Mark F Harris

UNSW Sydney | UNSW · Centre for Primary Health Care and Equity

[This corrects the article DOI: 10.2196/45942.].

Background Patients from culturally and linguistically diverse (CALD) backgrounds often face difficulties in accessing health and social care services. This study explored the feasibility and acceptability of involving community health workers (CHWs) as bilingual community navigators (BCNs) in general practice setting, to help patients from CALD ba...

The present study aims to investigate the prevalence of loneliness and its associated factors among older adults during the COVID-19 pandemic in Bangladesh. This cross-sectional study was conducted in October 2020 among 1032 older Bangladeshi adults aged 60 years and above through telephone interviews. A semi-structured questionnaire was used to co...

This research aimed to explore the needs, potential roles and implementation of Bilingual Community Navigators (BCNs) in providing navigation support for patients in general practice settings in Australia. A total of 19 participants (general practitioners, practice managers, practice nurses and receptionists) from five general practices in Sydney w...

Background COVID-19 has seriously disrupted health services in many countries including Bangladesh. This research aimed to explore whether Rohingya (forcefully displaced Myanmar nationals) older adults in Bangladesh faced difficulties accessing medicines and routine medical care services amid this pandemic. Methods This cross-sectional study was c...

Background Inequitable access to primary health care (PHC) remains a problem for most western countries. Failure to scale up effective interventions has been due, in part, to a failure to share the logic and essential elements of successful programs. The aim of this paper is to describe what we learned about improving access to PHC for vulnerable g...

Objectives To examine whether primary care outreach facilitation improves the quality of care for general practice patients from refugee backgrounds. Design Pragmatic, cluster randomised controlled trial, with stepped wedge allocation to early or late intervention groups. Setting, participants 31 general practices in three metropolitan areas of S...

Background Language is a barrier to many patients from refugee backgrounds accessing and receiving quality primary health care. This paper examines the way general practices address these barriers and how this changed following a practice facilitation intervention. Methods The OPTIMISE study was a stepped wedge cluster randomised trial set within...

Background Burgeoning burden of non-communicable disease among older adults is one of the emerging public health problems. In the COVID-19 pandemic, health services in low- and middle-income countries, including Bangladesh, have been disrupted. This may have posed challenges for older adults with non-communicable chronic conditions in accessing ess...

The COVID-19 pandemic has been the most challenging public health issue which not only affected the physical health of the global population but also aggravated the mental health conditions such as stress, anxiety, fear, depression and anger. While mental health services are seriously hampered amid this COVID-19 pandemic, health services, particula...

Objective This study was aimed to assess the perceived fear of COVID-19 and its associated factors among older adults in Bangladesh. Methods This cross-sectional study was conducted in October 2020 among 1032 older Bangladeshi adults aged ≥60 years. A semi-structured questionnaire was used to collect information on participants’ characteristics an...

Background This review was carried out to synthesize the evidence of the effectiveness of community health worker (CHW) navigation in primary care chronic disease management. Methods We searched the English language literature between January 1990 and March 2020 in Medline, Embase, Emcare, PubMed, Psych Info, CINAHL, Scopus, and Medline Epub ahead...

Objectives This study’s objectives were to estimate the prevalence of major non-communicable conditions and multimorbidity among older adults in rural Nepal and examine the associated socioeconomic and behavioural risk factors. Design This was a community-based cross-sectional study conducted between January and April 2018. Setting Rural municipa...

Objective To identify barriers (patient, provider, practice and system levels) to consider when implementing patient experience surveys in Australian general practice and enablers of their systematic use to inform service improvement in clinical practice as well as the broader health system. Methods and analysis An expert consultation and qualitat...

Objective To assess the cost‐effectiveness of a computer‐guided quality improvement intervention for primary health care management of cardiovascular disease (CVD ) in people at high risk. Design Modelled cost‐effectiveness analysis of the HealthTracker intervention and usual care for people with high CVD risk, based on TORPEDO trial data on presc...

Objective The Patient Activation Measure (PAM) assesses the knowledge, skills and confidence of patients to manage their health, and has been consistently used as an outcome measure of health interventions. Using the PAM to tailor interventions to a patient’s activation level is less understood. This literature review aimed to examine evidence for...

