Cargando…

Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia

Aboriginal and Torres Strait Islander women have significantly higher cervical cancer incidence and mortality than other Australian women. In this study, we assessed the documented delivery of cervical screening for women attending Indigenous Primary Health Care (PHC) centres across Australia and id...

Descripción completa

Detalles Bibliográficos
Autores principales: Diaz, Abbey, Vo, Brenda, Baade, Peter D., Matthews, Veronica, Nattabi, Barbara, Bailie, Jodie, Whop, Lisa J., Bailie, Ross, Garvey, Gail
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801551/
https://www.ncbi.nlm.nih.gov/pubmed/31569670
http://dx.doi.org/10.3390/ijerph16193630
_version_ 1783460599999496192
author Diaz, Abbey
Vo, Brenda
Baade, Peter D.
Matthews, Veronica
Nattabi, Barbara
Bailie, Jodie
Whop, Lisa J.
Bailie, Ross
Garvey, Gail
author_facet Diaz, Abbey
Vo, Brenda
Baade, Peter D.
Matthews, Veronica
Nattabi, Barbara
Bailie, Jodie
Whop, Lisa J.
Bailie, Ross
Garvey, Gail
author_sort Diaz, Abbey
collection PubMed
description Aboriginal and Torres Strait Islander women have significantly higher cervical cancer incidence and mortality than other Australian women. In this study, we assessed the documented delivery of cervical screening for women attending Indigenous Primary Health Care (PHC) centres across Australia and identified service-level factors associated with between-centre variation in screening coverage. We analysed 3801 clinical audit records for PHC clients aged 20–64 years from 135 Indigenous PHC centres participating in the Audit for Best Practice in Chronic Disease (ABCD) continuous quality improvement (CQI) program across five Australian states/territories during 2005 to 2014. Multilevel logistic regression models were used to identify service-level factors associated with screening, while accounting for differences in client-level factors. There was substantial variation in the proportion of clients who had a documented cervical screen in the previous two years across the participating PHC centres (median 50%, interquartile range (IQR): 29–67%), persisting over years and audit cycle. Centre-level factors explained 40% of the variation; client-level factors did not reduce the between-centre variation. Screening coverage was associated with longer time enrolled in the CQI program and very remote location. Indigenous PHC centres play an important role in providing cervical screening to Aboriginal and Torres Strait Islander women. Thus, their leadership is essential to ensure that Australia’s public health commitment to the elimination of cervical cancer includes Aboriginal and Torres Strait Islander women. A sustained commitment to CQI may improve PHC centres delivery of cervical screening; however, factors that may impact on service delivery, such as organisational, geographical and environmental factors, warrant further investigation.
format Online
Article
Text
id pubmed-6801551
institution National Center for Biotechnology Information
language English
publishDate 2019
publisher MDPI
record_format MEDLINE/PubMed
spelling pubmed-68015512019-10-31 Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia Diaz, Abbey Vo, Brenda Baade, Peter D. Matthews, Veronica Nattabi, Barbara Bailie, Jodie Whop, Lisa J. Bailie, Ross Garvey, Gail Int J Environ Res Public Health Article Aboriginal and Torres Strait Islander women have significantly higher cervical cancer incidence and mortality than other Australian women. In this study, we assessed the documented delivery of cervical screening for women attending Indigenous Primary Health Care (PHC) centres across Australia and identified service-level factors associated with between-centre variation in screening coverage. We analysed 3801 clinical audit records for PHC clients aged 20–64 years from 135 Indigenous PHC centres participating in the Audit for Best Practice in Chronic Disease (ABCD) continuous quality improvement (CQI) program across five Australian states/territories during 2005 to 2014. Multilevel logistic regression models were used to identify service-level factors associated with screening, while accounting for differences in client-level factors. There was substantial variation in the proportion of clients who had a documented cervical screen in the previous two years across the participating PHC centres (median 50%, interquartile range (IQR): 29–67%), persisting over years and audit cycle. Centre-level factors explained 40% of the variation; client-level factors did not reduce the between-centre variation. Screening coverage was associated with longer time enrolled in the CQI program and very remote location. Indigenous PHC centres play an important role in providing cervical screening to Aboriginal and Torres Strait Islander women. Thus, their leadership is essential to ensure that Australia’s public health commitment to the elimination of cervical cancer includes Aboriginal and Torres Strait Islander women. A sustained commitment to CQI may improve PHC centres delivery of cervical screening; however, factors that may impact on service delivery, such as organisational, geographical and environmental factors, warrant further investigation. MDPI 2019-09-27 2019-10 /pmc/articles/PMC6801551/ /pubmed/31569670 http://dx.doi.org/10.3390/ijerph16193630 Text en © 2019 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Diaz, Abbey
Vo, Brenda
Baade, Peter D.
Matthews, Veronica
Nattabi, Barbara
Bailie, Jodie
Whop, Lisa J.
Bailie, Ross
Garvey, Gail
Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia
title Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia
title_full Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia
title_fullStr Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia
title_full_unstemmed Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia
title_short Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia
title_sort service level factors associated with cervical screening in aboriginal and torres strait islander primary health care centres in australia
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6801551/
https://www.ncbi.nlm.nih.gov/pubmed/31569670
http://dx.doi.org/10.3390/ijerph16193630
work_keys_str_mv AT diazabbey servicelevelfactorsassociatedwithcervicalscreeninginaboriginalandtorresstraitislanderprimaryhealthcarecentresinaustralia
AT vobrenda servicelevelfactorsassociatedwithcervicalscreeninginaboriginalandtorresstraitislanderprimaryhealthcarecentresinaustralia
AT baadepeterd servicelevelfactorsassociatedwithcervicalscreeninginaboriginalandtorresstraitislanderprimaryhealthcarecentresinaustralia
AT matthewsveronica servicelevelfactorsassociatedwithcervicalscreeninginaboriginalandtorresstraitislanderprimaryhealthcarecentresinaustralia
AT nattabibarbara servicelevelfactorsassociatedwithcervicalscreeninginaboriginalandtorresstraitislanderprimaryhealthcarecentresinaustralia
AT bailiejodie servicelevelfactorsassociatedwithcervicalscreeninginaboriginalandtorresstraitislanderprimaryhealthcarecentresinaustralia
AT whoplisaj servicelevelfactorsassociatedwithcervicalscreeninginaboriginalandtorresstraitislanderprimaryhealthcarecentresinaustralia
AT bailieross servicelevelfactorsassociatedwithcervicalscreeninginaboriginalandtorresstraitislanderprimaryhealthcarecentresinaustralia
AT garveygail servicelevelfactorsassociatedwithcervicalscreeninginaboriginalandtorresstraitislanderprimaryhealthcarecentresinaustralia