Playing their part: the role of physical activity and sport in sustaining the health and well being of small rural communities

It is widely recognised that the health of rural Australians is poor in comparison with their urban counterparts. Similarly, the role played by physical activity in maintaining health has been well researched and is well documented. However, little appears to have been published in recent years about the links between physical activity and health in rural communities. The objective of this article was to begin to address that gap. To achieve this, the article drew on research conducted in two small rural communities in Victoria Australia, and highlighted the role that physical activity and sport played in sustaining the health and wellbeing of individuals and communities in rural areas. Taking the World Health Organisation's definition of health (a state of complete physical, mental and social well-being and not merely the absence of disease) as its measure, the paper highlighted the many ways in which physical activity and sport in rural communities contribute to physical health, mental wellbeing and social cohesiveness. Based this finding, the authors suggest that physical activity and sport make a significant contribution to the health and wellbeing of rural people and their communities and suggest that further research is necessary to better define this apparent contribution.

Governance in rural communities: the case of Victoria

State and federal government policies for rural areas have encouraged local people and organizations to play a greater role in the provision of their local services. This emphasis on local participation has been described as a shift from ‘government’ to ‘governance’. However while there is an emerging research around small towns in Australia there is very little known about the processes of community governance. This paper focuses on local development groups in small towns in rural Victoria that have emerged or have been reconstituted with a broader community focus following municipal amalgamations. The basic aim of this paper is analyse to what degree these local community development groups can be regarded as constituting a form of community governance and the implications this has for democracy and accountability in small rural areas. The paper begins with a discussion of community governance as it represented in the literature. We then analyse ten case studies from across Victoria in the light of the changing political context.

Prevalence of psychological distress, anxiety and depression in rural communities in Australia

Objective: To describe the prevalence of psychological distress, depression and anxiety in three Australian rural settings and to identify the levels of risk by gender and age.

Design and setting: Three cross-sectional surveys in the Greater Green Triangle area covering the south-east of South Australia (Limestone Coast), and south-west (Corangamite Shire) and north-west (Wimmera) of Victoria.

Participants: A total of 1563 people, aged 25–74 years, randomly selected from the electoral roll.

Main outcome measures: Psychological distress assessed by the Kessler 10, and anxiety and depression assessed by the Hospital Anxiety and Depression Scale.

Results: The prevalence of psychological distress was 31% for both men and women with two-thirds reporting moderate and one-third high levels of psychological distress. The prevalence of depression and anxiety was approximately 10%. The highest rate of psychological distress, anxiety and depression occurred in the 45–54 years age group. There were no consistent gender or area differences in the prevalence of psychological distress, depression or anxiety.

Conclusions: A third of the rural population reported psychological distress, with the highest prevalence observed in middle-aged men and women. Thus, health professionals should attend not only to physical health, but also to mental health status in this age group. It is also important to target prevention strategies at the 20% who reported moderate levels of psychological distress in order to prevent the development of more serious conditions.

Teacher education for rural communities : a focus on 'incentives'

In Australia we face a national crisis in attracting and retaining teachers and other professionals with regard to rural areas. In response to this difficulty in ‘staffing the empty schoolhouse’ (Roberts 2004), the majority of state  education departments have initiated some form of rural incentive scheme designed to attract teachers to rural schools. This paper argues that such  schemes have little chance of success unless teachers taking up such  incentives have actually been prepared for teaching in nonmetropolitan   schools. Although many universities claim to prioritise rural and regional  education and community development as part of their vision statements, in reality relatively few education providers reflect this rhetoric in their practice  and only a handful have made direct links to such state-based schemes in  pre-service teacher education, or initiated their own rural incentives. A  preliminary study into pre-service preparation and rural incentive schemes, as part of a three-year ARC Discovery Grant, indicates that, nationally, the  majority of Faculties and Schools of Education have no easily accessible or  advertised incentive programs to encourage students to undertake a rural  practicum. Nor do many reflect rural education in their course-work.

