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Purpose: Education, training and continuing professional development are amongst the evidence-based initiatives for attracting and retaining rural and remote health professionals. With rapidly increasing access to and use of digital technology worldwide, there are new opportunities to leverage training and support for those who are working in rural and remote areas. In this paper we determine the key elements associated with the utility of digital technologies to provide education, training, professional learning and support for rural health workforce outside the University and tertiary sector. Design/methodology/approach: A scoping review of peer-reviewed literature from Australia, Canada, US and New Zealand was conducted in four bibliographic databases -- Medline complete, CINAHL, Academic Search complete and Education Complete. Relevant studies published between January 2010 and September 2020 were identified. The Levac "et al." (2010) enhanced methodology of the Arksey and O'Malley (2005) framework was used to analyse the literature. Findings: The literature suggests there is mounting evidence demonstrating the potential for online platforms to address the challenges of rural health professional practice and the tyranny of distance. After analysing 22 publications, seven main themes were found -- Knowledge and skills (n = 13), access (n = 10), information technology (n = 7), translation of knowledge into practice (n = 6), empowerment and confidence (n = 5), engagement (n = 5) and the need for support (n = 5). Ongoing evaluation will be critical to explore new opportunities for digital technology to demonstrate enhanced capability and retention of rural health professionals. Originality/value: To date there has been limited examination of research that addresses the value of digital platforms on continuing professional development, education and support for rural health professionals outside the university and tertiary training sectors.

Purpose: This paper explores the impact of a suite of alcohol culture change interventions implemented by Deakin University in Melbourne, Australia. The interventions were designed to change the alcohol culture at a bi-annual nation-wide university multi-sport competition known as Uni Nationals. This study aims to understand the critical success factors of the alcohol culture change initiatives that were developed by the university and implemented as part of a broader set of institutional practices. Design/methodology/approach: A qualitative research design utilised in-depth, semi-structured interviews with nine Uni Nationals student team leaders. In total, two group interviews and four individual interviews were conducted with student team leaders who participated in the Uni Nationals. The interview transcripts were coded and themed. The themes were further refined and interpreted into a narrative. A total of two transcripts were independently coded by the first two authors. Discordant coding was flagged and discussed until a consensus was achieved. The remaining interviews were coded by the first author and discussed with the second author to ensure consistency. A socio-ecological framework was used to understand perceived changes to alcohol culture. Findings: Student leaders were aware of and felt supported by the university-wide approach to changing the culture of Uni Nationals. Overall, the qualitative study indicated that students were positive about the alcohol culture change interventions. The leadership training that engaged team leaders in interactive activities had the greatest impact. Student leaders found the targeted messages, mocktail events and Chef de Mission (CdM) less effective cultural change strategies. However, they helped to establish expectations of students in this setting where a heightened focus on sport was associated with higher alcohol consumption. Originality/value: While there has been growing academic interest in exploring "drinking cultures", there has been relatively little focus on alcohol culture of university students at sporting events. The paper contributes to addressing this gap by shedding light on the impact of a group of interventions on the drinking culture of the Uni Nationals subculture.

Objective: To identify the technology and connectivity issues in rural and remote general practices, and the factors independently associated with these issues that negatively impact staff's capability to perform their job. Methods: An annual cross‐sectional survey of rural and remote general practice managers. Dependent variables included demographic data, practice size, geographic location, connection type and frequency of connectivity issues. Descriptive statistics are presented, and bivariate logistic regression was undertaken to determine factors independently associated with connectivity issues that negatively impact staff's capability to perform their job. Participants: One hundred sixty‐eight general practice managers from rural and remote New South Wales. Results: The majority of respondents (87%, n = 146) indicated that technology and connectivity issues had impacted staff's capability to perform their job. Internet problems were the most frequently reported issue (36%, n = 61). In bivariate analysis, practices that had a total clinical staff headcount between 5 and 7 (OR 0.27; 95% CI 0.10–0.67; p = 0.005) or between 8 and 11 (OR 0.39; 95% CI 0.16–0.95; p = 0.038) were significantly less likely to report technology and connectivity issues that negatively impact staff's capability to perform their job, compared with practices with a total clinical headcount of less than five. Conclusions: Technology and connectivity issues persist in rural and remote general practices. This is the first study to demonstrate that technology and connectivity issues impact on rural staff's capability to perform their job. Furthermore, smaller practices face more technology and connectivity issues that negatively impact staff's capability to do their job than larger practices. Further research is required to find solutions to address these challenges. [ABSTRACT FROM AUTHOR]

