The Chronicle Volume 27, Issue 1, AprIl 2016 publIcAtIon of the chronIc DIseAses network

IN THIS ISSUE...

+ From the CDN Team..................p1+ Introducing the CDN Team.........p2+ 19th Annual CDN Conference Review.......................................p2+ CDN Conference Award Photos ...................................................p3+ CDN Conference Photos...........p4+ 2016 Conference Update...........p5+ Updates from CCSU

- Australian National Diabetes Strategy 2016-2020...............p6 - Update - National Strategic Framework for Chronic Conditions..............................p6 - Targets & Indicators for Chronic Disease Prevention in Australia, AHPC.....................................p7

+ Health Statistics at a Glance......p7+ Profiling the PCCEs...................p8+ Article ‘Remote Alcohol & Other Drugs Workforce Program’.......p10+ Article ‘Midway review of the CCPMS NT 2010-2020............p11+ Chronic Condition Journal Articles of Interest.................................p12

The Chronic Diseases Network was set up in the 1997 in response to the rising impact of chronic conditions in the NT. The Network is made up of organisations and individuals who have an interest in chronic conditions. These include:• Aboriginal Medical Services of the

NT• Arthritis & Osteoporosis Founda-

tion of the NT• Asthma Foundation of the NT• Cancer Council of the NT• Healthy Living NT• Heart Foundation - NT Division• Medicare Local NT• Menzies School of Health Re-

search• NT Department of Health (Chronic

Conditions Strategy Unit, Aborigi-nal Policy & Stakeholder Engage-ment Unit, Health Gains Planning Unit & Remote Health Unit) & DoH Top End and Central Australia Health and Hospital Services

The Chronic Diseases Network

nt Department of health www.health.nt.gov.au/chronic_conditions/chronic_Disease_network

The Chronicle

CDN Editorial Committee

Chronic Disease NetworkT: 08 8985 8174E: ChronicDiseasesNetwork.THS@nt.gov.au

Contributions appearing in The Chronicledonotnecessarilyreflectthe views of the editor or DoH.

Contributions are consistent with the aims of the Chronic Diseases Network and are intended to:• Inform and stimulate thought

and action• Encourage discussion and

comment• Promote communication, col-

laboration, coordination and collective memory

From the CDN team

WelcomebacktothefirsteditionofTheChroniclefor2016.Wesincerelyapologise for the recent silence throughout the network. The CDN support team was going through vacancies and recruitment process which resulted in limited publications of the e-CDNews and no publications of The Chroniclefor2015.

Arising from the break in publications of The Chronicle, the CDN has decided to evaluate this and it’s other publications. CDN has completed a brief survey and commenced preliminary liaison with some of our key stakeholders to gain feedback on The Chronicle, and determine the most effectivenewdirectionfor2016.

Feedback received to date has highlighted some common themes: • The Chronicle remains an important resource • TheChroniclefillsatargetaudienceandrequiredinformationgap not duplicated by current organisations/publications• That articles and information should focus at a grass roots level• A short format with key pieces of information is preferred and there remains divided thoughts regarding electronic vs paper based publications,• Foreseen challenges include member engagement in regards to information sharing and article input.

The format for the The Chronicle is still evolving therefore will be subject to further changes. We appreciate and value everyone’s input and under-stand its importance for the success of this publication. We look forward to integrating information and resources throughout the NT with the support of member contributions. This will ensure The Chronicle is collaborative in its aim to support prevention strategies and reduce the health impact of chronic conditions on the NT population.

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Introducing the CDN Team

CDN CoordinatorAlexandra Young

Alex, as she is known to many people in the health sec-tor, has recently joined the Chronic Conditions Strategy Unit as the new CDN Coordinator. She was a Senior Physiotherapist with Royal Darwin Hospital who is keen and excited to take up the challenging role in coordinat-ing and managing a number of CDN activities. She has more than ten years’ experience in physiotherapy and is currently studying Masters in Public Health to support the transition from clinical to policy/program development in public and population health focus. Alex will continue andleadtheplanningandimplementationofthe20thCDN conference jointly delivered with the Public Health AssociationofAustraliaon18to21September2016inAlice Springs. She is calling for CDN members for their support on this year’s conference by presenting and/or attending this highly popular conference.

CDN Member Services OfficerLevonne Chin

LevonnehasrecentlycommencedinJanuary2016withthe Chronic Conditions Strategy Unit, as the CDN MemberSupportOfficer.ShehasadegreeinOccupational Therapy and has experience in both this profession and a variety of administration roles. Over the past few months with the CDN team, she has published 3 monthly e-CDNews publication and started preliminary conversations with PHAA on the organisation of the joint PHAA/CDN Annual Conference for2016.Levonne,alongsideAlex,willbestartingtopromote the upcoming conference throughout the Network and calling for article submissions for future The Chronicle editions from CDN members.

