Physical Therapy, Sports Therapy and Rehabilitation, Multidisciplinary, Respiratory Care
31
Scopus Publications
Scopus Publications
Towards a Sustainable Future: Embedding Planetary Health in Allied Health Professional Education Through the Lens of Indigenous Knowledges Kerstin McPherson, Sarah Barradell, Katrina Li, Michael Watkins, Anna Phillips Health Promotion Journal of Australia, 2026 Planetary health is increasingly recognised as an essential aspect of health professional education, yet its integration within allied health curricula in Australia remains fragmented. This commentary argues that meaningful and sustainable embedding of planetary health requires explicit engagement with Indigenous knowledges. Expanding curricula beyond Western views to include Indigenous eco‐centric worldviews enables a deeper understanding of the interconnections between environmental health, human wellbeing and spiritual identity. We reflect on the influential role of accreditation standards in shaping educational priorities, highlighting the leadership demonstrated by medical and nursing professions and the relative absence of coordinated action across allied health in the context of planetary health. We propose the Aboriginal and Torres Strait Islander Health Curriculum Framework as a culturally grounded lens through which planetary health education can be advanced within allied health education. Aligning planetary health capabilities with the Framework’s five interconnected cultural capabilities offers a practical and transformative pathway to develop culturally capable graduates, strengthen environmental stewardship and promote climate justice. Urgent and inclusive educational reform is required to prepare the future allied health workforce for escalating planetary health challenges.
Characteristics and outcomes of communities of practice in allied health educators: rapid review Emma Edwards, Anna Phillips, Maureen McEvoy, Kylie Johnston Journal of Interprofessional Care, 2025 Allied health clinical educators (AHCEs) are vital to health professional student education and clinical education is often expected in a job role. Communities of practice (CoPs) may be a strategy to meet educator learning needs. A rapid review was conducted to determine the structures, purposes, and outcomes of AHCE CoPs, and barriers or enablers of participation in CoPs. A systematic electronic search of three peer-reviewed literature databases (1/1/1998 to 10/7/23) and gray literature search were conducted. Data were extracted using a purposively designed form and synthesized descriptively. One peer-reviewed paper and four unpublished reports were included. CoPs aimed to provide a platform for knowledge creation and resources. Most were single-discipline specific and conducted virtually with occasional face-to-face meetings. Evaluation of CoPs was limited: one paper reported the impact of a CoP on CE skills and confidence. Outputs included documentation and clinical reasoning tools, resource repositories and training packages. Enablers included having a facilitator, and an online platform for resource sharing. Lack of support by management limited participation. While published research on CoPs in AHCE is scarce, communities are growing informally within local health networks, predominantly online. Further research is indicated to evaluate effectiveness of CoPs and make the most of this opportunity for interprofessional collaboration and practice.
Unveiling the Exodus: A scoping review of attrition in allied health Su Ann Yeoh, Saravana Kumar, Anna Phillips, Lok Sze Katrina Li Plos One, 2024 Background Efficient utilisation of allied health workforce may help address the predicted shortfall of 18 million health workers estimated by 2030. Knowledge about allied health professionals’ attrition, or intention to leave, and factors influencing attrition can assist in developing evidence-informed strategies to mitigate this issue. The review aimed to map attrition and attrition intention rates, and its attributing factors for allied health professions worldwide. Methods Adhering to the PRISMA-ScR guidelines, a comprehensive search was conducted across academic databases (PsycINFO, MEDLINE, Embase, Emcare, CINAHL, Scopus, and the Cochrane Library database) and grey literature (Google, Google Scholar, organisational websites). Two reviewers independently undertook a two-stage screening process along with data extraction using customised data extraction forms. A narrative synthesis was used to synthesise the data. Results Thirty-two studies published between 1990 and 2024 were included. Attrition rates ranged from 0.5% to 41% across allied health disciplines. Pharmacists demonstrated the lowest attrition rates, while audiologists reported the highest. Radiographers reported the lowest intent to leave at 7.6%, while occupational therapists showed highest intent to leave, ranging from 10.7% to 74.1%. The analysis revealed three recurring themes contributing to attrition: profession-centric factors (e.g., career progression, job satisfaction, support, and professional growth), systemic-centric factors (e.g., compensation, staffing challenges, clinical practices, patient care, workload), and individual-centric factors (e.g., recognition, the need for change, and burnout). Conclusion Attrition in allied health remains a significant challenge. Addressing this issue requires a systemic, nuanced, and evidence-based approach, given the complex, interlinked, and multifaceted factors contributing to attrition. The younger workforce, characterized by changing generational values, necessitates innovative thinking, intersectoral collaboration, and the potential for co-created solutions with, for, and by the allied health workforce.