This paper will introduce the ‘TERRAnova’ project, and then discuss findings of the preliminary work to date that has focussed on identifying incentives and their significance. Drawing on evidence collected from websites from   Australian Universities representing all pre-service teacher education programs in the nation, we argue that few Faculties and Schools appear to  see it necessary or desirable to provide students with links to information  about particular state-based rural funding opportunities. We show how some, either directly or indirectly, imply the importance of a rural practicum, and that  a few teacher education programs provide written advice to students who  are considering taking up a rural practicum. It is unclear, however, whether  follow-up advice is provided, so that the impact and effectiveness of such advice on students’ experiences and willingness to take rural education   seriously can be questioned. Our analysis so far indicates that it is the regional universities which are more likely to address rural education needs, and on this basis we question the metro-centricity of teacher education practice more broadly and suggest ways of expanding the options of teachers in their initial teaching appointments.

Adapting to rural communities by overseas-born health professionals

Introduction
As with other multicultural nations, cultural diversity is a prominent feature of Australian society that leads to intercultural awareness and respect through citizen interactions. While this enriching multicultural interaction is clearly seen in big cities like Sydney and Melbourne, it can be very different in the Australian rural context. Living in an isolated rural area is challenging for health professionals who were brought up in urban areas, particularly those born overseas as they experience two types of cultural and social adaptation: urban into rural and native culture into new culture.

As a result of workforce shortages, many overseas trained health professionals are recruited to work in Australia, particularly in rural areas. This has given rise to various initiatives and strategies developed to support and assist these health professionals in their dual cultural and social adaptation. These include University Departments of Rural Health and Rural Clinical Schools programs as well as the Rural Workforce Agencies. However, these programs do not extend to those health professionals who were born overseas and trained in Australia as they are ‘Australian graduates’. In this paper we argue that in ways similar to those born and trained overseas, overseas-born Australian-trained health professionals may require additional support during the acculturation process and making the transition to working in rural communities.

Aim
The aim of this study is to examine some aspects of the acculturation of overseas-born Australian trained health professionals working in rural areas. This study seeks to understand the particular issues that emerge as a result of cultural difference in order to propose strategies that may more adequately prepare these Australian graduates for their rural health experience.

Method
Six overseas-born Australian-trained health professionals were invited to participate in this qualitative study using snowball sampling. The interviews were recorded with the approval of the participants. The interview data were transcribed as raw data and later coded for thematic analysis, which includes topics and themes arising from the raw data as well as from the interview questions with a focus on issues and strategies of acculturation into a rural health context.

Results/conclusion
There were different factors which facilitated or hindered the acculturation of overseas-born health professionals into a rural workforce such as professional isolation, cultural shock, family pressure, and cultural identity. The acculturation process was also affected by the quality of their perceived ‘social and cultural capital’. Different coping strategies were employed to deal with the changes in a new rural environment. The paper discusses some implications of this study with focus on how to improve the living and working conditions of overseas-born Australian-trained health professionals in order to attract them to rural Australia.

Landscapes of learning : lifelong learning in rural communities

Reviews the non-fiction book 'Landscapes of Learning: Lifelong Learning in Rural Communities,' edited by Fred Gray.

Interactional infrastructure in rural communities : matching training needs and provision

This paper reports some of the main lessons learnt from a collaborative project titled Generating jobs in regional Tasmania: a social capital approach investigating how two small rural Tasmanian communities could better match local training needs with training provision. The project was conducted within the context of the wider social, economic and demographic changes affecting the two rural communities and their ongoing efforts to manage such change. The paper provides a profile of the two communities with particular attention to their local education, training and employment infrastructure. Three research questions in terms of improving the contributions of leadership, partnerships and social capital are addressed. Development and utilisation of social capital, particularly in the form of interactional infrastructure (defined as opportunities and structures for interaction in a community) that brought together the range of stakeholders, appeared the key to successfully matching needs with provision.

Education to gain sustainability : analysis and approach from the experience obtained from two high school systems in mexican rural communities

The decade “Education for Sustainability” is just emerging and one of its goals emphasized the importance of considering the currícula in a transdisciplinary and community based programs. This includes recognizing local and regional interests as relevant topics into the currícula. “Education for sustainability” does not appear to have a strong basis on their actions as its theoretical discourse does. The study we present here about content analysis in the curricula of two high schools systems in rural Mexican communities is an example. In this research we analyzed: 1) how the curricula is oriented towards forest management and the way is connected to the social reality of the communities; 2) how does the learning process develops in the classroom and its dynamics with teachers and students and 3) how does the environmental learning take place. Results revealed that more research is needed with adolescents in order to change the educational structure in rural Mexican high schools.

