2024 |
Rush A, Weil C, Siminoff L, Griffin C, Paul CL, Mahadevan A, Sutherland G, 'The Experts Speak: Challenges in Banking Brain Tissue for Research.', Biopreserv Biobank, 22 179-184 (2024) [C1]
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2024 |
Longman J, Paul C, Cashmore A, Twyman L, Barnes LAJ, Adams C, et al., 'Protocol for the process evaluation of an intervention to improve antenatal smoking cessation support (MOHMQuit) in maternity services in New South Wales, Australia', BMJ Open, 14 e081208-e081208 (2024)
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2024 |
Griffin CP, Paul CL, Lynam J, 'A legacy of hope', CANADIAN MEDICAL ASSOCIATION JOURNAL, 196 E270-E271 (2024) [C1]
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Nova |
2024 |
Paul CL, Verrills NM, Ackland S, Scott R, Goode S, Thomas A, et al., 'The impact of a regionally based translational cancer research collaborative in Australia using the FAIT methodology.', BMC Health Serv Res, 24 320 (2024) [C1]
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2024 |
Carlson MA, Fradgley EA, Paul CL, 'Understanding experiences of cognitive decline and cognitive assessment from the perspectives of people with glioma and their caregivers: A qualitative interview study', International Journal of Nursing Studies Advances, 6 (2024) [C1]
Background: Despite the impact of cognitive decline during brain cancer care, implementing routine cognitive assessment can be challenging. Effective implementation of cognitive a... [more]
Background: Despite the impact of cognitive decline during brain cancer care, implementing routine cognitive assessment can be challenging. Effective implementation of cognitive assessment necessitates an understanding of implementation from the patient perspective. However, little is known about how people with glioma and their caregivers experience cognitive changes, assessment and support. Objective: To understand the lived experiences of changes in cognition for people with glioma and their caregivers including experiences of: i) perceived or objectively measured cognitive decline (or absence of decline); ii) cognitive assessment following diagnosis, and; iii) met and unmet cognition-related supportive care needs. Design: Semi-structured qualitative telephone interviews were conducted with people with gliomas and support persons and analysed using reflexive thematic analysis. Setting(s): Two Australian cancer services Participants: 18 people with glioma and caregivers Methods: Semi-structured qualitative telephone interviews were conducted with people with gliomas and caregivers and analysed using reflexive thematic analysis. Results: People with glioma (n = 5) and caregivers (n = 13) completed interviews. Four themes were identified: Cognition needs to be considered within the context of glioma diagnosis and treatment; concerns about cognition were initially subordinate to survival but become important; there are challenges identifying and communicating about people with gliomas¿ changes in cognition; cognition-related supportive care can be helpful but challenging for people with glioma and caregivers to identify and access. Conclusions: Changes to cognition can have considerable impacts of people with glioma and their caregivers which may be overshadowed by treatment and survival. A multi-disciplinary approach to timely cognitive screening, structured referral pathways, and communication with caregivers may provide opportunities for support. Registration: n/a Tweetable abstract: Identifying cognitive changes in people with glioma is important and challenging. A multidisciplinary approach and inclusion of care coordination and caregivers can help.
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2023 |
Carlson MA, Fradgley EA, Yates D, Morris S, Tait J, Paul CL, 'Response to Gorter et al. regarding "Acceptability and feasibility of neurocognitive assessments with adults with primary brain cancer and brain metastases: A systematic review"', NEURO-ONCOLOGY PRACTICE, 10 493-494 (2023)
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2023 |
White C, Scott RJ, Paul C, Ackland S, 'Reply to "Implementation of DPYD Genotyping in Admixed American Populations: Brazil as a Model Case"', CLINICAL PHARMACOLOGY & THERAPEUTICS, 114 25-25 (2023)
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2023 |
Carlson MA, Fradgley EA, Yates D, Morris S, Tait J, Paul CL, 'Acceptability and feasibility of cognitive assessments with adults with primary brain cancer and brain metastasis: A systematic review', Neuro-Oncology Practice, 10 219-237 (2023) [C1]
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2023 |
O'Neill CJ, Carlson MA, Rowe CW, Fradgley EA, Paul C, 'Hearing the Voices of Australian Thyroid Cancer Survivors: Qualitative Thematic Analysis of Semistructured Interviews Identifies Unmet Support Needs.', Thyroid : official journal of the American Thyroid Association, 33 1455-1464 (2023) [C1]
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2023 |
Thawal VP, Paul C, Nolan E, Tzelepis F, 'Erratum: Development and psychometric evaluation of the Khaini Smokeless Tobacco Dependence Scale (Tobacco Induced Diseases (2023) 21 (1-14), 10.18332/tid/160073)', Tobacco Induced Diseases, 21 (2023)
In the original article, in the 13th page, the accessed date in reference 1 should have been changed to "Accessed February 10, 2022", in reference 3 to "Accessed Ma... [more]
In the original article, in the 13th page, the accessed date in reference 1 should have been changed to "Accessed February 10, 2022", in reference 3 to "Accessed May 20, 2022", in reference 4 to "Accessed April 15, 2022" whilst in page 14, the accessed date of the reference 25 should have been changed to "Accessed May 20, 2022" and of reference 26 to "Accessed May 20, 2022". Furthermore "Acknowledgements" section should have been placed before the section "Conflicts of Interest". Finally, the approval dates in the section "Ethical approval and informed consent" were missing and now the section has been corrected as follows: "Approval number: HREC-H-2018-0401; Date: 6 November 2018) and from the Joint Ethics Committee, Narotam Sekhsaria Foundation-Salaam Bombay Foundation, Mumbai, India (Approval number: JEC/NSF-SBF/2019/02; Date: 19 February 2019)". The mentioned changes are corrected also online.
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2023 |
Widjaja W, Rowe CW, Oldmeadow C, Cope D, Fradgley EA, Paul C, O'Neill CJ, 'Current patterns of care in low-risk thyroid cancer-A national cross-sectional survey of Australian thyroid clinicians.', Endocrinol Diabetes Metab, 6 e398 (2023) [C1]
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2023 |
Guillaumier A, Tzelepis F, Paul C, Passey M, Oldmeadow C, Handley T, et al., 'Outback Quit Pack: Feasibility trial of outreach smoking cessation for people in rural, regional, and remote Australia.', Health Promot J Austr, (2023) [C1]
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2023 |
Taylor J, Fradgley EA, Clinton-McHarg T, Hall A, Paul CL, 'Perceived importance of emotional support provided by health care professionals and social networks: Should we broaden our focus for the delivery of supportive care?', Asia Pac J Clin Oncol, 19 681-689 (2023) [C1]
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2023 |
Atorkey P, Paul C, Wiggers J, Bonevski B, Mitchell A, Tzelepis F, 'Intention to change multiple health risk behaviors and predictors of behavior change in vocational education students', JOURNAL OF AMERICAN COLLEGE HEALTH, [C1]
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2023 |
Thawal VP, Paul C, Nolan E, Tzelepis F, 'Development and psychometric evaluation of the Khaini Smokeless Tobacco Dependence Scale.', Tob Induc Dis, 21 40 (2023) [C1]
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2023 |
Ryan A, Young AL, Tait J, McCarter K, McEnallay M, Day F, et al., 'Building staff capability, opportunity, and motivation to provide smoking cessation to people with cancer in Australian cancer treatment centres: development of an implementation intervention framework for the Care to Quit cluster randomised controlled trial', HEALTH SERVICES AND OUTCOMES RESEARCH METHODOLOGY, 23 280-312 (2023) [C1]
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2023 |
Griffin CP, Bowen JR, Walker MM, Lynam J, Paul CL, 'Understanding the value of brain donation for research to donors, next-of-kin and clinicians: A systematic review.', PLoS One, 18 e0295438 (2023) [C1]
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2023 |
Maltby S, Garcia-Esperon C, Jackson K, Butcher K, Evans JW, O'Brien W, et al., 'TACTICS VR Stroke Telehealth Virtual Reality Training for Health Care Professionals Involved in Stroke Management at Telestroke Spoke Hospitals: Module Design and Implementation Study.', JMIR Serious Games, 11 e43416 (2023) [C1]
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2023 |
Thawal VP, Tzelepis F, Bagade T, Paul C, 'Psychometric properties of smokeless tobacco dependence measures: A COSMIN systematic review', Journal of Substance Use and Addiction Treatment, 147 208978-208978 (2023) [C1]
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2023 |
Young AL, Stefanovska E, Paul C, McCarter K, McEnallay M, Tait J, et al., 'Implementing Smoking Cessation Interventions for Tobacco Users Within Oncology Settings A Systematic Review', JAMA ONCOLOGY, 9 981-1000 (2023) [C1]
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2023 |
O'Neill CJ, Morris-Baguley H, Alam AS, Carlson MA, Blefari N, Rowe CW, et al., 'Thyroid cancer patient reported outcome measures in clinical practice: analysing acceptability and optimizing recruitment.', ANZ J Surg, 93 2214-2221 (2023) [C1]
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2022 |
Griffin CP, Paul CL, Alexander KL, Walker MM, Hondermarck H, Lynam J, 'Postmortem brain donations vs premortem surgical resections for glioblastoma research: viewing the matter as a whole.', Neurooncol Adv, 4 vdab168 (2022) [C1]
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2022 |
Thawal VP, Tzelepis F, Ahmadi S, Palazzi K, Paul C, 'Addiction perceptions among users of smokeless or combustible tobacco attending a tertiary care hospital in India', Drug and Alcohol Review, 41 1184-1194 (2022) [C1]
Introduction: Addiction plays a key role in continued tobacco use. The study assessed association of perceived personal addiction and the perceived addictiveness of different form... [more]
Introduction: Addiction plays a key role in continued tobacco use. The study assessed association of perceived personal addiction and the perceived addictiveness of different forms of tobacco with type of tobacco product used, demographic characteristics and socio-cultural factors. Methods: A cross-sectional survey of 607 adult tobacco users with age 18 years and above attending a general medicine out-patient department was conducted. Participants were asked questions on perceived personal addiction to tobacco use and perception of addiction on tobacco products. Logistic regression was applied to investigate the association between demographic characteristics, type of tobacco, socio-cultural factors and addiction perceptions. Results: The odds of perceived addiction (PA) were lower among smokeless tobacco (SLT) users [OR (95% CI): 0.57 (0.37, 0.89) P¿=¿0.01]. An increase in the odds of PA was seen as age increased [OR (95% CI):1.02 (1.00, 1.03) P¿=¿0.01] and participants with secondary education and above had higher odds of PA compared to participants with no formal education [OR (95% CI): 1.68 (1.09, 2.58) P¿=¿0.02]. The odds of perceiving SLT products to be addictive was lower among SLT users [OR (95% CI): 0.48 (0.30, 0.75) P¿=¿0.002)] compared to combustible tobacco users. The odds of perceiving SLT products to be addictive was lower [(OR (95% CI): 0.35 (0.18, 0.67) P¿=¿0.002)] among females. Participants with secondary education and above had higher odds of perceiving combustible [OR (95% CI): 1.80 (1.17, 2.77) P¿=¿0.008)] and SLT products [OR (95% CI): 1.98 (1.20, 3.30) P¿=¿0.008)] to be addictive compared to no schooling. Discussion and Conclusions: There is a need to raise awareness in India of the addictiveness of tobacco, particularly for users of SLT, younger people and those with less education.
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2022 |
Thawal VP, Tzelepis F, Ahmadi S, Paul C, 'Association between perceived addiction and cessation behaviours among users of smokeless or combustible tobacco in India.', Drug Alcohol Rev, 41 1510-1520 (2022) [C1]
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2022 |
Dave N, Bui S, Morgan C, Hickey S, Paul CL, 'Interventions targeted at reducing diagnostic error: systematic review.', BMJ Qual Saf, 31 297-307 (2022) [C1]
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2022 |
Ugalde A, White V, Rankin NM, Paul C, Segan C, Aranda S, et al., 'How can hospitals change practice to better implement smoking cessation interventions? A systematic review', CA Cancer Journal for Clinicians, 72 266-286 (2022) [C1]
Smoking cessation reduces the risk of death, improves recovery, and reduces the risk of hospital readmission. Evidence and policy support hospital admission as an ideal time to de... [more]
Smoking cessation reduces the risk of death, improves recovery, and reduces the risk of hospital readmission. Evidence and policy support hospital admission as an ideal time to deliver smoking-cessation interventions. However, this is not well implemented in practice. In this systematic review, the authors summarize the literature on smoking-cessation implementation strategies and evaluate their success to guide the implementation of best-practice smoking interventions into hospital settings. The CINAHL Complete, Embase, MEDLINE Complete, and PsycInfo databases were searched using terms associated with the following topics: smoking cessation, hospitals, and implementation. In total, 14,287 original records were identified and screened, resulting in 63 eligible articles from 56 studies. Data were extracted on the study characteristics, implementation strategies, and implementation outcomes. Implementation outcomes were guided by Proctor and colleagues' framework and included acceptability, adoption, appropriateness, cost, feasibility, fidelity, penetration, and sustainability. The findings demonstrate that studies predominantly focused on the training of staff to achieve implementation. Brief implementation approaches using a small number of implementation strategies were less successful and poorly sustained compared with well resourced and multicomponent approaches. Although brief implementation approaches may be viewed as advantageous because they are less resource-intensive, their capacity to change practice in a sustained way lacks evidence. Attempts to change clinician behavior or introduce new models of care are challenging in a short time frame, and implementation efforts should be designed for long-term success. There is a need to embrace strategic, well planned implementation approaches to embed smoking-cessation interventions into hospitals and to reap and sustain the benefits for people who smoke.
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2022 |
Taylor J, Fradgley EA, Clinton-McHarg T, Hall A, Paul CL, 'Referral and uptake of services by distressed callers to the Cancer Council Information and Support telephone service', Asia-Pacific Journal of Clinical Oncology, 18 303-310 (2022) [C1]
Background: Patient-centered cancer care includes emotional, informational, and practical support that is personalised to the needs of patients and inclusive of family and friends... [more]
Background: Patient-centered cancer care includes emotional, informational, and practical support that is personalised to the needs of patients and inclusive of family and friends. However, when supportive care referrals are offered in hospital settings, distressed patients and carers do not consistently act on those referrals, which can prolong patient suffering. The degree to which sub-optimal referral uptake also occurs in Australian telephone support services is unknown. Aims: To report, among a sample of distressed patients and caregivers who called a cancer information and support service: 1) the types of services used; 2) proportion who received and actioned a referral (uptake); 3) associations between referral to a service and callers¿ characteristics); and, 4) associations between uptake of a referred service and callers¿ characteristics. Methods: This study used cross-sectional data collected at 3-month post-baseline from control participants (usual care group) enrolled in the Structured Triage and Referral by Telephone (START) trial. The START trial recruited distressed adult cancer patients and caregivers from the Cancer Council Information and Support Service (CIS). A research assistant conducted a 30¿45 min telephone interview with participants, which included recall of referrals provided by CIS staff and reported uptake of referral(s) to the offered service types. Results: Most patients (98%) and caregivers (97%) reported receiving a referral to a service. For patients and caregivers respectively, information materials (71%, 77%), CIS call-back (51%, 43%), practical services (52%, 45%), and group peer support (49%, 51%) were the services most frequently offered. For callers receiving a referral, uptake was highest for information materials (91%) and CIS call-backs (89%) and lowest for specialist psychological services (30%). Significant association was found between older age and reduced uptake of services (p = 0.03). Conclusion: The high uptake rate of CIS call-backs suggests it is a potentially more acceptable form of support compared to specialist psychological services. Efforts to reduce the barriers to telephone-based psychological services are required. Specifically, older age peoples¿ and caregivers¿ preferences for support and priorities who may benefit from a referral coordinator.
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2022 |
White C, Scott RJ, Paul C, Ziolkowski A, Mossman D, Fox SB, et al., 'Dihydropyrimidine Dehydrogenase Deficiency and Implementation of Upfront
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2022 |
Carlson MA, Fradgley EA, Bridge P, Taylor J, Morris S, Coutts E, Paul C, 'The dynamic relationship between cancer and employment-related financial toxicity: an in-depth qualitative study of 21 Australian cancer survivor experiences and preferences for support', SUPPORTIVE CARE IN CANCER, 30 3093-3103 (2022) [C1]
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Nova |
2022 |
Ryan A, Paul CL, Cox M, Whalen O, Bivard A, Attia J, et al., 'TACTICS-Trial of Advanced CT Imaging and Combined Education Support for Drip and Ship: evaluating the effectiveness of an 'implementation intervention' in providing better patient access to reperfusion therapies: protocol for a non-randomised controlled stepped wedge cluster trial in acute stroke', BMJ OPEN, 12 (2022)
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2022 |
Rose S, Boyes AW, Kelly B, Bridge P, Carlson M, Coutts E, Paul C, 'Antitobacco advertising and lung cancer stigma: a qualitative study of the experiences of people with a lung cancer diagnosis', Journal of Psychosocial Oncology Research & Practice, 4 e069-e069 (2022) [C1]
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2022 |
White C, Scott R, Paul CL, Ackland SP, 'Pharmacogenomics in the era of personalised medicine', MEDICAL JOURNAL OF AUSTRALIA, 217 510-513 (2022)
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2022 |
Stone E, Paul C, 'The Tobacco Endgame-A New Paradigm for Smoking Cessation in Cancer Clinics', CURRENT ONCOLOGY, 29 6325-6333 (2022) [C1]
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Nova |
2022 |
Maltby S, Garcia-Esperon C, Jackson K, Butcher K, Evans JW, O'Brien W, et al., 'TACTICS VR Stroke Telehealth Virtual Reality Training for Health Care Professionals Involved in Stroke Management at Telestroke Spoke Hospitals: Module Design and Implementation Study (Preprint) (2022)
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2022 |
Barnes LAJ, Longman J, Adams C, Paul C, Atkins L, Bonevski B, et al., 'The MOHMQuit (Midwives and Obstetricians Helping Mothers to Quit Smoking) Trial: protocol for a stepped-wedge implementation trial to improve best practice smoking cessation support in public antenatal care services', IMPLEMENTATION SCIENCE, 17 (2022)
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2021 |
Hood RJ, Maltby S, Keynes A, Kluge MG, Nalivaiko E, Ryan A, et al., 'Development and Pilot Implementation of TACTICS VR: A Virtual Reality-Based Stroke Management Workflow Training Application and Training Framework', FRONTIERS IN NEUROLOGY, 12 (2021) [C1]
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2021 |
Bygrave A, Whittaker K, Paul C, Fradgley EA, Varlow M, Aranda S, 'Australian experiences of out-of-pocket costs and financial burden following a cancer diagnosis: A systematic review', International Journal of Environmental Research and Public Health, 18 1-24 (2021) [C1]
(1) Background: This systematic review was conducted to identify cancer patient experi-ences, and the impact of out-of-pocket costs and financial burden in Australia. (2) Methods:... [more]
(1) Background: This systematic review was conducted to identify cancer patient experi-ences, and the impact of out-of-pocket costs and financial burden in Australia. (2) Methods: A systematic review, following the Preferring Reporting Items for Systematic Reviews and Meta-Anal-yses, was conducted. Cumulative Index of Nursing and Allied Health Literature and PubMed were searched. The primary outcome was financial burden among cancer patients and their families in Australia. The secondary outcome was out-of-pocket costs associated with cancer care and treatment within the population sample, and the impact of financial burden. (3) Results: Nineteen studies were included, covering more than 70,000 Australians affected by cancer. Out-of-pocket costs varied by cancer type and ranged from an average of AUD 977 for breast cancer and lymphoedema patients to AUD 11,077 for prostate cancer patients. Younger aged patients (=65 years), Aboriginal and Torres Strait Islander people, people in rural and/or remote areas, households with low income, those who were unemployed and people with private health insurance were at increased risk of experiencing out-of-pocket costs, financial burden or a combination of both. (4) Conclusions: Australians diagnosed with cancer frequently experience financial burden, and the health and financial consequences are significant. Focusing efforts on the costs of care and options about where to have care within the context of informed decisions about cancer care is necessary.
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2021 |
Rose S, Boyes A, Kelly B, Cox M, Palazzi K, Paul C, 'Lung cancer stigma is a predictor for psychological distress: A longitudinal study. Lung cancer stigma is a predictor for psychological distress', Psycho-Oncology, 30 1137-1144 (2021) [C1]
Objectives: To examine if baseline stigma predicts psychological distress at 3 and 6 months follow-up among patients newly diagnosed with lung cancer. Methods: This longitudinal s... [more]
Objectives: To examine if baseline stigma predicts psychological distress at 3 and 6 months follow-up among patients newly diagnosed with lung cancer. Methods: This longitudinal study was nested within a larger randomised controlled trial. Eligible participants were recruited via respiratory and oncology out-patient clinics in Australia (n¿=¿194). Consenting participants were asked to complete surveys at baseline, 3 and 6 months post-recruitment. Measures included lung cancer stigma (Cataldo Lung Cancer Stigma Scale) and psychological distress (General Health Questionnaire-12 [GHQ-12]). Results: One-hundred and ninety-four participants were included for analysis. Most were male (57.7%) with a mean age of 68 years (SD¿=¿8.8). A significant relationship between baseline lung cancer stigma and psychological distress at 6 months was found, where a one unit increase in lung cancer stigma increases psychological distress by 0.044 when adjusting for age, gender, smoking status, baseline GHQ-12 scores and intervention allocation (as part of the larger trial; p¿=¿0.001; ß¿=¿0.044, 95% CI¿=¿0.010, 0.079). Conclusion: Temporal links between lung cancer stigma and psychological distress was found at 6 months, suggesting stigma-related experiences may have a delayed impact. Development of routine lung cancer stigma assessments is recommended to identify those at risk of psychological distress.
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2021 |
Atorkey P, Paul C, Wiggers J, Bonevski B, Mitchell A, Tzelepis F, 'Barriers and facilitators to the uptake of online and telephone services targeting health risk behaviours among vocational education students: A qualitative study', International Journal of Environmental Research and Public Health, 18 (2021) [C1]
Uptake of online and telephone services targeting health behaviours is low among vocational education students and barriers and facilitators are unknown. This study aimed to explo... [more]
Uptake of online and telephone services targeting health behaviours is low among vocational education students and barriers and facilitators are unknown. This study aimed to explore barriers and facilitators to uptake of online and telephone services for smoking, nutrition, alcohol, and physical activity (SNAP) risk behaviours via semi-structured individual telephone interviews with fifteen vocational education students. Two authors independently completed thematic analysis, classified themes according to the COM-B (Capability, Opportunity, Motivation, Behaviour) frame-work, and discussed disagreements until consensus was reached. Facilitators to uptake of online (e.g., desire to learn something new, cost-free, accessible) and telephone services (e.g., prefer to talk to provider, complements online support) primarily related to capability and opportunity. For telephone services, difficulty understanding accent/language was a capability-related barrier. Opportunity-related barriers for online and telephone services were preference for face-to-face interaction and lack of time, while preference for apps/online programs was a barrier for telephone services. For online and telephone services, not wanting to change SNAP behaviours was a motivation-related barrier and being able to change SNAP risk behaviours themselves was a motivation-related barrier for online services. Barriers and facilitators to online and telephone services are relevant for designing interventions vocational education students are more likely to use.
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2021 |
Courtney RJ, McRobbie H, Tutka P, Weaver NA, Petrie D, Mendelsohn CP, et al., 'Effect of Cytisine vs Varenicline on Smoking Cessation A Randomized Clinical Trial', JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 326 56-64 (2021) [C1]
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2021 |
Guillaumier A, Skelton E, Tzelepis F, D'Este C, Paul C, Walsberger S, et al., 'Patterns and predictors of nicotine replacement therapy use among alcohol and other drug clients enrolled in a smoking cessation randomised controlled trial', ADDICTIVE BEHAVIORS, 119 (2021) [C1]
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2021 |
Sharma A, Minh Duc NT, Luu Lam Thang T, Nam NH, Ng SJ, Abbas KS, et al., 'A Consensus-Based Checklist for Reporting of Survey Studies (CROSS)', JOURNAL OF GENERAL INTERNAL MEDICINE, 36 3179-3187 (2021) [C1]
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2021 |
McCarter K, Carlson MA, Baker AL, Paul CL, Lynam J, Johnston LN, Fradgley EA, 'A qualitative study investigating Australian cancer service outpatients' experience of distress screening and management: what is the personal relevance, acceptability and improvement opportunities from patient perspectives?', SUPPORTIVE CARE IN CANCER, 30 2693-2703 (2021) [C1]
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2021 |
Skelton E, Guillaumier A, Tzelepis F, Walsberger S, Paul CL, Dunlop AJ, et al., 'Alcohol and other drug health-care providers and their client's perceptions of e-cigarette use, safety and harm reduction', DRUG AND ALCOHOL REVIEW, 40 998-1002 (2021) [C1]
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2021 |
Fradgley EA, Booth K, Paul C, Zdenkowski N, Rankin NM, 'Facilitating High Quality Cancer Care: A Qualitative Study of Australian Chairpersons' Perspectives on Multidisciplinary Team Meetings', JOURNAL OF MULTIDISCIPLINARY HEALTHCARE, 14 3429-3439 (2021) [C1]
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2021 |
Carlson MA, Morris S, Day F, Dadich A, Ryan A, Fradgley EA, Paul C, 'Psychometric properties of leadership scales for health professionals: a systematic review', IMPLEMENTATION SCIENCE, 16 (2021) [C1]
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2021 |
White R, Bruggink L, Hayes C, Boyes A, Paul C, 'Feasibility of patient-focused behavioral interventions to support adults experiencing chronic noncancer pain during opioid tapering: a systematic literature review', TRANSLATIONAL BEHAVIORAL MEDICINE, 11 1481-1494 (2021) [C1]
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2021 |
Atorkey P, Paul C, Wiggers J, Bonevski B, Nolan E, Oldmeadow C, et al., 'Clustering of multiple health-risk factors among vocational education students: a latent class analysis', TRANSLATIONAL BEHAVIORAL MEDICINE, 11 1931-1940 (2021) [C1]
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2021 |
Yoong SL, Hall A, Leonard A, McCrabb S, Wiggers J, d'Espaignet ET, et al., 'Prevalence of electronic nicotine delivery systems and electronic non-nicotine delivery systems in children and adolescents: a systematic review and meta-analysis', LANCET PUBLIC HEALTH, 6 E661-E673 (2021) [C1]
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2021 |
Passey ME, Adams C, Paul C, Atkins L, Longman JM, 'Improving implementation of smoking cessation guidelines in pregnancy care: development of an intervention to address system, maternity service leader and clinician factors.', Implementation science communications, 2 128 (2021) [C1]
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2021 |
Atorkey P, Byaruhanga J, Paul C, Wiggers J, Bonevski B, Tzelepis F, 'Multiple Health Risk Factors in Vocational Education Students: A Systematic Review', INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 18 (2021) [C1]
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2021 |
Longman JM, Adams C, Paul C, McLennan J, Passey ME, 'Improving Clinicians' Implementation of Guidelines to Help Women Stop Smoking in Pregnancy: Developing Evidence-Based Print and Video Materials', INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 18 (2021) [C1]
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2021 |
Griffin C, Vilain R, King S, Nixon S, Gooley A, Bray S, et al., 'Mind Over Matter: Confronting Challenges in Post-Mortem Brain Biobanking for Glioblastoma Multiforme', Biomarker Insights, 16 (2021) [C1]
Over the past 10 years, there has been limited progress for the treatment of brain cancer and outcomes for patients are not much improved. For brain cancer researchers, a major ob... [more]
Over the past 10 years, there has been limited progress for the treatment of brain cancer and outcomes for patients are not much improved. For brain cancer researchers, a major obstacle to biomarker driven research is limited access to brain cancer tissue for research purposes. The Mark Hughes Foundation Brain Biobank is one of the first post-mortem adult brain banks in Australia to operate with protocols specifically developed for brain cancer. Located within the Hunter New England Local Health District and operated by Hunter Cancer Biobank, the boundaries of service provided by the Brain Bank extend well into the surrounding regional and rural areas of the Local Health District and beyond. Brain cancer biobanking is challenging. There are conflicting international guidelines for best practice and unanswered questions relating to scientific, psychosocial and operational practices. To address this challenge, a best practice model was developed, informed by a consensus of existing data but with consideration of the difficulties associated with operating in regional or resource poor settings. The regional application of this model was challenged following the presentation of a donor located in a remote area, 380km away from the biobank. This required biobank staff to overcome numerous obstacles including long distance patient transport, lack of palliative care staff, death in the home and limited rural outreach services. Through the establishment of shared goals, contingency planning and the development of an informal infrastructure, the donation was facilitated within the required timeframe. This experience demonstrates the importance of collaboration and networking to overcome resource insufficiency and geographical challenges in rural cancer research programmes.