Psychosocial interventions for ovarian cancer survivors: A systematic review Su Ann Yeoh, Stephanie Webb, Anna Phillips, Lok Sze Katrina Li, Saravana Kumar Psycho Oncology, 2024 ObjectivesOvarian cancer survivorship is complex and is associated with greater symptom burden, fear of reoccurrence, sexual dysfunction, lower quality of life and heightened existential distress in contrast to other cancers. This systematic review aimed to investigate the effectiveness for, and perspective of, psychosocial interventions encompassing psychological, social, and emotional support, tailored to, or involving ovarian cancer survivors at all stages of disease.MethodsAdhering to the PRISMA‐SR statement guidelines, a systematic search was conducted across PsycINFO, MEDLINE, Embase, Emcare, CINAHL, Scopus, Cochrane Library databases, Google, and Google Scholar. Two reviewers independently undertook a two‐stage screening process. The Mixed Methods Appraisal Tool was utilised to assess the methodological quality of included studies. Data were extracted using customised data extraction tools and narratively synthesised.ResultsThirteen studies were included in this review. Generally positive effects of psychosocial interventions were observed across a range of outcome domains (meaning enhancing, cognitive, social, emotional, and cancer‐specific). However, the characteristics of interventions and outcome measures varied across studies. Psychoeducational interventions were identified as the most common psychosocial approach, while Acceptance and Commitment Therapy showed promise in addressing the disease's high symptom burden. Women's perspectives of psychosocial interventions were described as “useful” and promoted positive self‐regard.ConclusionWhile the evidence base largely support positive effects of psychosocial interventions for ovarian cancer survivors, this finding is constrained by heterogeneity of interventions and modest gains. Future research may explore the standardisation of psychosocial interventions for this demographic, investigating its effects on less explored but prevalent concerns among ovarian cancer survivors such as fear of cancer recurrence and sexual dysfunction.
Evaluating allied health students’ readiness for placement learning Belinda Judd, Jennie Brentnall, Justin Newton Scanlan, Kate Thomson, Felicity Blackstock, et al. BMC Medical Education, 2023 Background Experiential learning opportunities, such as work integrated learning placements, are often challenging for health professional students. It is therefore imperative that students are adequately prepared before engaging in placement learning. Operationalising ‘readiness for learning on placement’ as a construct, is necessary for providing quality student feedback and assessment. Methods An integrative mixed methods approach was adopted for this study, utilising a survey to canvass the perspectives of academics, students, and placement educators around the construct of readiness to inform potential assessment items. An assessment tool measuring student readiness for placement was then developed. Data from occupational therapy, physiotherapy and speech pathology programs were evaluated using Rasch analysis to explore the unidimensionality of this construct. Results The online survey was completed by 64 participants, confirming the importance and measurability of foundational skills integral to readiness for placement learning. These foundational skills were then reflected in a pilot 20-item tool covering domains of professional and learner behaviour, communication, information gathering skills and reasoning. The Rasch analysis of 359 pre-registration student assessments confirmed unidimensionality, suggesting that the skills and attributes (operationalised as assessment items) that are considered part of ‘readiness for placement’ are components of this construct. Together, these findings provide support that the items on this tool are relevant and representative of the skills and behaviours that indicate readiness for placement learning. Two items regarding documentation and appropriate professional dress demonstrated some lower importance scores and interpretation variance warranting further investigation. Conclusion Through the exploration of the construct of readiness for placement learning, we have created and subsequently revised, an innovative assessment tool that measures novice students’ pre-placement capabilities. Further research is now needed to explore the psychometric properties of the tool.
