Evidence map›Paper›PMID 31061040›Full record

ArticleBMJ open2019

Qualitative perspectives on the sustainability of sexual health continuous quality improvement in clinics serving remote Aboriginal communities in Australia.

Praveena Gunaratnam, Gill Schierhout, Jenny Brands, Lisa Maher, Ross Bailie, James Ward, Rebecca Guy, Alice Rumbold, Nathan Ryder, Christopher K Fairley and 4 more

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors.

Praveena GunaratnamKirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Gill SchierhoutKirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Jenny BrandsMenzies School of Health Research, Brisbane, Queensland, Australia.
Lisa MaherKirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Ross BailieUniversity Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia.
James WardSouth Australian Health and Medical Research Centre, Adelaide, South Australia, Australia.
Rebecca GuyKirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Alice RumboldRobinson Research Institute, University of Adelaide, Adelaide, South Australia, Australia.
Nathan RyderKirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Christopher K FairleyMelbourne Sexual Health Centre, Melbourne, Victoria, Australia.
Basil DonovanKirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Liz MooreAboriginal Medical Services Alliance Northern Territory, Darwin, Northern Territory, Australia.
John KaldorKirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.
Stephen BellKirby Institute, UNSW Sydney, Sydney, New South Wales, Australia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo examine barriers and facilitators to sustaining a sexual health continuous quality improvement (CQI) programme in clinics serving remote Aboriginal communities in Australia.

designQualitative study.

settingPrimary health care services serving remote Aboriginal communities in the Northern Territory, Australia.

participantsSeven of the 11 regional sexual health coordinators responsible for supporting the Northern Territory Government Remote Sexual Health Program.

methodsSemi-structured in-depth interviews conducted in person or by telephone; data were analysed using an inductive and deductive thematic approach.

resultsDespite uniform availability of CQI tools and activities, sexual health CQI implementation varied across the Northern Territory. Participant narratives identified five factors enhancing the uptake and sustainability of sexual health CQI. At clinic level, these included adaptation of existing CQI tools for use in specific clinic contexts and risk environments (eg, a syphilis outbreak), local ownership of CQI processes and management support for CQI. At a regional level, factors included the positive framing of CQI as a tool to identify and act on areas for improvement, and regional facilitation of clinic level CQI activities. Three barriers were identified, including the significant workload associated with acute and chronic care in Aboriginal primary care services, high staff turnover and lack of Aboriginal staff. Considerations affecting the future sustainability of sexual health CQI included the need to reduce the burden on clinics from multiple CQI programmes, the contribution of regional sexual health coordinators and support structures, and access to and use of high-quality information systems.

conclusionsThis study contributes to the growing evidence on how CQI approaches may improve sexual health in remote Australian Aboriginal communities. Enhancing sustainability of sexual health CQI in this context will require ongoing regional facilitation, efforts to build local ownership of CQI processes and management of competing demands on health service staff.

Indexed as

Quality ImprovementSexual HealthFemaleHealth Services, IndigenousHumansMaleNorthern TerritoryQualitative Researchaboriginalaustraliacontinuous quality improvementprimary health careremotesexual health

Identifiers

PMID31061040
PMCPMC6502047

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.