Mental ill health is common and disabling for young people, particularly when they live with intersectional disprivilege. Navigating healthcare services can be difficult, costly and confusing.   

The JAMMed project analyses the healthcare journeys of diverse young people using a prospective longitudinal qualitative method. Co-design has helped test our assumptions, improving recruitment, interview methods and analysis. We have gained insight into the lives of people rarely included in existing evidence to better understand and challenge systemic bias inherent in health systems. 

We previously presented the prevalence and predictors of probiotic use among a cohort of healthy four and five-year-old children. In this follow up analysis, we explore the species and strains most commonly used, reasons probiotics are used, perceptions of impact on children’s health, and parental behaviours around probiotic supplementation in children, issues not described to date.

Parents of 4 and 5-year-old children living in the Australian Capital Territory were invited to participate in an observational, cross-sectional study by completing a web-based survey in February-May 2020. Data concerning 481 children were eligible for analysis. Results are presented as simple proportions, with odds ratios and 95% confidence intervals where appropriate. 

Lacticaseibacillus rhamnosus and Bifidobacterium animalis subsp. Lactis were the most frequently reported species and Lacticaseibacillus rhamnosus-GG the most frequent strain. The most common reason for administering probiotics to the 228/481 (47.4%) children ever exposed was to promote general health (54%). Half (51%) of parents perceived probiotics had improved their child’s general health, though this was more likely for children who had recently (OR: 2.69, CI: 1.47-4.93) or regularly (OR: 2.92, CI: 1.46-5.85) used probiotics or whose parent recently used probiotics (OR: 2.47, CI: 1.34-4.55). Initial exposure to probiotics occurred before age two years in 65% of the cohort. 

This community-based study suggests that parents use probiotics primarily to improve children’s general health and with modest perceived effect. The long-term effects of early and prolonged exposure to probiotics are not well understood. 

This study contributes new knowledge to an emerging field and provides a baseline for future work.


Nicola Irwin1,2, Marian J Currie2, Deborah Davis2, 3

 
 

1.     Paediatrics, Centenary Hospital for Women and Children, Canberra Health Services, Garran, ACT, 2605

2.     Faculty of Health, University of Canberra Bruce, ACT 2617

3.     ACT Health Directorate, Phillip, ACT, 2606

Developmental delay and disability affect a significant minority of Australian children. Identification of those at risk and providing early intervention is important to support improving developmental and behavioural health outcomes for children and their families.

We aimed to describe the proportion of children attending their first year at school (Kindergarten) in the ACT at increased risk of developmental delay and disability, as measured through the Parents’ Evaluation of Developmental Status (PEDS), and explore how this varied for selected sociodemographic characteristics.

Cross-sectional analysis of the 2014 to 2017 Kindergarten Health Check survey series. Descriptive and comparative statistics were produced for high risk PEDS for characteristics including age, sex, Indigenous background, and relative socioeconomic disadvantage.

19,414 children were included in the study, with the majority aged 5 to <6 years, 51.4% boys, 2.3% of Aboriginal or Torres Strait Islander background, and 18.4% in the most disadvantaged socioeconomic quintile. More than half of Kindergarten children had low or no developmental risk identified through the PEDS screening tool, with 10% at high risk.

Children more likely to have a high risk PEDS score were boys, those from the most disadvantaged socioeconomic groups, and Aboriginal and Torres Strait Islander children.

Results of the PEDS screening tool are provided to the nominated GP and parents/guardians of individual participants for discussion and appropriate follow up. Having knowledge of which children are more likely to be at risk can inform policy development and resource allocation with the aim to address underlying causes of health inequality.


Kathleen O'Brien, Jason Agostino, Karen Ciszek, Kirsty A Douglas

 
 

1.     Academic Unit of General Practice, Australian National University, Canberra, ACT, 2605

Residents of residential aged care are frequently lonely and have low quality of life. Activities between adolescents and residents have been shown to provide benefits to both groups. 

 

To determine the feasibility and acceptability of individually tailored activity videos on enhancing intergenerational relationships and their impact on quality of life of residents and dementia knowledge of adolescents. 

 

A mixed methods feasibility observational study. 

