Remote Australia Online

This chapter reports on the continued exploration of the capacity of existing data sources to describe the economies of three groups of remote Aboriginal settlements in the Northern Territory (NT). The purpose is to contribute research that supports better place-based policy fit with remote settlements to augment opportunities for social and economic benefit. Understanding how the non-market (governments, philanthropic foundations and/or charities) might better amplify local, open and competitive market capacities requires rethinking fundamental constraints applied to the interpretation of national data. This includes an acceptance that remoteness has many facets and remains difficult to describe using existing economic and population data sets.

Aims To describe the population distribution and socio-economic position of residents across all states and territories of Australia, stratified using the 7 Modified Monash Model classifications. The numerical summary, and the methods described, can be applied by a variety of end users including workforce planners, researchers, policy-makers and funding bodies for guiding future investment under different scenarios, and aid in evaluating geographically focused programs. Context The Commonwealth Department of Health is transitioning to the Modified Monash Model to objectively describe geographical access. This change applies to the Rural Health Multidisciplinary Training Program, one of the Australian Government's key policies to address the maldistribution of the rural health workforce. Unlike the previously applied Australian Statistical Geography Standard-Remoteness Areas, a summary of the population in each Modified Monash Model classification is not available, nor is a socio-economic overview of the communities within these areas. Approach Spatial analysis of Australian Bureau of Statistics data (Modified Monash Model, population data and the Index of Relative Socio-economic Advantage and Disadvantage collected or derived from the 2016 census) at the Statistical Area 1 - the smallest unit for the release of census data. Conclusion Linking the Modified Monash Model, a socio-economic index and granular population data at the national level highlights the disadvantage of many residents in small rural towns (Modified Monash 5). The Modified Monash Model does not exhibit a continuum of the largest population residing in the most accessible classification and the smallest population residing in the least accessible classification that is seen in the Australian Statistical Geography Standard-Remoteness Areas. Coupled with policy relevance, the advantage of using the Modified Monash Model as the basis for analysis is that it highlights areas that have both a critical mass of residents and differing levels of socio-economic advantage and disadvantage. This will help end users to target funding to those regions where there is potential to improve access to services for the greatest number of rural residents.

This paper offers a narrative review of existing academic and grey literature on the roles of Australian First Nations' Knowledges and the arts in regional and remote development. We do so to examine the degree to which current mainstream approaches to development are actualising international calls for “inclusive” development that accentuate “Indigenous” local and knowledges and strengths. The paper discusses existing regional and remote development literature through a lens of holistic, strength-based, and inclusive development. This incorporates many forms of valuing and developing including: cultural, social, environmental, and economic forms of value and activity. We conclude by offering recommendations for future research, policy, and practice that can draw on the strengths of First Nations’ Knowledges and the arts to achieve inclusive and holistic development.

There is limited qualitative research specifically exploring the experiences of young people living with cancer in nonmetropolitan Australia. This article reports on an in-depth qualitative study exploring young people?s experiences of diagnosis, treatment, and postcancer care and support, focusing on the impact of living in regional and remote Queensland, Australia. Thematically coded data from in-depth interviews were managed using NVivo 12 qualitative software. Connections with place, knowledge, people, support, lifestyle, and peers were key themes. Travelling for treatment interrupted these connections, with participants desiring treatment closer to home. Preventive social work in metropolitan and nonmetropolitan areas that supports maintaining connections for young patients from regional and remote areas is recommended. Further research, including the impact on young Aboriginal and Torres Strait Islander people with cancer and on the role of social workers, will inform improvements in social work practice.IMPLICATIONS Recognising the importance of connections for young people living with cancer from regional and remote areas can inform social work psychosocial assessments in metropolitan and nonmetropolitan settings, assisting social workers to respond appropriately to information young people share and supporting these valued connections.Enhancing preventive social work care with young people living with cancer from regional and remote areas will involve direct, regular communication at diagnosis and during and after cancer treatment using appropriate age-specific interventions.

