Many trainee interns will have had to reconsider their elective plans for 2020/21 because of pandemic travel restrictions. Some of you may be interested in an elective working on a rural health research project as an alternative. We have a number of possibilities that are listed below that build on existing projects. Feel free to make contact with the rurally based researchers below if you want more information. Some of the options could be combined with rural clinical work.
Dr Kyle Eggleton
The majority of mental health initiatives are ‘top-down’ and are not responsive to communities. The most recent published statistics for the burden of mental health shows that Northland has the highest number of people per 100 000 on a compulsory treatment order, and a suicide rate above the national average. In addition, the burden of mental health problems is likely higher in rural areas compared to urban. While ‘mainstream’ general practice approaches to mental health are important there is evidence to suggest that GPs may be less likely to diagnose depression among Māori compared to non-Māori. Poor communication, cultural safety issues and lack of trust have been identified as barriers to diagnosis and treatment of depression. In contrast tikanga based mental health services have demonstrated high cultural safety and acceptability for Māori and underserved populations as well as improvements in mental health measures. In addition, indigenous approaches to mental health are more likely to address root causes of mental health problems for indigenous people, such as historical trauma and colonisation, than non-indigenous approaches. This project involves working with a rural Northland based Māori health provider who is undertaking a participatory action-based research project to determine the tikanga based approach to mental health that would best serve this rohe. The student research aspect of this project involves:
This project would suit a student interested in developing qualitative skills, who is comfortable within Te Ao Māori and who is able to be located in Whangārei for the duration of the research elective. Some knowledge of te reo Māori would be advantageous. A small scholarship of $2000 is available. The research elective is available in the second or third quarters.
Dr Garry Nixon
This is an opportunity to join an existing Health Research Council funded project to develop ‘fit for purpose’ rural-urban geographic classification for health research and policy in New Zealand. The team includes researchers from Otago and Waikato Universities. The PI and several other investigators are based in Central Otago.
The project would involve undertaking a literature search in order to document the multiple different ways in which ‘rural’ has been defined in the NZ health research literature and policy documents. Preliminary work has suggested there are at least 15 different definitions that have been used in recent times. The student would then work with members of the research team to write a journal article based on the results of the literature search.
This attachment could be in the 3rd or 4th quarter.
It may be possible to combine it with work at Dunstan Hospital in which case it might work well as full quarter rural attachment, with a clinical and research component. If solely research it could be based anywhere as the research team is a dispersed one. It may however be particularly attractive for a student whose home base is in Central Otago or who has an interest in rural health.
Dr Kati Blattner and Dr Rory Miller
In early 2020, due to the COVID-19 pandemic, all Post Graduate Rural programme in-person residentials were cancelled and virtual workshops run in their place. This change was thought to create the best opportunity for students to continue their respective training programmes and complete papers.
Objective : To determine students’,( including those based in Pacific Island Countries), perceptions of the entirely virtual residential course and paper.
Dr Rory Miller, Dr Steve Withington, Dr Garry Nixon and Dr Valarie August
Transfers between rural hospitals and metropolitan hospitals are common and an essential part of the rural health service. Rural hospitals within NZ have varying local resources. It is currently unknown what patients are transferred to metropolitan hospitals.
Objective: To determine the number and characteristics of patients transferred to metropolitan hospitals. In particular, whether there were additional investigations or interventions performed at the metropolitan hospital that were not available locally.