19th Annual CDN Conference Review

The 19th Annual Chronic Disease Network Conference, Connecting the Care Across the Life Span was held at Darwin Convention Centre.

Overthe24thand25thSeptember2015,214delegatesgathered from around Australia, to discuss and share ideas. Six keynote speakers addressed the conference and42presenterspresentedtheirresearchstudies,projects or programs alongside poster displays and workshops. Featured keynote speakers were Dr Sharon Willcox, Kerry Copley, Dr Sue Kildea, Dr Leon Earle,

Heather D’Antoine and Professor Nick Lennox. Charlie King assisted as the Master of Ceremonies.

Exhibitor booths at the conference featured some CDN key stakeholders and other key organisations including AMSANT, Alzheimer’s Australia NT, Arthritis & Osteopo-rosis NT, Cancer Council, Communicare, Donate Life NT, Edith Cowan University, Good Health Alliance NT, Heart Foundation, NT Aids & Hepatitis Council, NT PHN and Roche.

The2015conferencealsoheldaWelcomeReceptionand CDN Recognition Awards evening, which provided an opportunity to recognise and celebrate innovation, leadership and achievements made by those working in thefieldofChronicConditionsthroughouttheNT.

Winnersofthe2015CDNRecognitionAwardswere:

Chronic Disease Health Promotion/ Program Delivery Award (Team)Primary Health Care Team at Santa Teresa

Aboriginal and Torres Strait Islander Health & Leadership Award – FemaleEmslie Dianne Lankin

Aboriginal and Torres Strait Islander Health & Leadership Award – MaleDavid Adams

Outstanding Contribution to the Prevention and Man-agement of Chronic Conditions in the Northern Territory (Individual)Katie Michell

Continuous Quality Improvement (Individual)Grace Daly

Written feedback indicated that delegates’ appreciated the values the conference had presented including the strong Northern Territory focus within the concurrent presentations and excellent opportunity to network with colleagues from and outside the Northern Territory.

Thank you to all colleagues and stakeholders who have contributedinorganisingandparticipatinginthe2015CDN Conference. We look forward to seeing you all againatthe2016Conference.

Photosfromthe2015Conferencearefeaturedonthefollowing pages.

Detailsontheupcoming2016CDNConferenceareprovided on Page 5.

From the CDN team.

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CDN Award Event Photos

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CDN Award Recipient Photos

The Chronicle

Conference Exhibitor Photos

PHC Team Santa TeresaDr Maypilama

Grace Daly

David Adams

Emslie Dianne Lankin

Katie Michell

Publication of The Chronic Diseases Network

The20thChronicDiseasesNetworkConferenceisbeingjointlyhostedwiththePublicHealthAssociationAustralia(PHAA)44thAnnualConferencefromSunday18toWednesday21September2016attheAliceSpringsConventionCentre.

The Conference theme is based around the World Federation of Public Health Associations Global Charter for the Public’s Health, with a focus on services proposed in the charter of protection, prevention, promotion.

Increasingpublichealthawarenessisrequiredtoassistinreducingtheimpactofchronicconditionsthroughpopulation health approaches in order to have an impact on individual’s health outcomes. Population health is directly affected by health policies, funding, and service models.

Theconferencewillpresentthefieldsofbothpublichealthandchronicconditions.Thethemewillbesupportedbya number of complementary streams, each with a strong focus on building capacities for improving health outcomes with a focus on contemporary health initiatives, health policy, research, models of care, Aboriginal and Torres Strait Islander health, leadership, workforce, telehealth, tools/applications and resources.

Call for Abstracts

CallforabstractsarenowopenforthejointlyhostedPHAA44thAnnualConferenceand20thChronicDiseasesNetwork Conference.

For more information on the call for abstracts of to submit an abstract please visit:https://phaa.eventsair.com/QuickEventWebsitePortal/phaa-cdn-conference/eis/ExtraContent/ContentPage2

Call for abstracts close midnight, Sunday15May2016.

Key dates

Callforabstractsopen:Wednesday6April2016Earlybirdregistrationsopen:Monday2May2016Callforabstractsclose:midnight,Sunday15May2016Earlybirdregistrationsclose:midnight,Thursday30June2016Conference:Sunday18toWednesday21September2016

Conference Website

https://phaa.eventsair.com/QuickEventWebsitePortal/phaa-cdn-conference/eis

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6 April2016

Australian National Diabetes Strategy 2016-2020

The Australian Government has developed and published a newNationalDiabetesStrategy2016-2020(theStrategy).This strategy provides an outline to Australian’s national response to diabetes and aims to inform how existing limited health care resources may be better coordinated and targeted through and across all levels of government.