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2021 |
Clinton-McHarg T, Paul C, Sanson-Fisher R, Turon H, Butler M, Lindeman R, 'Are the Physical Environments of Treatment Centres Meeting Recommendations for Patient-Centred Care? Perceptions of Haematological Cancer Patients', INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 18 (2021) [C1]
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2021 |
White C, Scott RJ, Paul C, Ziolkowski A, Mossman D, Ackland S, 'Ethnic Diversity of DPD Activity and the DPYD Gene: Review of the Literature', PHARMACOGENOMICS & PERSONALIZED MEDICINE, 14 1603-1617 (2021) [C1]
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Nova |
2021 |
Atorkey P, Paul C, Bonevski B, Wiggers J, Mitchell A, Byrnes E, et al., 'Uptake of proactively offered online and telephone support services targeting multiple health risk behaviors among vocational education students: Process evaluation of a cluster randomized controlled trial', Journal of Medical Internet Research, 23 (2021) [C1]
Background: A high proportion of vocational education students smoke tobacco, have inadequate nutrition (ie, low fruit and vegetable intake), drink alcohol at risky levels, or are... [more]
Background: A high proportion of vocational education students smoke tobacco, have inadequate nutrition (ie, low fruit and vegetable intake), drink alcohol at risky levels, or are physically inactive. The extent to which vocational education students will sign up for proactively offered online and telephone support services for multiple health risk behaviors is unknown. Objective: The aim of this study is to examine the uptake of proactively offered online and telephone support services for smoking, nutrition, alcohol consumption, and physical activity risk behaviors, individually and in combination, among vocational education students in the Technical and Further Education (TAFE) setting. The characteristics associated with the uptake of online or telephone services for smoking, nutrition, alcohol consumption, and physical activity risk behaviors were also examined. Methods: Vocational education students enrolled in a TAFE class in New South Wales, Australia, which ran for 6 months or more, were recruited to participate in a cluster randomized controlled trial from May 2018 to May 2019. In the intervention arm, participants who did not meet the Australian health guidelines for each of the smoking, nutrition, alcohol consumption, and physical activity risk behaviors were provided electronic feedback and proactively offered online and telephone support services. Uptake of support was measured by whether participants signed up for the online and telephone services they were offered. Results: Vocational education students (N=551; mean age 25.7 years, SD 11.1; 310/551, 56.3% male) were recruited into the intervention arm. Uptake of the proactive offer of either online or telephone services was 14.5% (59/406) for fruit and vegetables, 12.7% (29/228) for physical activity, 6.8% (13/191) for smoking, and 5.5% (18/327) for alcohol use. Uptake of any online or telephone service for at least two health behaviors was 5.8% (22/377). Participants who were employed (odds ratio [OR] 0.10, 95% CI 0.01-0.72) and reported not being anxious (OR 0.11, 95% CI 0.02-0.71) had smaller odds of signing up for online or telephone services for smoking, whereas participants who reported not being depressed had greater odds (OR 10.25, 95% CI 1.30-80.67). Participants who intended to change their physical activity in the next 30 days had greater odds (OR 4.01, 95% CI 1.33-12.07) of signing up for online or telephone services for physical activity. Employed participants had smaller odds (OR 0.18, 95% CI 0.06-0.56) of signing up for support services for at least two behaviors. Conclusions: Although the uptake of proactively offered online and telephone support services is low, these rates appear to be higher than the self-initiated use of some of these services in the general population. Scaling up the proactive offer of online and telephone services may produce beneficial health outcomes.
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Nova |
2021 |
Paul CL, Warren G, Vinod S, Meiser B, Stone E, Barker D, et al., 'Care to Quit: a stepped wedge cluster randomised controlled trial to implement best practice smoking cessation care in cancer centres', IMPLEMENTATION SCIENCE, 16 (2021)
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2021 |
Janda M, Paul C, Horsham C, 'Changes in cancer preventive behaviours, screening and diagnosis during COVID-19', PSYCHO-ONCOLOGY, 30 271-273 (2021)
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2021 |
Byaruhanga J, Paul CL, Wiggers J, Byrnes E, Mitchell A, Lecathelinais C, et al., 'The short-term effectiveness of real-time video counselling on smoking cessation among residents in rural and remote areas: An interim analysis of a randomised trial', Journal of Substance Abuse Treatment, 131 (2021) [C1]
Background: Real-time video counselling for smoking cessation uses readily accessible software (e.g. Skype). This study aimed to assess the short-term effectiveness of real-time v... [more]
Background: Real-time video counselling for smoking cessation uses readily accessible software (e.g. Skype). This study aimed to assess the short-term effectiveness of real-time video counselling compared to telephone counselling or written materials (minimal intervention control) on smoking cessation and quit attempts among rural and remote residents. Methods: An interim analysis of a three-arm, parallel group randomised trial with participants (n = 655) randomly allocated to; 1) real-time video counselling; 2) telephone counselling; or 3) written materials only (minimal intervention control). Participants were daily tobacco users aged 18 years or older residing in rural or remote areas of New South Wales, Australia. Video and telephone counselling conditions offered up to six counselling sessions while those in the minimal intervention control condition were mailed written materials. The study measured seven-day point prevalence abstinence, prolonged abstinence and quit attempts at 4-months post-baseline. Results: Video counselling participants were significantly more likely than the minimal intervention control group to achieve 7-day point prevalence abstinence at 4-months (18.9% vs 8.9%, OR = 2.39 (1.34¿4.26), p = 0.003), but the video (18.9%) and telephone (12.7%) counselling conditions did not differ significantly for 7-day point prevalence abstinence. The video counselling and minimal intervention control groups or video counselling and telephone counselling groups did not differ significantly for three-month prolonged abstinence or quit attempts. Conclusion: Given video counselling may increase cessation rates at 4 months post-baseline, quitlines and other smoking cessation services may consider integrating video counselling into their routine practices as a further mode of cessation care delivery. Trial registration: www.anzctr.org.au ACTRN12617000514303.
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Nova |
2021 |
Taylor J, Fradgley E, Clinton-McHarg T, Byrnes E, Paul C, 'What are the sources of distress in a range of cancer caregivers? A qualitative study', Supportive Care in Cancer, 29 2443-2453 (2021) [C1]
Purpose: Caring for a person diagnosed with cancer is associated with elevated distress that may impact on caregiver health and patient outcomes. However, caregivers¿ distress is ... [more]
Purpose: Caring for a person diagnosed with cancer is associated with elevated distress that may impact on caregiver health and patient outcomes. However, caregivers¿ distress is relatively under-researched. This Australian study explored a range of caregivers¿ reported sources of distress. Methods: The grounded theory approach informed semi-structured interviews that were conducted with a purposive and broad range sample of distressed caregivers identified through the ¿Structured Triage And Referral by Telephone¿ (START) trial. A grounded theory framework was used to generate themes with data analysed by two independent coders using the NVivo software. Results: Caregivers (n = 14) were aged from 25 to 80 years, including two bereaved caregivers. The relationships of the caregivers to the patients were as follows: partner (n = 8), parent (n = 1), child (n = 3), sibling (n = 1), and friend (n = 1). Six major themes emerged in relation to sources of distress: (1) a lack of sufficient and timely information; (2) uncertainty; (3) the role and duties of caregiving; (4) lack of family-centred services; (5) practical challenges; and (6) impact of distress. Conclusion: Caregivers face a number of specific challenges beyond those experienced by patients. It is essential to ensure that caregivers are actively well-informed and well-supported alongside the person who is diagnosed with cancer.
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Nova |
2021 |
Noble N, Bryant J, Maher L, Jackman D, Bonevski B, Shakeshaft A, Paul C, 'Patient self-report versus medical records for smoking status and alcohol consumption at Aboriginal Community Controlled Health Services', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, 45 277-282 (2021) [C1]
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Nova |
2020 |
Taylor J, Fradgley EA, Clinton-McHarg T, Roach D, Paul CL, 'Distress screening and supportive care referrals used by telephone-based health services: a systematic review', Supportive Care in Cancer, 28 2059-2069 (2020) [C1]
Purpose: People affected by chronic diseases such as cancer report high levels of distress and a need for psychosocial support. It is unclear whether telephone-based services for ... [more]
Purpose: People affected by chronic diseases such as cancer report high levels of distress and a need for psychosocial support. It is unclear whether telephone-based services for people affected by chronic disease are a practical setting for implementing distress screening, referral protocols and rescreening to direct supportive care where it is needed. This systematic review aimed to describe the published literature regarding distress screening and supportive care referral practices in telephone-based services for people affected by chronic diseases such as cancer. Methods: A systematic literature search of MEDLINE, Embase, PsycInfo, CINAHL, Cochrane and Scopus was conducted in February 2018. Included quantitative studies involved: patients or caregivers affected by chronic diseases including cancer and describe a health service assessing psychosocial needs or distress via telephone. Extracted data included the type of cancer or other chronic disease, sample size, screening tool, referral or rescreening protocols, and type of health service. Results: The search identified 3989 potential articles with additional searches returning 30 studies (n = 4019); fourteen were eligible for full-text review. Of the 14 studies, 13 included cancer patients. Studies were across multiple settings and identified nine distress screening tools in use. Conclusion: The reviewed studies indicate that validated distress-screening tools are being used via telephone to identify distress, particularly in relation to cancer. Screening-driven supportive care referrals are also taking place in telephone-based services. However, not all services use an established referral protocol. Ongoing rescreening of callers¿ distress is also limited despite it being an important recommendation from psycho-oncology guidelines.
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Nova |
2020 |
Hasnain MG, Paul CL, Attia JR, Ryan A, Kerr E, Oldmeadow C, et al., 'Thrombolysis implementation intervention and clinical outcome: A secondary analysis of a cluster randomized trial', BMC Cardiovascular Disorders, 20 432-440 (2020) [C1]
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Nova |
2020 |
Byaruhanga J, Atorkey P, McLaughlin M, Brown A, Byrnes E, Paul C, et al., 'Effectiveness of individual real-time video counseling on smoking, nutrition, alcohol, physical activity, and obesity health risks: Systematic review', Journal of Medical Internet Research, 22 1-17 (2020) [C1]
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Nova |
2020 |
Fradgley EA, Byrnes E, McCarter K, Rankin N, Britton B, Clover K, et al., 'A cross-sectional audit of current practices and areas for improvement of distress screening and management in Australian cancer services: is there a will and a way to improve?', Supportive Care in Cancer, 28 249-259 (2020) [C1]
Background: It is unknown how many distressed patients receive the additional supportive care recommended by Australian evidence-based distress management guidelines. The study id... [more]
Background: It is unknown how many distressed patients receive the additional supportive care recommended by Australian evidence-based distress management guidelines. The study identifies the (1) distress screening practices of Australian cancer services; (2) barriers to improving practices; and (3) implementation strategies which are acceptable to service representatives interested in improving screening practices. Method: Clinic leads from 220 cancer services were asked to nominate an individual involved in daily patient care to complete a cross-sectional survey on behalf of the service. Questions related to service characteristics; screening and management processes; and implementation barriers. Respondents indicated which implementation strategies were suitable for their health service. Results: A total of 122 representatives participated from 83 services (51%). The majority of respondents were specialist nurses or unit managers (60%). Approximately 38% of representatives¿ services never or rarely screen; 52% who screen do so for all patients; 55% use clinical interviewing only; and 34% follow referral protocols. The most common perceived barriers were resources to action screening results (74%); lack of time (67%); and lack of staff training (66%). Approximately 65% of representatives were interested in improving practices. Of the 8 implementation strategies, workshops (85%) and educational materials (69%) were commonly selected. Over half (59%) indicated a multicomponent implementation program was preferable. Conclusions: Although critical gaps across all guideline components were reported, there is a broad support for screening and willingness to improve. Potential improvements include additional services to manage problems identified by screening, more staff time for screening, additional staff training, and use of patient-report measures.
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Nova |
2020 |
Stevenson W, Bryant J, Watson R, Sanson-Fisher R, Oldmeadow C, Henskens F, et al., 'A multi-center randomized controlled trial to reduce unmet needs, depression, and anxiety among hematological cancer patients and their support persons', Journal of Psychosocial Oncology, 38 272-292 (2020) [C1]
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Nova |
2020 |
Mogre V, Johnson NA, Tzelepis F, Hall A, Paul C, 'Barriers to self-care and their association with poor adherence to self-care behaviours in people with type 2 diabetes in Ghana: A cross sectional study', Obesity Medicine, 18 (2020) [C1]
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Nova |
2020 |
Byaruhanga J, Paul CL, Wiggers J, Byrnes E, Mitchell A, Lecathelinais C, Tzelepis F, 'Connectivity of Real-Time Video Counselling Versus Telephone Counselling for Smoking Cessation in Rural and Remote Areas: An Exploratory Study', INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 17 (2020) [C1]
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Nova |
2020 |
Fradgley EA, Karnon J, Roach D, Harding K, Wilkinson-Meyers L, Chojenta C, et al., 'Taking the pulse of the health services research community: A cross-sectional survey of research impact, barriers and support', Australian Health Review, 44 160-167 (2020) [C1]
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Nova |
2020 |
Guillaumier A, Skelton E, Shakeshaft A, Farrell M, Tzelepis F, Walsberger S, et al., 'Effect of increasing the delivery of smoking cessation care in alcohol and other drug treatment centres: a cluster-randomized controlled trial', Addiction, 115 1345-1355 (2020) [C1]
Aim: Aims were to test the effectiveness of an organizational change intervention integrating smoking cessation treatment into usual alcohol and other drug (AOD) treatment, compar... [more]
Aim: Aims were to test the effectiveness of an organizational change intervention integrating smoking cessation treatment into usual alcohol and other drug (AOD) treatment, compared with usual care, on (1) 7-day point prevalence abstinence (PPA) at 8¿weeks follow-up; (2) prolonged abstinence; (3) cigarettes smoked per day; (4) number of quit attempts; and (5) offer and use of nicotine replacement therapy (NRT). All outcomes were assessed at 8¿weeks and 6.5¿months follow-up. Design: Cluster-randomized controlled trial, with AOD service as unit of randomization, conducted January 2015¿March 2016. Setting: Thirty-two eligible services (provided face-to-face client sessions to =¿50 clients/year) in Australia were randomized to control (usual care; n¿=¿15) or intervention (n¿=¿17) groups by an independent blinded biostatistician. Participants: Eligible participants (= 16¿years, current smoker) completed surveys at the service at baseline (n¿=¿896) and telephone follow-up surveys (conducted by blinded assessors) at 8¿weeks (n¿=¿471; 53%) and 6.5¿months (n¿=¿427; 48%). Intervention: Intervention services received an intervention to establish routine screening, assessment and delivery of smoking cessation care. Measurements: Primary outcome was biochemically verified 7-day PPA at 8-week follow-up. Secondary outcomes included verified and self-reported prolonged abstinence, self-reported 7-day PPA, cigarettes/day, quit attempts and offer and use of NRT. Intention-to-treat analyses were performed, assuming missing participants were not abstinent. Findings: At 8¿weeks, the findings in verified 7-day PPA between groups [2.6 versus 1.8%, odds ratio (OR)¿=¿1.72, 95% confidence interval (CI)¿=¿0.5¿5.7, P¿=¿0.373] were inconclusive as to whether a difference was present. Significantly lower mean cigarettes/day were reported in the intervention group compared to the usual care group at 8¿weeks [incidence rate ratio (IRR)¿=¿0.88, 95% CI¿=¿0.8¿0.95, P¿=¿0.001] but were similar at 6.5 months (IRR¿=¿0.96, 95% CI¿=¿0.9¿1.02, P¿=¿0.240) follow-up. At both follow-ups the intervention group reported higher rates of NRT use. Conclusions: Integrating smoking cessation treatment into addiction services did not significantly improve short-term abstinence from smoking.
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Nova |
2020 |
Hasnain MG, Attia JR, Akter S, Rahman T, Hall A, Hubbard IJ, et al., 'Effectiveness of interventions to improve rates of intravenous thrombolysis using behaviour change wheel functions: a systematic review and meta-analysis', IMPLEMENTATION SCIENCE, 15 (2020) [C1]
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Nova |
2020 |
McCarter K, Fradgley EA, Britton B, Tait J, Paul C, 'Not seeing the forest for the trees: a systematic review of comprehensive distress management programs and implementation strategies.', Curr Opin Support Palliat Care, 14 220-231 (2020) [C1]
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Nova |
2020 |
Byaruhanga J, Wiggers J, Paul CL, Byrnes E, Mitchell A, Lecathelinais C, Tzelepis F, 'Acceptability of real-time video counselling compared to other behavioural interventions for smoking cessation in rural and remote areas', Drug and Alcohol Dependence, 217 (2020) [C1]
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Nova |
2020 |
Levi CR, Attia JA, D'Este C, Ryan AE, Henskens F, Kerr E, et al., 'Cluster-Randomized Trial of Thrombolysis Implementation Support in Metropolitan and Regional Australian Stroke Centers: Lessons for Individual and Systems Behavior Change', JOURNAL OF THE AMERICAN HEART ASSOCIATION, 9 (2020) [C1]
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Nova |
2020 |
White R, Hayes C, Boyes AW, Paul CL, 'Integrated Primary Healthcare Opioid Tapering Interventions: A Mixed-Methods Study of Feasibility and Acceptability in Two General Practices in New South Wales, Australia.', International journal of integrated care, 20 6 (2020) [C1]
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Nova |
2019 |
Mogre V, Johnson NA, Tzelepis F, Paul C, 'Barriers to diabetic self-care: A qualitative study of patients and healthcare providers perspectives', Journal of Clinical Nursing, 28 2296-2308 (2019) [C1]
Aims and objectives: To explore patient and healthcare provider (HCP) perspectives about patients¿ barriers to the performance of diabetic self-care behaviours in Ghana. Backgroun... [more]
Aims and objectives: To explore patient and healthcare provider (HCP) perspectives about patients¿ barriers to the performance of diabetic self-care behaviours in Ghana. Background: Sub-Saharan African urban populations are increasingly affected by type 2 diabetes due to nutrition transition, sedentary lifestyles and ageing. Diabetic self-care is critical to improving clinical outcomes. However, little is known about barriers to diabetic self-care (diet, exercise, medication taking, self-monitoring of blood glucose and foot care) in sub-Saharan Africa. Design: Qualitative study that followed the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines. Methods: Semi-structured interviews were conducted among 23 people living with type 2 diabetes and 14 HCPs recruited from the diabetes clinics of three hospitals in Tamale, Ghana. Interviews were audiotaped and transcribed verbatim. The constant comparative method of data analysis was used and identified themes classified according to constructs of the theory of planned behaviour (TPB): attitudes/behavioural beliefs, subjective norms and perceived behavioural control. Results: Barriers relating to attitudes included misconceptions that diabetes was caused by spiritual forces or curses, use of herbal medicines, intentional nonadherence, difficulty changing old habits, and feeling or lacking motivation to exercise. Barriers relating to subjective norms were inadequate family support, social stigma (usually by spouses and other members of the community) and cultural beliefs. Perceived behavioural control barriers were poor income levels, lack of glucometers, busy work schedules, long distance to the hospital and inadequate access to variety of foods due to erratic supply of foods or seasonality. Conclusions: Both patients and HCPs discussed similar barriers and those relating to attitude and behavioural control were commonly discussed. Relevance to Clinical Practice: Interventions to improve adherence to diabetic self-care should focus on helping persons with diabetes develop favourable attitudes and how to overcome behavioural control barriers. Such interventions should have both individualised and community-wide approaches.
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Nova |
2019 |
Thomas D, Farrell M, McRobbie H, Tutka P, Petrie D, West R, et al., 'The effectiveness, safety and cost-effectiveness of cytisine versus varenicline for smoking cessation in an Australian population: a study protocol for a randomized controlled non-inferiority trial', ADDICTION, 114 923-933 (2019)
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2019 |
White R, Hayes C, Boyes AW, Chiu S, Paul CL, 'General practitioners and management of chronic noncancer pain: A cross-sectional survey of influences on opioid deprescribing', Journal of Pain Research, 12 467-475 (2019) [C1]
Background: General practitioners¿ (GPs) views about deprescribing prescription opioid analgesics (POAs) may influence the care provided for patients experiencing chronic noncance... [more]
Background: General practitioners¿ (GPs) views about deprescribing prescription opioid analgesics (POAs) may influence the care provided for patients experiencing chronic noncancer pain (CNCP). There are limited data addressing GPs¿ beliefs about deprescribing, including their decisions to deprescribe different types of POAs. Aim: To determine the proportion of GPs who hold attitudes congruent with local pain stewardship, describe their deprescribing decisions, and determine whether type of POA influences deprescribing. Design and setting: In 2016, a cross-sectional survey of all GPs (n=1,570) in one mixed urban and regional primary health network (PHN) in Australia was undertaken. Methods: A mailed self-report questionnaire assessed agreement with local guidelines for treating CNCP; influences on deprescribing POAs and likelihood of deprescribing in a hypothetical case involving either oral codeine or oxycodone. Results: A response rate of 46% was achieved. Approximately half (54%) of GPs agreed POAs should be reserved for people with acute, cancer pain or palliative care and a third (32%) did not agree that a medication focus has limited benefits for peoples¿ long-term quality of life and function. Most (77%) GPs were less likely to deprescribe when effective alternate treatments were lacking, while various patient factors (eg, fear of weaning) were reported to decrease the likelihood of deprescribing for 25% of GPs. A significantly higher proportion of GPs reported being very likely to deprescribe codeine compared to the equivalent opioid dose of oxycodone for a hypothetical patient. Conclusions: Many GPs in the PHN hold attitudes at odds with local guidance that opioids are a nonsuperior treatment for CNCP. Attitudinal barriers to deprescribing include: a lack of consistent approach to deprescribing opioids as a class of drugs, perceived lack of effective treatment alternatives and patient fear of deprescribing. Therefore, the next step in this target population is to appropriately train and support GPs in how to apply the evidence in practice and how to support patients appropriately.
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Nova |
2019 |
Lynagh M, Carey M, Paul C, Tzelepis F, Sanson-Fisher R, 'The needs of carers of blood cancer survivors: are there differences between Australia rural and urban dwellers?', Atlas of Science, (2019)
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2019 |
Mogre V, Johnson NA, Tzelepis F, Shaw JE, Paul C, 'A systematic review of adherence to diabetes self-care behaviours: Evidence from low- and middle-income countries', Journal of Advanced Nursing, 75 3374-3389 (2019) [C1]
Aims: To determine diabetes patient's adherence to five self-care behaviours (diet, exercise; medication, self-monitoring of blood glucose [SMBG] and foot care) in low- and m... [more]
Aims: To determine diabetes patient's adherence to five self-care behaviours (diet, exercise; medication, self-monitoring of blood glucose [SMBG] and foot care) in low- and middle-income countries. Design: Systematic review. Data sources: We searched MEDLINE, CINAHL, PUBMED, SCOPUS, PsycINFO, EMBASE, Cochrane library and EMCARE for the period January 1990 ¿ June 2017. Review Methods: Title, abstract and full text screening were done according to eligibility criteria. A narrative synthesis of the literature was conducted. Results: A total of 7,109 studies were identified of which 27 met the review eligibility criteria and were included. All the studies used self-report of adherence to diabetes self-care. Studies reported adherence rates in two major forms: (a) mean number of days participants performed a recommended dietary behaviour/activity during the past week; and (b) proportions of participants adhering to a recommended self-care behaviour. Mean number of days per week participants adhered to a self-care behaviour ranged from 2.34.6¿days per week for diet, 5.5¿6.8¿days per week for medication, 1.8¿5.7¿days per week for exercise, 0.2¿2.2¿days per week for SMBG and 2.2¿4.3¿days per week for foot care. Adherence rates ranged from 29.9%¿91.7% for diet, 26.0%¿97.0% for medication taking, 26.7%¿69.0% for exercise, 13.0%¿79.9% for self-monitoring of blood glucose and 17.0%¿77.4% for foot care. Conclusion: Although most diabetes patients do not adhere to recommended self-care behaviours, adherence rates vary widely and were found to be high in some instances. Impact: Health services in low- and middle-income countries should monitor adherence to diabetes self-care behaviours rather than assume adherence and resources should be invested in improving adherence to the self-care behaviours. Large-scale accurate monitoring of adherence to diabetes self-care behaviour is needed and consideration should be given to choice of measurement tool for such exercise.
