Special Issue "Rural Health Workforce (2nd Edition)"

A special issue of International Journal of Environmental Research and Public Health (ISSN 1660-4601). This special issue belongs to the section "Health Economics".

Deadline for manuscript submissions: 30 November 2021.

Special Issue Editors

Dr. Belinda O’Sullivan
E-Mail Website
Leading Guest Editor
Rural Clinical School, Faculty of Medicine, University of Queensland, Toowoomba, QLD 4350, Australia
Interests: rural workforce training and development; workforce support; rural health systems; rural health outcomes; rural communities
Dr. Matthew McGrail
E-Mail Website
Assistant Guest Editor
Rural Clinical School, University of Queensland, Rockhampton, QLD 4700, Australia
Interests: rural health workforce; access to health care; health services research; GIS methodologies in health; health workforce policy/incentives; recruitment, retention and mobility
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Special Issue Information

Dear Colleagues,

Rural communities remain challenging environments in which to address healthcare needs, particularly across secondary (‘specialty’) levels of care. Lower population density, size, staffing, and infrastructure often make the delivery of specialty care to rural populations more difficult. Moreover, rural people often have more extreme health needs, sometimes due to later presentations or poorer primary care access. Improving access to specialist-level healthcare in rural settings involves consideration of the workforce and their scope of skills (including primary care health workers being trained and supported to deliver additional specialty services independently or under supervision) and methods for delivering services (such as outreach, telehealth, and face-to-face models). It also involves the development of regional service hubs, which support the delivery of care to wider geographic catchments.

With this background in mind, we make a special call for papers about rural specialty care. We encourage articles about specialty-level services by various health worker types, countries, rural contexts, and clinical settings. These may include literature reviews, articles describing or evaluating workforce and service interventions, and insights that can inform the development and maintenance of specialist service capacity in rural areas. Articles will need to define the rural location and its characteristics, be clear about the context of the population’s need for the form of specialty care (what the rural problem is), define any specialist providers and their qualifications, and ensure that it is clear as to how the specialist care is accessed, for example, through referral or first point of contact, and any telehealth modalities or outreach parameters are clear. We encourage the use of globally standard terminology to allow for generalizability. We thank you in advance for your contributions. With your assistance, we can shed some light on this critical issue in order to improve the health of regional, rural, and remote people.

Dr. Belinda O’Sullivan
Dr. Matthew McGrail
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All papers will be peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. International Journal of Environmental Research and Public Health is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2300 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • rural specialists
  • scope of practice
  • extended primary healthcare
  • models of care
  • regional hubs
  • specialist services
  • specialist telehealth
  • specialist outreach
  • rural health workforce

Published Papers (4 papers)