The Strategy was endorsed by the Australian Health Ministers’ Advisory Council (AHMAC) on 2 October2015, and publically released on 13 November 2015.The Strategy was informed by expert advice from the National Diabetes Strategy Advisory Group, alongside consultations with key stakeholders and the community.

An implementation plan is to be developed to consider ways to direct funding and other resourses to priority initiatives and ways to evaluate the progress of the Strategy. The Australian Government’s Department of Health, in consultations with jurisdictions across Australia, is establishing a jurisdictional implementation group, which includes the NT. Implementing the Strategy will requireacoordinatedeffort fromgovernmentsandotherparts of the community including people with diabetes, heath care professionals, non-government organisations, researchers, families, carers, communities and industry.

Copies of the Strategy can be accessed via the Commonwealth Department of Health’s website.

www.health.gov.au/internet/main/publishing.nsf/Content/nds-2016-2020

Update - National Strategic Framework for Chronic Conditions

The Australian Government, in consultation with the Northern Territory (NT) and other jurisdictions, is developing the National Strategic Framework for Chronic Conditions (the Framework). An inter-jurisdictional working group, which includes the NT, has been established by the Community Care and Population Health Principle Committee of the Australian Health Ministers’ Advisory Council.

The Framework is being developed to supersede the National ChronicDiseaseStrategy2005andassociatedNationalService Improvement Frameworks. The overall purpose and role of the national Framework is to provide national leadership and support the work of States and Territories in the prevention, early detection and management of chronic conditions. The Framework will address shared health determinants, risk factors and multi-morbidities across a broad range of chronic conditions. As such the Framework is intended to be an overarching document to guidethedevelopmentofdisease-specificimplementationplanswhenorifrequired..Theconsultationprocess,on-line and face-to-face, has been completed last November 2015. In the NT, consultation inAlice Springs was heldon26October2015andinDarwinon30October2015.

A brief summary of responses gathered from the NT consultation process in 2015 are as follows.

As the NT has experience in implementing a strategy, the following were discussed:

•The proposed timeline of 10 years of the Framework appearsappropriatetoreflectthelongtermapproachrequiredfortheareaofchronicconditions.•A clear and continued commitment to evidence

based planning, development, implementation, reviewandevaluationshouldberequiredfromtheFramework in order to accurately measure progress and outcomes. •Identifying how progress is measured is important to

outline within the Framework. •It should be outlined how care providers will be

supported to deliver ‘improved outcomes in chronic conditions’ under the Framework.

Further feedback in relation to the draft Framework included:

•The role of social determinants of health should be clarifiedandhowthedeterminantsaretargetedandmeasured against within the Framework should be moreclearlydefined.•Changing the language within the draft to include

greater focus on chronic condition prevention wouldassistinstrengtheningandfurtherdefiningpreventative approaches.

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•The lack of links to chronic conditions prevention in children’s health should be addressed.•Further focus should be included on the importance

of workforce development. The Framework should be used to support the NT in strengthening the link of in-practice research within the areas of prevention and management.

These responses to the Draft National Strategic Framework for Chronic Conditions were presented back totheworkinggroupinlate2015.ThecompletionoftheNational Strategic Framework for Chronic Conditions is anticipatedbylate2016.

Targets and indicators for chronic disease prevention in Australia

Australian Health Policy Collaboration

The Australian Health Policy Collaboration’s (AHPC) work at Victoria University aims to contribute to a whole of population approach in policies, institutional arrangements and service models to better prevent and manage chronic conditions in Australia. The AHPC in the last few months has worked with eminent health experts from around Australia to develop national chronic disease targets and indicators that can support, guide and track progress towards a substantial change in health outcomes. The development of the chronic conditions targets and indicators is based on the World Health Organisation Global Action Plan for the Prevention and Control of Non-communicable Diseases (NCD) 2013-2020, with the added inclusion of mental health. The NT Department of Health (DoH) has received an invite from the AHPC to discuss the proposed chronic conditions targets and indicators and their value to the Northern Territory’s policy agenda and objectives.

The NT DoH will be seeking involvement from relevant stakeholders including Top End and Central Australia Health Services, Aboriginal Medical Services Alliance of NT (AMSANT), Menzies School of Health Research, and other key non-government organisations in these discussions. Updates are to follow.

Coming Soon!

The Annual Progress Report for 2012-2013 of the NTChronic Conditions Prevention and Management Strategy 2010-2020will soonbepublishedon theDepartmentofHealth’s website. This report presents a range of activities undertaken by the Department of Health and its partners under each of the eight key action areas of the Strategy.

