https://www.rrh.org.au Rural and Remote Health is an open-access international academic journal serving rural and remote communities and publishing articles by rural health practitioners, educators, researchers and policy makers. en-gb Tue, 28 Jul 26 17:29:27 +0000 Papir Journal Platform melissa.storey@rrh.org.au (Melissa Storey) webmaster@commonline.com.au (Webmaster) https://www.rrh.org.au/images/rrh_og_branding.jpg https://www.rrh.org.au https://www.rrh.org.au/journal/article/10378 https://www.rrh.org.au/journal/article/10378 Aging is a complex process associated with the emergence of multiple comorbidities, which can significantly affect functionality, wellbeing, and self-esteem. Despite a range of barriers, Indigenous older adults living in Indigenous communities often maintain higher levels of physical activity through their traditional lifestyle practices compared with people in urban populations. Furthermore, Indigenous older adults hold a distinct and respected position within their communities, where their ancestral knowledge is highly valued, and their experiences serve as a vital resource for preserving traditions, culture, and communal practices. This Original Research study describes the functional capacity of Indigenous older adults in the Peruvian Amazon and analyzes the association between functional capacity and self-esteem in this population. Tue, 28 Jul 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10086 https://www.rrh.org.au/journal/article/10086 Healthcare organisations' engagement in research and investment in enhancing research culture has been linked to improved quality of care, including better patient outcomes and more effective care processes. However, engaging in research may be particularly challenging for rural health services because of a limited number of rural researchers, high workloads, lack of organisational support, and lack of targeted research grants and scholarships for rural researchers. Strategies identified to address some of the challenges to undertaking rural health service research include establishing dedicated research support roles within organisations, and fostering networks and collaborations to enhance research capacity. An additional yet underexplored component of these strategies is hosting student researchers in the health service setting. This Original Research study explores key motivations, barriers, enablers, benefits, and burdens of hosting student researchers from the perspective of rural health service staff, and uses these findings to inform the development of an implementation support tool to assist rural health services in becoming hosting organisations. Sun, 26 Jul 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10953 https://www.rrh.org.au/journal/article/10953 Health worker productivity is a core determinant of health system performance, especially in low- and middle-income countries where shortages of skilled professionals constrain service availability and quality. Efficient utilization of available working hours is particularly critical in rural and remote settings, where geographic isolation, limited resources, and staffing shortages intensify system pressures. This Original Research study reports on the results of a multi-site time-motion assessment in public and private hospitals, including rural hospitals, across Ethiopia. By quantifying productive and non-productive time and examining associated factors such as experience, training, supervision, and workload, this study provides context-specific insights crucial for informing workforce optimization in Ethiopia's rural health system. Fri, 24 Jul 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10652 https://www.rrh.org.au/journal/article/10652 Access to effective mental health care remains critically limited in low- and middle-income countries, particularly across Sub-Saharan Africa. The Friendship Bench, in which therapy sessions take place in an informal, confidential, and non-stigmatizing space - like a wooden bench - is a well-documented community-based innovation for delivering mental health care in resource-constrained settings. The Friendship Bench was piloted and adapted in rural parts of Zimbabwe and its success has prompted replication and adaptation across various African contexts, where lay health workers and peer counselors have been trained to provide mental health support in both clinical and community settings. This Review identifies and evaluates the implementation strategies, barriers, and facilitators associated with the Friendship Bench model across different African health systems and explores how practices consistent with person-centered care principles (respect, empathy, shared decision-making, tailoring, holistic support, and confidentiality) are described in Friendship Bench implementation studies. Thu, 23 Jul 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9948 https://www.rrh.org.au/journal/article/9948 Musculoskeletal system disorders are one of the leading occupational diseases, and these disorders are mostly observed in factory workers who are likely to do physical labor. The most common causes of these disorders are working with incorrect posture, lifting of heavy objects, and movements that require excessive strength and repetitive loading. Long working hours, insufficient rest hours, depression, and insomnia are among the risk factors that trigger these disorders in workers. This Original Research study evaluates posture disorders, physical activity level, pain, and body awareness in rural factory workers in three provinces of Türkiye. Wed, 22 Jul 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10326 https://www.rrh.org.au/journal/article/10326 Sustaining a multidisciplinary allied health workforce of adequate size and