Department of Rural Health, University of Melbourne, Docker Street, Wangaratta, VIC, Australia.
Department of Rural Health, University of Melbourne, 49 Graham Street, Shepparton, VIC, Australia.
BMC Public Health. 2018 May 30;18(1):670. doi: 10.1186/s12889-018-5511-9.
High quality, contemporary data regarding patterns of chronic disease is essential for planning by health services, policy makers and local governments, but surprisingly scarce, including in rural Australia. This dearth of data occurs despite the recognition that rural Australians live with high rates of ill health, poor health behaviours and restricted access to health services. Crossroads-II is set in the Goulburn Valley, a rural region of Victoria, Australia 100-300 km north of metropolitan Melbourne. It is primarily an irrigated agricultural area. The aim of the study is to identify changes in the prevalence of key chronic health conditions including the extent of undiagnosed and undermanaged disease, and association with access to care, over a 15 year period.
METHODS/DESIGN: This study is a 15 year follow up from the 2000-2003 Crossroads-I study (2376 households participated). Crossroads-II includes a similar face to face household survey of 3600 randomly selected households across four towns of sizes 6300 to 49,800 (50% sampled in the larger town with the remainder sampled equally from the three smaller towns). Self-reported health, health behaviour and health service usage information is verified and supplemented in a nested sub-study of 900 randomly selected adult participants in 'clinics' involving a range of additional questionnaires and biophysical measurements. The study is expected to run from October 2016 to December 2018.
Besides providing epidemiological and health service utilisation information relating to different diseases and their risk factors in towns of different sizes, the results will be used to develop a composite measure of health service access. The importance of access to health services will be investigated by assessing the correlation of this measure with rates of undiagnosed and undermanaged disease at the mesh block level. Results will be shared with partner organisations to inform service planning and interventions to improve health outcomes for local people.
对于卫生服务、政策制定者和地方政府而言，规划需要高质量的、具有当代性的慢性病模式相关数据，但令人惊讶的是，此类数据在澳大利亚农村地区十分匮乏。尽管澳大利亚农村居民的健康状况不佳、健康行为不佳且获得卫生服务的机会有限已得到认可，但这方面的数据仍然非常缺乏。Crossroads-II 研究位于澳大利亚维多利亚州的古尔本市，距离墨尔本市区北部 100-300 公里，是一个农村地区。该地区主要是一个灌溉农业区。本研究旨在确定 15 年来包括未确诊和管理不善疾病程度在内的主要慢性健康状况的流行率变化，并探讨其与获得医疗服务的关联。
方法/设计：这是一项为期 15 年的后续研究，对 2000-2003 年的 Crossroads-I 研究（2376 户家庭参与）进行了跟踪调查。Crossroads-II 包括对四个城镇的 3600 户家庭进行类似的面对面家庭调查（较大的城镇抽取 50%的样本，其余三个较小的城镇各抽取 25%）。通过在 900 名随机选择的成年参与者的“诊所”中进行嵌套子研究，对自我报告的健康、健康行为和卫生服务使用信息进行验证和补充，其中涉及一系列额外的问卷和生物物理测量。预计该研究将于 2016 年 10 月至 2018 年 12 月进行。
除了提供不同大小城镇中不同疾病及其风险因素的流行病学和卫生服务利用信息外，研究结果还将用于开发卫生服务获取的综合衡量标准。通过评估该衡量标准与网格块水平上未确诊和管理不善疾病的发生率之间的相关性，来研究获取卫生服务的重要性。研究结果将与合作伙伴组织共享，以为当地居民的服务规划和干预措施提供信息，以改善健康结果。
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