Health Statistics at a Glance

Northern Territory Indigenous Australians and Chronic Conditions

Data from the Australian Institute of Health and Welfare on Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report – Northern Territory for the period of2008–2012,reportsthat:

In the Northern Territory, 22% of Indigenous Australians have circulatory disease compared to 20% of Indigenous

Australians across Australia.

For Circulatory Disease in Indigenous Australians in the NT, according to the National Mortality

Database during the period from 2008 to 2012, there were 523 deaths reported.

19% of Indigenous Australians adults in the NT had diabetes, compared to 11% of Indigenous Australians nationally.

Diabetes mortality age-standardised rate for NT Indigenous Australians was 185 per 100,000. The gap

between Indigenous and non-Indigenous Australians was 162 per 100,000.

Indigenous Australians in the NT aged over 18 years have a rate of 40 per 100 of chronic kidney disease, while non-

Indigenous Australians are 9 per 100.

Chronic kidney disease mortality rates in the NT. Age-standardised rate for Indigenous Australians is 63 per 100,000 compared to 10 per

100,000 for non-Indigenous Australians.

13% of Indigenous Australians in the NT had respiratory disease that lasted 6 months or more. NT Indigenous Australians are 0.7 times as likely

as non-Indigenous Australians to report respiratory disease.

For respiratory disease mortality rates in the NT, the age-standardised rate for Indigenous Australians is 152 per 100,000

compared to 59 per 100,000 for non-Indigenous Australians.

Full publication of Aboriginal and Torres Strait Islander Health Performance Framework 2014 Report: Northern Territory accessible via: www.aihw.gov.au/publication-detail/?id=60129553241

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Profiling the Preventable Chronic Conditions Educators in the Top End and Central Australia Health Services

The Preventable Chronic Conditions Educators (PCCEs) are an essential group of health professionals who provide support to primary health care staff in implementing key action areas of the NT Chronic Conditions Prevention and Management Strategy. They focus on improving clients’ health outcomes by improving the prevention, early detection and management of chronic conditions.

ThisfeaturearticlepresentsprofilesofafewPCCEsaroundtheTopEndandCentralAustraliatoprovideaninsightinto some of their valuable current and future activities to improve chronic care.

Charmaine Rungan

CharmaineworkedatMiwatjHealthandjoinedtheEastArnhemNorthOutreachteaminNovember2015.Shehasbeenintroducedto2ofher3communities,namelyGapuwiyakandMillingimbiandisduetovisitRaminginingshortly.She is looking forward to being able to establish relationships with communities, local health staff and other stake holders, to assist in improving client health outcomes. She plans to work closely with the local primary health care team in addressing key performance indicators, organising education and clinical support as well as assisting the local team to improve the uptake of Adult Health Checks and client recalls.

Charmaine is determined to work together with the local primary health care team to strengthen chronic care in East Arnhem North.

From her recent visit to The Aged Care Centre at Millingimbi, the Manager there is keen to have Charmaine provide educational support on chronic conditions relevant to client’s needs, for their students studying through Charles Darwin University.

At the recent visit she delivered a diabetic information session to Gapuwiyak Indigenous Aged Care staff, to help support their clients with diabetes and to recognise hypoglycaemia or hyperglycaemia. The Aboriginal Health Worker fromtheclinicandtheNutritionistfromtheteamwillprovideongoingsupportonthespecificdietfortheseclients.

Contact: Charmaine.Rungan@nt.gov.au

Fiona Stimpson

FionajoinedtheEastArnhemSouthOutreachteaminJanuary2015.SheprovidessupporttothePrimaryHealthCare team in Numbulwar, Bickerton Island, Umbakumba, Angurugu and Alyangula. As a PCCE her work includes on-going education to support Remote Area Nurses, Allied Health Professionals, Medical staff and Primary Health Care Managers on best practice chronic care including changes in chronic condition care plans. She also participates in community engagement and works with multiple stakeholders to identify the needs within the communities regarding specifichealthconcerns.In her allocated communities, Fiona is able to initiate and nurture strong relationships with community members who are willing to engage in conversations regarding health concerns. The school principals are supportive of the healthy lifestyle program and the inclusion of the primary health care outreach team (PHCOT) in the education of their students. Access to health centres, at times, can be challenging due to lack of space. Fiona is working hard to encourage the implementation of preventive health programs in this challenging environment where staff turnover is common.

Some programs Fiona is currently progressing include: * HealthyLifestyleSchoolProgramatNumbulwarSchool.Thisprojecthasbeenrunningsince2015andwasaimed

at senior students. The program was undertaken in collaboration with the Primary Health Care Nutritionist with follow up lessons on health food choices and cooking classes.