Aims: The Drug Education in Victorian Schools (DEVS) programme taught about licit and illicit drugs over two years (2010-2011), with follow up in the third year (2012). It focussed on minimising harm and employed participatory, critical-thinking and skill-focussed pedagogy. This study evaluated the programme's residual effectiveness at follow up in reducing alcohol-related risk and harm. Methods: A cluster-randomised, controlled trial was conducted with a student cohort during years eight (13-14 years old), nine (14-15 years old) and 10 (15-16 years old). Schools were randomly allocated to the DEVS programme (14 schools, n = 1163), or their usual drug education (7 schools, n = 589). Multi-level models were fitted to the data, which were analysed on an intent-to-treat basis. Statistically significant findings: Over the 3 years, there was a greater increase in intervention students' knowledge about drugs, including alcohol. Their alcohol consumption did not increase as much as controls. Their alcohol-related harms decreased, while increasing for controls. There were fewer intervention group risky drinkers, and they reduced their consumption compared to controls. Similarly, harms decreased for intervention group risky drinkers, while increasing for controls. Conclusions: Skill-focussed, harm minimisation drug education can remain effective, subsequent to programme completion, in reducing students' alcohol consumption and harm, even with risky drinkers.

Introduction: This study examines the impact of funding provided to support the well‐being of rural health practitioners and their practice staff following the 2019–2022 bushfires. Objective: To assess the benefits and implications of grant funding for rural practices to aid recovery following bushfires in NSW, Australia. Design: An explanatory sequential mixed method design consisted of a survey and a thematic analysis of semi‐structured Interviews. Findings: Five key themes emerged from analysis: (1) the disasters altered the role of the practice and therapeutic relationships; (2) the funding had a positive impact on access to professional development; (3) the training had a positive impact on staff well‐being and resilience; (4) the professional development had a positive impact on rural practitioner's sense of capability; and (5) important elements of future grant opportunities. Discussion: The findings indicate the importance of recovering funding to facilitate access to professional development for rural health practioners during natural disasters which improved their mental health and wellbeing, capability and support to clients. Conclusion: Recovery funding facilitated improvement in workforce capability, professional resilience, mental health and well‐being in the face of natural disasters and emergencies. There was a link between training and maintaining the capability of rural health care practitioners and their practice staff. Capability was an important factor in the well‐being and resilience of the health workforce and their ability to support clients. [ABSTRACT FROM AUTHOR]

The non-acute health charity sector forms part of the global health services industry. Organisational Performance Measurement (OPM) is fundamental for modern business to achieve sustained excellence yet is under-utilised by non-acute health charities. The Non-Acute Health Charity Performance Implementation Framework (NCPI Framework) was developed to support non-acute health charities undertaking OPM. A non-acute health charity case study undertook a 12-month OPM implementation process using the NCPI Framework. This study had three aims. Firstly, to understand the perceptions of staff employed by the case study organisation regarding their experience of the 12-month NCPI Framework implementation process, secondly to identify whether an interrelationship existed between the NCPI Framework's implementation elements and the staff's perspectives, and thirdly, identify areas of strength and improvement which could enhance the NCPI Framework's effectiveness. Data were collected post implementation and analysed thematically from open-ended question responses from an anonymous survey and semi-structured interviews. Participants supported the introduction of OPM and valued the NCPI Framework's structured implementation guidelines. Six interrelated themes were identified: clarity, adaptability, alignment, transparent communication, capability and accountability. Participants suggested adaptations to enhance the NCPI Framework's impact. A culture aligned with organisational learning was identified as potentially having a positive impact on the NCPI Framework's implementation. The NCPI Framework may also have relevance and application to the non-profit industry beyond non-acute health care and for use in program development and service quality initiatives. [ABSTRACT FROM AUTHOR]

