{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T05:48:29Z","timestamp":1782539309614,"version":"3.54.5"},"reference-count":18,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:00:00Z","timestamp":1781913600000},"content-version":"vor","delay-in-days":19,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100004752","name":"State Government of Victoria","doi-asserted-by":"publisher","award":["PCCRG23010"],"award-info":[{"award-number":["PCCRG23010"]}],"id":[{"id":"10.13039\/501100004752","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":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To describe an evidence\u2010informed, experience\u2010based co\u2010design process used to adapt metropolitan early palliative care referral models for implementation in a regional Australian health service.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A scoping review of palliative care delivery and early referral models to inform evidence\u2010informed, experience\u2010based co\u2010design workshops involving consumers, clinicians, and health service staff.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Sequential mixed\u2010methods development study comprising evidence synthesis to identify model components, followed by two iterative workshops to construct and refine a context\u2010appropriate outpatient early referral model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>A regional public health service in Victoria, Australia, seeking to establish an outpatient early referral palliative care clinic for people with advanced cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Purposefully sampled stakeholders (patients\/carers, oncologists, palliative care clinicians, cancer care coordinators, Aboriginal health worker, managers, and researchers) took part in two online workshops.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Co\u2010designed model structure and components, perceived feasibility in a resource\u2010constrained regional context, and agreed service scope and patient eligibility.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The process generated a regionally tailored early referral pathway incorporating needs\u2010based screening, prioritisation to manage limited capacity, and staged roll\u2010out initially focused on selected cancer groups. These adaptations, while pragmatic, highlight the resourcing disparities faced by rural and regional services and the equity implications of resource\u2010driven variation in care delivery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Evidence\u2010informed co\u2010design enabled pragmatic adaptation of metropolitan palliative care models to a regional setting and offers a transferable approach for other rural and regional services.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/ajr.70224","type":"journal-article","created":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T09:07:03Z","timestamp":1781946423000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Using Pragmatic Co\u2010Design Processes in a Resource\u2010Constrained Regional Health Service: Insights From the\n                    <scp>TROPICAL<\/scp>\n                    \u2010\n                    <scp>VIC<\/scp>\n                    Early Referral to Palliative Care Project"],"prefix":"10.1111","volume":"34","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3928-0324","authenticated-orcid":false,"given":"Stacey Ann","family":"Rich","sequence":"first","affiliation":[{"name":"Border Medical Oncology Research Unit  Albury Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3312-0645","authenticated-orcid":false,"given":"Jennifer","family":"Philip","sequence":"additional","affiliation":[{"name":"University of Melbourne  Parkville Australia"},{"name":"St Vincent's Hospital  Sydney Australia"},{"name":"Peter MacCallum Cancer Centre  Parkville Australia"},{"name":"Royal Melbourne Hospital  Parkville Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annie","family":"Williams","sequence":"additional","affiliation":[{"name":"Hume Regional 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