* The Healthy Lifestyle School program will be extended to Angurugu, although it is still in the planning process, it had been proposed to commence 17th February.

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* East Arnhem South primary health care outreach team is developing and implementing a project across all regions to identify common health concerns across the whole region. Community consultation and engagement is currently underway. Utilising the PHCOT, the end goal is to support the community build its own capacity in addressingthe(identified)healthconcernsandassistthemtoimplementsustainablestrategiesinordertoachievemeaningful changes to improve health outcomes.

Contact: Fiona.Stimpson@nt.gov.au

Julie Pedersen

Julie Pedersen is a Preventable Chronic Conditions and is responsible to provide support to the primary health care teaminYuendumu,NyirripuandYuelumu.Sheenjoysworkinginthisfieldincludingchallengesthatcomewiththework. She said the most rewarding part of her role is working with clients and their families to help them understand health issues and work with them to make positive changes for improved health outcomes. She also assists the primary health care centre staff to ensure their awareness of and ability to utilise systems in place in order to improve chronic care. Her other roles include being involved with the development of processes and tools to improve systems used for day-to-day delivery of chronic care in remote communities. She is currently working with the Alice Springs Correction Service to improve chronic disease management program in prison.

Although this piece of work is taking much of Julie’s time, at the same time, it has been very rewarding. Contact: Julie.Pedersen@nt.gov.au

Susan Twining

SusanhasveryrecentlyjoinedtheTopEndCentralOutreachTeaminFebruary2016.AsaPCCEbasedinMilikapiti,her work areas include Tiwi Islands and Belyuen. She is currently attending orientation work to familiarise herself tothisnewrole.Shebelievesoneofthechallengesinherworkmayarisefromtravelrequirementstoothertargetcommunities as at this time she is based at Milikapiti. Having lived for a number of years in Nguiu, she is fully aware that the best enabler to successfully perform in this position is being on the ground and being familiar or have good rapport with people in the communities.

Current/future programs:* Susan was involved in the diabetes and nutrition projects conducted in a Top End community prior to her

commencement as the PCCE in this region. Once Susan gets settled in her role, she plans to re-initiate and/or conduct new programs within her target work areas.

Contact: Susan.Twining@nt.gov.au

If you wish to seek further information from any of these PCCEs, they are more than happy for you to contact them directly at the above mentioned email address.

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Tiwi Islands, Wikipedia

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Remote Alcohol & Other Drugs Workforce Program

Jen Frendin, CoordinatorRemote Alcohol & Other Drug Workforce Program, DoH

In2006fundingthroughtheCouncilofAustralianGovernmentwasprovidedtoenabletheestablishmentofaRemoteAlcohol and Other Drugs workforce tasked with delivering services to remote communities that currently have limited accesstocare.FundingwasallocatedtospecificDepartmentofHealthPrimaryHealthCareCentresandAboriginalMedical Services to develop and implement a Remote AOD Workforce within a Primary Health Care . The Workforce aims to be: manageable and sustainable, culturally appropriate, and delivering evidence-based services. There are now 50 funded positions that extend from Central Australia to the Barkly tablelands, to the Top End and Gulf region of the Northern Territory.

The workforce is supported by the Program Support Unit (PSU) and includes the Program Manager, Clinical Supervisor, ClinicalNurseMentor,TrainingandEducationOfficer,SeniorOperationalPolicyOfficer,WorkforceDevelopmentOfficer,RemoteAODOutreachWorkerandProgramSupportOfficer,employedwithintheDepartmentofHealth.

AkeyfeatureoftheRemoteAODWorkerroleisthatitcomprisestwodistinctrelatedsetsofactivity–directclientandfamily service delivery - comprising of eight activities from assessment to feedback and four activities - for community developmentconsistingofcommunitynetworksandlinking,communityself-assessmentandreflection,planningandcommunity action and evaluation.

The workforce program has developed a best practice ‘tool kit’ in consultation with the Remote AOD Workers. The assessment tools use plain English to enhance health literacy and are largely pictorial. They are culturally-adapted to the needs of the workforce, their clients and community. The dual role of workers (service delivery and community development) encourages outreach and social interventions, and acknowledges that the proportion of time spent in each activity will vary according to individual worker experience, expertise, and community context.

TheWorkforcewasawardedtheChiefMinister’sAwardforExcellenceinEnhancingHealthandWellbeingin2013,andhas presented at numerous interstate and international conferences. The Workforce was evaluated by Menzies School ofHealthResearch,andwillbeevaluatedagainin2016bytheCentreforRemoteHealth.Thisevaluationenablestheopportunity for this Workforce model to be promoted throughout the academic literature, with the publication of several journal articles.

