Papers by Joanne Enticott
DIGITAL HEALTH
Objective Machine learning involves the use of algorithms without explicit instructions. Of late,... more Objective Machine learning involves the use of algorithms without explicit instructions. Of late, machine learning models have been widely applied for the prediction of type 2 diabetes. However, no evidence synthesis of the performance of these prediction models of type 2 diabetes is available. We aim to identify machine learning prediction models for type 2 diabetes in clinical and community care settings and determine their predictive performance. Methods The systematic review of English language machine learning predictive modeling studies in 12 databases will be conducted. Studies predicting type 2 diabetes in predefined clinical or community settings are eligible. Standard CHARMS and TRIPOD guidelines will guide data extraction. Methodological quality will be assessed using a predefined risk of bias assessment tool. The extent of validation will be categorized by Reilly–Evans levels. Primary outcomes include model performance metrics of discrimination ability, calibration, and ...
Australian Journal of General Practice
International Journal of Epidemiology
Background The population prevalence of mental illness over time, and by sociodemographic subgrou... more Background The population prevalence of mental illness over time, and by sociodemographic subgroups, are important benchmark data. Examining reliable population level data can highlight groups with greater mental-illness related symptom burden and inform policy and strategy. Methods Secondary analysis of Australian National Health Surveys (n = 78,204) from 2001-02 to 2017-18. Trends in the prevalence of very high scores on the Kessler-10 (K10), a measure of psychological distress capturing symptoms of affective and anxiety disorders, were examined by time, age, gender, and socioeconomic status. Data were standardised to the 2001 Australian census population on the strata of sex and age. Results In 2017-18, the rate of probable mental illness was estimated at 5.1%, a 1.5% increase (representing an additional 367,000 Australians) since 2007. In 2017-18, the subgroups with the highest rates were women aged 18-24 (8.01%, 95% CI = 5.9%-10.2%), and the poorest fifth of Australians (8.02%,...
Computers in Biology and Medicine
Background: Integrated utilisation of digital health data has the power to transform healthcare t... more Background: Integrated utilisation of digital health data has the power to transform healthcare to deliver more efficient and effective services, and the learning health system (LHS) is emerging as a model to achieve this. The LHS uses routine data from service delivery and patient care to generate knowledge to continuously improve healthcare. The aim of this project was to explore key features of a successful and sustainable LHS to inform implementation in an Academic Health Science Centre context.Methods: We purposively identified and conducted semi-structured qualitative interviews with leaders, experienced in supporting or developing data driven innovations in healthcare. A thematic analysis using NVivo was undertaken.Results: Analysis of 26 interviews revealed five themes thought to be integral in an effective, sustainable LHS: (1) Systematic approaches and iterative, continuous learning with implementation into healthcare contributing to new best-practice care; (2) Broad stake...
UNSTRUCTURED Introduction Games, when used as interventional tools, can influence behavior change... more UNSTRUCTURED Introduction Games, when used as interventional tools, can influence behavior change by incentivizing, reinforcing, educating, providing feedback loops, prompting, persuading or providing meaning, fun and community. However, not all game elements will appeal to consumers equally, and different elements might work for different people and in different contexts. Methods A realist review was conducted to inform program theory in the development of tabletop games for health behavior change. Context, mechanisms used to change behavior and outcomes of included studies were reviewed through a realist lens. Results 31 articles met eligibility criteria and were included in the review. Several design methods were identified that enhanced efficacy of games to change behavior. These included design by local teams, pilot testing, clearly defined targets of behavior change, conscious attention to all aspects of game design including game mechanics, dynamics, aesthetics, and the elici...
Social Psychiatry and Psychiatric Epidemiology
Developmental Medicine & Child Neurology
International Wound Journal
BMC Psychiatry
Background Effective transdiagnostic treatments for patients presenting with principal or comorbi... more Background Effective transdiagnostic treatments for patients presenting with principal or comorbid symptoms of anxiety and depression enable more efficient provision of mental health care and may be particularly suitable for the varied population seen in primary healthcare settings. Mindfulness-integrated cognitive behavior therapy (MiCBT) is a transdiagnostic intervention that integrates aspects of CBT, including exposure skills targeting avoidance, with training in mindfulness meditation skills adopted from the Vipassana or insight tradition taught by the Burmese teachers U Ba Khin and Goenka. MiCBT is distinguished from both cognitive therapy and mindfulness-based cognitive therapy by the use of a theoretical framework which proposes that the locus of reinforcement of behavior is the interoceptive experience (body sensations) that co-arises with self-referential thinking. Consequently, MiCBT has a strong focus on body scanning to develop interoceptive awareness and equanimity. De...
Ageing and Society
The global population is ageing and the likelihood of living alone increases with age. Services a... more The global population is ageing and the likelihood of living alone increases with age. Services are necessary to help older people living alone to optimise health and wellbeing. This systematic review aimed to summarise the effectiveness and accessibility of interventions to improve the health and wellbeing of older people living alone. Relevant electronic databases (CINAHL, MEDLINE, PsycINFO and Scopus) were searched for all years up to August 2018. Studies were included if they involved older people (aged ⩾55 years) living alone, and an intervention with measured health and wellbeing outcomes. All study types were included. The Theory of Access was used to assess interventions across dimensions of accessibility, availability, acceptability, affordability, adequacy and awareness. Twenty-eight studies met the eligibility criteria; 17 studies focused on ageing safely in place and 11 on psychological and social wellbeing. Studies comprised quantitative (N = 19), qualitative (N = 4) an...
