Acute respiratory infection symptoms and COVID-19 testing behaviour: results based on South Australian health surveys.

BACKGROUND: Effective syndromic surveillance alongside COVID-19 testing behaviours in the population including in higher risk and hard to reach subgroups is vital to detect re-emergence of COVID-19 transmission in the community. The aim of this paper was to identify the prevalence of acute respiratory infection symptoms and coronavirus testing behaviour among South Australians using data from a population based survey. METHODS: We used cross-sectional data from the 2020 state-wide population level health survey on 6857 respondents aged 18 years and above. Descriptive statistics were used to explore the risk factors and multivariable logistic regression models were used to assess the factors associated with the acute respiratory infection symptoms and coronavirus testing behaviour after adjusting for gender, age, household size, household income, Aboriginal and/or Torres Strait Islander status, SEIFA, Country of birth, number of chronic diseases, wellbeing, psychological distress, and mental health. RESULTS: We found that 19.3% of respondents reported having symptoms of acute respiratory infection and the most commonly reported symptoms were a runny nose (11.2%), coughing (9.9%) and sore throat (6.2%). Fever and cough were reported by 0.8% of participants. Of the symptomatic respondents, 32.6% reported seeking health advice from a nurse, doctor or healthcare provider. Around 18% (n = 130) of symptomatic respondents had sought testing and a further 4.3% (n = 31) reported they intended to get tested. The regression results suggest that older age, larger household size, a higher number of chronic disease, mental health condition, poor wellbeing, and psychological distress were associated with higher odds of ARI symptoms. Higher household income was associated with lower odds of being tested or intending to be tested for coronavirus after adjusting for other explanatory variables. CONCLUSIONS: There were relatively high rates of self-reported acute respiratory infection during a period of very low COVID-19 prevalence and low rate of coronavirus testing among symptomatic respondents. Ongoing monitoring of testing uptake, including in higher-risk groups, and possible interventions to improve testing uptake is key to early detection of disease.

Modelling Medications for Public Health Research.

Most patients with chronic disease are prescribed multiple medications, which are recorded in their personal health records. This is rich information for clinical public health researchers but also a challenge to analyse. This paper describes the method that was undertaken within the Public Health Research Data Management System (PHReDMS) to map medication data retrieved from individual patient health records for population health researcher's use. The PHReDMS manages clinical, health service, community and survey research data within a secure web environment that allows for data sharing amongst researchers. The PHReDMS is currently used by researchers to answer a broad range of questions, including monitoring of prescription patterns in different population groups and geographic areas with high incidence/prevalence of chronic renal, cardiovascular, metabolic and mental health issues. In this paper, we present the general notion of abstraction network, a higher level network that sits above a terminology and offers compact and more easily understandable view of its content. We demonstrate the utilisation of abstraction network methodology to examine medication data from electronic medical records to allow a compact and more easily understandable view of its content.

Managing Aboriginal and Torres Strait Islander Data for Public Health Research.

Good quality data on Aboriginal and Torres Strait Islander peoples are needed to assess the effectiveness of programs and interventions, and to evaluate policies that are designed to improve the status of, and service delivery to, Aboriginal and Torres Strait Islander peoples. Due to the lack of longitudinal data it is difficult to gain knowledge on the specific causes or consequences of changes in indigenous outcomes. Variables such as name, date of birth and address for Aboriginal and Torres Strait Islanders may be subject to more variation and be less consistently reported than other Australians. Improving the collection and management of key identifying variables for Aboriginal and Torres Strait Islanders are key to providing more quality information on this population group.

Does an early childhood intervention affect cardiometabolic risk in adulthood? Evidence from a longitudinal study of preschool attendance in South Australia.

