Please use this identifier to cite or link to this item:
https://hdl.handle.net/1959.11/29629
Title: | Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia | Contributor(s): | Diaz, Abbey (author); Vo, Brenda (author) ; Baade, Peter D (author); Matthews, Veronica (author); Nattabi, Barbara (author); Bailie, Jodie (author); Whop, Lisa J (author); Bailie, Ross (author); Garvey, Gail (author) | Publication Date: | 2019-10-01 | Early Online Version: | 2019-09-27 | Open Access: | Yes | DOI: | 10.3390/ijerph16193630 | Handle Link: | https://hdl.handle.net/1959.11/29629 | Abstract: | Aboriginal and Torres Strait Islander women have significantly higher cervical cancer incidence and mortality than other Australian women. In this study, we assessed the documented delivery of cervical screening for women attending Indigenous Primary Health Care (PHC) centres across Australia and identified service-level factors associated with between-centre variation in screening coverage. We analysed 3801 clinical audit records for PHC clients aged 20–64 years from 135 Indigenous PHC centres participating in the Audit for Best Practice in Chronic Disease (ABCD) continuous quality improvement (CQI) program across five Australian states/territories during 2005 to 2014. Multilevel logistic regression models were used to identify service-level factors associated with screening, while accounting for differences in client-level factors. There was substantial variation in the proportion of clients who had a documented cervical screen in the previous two years across the participating PHC centres (median 50%, interquartile range (IQR): 29–67%), persisting over years and audit cycle. Centre-level factors explained 40% of the variation; client-level factors did not reduce the between-centre variation. Screening coverage was associated with longer time enrolled in the CQI program and very remote location. Indigenous PHC centres play an important role in providing cervical screening to Aboriginal and Torres Strait Islander women. Thus, their leadership is essential to ensure that Australia’s public health commitment to the elimination of cervical cancer includes Aboriginal and Torres Strait Islander women. A sustained commitment to CQI may improve PHC centres delivery of cervical screening; however, factors that may impact on service delivery, such as organisational, geographical and environmental factors, warrant further investigation. | Publication Type: | Journal Article | Grant Details: | NHMRC/545267 NHMRC/1078927 NHMRC/1153027 NHMRC/1041111 NHMRC/1072777 NHMRC/1142035 NHMRC/1105399 ARC/FT100100087 |
Source of Publication: | International Journal of Environmental Research and Public Health, 16(19), p. 1-12 | Publisher: | MDPI AG | Place of Publication: | Switzerland | ISSN: | 1660-4601 1661-7827 |
Fields of Research (FoR) 2008: | 111717 Primary Health Care 111701 Aboriginal and Torres Strait Islander Health 010401 Applied Statistics |
Fields of Research (FoR) 2020: | 490501 Applied statistics 420319 Primary health care |
Socio-Economic Objective (SEO) 2008: | 920302 Aboriginal and Torres Strait Islander Health - Health Status and Outcomes | Socio-Economic Objective (SEO) 2020: | 210302 Aboriginal and Torres Strait Islander health status and outcomes | Peer Reviewed: | Yes | HERDC Category Description: | C1 Refereed Article in a Scholarly Journal |
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Appears in Collections: | Journal Article School of Science and Technology |
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openpublished/ServiceVo2019JournalArticle.pdf | Published version | 304.42 kB | Adobe PDF Download Adobe | View/Open |
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