Sex workers experience risk and protective factors that affect their psychological well-being, yet little is known about sex workers? mental health and their experiences with related services in rural and remote Tasmania, Australia. Semi-structured interviews were conducted with six current or former sex workers with pre-existing mental health problems, and thematic analysis was used to identify their experiences with mental health and related care. Generally, sex work does not contribute to participants? mental health concerns; rather, social exclusion and systemic issues cause psychological harm. Ineffective mental health professionals and the lack of tailored or culturally competent support serve as barriers to care. Significantly, widespread stigma was both a risk factor to participants? mental health and a barrier to help seeking and resulted in isolation and identity concealment. Resilience, self-awareness and social inclusion reduce the psychological impact of exogenous oppression and encourage help seeking. The decriminalisation of sex work could improve sex worker mental health and reduce stigma by normalising sex work.

Background The oral rotavirus vaccine, Rotarix (GlaxoSmithKline), is licensed for use in infants as two doses in the first six months of life. For infants living in settings with high child-mortality, and also for rural and remote Australian Aboriginal infants, clinical protection conferred by two doses of Rotarix appears to be reduced. We assessed the effect of an additional dose of Rotarix on vaccine immune responses among Aboriginal children who are 6 to < 12 months old. Methods ORVAC is a two-stage, double-blind, randomised, placebo-controlled trial conducted across regional urban and remote locations of Australia’s Northern Territory. Aboriginal children 6 to < 12 months old who had received one or two prior doses of Rotarix were randomised 1:1 to receive an additional dose of Rotarix or matched placebo. The primary immunological endpoint was seroresponse defined as an anti-rotavirus IgA level ≥ 20 AU/mL, approximately one month following Rotarix or placebo. ClinicalTrials.gov (NCT02941107). Findings Between March 2018 and August 2020, 253 infants were enrolled. Of these, 178 infants (70%) had analysable serological results after follow-up; 89 randomised to Rotarix and 89 to placebo. The proportion with a seroresponse was 85% after Rotarix compared to 71% after placebo; the probability of a higher rate of seroresponse in the Rotarix than the placebo arm was 99%. There were no occurrences of intussusception or any serious adverse events attributed to Rotarix or placebo in the 28 days following the additional dose of Rotarix or placebo. Interpretation An additional dose of Rotarix among Australian Aboriginal infants 6 to < 12 months old increased the proportion with a vaccine seroresponse. If it can be proven that this translates into better protection against disease, scheduling an additional dose may be a viable strategy for further reducing the global burden of rotavirus disease. Funding NHMRC (GNT1086952). Evidence before this study Rotavirus vaccine programs have reduced the global burden of gastroenteritis disease among young children, but rotavirus still causes > 200,000 child deaths each year. A recent systematic review in the Lancet Global Health found that the effectiveness of oral rotavirus vaccines is variable, from 45 – 58% in settings with high child mortality to 83%-85% in settings with low child mortality. In high child mortality settings there is also evidence of waning effectiveness after 12 months old. Reduced vaccine effectiveness has also been reported among Australian Aboriginal children. Previous trials have failed to demonstrate improved rotavirus vaccine effectiveness with strategies such as withholding breastfeeding, or co-administering vaccines with probiotics or zinc. Pre-licensure studies of Rotarix in Africa did not clearly indicate whether a three-dose Rotarix schedule had benefit over a two-dose schedule, although all vaccine doses were given before infants were six months old when maternal antibodies may impede vaccine responses. Trials in Bangladesh and Mali found that a third Rotarix dose given after 6 months old improved the immune response to vaccine.Added value of this study In the first stage of our novel two-stage randomised clinical trial, we showed that scheduling an additional Rotarix dose for remote Australian Aboriginal infants after 6 months old increased the proportion with evidence of vaccine seroresponse.Implications of all the available evidence Scheduling an additional dose of Rotarix after 6 months old is feasible, and trials in three settings have now demonstrated that it improves immune responses. Trials should now be conducted in a number of high burden settings to determine whether this strategy results in improved clinical protection against severe gastroenteritis.