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Research

Article
Exploring Doctors’ Emerging Commitment to Rural and General Practice Roles over Their Early Career
Int. J. Environ. Res. Public Health 2021, 18(22), 11835; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph182211835 - 11 Nov 2021
Viewed by 318
Abstract
Producing enough doctors working in general practice or rural locations, or both, remains a key global policy focus. However, there is a lack of evidence about doctors’ emerging commitment to these decisions. This study aimed to explore changes in the level of certainty [...] Read more.
Producing enough doctors working in general practice or rural locations, or both, remains a key global policy focus. However, there is a lack of evidence about doctors’ emerging commitment to these decisions. This study aimed to explore changes in the level of certainty about career interest in working in general practice and working rurally, as doctors pass through various early career stages. The participants were 775 eligible respondents to a 2019 survey of medical graduates of The University of Queensland from 2002–2018. Certainty levels of specialty choice were similar between GPs and specialists up until the beginning of registrar training. At that point, 65% of GPs compared with 80% of other specialists had strong certainty of their specialty field. Consistently (and significantly) less of those working rurally had strong certainty of the location where they wanted to practice medicine at each career time point. At the start of registrar training, a similar gap remained (strong certainty: 51% rural versus 63% metropolitan). This study provides new evidence that career intent certainty is more delayed for the cohort choosing general practice and rural practice than the other options. The low level of certainty in early career highlights the importance of regular positive experiences that help to promote the uptake of general practice and rural practice. Full article
(This article belongs to the Special Issue Rural Health Workforce (2nd Edition))
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Article
Uganda Mountain Community Health System—Perspectives and Capacities towards Emerging Infectious Disease Surveillance
Int. J. Environ. Res. Public Health 2021, 18(16), 8562; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18168562 - 13 Aug 2021
Viewed by 704
Abstract
In mountain communities like Sebei, Uganda, which are highly vulnerable to emerging and re-emerging infectious diseases, community-based surveillance plays an important role in the monitoring of public health hazards. In this survey, we explored capacities of village health teams (VHTs) in Sebei communities [...] Read more.
In mountain communities like Sebei, Uganda, which are highly vulnerable to emerging and re-emerging infectious diseases, community-based surveillance plays an important role in the monitoring of public health hazards. In this survey, we explored capacities of village health teams (VHTs) in Sebei communities of Mount Elgon in undertaking surveillance tasks for emerging and re-emerging infectious diseases in the context of a changing climate. We used participatory epidemiology techniques to elucidate VHTs’ perceptions on climate change and public health and assessed their capacities to conduct surveillance for emerging and re-emerging infectious diseases. Overall, VHTs perceived climate change to be occurring with wider impacts on public health. However, they had inadequate capacities in collecting surveillance data. The VHTs lacked transport to navigate through their communities and had insufficient capacities in using mobile phones for sending alerts. They did not engage in reporting other hazards related to the environment, wildlife, and domestic livestock that would accelerate infectious disease outbreaks. Records were not maintained for disease surveillance activities and the abilities of VHTs to analyze data were also limited. However, VHTs had access to platforms that could enable them to disseminate public health information. The VHTs thus need to be retooled to conduct their work effectively and efficiently through equipping them with adequate logistics and knowledge on collecting, storing, analyzing, and relaying data, which will improve infectious disease response and mitigation efforts. Full article
(This article belongs to the Special Issue Rural Health Workforce (2nd Edition))
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Article
Developing an Ear Health Intervention for Rural Community Pharmacy: Application of the PRECEDE-PROCEED Model
Int. J. Environ. Res. Public Health 2021, 18(12), 6456; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18126456 - 15 Jun 2021
Viewed by 1018
Abstract
Unaddressed hearing loss affects an estimated 466 million people worldwide, costing over $750 billion globally, with rural communities being particularly disadvantaged, due to the greater inequity in access to healthcare services. This mixed-methods study aimed to use the PRECEDE-PROCEED model to develop and [...] Read more.
Unaddressed hearing loss affects an estimated 466 million people worldwide, costing over $750 billion globally, with rural communities being particularly disadvantaged, due to the greater inequity in access to healthcare services. This mixed-methods study aimed to use the PRECEDE-PROCEED model to develop and pilot a rural community pharmacy-based ear health service, LISTEN UP (Locally Integrated Screening and Testing Ear aNd aUral Program). The PRECEDE process involved an assessment of the predisposing, reinforcing and enabling constructs to support practice change through a scoping review, stakeholder surveys and interviews and consultation with governing bodies and regulatory authorities. The PROCEED segment structured the evaluation of the service pilot and informed planned implementation, process, impact and outcome evaluation. The pilot study conducted in February 2021 included 20 participants, with the most common ear complaints presented being pain, pressure or blockage. All these participants reported high levels of satisfaction with the service, would recommend the service to others and would attend the pharmacy first before seeing a GP for future ear complaints. The PRECEDE-PROCEED model provides a comprehensive model to guide the design of the LISTEN UP program, an innovative model, expanding services offered by rural community pharmacies, with preliminary results demonstrating high consumer satisfaction. Full article
(This article belongs to the Special Issue Rural Health Workforce (2nd Edition))
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Article
A Framework to Guide the Implementation of Best Practice Clinical Learning Environments in Community General Practice: Australia
Int. J. Environ. Res. Public Health 2021, 18(4), 1482; https://0-doi-org.brum.beds.ac.uk/10.3390/ijerph18041482 - 04 Feb 2021
Viewed by 891
Abstract
Clinical education/training is increasingly being expanded to community general practice settings (primary care clinics led by doctors). This plays an important role in developing a skilled “primary-care ready” workforce. However, there is limited information to guide the implementation of high-quality learning environments suitable [...] Read more.
Clinical education/training is increasingly being expanded to community general practice settings (primary care clinics led by doctors). This plays an important role in developing a skilled “primary-care ready” workforce. However, there is limited information to guide the implementation of high-quality learning environments suitable for the range of general practices and clinical learners they oversee. We aimed to develop a consensus-based framework to address this. A co-design participatory action research method involved working with stakeholders to agree a project plan, collect and interpret data and endorse a final framework. As a starting point, an initial draft framework was adapted from an existing framework, the Best Practice Clinical Learning Environment (BPCLE) Framework. We gathered feedback about this from a national GP Supervisor Liaison Officer Network (SLON) (experienced GP clinical supervisors) during a 90-minute face-to-face focus group. They rated their agreement with the relevance of objectives and elements, advising on clear terminology and rationale for including/excluding various components. The resulting framework was refined and re-tested with the SLON and wider GP educational stakeholders until a final graphically designed version was endorsed. The resulting “GP Clinical Learning Environment” (GPCLE) Framework is applicable for planning and benchmarking best practice learning environments in general practice. Full article
(This article belongs to the Special Issue Rural Health Workforce (2nd Edition))
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