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Nova |
2019 |
Mogre V, Abanga ZO, Tzelepis F, Johnson NA, Paul C, 'Psychometric evaluation of the summary of diabetes self-care activities measure in Ghanaian adults living with type 2 diabetes', Diabetes Research and Clinical Practice, 149 98-106 (2019) [C1]
Aims: We evaluated the content validity, factorial structure, internal consistency, construct validity, and floor and ceiling effects of the SDSCA among Ghanaian persons with type... [more]
Aims: We evaluated the content validity, factorial structure, internal consistency, construct validity, and floor and ceiling effects of the SDSCA among Ghanaian persons with type 2 diabetes. Methods: The summary of diabetes self-care activities measure (SDSCA) was administered to 187 adults living with type 2 diabetes from three diabetes clinics. Results: A confirmatory factor analysis maintained the four factor structure of the SDSCA. However, two items, 3 (fruit and vegetable servings) and 4 (red meat or full-fat dairy products) had factor loadings of 0.26 and 0.16 respectively. The model also had a statistical power of 0.72 (below acceptable criteria). Modification of the model by removing item 4 resulted in an improved revised model with a power of 0.82. Construct validity was found for the exercise and diet subscales of the SDSCA but not for the self-monitoring of blood glucose and foot care subscales. The internal consistency of the SDSCA measure was 0.68, below acceptable criteria for internal consistency. No floor effects were present but the exercise subscale had ceiling effects. Conclusion: The SDSCA measure had content validity, maintained its multidimensionality and met the criteria for floor effects but not for construct validity, internal consistency and ceiling effects. The SDSCA measure may require improvements to evaluate self-care behaviours of adult type 2 diabetes patients in Ghana and probably in other sub-Saharan countries.
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Nova |
2019 |
Byaruhanga J, Tzelepis F, Paul C, Wiggers J, Byrnes E, Lecathelinais C, 'Cost Per Participant Recruited From Rural and Remote Areas Into a Smoking Cessation Trial Via Online or Traditional Strategies: Observational Study', JOURNAL OF MEDICAL INTERNET RESEARCH, 21 (2019) [C1]
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Nova |
2019 |
Fradgley EA, Chong SE, Cox ME, Gedye C, Paul CL, 'Patients experiences and preferences for opt-in models and health professional involvement in biobanking consent: A cross-sectional survey of Australian cancer outpatients', Asia-Pacific Journal of Clinical Oncology, 15 31-37 (2019) [C1]
Background: Many biobanks rely upon patients¿ willingness to donate biospecimens and healthcare professionals to initiate opt-in consent processes. This study explored if: (1) pat... [more]
Background: Many biobanks rely upon patients¿ willingness to donate biospecimens and healthcare professionals to initiate opt-in consent processes. This study explored if: (1) patients accept opt-in or opt-out consent models with varying levels of professional involvement; (2) professionals discuss participation with specific patient groups; and (3) this discussion is associated with patient knowledge of biobanking processes. Methods: Outpatients completed surveys at a tertiary cancer center in New South Wales, Australia. Eligible participants were English-speaking adults who recently had cancer-related surgery. Participants completed 27 questions exploring acceptable consent models, biobanking experiences, knowledge, and willingness. Logistic regression and chi-square tests examined differences in the characteristics and knowledge of participants who were offered the opportunity to participate versus those who were not. Results: A total of 113 outpatients participated (97% response). Most participants (92%) found opt-out, patient-initiated consent acceptable; however, high acceptability was reported for all models except for opt-in, patient-initiated consent (58%). University or technical qualifications (P = 0.001) was associated with increased odds (OR¿=¿4.5) of being offered biobanking. The majority did not know what occurred to samples after surgery (59.3%) or pathology review (81.4%) and ability to answer these questions was associated with discussion of participation (P¿<¿0.001). Of the few outpatients who discussed biobanking with their doctor (29%), all consented. Conclusion: Professional-initiated, opt-in consent resulted in a few educated patients being approached; greater professional initiation of consent would be fruitful as most patients were willing to participate if asked. However, other consent approaches minimizing professional involvement were as acceptable to participants warranting further consideration.
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Nova |
2019 |
Fradgley EA, Boltong A, O'Brien L, Boyes AW, Lane K, Beattie A, et al., 'Implementing Systematic Screening and Structured Care for Distressed Callers Using Cancer Council's Telephone Services: Protocol for a Randomized Stepped-Wedge Trial', JMIR RESEARCH PROTOCOLS, 8 93-103 (2019)
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2019 |
McCrabb S, Twyman L, Palazzi K, Guillaumier A, Paul C, Bonevski B, 'A cross sectional survey of internet use among a highly socially disadvantaged population of tobacco smokers', Addiction Science and Clinical Practice, 14 (2019) [C1]
Background: Tobacco smoking is highest among population groups which are the most socially disadvantaged. Internet-based smoking cessation programs have been found to be effective... [more]
Background: Tobacco smoking is highest among population groups which are the most socially disadvantaged. Internet-based smoking cessation programs have been found to be effective, though rates of internet access are not well known in these groups. This study describes the rates of internet use and types of technology used to access the internet by a population of socially disadvantaged smokers. The study also examined relationships between sociodemographic and smoking behaviours with amount of internet use and type of device used. Methods: A cross-sectional survey of 369 clients (response rate 77%) from two non-government community service organisations in metropolitan New South Wales, Australia was conducted using touchscreen computers. Descriptive statistics and logistic regressions were used to examine results. Results: Eligible participants ranged from 19 to 88 years old current tobacco users. Over half (58%) of the participants reported weekly or more frequent use of the internet with less than a third (28%) not having any access. The odds of using the internet at least weekly decreased with age and as heaviness of smoking increased (OR = 0.94, p < 0.001; OR = 0.81, p = 0.022, respectively). Odds of internet use were higher as income increased (OR = 2.74, p < 0.001 for individuals earning $201-$400 per week; OR = 2.83, p = 0.006 for individuals earning > $400 per week). Device use differed for age and income. Conclusions: Internet-based interventions appear to reach the majority of socially disadvantaged populations. It is expected that this reach will continue to grow, making internet-based interventions a potential platform for providing care to low socioeconomic individuals who smoke, however inequalities may be exacerbated for those individual without internet access. Implications: Internet use among socially disadvantaged tobacco users is moderate (58%). An internet-based smoking cessation intervention for socially disadvantaged tobacco users may be an effective intervention however, older, heavier tobacco users may not benefit as easily due to limited internet access and therefore acknowledging these limitations when developing an intervention can help to acknowledge limitation of intervention reach.
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Nova |
2019 |
Koye DN, Magliano DJ, Reid CM, Pavkov ME, Chadban SJ, McDonald SP, et al., 'Trends in Incidence of ESKD in People With Type 1 and Type 2 Diabetes in Australia, 2002-2013', American Journal of Kidney Diseases, 73 300-308 (2019) [C1]
Rationale & Objective: The number of people with diabetes and end-stage kidney disease (ESKD) is increasing worldwide, but it is unknown whether this indicates an increasing r... [more]
Rationale & Objective: The number of people with diabetes and end-stage kidney disease (ESKD) is increasing worldwide, but it is unknown whether this indicates an increasing risk for ESKD in people with diabetes. We examined temporal trends in the incidence of ESKD within the Australian population with diabetes from 2002 to 2013. Study Design: Follow-up study using a national health care services registry. Setting & Participants: Registrants with type 1 or type 2 diabetes in Australia's National Diabetes Services Scheme (NDSS). Predictors: Age, sex, indigenous status, diabetes type, and calendar year. Outcome: Incidence of ESKD (dialysis or kidney transplantation) or death ascertained using the Australian and New Zealand Dialysis and Transplant Registry and the Australian national death index. Analytical Approach: NDSS registrants were followed up from 2002 or date of registration until onset of ESKD, death, or December 31, 2013. The incidence of ESKD in type 1 diabetes was calculated only in those younger than 55 years. Results: Among 1,375,877 registrants between 2002 and 2013, a total of 9,977 experienced incident ESKD, representing an overall incidence of ESKD in people with diabetes of 10.0 (95% CI, 9.8-10.2) per 10,000 person-years. Among those with type 1 diabetes, the age-standardized annual incidence was stable during the study period. Among those with type 2 diabetes, the incidence increased in nonindigenous people (annual percentage change, 2.2%; 95% CI, 0.4%-4.1%) with the greatest increases in those younger than 50 and those older than 80 years. No significant change over time was observed in indigenous people, although the adjusted incident rate ratio for indigenous versus nonindigenous was 4.03 (95% CI, 3.68-4.41). Limitations: Lack of covariates such as comorbid conditions, medication use, measures of quality of care, and baseline kidney function. Conclusions: The age-standardized annual incidence of ESKD increased in Australia from 2002 to 2013 for nonindigenous people with type 2 diabetes but was stable for people with type 1 diabetes. Efforts to prevent the development of ESKD, especially among indigenous Australians and those with early-onset type 2 diabetes, are warranted.
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Nova |
2019 |
Paul CL, Tzelepis F, Boyes AW, D'Este C, Sherwood E, Girgis A, 'Continued smoking after a cancer diagnosis: a longitudinal study of intentions and attempts to quit', JOURNAL OF CANCER SURVIVORSHIP, 13 687-694 (2019) [C1]
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Nova |
2019 |
Paul C, D'Este C, Ryan A, Jayakody A, Attia J, Oldmeadow C, et al., 'Staff perspectives from Australian hospitals seeking to improve implementation of thrombolysis care for acute stroke', SAGE OPEN MEDICINE, 7 (2019) [C1]
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Nova |
2019 |
Tzelepis F, Paul CL, Williams CM, Giligan C, Regan T, Daly J, et al., 'Real-time video counselling for smoking cessation', COCHRANE DATABASE OF SYSTEMATIC REVIEWS, (2019) [C1]
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Nova |
2019 |
Noble N, Paul C, Walsh J, Wyndham K, Wilson S, Stewart J, 'Concordance between self-report and medical records of preventive healthcare delivery among a sample of disadvantaged patients from four aboriginal community controlled health services', BMC Health Services Research, 19 (2019) [C1]
Background: This cross-sectional study aimed to explore, among a sample of patients attending one of four Aboriginal Health Services (ACCHSs), the degree of concordance between se... [more]
Background: This cross-sectional study aimed to explore, among a sample of patients attending one of four Aboriginal Health Services (ACCHSs), the degree of concordance between self-report and medical records for whether screening for key healthcare items had ever been undertaken, or had been undertaken within the recommended timeframe. Methods: Across the four ACCHSs, a convenience sample of 109 patients was recruited. Patients completed a self-report computer survey assessing when they last had preventive care items undertaken at the service. ACCHS staff completed a medical record audit for matching items. The degree of concordance (i.e. the percentage of cases in which self-reports matched responses from the medical record) was calculated. Results: Concordance was relatively high for items including assessment of Body Mass Index and blood pressure, but was substantially lower for items including assessment of waist circumference, alcohol intake, physical activity, and diet. Conclusions: Reliance on either patient self-report or medical record data for assessing the level of preventive care service delivery by ACCHSs requires caution. Efforts to improve documentation of some preventive care delivery in medical records are needed. These findings are likely to also apply to patients in other general practice settings.
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Nova |
2019 |
Hasnain MG, Levi CR, Ryan A, Hubbard IJ, Hall A, Oldmeadow C, et al., 'Can a multicomponent multidisciplinary implementation package change physicians' and nurses' perceptions and practices regarding thrombolysis for acute ischemic stroke? An exploratory analysis of a cluster-randomized trial', IMPLEMENTATION SCIENCE, 14 (2019) [C1]
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Nova |
2019 |
Hasnain MG, Paul CL, Attia JR, Ryan A, Kerr E, D'Este C, et al., 'Door-to-needle time for thrombolysis: a secondary analysis of the TIPS cluster randomised controlled trial', BMJ open, 9 (2019) [C1]
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Nova |
2019 |
Mogre V, Johnson NA, Tzelepis F, Paul C, 'Attitudes towards, facilitators and barriers to the provision of diabetes self-care support: A qualitative study among healthcare providers in Ghana', Diabetes and Metabolic Syndrome: Clinical Research and Reviews, 13 1745-1751 (2019) [C1]
Statement of the problem: Self-care support provided by healthcare providers (HCPs) is critical to diabetes self-care. However, a number of barriers prevent HCPs from providing se... [more]
Statement of the problem: Self-care support provided by healthcare providers (HCPs) is critical to diabetes self-care. However, a number of barriers prevent HCPs from providing self-care support to people with diabetes. We explored attitudes towards, barriers and facilitators of the provision of diabetes self-care support among Ghanaian HCPs. Methods: Fourteen semi-structured interviews were conducted among HCPs recruited from three diabetes clinics in Tamale, Ghana. All interviews were digitally recorded and transcribed verbatim. Transcripts were coded and analysed thematically. Results: HCPs reported a sense of responsibility and urgency to provide self-care education to diabetes patients; while believing it was the patients¿ responsibility to self-care for their diabetes condition. Accordingly, HCPs perceived their role to be limited to information sharing rather than behaviour change interventions. Facilitators to the provision of self-care support included patients¿ motivation, and team work among healthcare professionals. Barriers that hindered self-care support included language barriers and poor inter-professional collaboration. Furthermore, HCPs discussed that they felt inadequately trained to provide self-care support. Healthcare-system-related barriers were inadequate office space, lack of professional development programmes, high patient numbers, inadequate staff numbers, inadequate health insurance and a lack of sufficient supplies and equipment in the hospital. Conclusion: HCPs attitudes were generally favourable towards supporting self-care, albeit with a focus on information provision rather than behaviour change. Training in effective strategies for providing self-care support are needed, and better use of the resources that are available.
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Nova |
2018 |
Haines MM, Brown B, D'Este CA, Yano EM, Craig JC, Middleton S, et al., 'Improving the quality of healthcare: a cross-sectional study of the features of successful clinical networks', Public health research & practice, 28 (2018) [C1]
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Nova |
2018 |
Twyman L, Bonevski B, Paul C, Bryant J, West R, Siahpush M, et al., 'What factors are associated with abstinence amongst socioeconomically disadvantaged smokers? A cross-sectional survey of use of cessation aids and quitting approach', Drug and Alcohol Review, 37 170-179 (2018) [C1]
Introduction and Aims: This study aimed to compare current and ex-smokers' sociodemographic and psychosocial characteristics, use of cessation aids and abrupt versus gradual ... [more]
Introduction and Aims: This study aimed to compare current and ex-smokers' sociodemographic and psychosocial characteristics, use of cessation aids and abrupt versus gradual quitting approaches. Design and Methods: A cross-sectional survey of financially disadvantaged adults attending a community service organisation was conducted in New South Wales, Australia, between February 2012 and December 2013. Sociodemographic and psychosocial factors, use of cessation aids and gradual versus abrupt quit approach were assessed. ¿2 tests and logistic regression compared characteristics of current and ex-smokers. Results: Of 905 individuals who completed the survey, 639 (71%) were current smokers and 107 (12%) were ex-smokers. Ex-smokers were older [odds ratio (OR)¿=¿1.03, 95% confidence interval (CI)¿=¿1.01, 1.05], had higher odds of being female (OR¿=¿1.67, 95% CI¿=¿1.06, 2.65), lower odds of being financially stressed (OR¿=¿0.87, 95% CI¿=¿0.76, 0.99), lower odds of anxiety and depression symptoms (OR¿=¿0.91, 95% CI¿=¿0.84, 0.98) and lower odds of having friends and family who were smokers (ORs ranged from 0.30¿0.43). Ex-smokers had lower odds of using cessation aids and higher odds of reporting abrupt quitting during their last quit attempt (OR¿=¿4.48, 95% CI¿=¿2.66, 7.54). Conclusions: Lower levels of disadvantage, less smoking in social networks, less use of cessation aids and abrupt (vs. gradual) quitting approaches were associated with being an ex-smoker. Lower use of evidence based methods to quit by disadvantaged ex-smokers requires further exploration. [Twyman L, Bonevski B, Paul C, Bryant J, West R, Siahpush M, D'este C, Oldmeadow C, Palazzi K. What factors are associated with abstinence amongst socioeconomically disadvantaged smokers? A cross-sectional survey of use of cessation aids and quitting approach. Drug Alcohol Rev 2017;00:000-000].
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Nova |
2018 |
Tzelepis F, Paul CL, Sanson-Fisher RW, Campbell HS, Bradstock K, Carey ML, Williamson A, 'Unmet supportive care needs of haematological cancer survivors: rural versus urban residents', Annals of Hematology, 97 1283-1292 (2018) [C1]
Due to fewer cancer services in rural locations, rural survivors may have unique unmet needs compared to urban survivors. This study compared among rural and urban haematological ... [more]
Due to fewer cancer services in rural locations, rural survivors may have unique unmet needs compared to urban survivors. This study compared among rural and urban haematological cancer survivors the most common ¿high/very high¿ unmet supportive care needs and the unmet need scores for five domains (information, financial concerns, access and continuity of care, relationships and emotional health). Survivors¿ socio-demographics, rurality, cancer history and psychological factors associated with each unmet need domain were also explored. A total of 1511 haematological cancer survivors were recruited from five Australian state cancer registries and 1417 (1145 urban, 272 rural) allowed extraction of their residential postcode from registry records. A questionnaire that contained the Survivor Unmet Needs Survey was mailed to survivors. Dealing with feeling tired was the most common ¿high/very high¿ unmet need for rural (15.2%) and urban (15.5%) survivors. The emotional health domain had the highest mean unmet need score for rural and urban survivors. Rurality was associated with a decreased unmet emotional health domain score whereas travelling for more than 1¿h to treatment was associated with increased unmet financial concerns and unmet access and continuity of care. Depression, anxiety and stress were associated with increased unmet need scores for all five domains. Unmet need domain scores generally did not differ by rurality. Travelling for more than 1¿h to treatment was associated with increased unmet need scores on two domains. Telemedicine and increased financial assistance with travel and accommodation may help those travelling long distances for treatment.
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Nova |
2018 |
Yoong SL, Stockings E, Chai LK, Tzelepis F, Wiggers J, Oldmeadow C, et al., 'Prevalence of electronic nicotine delivery systems (ENDS) use among youth globally: A systematic review and meta-analysis of country level data', Australian and New Zealand Journal of Public Health, 42 303-308 (2018) [C1]
Objective: To describe the prevalence and change in prevalence of electronic nicotine delivery systems (ENDS) use in youth by country and combustible smoking status. Methods: Data... [more]
Objective: To describe the prevalence and change in prevalence of electronic nicotine delivery systems (ENDS) use in youth by country and combustible smoking status. Methods: Databases and the grey literature were systematically searched to December 2015. Studies describing the prevalence of ENDS use in the general population aged =20 years in a defined geographical region were included. Where multiple estimates were available within countries, prevalence estimates of ENDS use were pooled for each country separately. Results: Data from 27 publications (36 surveys) from 13 countries were included. The prevalence of ENDS ever use in 2013¿2015 among youth were highest in Poland (62.1%; 95%CI: 59.9-64.2%), and lowest in Italy (5.9%; 95%CI: 3.3-9.2%). Among non-smoking youth, the prevalence of ENDS ever use in 2013¿2015 varied, ranging from 4.2% (95%CI: 3.8-4.6%) in the US to 14.0% in New Zealand (95%CI: 12.7-15.4%). The prevalence of ENDS ever use among current tobacco smoking youth was the highest in Canada (71.9%, 95%CI: 70.9-72.8%) and lowest in Italy (29.9%, 95%CI: 18.5-42.5%). Between 2008 and 2015, ENDS ever use among youth increased in Poland, Korea, New Zealand and the US; decreased in Italy and Canada; and remained stable in the UK. Conclusions: There is considerable heterogeneity in ENDS use among youth globally across countries and also between current smokers and non-smokers. Implications for public health: Population-level survey data on ENDS use is needed to inform public health policy and messaging globally.
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Nova |
2018 |
Rose S, Boyes A, Kelly B, Cox M, Palazzi K, Paul C, 'Help-seeking behaviour in newly diagnosed lung cancer patients: Assessing the role of perceived stigma', Psycho-Oncology, 27 2141-2147 (2018) [C1]
Objective: This study explored help-seeking behaviours, group identification, and perceived legitimacy of discrimination, and its potential relationship with perceived lung cancer... [more]
Objective: This study explored help-seeking behaviours, group identification, and perceived legitimacy of discrimination, and its potential relationship with perceived lung cancer stigma. Methods: Consecutive consenting adults (n¿=¿274) with a primary diagnosis of lung cancer within the previous 4¿months were recruited at 31 outpatient clinics in Australia. A self-report survey assessed help-seeking, group identification, perceived legitimacy of discrimination, and perceived lung cancer stigma. Results: Services providing assistance from health professionals (69.5%) and informational support (68.5%) were more frequently used than emotional-based support. Only a small proportion (2.6%) of participants were unlikely to seek help from anyone, with the most popular sources of help being the general practitioner (91.0%), and oncologist/treating clinician (81.3%). One-fifth (21.1%) indicated they identified with being a lung cancer patient, and most did not perceive discrimination against lung cancer patients. Higher perceived lung cancer stigma was significantly associated with greater perceived legitimacy of discrimination (P¿<¿0.001), but not help-seeking behaviours or group identification. Conclusions: The relationship between lung cancer stigma and perceived legitimacy of discrimination may guide initiatives to reduce stigma for patients. It is encouraging that perceived stigma did not appear to inhibit help-seeking behaviours. However, further research in this emerging field is needed to investigate patterns of perceived stigma and help-seeking over time to identify how and when to offer support services most appropriate to the needs of lung cancer patients.
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Nova |
2018 |
White RA, Hayes C, Boyes AW, Chiu S, Paul CL, 'Therapeutic alternatives for supporting GPs to deprescribe opioids: a cross-sectional survey.', BJGP open, 2 (2018) [C1]
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Nova |
2018 |
Lynagh MC, Williamson A, Bradstock K, Campbell S, Carey M, Paul C, et al., 'A national study of the unmet needs of support persons of haematological cancer survivors in rural and urban areas of Australia', Supportive Care in Cancer, 26 1967-1977 (2018) [C1]
Purpose: This study aimed to compare support persons of haematological cancer survivors living in rural and urban areas in regard to the type, prevalence and factors associated wi... [more]
Purpose: This study aimed to compare support persons of haematological cancer survivors living in rural and urban areas in regard to the type, prevalence and factors associated with reporting unmet needs. Methods: One thousand and four (792 urban and 193 rural) support persons of adults diagnosed with haematological cancer were recruited from five Australian state population-based cancer registries. Participants completed the Support Person Unmet Needs Survey (SPUNS) that assessed the level of unmet needs experienced over the past month across six domains. Results: Overall, 66% of support persons had at least one ¿moderate, high or very high¿ unmet need and 24% (n = 182) reported having multiple (i.e. 6 or more) ¿high/very high¿ unmet needs in the past month. There were no significant differences between rural and urban support persons in the prevalence of multiple unmet needs or mean total unmet needs scores. There were however significant differences in the types of ¿high/very high¿ unmet needs with support persons living in rural areas more likely to report finance-related unmet needs. Support persons who indicated they had difficulty paying bills had significantly higher odds of reporting multiple ¿high/very high¿ unmet needs. Conclusions: This is the first large, population-based study to compare the unmet needs of support persons of haematological cancer survivors living in rural and urban areas. Findings confirm previous evidence that supporting a person diagnosed with haematological cancer correlates with a high level of unmet needs and highlight the importance of developing systemic strategies for assisting support persons, especially in regard to making financial assistance and travel subsidies known and readily accessible to those living in rural areas.
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Nova |
2018 |
Fradgley EA, Paul CL, Bryant J, Zucca A, Oldmeadow C, 'System-wide and group-specific health service improvements: Cross-sectional survey of outpatient improvement preferences and associations with demographic characteristics', International Journal of Environmental Research and Public Health, 15 (2018) [C1]
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Nova |
2018 |
Tzelepis F, Wiggers J, Paul CL, Byaruhanga J, Byrnes E, Bowman J, et al., 'A randomised trial of real-time video counselling for smoking cessation in regional and remote locations: study protocol', CONTEMPORARY CLINICAL TRIALS, 74 70-75 (2018)
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2018 |
Tzelepis F, Clinton-McHarg T, Paul CL, Sanson-Fisher RW, Joshua D, Carey ML, 'Quality of patient-centered care provided to patients attending hematological cancer treatment centers', International Journal of Environmental Research and Public Health, 15 (2018) [C1]
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Nova |
2018 |
Bonevski B, Twyman L, Paul C, D'Este C, West R, Siahpush M, et al., 'Smoking cessation intervention delivered by social service organisations for a diverse population of Australian disadvantaged smokers: A pragmatic randomised controlled trial', Preventive Medicine, 112 38-44 (2018) [C1]
Objectives: There remains a need to identify effective smoking cessation interventions in severely disadvantaged populations. This trial aimed to examine the effectiveness of an i... [more]
Objectives: There remains a need to identify effective smoking cessation interventions in severely disadvantaged populations. This trial aimed to examine the effectiveness of an intervention (Call it Quits) developed to promote smoking cessation and delivered by community social service case-workers. Methods: Call it Quits was a pragmatic, parallel randomised trial of a case-worker delivered smoking cessation intervention conducted in a non-government community social service organisation in New South Wales (NSW), Australia. Adult smokers requiring financial assistance were randomly assigned to the five-session Call it Quits intervention or usual care control group. Of the 618 eligible individuals, 300 were randomised to the intervention group, of whom 187 (62%) consented and 318 were randomised to the control group, of whom 244 (77%) consented, resulting in 431 participants. The primary outcome measure was self-reported continuous abstinence up to 6-month follow-up with biochemical verification. Primary analysis was performed using all the available data from participants under the assumption the data is missing completely at random, followed by sensitivity analyses. Results: No statistically significant differences in the primary outcome were found (1.4% in the control group versus 1.0% in the intervention group, OR = 0.77, p = 0.828). Conclusions: A multi-component smoking cessation intervention delivering motivational interviewing-based counselling and free NRT by a trained case-worker within a community social service setting was not effective at achieving abstinence in a highly disadvantaged sample of smokers but increased attempts to stop and led to a reduction in number of cigarettes smoked daily.