For more information visit the website www.remoteaod.com.au

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Midway evaluation of the Chronic Condition’s Prevention and Management Strategy (NT 2010-2020)

Jenne Roberts, ManagerEvaluation and Research Support Unit, Menzies School of Health Research

A Midway evaluation of the Chronic Conditions Prevention and Management Strategy (CCPMS) has been commissionedbytheNTDepartmentOfficeofEvaluation.LedbyMenziesstaffJenneRobertsandDrPaulLawton,it will assess the effectiveness of the CCPMS against its aims, goals and objectives and assess whether or not the CCPMS has contributed towards changes as outlined in the Strategy. The team have been asked to survey staff about the Strategy but otherwise rely on existing publicly-available data to determine if changes in risk factor and disease burden are occurring in line with the Strategy.

The mixed methods review is taking place now. It will provide some insights into lessons learnt during implementation, and areas needing additional focus and effort for the remaining lifespan of the CCPMS.

Have you been delivering a program mentioned in the Implementation Plan? Let us know how it’s going; we would love to hear feedback from you.

The midway evaluation process will include:1. Document collection and review to gain insight into the background, goals and objectives, activities and

achievements of the CCPMS2. Data Collection from key stakeholders, either through interviews, by completing an online survey or via small

group discussions during site visits3. Interviews and small group discussions will be held in regional centres to create a clear image of the strengths

and achievements of the Strategy and identify areas where additional effort is needed. 4. DraftfindingsandsomeproposedrecommendationswillbepreparedbytheMenziesteamfollowinganinitial

analysis all data. These will then be subject to participatory analysis and some interpretation with the Advisory Groupinordertoprioritise,review,andappropriatelygroupfindingsandrecommendations.

5. Synthesisoffindings-Thefinalreportwilloutlinekeyfindings,inrelationtoprogressagainsttheKeyActionareasandoverallgoalsandproviderecommendationsforimplementationoftheStrategyoverthenextfiveyears.

This will be used to guide the development of the next Implementation plan.

Participation by health professionals and human service providers is voluntary. Several online surveys have already been distributed and more are to come. A draft report will be completed for the Chronic Diseases Network Steering CommitteebyJune2016.

If you are willing to participate please send your contact details to jenne.roberts@menzies.edu.au

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Chronic Condition Journal Articles of Interest

Cardiovascular Disease

‘Implementing guidelines to routinely prevent chronic vascular disease in primary care: the Preventative Evidence into Practice cluster randomised controlled trial’Authors: Harris MF, et al.

This article aimed to evaluate an intervention which improves the implementation of guidelines for prevention of chronicvasculardisease.Setin32urbangeneralpracticesin4Australianstates,thepracticelevelinterventionforover6monthsincludedsmallgrouptrainingofpracticestaff,feedbackonauditedperformance,practicefacilitationvisits and provision of patient education and referral information. Results from this article were that risk recording improved in the intervention group but not the control group for waist circumference, alcohol consumption, smoking status and cardiovascular risk. There was no change in recording of blood pressure, lipids, glucose or BMI and no significantchangeinthelevelofriskfactorsbasedonauditdata.Theconclusionofthisarticlereportstheinterventionwas associated with improved recording of some risk factors but no change in the level of risk at the follow up audit.

BMJOpen.2015.5(12).doi:10.1136/bmjopen-2015-009397

Rheumatic Heart Disease

‘South Asians and Anglo Australians with heart disease in Australia’ Authors: Gupta S, et al.

The aim of this study was to determine cardiovascular disease (CVD) risk factors and compare presentation and severity of ischaemic heart disease (IHD) among South Asians and Anglo Australians. A retrospective clinical case audit was conducted at a public tertiary hospital and included South Asians and Anglo Australian patients hospitalised forIHD.ThisstudyconcludesfromthefindingsthatthosepatientswithestablishedIHD,cardiovascularriskfactors,such as age at onset and BMI, differ between South Asians and Anglo Australians and these differences should be considered in the preventions and management of IHD.

AustralianHealthReview.2015.39(5).doi:10.1071/AH14254

Diabetes

‘The relationships between illness and treatment perceptions with adherence to diabetes self-care: A comparison between Arabic-speaking migrants and Caucasian English-speaking patients’Authors: Alzubaidi H, et al.

The aim for this study was to compare illness and treatment perceptions between Arabic-speaking immigrants andCaucasianEnglish-speakingpeoplewithtype2diabetes,andexploretherelationshipsbetweenthesebeliefsand adherence to self-care activities. A cross-sectional study was conducted in metropolitan and rural Victoria, Australia. Adherence to self-care activities, illness and treatment perceptions, and clinical data were recorded for 701 participants.ThisstudyconcludesthatArabic-speakingmigrants’illnessandtreatmentperceptionsweresignificantlydifferent from the English-speaking group. There is a pressing need to develop new innovate interventions that deliver much-needed improvements in adherence to self-care activities and key health outcomes.

