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How does GP training impact rural and remote underserved communities? Exploring community and professional perceptions.

ABSTRACT: BACKGROUND:Substantial government funding has been invested to support the training of General Practitioners (GPs) in Australia to serve rural communities. However, there is little data on the impact of this expanded training on smaller communities, particularly for smaller rural and more remote communities. Improved understanding of the impact of training on underserved communities will assist in addressing this gap and inform ongoing investment by governments and communities. METHOD:A purposive sample of GP supervisors, GP registrars, practice managers and health services staff, and community members (n?=?40) from previously identified areas of workforce need in rural and remote North-West Queensland were recruited for this qualitative study. Participants had lived in their communities for periods ranging from a few months to 63?years (Median?=?12?years). Semi-structured interviews and a focus group were conducted to explore how establishing GP training placements impacts underserved communities from a health workforce, health outcomes, economic and social perspective. The data were then analysed using thematic analysis. RESULTS:Participants reported they perceived GP training to improve communities' health services and health status (accessibility, continuity of care, GP workforce, health status, quality of health care and sustainable health care), some social factors (community connectedness and relationships), cultural factors (values and identity), financial factors (economy and employment) and education (rural pathway). Further, benefits to the registrars (breadth of training, community-specific knowledge, quality of training, and relationships with the community) were reported that also contributed to community development. CONCLUSION:GP training and supervision is possible in smaller and more remote underserved communities and is perceived positively. Training GP registrars in smaller, more remote communities, matches their training more closely with the comprehensive primary care services needed by these communities.

SUBMITTER: Kanakis K

PROVIDER: S-EPMC7457499 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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How does GP training impact rural and remote underserved communities? Exploring community and professional perceptions.

Kanakis Katerina K Young Louise L Reeve Carole C Hays Richard R Gupta Tarun Sen TS Malau-Aduli Bunmi B

BMC health services research 20200831 1

<h4>Background</h4>Substantial government funding has been invested to support the training of General Practitioners (GPs) in Australia to serve rural communities. However, there is little data on the impact of this expanded training on smaller communities, particularly for smaller rural and more remote communities. Improved understanding of the impact of training on underserved communities will assist in addressing this gap and inform ongoing investment by governments and communities.<h4>Method ...[more]

PMID: 32867750

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Project description:Background:Community engagement in research has the potential to support the development of meaningful health promotion interventions to address health inequities. People living in rural and remote areas face increased barriers to participation in health research and may be unjustly excluded from participation. It is necessary to understand the process of patient and public engagement from the perspective of community members to support partnered research in underserved areas. The aim of this project was to increase understanding on how to include community members from rural and remote areas as partners on research teams. Methods:Using purposive sampling, we completed semi-structured interviews with a representative sample of 12 community members in rural and remote areas of northern British Columbia, Canada. Interviews were audio recorded and transcribed verbatim. Following an integrated knowledge translation approach, an inductive thematic analysis was completed to incorporate researcher and knowledge user perspectives. Results:The factors important to community members for becoming involved in research include: 1) relevance; 2) communication; and 3) empowering participation. The analysis suggests projects must be relevant to both communities and individuals. Most participants stated that they would not be interested in becoming partners on research projects that did not have a direct benefit or value for their communities. Participants expressed the need for clear expectations and clarification of preferred communication mechanisms. Communication must be regular, appropriate in length and content, and written in a language that is accessible. It is essential to ensure that community members are recognized as subject matter experts, to provide appropriate training on the research process, and to use research outcomes to support decision making. Conclusions:To engage research partners in rural and remote communities, research questions and outcomes should be co-produced with community members. In-person relationships can help establish trust and bidirectional communication mechanisms are prudent throughout the research process, including the appropriate sharing of research findings. Although this project did not include community members as research team members or in the co-production of this research article, we present guidelines for research teams interested in adding a patient or public perspective to their integrated knowledge translation teams.

Project description:Background:The Mississippi Community Research Fellows Training Program (MSCRFTP) is a 15-week program conducted in Jackson, MS, USA consisting of training in the areas of evidence-based public health, research methods, research ethics, and cultural competency. The purpose of the program was to increase community knowledge and understanding of public health research, develop community-based projects that addressed health disparity in the participants' community, increase individual and community capacity, and to engage community members as equal partners in the research process. Methods:A comprehensive evaluation of the MSCRFTP was conducted that included both quantitative and qualitative methods. All participants were asked to complete a baseline, midterm, and final assessment as part of their program requirements. Knowledge gained was assessed by comparing baseline assessment responses to final assessment responses related to 27 key content areas addressed in the training sessions. Assessments also collected participants' attitudes toward participating in research within their communities, their perceived influence over community decisions, and their perceptions of community members' involvement in research, satisfaction with the program, and the program's impact on the participants' daily practice and community work. Results:Twenty-one participants, the majority of which were female and African-American, completed the MSCRFTP. Knowledge of concepts addressed in 15 weekly training sessions improved significantly on 85.2% of 27 key areas evaluated (p?<?0.05). Two mini-grant community based participatory research projects proposed by participants were funded through competitive application. Most participants agreed that by working together, the people in their community could influence decisions that affected the community. All participants rated their satisfaction with the overall program as "very high" (76.2%, n?=?16) or "high" (23.8%, n?=?5). Conclusion:The evaluation of the MSCRFTP demonstrates that participants have the necessary knowledge to engage as research partners, and the pilot projects provided an opportunity for application of this objective to be realized. Overall, the MSCRFTP was an intervention that assisted community members in identifying their communities' strengths and weaknesses, interpret knowledge in a meaningful way, and create a self-reflective community of inquiry for change.

Project description:Cervical cancer is the second most common cancer diagnosed among women in India and current estimates indicate low screening rates. To implement successful population-based screening programs, there is an urgent need to explore the social and cultural beliefs among women residing in underserved communities. An innovative, community-based participatory approach called photovoice was used with 14 women aged between 30-51 years, residing in rural and tribal villages around Mysore, Karnataka, India. Each participant was trained in photovoice techniques, provided with a digital camera, and asked to photo document their everyday realities that could influence their intentions to undergo cervical cancer screening. Over 6 months, participants took a total of 136 photos and participated in 42 individual interviews and two group discussions. These data helped identify specific beliefs prevalent in the target population and were organized according to the Integrated Behavior Model. Some women reported a lack of perceived susceptibility to cervical cancer whereas others mentioned the fatal nature of cancer as a disease and believed that no screening exam could prevent death if they were destined to get cancer. Husbands, mothers-in-law, and their peers in the community had an important influence on the social identity of women and influenced their intentions to participate in the screening exams. Seeking healthcare was associated with an economic burden, not only in terms of out-of-pocket expenses for healthcare services but also in missing daily labor wages or taking unpaid leave from work to seek healthcare when they were asymptomatic. Several action steps were proposed including: identifying community liaisons or champions, repeated community activities to raise awareness of cervical cancer, and educating men and other family members about women's health issues. Study findings can conceptually help design and develop educational efforts for mobilizing women to undergo screening and inform future research to help understand disparities.

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How does GP training impact rural and remote underserved communities? Exploring community and professional perceptions.

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How does GP training impact rural and remote underserved communities? Exploring community and professional perceptions.

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