{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T21:45:16Z","timestamp":1784238316010,"version":"3.55.0"},"reference-count":27,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,1,9]],"date-time":"2026-01-09T00:00:00Z","timestamp":1767916800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100025520","name":"Medical Research Future Fund","doi-asserted-by":"publisher","award":["APP1193796"],"award-info":[{"award-number":["APP1193796"]}],"id":[{"id":"10.13039\/501100025520","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100023759","name":"Telethon Kids Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100023759","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Australian J Rural Health"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify the barriers and facilitators for timely detection and optimal management of otitis media (OM) in Aboriginal children in a primary care setting from the perspective of Health Care Providers (HCPs).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A large regional town in the Kimberley region of Western Australia.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Thirty HCPs to Aboriginal children.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A qualitative, aboriginal co\u2010designed, participatory action research study with semi\u2010structured interviews and focus groups.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Barriers were identified throughout the child's presentation and management and included challenges with paediatric ear examinations, earwax obstructing the view of the tympanic membrane, unfamiliarity with diagnostic tools, multiple guidelines with varying recommendations, and confusion with accessing ENT specialists. Multiple facilitators were identified and included training HCPs in paediatric examination techniques and wax removal, a single best practice guideline, and system changes to facilitate access to ENT specialist support if required. Importantly, an expanded clinical role of Aboriginal Health Practitioners (AHPs) was identified to augment efficient and effective clinical OM assessment and management in children presenting to clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>All barriers could potentially be overcome through a programme that enhances theoretical knowledge and practical skills in paediatric ear examination, otoscopy, and safe, timely removal of earwax, improved communication with ENT specialists, and an expanded clinical role for AHPs. Our findings carry important implications for managing OM in primary care services across Australia.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajr.70144","type":"journal-article","created":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T07:30:54Z","timestamp":1768030254000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["The Determinants to Effective Diagnosis and Management of Otitis Media in Aboriginal Children in Primary Care From the Perspective of Health Care Practitioners"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4892-1285","authenticated-orcid":false,"given":"Gloria","family":"Lau","sequence":"first","affiliation":[{"name":"Wal\u2010Yan Respiratory Research Centre, The Kids Research Institute Australia  Perth Western Australia Australia"},{"name":"Department of Respiratory and Sleep Medicine, Perth Children's Hospital  Perth Western Australia Australia"},{"name":"Medical School, the University of Western Australia  Crawley Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roz","family":"Walker","sequence":"additional","affiliation":[{"name":"Ngangk Yira Institute for Change, Murdoch University  Murdoch Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pamela","family":"Laird","sequence":"additional","affiliation":[{"name":"Wal\u2010Yan Respiratory Research Centre, The Kids Research Institute Australia  Perth Western Australia Australia"},{"name":"Department of Respiratory and Sleep Medicine, Perth Children's Hospital  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Philomena","family":"Lewis","sequence":"additional","affiliation":[{"name":"Broome Regional Aboriginal Medical Service  Broome Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jafri","family":"Kuthubutheen","sequence":"additional","affiliation":[{"name":"Division of Surgery, Medical School University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2000-8910","authenticated-orcid":false,"given":"Andr\u00e9","family":"Schultz","sequence":"additional","affiliation":[{"name":"Wal\u2010Yan Respiratory Research Centre, The Kids Research Institute Australia  Perth Western Australia Australia"},{"name":"Department of Respiratory and Sleep Medicine, Perth Children's Hospital  Perth Western Australia Australia"},{"name":"Division of Paediatrics, Faculty of Medicine University of Western Australia  Perth Western Australia Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,1,9]]},"reference":[{"key":"e_1_2_14_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2012.02.031"},{"key":"e_1_2_14_3_1","unstructured":"World Health Organization \u201cChronic Suppurative Otitis Media: Burden of Ilness and Management Options [Internet] \u201d2004 accessed December 18 2024 http:\/\/healthbulletin.org.au\/wp\u2010content\/uploads\/2013\/10\/ear_health_review_2013.pdf."},{"key":"e_1_2_14_4_1","doi-asserted-by":"publisher","DOI":"10.1097\/INF.0b013e3180621177"},{"key":"e_1_2_14_5_1","volume-title":"Chronic Suppurative Otitis Media: Burden of Illness and Management Options [Online]","author":"Acuin J.","year":"2004"},{"key":"e_1_2_14_6_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2009.tb02931.x"},{"issue":"7","key":"e_1_2_14_7_1","first-page":"2051","article-title":"Acute Otitis Media: Part I. 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