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Nova |
2018 |
Carey M, Sanson-Fisher R, Clinton-McHarg T, Boyes A, Olver I, Oldmeadow C, et al., 'Examining variation across treatment clinics in cancer patients psychological outcomes: results of a cross sectional survey', Supportive Care in Cancer, 26 3201-3208 (2018) [C1]
Purpose: The majority of research on psychological outcomes for cancer patients has focussed on the role of individual characteristics, and disease and treatment factors. There ha... [more]
Purpose: The majority of research on psychological outcomes for cancer patients has focussed on the role of individual characteristics, and disease and treatment factors. There has been very little exploration of the potential contribution of the treatment clinic to these outcomes. This study explored whether there is variation among clinics in cancer patients¿ psychological outcomes. Methods: Cancer outpatients were recruited from 22 medical oncology and haematology clinics in Australia. Participants completed a pen and paper survey including the Hospital Anxiety and Depression Scale (HADS), as well as sociodemographic, disease and treatment characteristics. Results: Of those eligible to participate, 4233 (82%) consented and 2811 (81% of consenters) returned the completed survey. There was no statistically significant variation in HADS depression scores across clinics. Some difference in anxiety scores derived from the HADS questionnaire between clinics (p = 0.03) was found with the percentage of between-clinic variation estimated to be 1.11%. However, once all demographic, disease and treatment predictors were adjusted for there was no statistical differences between clinics (percent of between-clinic variation = 0.53%; p = 0.1415). Conclusions: Psychological outcomes were not found to vary between clinics. Other sources of variation including patient characteristics may over-ride between-clinic variability, if it exists.
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Nova |
2018 |
Rose S, Kelly B, Boyes A, Cox M, Palazzi K, Paul C, 'Impact of perceived stigma in people newly diagnosed with lung cancer: A cross-Sectional analysis', Oncology Nursing Forum, 45 737-747 (2018) [C1]
OBJECTIVES: To investigate perceived stigma and its possible associations with treatment expectations and preferences in newly diagnosed patients with lung cancer. SAMPLE & SE... [more]
OBJECTIVES: To investigate perceived stigma and its possible associations with treatment expectations and preferences in newly diagnosed patients with lung cancer. SAMPLE & SETTING: 274 patients with lung cancer diagnosed in the previous four months at oncology and respiratory outpatient clinics in Australia. METHODS & VARIABLES: Participants completed a self-report survey about perceived lung cancer stigma and treatment expectations and preferences. RESULTS: A mean perceived stigma score of 52 of a possible 124 was reported, which is lower than scores reported in other studies using the same measure; the current study determined that perceived lung cancer stigma was observed less frequently. Significantly higher scores were observed in participants who were younger or who had a history of smoking. Perceived lung cancer stigma was significantly related to treatment expectations. No relationship was found between perceived lung cancer stigma and treatment preferences. IMPLICATIONS FOR NURSING: Healthcare providers are in a key position to provide support and communicate empathetically with patients to minimize potential stigma experiences.
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Nova |
2018 |
Wynne O, Guillaumier A, Twyman L, McCrabb S, Denham AMJ, Paul C, et al., 'Signs, fines and compliance officers: A systematic review of strategies for enforcing smoke-free policy', International Journal of Environmental Research and Public Health, 15 (2018) [C1]
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Nova |
2018 |
Fradgley EA, Chong SE, Cox ME, Paul CL, Gedye C, 'Enlisting the willing: A study of healthcare professional initiated and opt-in biobanking consent reveals improvement opportunities throughout the registration process', European Journal of Cancer, 89 36-41 (2018) [C1]
Biobanking consent processes should accord with patients' preferences and be offered in a consistent and systematic manner. However, these aims can be difficult to achieve un... [more]
Biobanking consent processes should accord with patients' preferences and be offered in a consistent and systematic manner. However, these aims can be difficult to achieve under healthcare professionals' (HCPs) time-constrained workflows, resulting in low participation rates. This current perspective provides a brief overview of HCP involvement in consent and reports new data on participant attrition at each step of the biobanking consent process as experienced by 113 patients at an Australian tertiary cancer centre. To determine attrition in this HCP-driven consent process, we reviewed medical records for the following events: inclusion of biobanking consent forms; visible patient and HCP signatures; consent status selected (decline or accept) and specimen registration with local biobank. Accessible medical records revealed the following data: 75 of 85 records included viewable forms; 22 of 85 records included patient and 19 of 85 included HCP signatures; 15 of 85 records included signed and completed forms and 3 of 85 had samples banked with annotated clinical data. We compared these data with self-reported experiences of being approached to participate by HCPs. Of the 15 participants (17.6%) who successfully completed consent, only five could recall being asked and providing consent. The low enrolment rate is a considerable lost opportunity because most patients (59%) who were not asked to participate indicated they would have consented if asked. Furthermore, in comparing self-reported experiences with medical records, we believe cancer patients' preferences for participation are mismatched with actual biobanking enrolment, which has considerable attrition at each step in the consent process.
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Nova |
2018 |
Day FL, Sherwood E, Chen TY, Barbouttis M, Varlow M, Martin J, et al., 'Oncologist provision of smoking cessation support: A national survey of Australian medical and radiation oncologists', Asia-Pacific Journal of Clinical Oncology, 14 431-438 (2018) [C1]
Aim: Continued smoking in patients diagnosed with cancer affects treatment outcomes and overall survival. With national surveys of Australian medical oncologists (MO) and radiatio... [more]
Aim: Continued smoking in patients diagnosed with cancer affects treatment outcomes and overall survival. With national surveys of Australian medical oncologists (MO) and radiation oncologists (RO) we sought to determine current clinical practices, preferences and barriers in providing patient smoking cessation support. Methods: Oncologist members of the Medical Oncology Group of Australia (n¿=¿452) and Trans-Tasman Radiation Oncology Group (n¿=¿230) were invited to participate in a multiple choice survey exploring smoking cessation practices and beliefs. Results: The survey response rate was 43%. At first consultations more than 90% of MO and RO regularly asked patients if they smoke or use tobacco products, closely followed by documentation of duration of smoking history and current level of consumption. Less common was asking the patient if they intended to quit (MO 63%, RO 53%) and advising cessation (MO 70%, RO 72%). Less than 50% of oncologists regularly asked about current smoking in follow-up consultations. Although a range of referral options for smoking cessation care were used by oncologists, only 2% of MO and 3% of RO actively managed the patients¿ smoking cessation themselves and this was the least preferred option. The majority believed they require more training in cessation interventions (67% MO, 57% RO) and cited multiple additional barriers to providing cessation care. Conclusions: Oncologists strongly prefer smoking cessation interventions to be managed by other health workers. A collaborative approach with other health professionals is needed to aid the provision of comprehensive smoking cessation care tailored to patients with cancer.
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Nova |
2017 |
Bonevski B, Borland R, Paul CL, Richmond RL, Farrell M, Baker A, et al., 'No smoker left behind: it's time to tackle tobacco in Australian priority populations', MEDICAL JOURNAL OF AUSTRALIA, 207 141-+ (2017)
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2017 |
Carey M, Sanson-Fisher R, Paul C, Bradstock K, Williamson A, Campbell HS, 'Psychological morbidity among Australian rural and urban support persons of haematological cancer survivors: Results of a national study', Psycho-Oncology, 26 1952-1958 (2017) [C1]
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Nova |
2017 |
Paul CL, Piterman L, Shaw JE, Kirby C, Forshaw KL, Robinson J, et al., 'Poor uptake of an online intervention in a cluster randomised controlled trial of online diabetes education for rural general practitioners', Trials, 18 (2017) [C1]
Background: In Australia, rural and remote communities have high rates of diabetes-related death and hospitalisation. General practitioners (GPs) play a major role in diabetes det... [more]
Background: In Australia, rural and remote communities have high rates of diabetes-related death and hospitalisation. General practitioners (GPs) play a major role in diabetes detection and management. Education of GPs could optimise diabetes management and improve patient outcomes at a population level. The study aimed to describe the uptake of a continuing medical education intervention for rural GPs and its impact on the viability of a cluster randomised controlled trial of the effects of continuing medical education on whole-town diabetes monitoring and control. Method: Trial design: the cluster randomised controlled trial involved towns as the unit of allocation and analysis with outcomes assessed by de-identified pathology data (not reported here). The intervention programme consisted of an online active learning module, direct electronic access to specialist advice and performance feedback. Multiple rounds of invitation were used to engage GPs with the online intervention content. Evidence-based strategies (e.g. pre-notification, rewards, incentives) were incorporated into the invitations to enrol in the programme. Recruitment to the programme was electronically monitored through the hosting software package during the study intervention period. Results: Eleven matched pairs of towns were included in the study. There were 146 GPs in the 11 intervention towns, of whom 34 (23.3%) enrolled in the programme, and 8 (5.5%) completed the online learning module. No town had more than 10% of the resident GPs complete the learning module. There were no contacts made by GPs regarding requests for specialist advice. Consequently, the trial was discontinued. Conclusion: There is an ongoing need to engage primary care physicians in improving diabetes monitoring and management in rural areas. Online training options, while notionally attractive and accessible, are not likely to have high levels of uptake, even when evidence-based recruitment strategies are implemented. Trial registration: Australian New Zealand Clinical Trials Registry, identifier: ACTRN12611000553976. Retrospectively registered on 31 May 2011.
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Nova |
2017 |
Paul CL, Fradgley EA, Roach D, Baird H, 'Impact of financial costs of cancer on patients - the Australian experience', CANCER FORUM, 41 4-9 (2017) [C1]
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Nova |
2017 |
Rose S, Paul C, Boyes A, Kelly B, Roach D, 'Stigma-related experiences in non-communicable respiratory diseases: A systematic review', Chronic Respiratory Disease, 14 199-216 (2017) [C1]
The stigma of non-communicable respiratory diseases (NCRDs), whether perceived or otherwise, can be an important element of a patient's experience of his/her illness and a co... [more]
The stigma of non-communicable respiratory diseases (NCRDs), whether perceived or otherwise, can be an important element of a patient's experience of his/her illness and a contributing factor to poor psychosocial, treatment and clinical outcomes. This systematic review examines the evidence regarding the associations between stigma-related experiences and patient outcomes, comparing findings across a range of common NCRDs. Electronic databases and manual searches were conducted to identify original quantitative research published to December 2015. Articles focussing on adult patient samples diagnosed with asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, lung cancer or mesothelioma, and included a measurement of stigma-related experience (i.e. perceived stigma, shame, blame or guilt), were eligible for inclusion. Included articles were described for study characteristics, outcome scores, correlates between stigma-related experiences and patient outcomes and methodological rigor. Twenty-five articles were eligible for this review, with most (n = 20) related to lung cancer. No articles for cystic fibrosis were identified. Twenty unique scales were used, with low to moderate stigma-related experiences reported overall. The stigma-related experiences significantly correlated with all six patient-related domains explored (psychosocial, quality of life, behavioral, physical, treatment and work), which were investigated more widely in COPD and lung cancer samples. No studies adequately met all criteria for methodological rigor. The inter-connectedness of stigma-related experiences to other aspects of patient experiences highlight that an integrated approach is needed to address this important issue. Future studies should adopt more rigorous methodology, including streamlining measures, to provide robust evidence.
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Nova |
2017 |
Paul CL, Ishiguchi P, D Este CA, Shaw JE, Sanson-Fisher RW, Forshaw K, et al., 'Testing for type 2 diabetes in indigenous Australians: Guideline recommendations and current practice', Medical Journal of Australia, 207 206-210 (2017) [C1]
Objectives: To determine the proportion of Aboriginal Controlled Community Health Service (ACCHS) patients tested according to three national diabetes testing guidelines; to inves... [more]
Objectives: To determine the proportion of Aboriginal Controlled Community Health Service (ACCHS) patients tested according to three national diabetes testing guidelines; to investigate whether specific patient characteristics were associated with being tested. Design, setting and participants: Cross-sectional study of 20 978 adult Indigenous Australians not diagnosed with diabetes attending 18 ACCHSs across Australia. De-identified electronic whole service data for July 2010 e June 2013 were analysed. Main outcomes measures: Proportions of patients appropriately screened for diabetes according to three national guidelines for Indigenous Australians: National Health and Medical Research Council (at least once every 3 years for those aged 35 years or more); Royal Australian College of General Practitioners and Diabetes Australia (at least once every 3 years for those aged 18 years or more); National Aboriginal Community Controlled Health Organisation (annual testing of those aged 18 years or more at high risk of diabetes). Results: 74% (95% CI, 74¿75%) of Indigenous adults and 77% (95% CI, 76¿78%) of 10 760 patients aged 35 or more had been tested for diabetes at least once in the past 3 years. The proportions of patients tested varied between services (range: all adults, 16¿90%; people aged 35 years or more, 23¿92%). 18% (95% CI, 18¿19%) of patients aged 18 or more were tested for diabetes annually (range, 0.1¿43%). Patients were less likely to be tested if they were under 50 years of age, were transient rather than current patients of the ACCHS, or attended the service less frequently. Conclusions: Some services achieved high rates of 3-yearly testing of Indigenous Australians for diabetes, but recommended rates of annual testing were rarely attained. ACCHSs may need assistance to achieve desirable levels of testing.
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Nova |
2017 |
Tzelepis F, Paul CL, Williams CM, Gilligan C, Regan T, Daly J, et al., 'Real-time video counselling for smoking cessation', Cochrane Database of Systematic Reviews, 2017 (2017)
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The objectives of this review are to assess the following, across community, healthcare or ... [more]
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: The objectives of this review are to assess the following, across community, healthcare or other settings. The effectiveness of real-time video counselling delivered individually or to a group for increasing smoking cessation. The effectiveness of real-time video counselling on increasing the number of quit attempts. The effect of real-time video counselling on intervention adherence and duration of consultations. The effect of real-time video counselling on satisfaction, including ease of use. The effect of real-time video counselling on therapeutic alliance. To provide a brief economic commentary of real-time video counselling.
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2017 |
Tzelepis F, Hanna JH, Paul CL, Boyes AW, Carey ML, Regan T, 'Quality of patient-centred care: Medical oncology patients' perceptions and characteristics associated with quality of care', Psycho-Oncology, 26 1998-2001 (2017) [C1]
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Nova |
2017 |
Guillaumier A, Twyman L, Paul C, Siahpush M, Palazzi K, Bonevski B, 'Financial Stress and Smoking within a Large Sample of Socially Disadvantaged Australians', INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH, 14 (2017) [C1]
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Nova |
2017 |
Paul C, Tzelepis F, Girgis A, Boyes A, DEste C, Sherwood E, 'Continued Smoking after a Cancer Diagnosis: A Longitudinal Study of Intentions and Attempts to Quit', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, 13 197-197 (2017)
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2017 |
Paul CL, Cox ME, Small HJ, Boyes AW, O'Brien L, Rose SK, et al., 'Techniques for Improving Communication of Emotional Content in Text-Only Web-Based Therapeutic Communications: Systematic Review', JMIR MENTAL HEALTH, 4
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2017 |
Mogre V, Abanga ZO, Tzelepis F, Johnson NA, Paul C, 'Adherence to and factors associated with self-care behaviours in type 2 diabetes patients in Ghana', BMC ENDOCRINE DISORDERS, 17 (2017) [C1]
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Nova |
2017 |
Guillaumier A, Bonevski B, Paul C, d'Este C, Durkin S, Doran C, 'Which Type of Antismoking Advertisement Is Perceived as More Effective? An Experimental Study With a Sample of Australian Socially Disadvantaged Welfare Recipients', AMERICAN JOURNAL OF HEALTH PROMOTION, 31 209-216 (2017) [C1]
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Nova |
2017 |
Paul C, Hall A, Oldmeadow C, Lynagh M, Campbell S, Bradstock K, et al., 'Dyadic interdependence of psychosocial outcomes among haematological cancer survivors and their support persons', Supportive Care in Cancer, 25 3339-3346 (2017) [C1]
Purpose: This study aimed to explore the dyadic relationships between unmet need, depression, and anxiety in people diagnosed with haematological cancer and their support persons.... [more]
Purpose: This study aimed to explore the dyadic relationships between unmet need, depression, and anxiety in people diagnosed with haematological cancer and their support persons. Methods: Adult survivors (18¿years+) who had been diagnosed with a haematological cancer were recruited to a cross-sectional mailed survey via five state cancer registries in Australia. Participating survivors invited a support person to also complete a survey. Structural equation modelling was used to explore the relationships among survivor and support person self-reported depression, anxiety, and unmet needs. Results: Of the 4299 eligible haematological cancer survivors contacted by the registries, 1511 (35%) returned a completed survey as did 1004 support persons. There were 787 dyads with complete data. After adjusting for age, gender, rurality, cancer type, and whether the support person was a relative, positive correlations were found between survivor and support person scores for depression (p¿=¿0.0029) and unmet needs (p¿<¿0.001), but not anxiety scores (p¿=¿0.075). Survivor unmet needs were significantly related to support person depression (p¿=¿0.0036). Support person unmet needs were significantly related to a higher depression score for survivors (p¿=¿0.0067). Greater support person unmet needs were significantly related to a higher anxiety score for survivors (p¿=¿0.0083). Survivor unmet needs did not have a significant relationship to support person anxiety (p¿=¿0.78). Conclusion: Unmet needs may mediate the interdependence of psychosocial experiences for survivors and support persons, although a longitudinal study is required to confirm causality. Addressing unmet needs may be a potential target for improving outcomes for both groups.
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Nova |
2017 |
Regan T, Paul C, Ishiguchi P, D Este C, Koller C, Forshaw K, et al., 'Comparison of two sources of clinical audit data to assess the delivery of diabetes care in aboriginal communities', International Journal of Environmental Research and Public Health, 14 (2017) [C1]
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Nova |
2017 |
Bonevski B, Borland R, Paul CL, Richmond RL, Farrell M, Baker A, et al., 'No smoker left behind: It s time to tackle tobacco in Australian priority populations', Medical Journal of Australia, 207 141-142 (2017)
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2017 |
Mogre V, Johnson NA, Tzelepis F, Shaw J, Paul C, 'Adherence to self-care behaviours and associated barriers in type 2 diabetes patients of low-and middle-income countries: a systematic review protocol', SYSTEMATIC REVIEWS, 6 (2017)
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2017 |
Guillaumier A, Bonevski B, Paul C, Wiggers J, Germov J, Mitchell D, Bunch D, 'Australian university smoke-free policy implementation: a staff and student survey', Health promotion journal of Australia : official journal of Australian Association of Health Promotion Professionals, 28 165-169 (2017) [C1]
Issue addressed Universities represent important settings for the implementation of public health initiatives such as smoke-free policies. The study aimed to assess staff and stud... [more]
Issue addressed Universities represent important settings for the implementation of public health initiatives such as smoke-free policies. The study aimed to assess staff and student attitudes towards policy enforcement and compliance as well as the acceptability of the provision of cessation support in this setting. Methods A cross-sectional study was conducted following the introduction of a designated-areas partial smoke-free policy at two campuses of one Australian university in 2014. Staff (n=533) and students (n=3060) completed separate online surveys assessing attitudes towards smoke-free policy enforcement and compliance, and acceptability of university-provided cessation support. Results Students held significantly stronger beliefs than staff that the smoke-free policy required staff enforcement (69% vs 60%) and violation penalties (67% vs 60%; both P's <0.01); however, most staff (66%) did not believe enforcement was part of their role. Only 55% of student smokers were aware that the university provided any cessation support. 'Free or cheap nicotine replacement therapy' (65%) and 'free stop smoking counselling service' (60%) were the most popular strategies student smokers thought the university should provide. Conclusions University staff and students hold conflicting views over the need for policy enforcement and who is responsible for enforcement roles. Students view the university as an acceptable setting for the provision of smoking cessation support. So what? Where staff are expected to enforce smoke-free policies, specific education and training should be provided. Ongoing monitoring of compliance and enforcement behaviour appears necessary to avoid the pervasive kind of non-compliance to smoke-free policies that have been seen in other settings.
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Nova |
2016 |
Hall AE, Paul C, Bryant J, Lynagh MC, Rowlings P, Enjeti A, Small H, 'To adhere or not to adhere: Rates and reasons of medication adherence in hematological cancer patients', Critical Reviews in Oncology/Hematology, 97 247-262 (2016) [C1]
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Nova |
2016 |
Paul CL, Cameron E, Doran C, Hill D, Macrae F, Carey ML, Sanson-Fisher RW, 'Experiences of colorectal cancer patients in the 2-years post-diagnosis and patient factors predicting poor outcome', Supportive Care in Cancer, 24 4921-4928 (2016) [C1]
Purpose: There are few recent longitudinal studies investigating the quality of life of colorectal cancer patients in the early years following diagnosis. This study aimed to (i) ... [more]
Purpose: There are few recent longitudinal studies investigating the quality of life of colorectal cancer patients in the early years following diagnosis. This study aimed to (i) compare the health status of people with colorectal cancer less than 1¿year from diagnosis with health status 1¿year later and (ii) determine the characteristics associated with a change in overall health status. Methods: The study was conducted as part of a larger trial. Participants (n = 539) were identified via the Victorian Cancer Registry in Australia, completed a computer-assisted baseline telephone interview (including the EQ-5D-3L) within 6¿12¿months of diagnosis, and mailed a survey 12¿months later. Results: At baseline, the majority of participants (55¿%) reported some problems, including difficulties in usual activities (26¿%), pain or discomfort (25¿%), anxiety or depression (23¿%) and mobility issues (15¿%). Sixty-nine percent had either an unchanged or increased health utility score from baseline to follow-up. The largest proportion reporting an increase in problems between baseline and follow-up related to pain or discomfort (18¿%). While visual analogue scale scores indicated a significantly improved health state over time overall, 32¿% reported a decreased health utility score from baseline to follow-up. Those aged over 80¿years were more likely to report a decreased health utility score compared to 60¿80-year-olds. Conclusions: A sizeable minority of patients experience ongoing problems in their daily lives and should be offered assistance in overcoming disabilities and returning to best possible functioning, particularly older patients who appear to be vulnerable to poor outcomes.
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2016 |
'Proceedings of the 3rd IPLeiria's International Health Congress : Leiria, Portugal. 6-7 May 2016.', BMC health services research, 16 Suppl 3 200 (2016)
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2016 |
Aranda S, Paul CL, 'Rethinking system change in cancer', ASIA-PACIFIC JOURNAL OF CLINICAL ONCOLOGY, 12 10-12 (2016)
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2016 |
Brown BB, Haines M, Middleton S, Paul C, D'Este C, Klineberg E, et al., 'Development and validation of a survey to measure features of clinical networks', BMC Health Services Research, 16 1-11 (2016) [C1]
Background: Networks of clinical experts are increasingly being implemented as a strategy to improve health care processes and outcomes and achieve change in the health system. Fe... [more]
Background: Networks of clinical experts are increasingly being implemented as a strategy to improve health care processes and outcomes and achieve change in the health system. Few are ever formally evaluated and, when this is done, not all networks are equally successful in their efforts. There is a need to formatively assess the strategic and operational management and leadership of networks to identify where functioning could be improved to maximise impact. This paper outlines the development and psychometric evaluation of an Internet survey to measure features of clinical networks and provides descriptive results from a sample of members of 19 diverse clinical networks responsible for evidence-based quality improvement across a large geographical region. Methods: Instrument development was based on: a review of published and grey literature; a qualitative study of clinical network members; a program logic framework; and consultation with stakeholders. The resulting domain structure was validated for a sample of 592 clinical network members using confirmatory factor analysis. Scale reliability was assessed using Cronbach's alpha. A summary score was calculated for each domain and aggregate level means and ranges are reported. Results: The instrument was shown to have good construct validity across seven domains as demonstrated by a high level of internal consistency, and all Cronbach's a coefficients were equal to or above 0.75. In the survey sample of network members there was strong reported commitment and belief in network-led quality improvement initiatives, which were perceived to have improved quality of care (72.8 %) and patient outcomes (63.2 %). Network managers were perceived to be effective leaders and clinical co-chairs were perceived as champions for change. Perceived external support had the lowest summary score across the seven domains. Conclusions: This survey, which has good construct validity and internal reliability, provides a valid instrument to use in future research related to clinical networks. The survey will be of use to health service managers to identify strengths and areas where networks can be improved to increase effectiveness and impact on quality of care and patient outcomes. Equally, the survey could be adapted for use in the assessment of other types of networks.
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Nova |
2016 |
Paul CL, Boyes AW, O'Brien L, Baker AL, Henskens FA, Roos I, et al., 'Protocol for a Randomized Controlled Trial of Proactive Web-Based Versus Telephone-Based Information and Support: Can Electronic Platforms Deliver Effective Care for Lung Cancer Patients?', JMIR RESEARCH PROTOCOLS, 5
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2016 |
Paul C, Rose S, Hensley M, Pretto J, Hardy M, Henskens F, et al., 'Examining uptake of online education on obstructive sleep apnoea in general practitioners: A randomised trial', BMC Research Notes, 9 (2016) [C1]
Background: Obstructive sleep apnoea (OSA) affects up to 28 % of the adult population in Western countries. The detection and management of OSA by general practitioners (GPs) can ... [more]
Background: Obstructive sleep apnoea (OSA) affects up to 28 % of the adult population in Western countries. The detection and management of OSA by general practitioners (GPs) can be poor. The study aimed to examine what influence enhanced invitations had on uptake of on-line learning modules for OSA by GPs, and whether recent referrals of patients to sleep specialists influenced uptake. Methods: Practicing GPs in regional Australia were identified and randomised to receive either an enhanced or standard invitation letter to a new on-line education module for OSA. The enhanced letter included indication that the module was eligible for professional accreditation and described the prevalence and burden of sleep disorders. Some included extra emphasis if the GP had recently referred a patient for diagnostic investigation of OSA. Two reminder letters were sent. Results: Of 796 eligible GPs who received the letters, sixteen (2 %) accessed the website and four completed the modules over the four-month study period. GPs who received an enhanced invitation letter were not significantly more likely to access the website compared to GPs who received the standard invitation letter. Recent referral of a patient for diagnostic investigation was also not a significant factor in influencing use of the module. Conclusion: GP interest in on-line education about OSA appears low, and emphasis of relevant recent past patient(s) and the opportunity for professional education points was not successful in increasing engagement. There is a need to identify effective approaches to improving the detection and management of OSA in general practice.