Eighteen residents were matched by mutual interests to small groups of adolescents from a cohort of 25 year 11 high-school students. Following four discussions over two weeks between the students and the residents, the students were tasked to make a video that covered a meaningful activity for the resident. Students used their phone or a GoPro to film the activity. The students and residents then watched the videos and used pedal exercisers together.

Outcome measures included EQ-5D-5L, loneliness (UCLA loneliness scale), and adolescent attitude towards dementia (A-ADS). To determine acceptability, residents, staff and students were interviewed. 

 

Students made videos that ranged from bike riding, walking the dog, and snorkelling at a local beach. Participants provided positive feedback, with the school seeking to continue the program.

Small improvements were seen in the EQ-5D-5L and A-ADS, but not in the loneliness scale.

Less oversight by the researchers was required than expected. 

 

With minor adjustments, the program is feasible. 

Introducing adolescents to aged care residents may provide benefits to both groups. 

 

This study provides preliminary data for a fully funded and powered study.

 

Angie Fearon, Nathan D'Cunha, Jane Kellett, Jane Frost, Stephen Isbel
 
 

1.     Faculty of Health, University of Canberra, Bruce, ACT, 2617

Reminiscence activities are effective in supporting people living with dementia, but translation into digital tools is under-researched. This project sought to understand the effectiveness of a digital reminiscence tool in aiding person-centred dementia care in Community Home Australia (CHA) organisation in Canberra, Australia.

 

This study used qualitative research methodology in the form of semi-structured interviews and ethnographic observations. 17 participants were observed and or interviewed about the use of the StoryTiling application as a digital reminiscence tool in aiding person-centred care. The interviews were recorded and transcribed, coded by individual researchers and then discussed to reach consensus before thematic analysis.

 

Themes identified were: 1.Reminiscence for guests and members, and 2. for loved ones; 3. Enhanced relationships; 4. Person centered adaptation; 5. Other potential uses. Findings indicate that the StoryTiling app was user friendly and well liked and aided in enhancing person-centred care. The reminiscence activity enhanced relationships between participants, families and carers, facilitating a deeper knowing of the participant with dementia, and supported positive memories and emotions and sustained the identity of the person with dementia in their own mind, and their loved ones. The process was dependent on the ‘art of the question’ and the ‘art of the interview’ to effectively progress interviews, and continue to utilise them within the respite care environment. 

 

Enabling nudge activities that promote person centered engagement such as reminiscence through storytelling may help create environments that foster person centred care. This site was already very person-focussed; trials in larger and institutional sites would be beneficial to understand transferability.

 

 Kasia Bail1,2, Diane Gibson1, Stephanie Munk1, Rhiannon Toohey1, Stephen Isbel1, Nathan D'Cunha1

 

1.     University of Canberra, Bruce, ACT, 2617 
2.    Canberra Health Services, Garran, ACT, 2605 

Clinical audits are commonly used to identify opportunities for quality improvement (QI). The notion of ‘a good death’ and associated contributing factors are well described in the literature. Measuring the quality of care provision at end of life in residential aged care facilities (RACF) however, remains challenging. Multiple after death audit (ADA) tools are available but little is known about their use or whether they contribute to quality improvement.

To identify the prevalence, tools, barriers and facilitators of ADA in RACF in the Australian Capital Territory (ACT). 

A telephone survey of RACF in the ACT using purposive sampling between April and May 2022.

Of the 28 participating facilities 43% used an ADA tool. Tools identified included Moving On (n=5), purpose built ‘in house’ (n=5) and ELDAC (n=3). Only 33% described the audit data being used to inform quality improvement. Workforce characteristics including culture, professional maturity, and limited resources were identified as barriers to ADA. Respondents reported a need for further education and support for RACF staff.

The findings of this study revealed that ADA are not routinely conducted or used for quality improvement. Significant barriers exist to implementing ADA in RACF. Research is required to investigate if current audit tools are fit for purpose and are suitable for QI and achieving a ‘good death’ for residents and families. 

This QI project identifies gaps and barriers to ADA and QI in RACF. It highlights the need for further research in this area and the need for education, mentoring and support for the aged care workforce.

 

Juliane Samara1, Tricia O'Connor1, Paresh Dawda2

 
 

1.     Clare Holland House Specialist Palliative Aged Care, Calvary Public Hospital Bruce, Canberra, ACT, 2600

2.     Next Practice Medical Centre, Deakin, ACT, 2604