The 2019 monsoon trough event exposed both strengths and weaknesses in the resilience of the Gulf Savannah region, its communities, its businesses, its families, and its people. A key factor influencing the region’s response and recovery to the disaster relates to digital connectivity. This includes the capacity of people in the region to take advantage of existing telecommunications services, and the strength and resilience of mobile and broadband infrastructure itself. In a cohesive and resilient response, this project has supported the Gulf Savannah to bring together property owners, councils, communities, development organisations, businesses owners, technical experts, and telecommunications service providers to collaboratively identify and define mobile and broadband challenges during the 2019 event and the recovery phase. Funded under the Queensland Governments’ FNQ and NQ Monsoon Trough (Category C Flexible Funding) Grants Program, the aim of the project has been to develop legitimate, practical, and affordable options for individuals, businesses, and organisations to get connected, and pathways to developing greater digital capability to respond to challenges and to capitalise on opportunities in the future. Taken together, the qualitative and quantitative research identified and grouped types of needs (at individual, family, and community level) and responses (ranging from quick wins to long-term propositions) for consideration in proposing solutions. A comprehensive assessment of the needs and responses can be found in the Needs Analysis and Technical Audit reports that accompany this strategy document. Within this document, Section 5 outlines overall priority areas for solutions and opportunities for digital connectivity in the Gulf Savannah that cut across geographies and sectors. Then, Section 6 proposes a suite of 10 solutions which inform place-based connectivity packages.

Background As part of significant mental health reform, the Community Mental Health Rehabilitation Service (CMHRS) was implemented in rural South Australia. The CMHRS is a 10-bed mental health residential program offering rehabilitative mental health support to rural residents. Aim To analyse the CMHRS service delivery model and its impact on recovery outcomes for consumers. Methods A mixed method, realist evaluation approach was utilised. A purposive sample of CMHRS staff (n = 6) and consumers (n = 8) were recruited. Consumer recovery was measured using the RAS-DS (on admission and discharge). Participants’ perspectives of the service were gained via one staff focus group (n = 6) and individual semi-structured interviews (consumers n = 6; staff n = 2). Pre-post RAS-DS scores were analysed using paired t-tests/Wilcoxon paired-signed rank test, with qualitative data analysed thematically. Results Significant positive increases in RAS-DS total scores were observed at discharge, supported by the qualitative themes of (re)building relationships and social connections and recovering health and wellbeing. Contextual factors (e.g. staffing) and program mechanisms (e.g. scheduling) impacting on service implementation were identified. Conclusion Maintaining a rehabilitation recovery-focused approach, balanced with an appropriately trained multi-disciplinary team, are vital for maximising positive consumer outcomes. Significance This realist evaluation identifies critical factors impacting rural mental health rehabilitation service delivery.

For Indigenous housing to be sustainable, it should be safe and humane. It should support householders to enact healthy living practices and secure their wellbeing and be provided in the places Indigenous people prefer to live to meet different needs and purposes. • This requires a life-cycle approach to housing management, with appropriate levels of funding for planned and responsive repair and maintenance systems that attend to the functionality, quality and serviceability of a building, ensure safety, comply with statutory obligations, prioritise health hardware function, and protect householders from climate risks. • Repair and maintenance activities are an inevitable cost in the life cycle of a dwelling. Construction defects, wear and tear, ageing and environmental factors impact on building components. Planned maintenance programs are important for sustaining higher levels of house function across time. • Indigenous regional and remote communities will experience the negative impacts of climate change earlier and disproportionately, compared with most urban Australian settings. Funding for housing supply, design and maintenance must reflect this distribution of risk and higher cost. • Modelled in terms of various climate, occupancy, ventilation and other scenarios, the thermal performance of existing and improved Indigenous housing currently fails to ensure the health, safety and comfort of householders. • Addressing climate change in Indigenous housing and health policy is an urgent priority.

