title: Process evaluation of a pilot evidence-based Polycystic Ovary Syndrome clinic in the Torres Strait.
abstract: OBJECTIVE
  Polycystic ovary syndrome (PCOS) is a chronic endocrine syndrome in reproductive-aged women which is very common among Aboriginal and Torres Strait Islander women. The objective of this study was to conduct a process evaluation of a pilot clinic on Thursday Island which aimed to provide a comprehensive evidence-based service for women with PCOS throughout the Torres Strait.
  
  
  METHODS
  Mixed-method evaluation at 12 months comprising a medical record audit, semi-structured interviews and focus group discussions.
  
  
  METHODS
  Primary care.
  
  
  METHODS
  Audit of n = 11 clinics (n = 36 women), qualitative semi-structured interviews with n = 8 clinicians and focus group discussions with n = 8 women.
  
  
  METHODS
  (i) Fidelity to evidence-based guidelines, (ii) barriers and enablers to women using the service, (iii) the ability to meet the needs of women and the community.
  
  
  RESULTS
  The clinic was largely successful in providing evidence-based care with up to 78% of women receiving recommended cardiometabolic screening, 100% emotional screening and 89% lifestyle management despite the remoteness of the clinic and limited financial and human resources. Health care providers report sustainability of the clinic will be dependent on factors including staffing, administrative support and inclusion of Aboriginal and Torres Strait Islander health workers.
  
  
  CONCLUSIONS
  While the clinic has been largely successful there are areas identified for potential improvement and to facilitate sustainability which should be considered before up-scaling this model to a national level. These include systems, administrative and staffing support, engaging with other community services to facilitate lifestyle changes and ongoing engagement and upskilling of Aboriginal and Torres Strait Islander health care providers.
authors.affiliation: Monash Centre for Health Research Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Boyle
authors.affiliation: Monash Centre for Health Research Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
authors.forename: Grace
authors.initials: G
authors.lastname: Hollands
authors.affiliation: Community Wellness Centre - Thursday Island, Torres & Cape Hospital and Health Service, Queensland, Australia.
authors.forename: Sarah
authors.initials: S
authors.lastname: Beck
authors.affiliation: Community Wellness Centre - Thursday Island, Torres & Cape Hospital and Health Service, Queensland, Australia.
authors.forename: Gaynor
authors.initials: G
authors.lastname: Hampel
authors.affiliation: Apunipima Cape York Health Council, Cape York, Queensland, Australia.
authors.forename: Hylda
authors.initials: H
authors.lastname: Wapau
authors.affiliation: Community Wellness Centre - Thursday Island, Torres & Cape Hospital and Health Service, Queensland, Australia.
authors.forename: Marissa
authors.initials: M
authors.lastname: Arnot
authors.affiliation: Jean Hailes for Women's Health, Adelaide, South Australia, Australia.
authors.forename: Louise
authors.initials: L
authors.lastname: Browne
authors.affiliation: Monash Centre for Health Research Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.
authors.forename: Helena J
authors.initials: HJ
authors.lastname: Teede
authors.affiliation: Monash Centre for Health Research Implementation, School of Public Health and Preventive Medicine, Monash University, Clayton, Victoria, Australia.|The Robinson Research Institute, School of Paediatrics and Reproductive Health, University of Adelaide, Adelaide, South Australia, Australia.
authors.forename: Lisa J
authors.initials: LJ
authors.lastname: Moran
mesh_terms: D000328:Adult; D000554:Ambulatory Care Facilities / Q000458:organization & administration*; D001315:Australia / Q000453:epidemiology; D019317:Evidence-Based Medicine; D005260:Female; D017144:Focus Groups; D006303:Health Services, Indigenous / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D010865:Pilot Projects; D011085:Polycystic Ovary Syndrome / Q000453:epidemiology / Q000208:ethnology / Q000628:therapy*; D015995:Prevalence; D011320:Primary Health Care / Q000458:organization & administration*; D017064:Process Assessment, Health Care; D036301:Qualitative Research
keywords: Indigenous health; Polycystic ovary syndrome; lifestyle management; rural health; screening