OBJECTIVES: There is an expectation that a positive social, cognitive and behavioural trajectory from early childhood developmental interventions will lead to improved population health and reduced health inequalities. However, there is limited direct evidence for this. The aim of this study was to assess the effect of participation in the South Australian Kindergarten Union preschool programme on adult cardiovascular biomedical risk factors. Kindergarten Union preschools delivered high-quality, comprehensive services to children aged 2-4 years and their families, including education, parenting and health services. STUDY DESIGN: Retrospective population-based cohort study. METHODS: The effect of attendance at a Kindergarten Union preschool on a range of cardiometabolic risk factors was assessed using data from the North West Adelaide Health Study 1999-2007. The study sample was taken from participants in the 2007 survey (n = 1064, 44.8% attended preschool) who lived in South Australia as children and were born during the years 1937-1969. RESULTS: Preschool attendance had a beneficial effect on hypertension in adulthood [prevalence ratio 0.82, 95% confidence interval (CI) 0.69-0.97] and an indication of benefit on hypercholesterolaemia (prevalence ratio 0.86, 95% CI 0.71-1.05), but had no effect on dyslipidaemia, central obesity, high fasting blood glucose or metabolic syndrome. CONCLUSIONS: This study found that preschool attendance was associated with reduced risk of hypertension in adulthood, but no effect was seen for the other cardiometabolic factors. These findings may reflect differing causal pathways and trajectories of these risk factors from childhood to adulthood, but confirmation from other studies is required.

Can attending preschool reduce the risk of tobacco smoking in adulthood? The effects of Kindergarten Union participation in South Australia.

BACKGROUND: Innovative strategies beyond the health system are required to reduce the prevalence of smoking. Early child development interventions are examples of interventions that can help set children on positive social and educational trajectories, which in turn may also reduce the prevalence of smoking. The aim of this study was to examine the effect of attendance at Kindergarten Union preschools on tobacco smoking in adulthood. METHODS: Kindergarten Union preschools delivered comprehensive services to children and their families, including education, parenting and health services, with a number of features consistent with contemporary ideas of high-quality service delivery. Using a retrospective cohort design with data from the North West Adelaide Health Study, this study examined different aspects of smoking behaviour in adults aged 34-67 years who attended a Kindergarten Union preschool at some stage between 1940 and 1972. Data were analysed using generalised linear model poisson regression with robust variance estimates, adjusting for both child and adult socio-economic factors and history of parental smoking. RESULTS: People who attended preschool had a reduced risk of ever smoking (prevalence ratio 0.87, 95% CI 0.77 to 0.98) and a reduced risk of current smoking in adulthood (prevalence ratio 0.77 (95% CI 0.59 to 1.00)), compared with those who did not attend preschool. There was no effect of preschool attendance on age at smoking uptake, age at quitting or the probability of quitting smoking. CONCLUSION: Attendance at the high-quality Kindergarten Union preschools was associated with a reduction in the initial uptake of smoking and thus the probability of being a current smoker. Among their other potential social benefits, high-quality, universal preschool programmes have the potential to help reduce smoking prevalence across the population.

Does attendance at preschool affect adult health? A systematic review.

BACKGROUND: Early child development interventions can set children on positive social and educational trajectories. The aim of this review was to examine the evidence for the adult health impacts of centre-based preschool interventions for preschoolers. METHODS: Medline, Embase, ERIC, Psych Info, Sociological Abstracts, the Cochrane Library, C2-SPECTR and the Head Start database were searched (1980-2008), and reference lists were searched for articles missed by the electronic search. RESULTS: The 12 eligible articles reviewed reported multi-faceted interventions and involved disadvantaged populations in all but one study. Limitations included a restricted range of health outcomes, reliance on self-report measures (11 studies), small sample sizes (nine studies with <100 in each arm) and a relatively young adult age at follow-up. There were positive intervention effects across the majority of behavioural outcomes, and a suggestion of a reduction in symptoms of depression. Non-communicable disease outcomes (e.g. diabetes mellitus) tended to have adverse or near-zero effect estimates. CONCLUSIONS: The reviewed articles provide some support for the role of early childhood interventions to improve health behaviours but not chronic disease outcomes. Population health researchers should become more involved in the evaluation of preschool interventions as there is great potential for broad population health benefit.