Sexually transmissible infections (STIs), such as gonorrhoea and chlamydia, are highly prevalent, particularly in remote Aboriginal and Torres Strait Islander communities in Australia. In these settings, due to distance to centralised laboratories, the return of laboratory test results can take a week or longer, and many young people do not receive treatment, or it is considerably delayed. Point-of-care testing (POCT) provides an opportunity for same day diagnosis and treatment. Molecular POC testing for STIs was available at 31 regional or remote primary health care clinic sites through the Test-Treat-And-GO (TANGO2) program. This qualitative study sought to identify barriers and facilitators to further scaling up STI POCT in remote Aboriginal communities within Australia.

This chapter will explore the case of one such company seeking to operate in the Northern Territory (NT) of Australia, which, for ethical reasons I will refer to as ‘Top End Mining’, as they are still seeking approval to develop a mine. I argue that a focus on junior miners provides an important (and largely overlooked) window into the strategic presence and absence of the state in resource extraction contexts, and helps to reveal the structural factors that shape the relationship between miners and Indigenous communities. In this chapter, I set out to achieve three things. In the first part of the chapter, I provide an overview of this particular mining project, and the key features of junior miners, addressing a gap in anthropology of mining literature (see Bainton 2020). I then consider the regulatory limitations within the environmental and social impact assessment processes in the NT, in comparison with other Australian jurisdictions, and the way that junior mining companies have been able to take advantage of this ‘absence’ to the detriment of Aboriginal communities in mine-affected areas. This provides the basis to consider the disconnection between this impact assessment process and the agreement- making process for which provision is made under the Aboriginal Land Rights (Northern Territory) Act 1976 (Cth) and subsequent native title legislation. This disconnection is by no means unique to the NT; it is also found in other parts of Australia, and in Papua New Guinea.

Despite prosperity in Australia, a high proportion of Aboriginal and Torres Strait Islander (Indigenous) people in rural and remote (regional) communities across the nation continue to live in poverty. Regardless, in 2021 the Senate Standing Committee on Foreign Affairs, Defence and Trade launched an inquiry into regional architecture with a view to progress Australia’s international standing and business dealings in the Indo-Pacific region. The author submitted a response to this inquiry, arguing that the majority of regional infrastructure investment must be, first and foremost, for the wellbeing of Indigenous Australians, who are also known as First Australians. This paper explores the critical need for regional infrastructure to close the gap in economic inequality between Indigenous people and other Australians.

Aims Suicide prevention remains a priority in rural and remote Australia, where suicide rates continue to be higher than those in urban communities. This commentary describes the Good SPACE suicide prevention program, and the lessons learned from delivering this program over a 14-year period. Context The Good SPACE program has been operating in rural New South Wales since 2007. The program focuses on educating rural community members to recognise the signs of suicide vulnerability, and how to take appropriate action if they encounter someone considering suicide. Approach Communities are selected to receive Good SPACE training in consultation with key stakeholder organisations, or by request from communities. Across the life of the program, key challenges in its administration have included short-term funding arrangements and staff turnover. Strengths have included the ability to adapt content to meet the needs of rural communities (eg from an initial focus on helping farmers during periods of drought, to a broader focus on all rural residents and a wider range of adversities). As the program moves forward, emphasis will be placed on harder-to-reach populations, including males and those with lower mental health literacy. Conclusion The Good SPACE program has ongoing funding to adapt its content and continue administration through the Rural Adversity Mental Health Program (https://www.ramhp.com.au/). The lessons learned throughout the life of the program might be of use to other organisations aiming to provide community-based education programs in rural and remote communities.