Journal of the American Medical Directors Association
Journal of Oral Research
Objective: To describe self-reported oral health-care visits and associated factors in older adul... more Objective: To describe self-reported oral health-care visits and associated factors in older adults in Melbourne, Australia. Material and Methods: 201 older adults, 79-96 years, took part in the Melbourne Longitudinal Studies on Healthy Ageing (MELSHA) in 2008. Participants who visited a dentist within 12-months prior were identified. Logistic regression examined factors associated with the 12-month visits. Results: 47.7% reported visits to the dentist in the previous 12 months. Multivariate analyses showed dentate participants (OR=11.27; 95% CI: 4.38-29.00) were more likely to have a 12-month visit, and; those receiving a government pension or benefit were less likely to have a 12-month visit (OR=0.38; 95% CI 0.18-0.79). Conclusion: Compared with existing data on the oral health of older Australians, MELSHA participants appear to have lower dental attendance. Findings highlight the need to increase older people sl eeking oral health-care, and the need to collect information to identify influencers of oral health service usage.
Social Science & Medicine
Australasian Journal on Ageing
International Journal for Equity in Health
Background: Refugees are potentially at an increased risk for health problems due to their past a... more Background: Refugees are potentially at an increased risk for health problems due to their past and current migration experiences. How migration factors shape refugee health is not well understood. We examined the association between migration factors and the self-rated general health of adult humanitarian refugees living in Australia. Methods: We analyzed the first three waves of data from the 'Building A New Life In Australia' longitudinal survey of 2399 humanitarian refugees resettled in Australia. The study outcome was self-rated health measured by the 36-Item Short Form Health Survey. Predictors were migration process and resettlement factors. We used generalized linear mixed models to investigate the relationship between predictor and outcome variables. Results: Poor general health persisted among this refugee population at high levels throughout the three-year follow-up. At baseline, 35.7% (95% CI: 33.8-37.7%) of the study population reported poorer general health. Female gender, increasing age and post-migration financial stressors were positively associated with poorer general health. Having a university degree and absence of chronic health conditions were seemingly protective against declining general health (OR: 0.50; 95% CI: 0.65-1.81 and OR: 0.15, 95% CI: 0.09-1.04, respectively). Conclusion: Our results show that there is persisting high prevalence of poorer general health among adult refugees across the initial years of resettlement in Australia. This finding suggests unmet health needs which may be compounded by the challenges of resettlement in a new society, highlighting the need for increased clinical awareness of this sustained health burden to help inform and prepare refugee health care and settlement service providers.
Frontiers in Psychiatry
Background: As refugee numbers grow worldwide, understanding prevalence and determinants of menta... more Background: As refugee numbers grow worldwide, understanding prevalence and determinants of mental illness in this population becomes increasingly important. Methods: We used longitudinal data to examine the initial years of resettlement in Australian refugees with a focus on ethnic-like social support. Three annual waves from a longitudinal, nationally representative cohort of 2,399 humanitarian migrants recently resettled in Australia were examined for two mental illness outcomes: post-traumatic stress disorder indicated by positive PTSD-8 screen and "high risk of severe mental illness" (HR-SMI) by Kessler Psychological Distress Scale (K6) ≥19. Generalized linear mixed models examined demographic and resettlement factors. Findings: Contrary to predictions, high prevalence of positive screens for mental illness persisted over 3 years. At baseline, 30.3% (95% CI, 28.5-32.2) screened positive for post-traumatic stress disorder (PTSD), and 15.4% (95% CI, 14.0-16.9) had HR-SMI. Over the 3 years, 52.2% met screening criteria for mental illness. PTSD was associated with older age, females, Middle Eastern birthplace, increasing traumatic events, more financial hardships, having a chronic health condition, and poor self-rated health. HR-SMI was associated with females, Middle Eastern birthplace, unstable housing, more financial hardships, having a chronic health condition, poor self-rated health, and discrimination. Also contrary to predictions, like-ethnic social support was positively associated with PTSD (OR, 1.51; 95% CI, 1.10-2.09). Interpretation: There is high prevalence of positive screens for mental illness throughout initial years of resettlement for refugees migrating to Australia. Our unexpected finding regarding like-ethnic social support raises future avenues for research. Predictors of mental illness in the post-migration context represent tangible opportunities for intervention and are likely relevant to similar resettlement settings globally.
Australian & New Zealand Journal of Psychiatry
A doubling of Australian expenditure on mental health services over two decades, inflation-adjust... more A doubling of Australian expenditure on mental health services over two decades, inflation-adjusted, has reduced prevalence of neither psychological distress nor mental disorders. Low rates of help-seeking, and inadequate and inequitable delivery of effective care may explain this partially, but not fully. Focusing on depressive disorders, drawing initially on ideas from the work of philosopher and socio-cultural critic Ivan Illich, we use evidence-based medicine statistics and simulation modelling approaches to develop testable hypotheses as to how iatrogenic influences on the course of depression may help explain this seeming paradox. Combined psychological treatment and antidepressant medication may be available, and beneficial, for depressed people in socioeconomically advantaged areas. But more Australians with depression live in disadvantaged areas where antidepressant medication provision without formal psychotherapy is more typical; there also are urban/non-urban disparities...
Uploads
Papers by Joanne Enticott