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Nova |
2016 |
Paul CL, Piterman L, Shaw JE, Kirby C, Barker D, Robinson J, et al., 'Patterns of type 2 diabetes monitoring in rural towns: How does frequency of HbA1c and lipid testing compare with existing guidelines?', Australian Journal of Rural Health, 24 371-377 (2016) [C1]
Objective: To indicate levels of monitoring of type 2 diabetes in rural and regional Australia by examining patterns of glycated haemoglobin (HbA1c) and blood lipid testing. Desig... [more]
Objective: To indicate levels of monitoring of type 2 diabetes in rural and regional Australia by examining patterns of glycated haemoglobin (HbA1c) and blood lipid testing. Design and Setting: Retrospective analysis of pathology services data from twenty regional and rural towns in eastern Australia over 24 months. Participants: Of 13 105 individuals who had either a single HbA1c result =7.0% (53 mmol mol-1); or two or more HbA1c tests within the study period. Main outcome measures: Frequency of testing of HbA1c and blood lipids (cholesterol, low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol and triglycerides) were compared with guideline recommendations. Results: About 58.3% of patients did not have the recommended 6-monthly HbA1c tests and 30.6% did not have annual lipid testing. For those who did not receive tests at the recommended interval, the mean between-test interval was 10.5 months (95% CI = 7.5¿13.5) rather than 6 months for HbA1c testing; and 15.7 (95% CI = 13.3¿18.1) months rather than annually for blood lipids. For those with at least one out-of-range test result, 77% of patients failed to receive a follow-up HbA1c test and 86.5% failed to receive a follow-up blood lipid test within the recommended 3 months. Patients less than 50 years of age, living in a more remote area and with poor diabetes control were less likely to have testing at the recommended intervals (P < 0.0001). Conclusions: Although poor diabetes testing is not limited to rural areas, more intensive diabetes monitoring is likely to be needed for patients living in non-metropolitan areas, particularly for some subgroups.
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Nova |
2016 |
Paul C, Boyes A, Hall A, Bisquera A, Miller A, O Brien L, 'The impact of cancer diagnosis and treatment on employment, income, treatment decisions and financial assistance and their relationship to socioeconomic and disease factors', Supportive Care in Cancer, 24 4739-4746 (2016) [C1]
Purpose: The financial impact of cancer diagnosis and treatment can be considerable to individuals and their households, leading to changes in treatment decision making. This stud... [more]
Purpose: The financial impact of cancer diagnosis and treatment can be considerable to individuals and their households, leading to changes in treatment decision making. This study aimed to quantify effects on income and employment; describe how cost-related factors influence treatment decision making and need for financial assistance; and to identify patient sociodemographic factors associated with treatment decision making, use of financial assistance and financial effects. Methods: A cross-sectional self-report questionnaire was administered to oncology outpatients from two hospitals in Australia: one regional and one metropolitan. Results: Of 255 participants, 67¿% indicated a change in employment and 63¿% of those reported reduced household income since their diagnosis. Travel (15¿%), loss of income (14¿%) and cost of treatments (11¿%) were commonly cited factors influencing treatment decision making. Seventy-four percent of participants reported that they did not access financial assistance, with more than a third (37¿%) of those being unaware that financial assistance was available. Being currently not employed and more recent diagnosis were associated with a reduced income since diagnosis. After adjusting for employment status and age, patients with private health insurance had higher odds of reporting that financial factors had influenced treatment decision making (OR¿=¿2.5). Conclusion: Unemployment is a major driver of the financial impact of cancer. The costs of treatment may be particularly challenging for those with private health insurance who are more likely to be treated in the private health system where out-of-pocket costs are greater. Improved access to financial assistance is required to better avoid potential inequities.
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Nova |
2016 |
Paul C, Wolfenden L, Tzelepis F, Yoong S, Bowman J, Wye P, et al., 'Nicotine replacement therapy as a smoking cessation aid among disadvantaged smokers: What answers do we need?', Drug and Alcohol Review, 35 785-789 (2016) [C1]
In Australia and New Zealand, population groups who experience social disadvantage smoke at much higher rates than the general population. As there are limited data specific to th... [more]
In Australia and New Zealand, population groups who experience social disadvantage smoke at much higher rates than the general population. As there are limited data specific to these groups regarding the success of nicotine replacement therapy for smoking cessation, this commentary will provide an overview of the relevant international literature supplemented with observational data relevant to the policy contexts in Australia and New Zealand. [Paul C, Wolfenden L, Tzelepis F, Yoong S, Bowman J, Wye P, Sherwood E, Rose S, Wiggers J. Nicotine replacement therapy as a smoking cessation aid among disadvantaged smokers: What answers do we need? Drug Alcohol Rev 2016;35:785¿789].
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2016 |
Fradgley EA, Paul CL, Bryant J, Oldmeadow C, 'Getting right to the point: Identifying Australian outpatients' priorities and preferences for patient-centred quality improvement in chronic disease care', International Journal for Quality in Health Care, 28 470-477 (2016) [C1]
Objectives: To identify specific actions for patient-centred quality improvement in chronic disease outpatient settings, this study identified patients' general and specific ... [more]
Objectives: To identify specific actions for patient-centred quality improvement in chronic disease outpatient settings, this study identified patients' general and specific preferences among a comprehensive suite of initiatives for change.Design and setting: A cross-sectional survey was conducted in three hospital-based clinics specializing in oncology, neurology and cardiology care located in New South Wales, Australia.Participants and measures: Adult English-speaking outpatients completed the touch-screen Consumer Preferences Survey in waiting rooms or treatment areas. Participants selected up to 23 general initiatives that would improve their experience. Using adaptive branching, participants could select an additional 110 detailed initiatives and complete a relative prioritization exercise.Results: A total of 541 individuals completed the survey (71.1% consent, 73.1% completion). Commonly selected general initiatives, presented in order of decreasing priority (along with sample proportion), included: improved parking (60.3%), up-to-date information provision (15.0%), ease of clinic contact (12.9%), access to information at home (12.8%), convenient appointment scheduling (14.2%), reduced wait-times (19.8%) and information on medical emergencies (11.1%). To address these general initiatives, 40 detailed initiatives were selected by respondents.Conclusions: Initiatives targeting service accessibility and information provision, such as parking and up-to-date information on patient prognoses and progress, were commonly selected and perceived to be of relatively greater priority. Specific preferences included the need for clinics to provide patient-designated parking in close proximity to the clinic, information on treatment progress and test results (potentially in the form of designated brief appointments or via telehealth) and comprehensive and trustworthy lists of information sources to access at home.
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Nova |
2016 |
Fradgley EA, Paul CL, Bryant J, Collins N, Ackland SP, Bellamy D, Levi CR, 'Collaborative Patient-Centered Quality Improvement: A Cross-Sectional Survey Comparing the Types and Numbers of Quality Initiatives Selected by Patients and Health Professionals.', Eval Health Prof, 39 475-495 (2016) [C1]
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Nova |
2016 |
Twyman L, Bonevski B, Paul C, Kay-Lambkin FJ, Bryant J, Oldmeadow C, et al., 'The association between cannabis use and motivation and intentions to quit tobacco within a sample of Australian socioeconomically disadvantaged smokers.', Health Educ Res, 31 771-781 (2016) [C1]
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Nova |
2016 |
Rose S, Pretto J, Paul C, Emmett B, Hensley M, Henskens F, 'Relationships between nutritional knowledge, obesity, and sleep disorder severity', Journal of Sleep Research, 25 350-355 (2016) [C1]
Obstructive sleep apnea affects 20% of the adult population. Weight control is considered the best non-medical means of managing the condition, therefore improving nutritional kno... [more]
Obstructive sleep apnea affects 20% of the adult population. Weight control is considered the best non-medical means of managing the condition, therefore improving nutritional knowledge in individuals may be an appropriate strategy. This study aimed to describe the relationship between nutritional knowledge and: (i) sleep disorder severity; (ii) body mass index; and (iii) demographic characteristics in persons suspected of obstructive sleep apnea. Nutrition knowledge scores were also compared with the general population. Consecutive newly-referred patients attending the sleep laboratory for diagnostic polysomnography were invited to participate. Those who consented (n = 97) were asked to complete a touchscreen survey. Apnea-hypopnea index to measure sleep disorder severity and anthropometric measurements were obtained from the clinic. A quarter of participants were diagnosed with severe obstructive sleep apnea; and a majority (88%) were classed as being overweight or obese. The overall mean nutrition knowledge score was 58.4 ± 11.6 (out of 93). Nutrition knowledge was not associated with sleep disorder severity, body mass index or gender. The only significant difference detected was in relation to age, with older (=35 years) participants demonstrating greater knowledge in the 'food choices' domain compared with their younger counterparts (18-34 years; P < 0.030). Knowledge scores were similar to the general population. The findings suggest that nutrition knowledge alone is not an important target for weight control interventions for people with obstructive sleep apnea. However, given the complexities of sleep disorders, it may complement other strategies.
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Nova |
2016 |
Guillaumier A, Bonevski B, Paul C, D Este C, Twyman L, Palazzi K, Oldmeadow C, 'Self-Exempting Beliefs and Intention to Quit Smoking within a Socially Disadvantaged Australian Sample of Smokers', International Journal of Environmental Research and Public Health, 13 118-118 [C1]
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Nova |
2016 |
Hall AE, Sanson-Fisher RW, Carey ML, Paul C, Williamson A, Bradstock K, Campbell HS, 'Prevalence and associates of psychological distress in haematological cancer survivors', Supportive Care in Cancer, 24 4413-4422 (2016) [C1]
Purpose: To explore outcomes of psychological distress, including anxiety, depression and stress, amongst adult haematological cancer survivors, with a specific focus on potential... [more]
Purpose: To explore outcomes of psychological distress, including anxiety, depression and stress, amongst adult haematological cancer survivors, with a specific focus on potential differences between rural and urban survivors. Methods: One thousand four hundred fourteen urban and rural survivors were recruited from five Australian population-based cancer registries and completed a self-report pen-and-paper survey on their well-being, including the Depression Anxiety and Stress Scale 21-item version. Results: A quarter of survivors were identified as reporting above normal levels of anxiety and depression, respectively, and almost one fifth (17¿%) reported above normal levels of stress. There were no statistically significant differences in the percentage of rural and urban survivors reporting above normal levels of anxiety, depression, or stress. Survivors who had experienced financial burden due to their cancer or were of middle age had higher odds of reporting multiple domains of psychological distress, compared to their counterparts. Conclusions: Haematological cancer survivors diagnosed during middle age or who experience increased financial burden as a result of their diagnosis may require additional support and care with regards to psychological distress.
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2016 |
Fradgley EA, Bryant J, Paul CL, Hall AE, Sanson-Fisher RW, Oldmeadow C, 'Cross-sectional data that explore the relationship between outpatients' quality of life and preferences for quality improvement in oncology settings', Journal of Oncology Practice, 12 e746-e754 (2016) [C1]
Purpose This cross-sectional study assessed the association between oncology outpatients' quality improvement preferences and health-related quality of life (HRQoL). Implemen... [more]
Purpose This cross-sectional study assessed the association between oncology outpatients' quality improvement preferences and health-related quality of life (HRQoL). Implementation of specific initiatives preferred by patients with lower HRQoL may be a strategic approach to enhancing care for potentially vulnerable patients. Methods English-speaking adults were recruited from five outpatient chemotherapy clinics located in New South Wales, Australia. Using touch screen devices, participants selected up to 25 initiatives that would improve their experiences and completed the Functional Assessment of Cancer Therapy-General (FACT-G) survey. The logistic odds of selecting an initiative according to FACT-G scores were calculated to determine whether preferences were associated with HRQoL after controlling for potential confounders. Results Of the 411 eligible outpatients approached to participate, 263 (64%) completed surveys. Commonly selected initiatives were up-to-date information on treatment and condition progress (19.8%), access to or information on financial assistance (18.3%), and reduced clinic wait times (17.5%). For those with relatively lower FACT-G scores, the adjusted odds of selecting five initiatives illustrated an increasing trend: convenient appointment scheduling systems (+23% [P =.002]), reduced wait times (+15% [P =.01]), information on medical emergencies (+14% [P =.04]), access to or information on financial assistance (+15% [P =.009]), help to maintain daily living activities (+18% [P =.007]). Conclusion Two areas of improvement were commonly selected: easily accessible health services and information and support for self-management. Although the results suggest an association between a few quality improvement preferences and HRQoL, a wider spectrum of patient characteristics must be considered when targeting quality improvement to patient subgroups.
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2016 |
Paul CL, Boyes A, Searles A, Carey M, Turon H, 'The impact of loss of income and medicine costs on the financial burden for cancer patients in Australia', Journal of Community and Supportive Oncology, 14 307-313 (2016) [C1]
Background The cost of medicines may prove prohibitive for some cancer patients, potentially reducing the ability of a health system to fully deliver best practice care. Objective... [more]
Background The cost of medicines may prove prohibitive for some cancer patients, potentially reducing the ability of a health system to fully deliver best practice care. Objective To identify nonuse or nonpurchase of cancer-related medicines due to cost, and to describe the perceived financial burden of such medicines and associated patient characteristics. Methods A cross-sectional pen- And-paper questionnaire was completed by oncology outpatients at 2 hospitals in Australia; 1 in regional New South Wales and 1 in metropolitan Victoria. Results Almost 1 in 10 study participants had used over- The-counter medicines rather than prescribed medicines for cancer and obtained some but not all of the medicines prescribed in relation to their cancer. 63% of the sample reported some level of financial burden associated with obtaining these medicines, with 34% reporting a moderate or heavy financial burden. 11.8% reported using alternatives to prescribed medicines. People reporting reduced income after being diagnosed with cancer had almost 4 times the odds (OR, 3.73; 95% CI, 1.1-12.1) of reporting a heavy or extreme financial burden associated with prescribed medicines for cancer. Limitations Study response rate, narrow survey population, self-reported survey used. Conclusion This study identifies that a number of cancer patients, especially those with a reduced income after their diagnosis, experience financial burden associated with the purchase of medicines and that some go as far as to not use or to not purchase medicines. It seems likely that limiting the cost of medicines for cancer may improve patient ability to fully participate in the intended treatment. Funding Cancer Council NSW, National Health and Medical Research Council, and Hunter Medical Research Institute, Australia.
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2016 |
Paul C, Tzelepis F, Bisquera A, Noble N, Wiggers J, 'Just how high-risk are ongoing smokers? Exploring clusters of health risk behaviours among current and ex-smokers.', Prev Med, 93 70-75 (2016) [C1]
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2016 |
Hall A, Lynagh M, Tzelepis F, Paul C, Bryant J, 'How can we help haematological cancer survivors cope with the changes they experience as a result of their cancer?', Ann Hematol, 95 2065-2076 (2016) [C1]
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2016 |
Twyman L, Bonevski B, Paul C, Bryant J, Gartner C, Guillaumier A, 'Electronic cigarettes: Awareness, recent use, and attitudes within a sample of socioeconomically disadvantaged Australian smokers', Nicotine and Tobacco Research, 18 670-677 (2016) [C1]
Introduction: Electronic cigarette (e-cigarette) awareness, trial of e-cigarettes in the past 12 months, source and perceptions of safety and effectiveness was assessed within a d... [more]
Introduction: Electronic cigarette (e-cigarette) awareness, trial of e-cigarettes in the past 12 months, source and perceptions of safety and effectiveness was assessed within a disadvantaged sample of adult Australian smokers receiving welfare aid. Methods: A cross-sectional survey was administered to clients who smoke at two community service organizations in New South Wales, Australia from October 2013 to July 2014. E-cigarette awareness, trial in past 12 months, sources of e-cigarettes and perceptions of the safety and effectiveness of e-cigarettes to help people quit were assessed along with sociodemographic and smoking-related variables. Results: In total, 369 participants completed the survey (77% response rate). Awareness and trial of e-cigarettes were reported by 77% (n = 283) and 35% (n = 103) of the sample, respectively. E-cigarettes were most commonly obtained from friends/strangers followed by tobacco shops (tobacconists). Trying e-cigarettes in the past 12 months was significantly associated with positive perceptions of their safety (odds ratio [OR] = 1.8, 95% confidence interval [CI] = 1, 3.1) and effectiveness (OR = 1.9, 95% CI = 1.1, 3.2). Motivation to quit tobacco smoking was also significantly positively associated with positive perceptions of e-cigarette safety (OR = 1.2, 95% CI = 1.1, 1.4) and effectiveness (OR = 1.2, 95% CI = 1.0, 1.3). Conclusions: Rates of awareness and trial of e-cigarettes within a disadvantaged sample of Australian smokers are comparable to rates found within representative samples of the general Australian population. Previously trying e-cigarettes and higher levels of motivation to quit were associated with more positive perceptions of e-cigarette safety and effectiveness. Implications: This study demonstrates that socioeconomically disadvantaged smokers are aware of and accessing e-cigarettes in a country with relatively high restrictions covering e-cigarette sale and use.
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Nova |
2016 |
Paul CL, Ryan A, Rose S, Attia JR, Kerr E, Koller C, Levi CR, 'How can we improve stroke thrombolysis rates? A review of health system factors and approaches associated with thrombolysis administration rates in acute stroke care', IMPLEMENTATION SCIENCE, 11 (2016) [C1]
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Nova |
2016 |
Noble N, Paul C, Sanson-Fisher R, Turon H, Turner N, Conigrave K, 'Ready, set, go: a cross-sectional survey to understand priorities and preferences for multiple health behaviour change in a highly disadvantaged group', BMC HEALTH SERVICES RESEARCH, 16 (2016) [C1]
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Nova |
2016 |
Bonevski B, Guillaumier A, Shakeshaft A, Farrell M, Tzelepis F, Walsberger S, et al., 'An organisational change intervention for increasing the delivery of smoking cessation support in addiction treatment centres: study protocol for a randomized controlled trial', TRIALS, 17 (2016)
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Nova |
2016 |
Paul C, Bonevski B, Twyman L, D'Este C, Siahpush M, Guillaumier A, et al., 'The 'price signal' for health care is loud and clear: A cross-sectional study of self-reported access to health care by disadvantaged Australians', Australian and New Zealand Journal of Public Health, 40 132-137 (2016) [C1]
Objective: To describe self-reported inability to access health care and factors associated with lack of access among a socioeconomically disadvantaged group. Method: A cross-sect... [more]
Objective: To describe self-reported inability to access health care and factors associated with lack of access among a socioeconomically disadvantaged group. Method: A cross-sectional survey with 906 adult clients of a large community welfare agency in New South Wales. Clients attending the service for emergency assistance completed a touchscreen survey. Results: Inability to access health care in the prior year was reported by more than one-third of the sample (38%), compared to the 5% found for the general population. Dentists (47%), specialists (43%) or GPs (29%) were the least accessible types of health care. The main reason for inability to access health care was cost, accounting for 60% of responses. Almost half (47%) the sample reported delayed or non-use of medicines due to cost. Increasing financial stress was associated with increased inability to access GP or specialist care, medicines and imaging. Higher anxiety scores were associated with inability to access health care, and with cost-related inability to access medicines and imaging. Conclusion: For disadvantaged groups, cost-related barriers to accessing care are prominent and are disproportionately high - particularly regarding dentistry, specialist and GP care. Implications: Improvements in health outcomes for disadvantaged groups are likely to require strategies to reduce cost-related barriers to health care.
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Nova |
2016 |
Brown BB, Haines M, Middleton S, Paul C, D'Este C, Klineberg E, Elliott E, 'Development and validation of a survey to measure features of clinical networks', BMC health services research, 16 531 (2016)
RESULTS: The instrument was shown to have good construct validity across seven domains as demonstrated by a high level of internal consistency, and all Cronbach's a coefficie... [more]
RESULTS: The instrument was shown to have good construct validity across seven domains as demonstrated by a high level of internal consistency, and all Cronbach's a coefficients were equal to or above 0.75. In the survey sample of network members there was strong reported commitment and belief in network-led quality improvement initiatives, which were perceived to have improved quality of care (72.8¿%) and patient outcomes (63.2¿%). Network managers were perceived to be effective leaders and clinical co-chairs were perceived as champions for change. Perceived external support had the lowest summary score across the seven domains. CONCLUSIONS: This survey, which has good construct validity and internal reliability, provides a valid instrument to use in future research related to clinical networks. The survey will be of use to health service managers to identify strengths and areas where networks can be improved to increase effectiveness and impact on quality of care and patient outcomes. Equally, the survey could be adapted for use in the assessment of other types of networks. BACKGROUND: Networks of clinical experts are increasingly being implemented as a strategy to improve health care processes and outcomes and achieve change in the health system. Few are ever formally evaluated and, when this is done, not all networks are equally successful in their efforts. There is a need to formatively assess the strategic and operational management and leadership of networks to identify where functioning could be improved to maximise impact. This paper outlines the development and psychometric evaluation of an Internet survey to measure features of clinical networks and provides descriptive results from a sample of members of 19 diverse clinical networks responsible for evidence-based quality improvement across a large geographical region. METHODS: Instrument development was based on: a review of published and grey literature; a qualitative study of clinical network members; a program logic framework; and consultation with stakeholders. The resulting domain structure was validated for a sample of 592 clinical network members using confirmatory factor analysis. Scale reliability was assessed using Cronbach's alpha. A summary score was calculated for each domain and aggregate level means and ranges are reported.
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2016 |
Twyman L, Bonevski B, Paul C, Bryant J, West R, Siahpush M, et al., 'Factors associated with concurrent tobacco smoking and heavy alcohol consumption within a socioeconomically disadvantaged Australian sample', Substance Use and Misuse, 51 459-470 (2016) [C1]
Background: Tobacco use and heavy alcohol consumption occur more frequently in socioeconomically disadvantaged groups. Little is known about the sociodemographic and psychosocial ... [more]
Background: Tobacco use and heavy alcohol consumption occur more frequently in socioeconomically disadvantaged groups. Little is known about the sociodemographic and psychosocial factors associated with use of alcohol and tobacco in disadvantaged groups in comparison to low-risk users. Objectives: This study aimed to compare the characteristics of low-risk users with: disadvantaged smokers only; disadvantaged heavy drinkers only; and disadvantaged concurrent smokers and heavy drinkers. Methods: A cross-sectional survey of socioeconomically disadvantaged adult clients attending a community welfare agency assessed tobacco use, alcohol use, demographic, and psychosocial variables. Multivariable analysis using multinomial logistic regression was carried out. Results: The sample consisted of 835 participants; 40% (n = 331) were concurrent users, 31% were smokers only (n = 252), 11% were heavy drinkers only (n = 93), and 18% were low-risk users (n = 149). Compared with those who neither smoked nor consumed alcohol heavily, concurrent users were more likely to be younger, have only some contact with family, have more friends and family who were smokers, have no fixed home address, live alone, and have higher levels of financial stress. Most of these factors were shared by individuals who were smokers only. Factors associated with heavy drinkers only were frequent contact with family and having more friends and family who were smokers. Conclusion: Among those Australians who suffer severe economic hardship, being a concurrent smoker and heavy drinker appears to be associated with more isolated living conditions and financial stress but some contact with family.
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Nova |
2015 |
Guillaumier A, Bonevski B, Paul C, 'Tobacco health warning messages on plain cigarette packs and in television campaigns: A qualitative study with Australian socioeconomically disadvantaged smokers', Health Education Research, 30 57-66 (2015) [C1]
Television advertisements, packaging regulations and health warning labels (HWLs) are designed to communicate anti-smoking messages to large number of smokers. However, only a few... [more]
Television advertisements, packaging regulations and health warning labels (HWLs) are designed to communicate anti-smoking messages to large number of smokers. However, only a few studies have examined how high smoking prevalence groups respond to these warnings. This study explored how socioeconomically disadvantaged smokers engage with health risk and cessation benefit messages. Six focus groups were conducted over September 2012-April 2013 with adult clients of welfare organizations in regional New South Wales, Australia who were current smokers (n = 51). Participants discussed HWLs, plain packaging and anti-smoking television advertisements. Discussions were audio-taped, transcribed verbatim and analysed using thematic analysis. Highly emotive warnings delivering messages of negative health effects were most likely to capture the attention of the study participants; however, these warning messages did not prompt quit attempts and participants were sceptical about the effectiveness of cessation programmes such as telephone quitlines. Active avoidance of health warning messages was common, and many expressed false and self-exempting beliefs towards the harms of tobacco. Careful consideration of message content and medium is required to communicate the anti-smoking message to disadvantaged smokers who consider themselves desensitized to warnings. Health communication strategies should continue to address false beliefs about smoking and educate on cessation services that are currently underutilized.
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Nova |
2015 |
Grady AM, Bryant J, Carey ML, Paul CL, Sanson-Fisher RW, Levi CR, 'Agreement with evidence for tissue Plasminogen Activator use among emergency physicians: A cross-sectional survey', BMC Research Notes, 8 (2015) [C1]
© 2015 Grady et al. Background: Emergency department staff play a crucial role in the triage of stroke patients and therefore the capacity to deliver time-dependent treatments suc... [more]
© 2015 Grady et al. Background: Emergency department staff play a crucial role in the triage of stroke patients and therefore the capacity to deliver time-dependent treatments such as tissue Plasminogen Activator. This study aimed to identify among emergency physicians, (1) rates of agreement with evidence supporting tissue Plasminogen Activator use in acute stroke care; and (2) individual and hospital factors associated with high agreement with evidence supporting tissue Plasminogen Activator use. Methods: Australian fellows and trainees of the Australasian College for Emergency Medicine were invited to complete an online cross-sectional survey assessing perceptions of tissue Plasminogen Activator use in acute stroke. Demographic and hospital characteristics were also collected. Results: 429 Australasian College for Emergency Medicine members responded (13% response rate). Almost half (47.2%) did not agree with any statements regarding the benefits of tissue Plasminogen Activator use for acute stroke. Perceived routine administration of tissue Plasminogen Activator by the head of respondents' emergency department was significantly associated with high agreement with the evidence supporting tissue Plasminogen Activator use in acute stroke. Conclusions: Agreement with evidence supporting tissue Plasminogen Activator use in acute stroke is not high among responding Australian emergency physicians. In order for tissue Plasminogen Activator treatment to become widely accepted and adopted in emergency settings, beliefs and attitudes towards treatment need to be in accordance with clinical practice guidelines.