Skill development for volunteering in rural communities

This paper examines the skills required of volunteers in the voluntary sector organisations that operate in three rural Tasmanian communities. It reports how volunteers acquire those skills and reveals the challenges faced by voluntary sector organisations in rural communities whose industries and, following from this, community members have a low-qualification profile. Training for volunteers in these rural communities must take account of motivations for volunteering, rural context, preferred learning styles, education and training, and the volunteers' confidence as learners.

The mobile skilled workforce : optimising benefits for rural communities

Many small rural communities with ageing populations and limited opportunities for young people are not attracting skilled workers, but have a flow of skilled people through the community as locums, seasonal workers or contractors. This project investigated the question: how can rural communities capture maximum benefit from professional and other highly skilled workers in the context of an increasingly mobile and transitory workforce? It found that rural communities derive a wide range of benefits from mobile skilled workers. Effectiveness of the integration process determines the nature and extent of mobile skilled worker contribution to the community. Community settings that encourage and support mobile skilled worker integration are identified in terms of culture, leadership and interactional infrastructure. These same settings also influence mobile skilled worker retention in rural communities. Rural communities need to be proactive in matching worker and community characteristics, and this begins with the recruitment process. Mobile skilled workers need assistance and support to develop a primary social contract, and the process needs to be monitored. This is a community-wide responsibility and requires a coordinated, whole-of-community approach. This is the first Australian study to explore how rural communities can capture the advantages from highly skilled mobile workers. Rural communities that make the most of the available pool of skills can increase resilience, identification and uptake of opportunities such as new enterprises, good practice in natural resource management, enhanced social and leisure opportunities, and the quality and range of local services. The importance of this report is that it provides a broad range of strategies for rural communities wanting to know how to optimise the benefits they derive from mobile skilled workers, regardless of their location or rural industry base.

Engaging rural communities in health care through a paramedic expanded scope of practice

Introduction: This article explores how community engagement by paramedics in an expanded scope role contributes to both primary health care and to an overall improved emergency response capacity in rural communities. Understanding how expanded scope paramedics (ESP) can strengthen community healthcare collaborations is an important need in rural areas where low workforce numbers necessitate innovation.

Methods: Four examples of Australian rural ESP roles were studied in Tasmania, New South Wales, South Australia and Victoria to gather information on consistent elements that could inform a paramedic expanded scope model. Qualitative data were collected from semi-structured interviews with key stakeholders and organisational documents. Thematic analysis within and across cases found community engagement was a key element in the varied roles. This article relies heavily on data from the Victorian and Tasmanian case studies because community engagement was a particularly strong aspect of these cases.

Results: The ESP in the case studies increased interactions between ambulance services and rural communities with an overall benefit to health care through: increasing community response capacity; linking communities more closely to ambulance services; and increasing health promotion and illness prevention work at the community level. Leadership, management and communication skills are important for paramedics to successfully undertake expanded scope roles.

Conclusion: ESP in rural locations can improve health care beyond direct clinical skill by active community engagement that expands the capacity of other community members and strengthens links between services and communities. As health services look to gain maximum efficiency from the health workforce, understanding the intensification of effort that can be gained from practitioner and community coalitions provides important future directions.

Training and experience of nurses in responding to alcohol misuse in rural communities

Objective Alcohol misuse by farmers continues to challenge rural nurses. This article reports on the experiences of Australian nurses participating in the Alcohol Intervention Training Program (AITP).

Design and Sample Qualitative interviews of 15 rural and remote nurses.

Measures Semi-structured phone interviews were utilized to assess the response to and implementation of the AITP—an intervention designed to build nurses' knowledge, confidence and skills when responding to alcohol misuse. It comprises practical and theoretical components and was designed for rural and remote settings where nurses encounter alcohol misuse.

Results Nurses found the training provided new—or built on existing—knowledge of alcohol misuse and offered practical hands-on “real life” skills. A range of workplace and personal situations where the content of the training was now being utilized were identified, and future use anticipated. Barriers to using the new knowledge and skills included both rural and generic issues. Constructive feedback to increasingly target the training to rural settings was recommended.

Conclusions The AITP is an effective training program. It can be further tailored to meet common needs of rural and remote nurses working with farmers who misuse alcohol, while recognizing diversity in rural practice.