Betts Juliana M, Gooey Michelle, Chung Alex, Craig Heather, Bergmeier Heidi, Amirtharajah Caroline, Peacock Bernie, Ping Sophie, Rix Kylie, Veal Stephanie, Skouteris Helen
Health and Social Care Unit, School of Public Health and Preventive Medicine, Monash University and Monash Health, Melbourne, Victoria, Australia.
Grampians Health, Ballarat, Victoria, Australia.
Aust J Rural Health. 2025 Feb;33(1):e13208. doi: 10.1111/ajr.13208.
Rates of childhood obesity have increased in regional and rural areas in Australia over the past two decades.
To review the current literature to gain an understanding of (i) ways to improve access to primary health care in the first 2000 days, (ii) models of care for delivering healthy lifestyle advice in the first 2000 days and (iii) the development of partnerships between health and social care services in the first 2000 days in rural and regional settings.
Three literature reviews were undertaken. Results were limited to published, peer-reviewed literature from the past 5 years (2017-2022).
Access to care could be improved through the expansion of telemedicine, nurse roles and community health worker models. A range of organisational and leadership factors facilitated the integration of health and social care services in the first 2000 days in rural areas with evidence of resultant positive health impacts.
Telemedicine, the expansion of nursing roles and the implementation of a formalised community health worker model, may serve to improve access to primary health care for families in the first 2000 days; however, further research on particular models of care for delivering healthy lifestyle advice to rural and regional families is required.
Policy-makers should consider the interdependent nature of increasing access to care, establishing best practice models of care and strengthening local partnerships to prevent and manage childhood obesity in the first 2000 days in rural and regional areas.
在过去二十年中,澳大利亚农村和偏远地区儿童肥胖率有所上升。
回顾当前文献,以了解(i)在生命最初2000天改善初级卫生保健可及性的方法;(ii)在生命最初2000天提供健康生活方式建议的护理模式;(iii)农村和偏远地区在生命最初2000天卫生与社会护理服务之间伙伴关系的发展情况。
进行了三项文献综述。结果仅限于过去五年(2017 - 2022年)发表的、经过同行评审的文献。
通过扩大远程医疗、护士角色和社区卫生工作者模式,可以改善医疗服务的可及性。一系列组织和领导因素促进了农村地区生命最初2000天卫生与社会护理服务的整合,并有证据表明对健康产生了积极影响。
远程医疗、护士角色的扩大以及正式社区卫生工作者模式的实施,可能有助于改善家庭在生命最初2000天获得初级卫生保健的机会;然而,需要对向农村和偏远地区家庭提供健康生活方式建议的特定护理模式进行进一步研究。
政策制定者应考虑在农村和偏远地区生命最初2000天增加医疗服务可及性、建立最佳护理实践模式以及加强地方伙伴关系以预防和管理儿童肥胖的相互依存性质。