skills is a longstanding issue for rural and remote health services, and workforce distribution in Australia remains skewed towards metropolitan areas. Rural Generalist Training Positions (RGTPs) for allied health professions have been trialled in Queensland as a new strategy to improve recruitment, retention and workforce capacity. This Original Research article reports on the largest evaluation of RGTPs in the public sector to date and adds to the emerging body of literature on allied health early-career rural generalist workforce development. Tue, 21 Jul 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/11144 https://www.rrh.org.au/journal/article/11144 Clinical courage describes an integral part of rural clinical practice in which doctors work at the limits of their scope of practice to provide place-based medical care not routinely available in their specific rural context, based on sound clinical reasoning. However, deviations from conventional best practice that result from rural doctors' adaptive expertise can potentially be considered poor practice by the city-based professional establishment. To make the practice of clinical courage more explicit, this Commentary proposes the COURAgE mnemonic, which can act as a tool for discussing modifications to conventional care with rural patients, their families and members of the local rural healthcare team as well as with city-based specialist support services. Sun, 19 Jul 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9875 https://www.rrh.org.au/journal/article/9875 Strong family networks contribute to health, resilience and support for all people. Building strong emotional support systems and positive family relationships can promote collective healing from stressors that may influence negative dynamics, such as social, environmental and economic pressures. To ensure effectiveness and sustainability of programs promoting health and wellbeing, it is crucial that communities, governments and organisations demonstrate long-term commitment and cultural competency. This article reports on an outcome-based evaluation of the Moordidjabiny Moort (Stronger Families) program's approach to encourage funders to provide support for staff and programs that include Aboriginal participants in developing, implementing and evaluating activities tailored to their individual priorities/needs. Thu, 16 Jul 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9969 https://www.rrh.org.au/journal/article/9969 Health practitioners in many rural and remote communities experience inadequate timely professional support because of a shortage of on-site, experienced practitioners and geographic barriers. Research suggests that telehealth technologies can help less-experienced local staff, healthcare providers and patients in such areas access real-time, effective professional support and guidance from experts located elsewhere. This Original Research study evaluates the usability of augmented reality technology for telementorship between central medical specialists and rural junior doctors in Vietnam, assesses the perceived effectiveness of the mentoring relationship, and explores patient acceptability of AR technology during clinical consultations. Wed, 15 Jul 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10622 https://www.rrh.org.au/journal/article/10622 In Ghana, diabetes prevalence is estimated at 4-9% and, while diabetic patients possess knowledge about dietary recommendations, significant barriers prevent effective self-care implementation. Diabetes patients in the Wa Municipality have additional challenges because socioeconomic and dietary factors exacerbate these issues. This Original Research study assesses the dietary practices, food preferences, and nutrition-related determinants among type 2 diabetic patients in the Wa Municipality of Ghana. Mon, 13 Jul 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10453 https://www.rrh.org.au/journal/article/10453 Mapping the knowledge, perceptions, and existing practices regarding rabies is considered an important milestone in the control and prevention of the disease. Although the magnitude and distribution of rabies exposure in the Tigray region of Ethiopia is high, there has been no coordinated study on the community's knowledge, attitudes, and practices (KAP) concerning rabies in the Tigray Region. This Original Research study assessed the community's level of KAP towards rabies and retrospectively analyzes human and animal rabies exposure cases over the past 5 years in the project area. Fri, 10 Jul 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9807 https://www.rrh.org.au/journal/article/9807 Papua New Guinea (PNG) is the largest Pacific Island country, and the majority of its population lives in rural and remote areas. PNG's persistent low immunisation coverage of 39% among children between 12 and 23 months is the underlying cause of vaccine-preventable disease outbreaks. This Original Research study investigates the individual, interpersonal, organisational and sociocultural factors that influence the use of immunisation services for children under the age of five in PNG. Thu, 09 Jul 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10270 https://www.rrh.org.au/journal/article/10270 Despite being particularly vulnerable due to the wide range of stressors they experience, farmers face ongoing challenges in accessing timely, appropriate, and culturally responsive mental health care. Barriers to help-seeking include stoicism, self-reliance, stigma, limited mental health literacy, and structural constraints such as distance, cost, and long wait times. In response to these barriers, mental healthcare providers have adapted their services to respond to the unique needs and challenges associated with the