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BackgroundDespite a plethora of research into Aboriginal employment and recruitment, the extent and nature of the retention of frontline Aboriginal people in health, ageing, and disability workforces are currently unknown. In this application, frontline service delivery is defined as Aboriginal people who are paid employees in the health, ageing, and disability service sectors in roles that involve direct client, participant, or patient contact. There is a need to identify the factors that inhibit (push) and promote (pull) staff retention or departure of this workforce from the sectors. This study will provide additional insight about this topic. ObjectiveThe objective of this project is to uncover the factors that influence the retention of frontline Aboriginal workers in the health, ageing, and disability workforces in New South Wales (NSW) who do not have university qualifications. The aim of the proposed project aims to discover the push and pull factors for the retention of the frontline Aboriginal workforce in the health, ageing, and disability sectors in NSW in relation to their role, employment, and community and design evidence-based strategies for retaining the Aboriginal frontline workforce in the health, ageing, and disability sectors in NSW. MethodsThe proposed research will use a mixed methods approach, collecting both quantitative and qualitative data via surveys and interviews to capture and represent the voices and perspectives of Aboriginal people in a way that the participants chose. ResultsIndigenous research methodologies are a growing field in Aboriginal health research in Australia. A key strength of this study is that it is led by Aboriginal scholars and Aboriginal controlled organizations that apply an Indigenous methodological framework throughout the research process. ConclusionsThis study uses a mixed methods design. The survey and interview questions and model were developed in partnership with Aboriginal health, ageing, and disability service workers rather than relying only on research publications on the workforce, government policies, and human resources strategies. This design places a strong emphasis on generalizable findings together with an inductive approach that explores employers and workers’ lived experience of the Aboriginal health workforce in NSW. Excluding workers who have graduated from university places a strong focus on the workforce who have obtained either school or Technical and Further Education or registered training organizations qualifications. Data collection was conducted during the COVID-19 pandemic, and results will include the unique experiences of Aboriginal workers and employers delivering services in an extremely challenging organizational, community, and personal context. International Registered Report Identifier (IRRID)PRR1-10.2196/25261

Training and support will be vital in developing and maintaining a skilled disability workforce in the roll-out of individualised disability funding across Australia. Technology has the potential to deliver training and support that is more accessible and cost-efficient in geographically isolated regions. The current qualitative study explored participants' experience of an autism-specific webinar and individual online support programme delivered to a range of early childhood staff in regional and remote areas. Researchers used purposive sampling to select and interview 11 participants enrolled in the training and support programme. Rigour and trustworthiness of the data were enhanced using member checking and a data analysis check on 20% of the transcripts. Several categories of responses were identified under three broad themes; impact of the training programme, interaction with technology, and barriers to access. Findings indicated that the programme had a positive impact on access to autism-specific learning and support. The interactive nature of webinars and individual online consultations (synchronous learning) was highly valued; however, barriers including extensive travel and busy caseloads resulted in participants relying on recorded webinars (asynchronous learning). Findings from the current study will inform the development of future training programme at an individual, organisational and policy level.

Purpose: The rollout of individualised disability funding in Australia resulted in an increased demand for services for people with a disability, particularly support for the high percentage of Australians with autism spectrum disorder. Continuing professional development is one way to grow and maintain a skilled workforce; however, face-to-face opportunities can be limited in remote areas of Australia. Technology may provide a low-cost and widely accessible platform for providing education and support for staff in these areas. Design/methodology/approach: The current study evaluated a novel webinar training and individual online support program for 36 allied health, education and community support staff. Data were collected via a survey on changes in perceived "knowledge and skills" and "confidence" in supporting children with autism, as well as mode of participation, and accessibility of the program. Findings: Participants reported a significant increase in their "knowledge and skills" and "confidence", in working with children with autism. This increase was positively related to the number of webinars the participants accessed. The mode of webinar access was predominantly via watching recordings of webinars (asynchronous learning). Synchronous learning via individual online sessions was accessed by a small number of participants, mostly allied health professionals. Workload and scheduling were identified as barriers to engaging in the program. The technology platform was found to be accessible and acceptable. Originality/value: A predominantly asynchronous mode of delivery was successful, thereby increasing program access and flexibility for remote staff. Technology was not a barrier to accessing the program regardless of remoteness or job role.

