Feasibility and acceptability of opportunistic screening to detect atrial fibrillation in Aboriginal adults

Rona Macniven; Josephine Gwynn; Hiroko Fujimoto; Sandy Hamilton; Sandra C Thompson; Kerry Taylor; Monica Lawrence; Heather Finlayson; Graham Bolton; Norman Dulvari; Daryl C Wright; Boe Rambaldini; Ben Freedman; Kylie Gwynne

doi:10.1111/1753-6405.12905

Feasibility and acceptability of opportunistic screening to detect atrial fibrillation in Aboriginal adults

Aust N Z J Public Health. 2019 Aug;43(4):313-318. doi: 10.1111/1753-6405.12905. Epub 2019 May 29.

Authors

Rona Macniven^{1

2}, Josephine Gwynn^{1

2}, Hiroko Fujimoto¹, Sandy Hamilton³, Sandra C Thompson³, Kerry Taylor⁴, Monica Lawrence⁵, Heather Finlayson⁶, Graham Bolton⁶, Norman Dulvari⁷, Daryl C Wright⁸, Boe Rambaldini¹, Ben Freedman^{1

2}, Kylie Gwynne¹

Affiliations

¹ Faculty of Medicine and Health, Sydney Medical School, Poche Centre for Indigenous Health, The University of Sydney, New South Wales.
² Charles Perkins Centre D17, The University of Sydney, New South Wales.
³ Poche Centre for Indigenous Health, School of Indigenous Studies, The University of Western Australia, Crawley, Western Australia.
⁴ Poche Centre for Indigenous Health, Alice Springs, Northern Territory.
⁵ Poche Centre for Indigenous Health, Flinders University of South Australia, Adelaide, South Australia.
⁶ Brewarrina Multipurpose Service, Brewarrina, New South Wales.
⁷ Albury Wodonga Aboriginal Health Service, Glenroy, New South Wales.
⁸ Tharawal Aboriginal Corporation, Airds, New South Wales.

PMID: 31141280
DOI: 10.1111/1753-6405.12905

Abstract

Objective: Examine the feasibility and acceptability of an electrocardiogram (ECG) attached to a mobile phone (iECG) screening device for atrial fibrillation (AF) in Aboriginal Controlled Community Health Services (ACCHS) and other community settings.

Methods: Semi-structured interviews were conducted with ACCHS staff in urban, rural and remote communities in three Australian states/territories. Quantitative and qualitative questions identified the enabling factors and barriers for staff and Aboriginal patients' receptiveness to the device. Mean quantitative scores and their standard deviation were calculated in Microsoft Excel and qualitative questions were thematically analysed.

Results: Eighteen interviews were conducted with 23 staff across 11 ACCHS. Quantitative data found staff were confident in providing iECG screening and managing the referral pathway, and thought the process was beneficial for patients. Qualitative data highlighted the usefulness of the device to undertake opportunistic screening and acceptability in routine practice, and provided opportunities to engage patients in education around AF.

Conclusion: The iECG device was well accepted within ACCHSs and was feasible to use to screen for AF among Aboriginal patients. Implications for public health: The device can be used in clinical and community settings to screen Aboriginal people for atrial fibrillation to help reduce rates of stroke and other cardiovascular diseases.

Keywords: indigenous health; primary health care; rural and remote health; screening.

MeSH terms

Adult
Atrial Fibrillation / diagnosis*
Australia
Cell Phone*
Electrocardiography / instrumentation*
Electrocardiography / methods
Feasibility Studies
Female
Humans
Interviews as Topic
Male
Mass Screening / methods*
Mobile Applications*
Native Hawaiian or Other Pacific Islander*
Patient Acceptance of Health Care*
Primary Health Care
Qualitative Research
Rural Health
Rural Population
Urban Population