Rural and regional community health service boards: perceptions of community health – a Delphi study
Diana Guzys A C , Guinever Threlkeld B , Virginia Dickson-Swift A and Amanda Kenny AA La Trobe Rural Health School, Bendigo, La Trobe University, PO Box 199, Bendigo, Vic. 3552, Australia.
B La Trobe Rural Health School Albury–Wodonga, La Trobe University, PO Box 821, Wodonga, Vic. 3689, Australia.
C Corresponding author. Email: d.guzys@latrobe.edu.au
Australian Journal of Primary Health 23(6) 543-548 https://doi.org/10.1071/PY16123
Submitted: 29 September 2016 Accepted: 6 December 2016 Published: 8 February 2017
Abstract
Much has been written about the composition of health service boards and the importance of recruiting people with skills appropriate for effective and accountable governance of health services. Governance training aims to educate directors on their governance responsibilities; however, the way in which these responsibilities are discharged is informed by board members’ understanding of health within their communities. The aim of this study was to identify how those engaged in determining the strategic direction of local regional or rural community health services in Victoria, Australia, perceived the health and health improvement needs of their community. The Delphi technique was employed to facilitate communication between participants from difference geographic locations. The findings of the study highlight the different ways that participants view the health of their community. Participants prioritised indicators of community health that do not align with standard measures used by government to plan for, fund or report on health. Devolved governance of healthcare services aims to improve local healthcare responsiveness. Yet, if not accompanied with the redistribution of resources and power, policy claimed to promote localised decision-making is simply tokenistic.
Additional keywords: governance, health policy reform, social health.
References
Adler M, Ziglio E (1996) ‘Gazing into the Oracle: the Delphi Method and its Application to Social Policy and Public Health.’ (Jessica Kingsley Publishers: London, UK)Attride-Stirling J (2001) Thematic networks: an analytic tool for qualitative research. Qualitative Research 1, 385–405.
| Thematic networks: an analytic tool for qualitative research.Crossref | GoogleScholarGoogle Scholar |
Australian Institute of Company Directors (2016) Director tools. General duties of directors: duties of directors. Available at http://aicd.companydirectors.com.au/~/media/cd2/resources/director-resources/director-tools/pdf/05446-6-2-duties-directors_general-duties-directors_a4-web.ashx [Verified 3 January 2017]
Baum FE, Laris P, Fisher M, Newman L, MacDougall C (2013) ‘Never mind the logic, give me the numbers’: former Australian health ministers’ perspectives on the social determinants of health. Social Science & Medicine 87, 138–146.
| ‘Never mind the logic, give me the numbers’: former Australian health ministers’ perspectives on the social determinants of health.Crossref | GoogleScholarGoogle Scholar |
Bismark MM, Studdert DM (2014) Governance of quality of care: a qualitative study of health service boards in Victoria, Australia. BMJ Quality & Safety 23, 474–482.
| Governance of quality of care: a qualitative study of health service boards in Victoria, Australia.Crossref | GoogleScholarGoogle Scholar |
Briedenhann J, Butts S (2006) Application of the Delphi technique to rural tourism project evaluation. Current Issues in Tourism 9, 171–190.
| Application of the Delphi technique to rural tourism project evaluation.Crossref | GoogleScholarGoogle Scholar |
Burris S, Hancock T, Lin V, Herzog A (2007) Emerging strategies for healthy urban governance. Journal of Urban Health 84, 154–163.
| Emerging strategies for healthy urban governance.Crossref | GoogleScholarGoogle Scholar |
Cohen DA, Finch BK, Bower A, Sastry N (2006) Collective efficacy and obesity: the potential influence of social factors on health. Social Science & Medicine 62, 769–778.
| Collective efficacy and obesity: the potential influence of social factors on health.Crossref | GoogleScholarGoogle Scholar |
Considine M, O’Sullivan S, Nguyen P (2014) Governance, boards of directors and the impact of contracting on not-for-profit organizations – an Australian study. Social Policy and Administration 48, 169–187.
| Governance, boards of directors and the impact of contracting on not-for-profit organizations – an Australian study.Crossref | GoogleScholarGoogle Scholar |
Downey CA, Chang EC (2013) Assessment of everyday beliefs about health: the lay concepts of health inventory, college student version. Psychology & Health 28, 818–832.
| Assessment of everyday beliefs about health: the lay concepts of health inventory, college student version.Crossref | GoogleScholarGoogle Scholar |
Eriksson M, Dahlgren L, Emmelin M (2013) Collective actors as driving forces for mobilizing social capital in a local community: what can be learned for health promotion? In ‘Social Capital and Rural Development in the Knowledge Society’. pp. 273–298. (Edward Elgar Publishing: Cheltenham, UK)
Fletcher AJ, Marchildon GP (2014) Using the Delphi method for qualitative, participatory action research in health leadership. International Journal of Qualitative Methods 13, 1–18.
| Using the Delphi method for qualitative, participatory action research in health leadership.Crossref | GoogleScholarGoogle Scholar |
Guzys D, Dickson-Swift V, Kenny A, Threlkeld G (2015) Gadamerian philosophical hermeneutics as a useful methodological framework for the Delphi technique. International Journal of Qualitative Studies on Health and Well-being 10, 26291
| Gadamerian philosophical hermeneutics as a useful methodological framework for the Delphi technique.Crossref | GoogleScholarGoogle Scholar |
Hasson F, Keeney S (2011) Enhancing rigour in the Delphi technique research. Technological Forecasting and Social Change 78, 1695–1704.