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Background: Australia's National Disability Insurance Scheme (NDIS) was launched in 2013 to provide financial support packages for people with disability to purchase supports and services to enhance independence. People with disability are required to develop a plan with the National Disability Insurance Agency (NDIA), the government department responsible for managing the NDIS. This scoping review aims to ascertain the level of research into people's experience of the NDIS planning process in these geographic areas. Methodology: Research publication databases were searched using a specific search string to identify research about people with disability and their families/carer's experiences of the NDIS planning process in regional, rural and remote regions of Australia. The Mixed Methods Appraisal Tool (MMAT) was adopted to appraise the quality of the research publications. Research publications focused on Aboriginal and Torres Strait Islander people were additionally appraised using the Aboriginal and Torres Strait Islander Quality Appraisal Tool developed by the Centre for Excellence in Aboriginal Chronic Disease Knowledge Translation and Exchange. A thematic synthesis of the publications' contents was undertaken to ascertain people with disabilities and carers experience of the NDIS planning process. Results: Ten (N = 10) research papers were found that met the inclusion criteria. Two papers were policy reviews and reported on the improvements of the NDIS planning process since its conception. The analysis found the research archive focused on five themes: (1) healthcare workforce and NDIA staff; (2) NDIS package holders and carers lack of awareness of the NDIS; (3) cultural/socio‐economic barriers; (4) travel funding; and (5) emotional burden of the NDIS planning process. Conclusion: There are limited papers available that explore people's experiences of the NDIS planning process in regional, rural and remote regions of Australia. This systematic review illuminates the difficulties, barriers and concerns of people with disability and their carers about the planning process. [ABSTRACT FROM AUTHOR]

Background: People with disability living in rural areas are vulnerable to the loss of access to allied health services due to a critical shortage of allied health professionals (AHPs). This study aimed to investigate recruitment and retention issues of importance to AHPs providing services to people with disability in rural New South Wales, Australia. Method: Focus groups and semistructured interviews were conducted with 97 purposively sampled service providers in the disability sector. Interviews and focus groups were digitally recorded and transcribed. A modified grounded theory approach using thematic analysis and constant comparison was used to analyse the data. Results: Three major themes relating to recruitment and retention were identified: (a) flexible recruitment, (b) retention strategies that work, and (c) challenges to retention. Conclusions: AHPs in the disability sector identified some of the same issues influencing recruitment and retention as AHPs in the health, education, and private sectors. Several unique issues were also identified that will assist policymakers to improve recruitment and retention of AHPs employed in the disability sector in rural areas.

Training and support will be vital in developing and maintaining a skilled disability workforce in the roll-out of individualised disability funding across Australia. Technology has the potential to deliver training and support that is more accessible and cost-efficient in geographically isolated regions. The current qualitative study explored participants' experience of an autism-specific webinar and individual online support programme delivered to a range of early childhood staff in regional and remote areas. Researchers used purposive sampling to select and interview 11 participants enrolled in the training and support programme. Rigour and trustworthiness of the data were enhanced using member checking and a data analysis check on 20% of the transcripts. Several categories of responses were identified under three broad themes; impact of the training programme, interaction with technology, and barriers to access. Findings indicated that the programme had a positive impact on access to autism-specific learning and support. The interactive nature of webinars and individual online consultations (synchronous learning) was highly valued; however, barriers including extensive travel and busy caseloads resulted in participants relying on recorded webinars (asynchronous learning). Findings from the current study will inform the development of future training programme at an individual, organisational and policy level. [ABSTRACT FROM AUTHOR]

Therapy service delivery models to non-Indigenous and Indigenous people living in outer regional, remote, and very remote areas of Australia have typically involved irregular outreach from larger regional towns and capital cities. New South Wales (NSW) is the most populous Australian state with 7.23 million people of whom 4.58 million live in the capital city, Sydney. With the state of NSW covering 801,600 square kilometres, the experience of NSW residents with a disability provides a useful overview of the challenges involved in accessing therapy services in rural and remote areas of Australia. NSW government policy advocates for early intervention and person-centred therapy services (New South Wales Government, 2002, 2006, 2007). While in keeping with best-practice principles, these policy goals must be translated on the ground in rural and remote areas. Innovation is required, and collaboration between rural and remote therapists, people with a disability and their carers, and researchers could provide opportunities to develop, implement, and evaluate collaborative new service delivery models that meet local needs across the disability sector. (Contains 1 note.)

Access to timely behaviour support services for children and adolescents with a disability in rural and remote regions of Australia is problematic due to the inadequate supply of specialised staff providing complex behaviour support in their local area. Technology has the potential to provide a timely, quality, low-cost option that extends access to behaviour support services for these children and their support teams in rural and remote areas. The purpose of this narrative review was to explore policy and practice guidelines on the delivery of behaviour support via telepractice for children and adolescents with a disability in Australia, and more specifically for those on the autism spectrum. Secondly, the review aimed to establish the evidence base of this model of service for children and adolescents with autism, in order to reflect on how it aligns with current Australian policy and practice. Practice and policy documents were drawn from selected websites relevant to the delivery of behaviour support via telepractice in Australia. Peer-reviewed literature (2004–2019) on the delivery of behaviour support via telepractice was sourced via four databases. While telepractice appears to have promising utility for the provision of support for children and adolescents with autism who present with challenging behaviour, there was very little policy documentation or guidelines found that related specifically to the delivery of this support. There is a need for further rigorous research to inform policy, establish efficacy, and develop practice guidelines that ensure delivery of high quality telepractice behaviour supports under the National Disability Insurance Scheme. [ABSTRACT FROM AUTHOR]

