Dr Alice Mitchell1, Ms Jade Naeve1, Associate Professor Josh Francis1,2,3, Dr Jennifer Yan1, Mr Alex Kaethner1,4, Ms Vicki Wade1,5, Dr Bo Remenyi1,4, Dr James Marangou1
1Menzies School Of Health Research, Darwin, 2Flinders University, Adelaide, Australia, 3James Cook University, Townsville, Australia, 4NT Cardiac, Darwin, Australia, 5National Heart Foundation of Australia, Sydney, Australia
Nurses and midwives working in remote/rural healthcare services can play a vital role in addressing rheumatic heart disease (RHD) through diagnosis, ongoing support, including staff support, raising awareness and education. Recent data-linked studies and lived experience research of this complex condition reveal the high prevalence of RHD in remote and rural communities and how it can wreak havoc in the lives of young Aboriginal and Torres Strait Islander people, including during pregnancy.
Our implementation study evaluates a new diagnostic approach to screening for RHD in children and pregnant women by incorporating novel technology into routine healthcare: training local healthcare practitioners in handheld single-view echocardiography with offsite image review and timely feedback from specialists. The aim is early diagnosis and prevention of delays in commencing proven secondary prevention to reduce damage to young people’s hearts. Prior research shows that this screening strategy is effective and feasible, and our follow-on study translates research into practice.
Our study uses principles of co-design, community participation and capacity building for local healthcare staff, to implement the new screening strategy into selected remote and rural health services in the Northern Territory and Western Australia. We use a theory-based approach to evaluate the implementation of the new screening strategy.
This study contributes to improving access to echocardiography screening and diagnosis of RHD in high burden communities, improves entry into and retention in a cascade of care including culturally safe care, builds capacity for echocardiography in remote settings, reduces pressure on waiting lists for offsite echocardiography, and supports community-led action to address RHD through health promotion and training.
We present early evaluation findings that reveal insight into best ways to incorporate handheld scanning into routine practice in remote/rural health services, including context specific enablers and barriers, with a view to incorporation of scanning more broadly into services.
Biography:
Alice is a registered nurse and midwife, and holds a Master of Applied Linguistics and PhD in Public Health. Living in Aboriginal communities in the NT since early adulthood provided Alice with rich opportunities to experience and reflect on cross cultural histories, relationships, and attitudes. Undertaking clinical practice in remote communities, and in regional and tertiary hospitals, enabled Alice to develop a generalist repertoire of skills. Moving into Public Health research furthered Alice’s career, leading to personal growth and deeper understanding of current health and remote healthcare situations. Alice’s current role is qualitative evaluation design, interviewing and analysis.