Objective: Participatory learning strategies are integral to the effectiveness of school-based health education programmes; however, use of such methods is not the norm in teaching. The omission of participatory learning strategies is a common form of programme breakdown leading to erosion of positive learning and behavioural outcomes. Based on a survey of 75 Australian high school health education teachers, the study's objective is to examine teachers' perspectives on the factors that influence their use of participatory learning strategies. Results: Whilst it is often presumed that training is the most significant factor, this study found that teachers identify understanding the educational rationale for the approach, student engagement, confidence in class control, and having positive relationships with the students, along with practicalities such as having time to adequately prepare a class, as the most significant influences on their pedagogical choices. Conclusion: The study concludes that a better understanding of the reasons why teachers make particular choices in their delivery of programmes gives valuable insight into what teachers need in order to support uptake or maintenance of such approaches. This understanding may in turn contribute to health education programmes being delivered with a higher fidelity and better outcomes for students.

The Drug Education in Victorian Schools program provided integrated education about licit and illicit drugs, employed a harm minimization approach that incorporated participatory, critical thinking and skill-based teaching methods, and engaged parental influence through home activities. A cluster-randomized, controlled trial of the program was conducted with a student cohort during Year 8 (13 years) and Year 9 (14 years). Twenty-one secondary schools in Victoria, Australia, were randomly allocated to the Drug Education in Victorian Schools program (14 schools, n?=?1,163) or their usual drug education program (7 schools, n?=?589). This study reports program effects for alcohol. There was a greater increase in the intervention students' knowledge about drugs, including alcohol; there was a greater increase in communication with parents about alcohol; they recalled receiving more alcohol education; their alcohol consumption increased less; and they experienced a lesser increase in alcohol-related harms. Among intervention group risky drinkers, consumption and harm increased less. There were no differences between study groups in attitudes toward alcohol or in the proportion of drinkers or risky drinkers. While the program did not stop students taking up drinking, it did reduce their consumption and harm.

Aim: This pilot study investigated what alcohol prevention benefits could be achieved by a harm reduction focused school drug education intervention that addressed all drug use, both licit and illicit. Method: The study population comprised a cohort of 225 students in three intervention secondary schools and 93 students in a matched control school in Victoria, Australia. A classroom drug education programme, derived from evidence of effective practice and designed to reduce alcohol and other drug harm, was provided to the intervention students during years eight (13-14 year olds) and nine (14-15 year olds) by teachers trained in its delivery. The control students received the drug education programme normally provided by their school. Findings: The students, who received the intervention, were more knowledgeable about drug use issues, communicated more with their parents about alcohol, drank less, got drunk less, and experienced fewer alcohol related harms. They also remembered receiving more alcohol lessons. They were, however, no less likely to have tried alcohol. Conclusions: The findings are consistent with other studies that have demonstrated school alcohol education that focuses on harm reduction can be effective in reducing consumption, risk and harm. In this study, this was achieved even though the students were not persuaded against taking up drinking, and the intervention did not focus solely on alcohol. These findings have implications for both the goals and coverage of future school drug education programmes. (Contains 6 tables and 2 figures.)

This study describes Australian year eight students' (13-14 years old) experiences with alcohol in terms of communication with parents, initiation into drinking, patterns of consumption, context of use, and harms experienced. The sample comprised 521 year eight students from four state government secondary schools in the state of Victoria. Three of the schools are in Melbourne, the capital of Victoria; the fourth is in a rural center. Female and rural students were more likely to talk to parents about alcohol, but this was not associated with safer drinking. Initiation into drinking was higher among rural students. Rural students also drank more, were more likely to drink without adult supervision, to drink to get drunk, and drink more than planned. Student drinkers experienced just over four alcohol-related harms on average in 12 months, with some indication of greater harm among rural students. Higher levels of drinking by rural students, accompanied by more risky patterns of consumption and the possibility of greater harm, supports prioritizing interventions in rural schools. (Contains 6 tables.)

