An evaluation of the use of short message service during an avian influenza outbreak on a poultry farm in Young.

In 2013 an avian influenza outbreak occurred in a large poultry farm in Young (approximately 2 hours north-west of Canberra.) The responsible strain was H7N2, which is highly pathogenic and can affect humans. Daily surveillance was required for those individuals who were possibly exposed. This was conducted through the use of daily message through the short message service (SMS). A total of 55 people were identified as having had high risk exposure and requiring monitoring during the surveillance period from 16 to 25 October 2013. A SMS message was sent daily to each contact within 2 groups. (Group 1 were contacts who agreed to take Tamiflu prophylaxis, and Group 2 were contacts who were under surveillance but declined Tamiflu prophylaxis). The average daily response rate for SMS was 66% (median 75%) over a 9 day period. Of those who nominated to receive the daily SMS 98% confirmed they'd received the SMS and it reminded them to take their Tamiflu medication. The public health unit (PHU) team found the use of SMS to be less time consuming than conducting telephone follow-up interviews. The PHU team believed that the use of the technology decreased the likelihood of additional staff being required to assist in the outbreak. Utilising SMS was a new initiative for the PHU and staff found it overall easy to use. These findings confirm there can be significant benefits to using SMS during a large surveillance activity. The application of SMS during this outbreak was estimated at 2.5 times more cost effective that telephone follow-ups and would substantially reduce staffing costs further in the event of a very large outbreak.

Applying process mapping and analysis as a quality improvement strategy to increase the adoption of fruit, vegetable, and water breaks in Australian primary schools.

Over the past decade, public health policy in Australia has prioritized the prevention and control of obesity and invested in programs that promote healthy eating-related behaviors, which includes increasing fruit and vegetable consumption in children. This article reports on a study that used process mapping and analysis as a quality improvement strategy to improve the delivery of a nutrition primary prevention program delivered in primary schools in New South Wales, Australia. Crunch&Sip® has been delivered since 2008. To date, adoption is low with only 25% of schools implementing the program. We investigated the cause of low adoption and propose actions to increase school participation. We conducted semistructured interviews with key stakeholders and analyzed the process of delivering Crunch&Sip to schools. Interviews and process mapping and analysis identified a number of barriers to schools adopting the program. The analyses identified the need to simplify and streamline the process of delivering the program to schools and introduce monitoring and feedback loops to track ongoing participation. The combination of stakeholder interviews and process mapping and analysis provided important practical solutions to improving program delivery and also contributed to building an understanding of factors that help and hinder program adoption. The insight provided by this analysis helped identify usable routine measures of adoption, which were an improvement over those used in the existing program plan. This study contributed toward improving the quality and efficiency of delivering a health promoting program to work toward achieving healthy eating behaviors in children.

Developing a strategy to promote the generation and effective use of population health research for NSW Health: 2011-2015.

The Population Health Division of the NSW Department of Health has developed a 5-year strategy to improve the effectiveness of its resource investment in population health research. This paper describes the development of the strategy, Promoting the generation and effective use of population health research in NSW: a Strategy for NSW Health 2011-2015. A review of Australian and international strategic research documents and stakeholder interviews was conducted to support the development of the strategy. The findings from these two processes influenced the structure of the document and supported the inclusion of strategies and actions to assist with identifying research priorities, improving communication, enhancing networks and partnerships, supporting workforce development initiatives, providing research infrastructure, enhancing research and the use of research evidence and streamlining research governance and ethics processes. Small group discussions and a detailed review of literature were conducted to refine the thinking around four of the more complex aspects of the strategy. Finally, a broad consultation process was used to test the face validity of the proposed strategy content.