Browsing by Author "Towers A"

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    A mixed-methods evaluation of an intervention for enhancing alcohol screening in adults aged 50+ attending primary health care
    (CSIRO Publishing on behalf of The Royal New Zealand College of General Practitioners, 2025-01-02) Towers A; Newcombe D; White G; McMenamin J; Sheridan J; Rahman J; Moore A; Stokes T
    Introduction Adults aged 50 years and over are drinking more than ever but primary health care (PHC) professionals find it challenging to screen them for alcohol-related harm, despite being at greater risk for harm than younger drinkers. Aim This intervention aimed to enhance alcohol screening for this cohort by (a) introducing an algorithm in the patient management system to automate detection of alcohol risk in patients and (b) providing training to support health professionals' practice of, knowledge about, and comfort with alcohol screening in this cohort. Methods Eleven PHC practices in Aotearoa New Zealand took part in this intervention, including 41 PHC health professionals. Development and integration of the automated alcohol screening process within PHC patient management systems was undertaken in parallel with health professional training approaches. Results Screening rates increased substantially at intervention initiation but fell immediately with the onset of the New Zealand COVID-19 national lockdown. Two-thirds of health professionals identified the system screening prompts, over 40% felt this changed their screening practice, and 33% increased their awareness of - and felt more comfortable screening for - alcohol-related risk in those aged 50+. Discussion We illustrated an initial increase in alcohol screening rates in those aged 50+ as a result of this intervention, but this increase could not be sustained in part due to COVID-19 disruption. However, health professionals indicated that this intervention helped many change their practice and enhanced their awareness of such risk and comfort in screening for alcohol-related risk in those aged 50+.
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    Prevalence of unmet health care need in older adults in 83 countries: measuring progressing towards universal health coverage in the context of global population ageing.
    (BioMed Central Ltd, 2023-09-15) Kowal P; Corso B; Anindya K; Andrade FCD; Giang TL; Guitierrez MTC; Pothisiri W; Quashie NT; Reina HAR; Rosenberg M; Towers A; Vicerra PMM; Minicuci N; Ng N; Byles J
    Current measures for monitoring progress towards universal health coverage (UHC) do not adequately account for populations that do not have the same level of access to quality care services and/or financial protection to cover health expenses for when care is accessed. This gap in accounting for unmet health care needs may contribute to underutilization of needed services or widening inequalities. Asking people whether or not their needs for health care have been met, as part of a household survey, is a pragmatic way of capturing this information. This analysis examined responses to self-reported questions about unmet need asked as part of 17 health, social and economic surveys conducted between 2001 and 2019, representing 83 low-, middle- and high-income countries. Noting the large variation in questions and response categories, the results point to low levels (less than 2%) of unmet need reported in adults aged 60+ years in countries like Andorra, Qatar, Republic of Korea, Slovenia, Thailand and Viet Nam to rates of over 50% in Georgia, Haiti, Morocco, Rwanda, and Zimbabwe. While unique, these estimates are likely underestimates, and do not begin to address issues of poor quality of care as a barrier or contributing to unmet need in those who were able to access care. Monitoring progress towards UHC will need to incorporate estimates of unmet need if we are to reach universality and reduce health inequalities in older populations.
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    The Whakapiri framework in higher education: nurturing relational teaching
    (SAGE Publications, 2025-01-10) Moriarty H; Severinsen C; Rowe L; Towers A
    A growing body of research suggests that utilising Indigenous frameworks grounded in relational connection and multi-modal knowledge acquisition has numerous benefits for both Indigenous and non-Indigenous communities. This article focuses on the Whakapiri framework, and its application at Te Kunenga ki Pūrehuroa Massey University, Aotearoa New Zealand, within a new undergraduate mental health and addiction programme. This programme aims to equip graduates in the field, providing them with the foundational knowledge and engagement competencies necessary for working with both Māori (Indigenous people of New Zealand) and non-Māori. The Whakapiri framework enhances student engagement, fosters relational teaching practices, and designs effective online learning curricula. The framework also informs the design of online learning curricula, acknowledging the unique challenges and opportunities of digital education environments. Through its emphasis on engaging, enlightening, and empowering, the Whakapiri framework offers professional guidance and enriches student engagement, teaching methodologies, and the development of online learning curricula.