Background: Health professionals' perceptions of persuasive design techniques for use in technological solutions to improve health workforce capability have not been previously explored. Objective: This study aims to explore rural health professionals' perceptions of health workforce capability and persuasive design techniques; and translate these into recommendations for designing a health workforce capability app to increase their impact and usefulness. Methods: Qualitative interviews with 13 rural health professionals were conducted. Subsequently, 32 persuasive techniques were used as a framework to deductively analyze the data. Persuasive design technique domains were Primary Task Support, Dialog Support, System Credibility Support, Social Support, and Cialdini's Principles of Persuasion. Results: Persuasive design techniques can be applied across the factors that influence health workforce capability including health and personal qualities; competencies and skills; values, attitudes, and motivation; and factors that operate outside of work and at the team, organizational, and labor market levels. The majority of the 32 persuasive design techniques were reflected in the data from the interviews and led to recommendations as to how these could be translated into practice, with the exception of scarcity. Many suggestions and persuasive design techniques link back to the need for tailored and localized solutions such as the need for country-specific-based evidence, the wish for localized communities of practice, learning from other rural health professionals, and referral pathways to other clinicians. Participants identified how persuasive design techniques can optimize the user experience to help meet rural health professionals needs for more efficient systems to improve patient access to care, quality care, and to enable working in interprofessional team-based care. Social inclusion plays a vital role for health professionals, indicating the importance of the Social Support domain of persuasive techniques. Overall, health professionals were open to self-monitoring of their work performance and some professionals used wearables to monitor their health. Conclusions: Rural health professionals' perceptions of health workforce capability informed which persuasive design techniques can be used to optimize the user experience of an app. These were translated into recommendations for designing a health workforce capability app to increase likelihood of adoption. This study has also contributed to the further validation of the Persuasive Systems Design model through empirically aligning elements of the model to increase persuasive system content and functionality with real-world applied data, in this case the health workforce capability of rural health professionals. Our findings confirm that these techniques can be used to develop a future prototype of an app that may assist health professionals in improving or maintaining their health workforce capability which in turn may increase recruitment and retention in rural areas. Health professionals need to be central during the design phase. Interventions are needed to provide a supportive environment to rural and remote health professionals to increase their rural health workforce capability. [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 This study seeks to extend earlier Australian school drug education research by developing and measuring the effectiveness of a comprehensive, evidence-based, harm reduction focused school drug education program for junior secondary students aged 13 to 15 years. The intervention draws on the recent literature as to the common elements in effective school curriculum. It seeks to incorporate the social influence of parents through home activities. It also emphasises the use of appropriate pedagogy in the delivery of classroom lessons. Methods/Design A cluster randomised school drug education trial will be conducted with 1746 junior high school students in 21 Victorian secondary schools over a period of three years. Both the schools and students have actively consented to participate in the study. The education program comprises ten lessons in year eight (13-14 year olds) and eight in year nine (14-15 year olds) that address issues around the use of alcohol, tobacco, cannabis and other illicit drugs. Control students will receive the drug education normally provided in their schools. Students will be tested at baseline, at the end of each intervention year and also at the end of year ten. A self completion questionnaire will be used to collect information on knowledge, patterns and context of use, attitudes and harms experienced in relation to alcohol, tobacco, cannabis and other illicit drug use. Multi-level modelling will be the method of analysis because it can best accommodate hierarchically structured data. All analyses will be conducted on an Intent-to-Treat basis. In addition, focus groups will be conducted with teachers and students in five of the 14 intervention schools, subsequent to delivery of the year eight and nine programs. This will provide qualitative data about the effectiveness of the lessons and the relevance of the materials. Discussion The benefits of this drug education study derive both from the knowledge gained by trialling an optimum combination of innovative, harm reduction approaches with a large, student sample, and the resultant product. The research will provide better understanding of what benefits can be achieved by harm reduction education. It will also produce an intervention, dealing with both licit and illicit drug use that has been thoroughly evaluated in terms of its efficacy, and informed by teacher and student feedback. This makes available to schools a comprehensive drug education package with prevention characteristics and useability that are well understood. Trial registration Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000079842