DiabetesResearchandClinicalPractice.2015.110(2).doi:10.1016/j.diabres.2015.08.006

‘Are general practice characteristics predictors of good glycaemic control in patients with diabetes? A cross-sectional study’Authors: Esterman AJ, et al.

The data which contributed to this research article came from the Australian Diabetes Care Project conducted between2011and2014wasusedinthisstudytodeterminewhethercertaincharacteristicsofgeneralpracticesareassociated with good glycaemic control in patients with diabetes and with completing an annual cycle of care (ACC). Datafrom147generalpracticesand5455patientswithestablishedtype1ortype2diabetesacrossthreeAustralianstates were collated. The results from this study conclude that patient characteristics are moderately good predictors

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of whether the patient is in glycaemic control, whereas practice characteristics appear to predict only the likelihood of patientscompletinganACC.TheACCisanestablishedindicatorofgooddiabetesmanagement.Thisstudyisthefirststudy to report a positive association between having completed an ACC and the patient being in glycaemic control.

MedicalJournalofAustralia.2016.204(1).doi:10.5694/mja15.00739

‘Hypoglycaemia in elderly patients with type 2 diabetes mellitus: a review of risk factors, consequences and prevention’Authors: Jafari B & Britton ME

This journal article presents that hypoglycaemia may be a barrier to achieving optimal glycaemic control and is associated with increased risk of morbidity and mortality. The aim of this article was to provide a narrative review of publishedliteraturerelatedtothefrequency,riskfactors,consequencesandpreventionofhyperglycaemiainelderlypatientswithtype2diabetesmellitus.

TheAustralianJournalofPharmacy.2016.97(1147).ISSN:0311-8002

Chronic Airway Disease

‘Culturally appropriate flipcharts improve the knowledge of common respiratory conditions among Northern Territory Indigenous families’Authors: McKay CC, et al.

FlipchartsarewidelyusedasaneducationtoolinIndigenoushealth,yetthereisnopublishedquantitativedateontheir use. Flipcharts were developed on 3 most common serious respiratory illnesses (bronchiolitis, pneumonia and bronchiectasis).Theknowledgeof60carerspre-andpost-flipcharteducationwerecollectedviaquestionnaire.InthisfirstpaediatricstudyontheuseofflipchartsasameansofprovidinghealtheducationtoIndigenousAustralians,itappearsthatculturallyappropriateflipchartsareaneffectivemethodofprovidinghealtheducation.

HealthPromotionJournalofAustralia.2015.26(2).doi:10.1071/HE14100

Chronic Kidney Disease

‘Patient kidney disease knowledge remains inadequate with standard nephrology outpatient care’Authors: Gray NA, et al.

This study aimed to determine if chronic kidney disease (CKD) knowledge 1 year after initial consultation in an outpatientnephrologyclinicimproveswithstandardcare.Questionnaireswereusedtocollectdatafrom210patientsat baseline and 1 year follow-up. This study concludes that after a year of standard care at outpatient clinics there were some minor improvements in patient knowledge; however, patient understanding of CKD remained poor.

ClinicalKidneyJournal.2016.9(1).doi:10.1093/ckj/sfv108

Chronic Mental Illness

‘Applying the World Health Organisation Health Action Plan to evaluate policy on addressing co-occurrence of physical and mental illnesses in Australia’Authors: Happell B, et al.

This study aims to document Australian policies on the physical health of people with mental illness and evaluate the capacity of policy to support health needs. The results present that national policy attention to the physical health of people with mental illness has grown, but there is little interconnection at the national and state levels. State policies around the country are inconsistent, and there is little evidence of consistent policy implementation. This study concludes that a coherent national health policy framework on addressing co-occurring physical and mental illnesses that includes healthcare system reforms and ensuring the interconnectedness of other relevant services should be prioritised.

AustralianHealthReview.2015.39.doi:10.1071/AH14098

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‘The portrayal of mental health in Australian daily newspapers’Authors: Kenez S, et al.

This article reviews how mental health is portrayed as a holistic construct in 3 major Australian daily newspapers (The Age, The Australian and Herald Sun). Results from this study present that mental health coverage in newspapers favoured stories featured illness over wellbeing. The analysis in this study suggested that positive mental health messages are commonly being presented, however improvements in the representation of psychotic disorders appear to be less progressive than other disorders reported. This suggests that mental health professionals and organisations need to continue to build relationships with and providing education to journalists to ensure responsible representations continue to dominate.

