Journal Articles
Permanent URI for this collectionhttps://mro.massey.ac.nz/handle/10179/7915
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Item Enabling Rural Telehealth for Older Adults in Underserved Rural Communities: Focus Group Study(JMIR Publications, 2022-11-04) Hunter I; Lockhart C; Rao V; Tootell B; Wong SBackground: Telehealth is often suggested to improve access to health care and has had significant publicity worldwide during the COVID-19 pandemic. However, limited studies have examined the telehealth needs of underserved populations such as rural communities. Objective: This study aims to investigate enablers for telehealth use in underserved rural populations to improve access to health care for rural older adults. Methods: In total, 7 focus group discussions and 13 individual interviews were held across 4 diverse underserved rural communities. A total of 98 adults aged ≥55 years participated. The participants were asked whether they had used telehealth, how they saw their community’s health service needs evolving, how telehealth might help provide these services, and how they perceived barriers to and enablers of telehealth for older adults in rural communities. Focus group transcripts were thematically analyzed. Results: The term telehealth was not initially understood by many participants and required an explanation. Those who had used telehealth reported positive experiences (time and cost savings) and were likely to use telehealth again. A total of 2 main themes were identified through an equity lens. The first theme was trust, with 3 subthemes—trust in the telehealth technology, trust in the user (consumer and health provider), and trust in the health system. Having access to reliable and affordable internet connectivity and digital devices was a key enabler for telehealth use. Most rural areas had intermittent and unreliable internet connectivity. Another key enabler is easy access to user support. Trust in the health system focused on waiting times, lack of and/or delayed communication and coordination, and cost. The second theme was choice, with 3 subthemes—health service access, consultation type, and telehealth deployment. Access to health services through telehealth needs to be culturally appropriate and enable access to currently limited or absent services such as mental health and specialist services. Accessing specialist care through telehealth was extremely popular, although some participants preferred to be seen in person. A major enabler for telehealth was telehealth deployment by a fixed community hub or on a mobile bus, with support available, particularly when combined with non–health-related services such as internet banking. Conclusions: Overall, participants were keen on the idea of telehealth. Several barriers and enablers were identified, particularly trust and choice. The term telehealth is not well understood. The unreliable and expensive connectivity options available to rural communities have limited telehealth experience to phone or patient portal use for those with connectivity. Having the opportunity to try telehealth, particularly by using video, would increase the understanding and acceptance of telehealth. This study highlights that local rural communities need to be involved in designing telehealth services within their communities.Item Wellbeing education increases skills and knowledge among tertiary students in the agricultural sector: insights from a mixed methods study(Taylor and Francis Group, 2024-05-21) Winder L; Stanley-Clarke N; Maris R; Hay A; Knook JPurpose The agricultural sector is facing a myriad of financial, environmental, social, and cultural challenges which affect the mental health of those working on-farm. This study focused on a tertiary education programme designed to increase recognition of mental health issues and convey strategies to address these. Methodology To identify the effect of such a programme, and which aspects contribute to that effect, this paper applied a mixed methods approach. Quantitative propensity score matching was used to identify changes in knowledge and skills, and qualitative surveys were conducted to explore the wellbeing of students and to identify aspects of the programme contributing to change. Findings Students report an increase in (i) ability recognising signs of poor mental health in self and others; (ii) confidence talking about their own and others’ mental health; and (iii) knowing how to access mental health support services. Programme aspects contributing to this effect are peer-to-peer education and building on existing knowledge. Practical implications This paper addresses a gap in the literature by providing insights into programme aspects that lead to successful delivery. Theoretical implications This study reports on the evaluation of a tertiary education programme and provides valuable insights into whether such programmes can contribute to increased knowledge on wellbeing. Originality This research describes and analyses the effectiveness of a mental health promotion programme aimed at young adults which is rare in the literature.Item Optimism bias as a barrier to accessing mental health support amongst tertiary students(Taylor and Francis Group, 2024-04-16) Stanley-Clarke N; Hay A; Marris R; Ryan A; Knook J; Winder LStudent wellbeing is a key concern for those delivering tertiary education. Tertiary providers such as universities use a range of techniques to support student wellbeing through times of stress. This article reports on one finding from a mixed methods study at two New Zealand universities that explored how students enrolled in agricultural courses saw and managed their wellbeing. The findings demonstrated that students reflected an optimism bias regarding managing their own stress believing most stressful situations would resolve without the need to involve support services. Their intent was that university support services were only to be used in times of mental health crisis. Consequently, students reported that they would not engage with support and education around managing their wellbeing but did find value in learning about how to support others through times of crisis. These findings contribute to knowledge about tertiary students’ attitudes to stress and support services. They have implications for those delivering wellbeing services at tertiary institutions in terms of how best to tailor and deliver services for students experiencing stress.Item What discourses shape and reshape men's experiences of accessing mental health support?