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Nova |
2015 |
Fradgley EA, Paul CL, Bryant J, 'A systematic review of barriers to optimal outpatient specialist services for individuals with prevalent chronic diseases: What are the unique and common barriers experienced by patients in high income countries?', International Journal for Equity in Health, 14 (2015) [C1]
Health utilization and need assessment data suggest there is considerable variation in access to outpatient specialist care. However, it is unclear if the types of barriers experi... [more]
Health utilization and need assessment data suggest there is considerable variation in access to outpatient specialist care. However, it is unclear if the types of barriers experienced are specific to chronic disease groups or experienced universally. This systematic review provides a detailed summary of common and unique barriers experienced by chronic disease groups when accessing and receiving care, and a synthesized list of possible health service initiatives to improve equitable delivery of optimal care in high-income countries. Quantitative articles describing barriers to specialist outpatient services were retrieved from CINAHL, MEDLINE, Embase, and PyscINFO. To be eligible for review, studies: were published from 2002 to May 2014; included samples with cancer, diabetes mellitus, osteoporosis, arthritis, ischaemic heart disease, stroke, asthma, chronic pulmonary disorder (COPD) or depression; and, were conducted in high-income countries. Using a previously validated model of access (Penchansky and Thomas' model of fit), barriers were grouped according to five overarching domains and defined in more detail using 33 medical subject headings. Results from reviewed articles, including the scope and frequency of reported barriers, are conceptualized using thematic analysis and framed as possible health service initiatives. A total of 3181 unique records were screened for eligibility, of which 74 studies were included in final analysis. The largest proportion of studies reported acceptability barriers (75.7 %), of which demographic disparities (44.6 %) were reported across all diseases. Other frequently reported barriers included inadequate need assessment (25.7 %), information provision (32.4 %), or health communication (20 %). Unique barriers were identified for oncology, mental health, and COPD samples. Based on the scope, frequency and measurement of reported barriers, eight key themes with associated implications for health services are presented. Examples include: common accommodation and accessibility barriers caused on service organization or physical structure, such as parking and appointment scheduling; common barriers created by poor coordination of care within the healthcare team; and unique barriers resulting from inadequate need assessment and referral practices. Consideration of barriers, across and within chronic diseases, suggests a number of specific initiatives are likely to improve the delivery of patient-centered care and increase equity in access to high-quality health services.
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Nova |
2015 |
Paul CL, Carey ML, Russell G, D'Este C, Sanson-Fisher RW, Zwar N, 'Prevalence of FOB testing in eastern-Australian general practice patients: What has a national bowel cancer screening program delivered?', Health Promotion Journal of Australia, 26 39-44 (2015) [C1]
Issues addressed The National Bowel Cancer Screening Program (NBCSP) was introduced in Australia in 2006, offering free immunochemical Faecal Occult Blood Test (FOBT) to persons a... [more]
Issues addressed The National Bowel Cancer Screening Program (NBCSP) was introduced in Australia in 2006, offering free immunochemical Faecal Occult Blood Test (FOBT) to persons aged 50, 55 or 65. The study aimed to examine the prevalence of self-reported screening for colorectal cancer (CRC) using the FOBT and factors associated with not having an FOBT. Methods A cross-sectional study of Australian general practice patients aged 50 and over with no personal history of CRC completed a health risk survey while waiting for scheduled appointments between November 2010 and November 2011. Results A total of 5671 patients from 12 practices were approached to participate. Of the 4707 eligible patients (adults attending for care who understood English and were capable of providing informed consent), 4062 (86%) consented to participate, with 2269 eligible to complete the FOBT items. Approximately half (52%) of participants reported ever having an FOBT. More than one-third (39.7%) of the sample reported having an FOBT in the prior three years. Those who recalled receiving a mailed kit as part of the NBCSP were five times more likely to report being screened. Those less likely to report screening were aged 50-59 years, were female and had been diagnosed with a form of cancer other than CRC. Conclusions There is justification for the extension of the NBCSP to ensure a majority of the age-appropriate population is screened for CRC. So what? Further work is needed to identify whether high rates of screening are achievable using the mailed-kit approach, and how to increase participation by females, those aged 50-69 years and those diagnosed with other cancers.
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Nova |
2015 |
Bonevski B, Twyman L, Paul C, D'Este C, West R, Siahpush M, et al., 'Comparing socially disadvantaged smokers who agree and decline to participate in a randomised smoking cessation trial', BMJ OPEN, 5 (2015) [C1]
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Nova |
2015 |
Tzelepis F, Sanson-Fisher RW, Hall AE, Carey ML, Paul CL, Clinton-Mcharg T, 'Development and psychometric evaluation of the Quality of Patient-Centered Cancer Care measure with hematological cancer survivors', Cancer, 121 2383-2392 (2015) [C1]
BACKGROUND The Institute of Medicine (IOM) recommended 6 objectives for achieving patient-centered care. However, most patient-reported outcome measures developed with cancer popu... [more]
BACKGROUND The Institute of Medicine (IOM) recommended 6 objectives for achieving patient-centered care. However, most patient-reported outcome measures developed with cancer populations fail to address all 6 patient-centeredness dimensions. The Quality of Patient-Centered Cancer Care (QPCCC) measure was developed on the basis of IOM recommendations, and the measure's validity, reliability, and floor and ceiling effects were examined. METHODS The development of the QPCCC measure included interviews with hematological cancer survivors and feedback from hematologists and cancer patients. To evaluate the measure's psychometric properties, hematological cancer survivors were identified via 2 cancer registries and were mailed the QPCCC measure. To examine test-retest reliability, a second QPCCC measure was mailed to survivors 7 to 14 days after they had returned the first measure. RESULTS Overall, 545 hematological cancer survivors completed the 48-item QPCCC measure. Exploratory factor analysis revealed a 10-factor structure with factor loadings>0.40. The subscales were labeled Treatment Delivery, Treatment Decision Making, Coordinated and Integrated Care, Emotional Support, Timely Care, Follow-Up Care, Respectful Communication, Patient Preferences and Values, Cancer Information, and Equitable Care. The QPCCC measure demonstrated acceptable internal consistency for all subscales (Cronbach's a=.73-.94). When test-retest reliability was assessed, 4 items demonstrated substantial agreement (¿>0.60), whereas 40 items showed moderate agreement (¿=0.41-0.60). Ceiling effects were present for 8 subscales. CONCLUSIONS The QPCCC measure has acceptable face and content validity, construct validity, and internal consistency. However, the measure's discriminant validity and test-retest reliability could be improved. The QPCCC measure could be used to improve patient-centered cancer care. Cancer 2015;121:2383-2392.
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Nova |
2015 |
Bryant J, Sanson-Fisher R, Stevenson W, Smits R, Henskens F, Wei A, et al., 'Protocol of a multi-centre randomised controlled trial of a web-based information intervention with nurse-delivered telephone support for haematological cancer patients and their support persons', BMC Cancer, 15 (2015) [C3]
Background: High rates of anxiety, depression and unmet needs are evident amongst haematological cancer patients undergoing treatment and their Support Persons. Psychosocial distr... [more]
Background: High rates of anxiety, depression and unmet needs are evident amongst haematological cancer patients undergoing treatment and their Support Persons. Psychosocial distress may be minimised by ensuring that patients are sufficiently involved in decision making, provided with tailored information and adequate preparation for potentially threatening procedures. To date, there are no published studies evaluating interventions designed to reduce psychosocial distress and unmet needs specifically in patients with haematological cancers and their Support Persons. This study will examine whether access to a web-based information tool and nurse-delivered telephone support reduces depression, anxiety and unmet information needs for haematological cancer patients and their Support Persons. Methods/Design: A non-blinded, parallel-group, multi-centre randomised controlled trial will be conducted to compare the effectiveness of a web-based information tool and nurse-delivered telephone support with usual care. Participants will be recruited from the haematology inpatient wards of five hospitals in New South Wales, Australia. Patients diagnosed with acute myeloid leukaemia, acute lymphoblastic leukaemia, Burkitt's lymphoma, Lymphoblastic lymphoma (B or T cell), or Diffuse Large B-Cell lymphoma and their Support Persons will be eligible to participate. Patients and their Support Persons will be randomised as dyads. Participants allocated to the intervention will receive access to a tailored web-based tool that provides accurate, up-to-date and personalised information about: cancer and its causes; treatment options including treatment procedures information; complementary and alternative medicine; and available support. Patients and Support Persons will complete self-report measures of anxiety, depression and unmet needs at 2, 4, 8 and 12 weeks post-recruitment. Patient and Support Person outcomes will be assessed independently. Discussion: This study will assess whether providing information and support using web-based and telephone support address the major psychosocial challenges faced by haematological patients and their Support Persons. The approach, if found to be effective, has potential to improve psychosocial outcomes for haematological and other cancer patients, reduce the complexity and burden of meeting patients' psychosocial needs for health care providers with high potential for translation into clinical practice.
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Nova |
2015 |
Noble N, Paul C, Turon H, Oldmeadow C, 'Which modifiable health risk behaviours are related? A systematic review of the clustering of Smoking, Nutrition, Alcohol and Physical activity ('SNAP') health risk factors', Preventive Medicine, 81 16-41 (2015) [C1]
Objective: There is a growing body of literature examining the clustering of health risk behaviours, but little consensus about which risk factors can be expected to cluster for w... [more]
Objective: There is a growing body of literature examining the clustering of health risk behaviours, but little consensus about which risk factors can be expected to cluster for which sub groups of people. This systematic review aimed to examine the international literature on the clustering of smoking, poor nutrition, excess alcohol and physical inactivity (SNAP) health behaviours among adults, including associated socio-demographic variables. Method: A literature search was conducted in May 2014. Studies examining at least two SNAP risk factors, and using a cluster or factor analysis technique, or comparing observed to expected prevalence of risk factor combinations, were included. Results: Fifty-six relevant studies were identified. A majority of studies (81%) reported a 'healthy' cluster characterised by the absence of any SNAP risk factors. More than half of the studies reported a clustering of alcohol with smoking, and half reported clustering of all four SNAP risk factors. The methodological quality of included studies was generally weak to moderate. Males and those with greater social disadvantage showed riskier patterns of behaviours; younger age was less clearly associated with riskier behaviours. Conclusion: Clustering patterns reported here reinforce the need for health promotion interventions to target multiple behaviours, and for such efforts to be specifically designed and accessible for males and those who are socially disadvantaged.
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Nova |
2015 |
Noble NE, Paul CL, Turner N, Blunden SV, Oldmeadow C, Turon HE, 'A cross-sectional survey and latent class analysis of the prevalence and clustering of health risk factors among people attending an Aboriginal Community Controlled Health Service', BMC Public Health, 15 (2015) [C1]
Background: Indigenous Australians are a socially disadvantaged group who experience significantly poorer health and a higher prevalence of modifiable health behaviours than other... [more]
Background: Indigenous Australians are a socially disadvantaged group who experience significantly poorer health and a higher prevalence of modifiable health behaviours than other Australians. Little is known about the clustering of health risks among Indigenous Australians. The aims of this study were to describe the clustering of key health risk factors, such as smoking, physical inactivity and alcohol consumption, and socio-demographics associated with clusters, among a predominantly Aboriginal sample. Methods: Participants (n = 377) attending an Aboriginal Community Controlled Health Service (ACCHS) in regional/rural New South Wales, Australia, in 2012-2013 completed a self-report touch screen health risk survey. Clusters were identified using latent class analysis. Results: Cluster 1 ('low fruit/vegetable intake, lower risk'; 51 %) consisted of older men and women; Cluster 2 ('risk taking'; 22 %) included younger unemployed males with a high prevalence of smoking, risky alcohol, and illicit drug use. Cluster 3 ('inactive, overweight, depressed'; 28 %) was characterised by younger to mid aged women likely to have experienced emotional or physical violence. Conclusions: If future research identifies similar stable clusters of health behaviours for this population, intervention approaches targeting these clusters of risk factors should be developed and tested for Aboriginal and Torres Strait Islander Australians.
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Nova |
2015 |
Tzelepis F, Sanson-Fisher RW, Hall AE, Carey ML, Paul CL, Clinton-Mcharg T, 'The quality of patient-centred care: Haematological cancer survivors' perceptions', Psycho-Oncology, 24 796-803 (2015) [C1]
Objective Patient-reported outcome measures (PROMs) that assess the quality of patient-centred cancer care have failed to measure all six patient-centredness dimensions endorsed b... [more]
Objective Patient-reported outcome measures (PROMs) that assess the quality of patient-centred cancer care have failed to measure all six patient-centredness dimensions endorsed by the Institute of Medicine (IOM). This study is the first to use the Quality of Patient-Centered Cancer Care (QPCCC) measure that covers all six IOM patient-centredness dimensions to examine haematological cancer survivors' perceptions of care and characteristics associated with perceived quality of care. Methods Haematological cancer survivors diagnosed in the last 6 years and aged 18-80 years were recruited from two Australian state population-based cancer registries. Survivors were mailed the 48-item QPCCC measure. Results Overall, 545 haematological cancer survivors completed the measure. Areas of care most commonly identified as delivered were hospital staff showing respect to survivors (93%) and making sure the correct treatment was received (93%). Aspects of care most frequently nominated as not delivered were hospital staff helping family and friends (34%) or the survivor (32%) to find other people with similar experiences to talk to. Characteristics associated with survivors perceiving higher quality care was delivered included being employed, having private health insurance, being younger, a Non-Hodgkin lymphoma diagnosis and more recent diagnosis. Being depressed or stressed was associated with perceived lower quality of care. Conclusions Provision of peer support programs that allow haematological cancer survivors and families and friends to talk to others in similar situations could be improved. Using PROMs to identify areas where cancer survivors perceive improvements are needed is essential to quality improvement efforts.
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Nova |
2015 |
Noble N, Paul C, Conigrave K, Lee K, Blunden S, Turon H, et al., 'Does a retrospective seven-day alcohol diary reflect usual alcohol intake for a predominantly disadvantaged Australian aboriginal population', Substance Use and Misuse, 50 308-319 (2015) [C1]
Background: Alcohol disproportionately affects socially disadvantaged groups including Aboriginal and Torres Strait Islander Australians. Methods to assess alcohol intake for disa... [more]
Background: Alcohol disproportionately affects socially disadvantaged groups including Aboriginal and Torres Strait Islander Australians. Methods to assess alcohol intake for disadvantaged communities need to be able to capture variable or episodic drinking. The ability of a seven-day diary to capture typical consumption for a predominantly Aboriginal sample has not been assessed. Objective: One aim of this paper was to examine agreement between a seven-day retrospective diary and 'usual' drinking assessed by a modified version of the Alcohol Use Disorders Identification Test question 3 (AUDIT-3m; two questions). Other aims were to describe drinking patterns as reported in the seven-day diary. Method: In 2012, consecutive adults attending an Aboriginal Community Controlled Health Service completed a cross-sectional health risk survey on a touch screen laptop (n = 188). Alcohol consumption questions included the retrospective diary and AUDIT-3m. Agreement was assessed using weighted kappa analysis. Results: There was good agreement between the two measures of consumption; however, the AUDIT-3m questions identified more current drinkers. Respondents who were drinkers (54%) tended to consume large amounts per drinking occasion: almost half (46%) of diary completers reported nine or more standard drinks on at least one occasion in the last week. Conclusions: The seven-day diary did not adequately capture variability in alcohol consumption common among this sample. Although the AUDIT-3m appeared acceptable, alternative approaches to assess usual or risky alcohol consumption, such as asking about specific drinking occasions, or allowing participants to respond in non-standard drink sizes, also need to be considered for indigenous and other disadvantaged communities.
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Nova |
2015 |
Tzelepis F, Paul CL, Wiggers J, Kypri K, Bonevski B, McElduff P, et al., 'Targeting multiple health risk behaviours among vocational education students using electronic feedback and online and telephone support: Protocol for a cluster randomised trial Health behavior, health promotion and society', BMC Public Health, 15 (2015) [C3]
Background: Technical and Further Education (TAFE) colleges are the primary provider of vocational education in Australia. Most TAFE students are young adults, a period when healt... [more]
Background: Technical and Further Education (TAFE) colleges are the primary provider of vocational education in Australia. Most TAFE students are young adults, a period when health risk behaviours become established. Furthermore, high rates of smoking, risky alcohol consumption, inadequate fruit and vegetable intake and insufficient physical activity have been reported in TAFE students. There have been no intervention studies targeting multiple health risk behaviours simultaneously in this population. The proposed trial will examine the effectiveness of providing TAFE students with electronic feedback regarding health risk behaviours and referral to a suite of existing online and telephone services addressing smoking, risky alcohol consumption, fruit and vegetable intake, and physical activity levels. Methods/Design: A two arm, parallel, cluster randomised trial will be conducted within TAFE campuses in New South Wales (NSW), Australia. TAFE classes will be randomly allocated to an intervention or control condition (50 classes per condition). To be eligible, students must be: enrolled in a course that runs for more than 6 months; aged 16 years or older; and not meet Australian health guideline recommendations for at least one of the following: smoking, alcohol consumption, fruit and/or vegetable intake, or physical activity. Students attending intervention classes, will undertake via a computer tablet a risk assessment for health risk behaviours, and for behaviours not meeting Australian guidelines be provided with electronic feedback about these behaviours and referral to evidence-based online programs and telephone services. Students in control classes will not receive any intervention. Primary outcome measures that will be assessed via online surveys at baseline and 6 months post-recruitment are: 1) daily tobacco smoking; 2) standard drinks of alcohol consumed per week; 3) serves of fruit consumed daily; 4) serves of vegetables consumed daily; and 5) metabolic equivalent minutes of physical activity per week. Discussion: Proactive enrolment to existing online and telephone services has the potential to address modifiable determinants of disease. This trial will be the first to examine a potentially scalable intervention targeting multiple health risk behaviours among students in the vocational training setting.
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Nova |
2015 |
Tzelepis F, Paul CL, Knight J, Duncan SL, McElduff P, Wiggers J, 'Improving the continuity of smoking cessation care delivered by quitline services', Patient Education and Counseling, 98 1643-1648 (2015) [C1]
Objectives: This study identified smokers' intended use of new quitline features aimed at improving smoking cessation such as having the same quitline advisor for each call, ... [more]
Objectives: This study identified smokers' intended use of new quitline features aimed at improving smoking cessation such as having the same quitline advisor for each call, longer-term telephone counselling and provision of additional cessation treatments. Methods: Smokers who had previously used quitline counselling completed a computer-assisted telephone interview examining intended use of potential quitline enhancements. Results: The majority of smokers (61.1%) thought their chances of quitting would have increased a lot/moderately if they had the same quitline advisor for each call. Most smokers reported likely use of longer-term quitline telephone support after a failed (58.3%) or successful (60%) quit attempt. Smokers were likely to use quitline support long-term (mean = 9.9 months). Most smokers would be likely to use free or subsidised nicotine replacement therapy (NRT) (74.9%) if offered by quitlines. Younger smokers had greater odds of being likely to use text messages, whereas less educated smokers had greater odds of being likely to use free or subsidised NRT. Conclusions: Smokers appear interested in quitlines offering longer-term telephone support, increased continuity of care and additional effective quitting strategies. Practice implications: Quitlines could adopt a stepped care model that involves increasingly intensive treatments and extended telephone counselling delivered by the same quitline advisor.
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Nova |
2015 |
Guillaumier A, Bonevski B, Paul C, ''Cigarettes are priority': A qualitative study of how Australian socioeconomically disadvantaged smokers respond to rising cigarette prices', Health Education Research, 30 599-608 (2015) [C1]
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Nova |
2015 |
Noble N, Paul C, Carey M, Blunden S, Turner N, 'A randomised trial assessing the acceptability and effectiveness of providing generic versus tailored feedback about health risks for a high need primary care sample', BMC Family Practice, 16 (2015) [C1]
Background: Tailored feedback has been shown to be effective for modifying health risk behaviours and may aid the provision of preventive care by general practitioners (GPs). Howe... [more]
Background: Tailored feedback has been shown to be effective for modifying health risk behaviours and may aid the provision of preventive care by general practitioners (GPs). However, provision of tailored patient feedback for vulnerable or socially disadvantaged groups is not well explored. The aims of this study were to examine the acceptability and effectiveness of providing generic compared to tailored feedback on self-reported health risk behaviours among a high need sample of people attending an Aboriginal Community Controlled Health Service (ACCHS). Methods: Participants attending two ACCHSs in regional New South Wales completed a touch screen health risk survey and received either generic or tailored health risk feedback. Participants were asked to complete an exit survey after their appointment. The exit survey asked about feedback acceptability and effectiveness. Self-reported ease of understanding, relevance and whether the generic versus tailored feedback helped patients talk to their GP was compared using Chi-square analysis; The mean number of survey health risks talked about or for which additional actions were undertaken (such as provision of lifestyle advice or referral) was compared using t-tests. Results: Eighty seven participants (36 % consent rate) completed the exit survey. Tailored feedback was rated as more relevant and was more likely to be shown to the participant's GP than generic feedback. There was no difference in the mean number of health risk topics discussed or number of additional actions taken by the GP by type of feedback. Conclusions: Tailored and generic feedback showed no difference in effectiveness, and little difference in acceptability, among this socially disadvantaged population. Completing a health risk survey and receiving any type of feedback may have overwhelmed more subtle differences in outcomes between the generic and the tailored feedback. Future work to rigorously evaluate the longer-term effectiveness of the provision of tailored health risk feedback for Aboriginal Australians, as well as other high need groups, is still needed. Trial Registration: Australian New Zealand Clinical Trials Registry ANZCTRN12614001205628. Registered 11 November 2014.
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Smits R, Bryant J, Sanson-Fisher R, Tzelepis F, Henskens F, Paul C, Stevenson W, 'Tailored and integrated Web-based tools for improving psychosocial outcomes of cancer patients: the DoTTI development framework.', J Med Internet Res, 16 e76 (2014) [C1]
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2014 |
Paul C, Yoong SL, Sanson-Fisher R, Carey M, Russell G, Makeham M, 'Under the radar: A cross-sectional study of the challenge of identifying at-risk alcohol consumption in the general practice setting', BMC Family Practice, 15 (2014) [C1]
Background: Primary care providers are an important source of information regarding appropriate alcohol consumption. As early presentation to a provider for alcohol-related concer... [more]
Background: Primary care providers are an important source of information regarding appropriate alcohol consumption. As early presentation to a provider for alcohol-related concerns is unlikely, it is important that providers are able to identify at-risk patients in order to provide appropriate advice. This study aimed to report the sensitivity, specificity, positive predictive value and negative predictive value of General Practitioner (GP) assessment of alcohol consumption compared to patient self-report, and explore characteristics associated with GP non-detection of at-risk status. Method. GP practices were selected from metropolitan and regional locations in Australia. Eligible patients were adults presenting for general practice care who were able to understand English and provide informed consent. Patients completed a modified AUDIT-C by touchscreen computer as part of an omnibus health survey while waiting for their appointment. GPs completed a checklist for each patient, including whether the patient met current Australian guidelines for at-risk alcohol consumption. Patient self-report and GP assessments were compared for each patient. Results: GPs completed the checklist for 1720 patients, yielding 1565 comparisons regarding alcohol consumption. The sensitivity of GPs' detection of at-risk alcohol consumption was 26.5%, with specificity of 96.1%. Higher patient education was associated with GP non-detection of at-risk status. Conclusions: GP awareness of which patients might benefit from advice regarding at-risk alcohol consumption appears low. Given the complexities associated with establishing whether alcohol consumption is 'at-risk', computer-based approaches to routine screening of patients are worthy of exploration as a method for prompting the provision of advice in primary care. © 2014 Paul et al.; licensee BioMed Central Ltd.
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2014 |
Paul CL, Levi CR, D'Este CA, Parsons MW, Bladin CF, Lindley RI, et al., 'Thrombolysis ImPlementation in Stroke (TIPS): Evaluating the effectiveness of a strategy to increase the adoption of best evidence practice - protocol for a cluster randomised controlled trial in acute stroke care', Implementation Science, 9 (2014) [C3]
Background: Stroke is a leading cause of death and disability internationally. One of the three effective interventions in the acute phase of stroke care is thrombolytic therapy w... [more]
Background: Stroke is a leading cause of death and disability internationally. One of the three effective interventions in the acute phase of stroke care is thrombolytic therapy with tissue plasminogen activator (tPA), if given within 4.5 hours of onset to appropriate cases of ischaemic stroke.Objectives: To test the effectiveness of a multi-component multidisciplinary collaborative approach compared to usual care as a strategy for increasing thrombolysis rates for all stroke patients at intervention hospitals, while maintaining accepted benchmarks for low rates of intracranial haemorrhage and high rates of functional outcomes for both groups at three months.Methods and design: A cluster randomised controlled trial of 20 hospitals across 3 Australian states with 2 groups: multi- component multidisciplinary collaborative intervention as the experimental group and usual care as the control group. The intervention is based on behavioural theory and analysis of the steps, roles and barriers relating to rapid assessment for thrombolysis eligibility; it involves a comprehensive range of strategies addressing individual-level and system-level change at each site. The primary outcome is the difference in tPA rates between the two groups post-intervention. The secondary outcome is the proportion of tPA treated patients in both groups with good functional outcomes (modified Rankin Score (mRS <2) and the proportion with intracranial haemorrhage (mRS =2), compared to international benchmarks.Discussion: TIPS will trial a comprehensive, multi-component and multidisciplinary collaborative approach to improving thrombolysis rates at multiple sites. The trial has the potential to identify methods for optimal care which can be implemented for stroke patients during the acute phase. Study findings will include barriers and solutions to effective thrombolysis implementation and trial outcomes will be published whether significant or not.Trial registration: Australian New Zealand Clinical Trials Registry: ACTRN12613000939796. © 2014 Paul et al.; licensee BioMed Central Ltd.
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Grady A, Bryant J, Carey M, Paul C, Sanson-Fisher R, 'Enablers of the implementation of tissue plasminogen activator in acute stroke care: A cross-sectional survey', PLoS ONE, 9 (2014) [C1]
Objective: To assess emergency physicians' perceptions of individual and system enablers to the use of tissue Plasminogen Activator in acute stroke.... [more]
Objective: To assess emergency physicians' perceptions of individual and system enablers to the use of tissue Plasminogen Activator in acute stroke.