AustralianandNewZealandJournalofPublicHealth.2015.39(6).doi:10.1111/1753-6405.12441

Cancer

‘Cancer risk factors, diagnosis and sexual identity in the Australian Longitudinal Study of Women’s Health’Authors: Brown R, et al.

The aim of this publication was to examine cancer diagnosis, cancer treatment and related risk factors among Australian, middle-aged, exclusively heterosexual women compared with sexual minority women. Data from the AustralianLongitudinalStudyofWomen’shealthforwomenbornin1946throughto1951wasanalysed.Theoutcomes of this study concluded that sexual minority women had higher rates of several known cancer risk factors, seemingly placing them at higher risk of cancer as well as chronic health conditions. The study supports that further researchisrequiredtodeterminewhetherincreasedriskresultsinincreasedcancerasthesewomenage,andtoinform the development of interventions to reduce the risk of disease for this female population.

Women’sHealthIssues.2015.25(5).doi:10.1016/j.whi.2015.04.001

Social Determinants of Health

‘Familial risk for lifestyle-related chronic diseases: Can family health history be used as a motivational tool to promote health behaviour in young adults?’Authors: Prichard I, et al.

Both family health history (FHH) and lifestyle behaviours such as physical activity, dietary intake and alcohol consumption are risk factors for chronic disease. This paper examines whether FHH information could be used to motivate young people to intend to modify these lifestyle behaviours. The provision of a FHH assessment increased perceived vulnerability among young adults and intentions to communicate with family members about disease risk, but did not change dietary or physical activity intentions. This study concludes that FHH assessments may have the greatest value within the family context, however further research could examine the impact of providing FHH information to different family members as a health promotion strategy.

HealthPromotionJournalofAustralia.2015.26(2).doi:10.1071/HE14104

‘How integrating primary care and public health could improve population health outcomes: a view from Liverpool, UK’Authors: Gosling R, et al.

Health systems are currently attempting to integrate healthcare delivery with broader population health and wellbeing interventions due to the growing demand on healthcare services. As Liverpool, UK, has a history of taking action to improve population health, this paper reviews the range of healthcare interventions that have taken place within this city. This paper proposes four key enablers to strengthen the delivery of public health priorities through primary care: maximising opportunities to identify risk factors for preventable disease, fully exploiting the data collected in primary care to plan and design services, responding to community needs and assets through community engagement, and addressing wider determinants of health through strong partnerships.

PublicHealthResearchandPractice.2016.26(1).doi:10.17061/phrp2611602

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Publication of The Chronic Diseases Network

15 April2016

‘The new Australian Primary Health Networks: How will they integrate public health and primary care?’Authors: Booth M, et al.

Authors of this article discuss an objective of the new Primary Health Networks (PHNs), which were established in July 2015undertheAustralianGovernment,howthesenetworksmighthelptointegratepublichealthwithintheprimaryhealth care landscape. The article points out the huge overlap between public health and primary care and looks at evidenceshowingthegreatbenefitsforhealthsystemsofcollaborationbetweenthetwo.Thispaperstateschallengesahead for PHNs include a possible government focus on delivery of ‘frontline’ medical service, which may come at the expense of population health, and the complexity of dealing with all primary health care stakeholders, including health professionals, Local Health Districts, non-government organisations, research institutions and local communities.

PublicHealthResearchandPractice.2016.26(1).doi:10.17061/phrp2611603

‘Systematic review to inform prevention and management of chronic disease for Indigenous Australians: overview and priorities’Authors: Gomersall JS, et al. Theobjectiveofthisarticleistodescribethemaincharacteristicsofsystematicreviewsaddressingquestionsof chronic disease and related risk factors for Indigenous Australians. 14 systematic reviews were reviewed and characteristicswhereextractedusingpre-definedtools.Thestudyconcludesthatsystematicreviewsareanunder-utilised method for gathering evidence to inform chronic disease prevention and management for Indigenous Australians.Futuresystematicreviewscouldbeimprovedby:aligningquestionswithcommunityprioritiesaswellasdecision maker needs, involvement of, and leadership by, Indigenous researchers with relevant cultural and contextual knowledge, and the use of critical appraisal tools that include traditional risk of bias assessment criteria that also reflectsIndigenousstandardsofappropriateresearch.

AustralianandNewZealandJournalofPublicHealth.2015.40(1).doi:10.1111.1753-6405.12476

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If you would like to submit an article to feature in upcoming ‘The Chronicle’ or the ‘e-CDNews’ please contact the CDN Team on

ChronicDiseasesNetwork.THS@nt.gov.au

Publication of The Chronic Diseases Network

April2016

The Chronic Disease Network acknowledges the participation and support of the CDN Steering Committee members from the following organisations: