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Objective To describe parents'/carers' views of the characteristics of a clinical service model shown to improve asthma outcomes. Design A randomised controlled study on education intervention for childhood asthma by Indigenous health care workers. Setting Thursday Island, Horn Island and Bamaga. Participants Thirty-five children received the intervention and 53 were in the control group. At the last study visit 12 months after enrolment, carers were asked to give feedback about the clinical service delivered by paediatric respiratory physicians and the asthma education intervention. Intervention Additional asthma education. Main outcome measures Carers' responses to the open-ended questions were analysed separately by three Indigenous investigators who assigned codes and developed the themes. These were then cross-checked and combined to develop an overall interpretation of the data. Results The carers ( n = 81) of 88 children in the Torres Strait region of North Queensland reported positively to the clinical service delivery. Service was rated as excellent = 26.8%, very good = 51.2%, good = 19.5% and poor = 2.4%. Parents'/carers' views about the clinical service model were grouped into seven themes: clear communication by health professionals, service delivery, professional approach, clear transfer of knowledge and education/clinical knowledge of asthma, established rapport/caregiver satisfaction, importance of coming into the local community, and areas of concern for the carers/parents. Conclusion Community-based perspectives of an effective health service model include empowered Indigenous health care workers currently attached to the medical specialist service with elements of high expertise and appropriate cultural awareness that enabled clear communication and transfer of knowledge. [ABSTRACT FROM AUTHOR]

Problem: Townsville Cancer Centre provides video-consultation (VC) services to patients in rural/remote regions of North Queensland in order to improve access to specialist cancer care. The experience and responses of indigenous patients using this service have not been studied. Our objective is to assess the level of satisfaction and the responses of Indigenous patients, their families and health workers (HWs) to VC and such teleoncology service. Design: Descriptive study, using semistructured interviews. Setting: Tertiary referral centre (Townsville Cancer Centre) and various rural and remote towns in Queensland. Key measures for improvement: Satisfaction levels of Indigenous patients, their family members and Indigenous HWs with various aspects of the teleoncology service. Lessons learnt: Our evaluation suggests that teleoncology is an acceptable model of care for Indigenous patients, with high levels of satisfaction expressed from patients, families and HWs. Health professionals involved with providing this service need to be adaptive to the needs of individual patients and local communities in order to provide culturally appropriate care. Formal skills training for staff, effective communication between specialist and local HWs, and informed consent procedures are essential to maintain safety of practices. Strategies for change are: Mandatory informed consent procedure for all patients offered with VC., Formalised competency training for staff in skills essential to maintain safe practices in teleoncology., Clear clinical documentation to facilitate improved communication in patient management between medical staff at main centre and distant sites., Further efforts in promotion, education and support for staff to participate in telemedicine. [ABSTRACT FROM AUTHOR]