(John Wiley and Sons Australia, Ltd, 2024-04-10) Ferris-Day P; Harvey C; Minton C; Donaldson AThe research employs a single embodied case study design with the aim to examine the discourse of men accessing and receiving mental health support alongside those who are the providers of the support. Three groups of adults were interviewed: men who had experienced mental health problems and had attempted to access mental health support; lay people who supported them, such as partners and non-mental health professionals and professionals, such as mental health nurses, social workers, clinical psychologists and general practitioners. Critical discourse analysis (CDA) is used to identify discourses around three emergent themes: well-being, power and dominance and social capital. Participants seeking mental health support often referred to mental health services as not listening or that what was offered was not useful. A lack of belonging and community disconnectedness was apparent throughout all participant interviews. The study is reported according to the COREQ guidelines.Item Reducing ethnic and geographic inequities to optimise New Zealand stroke care (REGIONS Care): Protocol for a nationwide observational study(JMIR Publications, 12/01/2021) Ranta A; Thompson S; Harwood MLN; Cadilhac DA-M; Barber PA; Davis AJ; Gommans JH; Fink JN; McNaughton HK; Denison H; Corbin M; Feigin V; Abernethy V; Levack W; Douwes J; Girvan J; Wilson A; Derrick, TBackground: Stroke systems of care differ between larger urban and smaller rural settings and it is unclear to what extent this may impact on patient outcomes. Ethnicity influences stroke risk factors and care delivery as well as patient outcomes in nonstroke settings. Little is known about the impact of ethnicity on poststroke care, especially in Māori and Pacific populations. Objective: Our goal is to describe the protocol for the Reducing Ethnic and Geographic Inequities to Optimise New Zealand Stroke Care (REGIONS Care) study. Methods: This large, nationwide observational study assesses the impact of rurality and ethnicity on best practice stroke care access and outcomes involving all 28 New Zealand hospitals caring for stroke patients, by capturing every stroke patient admitted to hospital during the 2017-2018 study period. In addition, it explores current access barriers through consumer focus groups and consumer, carer, clinician, manager, and policy-maker surveys. It also assesses the economic impact of care provided at different types of hospitals and to patients of different ethnicities and explores the cost-efficacy of individual interventions and care bundles. Finally, it compares manual data collection to routine health administrative data and explores the feasibility of developing outcome models using only administrative data and the cost-efficacy of using additional manually collected registry data. Regarding sample size estimates, in Part 1, Study A, 2400 participants are needed to identify a 10% difference between up to four geographic subgroups at 90% power with an α value of .05 and 10% to 20% loss to follow-up. In Part 1, Study B, a sample of 7645 participants was expected to include an estimated 850 Māori and 419 Pacific patients and to provide over 90% and over 80% power, respectively. Regarding Part 2, 50% of the patient or carer surveys, 40 provider surveys, and 10 focus groups were needed to achieve saturation of themes. The main outcome is the modified Rankin Scale (mRS) score at 3 months. Secondary outcomes include mRS scores; EQ-5D-3L (5-dimension, 3-level EuroQol questionnaire) scores; stroke recurrence; vascular events; death; readmission at 3, 6, and 12 months; cost of care; and themes around access barriers. Results: The study is underway, with national and institutional ethics approvals in place. A total of 2379 patients have been recruited for Part 1, Study A; 6837 patients have been recruited for Part 1, Study B; 10 focus groups have been conducted and 70 surveys have been completed in Part 2. Data collection has essentially been completed, including follow-up assessment; however, primary and secondary analyses, data linkage, data validation, and health economics analysis are still underway. Conclusions: The methods of this study may provide the basis for future epidemiological studies that will guide care improvements in other countries and populations. International Registered Report Identifier (IRRID): DERR1-10.2196/25374Item Telling stories about farming: Mediated authenticity and New Zealand's Country Calendar(SAGE Publications, 2022-01) Fountaine S; Bulmer SMediated authenticity in New Zealand’s Country Calendar (CC) television program is explored from the perspective of its producers, and rural and urban audiences. Paradoxically, CC is understood as both “real” and “honest” television and a constructed, idyllic version of the rural good life in New Zealand. Techniques and devices such as a predictable narrative arc, consistent narration, invisible reporting and directing, and naturalized sound and vision contribute to the show’s predictability, ordinariness, spontaneity and im/perfection, mediating an authentic yet aspirational view of farming life. We elucidate how factual, primetime television contributes to a shared national sense of “who we are” while navigating different audience experiences and expectations. At stake is New Zealanders’ attachment to rural identity, which underpins public policy commitments to the farming sector, at a time when new agricultural politics are increasingly contested.