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A survey questionnaire was designed and implemented across three different communities to determine the current utilisation, importance, trust and future preference for the internet as a source of health information in three different socioeconomic groups. The following were the key results. Fewer respondents in the low socioeconomic group accessed online health information than the mid-high socioeconomic or university samples. The internet was a much more important source of health information for the university sample. The use of online health information and the importance ascribed to the internet as a source of health information was related to home internet access and the frequency of internet use in all three populations. Most respondents do not bring online health information to their doctor (>70% of those who access online health information). Age alone did not relate to the current use of the internet as a source of health information. Most respondents in all populations did not trust the internet. In all populations the internet was a more preferred source of health information than its current use would suggest, especially among those with home internet access and frequent users of the internet.

Group therapy and education and support sessions are used within health care across a range of disciplines such as chronic disease self-management and psychotherapy interventions. However, there are barriers that constrain group attendance, such as mobility, time, and distance. Using videoconferencing may overcome known barriers and improve the accessibility of group-based interventions. The aim of this study was to review the literature to determine the feasibility, acceptability, effectiveness, and implementation of health professional-led group videoconferencing to provide education or social support or both, into the home setting. Electronic databases were searched using predefined search terms for primary interventions for patient education and/or social support. The quality of studies was assessed using the Mixed Methods Appraisal Tool. We developed an analysis framework using hierarchical terms feasibility, acceptability, effectiveness, and implementation, which were informed by subheadings. Of the 1634 records identified, 17 were included in this review. Home-based groups by videoconferencing are feasible even for those with limited digital literacy. Overall acceptability was high with access from the home highly valued and little concern of privacy issues. Some participants reported preferring face-to-face groups. Good information technology (IT) support and training is required for facilitators and participants. Communication can be adapted for the Web environment and would be enhanced by clear communication strategies and protocols. A range of improved outcomes were reported but because of the heterogeneity of studies, comparison of these across studies was not possible. There was a trend for improvement in mental health outcomes. Benefits highlighted in the qualitative data included engaging with others with similar problems; improved accessibility to groups; and development of health knowledge, insights, and skills. Videoconference groups were able to replicate group processes such as bonding and cohesiveness. Similar outcomes were reported for those comparing face-to-face groups and videoconference groups. Groups delivered by videoconference are feasible and potentially can improve the accessibility of group interventions. This may be particularly useful for those who live in rural areas, have limited mobility, are socially isolated, or fear meeting new people. Outcomes are similar to in-person groups, but future research on facilitation process in videoconferencing-mediated groups and large-scale studies are required to develop the evidence base.

A survey questionnaire was designed and implemented across three different communities to determine the current utilisation, importance, trust and future preference for the internet as a source of health information in three different socioeconomic groups. The following were the key results. Fewer respondents in the low socioeconomic group accessed online health information than the mid-high socioeconomic or university samples. The internet was a much more important source of health information for the university sample. The use of online health information and the importance ascribed to the internet as a source of health information was related to home internet access and the frequency of internet use in all three populations. Most respondents do not bring online health information to their doctor (>70% of those who access online health information). Age alone did not relate to the current use of the internet as a source of health information. Most respondents in all populations did not trust the internet. In all populations the internet was a more preferred source of health information than its current use would suggest, especially among those with home internet access and frequent users of the internet.

Objective: To determine whether the community's attitudes to components of a community eHealth strategy differ across three different socioeconomic groups. Design: A survey questionnaire was designed and implemented across three different communities. Participants and setting. Paper-based surveys were left in community organisations and local health practices in a low socioeconomic community on the outskirts of Ipswich, Queensland (n = 262), a mid-high socioeconomic community in the western suburbs of Brisbane (n = 256) and at a local university (n = 200). Main outcome measures: Ascribed importance and comfort with proposed components of a community eHealth strategy. Results: A community-oriented health website was perceived as useful in getting access to relevant health information. Those who were most comfortable with accessing online health information were those who were: experienced, had home internet access and were frequent internet users. The most important types of health information for the website were: information about the treatment of conditions, how to manage a chronic illness, how to stay healthy and patient clinical pathways. The low socioeconomic community had different information priorities - all categories were considered more important, particularly information about how the public system operates, local health support groups, and the roles of health professionals. Conclusions. Different communities have different information demands but there is a strong demand for information which empowers community members to take control of their own health and become active participants in their health care. Tools such as a community health portal and patient clinical pathways should become more available.