Objective To explore rural financial counsellors' experiences interacting with psychologically distressed farmers and identify contextually appropriate methods to maintain their own well-being and link farmers to psychological supports, within their existing roles. Setting Rural, regional and remote Australia. Participants Fifty rural financial counsellors participated. They worked across 6 Australian states/territories. Design Individual semi-structured telephone interviews were audio-recorded with consent. Qualitative data were analysed using thematic analysis. Themes were identified using an essentialist, bottom-up approach. Results Forty-six themes emerged relating to the 5 topics explored: (a) how to recognise distress in farmers (eg inability to focus/make decisions, deterioration in presentation/organisation, anger, blaming); (b) impact of farmers' psychological distress on the financial case management process (eg slows, disrupts or stops it, negatively impacts counsellor well-being); (c) strategies for working effectively with distressed farmers (eg flexibility, open-ended questions, listening to story, simplicity, instilling hope); (d) referral of distressed farmers to psychological support (eg willing if tried themselves/positive reports, lack of local rural face-to-face services, stigma and lack of understanding of importance challenging, a farming focus and support from family/ community assists); and (e) strategies to maintain their own well-being (eg compartmentalising, exercise, supervision). Conclusion Rural financial counsellors play an important role by recognising signs of distress in farmers and referring them to appropriate psychological supports. However, this is a demanding role and ensuring counsellors have appropriate services to refer farmers to, and support with their own well-being, is imperative.

The frameworks for regional and remote arts funding and delivery have shifted along a continuum of community ownership to fly-in-fly-out arts events, and with each change, the approaches to community consultation and project evaluation have also changed. What has not changed significantly is the underlying belief that regional and remote communities need arts and culture brought to them, and that urban arts events can be transplanted into these communities. This chapter explores methods and processes which aim to place the people most affected by community programmes at the heart of the design and development of the programmes and at the centre of funding strategies. The concerns and capacity of the community need to be the primary source for guidance in delivering impactful and sustainable arts and cultural events in under-served communities.

Background We aimed to determine whether heart, stroke, and vascular disease (HSVD) prevalence and emergency primary evacuation (EPE), hospitalisation, and mortality differ by patient characteristics. Methods An Australian-wide incidence population based study, with prospective data collected form the 1 July 2019 to the 30 October 2020. Findings Indigenous Australians reported significantly higher prevalence of HSVD at 229.0 per-1000 as compared to 152.0 per-1000 non-Indigenous Australians: risk ratio 1.5 (95% CI 1.2-1.8). 583 remote patients received an EPE for HSVD, consisting of 388 (66.6%; 95% CI: 62.6-70.4) males and 195 (33.0%; 95% CI: 29.6-37.4) females. There were 289 (49.6%; 95% CI 45.4- 53.7) patients who identified as Indigenous, and 294 (50.4%; 95% CI 46.3- 54.6) as non-Indigenous. The mean Indigenous age during EPE was 48.0 (95% CI 45.9-50.1) years old, significantly lower than the non-Indigenous mean age of 55.6 (95% CI 53.8-57.4). Indigenous patients hospitalised for HSVD were younger, the majority younger than 65 years (n=21175; 73.7% 95% CI 73.2-74.2) as compared to non-Indigenous patients (n= 357654; 33.1% 95% CI 33.0-33.15). When adjusted for HSVD prevalence, remote Indigenous patients had a higher hospitalisation rate as compared to non-remote Indigenous patients (rate ratio: 1.6; 95% CI 1.3-2.0) and remote non-Indigenous patients (rate ratio: 1.2; 95% CI 1.0-1.5). More Indigenous patients died of HSVD before the age of 65 years (n=1875; 56.5% 95% CI 54.8-58.2) as compared to non-Indigenous patients (n= 16161; 10.6% 95% CI 10.45-10.8). Interpretation Indigenous Australians have a higher prevalence, and younger age during EPE, and hospitalisation for HSVD than non-Indigenous Australians. Funding This is a self/internally-funded study, with the lead organisation being the Royal Flying Doctor Service (RFDS) of Australia. For the duration of the study period, the RFDS provided in-kind support including one full-time equivalent (FTE) and resources (office space, computer, research software, and office equipment). There was no external funding source that had a role in study design or data analysis or interpretation.