| Enhancing rigour in the Delphi technique research.Crossref | GoogleScholarGoogle Scholar |
Idler EL, Hudson SV, Leventhal H (1999) The meanings of self-ratings of health. A qualitative and quantitative approach. Research on Aging 21, 458–476.
| The meanings of self-ratings of health. A qualitative and quantitative approach.Crossref | GoogleScholarGoogle Scholar |
Keevers L, Treleaven L, Sykes C, Darcy M (2012) Made to measure: taming practices with results-based accountability. Organization Studies 33, 97–120.
| Made to measure: taming practices with results-based accountability.Crossref | GoogleScholarGoogle Scholar |
Kenny A, Hyett N, Sawtell J, Dickson-Swift V, Farmer J, O’Meara P (2013) Community participation in rural health: a scoping review. BMC Health Services Research 13, 64
| Community participation in rural health: a scoping review.Crossref | GoogleScholarGoogle Scholar |
Kezar A, Maxey D (2016) The Delphi technique: an untapped approach of participatory research. International Journal of Social Research Methodology 19, 143–160.
| The Delphi technique: an untapped approach of participatory research.Crossref | GoogleScholarGoogle Scholar |
Maier F, Meyer M, Steinbereithner M (2016) Nonprofit organizations becoming business-like: a systematic review. Nonprofit and Voluntary Sector Quarterly 45, 64–86.
| Nonprofit organizations becoming business-like: a systematic review.Crossref | GoogleScholarGoogle Scholar |
McIntyre S, Novak I, Cusick A (2010) Consensus research priorities for cerebral palsy: a Delphi survey of consumers, researchers, and clinicians. Developmental Medicine and Child Neurology 52, 270–275.
| Consensus research priorities for cerebral palsy: a Delphi survey of consumers, researchers, and clinicians.Crossref | GoogleScholarGoogle Scholar |
Mogford E, Gould L, DeVoght A (2011) Teaching critical health literacy in the US as a means to action on the social determinants of health. Health Promotion International 26, 4–13.
| Teaching critical health literacy in the US as a means to action on the social determinants of health.Crossref | GoogleScholarGoogle Scholar |
Okoli C, Pawlowski SD (2004) The Delphi method as a research tool: an example, design considerations and applications. Information & Management 42, 15–29.
| The Delphi method as a research tool: an example, design considerations and applications.Crossref | GoogleScholarGoogle Scholar |
Polkinghorne M, Arnold A (2014) A six step guide to using recursive abstraction applied to the qualitative analysis of interview data. Discussion paper. (Bournemouth University: Poole, UK) Available at http://eprints.bournemouth.ac.uk/21367/1/ISBN%20978-1-85899-296-9.pdf [Verified 3 January 2017]
Skulmoski G, Hartman F, Krahn J (2007) The Delphi method for graduate research. Journal of Information Technology Education: Research 6, 1–21.
Smith KB, Humphreys JS, Wilson MG (2008) Addressing the health disadvantage of rural populations: how does epidemiological evidence inform rural health policies and research? The Australian Journal of Rural Health 16, 56–66.
| Addressing the health disadvantage of rural populations: how does epidemiological evidence inform rural health policies and research?Crossref | GoogleScholarGoogle Scholar |
Smith PC, Anell A, Busse R, Crivelli L, Healy J, Lindahl AK, Westert G, Kene T (2012) Leadership and governance in seven developed health systems. Health Policy 106, 37–49.
| Leadership and governance in seven developed health systems.Crossref | GoogleScholarGoogle Scholar |
Sobaih AEE, Ritchie C, Jones E (2012) Consulting the oracle? Applications of modified Delphi technique to qualitative research in the hospitality industry. International Journal of Contemporary Hospitality Management 24, 886–906.
| Consulting the oracle? Applications of modified Delphi technique to qualitative research in the hospitality industry.Crossref | GoogleScholarGoogle Scholar |
Sykes S, Wills J, Rowlands G, Popple K (2013) Understanding critical health literacy: a concept analysis. BMC Public Health 13, 150
| Understanding critical health literacy: a concept analysis.Crossref | GoogleScholarGoogle Scholar |
Tritter JQ, McCallum A (2006) The snakes and ladders of user involvement: moving beyond Arnstein. Health Policy (Amsterdam) 76, 156–168.
| The snakes and ladders of user involvement: moving beyond Arnstein.Crossref | GoogleScholarGoogle Scholar |
Veronesi G, Keasey K (2012) A (new) model of board of directors: evidence from the National Health Service. International Journal of Public Sector Management 25, 272–286.
| A (new) model of board of directors: evidence from the National Health Service.Crossref | GoogleScholarGoogle Scholar |
Wentholt M, Rowe G, König A, Marvin H, Frewer L (2009) The views of key stakeholders on an evolving food risk governance framework: results from a Delphi study. Food Policy 34, 539–548.
| The views of key stakeholders on an evolving food risk governance framework: results from a Delphi study.Crossref | GoogleScholarGoogle Scholar |
Wilkes L (2015) Using the Delphi technique in nursing research. Nursing Standard 29, 43–49.
| Using the Delphi technique in nursing research.Crossref | GoogleScholarGoogle Scholar |