Physical activity and screen time in outside school hours care services across Australia: current versus best practice Rosa Virgara, Anna Phillips, Lucy K. Lewis, Mandy Richardson, Carol A. Maher BMC Public Health, 2022 Background Outside school hours care (OSHC) is accessed by millions of children internationally. Recently, physical activity and screen time guidelines in OSHC were developed. This study described the current physical activity and screen time scheduling in Australian OSHC, obtained sector feedback on the guidelines and compared current- with best-practice. Methods A cross-sectional online survey was administered to n = 3551 Australian OSHC directors. Participants reported scheduling for physical activity and screen time opportunities in before- and after-school care. Feedback was sought on the new guidelines, including barriers and enablers for implementation. Scheduling data were used to evaluate whether services were currently meeting the new guidelines; that is if time allocated matched with time recommended. Results Five hundred and sixty-six directors participated (response rate 16%). Physical activity and screen time practices varied widely (e.g., after-school physical activity opportunity ranged from 15 to 150 min, mean 74, SD 28; after-school screen time opportunity ranged from 15 to 195 min, mean 89, SD 43), with state (p = 0.002) and socioeconomic (based on postcode; p < 0.001) differences. Most participants (54–81%) agreed that the guideline’s recommended physical activity and screen time durations were appropriate, however, only 40% of participants’ OSHC services’ programs actually met the guidelines. Conclusions Physical activity and screen time scheduling in OSHC is highly variable. Despite support for the guidelines, current scheduling practice in the majority of OSHC services surveyed do not meet best practice guidelines.
Development of Australian physical activity and screen time guidelines for outside school hours care: an international Delphi study Rosa Virgara, Anna Phillips, Lucy Lewis, Mandy Richardson, Carol Maher International Journal of Behavioral Nutrition and Physical Activity, 2021 BackgroundChildren’s activity patterns in the periods before and after school make a key contribution to achieving 24-h movement guidelines. There are currently no national-level guidelines informing physical activity and screen time practices in Outside School Hours Care (OSHC) programs anywhere in the world. This study aimed to work with industry, government and academic stakeholders to develop draft physical activity and screen time guidelines for use in Australian OSHC.MethodsA 4-round online Delphi survey was conducted from May 2019 to January 2020. The Delphi participants included national and international experts and stakeholders from academia, education, government, health and the OSHC sectors. Round 1 consisted of open-ended questions exploring physical activity, screen time and sedentary behaviour in various periods of OSHC (before school, after school and vacation care). In rounds 2 and 3, participants rated the importance of items generated from the first round for inclusion in national guidelines using a Likert scale (1–9). Consensus was defined a priori as ≥80% of respondents rating an item as “critically important” (score 7–9). Between rounds 3 and 4, the guideline development panel used the consensus items, systematic review evidence, and followed the GRADE process, to draft the guidelines. In round 4, participants were invited to provide feedback on the draft guidelines and comment on barriers and enablers to implementation.ResultsSixty-seven stakeholders agreed to participate, with response rates 61, 81, 54 and 72% for the four rounds respectively. Of the 123 items generated across the three rounds, 48 statements achieved consensus agreement as critically important for inclusion in the guidelines. These included offering a variety of physical activities (free play, playground and equipment) and restriction of screen time. The final round provided feedback on the draft guidelines. The wording of the guidelines was found to be appropriate and preliminary enablers and barriers to implementation were identified.ConclusionsThis world-first expert and stakeholder consultation has underpinned the development of the draft Australian guidelines for physical activity and screen time in OSHC. Ongoing work is needed to further refine the guidelines, determine current rates of compliance with the guidelines and implement the guidelines into practice.