Background More than half of Australian adults manage one or more chronic conditions through ongoing interactions with general practitioners (GPs). Their experience of general practice interactions has important implications for their health outcomes and is thus important to explore in‐depth. Consumer expectations have emerged as a key consideratio...

Harris M; Fatema K; Spooner C; Harris-Roxas B; Mahimbo A; Barr M; Sitas F, 2019, Review of effectiveness of certain healthy lifestyle interventions to reduce alcohol consumption, increase levels of physical activity and healthy eating and reduce overweight and obesity (2014-2019). An Evidence Check rapid review brokered by the Sax Institute for the...

Background A perennial challenge of primary care quality improvement is to establish why interventions work in some circumstances, but not others. This study aimed to identify factors explaining variations in the impact on clinical practice of a facilitation led vascular health intervention in Australian family practice. Methods Our mixed methods...

Introduction Adults with lower levels of health literacy are less likely to engage in health-promoting behaviours. Our trial evaluates the impacts and outcomes of a mobile health-enhanced preventive intervention in primary care for people who are overweight or obese. Methods and analysis A two-arm pragmatic practice-level cluster randomised trial...

Background: Rates of obesity have increased globally and weight stigma is commonly experienced by people with obesity. Feeling stigmatised because of one's weight can be a barrier to healthy eating, physical activity and to seeking help for weight management. The aim of this study was to identify predictors of perceived weight among middle-older a...

Background We evaluated a multifaceted, computerized quality improvement intervention for management of cardiovascular disease (CVD) risk in Australian primary health care. After completion of a cluster randomized controlled trial, the intervention was made available to both trial arms. Our objective was to assess intervention outcomes in the post‐...

Objectives To quantify contemporary differences in cardiovascular disease (CVD) risk factor assessment and management between women and men in Australian primary healthcare services. Methods Records of routinely attending patients were sampled from 60 Australian primary healthcare services in 2012 for the Treatment of Cardiovascular Risk using Ele...

Introduction Technology-mediated strategies have potential to engage patients in modifying unhealthy behaviour and improving medication adherence to reduce morbidity and mortality from cardiovascular disease (CVD). Furthermore, electronic tools offer a medium by which consumers can more actively navigate personal healthcare information. Understandi...

Background: Weight management education is one of the key strategies to assist patients to manage their weight. Educational resources provide an important adjunct in the chain of communication between practitioners and patients. However, one in five Australian adults has low health literacy. The purpose of this study was to assess the readability...

Enhancing individual's health literacy for weight loss is important in addressing the increasing burden of chronic disease due to overweight and obesity. We conducted a systematic review and narrative synthesis to determine the effectiveness of lifestyle interventions aimed at improving adults' knowledge and skills for weight loss in primary health...

Socioeconomically disadvantaged adults are both more likely to be obese and have lower levels of health literacy. Our trial evaluates the implementation and effectiveness of primary care nurses acting as prevention navigators to support obese patients with low health literacy to lose weight. A pragmatic cluster randomised trial will be conducted. T...

To investigate variation according to country of birth and geography in the use of primary care services funded through Medicare Australia-Australian universal health insurance-for diabetes annual cycle of care among older overseas-born Australians with type-2 diabetes. Records of Medicare claims for medical services were linked to self-administere...

Blood pressure targets in individuals treated for hypertension in primary care remain difficult to attain. To assess the role of practice nurses in facilitating intensive and structured management to achieve ideal BP levels. We analysed outcome data from the Valsartan Intensified Primary carE Reduction of Blood Pressure Study. Patients were randoml...

Hepatitis C virus (HCV) establishes a persistent infection that in many cases leads to cirrhosis and hepatocellular carcinoma (HCC). The non-structural 5A protein (NS5A) has been implicated in this process as it contains a C-terminal polyproline motif (termed P2) that binds to Src homology 3 (SH3) domains to regulate cellular signalling and traffic...

Despite effective treatments to reduce cardiovascular disease risk, their translation into practice is limited. Using a parallel arm cluster-randomized controlled trial in 60 Australian primary healthcare centers, we tested whether a multifaceted quality improvement intervention comprising computerized decision support, audit/feedback tools, and st...

Background: Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. Despite the widespread availability of evidence-based clinical guidelines and validated risk predication equations for prevention and management of CVD, their translation into routine practice is limited. We developed a multifaceted quality improvement...