agricultural lifestyle. This Original Research study explored the perspectives of mental healthcare providers who work with farmers to identify their strategies for fostering trust and therapeutic alliance. Mon, 06 Jul 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9972 https://www.rrh.org.au/journal/article/9972 Global population ageing has far-reaching implications, including for public health. Challenges like rising chronic disease burden, increasing disability, caregiving shortages and deficiencies in long-term care are particularly acute in rural and regional areas, where access to health care is constrained by workforce shortages, geographic isolation and socioeconomic disadvantage. Addressing these challenges using participatory co-design approaches that engage older adults in the development and evaluation of services is promising, but the evidence base underpinning such approaches in rural aged care contexts remains underdeveloped. This Scoping Review maps the existing literature on the care needs of community-dwelling older adults in rural areas. Wed, 01 Jul 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10380 https://www.rrh.org.au/journal/article/10380 Non-communicable diseases (NCDs) are the leading causes of morbidity and premature mortality in Jamaica. NCD risk in the Caribbean is shaped by the interaction of socioeconomic constraints, environmental exposures, and health system limitations, some of which disproportionately affect rural residents, who face barriers to healthcare access that include limited diagnostic infrastructure and fragmented continuity of care. This Original Research study examined the prevalence and determinants of hypertension, diabetes, and obesity among rural adults in Jamaica using data from the Jamaica Health and Lifestyle Survey III. Mon, 29 Jun 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10085 https://www.rrh.org.au/journal/article/10085 Rural Australians continue to experience significant mental health challenges, including higher suicide rates and poorer mental health outcomes, compared with their urban counterparts. Accessibility barriers, specifically relating to service availability, have been well documented in rural areas, but further research is required to better understand the unique internal barriers - such as high rates of stigma, lower mental health literacy, and stoicism - faced by rural people across Australia. This Original Research study investigates the differences between rural and urban populations in internal barriers to help seeking and mental health outcomes, and identifies the unique challenges of rural mental health. Sat, 27 Jun 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10095 https://www.rrh.org.au/journal/article/10095 Nearly 21,000 deaths and 7.6% of the Australian disease and injury burden are attributable to tobacco use each year, with harms disproportionately impacting groups experiencing disadvantage and marginalisation. In Australia and globally, tobacco retailers are disproportionately concentrated in areas with greater disadvantage, and high tobacco retailer density is associated with higher smoking prevalence and lower smoking cessation success. This Original Research study maps the locations of tobacco retail licences in the Northern Territory, which has the highest smoking prevalence in Australia, and investigates associations between tobacco retailers, area remoteness and area-level socio-economic status. Thu, 25 Jun 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/10301 https://www.rrh.org.au/journal/article/10301 Traditional healthcare delivery models have proven inadequate in addressing the multifaceted challenges faced by rural communities (geographical isolation, inadequate health infrastructure, and a shortage of qualified healthcare professionals), necessitating innovative approaches that leverage technological advancements. The emergence of telehealth and artificial intelligence (AI) presents unprecedented opportunities to revolutionize healthcare delivery in underserved rural communities, but the integration of these technologies introduces complex legal, ethical, and regulatory considerations that must be carefully addressed. This Review provides novel insights by synthesizing multidisciplinary perspectives on technology integration, regulatory requirements, and implementation strategies across diverse global contexts. Wed, 24 Jun 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9926 https://www.rrh.org.au/journal/article/9926 In Australia, as globally, rural regions consistently struggle with severe health workforce shortages, exposing rural health professionals to the risk of professional isolation, increased stress and burnout. In addition, they have reduced access to continuing professional development, which is crucial for health professionals because it helps maintain and enhance professional knowledge, expertise and competence, and serves as an essential pathway to develop required personal and professional qualities. This Original Research study investigates rural health professionals' usage patterns and experiences with a digital support platform that offers news, resources, discussions, jobs and training. Mon, 22 Jun 26 00:00:00 +0000 https://www.rrh.org.au/journal/article/9893 https://www.rrh.org.au/journal/article/9893 Substantial international evidence supports the role of the arts in promoting health and wellbeing. This Original Research article reports on the health, behavioural and economic outcomes associated with participation in the Pinnaroo Project, which aimed to improve the health and wellbeing of Pinnaroo, South Australia, residents through sustained, community-led engagement in a diverse range of arts and creative activities. Fri, 19 Jun 26 00:00:00 +0000