This descriptive paper aims to describe the design and implementation of a community engaged primary healthcare strategy in rural Australia, the Primary Healthcare Registered Nurse: Schools-Based strategy. This strategy seeks to address the health, education and social inequities confronting children and adolescents through community engaged service provision and nursing practice.

There have been increasing calls for primary healthcare approaches to address rural health inequities, including contextualised healthcare, enhanced healthcare access, community engagement in needs and solutions identification and local-level collaborations. However, rural healthcare can be poorly aligned to community contexts and needs and be firmly entrenched in health systems, marginalising community participation.

This strategy has been designed to enhance nursing service and practice responsiveness to the rural context, primary healthcare principles, and community experiences and expectations of healthcare. The strategy is underpinned by a cross-sector collaboration between a local health district, school education and a university department of rural health. A research framework is being developed to explore strategy impacts for service recipients, cross-sector systems, and the establishment and maintenance of a primary healthcare nursing workforce.

Although in the early stages of implementation, key learnings have been acquired and strategic, relationship, resource and workforce gains achieved.

The aim of this study was to analyse the effects of preventive home visits (PHVs) by district nurses (DNs) on the self-reported health of 75-year-olds, including changes in self-reported health after the visits. The study also investigated whether or not the participants believed the visit was useful.

There is a need for methods that promote health among older persons so that they can remain healthy as long as possible. One such method is PHVs. In Sweden, the Stockholm County Council decided to implement such visits to 75-year-olds.

The study was a cluster-controlled trial carried out in Stockholm. Sixteen healthcare centres (HCCs) were randomly selected from five geographic medical areas in the county. Eight were assigned to the study group (SG) and eight to the control group (CG). The 75-year-olds registered at these centres (SG n=176, CG n=262) filled in a questionnaire before and after the intervention. Each SG member received a PHV from a DN, and the CG was treated as usual.

At follow-up, both the groups reported decreased health and well-being. However, the SG reported a significant reduction in pain as an effect of the PHV. Participants in the SG reported increased knowledge of local community and county council services, more contacts with their HCCs and increased use of medication. The PHV had no effect on health behaviour. The CG reported significantly more problems in the categories of activities of daily living (ADL) and breathing/circulation. Eighty-four per cent of the participants reported that the PHV was somewhat useful, useful or very useful.

To investigate the relationships between weight reduction behaviour among non-overweight schoolchildren and dietary habits, perception of health, well-being and health complaints.

Analysis of the 2006 Health Behaviour in School-aged Children survey, a cross-sectional study involving schoolchildren aged 10–17 years.

Schools in the Republic of Ireland.

The proportion of children (n 3599) engaged in weight reduction behaviour (‘dieting’ among non-overweight students) was 10·3 %. Older children, females and those from higher social classes (SC) were more likely to report such behaviour. Non-overweight schoolchildren who reported weight reduction behaviour were less likely than those not engaged in such behaviour to frequently consume sweets, soft drinks, crisps and chips/fried potatoes (OR from 0·39 (95 % CI 0·17, 0·89) to 0·72 (95 % CI 0·53, 0·99)); were more likely to consume diet soft drinks (OR 1·50 (95 % CI 1·03, 2·18); and were more likely to miss breakfast during the week (OR 0·62 (95 % CI 0·48, 0·80). The risk of subjective health complaints increased (OR from 1·47 (95 % CI 1·13, 1·91) to 1·92 (95 % CI 1·48, 2·49)); as did body dissatisfaction (OR 9·17 (95 % CI 6·99, 12·02)), while perception of health and well-being decreased (OR 0·47 (95 % CI 0·36, 0·61)) to 0·54 (95 % CI 0·41, 0·70)). All analyses were controlled for age, gender and SC.

Weight reduction behaviour among non-overweight schoolchildren is associated with considerable risk to physical health and emotional well-being. Since the risks associated with such behaviour varies by weight status, health professionals and researchers need to consider these issues in parallel.