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2014 |
Thepwongsa I, Kirby C, Paul C, Piterman L, 'Management of type 2 diabetes: Australian rural and remote general practitioners' knowledge, attitudes, and practices.', Rural Remote Health, 14 2499 (2014) [C1]
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2014 |
Clinton-McHarg T, Paul C, Boyes A, Rose S, Vallentine P, O'Brien L, 'Do cancer helplines deliver benefits to people affected by cancer? A systematic review', Patient Education and Counseling, 97 302-309 (2014) [C1]
Objectives: To determine the: (1) proportion of studies that describe characteristics of helpline service delivery, compared to the proportion that report trials testing efficacy ... [more]
Objectives: To determine the: (1) proportion of studies that describe characteristics of helpline service delivery, compared to the proportion that report trials testing efficacy or effectiveness of helplines in changing user outcomes; (2) proportion of efficacy or effectiveness studies that meet EPOC criteria for methodological rigor; and (3) potential benefits of cancer helplines for people affected by cancer based on findings from rigorous efficacy or effectiveness trials. Methods: Electronic databases (Medline, PsycINFO, EMBASE and CINAHL) were searched to identify English-language studies describing original research published from 1991 to 2011. Results: Twenty-eight publications met the review inclusion criteria. From these studies, data on: the characteristics of cancer helpline users; call content; and user satisfaction, were extracted. The potential for helplines to improve the psychosocial outcomes of callers was examined for the three intervention trials. Conclusion: There is a lack of robust evidence regarding the level and types of benefits that cancer helplines may deliver to callers affected by cancer. Given increased emphasis on delivering best-practise supportive care, building the evidence base in this field may assist cancer helplines to increase their service uptake, reach, and benefit to callers. Practise implications: There is a need for more rigorous intervention-focussed studies in this field across a broader range of cancer populations. Future studies should focus on relevant patient-centred outcomes, such as improved knowledge and greater involvement in decision-making, while incorporating process measures to account for intervention fidelity and clinical performance.
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2014 |
Bonevski B, Paul C, Jones A, Bisquera A, Regan T, 'Smoky homes: Gender, socioeconomic and housing disparities in second hand tobacco smoke (SHS) exposure in a large population-based Australian cohort', Preventive Medicine, 60 95-101 (2014) [C1]
Objective: Although research suggests that socioeconomic status (SES) will be related to housing type with regard to second-hand smoke (SHS) exposure, there has been no comprehens... [more]
Objective: Although research suggests that socioeconomic status (SES) will be related to housing type with regard to second-hand smoke (SHS) exposure, there has been no comprehensive examination of these relationships. This study aimed to explore associations between SHS exposure a) at home and b) at other places, and a number of SES, housing, and health factors. Method: Data were drawn from the 45 and Up Study, a large cohort study with 266,848 adults in New South Wales, Australia, of which 160,824 participants aged 45-65. years were included in this study. Associations between socio-demographic characteristics, smoking status, housing-type, SES, and exposure to SHS were explored initially using Chi-square tests. Ordinal logistic models were created with increasing exposure to SHS at home and at other places. Results: When measuring SHS exposure at home, being female (odds ratio (OR) = 1.2, 95% confidence interval (CI) = 1.2, 1.3); being of lower age (45-49. years vs 60-64. years, OR = 1.4, 95%CI = 1.3, 1.5), being a current smoker of over 20 cigarettes per day (vs never smoked, OR = 10.2, 95%CI = 9.4,11); living in other types of dwelling compared to living at home (OR = 1.3, 95%CI = 1.1, 1.4), living with a partner (vs being single OR = 2.3, 95%CI = 2.1, 2.5), and low SES measures were associated with increased exposure. Increasing SHS exposure at other places was also related to low SES measures, however unlike SHS exposure at home, SHS exposure at other places was associated with being male (OR = 1.5, 95%CI = 1.5, 1.6); and greater paid hours of work (OR = 1.3, 95%CI = 1.2, 1.3). Conclusion: Improved monitoring of SHS exposure in high risk environments is required. Tailoring SHS messages to environments may also be required, for example to women living in units, apartments and mobile homes and males in lower income workplaces. © 2014 Elsevier Inc.
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2014 |
Sanson-Fisher RW, D'Este CA, Carey ML, Noble N, Paul CL, 'Evaluation of Systems-Oriented Public Health Interventions: Alternative Research Designs', ANNUAL REVIEW OF PUBLIC HEALTH, VOL 35, 35 9-27 (2014) [C1]
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2014 |
Paul CL, Bryant J, Turon H, Brozek I, Noble N, Zucca A, 'A narrative review of the potential for self- tanning products to substitute for solaria use among people seeking a tanned appearance', PHOTODERMATOLOGY PHOTOIMMUNOLOGY & PHOTOMEDICINE, 30 160-166 (2014) [C1]
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2014 |
Guillaumier A, Bonevski B, Doran C, Paul C, D'Este C, Siahpush M, 'Paying the price: A cross-sectional survey of Australian socioeconomically disadvantaged smokers' responses to hypothetical cigarette price rises', Drug and Alcohol Review, 33 177-185 (2014) [C1]
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2014 |
Bonevski B, Regan T, Paul C, Baker AL, Bisquera A, 'Associations between alcohol, smoking, socioeconomic status and comorbidities: Evidence from the 45 and Up Study', Drug and Alcohol Review, 33 169-176 (2014) [C1]
Introduction and Aims.: Understanding how tobacco, alcohol and mental health are related is important for developing population-level policies and individual-level treatments that... [more]
Introduction and Aims.: Understanding how tobacco, alcohol and mental health are related is important for developing population-level policies and individual-level treatments that target comorbidities. The current study aimed to examine sociodemographic characteristics and mental health comorbidities associated with the odds of using tobacco and harmful levels of alcohol concurrently. Design and Methods.: Data were drawn from the 45 and Up Study, a large cohort study with 267153 adults aged 45 years and over in New South Wales, Australia. Participants completed a survey assessing alcohol, smoking, psychological distress, treatment for depression and anxiety, and a range of socioeconomic status indicators. Univariate analyses and three multiple-logistic regression models were used to determine associations with (i) tobacco but not alcohol use; (ii) alcohol but not tobacco use; and (iii) concurrent tobacco and risky levels of alcohol use. Results.: Being female, younger, lower individual and area-level socioeconomic status (SES) and depression and psychological distress were associated with tobacco use alone. Factors associated with alcohol use alone were older age, male gender, higher SES, and lower psychological distress and no recent depression treatment. Factors associated with concurrent risky alcohol consumption and tobacco use included being 45-64, being male, less education, earning <$30000, being employed, and living in lower-SES areas, treatment for depression, and high distress on the Kessler-10. Discussion and Conclusions.: Results suggest strong links between SES, treatment for depression, psychological distress, and concurrent tobacco and alcohol use. This has implications for public health policies and clinical treatment for tobacco and alcohol use, suggesting greater emphasis on addressing multiple health and social concerns. © 2013 Australasian Professional Society on Alcohol and other Drugs.
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2014 |
Fradgley EA, Paul CL, Bryant J, Roos IA, Henskens FA, Paul DJ, 'Consumer participation in quality improvements for chronic disease care: development and evaluation of an interactive patient-centered survey to identify preferred service initiatives.', Journal of medical Internet research, 16 e292 (2014) [C1]
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2014 |
Paul C, Courtney R, Sanson-Fisher R, Carey M, Hill D, Simmons J, Rose S, 'A randomized controlled trial of the effectiveness of a pre-recruitment primer letter to increase participation in a study of colorectal screening and surveillance', BMC MEDICAL RESEARCH METHODOLOGY, 14 (2014) [C1]
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2014 |
Noble NE, Paul CL, Carey ML, Sanson-Fisher RW, Blunden SV, Stewart JM, Conigrave KM, 'A cross-sectional survey assessing the acceptability and feasibility of self-report electronic data collection about health risks from patients attending an Aboriginal Community Controlled Health Service', BMC MEDICAL INFORMATICS AND DECISION MAKING, 14 (2014) [C1]
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2014 |
Carey M, Jones KA, Yoong SL, D'Este C, Boyes AW, Paul C, et al., 'Comparison of a single self-assessment item with the PHQ-9 for detecting depression in general practice', Family Practice, 31 (2014) [C1]
Background: Several factors need to be considered when selecting a screening tool for depression including accuracy, level of burden for patients and for staff to administer and f... [more]
Background: Several factors need to be considered when selecting a screening tool for depression including accuracy, level of burden for patients and for staff to administer and follow-up. Objective: This study aimed to explore the utility of a single self-assessment item in identifying possible cases of depression in primary care by examining sensitivity and specificity with the nine-item Patient Health Questionnaire (PHQ-9) at different thresholds. Design: Cross-sectional survey presented on a touchscreen computer. Participants. Adult patients attending 12 urban general practices in Australia completed a health status questionnaire (n = 1004). Main measures. Depression was assessed by the PHQ-9 and a single self-assessment item. Sensitivity, specificity, and positive and negative predictive values were calculated for the single item using a PHQ-9 score of 10 or more as the criterion value. Key results. A total of 1004 participants (61% female, 48% aged 55 years or older) completed both the PHQ-9 and a single self-assessment item. When using a threshold of mild depression or greater, the single item had adequate specificity (76%, 95% CI: 71-80%), with 76 out of every 100 people defined as non-depressed by the PHQ-9 also identified as not depressed by the single item. Sensitivity was high (91%, 95% CI: 84-95%), with the single item identifying 91 out of every 100 true cases (as defined by the PHQ-9). Conclusions: The single self-assessment item has high sensitivity and moderate specificity to identify possible cases of depression when used at a threshold of mild depression or greater. © The Author 2014.
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2014 |
Guillaumier A, Bonevski B, Paul C, Durkin S, D'Este C, 'Socioeconomically disadvantaged smokers' ratings of plain and branded cigarette packaging: an experimental study', BMJ OPEN, 4 (2014) [C1]
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2014 |
Mackenzie LJ, Carey ML, Sanson-Fisher RW, D'Este CA, Paul CL, Yoong SL, 'Agreement between HADS classifications and single-item screening questions for anxiety and depression: a cross-sectional survey of cancer patients.', Ann Oncol, 25 889-895 (2014) [C1]
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2014 |
Tzelepis F, Rose SK, Sanson-Fisher RW, Clinton-McHarg T, Carey ML, Paul CL, 'Are we missing the Institute of Medicine's mark? A systematic review of patient-reported outcome measures assessing quality of patient-centred cancer care', BMC Cancer, 14 (2014) [C1]
Background: The Institute of Medicine (IOM) has endorsed six dimensions of patient-centredness as crucial to providing quality healthcare. These dimensions outline that care must ... [more]
Background: The Institute of Medicine (IOM) has endorsed six dimensions of patient-centredness as crucial to providing quality healthcare. These dimensions outline that care must be: 1) respectful to patients' values, preferences, and expressed needs; 2) coordinated and integrated; 3) provide information, communication, and education; 4) ensure physical comfort; 5) provide emotional support-relieving fear and anxiety; and 6) involve family and friends. However, whether patient-reported outcome measures (PROMs) comprehensively cover these dimensions remains unexplored. This systematic review examined whether PROMs designed to assess the quality of patient-centred cancer care addressed all six IOM dimensions of patient-centred care and the psychometric properties of these measures.Methods: Medline, PsycINFO, Current Contents, Embase, CINAHL and Scopus were searched to retrieve published studies describing the development and psychometric properties of PROMs assessing the quality of patient-centred cancer care. Two authors determined if eligible PROMs included the six IOM dimensions of patient-centred care and evaluated the adequacy of psychometric properties based on recommended criteria for internal consistency, test-retest reliability, face/content validity, construct validity and cross-cultural adaptation.Results: Across all 21 PROMs, the most commonly included IOM dimension of patient-centred care was " information, communication and education" (19 measures). In contrast, only five measures assessed the " involvement of family and friends." Two measures included one IOM-endorsed patient-centred care dimension, two measures had two dimensions, seven measures had three dimensions, five measures had four dimensions, and four measures had five dimensions. One measure, the Indicators (Non-small Cell Lung Cancer), covered all six IOM dimensions of patient-centred care, but had adequate face/content validity only. Eighteen measures met the recommended adequacy criteria for construct validity, 15 for face/content validity, seven for internal consistency, three for cross-cultural adaptation and no measure for test-retest reliability.Conclusions: There are no psychometrically rigorous PROMs developed with cancer patients that capture all six IOM dimensions of patient-centred care. Using more than one measure or expanding existing measures to cover all six patient-centred care dimensions could improve assessment and delivery of patient-centred care. Construction of new comprehensive measures with acceptable psychometric properties that can be used with the general cancer population may also be warranted. © 2014 Tzelepis et al.; licensee BioMed Central Ltd.
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2014 |
Bonevski B, Randell M, Paul C, Chapman K, Twyman L, Bryant J, et al., 'Reaching the hard-to-reach: A systematic review of strategies for improving health and medical research with socially disadvantaged groups', BMC Medical Research Methodology, 14 (2014) [C1]
Background: This study aims to review the literature regarding the barriers to sampling, recruitment, participation, and retention of members of socioeconomically disadvantaged gr... [more]
Background: This study aims to review the literature regarding the barriers to sampling, recruitment, participation, and retention of members of socioeconomically disadvantaged groups in health research and strategies for increasing the amount of health research conducted with socially disadvantaged groups. Methods. A systematic review with narrative synthesis was conducted. Searches of electronic databases Medline, PsychInfo, EMBASE, Social Science Index via Web of Knowledge and CINHAL were conducted for English language articles published up to May 2013. Qualitative and quantitative studies as well as literature reviews were included. Articles were included if they reported attempts to increase disadvantaged group participation in research, or the barriers to research with disadvantaged groups. Groups of interest were those described as socially, culturally or financially disadvantaged compared to the majority of society. Eligible articles were categorised according to five phases of research: 1) sampling, 2) recruitment and gaining consent, 3) data collection and measurement, 4) intervention delivery and uptake, and 5) retention and attrition. Results: In total, 116 papers from 115 studies met inclusion criteria and 31 previous literature reviews were included. A comprehensive summation of the major barriers to working with various disadvantaged groups is provided, along with proposed strategies for addressing each of the identified types of barriers. Most studies of strategies to address the barriers were of a descriptive nature and only nine studies reported the results of randomised trials. Conclusions: To tackle the challenges of research with socially disadvantaged groups, and increase their representation in health and medical research, researchers and research institutions need to acknowledge extended timeframes, plan for higher resourcing costs and operate via community partnerships. © 2014 Bonevski et al.; licensee BioMed Central Ltd.
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2014 |
Twyman L, Bonevski B, Paul C, Bryant J, 'Perceived barriers to smoking cessation in selected vulnerable groups: A systematic review of the qualitative and quantitative literature', BMJ Open, 4 1-15 (2014) [C1]
Objectives: To identify barriers that are common and unique to six selected vulnerable groups: low socioeconomic status; Indigenous; mental illness and substance abuse; homeless; ... [more]
Objectives: To identify barriers that are common and unique to six selected vulnerable groups: low socioeconomic status; Indigenous; mental illness and substance abuse; homeless; prisoners; and at-risk youth. Design: A systematic review was carried out to identify the perceived barriers to smoking cessation within six vulnerable groups. Data sources: MEDLINE, EMBASE, CINAHL and PsycInfo were searched using keywords and MeSH terms from each database's inception published prior to March 2014. Study selection: Studies that provided either qualitative or quantitative (ie, longitudinal, crosssectional or cohort surveys) descriptions of selfreported perceived barriers to quitting smoking in one of the six aforementioned vulnerable groups were included. Data extraction: Two authors independently assessed studies for inclusion and extracted data. Results: 65 eligible papers were identified: 24 with low socioeconomic groups, 16 with Indigenous groups, 18 involving people with a mental illness, 3 with homeless groups, 2 involving prisoners and 1 involving at-risk youth. One study identified was carried out with participants who were homeless and addicted to alcohol and/or other drugs. Barriers common to all vulnerable groups included: smoking for stress management, lack of support from health and other service providers, and the high prevalence and acceptability of smoking in vulnerable communities. Unique barriers were identified for people with a mental illness (eg, maintenance of mental health), Indigenous groups (eg, cultural and historical norms), prisoners (eg, living conditions), people who are homeless (eg, competing priorities) and at-risk youth (eg, high accessibility of tobacco). Conclusions: Vulnerable groups experience common barriers to smoking cessation, in addition to barriers that are unique to specific vulnerable groups. Individual-level, community-level and social networklevel interventions are priority areas for future smoking cessation interventions within vulnerable groups
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Paul CL, Turon H, Bonevski B, Bryant J, McElduff P, 'A cross-sectional survey of experts' opinions about the relative effectiveness of tobacco control strategies for the general population versus disadvantaged groups: What do we choose in the absence of evidence?', BMC Public Health, 13 (2013) [C1]
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2013 |
Tzelepis F, Paul CL, Walsh RA, Knight J, Wiggers J, 'Who enrolled in a randomized controlled trial of quitline support? Comparison of participants versus nonparticipants.', Nicotine Tob Res, 15 2107-2113 (2013) [C1]
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2013 |
Paul CL, McLennan J, Baxendale A, Schnelle B, Rawson J, Turon HE, Tzelepis F, 'Implementation of a personalized workplace smoking cessation programme.', Occup Med (Lond), 63 568-574 (2013) [C1]
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2013 |
Rose S, Emmett B, Paul C, Hensley M, Henskens FA, Pretto J, 'Relationships between nutrition knowledge, obesity and severity of sleep-disordered breathing', Sleep and Biological Rhythm, 11 1-78 (2013)
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2013 |
Paul CL, Carey ML, Sanson-Fisher RW, Houlcroft LE, Turon HE, 'The impact of web-based approaches on psychosocial health in chronic physical and mental health conditions', Health Education Research, 28 450-471 (2013) [C1]
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2013 |
Paul CL, Hall AE, Carey ML, Cameron EC, Clinton-McHarg T, 'Access to Care and Impacts of Cancer on Daily Life: Do They Differ for Metropolitan Versus Regional Hematological Cancer Survivors?', Journal of Rural Health, 29 (2013) [C1]
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2013 |
Paul CL, Carey M, Yoong SL, D'Este C, Makeham M, Henskens F, 'Access to chronic disease care in general practice: The acceptability of implementing systematic waiting-room screening using computer-based patient-reported risk status', British Journal of General Practice, 63 (2013) [C1]
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2013 |
Tzelepis F, Paul CL, Walsh RA, Wiggers J, Duncan SL, Knight J, 'Predictors of abstinence among smokers recruited actively to quitline support', ADDICTION, 108 181-185 (2013) [C1]
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2013 |
Bonevski B, Guillaumier A, Paul C, Walsh R, 'The vocational education setting for health promotion: A survey of students' health risk behaviours and preferences for help', Health Promotion Journal of Australia, 24 185-191 (2013) [C1]
Background Adolescence and young adulthood is a time of risky health behaviour initiation and experimentation. Smoking, risky drinking, poor nutrition and physical activity, and a... [more]
Background Adolescence and young adulthood is a time of risky health behaviour initiation and experimentation. Smoking, risky drinking, poor nutrition and physical activity, and a lack of sun protection behaviour, often become established in early adulthood. Levels of health risk behaviours occurring amongst tertiary education and training students and their preferences for types of on-campus health promotion programs were examined. Method A cross-sectional pen-and-paper classroom survey was conducted at one Sydney-based TAFE New South Wales Institute campus in May 2010. The survey assessed demographics, smoking, alcohol use, sun protection, nutrition, physical activity and health promotion program preferences. Results: Two hundred and twenty-four students participated (97% consent); the majority were aged 16-24 years (59%) and female (51%). Current smoking (35%), risky drinking (49%) and inadequate physical activity (88%) rates were high. Adequate vegetable intake (3.6%) and sun protection behaviours (5.4%) were low and 33% of students were overweight or obese. Popular health promotion programs included food and activity subsidies, practical skills classes and social outings. Conclusion Participation in health risk behaviours among this sample was high. The setting of tertiary education and workplace training represents an opportunity for early intervention into risky health behaviours among young people. So what? This study is the first to provide information on the prevalence of health risk behaviours and preferences for types of health promoting programs among students of an Australian community college. The results show that young adults regularly participate in multiple health risk behaviours, such as smoking, drinking, poor nutrition, physical activity and lack of sun protection. © 2013 Australian Health Promotion Association.
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MacKenzie LJ, Carey ML, Paul CL, Sanson-Fisher RW, D'Este CA, 'Do we get it right? Radiation oncology outpatients' perceptions of the patient centredness of life expectancy disclosure', Psycho-Oncology, 22 2720-2728 (2013) [C1]
Objective A patient-centred approach to discussing life expectancy with cancer patients is recommended in Western countries. However, this approach to eliciting and meeting patien... [more]
Objective A patient-centred approach to discussing life expectancy with cancer patients is recommended in Western countries. However, this approach to eliciting and meeting patient preferences can be challenging for clinicians. The aims of this study were the following: (i) to examine cancer patients' preferences for life expectancy disclosure; and (ii) to explore agreement between cancer patients' preferences for, and perceived experiences of, life expectancy disclosure. Methods Cancer patients undergoing radiotherapy treatment in metropolitan Australia completed a cross-sectional touchscreen computer survey including optional questions about their life expectancy disclosure preferences and experiences. Results Of the 208 respondents, 178 (86%) indicated that they would prefer their clinician to ask them before discussing life expectancy, and 30 (14%) indicated that they would prefer others (i.e. clinicians, family) to decide whether they were given life expectancy information. Of the 175 respondents who were classified as having a self- determined or other-determined disclosure experience, 105 (60%) reported an experience of life expectancy disclosure that was in accordance with their preferences. Cohen's ¿ was -0.04 (95% CI, -0.17, 0.08), indicating very poor agreement between patients' preferences for and perceived experiences of life expectancy disclosure (p = 0.74). Conclusions In light of patient-centred prognosis disclosure guidelines, our findings of a majority preference for, and experience of, a self-determined approach to life expectancy disclosure amongst radiation oncology patients are encouraging. However, poor agreement between preferences and experiences highlights that additional effort from clinicians is required in order to achieve a truly patient-centred approach to life expectancy disclosure. Copyright © 2013 John Wiley & Sons, Ltd.
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Bryant J, Bonevski B, Paul CL, Lecathelinais CL, 'A cross-sectional survey of health risk behaviour clusters among a sample of socially disadvantaged Australian welfare recipients', Australian and New Zealand Journal of Public Health, 37 118-123 (2013) [C1]
Objective: To examine the prevalence and clustering of six health risk behaviours (smoking, alcohol, inadequate sun protection, physical inactivity, and inadequate fruit and veget... [more]
Objective: To examine the prevalence and clustering of six health risk behaviours (smoking, alcohol, inadequate sun protection, physical inactivity, and inadequate fruit and vegetable consumption) among severely disadvantaged individuals. Methods: A cross-sectional touch screen computer survey was conducted with 383 clients attending a social and community welfare organisation in New South Wales. Participants were assessed on smoking status, alcohol consumption, fruit and vegetable consumption, physical activity, sun protection and socio-demographic characteristics. Descriptive statistics, factor analysis and logistic regression were used to assess the prevalence, clustering and socio-demographic predictors of health risk behaviours. Results: Ninety-eight per cent of the participants reported inadequate vegetable consumption, 62.7% reported inadequate fruit consumption, 82.5% reported inadequate sun protection, 61.7% smoked tobacco, 51.4% consumed alcohol at risky levels and 36.5% were insufficiently active. Most participants (87%) reported three or more risk behaviours. Male participants, younger participants and those with lower education were more likely to smoke tobacco and consume alcohol. Conclusions: The prevalence of health risk behaviours among a sample of typically hard-to-reach, severely disadvantaged individuals is extremely high. Implications: Future intervention development should take into account the likelihood of health risk clustering among severely disadvantaged groups. © 2013 The Authors.