Teletherapy services are being increasingly provided by allied health professionals to address major inequities of access. While clinical outcomes and stakeholder satisfaction are crucial for paediatric teletherapy's continued viability, processes for increasing parent/caregiver satisfaction, and for modifying aspects of caregiver engagement to improve outcomes, are under‐researched. Studies of in‐person therapy have shown that engagement, satisfaction and outcomes are influenced by the development of therapeutic alliance. This study investigates influences on parents' engagement with a teletherapy program and their therapeutic alliance with the therapist. Using a qualitative approach, data were analysed from semi‐structured telephone interviews with six parents in rural New South Wales, whose children had completed paediatric teletherapy programs provided by a psychologist, speech pathologist or occupational therapist. Parents described factors that affected aspects of their engagement and alliance. Thematic analysis with constant comparison was used to determine the themes of the interviews, which were (a) initial engagement, (b) collaboration and (c) rapport. The themes demonstrate that parents were evaluating the efforts the therapists were making in (a) communicating, (b) truly partnering with them, both being elements of collaboration and (c) building rapport with them and the child. A conceptual model, Parent And Caregiver Evaluation Cycle In Teletherapy (PACECIT), is proposed by the researchers to explain how parents evaluated the therapist to judge the current state of a personal relationship and to judge the effectiveness of a collaborative relationship, both influencing the therapeutic alliance and motivation for engagement. The findings emphasise the importance of fulfilling parent/caregiver expectations for clear and frequent communication, and discussion of their ideas. Also important is the development of therapeutic alliance through utilising parents' observations of non‐verbal communication to maintain an effective rapport and enhance engagement. [ABSTRACT FROM AUTHOR]

Abstract Background Policy that supports rural allied health service delivery is important given the shortage of services outside of Australian metropolitan centres. The shortage of allied health professionals means that rural clinicians work long hours and have little peer or service support. Service delivery to rural and remote communities is further complicated because relatively small numbers of clients are dispersed over large geographic areas. The aim of this five-year multi-stage project is to generate evidence to confirm and develop evidence-based policies and to evaluate their implementation in procedures that allow a regional allied health workforce to more expeditiously respond to disability service need in regional New South Wales, Australia. Methods/Design The project consists of four inter-related stages that together constitute a full policy cycle. It uses mixed quantitative and qualitative methods, guided by key policy concerns such as: access, complexity, cost, distribution of benefits, timeliness, effectiveness, equity, policy consistency, and community and political acceptability. Stage 1 adopts a policy analysis approach in which existing relevant policies and related documentation will be collected and reviewed. Policy-makers and senior managers within the region and in central offices will be interviewed about issues that influence policy development and implementation. Stage 2 uses a mixed methods approach to collecting information from allied health professionals, clients, and carers. Focus groups and interviews will explore issues related to providing and receiving allied health services. Discrete Choice Experiments will elicit staff and client/carer preferences. Stage 3 synthesises Stage 1 and 2 findings with reference to the key policy issues to develop and implement policies and procedures to establish several innovative regional workforce and service provision projects. Stage 4 uses mixed methods to monitor and evaluate the implementation and impact of new or adapted policies that arise from the preceding stages. Discussion The project will provide policy makers with research evidence to support consideration of the complex balance between: (i) the equitable allocation of scarce resources; (ii) the intent of current eligibility and prioritisation policies; (iii) workforce constraints (and strengths); and (iv) the most effective, evidence-based clinical practice.

In Australia and around the world, people with disability and their carers living in rural areas face additional challenges compared to their urban-dwelling counterparts. This cross-sectional study explored current access to therapy services for people with disability living in western New South Wales as reported by their primary carers. Data were collected using an online and paper survey distributed to carers, from December 2012 until June 2013. Information was sought about the carers, the person they care for, access to physiotherapy, speech pathology, occupational therapy and psychology services. A total of 166 carers participated. Respondents were mostly the carers of a son or daughter (83.6%) , the person they care for had an average age of 17.6 years (range 1-69 years) and more than half were males (56%). The majority of people with disability (73.5%) had received therapy services in the last 2 years. Waiting time and distance travelled to access physiotherapy, speech and occupational therapy services varied. People with disability had to wait an average of 6.6 months to receive speech pathology and had to travel an average of 2.6 hours to receive physiotherapy. The main provider of all services was the specialist disability government department, except for psychology, which is mainly provided in the private sector. From the carers' perspective, availability and accessibility to services are limited. Carers noted that availability of services was more restricted once people with disability reached adulthood. Lack of choice and frustration with the lack of availability of specialist disability services was reported frequently. Carers believed that timely allied health intervention prevented the development of more severe or complicated conditions that had a greater impact on carers, families, communities and the person with disabilities. [ABSTRACT FROM AUTHOR]