Australia’s Collaborative Research Networks (CRNs) are a modest program (A$81.1 million for 15 projects each over three to five years) of publicly funded research, development and extension (RD&E) designed to support relatively youthful universities with rapidly developing research capacity (Department of Education and Training, 2015). For socio-historical reasons, many youthful Australian universities are located in Australian regional settings (including 60 per cent of CRN-eligible universities). This chapter features the Northern Research Futures CRN (NRF-CRN) to show how the CRN program has supported RD&E capacity building in regional settings. We propose that the CRN program fortuitously positioned Charles Darwin University as a well-qualified and well-prepared provider of RD&E capabilities that can support the re-invigorated government agenda to attend to the development of Australia’s north. The chapter argues that these capabilities have matured as the result of 1) an application of well-established policy drivers for public funding of RD&E that has been 2) applied to university-based RD&E and 3) aimed towards the needs of regional socioeconomic development of Australia’s north through 4) social science using a diverse menu of methods, team formation and rich networking. Public funding of research—how much and to what ends—emerged as a preoccupation of policymakers and research communities some half a century ago owing to the confluence of 1) clear opportunities to promote the protection and/or welfare of people and communities through the application of de-militarised scientific and project management methods forged in war and 2) advances in public financial systems that generated budgets and released funds for research and related activities (Bush, 1945; Snow, 1962). Since that time, many studies have explored the links between RD&E and prosperity in firms, industries, regions and nations (Aghion & Howitt, 2008; Geisler, 2000). Although the linkages are many and complex, the evidence for their potency is compelling. Accordingly, many national and supra-national governments now establish aspirational targets for the proportion of gross domestic product that is allocated to research and development, targets for the public and private funding components of this proportion and, in many cases, priorities for selecting fields and modalities of research focus. Public funding of research in relation to regional research capacity is often viewed as a particularly important part of this policy arena.

In this paper, we investigate the role of social enterprise in bridging a gap in health provision that is experienced commonly in rural Australia. Drawing on an exploratory case study conducted in the small town of Emerald in Central Queensland, we use primary interview data to understand better how one, wholly community-owned, not-for-profit, social enterprise has moved beyond the traditional primary health care model and constructed a new way to deliver services in a rural setting. This case study provides an example of a community-driven response that endeavors to transform health service challenges into opportunities. This research identifies key strategies, strengths and business factors that have contributed to a locally responsive health service. We also focus on the business model and examine how innovation has shaped the operation. Key findings are presented as ten critical actions that helped the business establish itself as a thriving social enterprise in rural Australia.

Background Internationally, there is a growing body of literature regarding nurse leadership in health research, including the importance of programs to strengthen nurses in academic leadership roles. Nurse leaders provide a valuable contribution to global health research, influencing policy, clinical practice, and decision-making processes. Nurse leadership is important in rural and remote communities who generally experience poorer health outcomes and barriers to accessing services. Aim To examine the contribution of nurse leaders to rural and remote health research by reviewing peer-reviewed publication outputs from the Rural Health Multidisciplinary Training (RHMT) program implemented in Australia. Methods A scoping review framework using non-systematic searching was used. Peer-reviewed publication outputs from the RHMT program database published between 2016 and 2020 were reviewed. Findings were synthesised within the research parameters of the RHMT program. Findings The RHMT program database contained 1222 unique citations. On title and abstract screening, 796 citations were excluded. Of the 426 citations reviewed for full text, 89 studies were included. Most studies examined the RHMT research parameters of rural health issues (n=24) and rural training strategies (n=22), followed by rural health workforce development (n=21), Aboriginal and Torres Strait Islander health and wellbeing (n=13), and innovative models of care (n=9). Research was largely descriptive, with few studies examining issues specific to the nursing profession (n=21). Discussion Nurse leaders supported by the RHMT program in Australia provide valuable contributions to rural and remote health research which is not limited to the nursing profession. A paucity of nurse-led innovative models of care were identified. Although included studies were research outputs under the RHMT program, findings are of value to informing future directions of nursing research addressing rural and remote health. Conclusion Findings provide an overview of the valuable contribution of nurse leaders to rural and remote health research by capturing the interdisciplinary and transdisciplinary nature of nursing research leadership.

