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This research dives into the challenges of accessing allied health services in rural areas of Far West NSW, focusing on workforce distribution, engagement with Aboriginal communities, service delivery models, and the impact on speech and language development. The study explores the Poche Centre Model's impact on service accessibility and effectiveness through a mixed methods design. Funding initiatives and resources for Allied Health Assistants are also highlighted.
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Missing in Action: Allied Health Services in Far West NSW Michelle Lincoln and Kylie Gwynne
An example August 2013 Brewarrina • Population 1,874 (ABS 2011)
Walgett Population: 6,797 (ABS 2011)
The Problem • Access to allied health services for people living in rural and remote areas • Small, unevenly distributed workforce • Recruitment and retention issues • ‘Patchy’ engagement with Aboriginal people and communities
In Far West NSW A Patchwork of Services, not based on population needs or size • Historical • Opportunistic recruitment • Outreach services from multiple government and nongovernment providers • Lack of clarity about service delivery model and expected outcomes
This has resulted in … • Overarching sense of instability and unreliability of allied health services • Unidentified need • Lack of awareness of the benefits • Inequity of access • Questionable effectiveness
Why is this a problem? • AHPs assist people to participate fully in their families, employment, and communities • Their supply is critical to health, quality of life, and community participation, particularly for those with significant disabilities. • Least services in areas of highest demand?
Aboriginal children and speech and language development • The prevalence of speech and language delays and disorders is unknown • Most likely due to a lack of culturally appropriate assessment tools and engagement strategies • Otitis media occurs at much higher rates in Aboriginal and Torres Strait Islander populations than in in non-Aboriginal and Torres Strait Islander populations which can have a significant impact on speech and language development and educational outcomes
Speech, language and communication skills • Oral language and literacy development • Oral language and ability to access the whole school curriculum • Communication skills and • social skills • ability to resolve conflict • employability, SES • incarceration rates
Fine motor, self care, self regulation andsocial skills • Make friends and form relationships • Grasp, write and manipulate objects • Participate in classroom activities • Participate in family and social activities
Poche Centre Model Postdoctoral Researcher Students
Resourcing • Funding for 3 Allied Health Assistant scholarships • Speech Pathologist and Occupational Therapist • Postdoctoral researcher
Research The impact of the Poche Model on accessibility and effectiveness of allied health services in rural and remote areas • Iterative cycle of health services research • Mixed methods design • Child outcome measures • Stakeholder perspectives
References • Davidson, B., Hill, A., & Nelson, A. (2013). Responding to the World Report on Disability in Australia: Lessons from collaboration in an urban Aboriginal and Torres Strait Islander school. International Journal of Speech-Language Pathology, 15, 1, 69-74. • Gould, J. (2008). Non-standard assessment practices in the evaluation of communication in Australian Aboriginal children. Clinical Linguistics and Phonetic., 22, 8, 643-657. • Morris, P., Leach, A., Silberberg, P., Mellon, G., Wilson, C., Hamilton, E. & Beissbarth, J. (2005). Otitis media in young Aboriginal children from remote communities in northern and central Australia. BMC Pediatrics, 5, 27. • Pearce, W., & Williams, C. (2013). The cultural appropriateness and diagnostic usefulness of standardized language assessments for Indigenous Australian children. International Journal of Speech-Language Pathology, 15, 4, 429-440. • Toohill, B., McLeod, S., & McCormack, J. (2012). Effect of dialect on identification and severity of speech impairment in Indigenous Aboriginal children. Clinical Linguistics and Phonetics, 26, 2, 101-119.
http://sydney.edu.au/medicine/public-health/poche/ http://sydney.edu.au/health-sciences/research/wobbly-hub http://twitter.com/WobblyHub