Objectives: Despite the need to develop effective strategies for improving health literacy for weight management in non-English speaking migrants, the evidence about the impact of ethnicity on health literacy remains poorly understood. This review sought to understand how ethnicity modifies the effect of interventions aimed at improving health lite...

Background: People with limited health literacy are more likely to be socioeconomically disadvantaged and have risk factors for preventable chronic diseases. General practice is the ideal setting to address these inequalities however these patients engage less in preventive activities and experience difficulties navigating health services. This stu...

Rationale: The Australian Government’s Closing the Gap Initiative encourages general practitioners to actively work towards the chronic disease management of their Aboriginal patients. Practitioners must know the Indigenous status of their patients in order to provide appropriately targeted care, yet in urban areas only around 35% of Aboriginal and...

The objective of the study was to explore the feasibility of an intervention that enhances preventive care for primary care patients with low health literacy. A mixed method study was conducted in four Sydney general practices in areas of socioeconomic disadvantage. The intervention included screening for low health literacy in patients aged 40-69...

To examine protocol adherence to structured intensive management in the Valsartan Intensified Primary carE Reduction of Blood Pressure (VIPER-BP) study involving 119 primary care clinics and 1562 randomized participants. Prospective criteria for assessing adherence to treatment prescription, uptitration, and visit attendance at 6, 10, 14, and 18 we...

Background: Cardiovascular disease (CVD) is the leading cause of death and disability worldwide. Despite the widespread availability of evidence-based clinical guidelines and validated risk predication equations for prevention and management of CVD, their translation into routine practice is limited. We developed a multifaceted quality improvement...

Aim: To assess how the Indigenous status of patients is identified in general practice in Sydney. Methods: Mixed methods using self-complete surveys, a medical records audit and Indigenous unannounced standardised patients (USP) visits to seven general practices in Sydney. Findings: Two GPs and four administration staff in separate practices did...

Outcomes for colorectal cancer patients vary significantly. Compared to other countries, Australia has a good record with patient outcomes, yet there is little information available on the referral pathway. This paper explores the views of Australian patients and their experiences of referral for colorectal cancer treatment following diagnosis; the...

Purpose: To explore the referral pathways of patients with newly diagnosed colorectal cancer to surgeons. Method: Australian surgeons from three states completed a questionnaire and their records were audited. Results: Thirty-three surgeons provided data on 530 patients seen in the preceding 12 months. The median time between colonoscopy and f...

Hepatitis C virus (HCV) infection results in the activation of numerous stress responses including oxidative stress, with the potential to induce an apoptotic state. Previously we have shown that HCV attenuates the stress-induced, p38MAPK-mediated up-regulation of the K⁺ channel Kv2.1, to maintain the survival of infected cells in the face of cellu...

The aims of this study were to explore the health-related quality of life (HRQoL) in a large sample of Australian chronically-ill patients (type 2 diabetes and/or hypertension/ischaemic heart disease), to investigate the impact of characteristics of patients and their general practitioners on their HRQoL and to examine clinically significant differ...

Background Despite being at high risk, disadvantaged patients may be less likely to receive preventive care in general practice. This study aimed to explore self-reported preventive care received from general practitioners and the factors associated with this by healthy New South Wales (NSW) residents aged 45–74 years. Methods A self-completed que...

Previous research suggests that lifestyle intervention for the prevention of diabetes and cardiovascular disease (CVD) are effective, however little is known about factors affecting participation in such programs. This study aims to explore factors influencing levels of participation in a lifestyle modification program conducted as part of a cluste...

Objective: To examine the effectiveness of telephone-based coaching services for the management of patients with chronic diseases. Methods: A rapid scoping review of the published peer reviewed literature, using Medline, Embase, CINAHL, PsychNet and Scopus. We included studies involving people aged 18 years or over with one or more of the follow...

There are gaps between current clinical guideline recommendations and current practice for the prevention of diabetes and heart disease. This study aims to explore patients' views on risk, assessment and their general practitioner's role, and how these factors may impact their uptake of preventive care. A qualitative study was conducted using semi-...

Background Interest in how to implement evidence-based practices into routine health care has never been greater. Primary care faces challenges in managing the increasing burden of chronic disease in an ageing population. Reliable prescriptions for translating knowledge into practice, however, remain elusive, despite intense research and publicatio...