This article examines the role that the arts sector plays in supporting and sustaining communities in one of Australia's remotest regions, the Barkly (Northern Territory). Drawing on findings from a three-year Australian Research Council Linkage project, 'Creative Barkly', the article outlines how artistic and creative activities in very remote regions, such as the Barkly, constitute significant cultural, social, and economic value. To illustrate this, the article explores one such example, the annual Desert Harmony Festival, run by Barkly Regional Arts. This example demonstrates how an event such as this can provide a site of diverse intercultural expression that promotes both social and economic linkages and networks and generates cultural vitality in the region.

In this article, we outline how evolutionary economic geography (EEG) explains peripheral economic development by comparing two peripheries over extended time periods. This comparison involves critically appraising EEG?s capacity to account for peripheral evolution. For geographical, historical, and political reasons, peripheries lack resources that lead to path creation and renewal. The hyper-peripheral regions of the Pilbara in north-west Australia and of Buryatia in south-east Russia provide excellent comparative case studies for understanding how peripheral regional development evolves in ways contingent upon time, state institutions, natural resource endowments, and region/firm dynamics. Our analysis shows that EEG is well equipped to deal with historical factors and capitalist economies but it struggles to reconcile these regions? resilience and ability to sustain both Indigenous and non-Indigenous socio-economies. Development in these regions over extended periods of time invites questions about whether it is appropriate to apply EEG and its constituent parts: path creation, renewal, and exhaustion; regional resilience; and institutional thinness and thickness. In addressing those questions, we show that EEG can incorporate temporal development, stretching over long periods and economic analysis. We also critique the extent to which EEG can be used to consider how state activities influence path creation and renewal, the importance of extra-regional contexts, and heterodox and Indigenous perspectives.

The Modified Monash Model (MMM) defines whether a location is a city, rural, remote or very remote. Read about the MMM and how to search for areas classified under its structure.

Design of the new remote engagement program is underway. It is scheduled to replace the existing Community Development Program (CDP) in 2023, subject to Government endorsement. The new program will be developed in partnership with remote communities, service providers and all levels of government to ensure Aboriginal and Torres Strait Islander people and communities have the best possible chance to share in Australia’s economy through improved employment participation. To support an open and transparent process, public submissions will be updated on the NIAA website (subject to author’s consent). Please submit your response to the paper to NREP@niaa.gov.au with your signed consent form.

Rural older adults (≥60), compared to their urban counterparts, are identified as higher users of general practitioner (GP) services. However, whether this pattern of health seeking is influenced more so by physical or mental conditions is unclear. We explore the independent effect of chronic physical and mental health conditions on GP use in Australia. Datasets on population health was available from the South Australia?s Department of health in 2013-2017 (n = 20,522). We examined prevalence of common physical and mental conditions and GP use by the Modified Monash Model of remoteness. Physical and mental health burden was similar across South Australia. General practitioner visits with suicidal ideation for rural and remote locations were 4.7 (95% CI, 1.6-13.6) and 4.8 (95% CI, 1.9-11.7), respectively, compared to urban Adelaide 1.5 (95% CI, 1.0-2.3). While there is equal burden of mental health across South Australia, access to mental health resources for nonurban Australians remains a significant challenge.

Background Introduction of telehealth for gynaecological oncology consultations aims to improve access to specialised care for rural and remote Queensland women with gynaecological malignancies. Aims This survey examines patient satisfaction with gynaecological oncology consultations via telehealth after introduction of the service in Far North Queensland in 2017. Materials and Methods Patients who accessed the gynaecological oncology telehealth service at Cairns Hospital from January 2019 to June 2020 were invited to participate in the study. Demographic details and results of a satisfaction survey were investigated. The questionnaire included 16 statements measured on a five-point Likert scale and three open-ended questions, which were coded into related responses and predominant themes developed. Results Fifty-three patients completed the study. The mean satisfaction score across all questions was 90.5% (standard deviation 8.7%). The lowest overall patient score was 77.5% and the highest was 100%. Themes emerging from the open questions were emotions experienced by women, communication, relationship building and acceptability of the service. Conclusions Patients were highly satisfied with the telehealth service. Our findings encourage further development and research into telehealth care models for surgical disciplines such as gynaecological oncology.