interventions. What is known about the topic?: Although mental illness continues to be one of the leading contributors to the burden of disease, there is limited information on the economic impact that mental illness imposes on individuals, families, workplaces and the wider economy. What does this paper add?: This review provides a summary of the economic impact and cost of mental illness. The included literature highlights the significant burden mental illness places on individuals, families, workplaces, society and the economy in general. The review identified several areas for improvement. For example, only limited information is available on the impact of attention deficit hyperactivity disorder, anxiety, cognitive function, conduct disorder, eating disorder and psychological distress. There was also a dearth of evidence on the intangible elements of pain and suffering of people and their families with depressive disorders. More research is required to better understand the full extent of the impact of mental illness and strategies that may be implemented to minimise this harm. What are the implications for practitioners?: Knowing the current and future impact of mental illness highlights the imperative to develop an effective policy response. [ABSTRACT FROM AUTHOR]

The Water Well Project is a health promotion charity that aims to improve the health literacy of individuals of refugee, asylum seeker and migrant backgrounds. Health literacy is an important predictor of health status, but many Australians cannot demonstrate functional health literacy, and individuals from culturally and linguistically diverse (CALD) backgrounds are at higher risk of poor health literacy. The primary participants of The Water Well Project's health education sessions are individuals of refugee, asylum seeker and migrant background, who are at risk of increased morbidity and mortality due to a range of factors. Secondary participants are volunteer healthcare professionals who facilitate these sessions. Because the Water Well Project is a community-centric organisation, the content and delivery of education sessions is shaped by the health literacy needs of the participants. During each session, The Water Well Project aims for a ratio of two volunteer healthcare professionals to every 5-15 participants. Sessions are interactive, with the use of visual aids, and incorporate the services of a professional interpreter when required. Since 2011, over 300 education sessions have been delivered to more than 3000 participants with anticipated flow-on effects to family and friends. The sessions provide a unique opportunity for participants and volunteer healthcare professionals to simultaneously acquire valuable health literacy skills. For participants, this fosters an improved awareness of and trust in the healthcare system; for volunteer healthcare professionals, this affords the opportunity to contribute to the health of vulnerable populations while developing skills in working effectively with interpreters and CALD communities. [ABSTRACT FROM AUTHOR]