Integrated multidisciplinary care is difficult to achieve between specialist clinical services and primary care practitioners, but should improve outcomes for patients with chronic and/or complex chronic physical diseases. This systematic review identifies outcomes of different models that integrate specialist and primary care practitioners, and characteristics of models that delivered favourable clinical outcomes. For quality appraisal, the Cochrane Risk of Bias tool was used. Data are presented as a narrative synthesis due to marked heterogeneity in study outcomes. Ten studies were included. Publication bias cannot be ruled out. Despite few improvements in clinical outcomes, significant improvements were reported in process outcomes regarding disease control and service delivery. No study reported negative effects compared with usual care. Economic outcomes showed modest increases in costs of integrated primary–secondary care. Six elements were identified that were common to these models of integrated primary–secondary care: (1) interdisciplinary teamwork; (2) communication/information exchange; (3) shared care guidelines or pathways; (4) training and education; (5) access and acceptability for patients; and (6) a viable funding model. Compared with usual care, integrated primary–secondary care can improve elements of disease control and service delivery at a modestly increased cost, although the impact on clinical outcomes is limited. Future trials of integrated care should incorporate design elements likely to maximise effectiveness.

The author is a junior doctor working in a Brisbane hospital. He has come to realise that the health system fails to integrate services to provide a systematic approach to dealing with patients' needs. (non- author abstract)

The author is a junior doctor working in a Brisbane hospital. He has come to realise that the health system fails to integrate services to provide a systematic approach to dealing with patients' needs. (non- author abstract)

OBJECTIVE: To determine the current utilisation, importance, trust and future preference for contemporary sources of health information in three different socioeconomic groups. DESIGN: A pilot study including key informant interviews and direct observation was conducted in a low socioeconomic community. From this work a survey questionnaire was designed and implemented across three different communities. PARTICIPANTS AND SETTING: Semi-structured key informant interviews and focus groups capturing 52 respondents. Paper-based surveys were left in community organisations and local health practices in a low socioeconomic (LSE) community on the outskirts of Ipswich, Queensland, a mid-high socioeconomic (MSE) community in the western suburbs of Brisbane, and at a local university. MAIN OUTCOME MEASURES: Rank of current and preferred future sources of health information, importance and trustworthiness of health information sources. RESULTS: Across all three communities the local doctor was the most currently used, important, trusted and preferred future source of health information. The most striking difference between the three communities related to the current use and preferred future use of the internet. The internet was a more currently used source of health information and more important source in the university population than the LSE or MSE populations. It was also a less preferred source of future health information in the LSE population than the MSE or university populations. Importantly, currently used sources of health information did not reflect community members' preferred sources of health information. CONCLUSIONS: People in different socioeconomic communities obtain health information from various sources. This may reflect access issues, education and awareness of the internet as a source of health information, less health information seeking as well as a reluctance by the e-health community to address the specific needs of this group. (author abstract)

Objective: To determine whether the community's attitudes to components of a community eHealth strategy differ across three different socioeconomic groups. Design: A survey questionnaire was designed and implemented across three different communities. Participants and setting. Paper-based surveys were left in community organisations and local health practices in a low socioeconomic community on the outskirts of Ipswich, Queensland (n = 262), a mid-high socioeconomic community in the western suburbs of Brisbane (n = 256) and at a local university (n = 200). Main outcome measures: Ascribed importance and comfort with proposed components of a community eHealth strategy. Results: A community-oriented health website was perceived as useful in getting access to relevant health information. Those who were most comfortable with accessing online health information were those who were: experienced, had home internet access and were frequent internet users. The most important types of health information for the website were: information about the treatment of conditions, how to manage a chronic illness, how to stay healthy and patient clinical pathways. The low socioeconomic community had different information priorities - all categories were considered more important, particularly information about how the public system operates, local health support groups, and the roles of health professionals. Conclusions. Different communities have different information demands but there is a strong demand for information which empowers community members to take control of their own health and become active participants in their health care. Tools such as a community health portal and patient clinical pathways should become more available.

OBJECTIVE: To determine the current utilisation, importance, trust and future preference for contemporary sources of health information in three different socioeconomic groups. DESIGN: A pilot study including key informant interviews and direct observation was conducted in a low socioeconomic community. From this work a survey questionnaire was designed and implemented across three different communities. PARTICIPANTS AND SETTING: Semi-structured key informant interviews and focus groups capturing 52 respondents. Paper-based surveys were left in community organisations and local health practices in a low socioeconomic (LSE) community on the outskirts of Ipswich, Queensland, a mid-high socioeconomic (MSE) community in the western suburbs of Brisbane, and at a local university. MAIN OUTCOME MEASURES: Rank of current and preferred future sources of health information, importance and trustworthiness of health information sources. RESULTS: Across all three communities the local doctor was the most currently used, important, trusted and preferred future source of health information. The most striking difference between the three communities related to the current use and preferred future use of the internet. The internet was a more currently used source of health information and more important source in the university population than the LSE or MSE populations. It was also a less preferred source of future health information in the LSE population than the MSE or university populations. Importantly, currently used sources of health information did not reflect community members' preferred sources of health information. CONCLUSIONS: People in different socioeconomic communities obtain health information from various sources. This may reflect access issues, education and awareness of the internet as a source of health information, less health information seeking as well as a reluctance by the e-health community to address the specific needs of this group. (author abstract)