Interventions in outside-school hours childcare settings for promoting physical activity amongst schoolchildren aged 4 to 12 years Rosa Virgara, Anna Phillips, Lucy K Lewis, Katherine Baldock, Luke Wolfenden, et al. Cochrane Database of Systematic Reviews, 2021 BACKGROUND Insufficient physical activity is one of four primary risk factors for non-communicable diseases such as stroke, heart disease, type 2 diabetes, cancer and chronic lung disease. As few as one in five children aged 5 to 17 years have the physical activity recommended for health benefits. The outside-school hours period contributes around 30% of children's daily physical activity and presents a key opportunity for children to increase their physical activity. Testing the effects of interventions in outside-school hours childcare settings is required to assess the potential to increase physical activity and reduce disease burden. OBJECTIVES To assess the effectiveness, cost-effectiveness and associated adverse events of interventions designed to increase physical activity in children aged 4 to 12 years in outside-school hours childcare settings. SEARCH METHODS We searched CENTRAL, MEDLINE, Embase, ERIC and SportsDISCUS to identify eligible trials on 18 August 2020. We searched two databases, three trial registries, reference lists of included trials and handsearched two physical activity journals in August 2020. We contacted first and senior authors on articles identified for inclusion for ongoing or unpublished potentially relevant trials in August 2020. SELECTION CRITERIA We included randomised controlled trials, including cluster-randomised controlled trials, of any intervention primarily aimed at increasing physical activity in children aged 4 to 12 years in outside-school hours childcare settings compared to usual care. To be eligible, the interventions must have been delivered in the context of an existing outside-school hours childcare setting (i.e. childcare that was available consistently throughout the school week/year), and not set up in the after-school period for the purpose of research. Two review authors independently screened titles and abstracts of identified papers with discrepancies resolved via a consensus discussion. A third review author was not required to resolve disagreements. DATA COLLECTION AND ANALYSIS Two review authors independently extracted data and assessed the risk of bias of included trials with discrepancies resolved via a consensus discussion; a third review author was not required to resolve disagreements. For continuous measures of physical activity, we reported the mean difference (MD) with 95% confidence intervals (CIs) in random-effects models using the generic inverse variance method for each outcome. For continuous measures, when studies used different scales to measure the same outcome, we used standardised mean differences (SMDs). We conducted assessments of risk of bias of all outcomes and evaluated the certainty of evidence (GRADE approach) using standard Cochrane procedures. MAIN RESULTS We included nine trials with 4458 participants. Five trials examined the effectiveness of staff-based interventions to change practice in the outside-school hours childcare setting (e.g. change in programming, activities offered by staff, staff facilitation/training). Two trials examined the effectiveness of staff- and parent-based interventions (e.g. parent newsletters/telephone calls/messages or parent tool-kits in addition to staff-based interventions), one trial assessed staff- and child-based intervention (e.g. children had home activities to emphasise physical activity education learnt during outside-school hours childcare sessions in addition to staff-based interventions) and one trial assessed child-only based intervention (i.e. only children were targeted). We judged two trials as free from high risk of bias across all domains. Of those studies at high risk of bias, it was across domains of randomisation process, missing outcome data and measurement of the outcome. There was low-certainty evidence that physical activity interventions may have little to no effect on total daily moderate-to-vigorous physical activity compared to no intervention (MD 1.7 minutes, 95% CI -0.42 to 3.82; P = 0.12; 6 trials; 3042 children). We were unable to pool data on proportion of the OSHC session spent in moderate-to-vigorous physical activity in a meta-analysis. Both trials showed an increase in proportion of session spent in moderate-to-vigorous physical activity (moderate-certainty evidence) from 4% to 7.3% of session time; however, only one trial was statistically significant. There was low-certainty evidence that physical activity interventions may lead to little to no reduction in body mass index (BMI) as a measure of cardiovascular health, compared to no intervention (SMD -0.17, 95% CI -0.44 to 0.10; P = 0.22; 4 trials, 1684 children). Physical activity interventions that were delivered online were more cost-effective than in person. Combined results suggest that staff-and-parent and staff-and-child-based interventions may lead to a small increase in overall daily physical activity and a small reduction or no difference in BMI. Process evaluation was assessed differently by four of the included studies, with two studies reporting improvements in physical activity practices, one reporting high programme satisfaction and one high programme fidelity. The certainty of the evidence for these outcomes was low to moderate. Finally, there was very low-certainty evidence that physical activity interventions in outside-school hours childcare settings may increase cardiovascular fitness. No trials reported on quality of life or adverse outcomes. Trials reported funding from local government health grants or charitable funds; no trials reported industry funding. AUTHORS' CONCLUSIONS Although the review included nine trials, the evidence for how to increase children's physical activity in outside-school hours care settings remains limited, both in terms of certainty of evidence and magnitude of the effect. Of the types of interventions identified, when assessed using GRADE there was low-certainty evidence that multi-component interventions, with a specific physical activity goal may have a small increase in daily moderate-to-vigorous physical activity and a slight reduction in BMI. There was very low-certainty evidence that interventions increase cardiovascular fitness. By contrast there was moderate-certainty evidence that interventions were effective for increasing proportion of time spent in moderate-to-vigorous physical activity, and online training is cost-effective.
Accelerometry shows inpatients with acute medical or surgical conditions spend little time upright and are highly sedentary: Systematic review Physical Therapy, 2017