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Paul C, Sanson-Fisher R, Carey M, 'Measuring psychosocial outcomes: is the consumer or the professional the best judge?', European Journal of Cancer Care, 22 281-288 (2013) [C1]
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2013 |
Rose S, Emmett B, Pretto J, Hensley M, Henskens FA, Tindall K, Paul C, 'Accuracy of questionnaire-based measures for predicting sleep disoriented breathing', Sleep and Biological Rhythms, 11 1-78 (2013)
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Bryant J, McDonald VM, Boyes A, Sanson-Fisher R, Paul C, Melville J, 'Improving medication adherence in chronic obstructive pulmonary disease: A systematic review', Respiratory Research, 14 (2013) [C1]
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2013 |
Courtney RJ, Paul CL, Carey ML, Sanson-Fisher RW, Macrae FA, D'Este C, et al., 'A population-based cross-sectional study of colorectal cancer screening practices of first-degree relatives of colorectal cancer patients', BMC CANCER, 13 (2013) [C1]
|
|
Nova |
2013 |
Courtney RJ, Paul CL, Sanson-Fisher RW, Macrae FA, Carey ML, Attia J, McEvoy M, 'Individual- and provider-level factors associated with colorectal cancer screening in accordance with guideline recommendation: a community-level perspective across varying levels of risk', BMC PUBLIC HEALTH, 13 (2013) [C1]
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|
Nova |
2013 |
Paul CL, Piterman L, Shaw J, Kirby C, Sanson-Fisher RW, Carey ML, et al., 'Diabetes in rural towns: effectiveness of continuing education and feedback for healthcare providers in altering diabetes outcomes at a population level: protocol for a cluster randomised controlled trial', IMPLEMENTATION SCIENCE, 8 (2013) [C3]
|
|
Nova |
2012 |
Courtney RJ, Paul CL, Sanson-Fisher RW, Macrae FA, Carey ML, Attia JR, McEvoy MA, 'Colorectal cancer screening in Australia: A community-level perspective', Medical Journal of Australia, 196 516-520 (2012) [C1]
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|
Nova |
2012 |
Bonevski B, Bryant JL, Lynagh MC, Paul CL, 'Money as motivation to quit: A survey of a non-random Australian sample of socially disadvantaged smokers' views of the acceptability of cash incentives', Preventive Medicine, 55 122-126 (2012) [C1]
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Nova |
2012 |
Courtney RJ, Paul CL, Sanson-Fisher RW, Carey ML, Macrae FA, Yoong SL, 'Community approaches to increasing colorectal screening uptake: A review of the methodological quality and strength of current evidence', Cancer Forum, 36 27-35 (2012) [C1]
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|
Nova |
2012 |
Carey ML, Anderson AE, Sanson-Fisher RW, Lynagh MC, Paul CL, Tzelepis F, 'How well are we meeting haematological cancer survivors' preferences for involvement in treatment decision making?', Patient Education and Counseling, 88 87-92 (2012) [C1]
|
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Nova |
2012 |
Carey ML, Lambert SD, Smits RE, Paul CL, Sanson-Fisher RW, Clinton-Mcharg TL, 'The unfulfilled promise: A systematic review of interventions to reduce the unmet supportive care needs of cancer patients', Supportive Care in Cancer, 20 207-219 (2012) [C1]
|
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Nova |
2012 |
Paul CL, Clinton-Mcharg TL, Lynagh MC, Sanson-Fisher RW, Tzelepis F, 'On-line information and support for supporters and carers of haematological cancer patients: Is access an issue?', Supportive Care in Cancer, 20 2687-2695 (2012) [C1]
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Nova |
2012 |
Guillaumier AM, Bonevski B, Paul CL, 'Anti-tobacco mass media and socially disadvantaged groups: A systematic and methodological review', Drug and Alcohol Review, 31 698-708 (2012) [C1]
|
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Nova |
2012 |
Bonevski B, Baker AL, Twyman LH, Paul CL, Bryant JL, 'Addressing smoking and other health risk behaviours using a novel telephone-delivered intervention for homeless people: A proof-of-concept study', Drug and Alcohol Review, 31 709-713 (2012) [C1]
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Nova |
2012 |
Paul CL, Bonevski B, Turon HE, Bryant JL, 'The balancing act: Experts' opinions about the relative resourcing of tobacco control efforts for the general population versus disadvantaged populations', Drug and Alcohol Review, 31 602-607 (2012) [C1]
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Nova |
2012 |
Bryant JL, Bonevski B, Paul CL, Hull P, O'Brien J, 'Implementing a smoking cessation program in social and community service organisations: A feasibility and acceptability trial', Drug and Alcohol Review, 31 678-684 (2012) [C1]
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Nova |
2012 |
Carey ML, Paul CL, Mackenzie LJ, Sanson-Fisher RW, Cameron EC, 'Do cancer patients' psychosocial outcomes and perceptions of quality of care vary across radiation oncology treatment centres?', European Journal of Cancer Care, 21 384-389 (2012) [C1]
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Nova |
2012 |
Paul CL, Carey ML, Anderson AE, Mackenzie LJ, Sanson-Fisher RW, Courtney RJ, Clinton-Mcharg TL, 'Cancer patients' concerns regarding access to cancer care: Perceived impact of waiting times along the diagnosis and treatment journey', European Journal of Cancer Care, 21 321-329 (2012) [C1]
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Nova |
2012 |
Carey ML, Paul CL, Cameron EC, Lynagh MC, Hall AE, Tzelepis F, 'Financial and social impact of supporting a haematological cancer survivor', European Journal of Cancer Care, 21 169-176 (2012) [C1]
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Nova |
2012 |
Wolfenden L, Paul CL, Tzelepis F, Freund MA, Wiggers JH, Gillham K, 'Acceptability of proactive telephone recruitment to a telephone support service to encourage healthy eating, physical activity and weight loss', Australian and New Zealand Journal of Public Health, 36 295-296 (2012) [C1]
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Nova |
2012 |
Courtney RJ, Paul CL, Sanson-Fisher RW, Carey ML, Macrae FA, Yoong SL, 'COMMUNITY APPROACHES TO INCREASING COLORECTAL SCREENING UPTAKE: A REVIEW OF THE METHODOLOGICAL QUALITY AND STRENGTH OF CURRENT EVIDENCE', CANCER FORUM, 36 25-33 (2012)
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2012 |
Tzelepis F, Paul CL, Duncan SL, Walsh RA, Wiggers JH, Knight JJ, 'Increasing the reach of quitlines through active telephone recruitment: Do cold-called smokers differ from quitline callers?', Nicotine & Tobacco Research, 14 1488-1493 (2012) [C1]
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Nova |
2012 |
Courtney RJ, Paul CL, Sanson-Fisher RW, Macrae F, Attia JR, McEvoy MA, 'Current state of medical-advice-seeking behaviour for symptoms of colorectal cancer: determinants of failure and delay in medical consultation', Colorectal Disease, 14 e222-e229 (2012) [C1]
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Nova |
2012 |
Courtney RJ, Paul CL, Sanson-Fisher RW, Macrae FA, Carey ML, Attia JR, McEvoy MA, 'Colorectal cancer risk assessment and screening recommendation: A community survey of healthcare providers' practice from a patient perspective', BMC Family Practice, 13 1-9 (2012) [C1]
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Nova |
2012 |
Courtney RJ, Paul CL, Sanson-Fisher RW, Macrae FA, Attia JR, McEvoy MA, 'Factors associated with consultation behaviour for primary symptoms potentially indicating colorectal cancer: A cross-sectional study on response to symptoms', BMC Gastroenterology, 12 1-9 (2012) [C1]
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Nova |
2012 |
Carey ML, Sanson-Fisher RW, Macrae F, Hill D, D'Este CA, Paul CL, Doran CM, 'Improving adherence to surveillance and screening recommendations for people with colorectal cancer and their first degree relatives: a randomized controlled trial', BMC Cancer, 12 62 (2012) [C3]
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Nova |
2012 |
Wolfenden L, Wiggers JH, Paul CL, Freund MA, Lecathelinais C, Wye PM, Gillham K, 'Increasing the use of preventative health services to promote healthy eating, physical activity and weight management: The acceptability and potential effectiveness of a proactive telemarketing approach', BMC Public Health, 12 (2012) [C1]
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Nova |
2012 |
McInnes E, Middleton S, Gardner G, Haines M, Haertsch M, Paul CL, Castaldi P, 'A qualitative study of stakeholder views of the conditions for and outcomes of successful clinical networks', BMC Health Services Research, 12 (2012) [C1]
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Nova |
2012 |
Sanson-Fisher RW, Mackenzie LJ, Butow P, Rankin N, Paul CL, 'Advancing the evidence base in cancer: Psychosocial multicenter trials', Trials, 13 171 (2012) [C2]
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Nova |
2012 |
Haines M, Brown B, Craig J, D'Este CA, Elliott E, Klineberg E, et al., 'Determinants of successful clinical networks: The conceptual framework and study protocol', Implementation Science, 7 1-10 (2012) [C3]
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Nova |
2012 |
Carey ML, Paul CL, Sanson-Fisher RW, Buchan H, 'Data systems for assessing quality of cancer care: Are building blocks in place for person-centered care?', The International Journal of Person Centred Medicine, 2 334-340 (2012) [C1]
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Nova |
2012 |
Yoong SL, Carey ML, Sanson-Fisher RW, Russell G, Mazza D, Makeham M, et al., 'Touch screen computer health assessment in Australian general practice patients: A cross-sectional study protocol', BMJ Open, 2 1-7 (2012) [C3]
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|
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2012 |
Lambert SD, Harrison JD, Smith E, Bonevski B, Carey ML, Lawsin C, et al., 'The unmet needs of partners and caregivers of adults diagnosed with cancer: A systematic review', BMJ Supportive & Palliative Care, 2 224-230 (2012) [C1]
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Nova |
2011 |
Bryant JL, Bonevski B, Paul CL, Lecathelinais LC, 'Assessing smoking status in disadvantaged populations: Is computer administered self report an accurate and acceptable measure?', BMC Medical Research Methodology, 11 153 (2011) [C1]
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Nova |
2011 |
Bonevski B, Paul CL, D'Este CA, Sanson-Fisher RW, West R, Girgis A, et al., 'RCT of a client-centred, caseworker-delivered smoking cessation intervention for a socially disadvantaged population', BMC Public Health, 11 70 (2011) [C1]
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Nova |
2011 |
Bryant JL, Bonevski B, Paul CL, O'Brien J, Oakes W, 'Developing cessation interventions for the social and community service setting: A qualitative study of barriers to quitting among disadvantaged Australian smokers', BMC Public Health, 11 493 (2011) [C1]
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Nova |
2011 |
Bryant JL, Bonevski B, Paul CL, 'A survey of smoking prevalence and interest in quitting among social and community service organisation clients in Australia: a unique opportunity for reaching the disadvantaged', BMC Public Health, 11 (2011) [C1]
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Nova |
2011 |
Johnson CE, Girgis A, Paul CL, Currow DC, 'Palliative care referral practices and perceptions: The divide between metropolitan and non-metropolitan general practitioners', Palliative and Supportive Care, 9 181-189 (2011) [C1]
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Nova |
2011 |
Bonevski B, Walsh RA, Paul CL, Smith A, 'Equity should be given high priority in population tobacco control. Letter', British Medical Journal, (2011) [C3]
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2011 |
Carey ML, Yoong SL, Sanson-Fisher RW, Paul CL, Inder KJ, Makeham M, 'Efforts to close the evidence-practice gap in the management of cardiovascular risk factors in general practice: Strategic or haphazard?', International Journal of Person Centered Medicine, 1 660-667 (2011) [C1]
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Nova |
2011 |
Tzelepis F, Paul CL, Walsh RA, McElduff P, Knight JJ, 'Proactive telephone counseling for smoking cessation: Meta-analyses by recruitment channel and methodological quality', Journal of the National Cancer Institute, 103 922-941 (2011) [C1]
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Nova |
2011 |
Johnson CE, Girgis A, Paul CL, Currow DC, Adams J, Aranda S, 'Australian palliative care providers' perceptions and experiences of the barriers and facilitators to palliative care provision', Supportive Care in Cancer, 19 343-351 (2011) [C1]
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Nova |
2011 |
Bonevski B, Bryant JL, Paul CL, 'Encouraging smoking cessation among disadvantaged groups: A qualitative study of the financial aspects of cessation', Drug and Alcohol Review, 30 411-418 (2011) [C1]
|
|
Nova |
2011 |
Paul CL, Sanson-Fisher RW, Douglas HE, Clinton-Mcharg TL, Williamson A, Barker DJ, 'Cutting the research pie: A value-weighting approach to explore perceptions about psychosocial research priorities for adults with haematological cancers', European Journal of Cancer Care, 20 345-353 (2011) [C1]
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Nova |
2011 |
Tzelepis F, Paul CL, Wiggers JH, Walsh RA, Knight JJ, Duncan SL, et al., 'A randomised controlled trial of proactive telephone counselling on cold-called smokers' cessation rates', Tobacco Control, 20 40-46 (2011) [C1]
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Nova |
2011 |
Bryant JL, Bonevski B, Paul CL, McElduff P, Attia JR, 'A systematic review and meta-analysis of the effectiveness of behavioural smoking cessation interventions in selected disadvantaged groups', Addiction, 106 1568-1585 (2011) [C1]
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Nova |
2011 |
Walsh RA, Paul CL, Paras LE, Stacey FG, Tzelepis F, 'Workplace-related smoking in New South Wales: Extent of bans, public attitudes and relationships with relapse', Health Promotion Journal of Australia, 22 85-90 (2011) [C1]
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Nova |
2011 |
Bonevski B, Paul CL, Walsh RA, Bryant JL, Lecathelinais LC, 'Support for smoke-free vocational education settings: An exploratory survey of staff behaviours, experiences and attitudes', Health Promotion Journal of Australia, 22 11-16 (2011) [C1]
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Nova |
2011 |
Johnson CE, Paul CL, Girgis A, Adams J, Currow DC, 'Australian general practitioners' and oncology specialists' perceptions of barriers and facilitators of access to specialist palliative care services', Journal of Palliative Medicine, 14 429-435 (2011) [C1]
|
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Nova |
2011 |
Paul CL, Paras LE, Harper A, Coppa K, 'Harm minimization in tan seekers: An exploration of tanning behaviour and the potential for substitutional use of sunless tanning products', Journal of Health Psychology, 16 929-937 (2011) [C1]
|
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Nova |
2011 |
Paul CL, Carey ML, Hall AE, Lynagh MC, Sanson-Fisher RW, Henskens FA, 'Improving access to information and support for patients with less common cancers: hematologic cancer patients' views about web-based approaches', Journal of Medical Internet Research, 13 (2011) [C1]
|
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Nova |
2010 |
Bonevski B, Paul CL, Paras LE, Lecathelinais LC, 'Spending, shopping and saving: Ex-smokers' perceptions about material gains following quitting', Journal of Smoking Cessation, 5 77-82 (2010) [C1]
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|
Nova |
2010 |
Bryant JL, Bonevski B, Paul CL, O'Brien J, Oakes W, 'Delivering smoking cessation support to disadvantaged groups: A qualitative study of the potential of community welfare organizations', Health Education Research, 25 979-990 (2010) [C1]
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|
Nova |
2010 |
Paul CL, Mee KJ, Judd TM, Walsh RA, Tang A, Penman A, 'Anywhere, anytime: Retail access to tobacco in New South Wales and its potential impact on consumption and quitting', Social Science and Medicine, 71 799-806 (2010) [C1]
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Nova |
2010 |
Paul CL, Sanson-Fisher RW, Stewart JM, Anderson AE, 'Being sorry is not enough: The sorry state of the evidence base for improving the health of indigenous populations', American Journal of Preventive Medicine, 38 566-568 (2010) [C1]
|
|
Nova |
2010 |
Clinton-Mcharg TL, Paul CL, Sanson-Fisher RW, D'Este CA, Williamson A, 'Determining research priorities for young people with haematological cancer: A value-weighting approach', European Journal of Cancer, 46 3263-3270 (2010) [C1]
|
|
Nova |
2010 |
Paul CL, Ross S, Bryant JL, Hill W, Bonevski B, Keevy N, 'The social context of smoking: A qualitative study comparing smokers of high versus low socioeconomic position', BMC Public Health, 10 1-7 (2010) [C1]
|
|
Nova |
2009 |
Sanson-Fisher RW, Carey ML, Paul CL, 'Measuring the unmet needs of those with cancer: A critical overview', Cancer Forum, 33 198-201 (2009) [C1]
|
|
Nova |
2009 |
Tzelepis F, Paul CL, Walsh RA, Wiggers JH, Knight JJ, Lecathelinais LC, et al., 'Telephone recruitment into a randomized controlled trial of Quitline support', American Journal of Preventive Medicine, 37 324-329 (2009) [C1]
|
|
Nova |
2009 |
Paul CL, Girgis A, Anniwell L, Paras LE, Lecathelinais LC, 'Outcomes of solarium industry efforts to improve compliance with recommended practices: A clear case for formal regulation', Photodermatology, Photoimmunology & Photomedicine, 25 185-190 (2009) [C1]
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Nova |
2009 |
Paul CL, Clinton-Mcharg TL, Sanson-Fisher RW, Douglas HE, Webb G, 'Are we there yet? The state of the evidence base for guidelines on breaking bad news to cancer patients', European Journal of Cancer, 45 2960-2966 (2009) [C1]
|
|
Nova |
2009 |
Freund MA, Campbell EM, Paul CL, Sakrouge R, Lecathelinais LC, Knight JJ, et al., 'Increasing hospital-wide delivery of smoking cessation care for nicotine-dependent in-patients: A multi-strategic intervention trial', Addiction, 104 839-849 (2009) [C1]
|
|
Nova |
2009 |
Bonevski B, Walsh RA, Paul CL, 'Government slow to act on public preference for total pub smoking ban', Australian and New Zealand Journal of Public Health, 33 95 (2009) [C3]
|
|
Nova |
2009 |
Freund MA, Campbell EM, Paul CL, Sakrouge R, McElduff P, Walsh RA, et al., 'Increasing smoking cessation care provision in hospitals: A meta-analysis of intervention effect', Nicotine & Tobacco Research, 11 650-662 (2009) [C1]
|
|
Nova |
2009 |
Tzelepis F, Paul CL, Walsh RA, Wiggers JH, Duncan SL, Knight JJ, 'Active telephone recruitment to quitline services: Are nonvolunteer smokers receptive to cessation support?', Nicotine & Tobacco Research, 11 1205-1215 (2009) [C1]
|
|
Nova |
2008 |
Freund MA, Campbell EM, Paul CL, Wiggers JH, Knight JJ, Mitchell EN, 'Provision of smoking care in NSW hospitals: Opportunities for further enhancement', NSW Public Health Bulletin, 19 50-55 (2008) [C1]
|
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Nova |
2008 |
Paul CL, Walsh RA, Stacey FG, Tzelepis F, Oakes W, Tang A, 'Smoking in movies in Australia: Who feels over-exposed and what level of regulation will the community accept?', Health Promotion Journal of Australia, 19 229-231 (2008) [C1]
|
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Nova |
2008 |
Paul CL, Tzelepis F, Parfitt N, Girgis A, 'How to improve adolescents' sun protection behavior? Age and gender issues', American Journal of Health Behavior, 32 387-398 (2008) [C1]
|
|
Nova |
2008 |
Walsh RA, Paul CL, Tzelepis F, Stojanovski E, Tang A, 'Is government action out-of-step with public opinion on tobacco control? Results of a New South Wales population survey', Australian and New Zealand Journal of Public Health, 32 482-488 (2008) [C1]
|
|
Nova |
2008 |
Freund MA, Campbell EM, Paul CL, McElduff P, Walsh RA, Sakrouge R, et al., 'Smoking care provision in hospitals: A review of prevalence', Nicotine & Tobacco Research, 10 757-774 (2008) [C1]
|
|
Nova |
2008 |
Paul CL, Tzelepis F, Walsh RA, Bonevski B, 'Is Australia headed for an epidemic of nicotine replacement therapy addicts?', Medical Journal of Australia, 189 346 (2008) [C3]
|
|
Nova |
2008 |
Johnson CE, Girgis A, Paul CL, Currow DC, 'Cancer specialists' palliative care referral practices and perceptions: Results of a national survey', Palliative Medicine, 22 51-57 (2008) [C1]
|
|
Nova |
2008 |
Walsh RA, Paul CL, 'School smoking bans', Drug and Alcohol Review, 27 570-571 (2008) [C3]
|
|
Nova |
2007 |
Paul CL, Tzelepis F, Walsh RA, Turner R, 'Pharmacists on the front line in providing support for nicotine replacement therapy and bupropion purchasers', Drug and Alcohol Review, 26 429-433 (2007) [C1]
|
|
|
2006 |
Stojanovski E, Walsh RA, Paul CL, 'Illegal tobacco use in Australia: how big is the problem of chop-chop? (Letter)', Australian and New Zealand Journal of Public Health, 30 484-485 (2006) [C3]
|
|
|
2006 |
Walsh RA, Paul CL, Tzelepis F, Stojanovski E, 'Quit smoking behaviours and intentions and hard-core smoking in New South Wales', Health Promotion Journal of Australia, 17 54-60 (2006) [C1]
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|
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2005 |
Paul CL, Walsh RA, Tzelepis F, 'A Monetary Incentive Increases Postal Survey Response Rates for Pharmacists', Journal of Epidemiology and Community Health, 59 1099-1101 (2005) [C1]
|
|
|
2005 |
Freund MA, Campbell EM, Paul CL, Sakrouge R, Wiggers JH, 'Smoking care provision in smoke-free hospitals in Australia', Preventive Medicine, 41 151-158 (2005) [C1]
|
|
Nova |
2005 |
Paul CL, Stacey FG, Girgis A, Brozek I, Baird H, Hughes J, 'Solaria compliance in an unregulated environment: The Australian experience', European Journal of Cancer, 41 1178-1184 (2005) [C1]
|
|
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2004 |
Paul CL, Redman S, Sanson-Fisher RW, 'A cost-effective approach to the development of printed materials: a randomized controlled trial of three strategies', Health Education Research: theory and practice, 19 698-706 (2004) [C1]
|
|
Nova |
2004 |
Paul CL, Wiggers JH, Daly JB, Green S, Walsh (Ext) RA, Knight JJ, Girgis A, 'Direct telemarketing of smoking cessation interventions: Will smokers take the call?', Addiction, 99 907-913 (2004) [C1]
|
|
Nova |
2004 |
Wolfenden L, Paul CL, Mitchell E, 'Managing Nicotine Dependence in NSW Hospital Patients', NSW Public Health Bulletin, 15 98-101 (2004) [C3]
|
|
|
2004 |
Wolfenden L, Freund M, Campbell E, Wiggers J, Paul C, Mitchell E, 'Managing nicotine dependence in NSW hospital patients', NSW Public Health Bulletin, 15 98-99 (2004) [C1]
|
|
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2004 |
Paul CL, Girgis A, Tzelepis F, Walsh RA, 'Solaria use by minors in Australia: Is there a cause for concern?', ANZ Journal of Public Health, 28 90 (2004) [C3]
|
|
|
2003 |
Paul CL, Tzelepis F, Walsh RA, Girgis A, King L, McKenzie J, 'Has the investment in public cancer education delivered observable changes in knowledge over the past 10 years?', Cancer, 97 2931-2939 (2003) [C1]
|
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Nova |
2003 |
Paul CL, Redman S, Sanson-Fisher RW, 'Print material content and design: is it relevant to effectiveness?', Health Education Research:, 18 181-190 (2003) [C1]
|
|
|
2003 |
Paul CL, Tzelepis F, Girgis A, Parfitt N, 'The Slip Slop Slap years: Have they had a lasting impact on todays' adolescents?', Health Promotion Journal of Australia, 14 219-221 (2003) [C3]
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2003 |
Cockburn JD, Paul CL, Tzelepis F, McElduff P, Byles JE, 'Delay in seeking advice for symptoms that potentially indicate bowel cancer', American Journal of Health Behavior, 27 401-407 (2003) [C1]
|
|
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2003 |
Tzelepis F, Walsh RA, Paul CL, 'Community attitudes towards environmental tobacco smoke in licensed premises: follow-up study after the Sharp case', Australia & New Zealand Journal of Public Health, 27 539-542 (2003) [C1]
|
|
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2003 |
Paul CL, Walsh RA, Girgis A, 'Nicotine replacement therapy products over the counter: real-life use in the Australian community', Australia & New Zealand Journal of Public Health, 27 491-495 (2003) [C1]
|
|
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2003 |
Girgis A, Tzelepis F, Paul CL, Walsh RA, McElduff P, McKenzie J, 'Australians' use of fake tanning lotions: another piece of the puzzle', Promoting Health, 27 529-532 (2003) [C1]
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|
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2002 |
Cockburn JD, Paul CL, Tzelepis F, McElduff P, Byles JE, 'Screening for bowel cancer among NSW adults with varying levels of risk: a community survey', Australian and New Zealand Journal of Public Health, 26(3) 236-241 (2002) [C1]
|
|
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2002 |
Walsh RA, Tzelepis F, Paul CL, McKenzie J, 'Environmental tobacco smoke in homes, motor vehicles and licensed premises: community attitudes and practices', Australian and New Zealand Journal of Public Health, 26(6) 536-542 (2002) [C1]
|
|
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2002 |
Walsh RA, Paul CL, 'New Year quit smoking resolutions', Australian and New Zealand Journal of Public Health, 26(2) 181 (2002) [C3]
|
|
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2001 |
Walsh RA, Paul CL, McElduff P, 'Smoking rates may be declining', Medical Journal of Australia, 175 339 (2001) [C3]
|
|
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2000 |
Gibbs A, Clavarino Z, Jones S, Paul C, Walsh R, 'Australian behavioural research in cancer', Cancer Forum, 24 182 (2000) |
|
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2000 |
Walsh RA, Paul CL, Tzelepis F, 'Overwhelming support for smoking bans', AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, 24 640-641 (2000)
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2000 |
Walsh R, Paul C, Girgis A, Penman A, 'Smoke rings around the Olympics', Australian and New Zealand Journal of Public Health, 24(4) 455 (2000) [C3]
|
|
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2000 |
Walsh RA, Paul CL, Tzelepis F, 'Just who is 'wrong' about the implications of heroin trials?', Australian and New Zealand Journal of Public Health, 24 640 (2000)
|
|
|
1999 |
Bonevski B, Sanson-Fisher RW, Hersey P, Paul C, Foot G, 'Assessing the perceived needs of patients attending an outpatient melanoma clinic', Journal of Psychosocial Oncology, 17(3/4) 101-118 (1999) [C1]
|
|
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1999 |
Paul C, Barratt A, Redman S, Cockburn JD, Lowe J, 'Knowledge and perceptions about breast cancer incidence, fatality and risk among Australian women', Australian and New Zealand Journal of Public Health, 23(4) 396-400 (1999) [C1]
|
|
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1998 |
Paul CL, Redman S, Sanson-Fisher RW, 'Print material as a public health education tool', Australian and New Zealand Journal of Public Health, 22(1) 146-148 (1998) [C1]
|
|
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1997 |
Barratt AL, Cockburn J, Redman S, Paul C, Perkins J, 'Mammographic screening: results from the 1996 National Breast Health Survey', MEDICAL JOURNAL OF AUSTRALIA, 167 521-524 (1997)
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1996 |
Paul CL, SansonFisher RW, 'Experts' agreement on the relative effectiveness of 29 smoking reduction strategies', PREVENTIVE MEDICINE, 25 517-526 (1996)
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1994 |
PAUL CL, SANSONFISHER RW, REDMAN S, CARTER S, 'PREVENTING ACCIDENTAL INJURY TO YOUNG-CHILDREN IN THE HOME USING VOLUNTEERS', HEALTH PROMOTION INTERNATIONAL, 9 241-249 (1994)
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1994 |
REDMAN S, SALTMAN D, STRATON J, YOUNG B, PAUL C, 'DETERMINANTS OF CAREER CHOICES AMONG WOMEN AND MEN MEDICAL-STUDENTS AND INTERNS', MEDICAL EDUCATION, 28 361-371 (1994)
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1992 |
PAUL CL, REDMAN S, EVANS D, 'THE COST AND AVAILABILITY OF DEVICES FOR PREVENTING CHILDHOOD INJURIES', JOURNAL OF PAEDIATRICS AND CHILD HEALTH, 28 22-26 (1992)
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1992 |
REDMAN S, BOOTH P, SMYTH H, PAUL C, 'PREVENTIVE HEALTH BEHAVIORS AMONG PARENTS OF INFANTS AGED 4 MONTHS', AUSTRALIAN JOURNAL OF PUBLIC HEALTH, 16 175-181 (1992)
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