Teen Clinic - An integrated primary healthcare model that improves access for young people in rural communities.

BACKGROUND: Young people in rural Australia have limited access to health care and are at increased risk of poor health outcomes. The Teen Clinic model was developed to increase access to health care for young people, particularly school-aged young people (12-18 years) living in small rural towns (<5000 people). OBJECTIVES: To determine the extent the Teen Clinic model meets its accessibility objective and to determine the barriers and enablers to sustainable delivery of the Teen Clinic service. DESIGN: A multimethod case study approach was used to assess access (multidimensional framework for patient-centred access) and determine the barriers and enablers to sustainable delivery. Data collection included a survey of young people in the included rural communities and key stakeholder interviews. FINDINGS: The survey of young people indicated Teen Clinic model was accessible across multiple dimensions. From a practice perspective, accessibility was achieved by varying from usual care to a nurse-led, young person-centred drop-in model. This required skilled nurses working at the top of their scope; however, unpredictable demand and patient complexity made accounting for the time and therefore funding somewhat complex. DISCUSSION: The Teen Clinic model meets its objective of increasing healthcare access for young rural people. Relational and cultural factors were more important facilitators of practice integration than organisational processes. A key challenge to the ongoing provision of Teen Clinic was dedicated sustainable funding. CONCLUSION: Teen Clinic is an integrated primary healthcare model that increases access for young people in small rural communities. Sustainable implementation would benefit from dedicated funding.

A mixed-methods feasibility study of routinely weighing patients in general practice to aid weight management.

BACKGROUND: The optimal role of general practice in population weight management remains unclear. The aim of this mixed-methods study was to test the feasibility of routinely weighing all adult patients attending their general practice as an intervention to aid weight management in clinical practice. METHODS: Consenting patients in six general practices were weighed at each presentation over a 12-month period. Data were analysed using linear mixed growth models. Participants' interviews at the completion of the study were thematically analysed. RESULTS: The overall weight loss in patients who completed the study (n = 217) was 0.51 kg (P = 0.26; not significant); in patients who were obese (n = 106) there was a greater weight loss of 1.79 kg (P = 0.04). Patients were receptive to the intervention; however, there was disruption to clinical workflow. DISCUSSION: Routinely weighing adult patients in general practice is feasible, requires resources and may be associated with weight loss in patients who are obese. Further research is required to inform support for implementation within practices.