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dc.contributor.authorDiaz, Abbey
dc.contributor.authorVo, Brenda
dc.contributor.authorBaade, Peter D
dc.contributor.authorMatthews, Veronica
dc.contributor.authorNattabi, Barbara
dc.contributor.authorBailie, Jodie
dc.contributor.authorWhop, Lisa J
dc.contributor.authorBailie, Ross
dc.contributor.authorGarvey, Gail
dc.date.accessioned2019-10-10T01:25:52Z
dc.date.available2019-10-10T01:25:52Z
dc.date.issued2019
dc.identifier.issn1661-7827
dc.identifier.doi10.3390/ijerph16193630
dc.identifier.urihttp://hdl.handle.net/10072/388221
dc.description.abstractAboriginal and Torres Strait Islander women have significantly higher cervical cancer incidence and mortality than other Australian women. In this study, we assessed the documented delivery of cervical screening for women attending Indigenous Primary Health Care (PHC) centres across Australia and identified service-level factors associated with between-centre variation in screening coverage. We analysed 3801 clinical audit records for PHC clients aged 20–64 years from 135 Indigenous PHC centres participating in the Audit for Best Practice in Chronic Disease (ABCD) continuous quality improvement (CQI) program across five Australian states/territories during 2005 to 2014. Multilevel logistic regression models were used to identify service-level factors associated with screening, while accounting for differences in client-level factors. There was substantial variation in the proportion of clients who had a documented cervical screen in the previous two years across the participating PHC centres (median 50%, interquartile range (IQR): 29–67%), persisting over years and audit cycle. Centre-level factors explained 40% of the variation; client-level factors did not reduce the between-centre variation. Screening coverage was associated with longer time enrolled in the CQI program and very remote location. Indigenous PHC centres play an important role in providing cervical screening to Aboriginal and Torres Strait Islander women. Thus, their leadership is essential to ensure that Australia’s public health commitment to the elimination of cervical cancer includes Aboriginal and Torres Strait Islander women. A sustained commitment to CQI may improve PHC centres delivery of cervical screening; however, factors that may impact on service delivery, such as organisational, geographical and environmental factors, warrant further investigation.
dc.description.peerreviewedYes
dc.languageEnglish
dc.publisherMultidisciplinary Digital Publishing Institute (MDPI)
dc.publisher.placeSwitzerland
dc.relation.ispartofpagefrom3630: 1
dc.relation.ispartofpageto3630: 12
dc.relation.ispartofissue19
dc.relation.ispartofjournalInternational Journal of Environmental Research and Public Health
dc.relation.ispartofvolume16
dc.subject.fieldofresearchPublic Health and Health Services
dc.subject.fieldofresearchPublic Health and Health Services
dc.subject.fieldofresearchcode1117
dc.subject.fieldofresearchcode1117
dc.subject.keywordsAboriginal and Torres Strait Islander
dc.subject.keywordsAustralia
dc.subject.keywordsIndigenous
dc.subject.keywordsPap smear
dc.subject.keywordscervical cancer screening
dc.titleService Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia.
dc.typeJournal article
dc.type.descriptionC1 - Articles
dcterms.bibliographicCitationDiaz, A; Vo, B; Baade, PD; Matthews, V; Nattabi, B; Bailie, J; Whop, LJ; Bailie, R; Garvey, G, Service Level Factors Associated with Cervical Screening in Aboriginal and Torres Strait Islander Primary Health Care Centres in Australia., International Journal of Environmental Research and Public Health, 2019, 16 (19), pp. 3630: 1-3630: 12
dcterms.dateAccepted2019-09-23
dcterms.licensehttps://creativecommons.org/licenses/by/4.0/
dc.date.updated2019-10-10T01:18:05Z
dc.description.versionPublished
gro.rights.copyright© 2019 by the authors. Licensee MDPI, Basel, Switzerland. This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
gro.hasfulltextFull Text
gro.griffith.authorBaade, Peter D.


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