Mr Ife Tokun1, Dr Gail Kingston2,3
1Podiatry Department, Townsville Hospital and Health Service, Townsville, Australia, 2Allied Health Governance Unit, Townsville Hospital and Health Service, Townsville, Australia, 3Public Health and Tropical Medicine, James Cook University, Townsville, Australia
Biography:
Ife Tokun is a Senior Podiatrist at Townsville Hospital and Health Service and a researcher specializing in diabetes-related foot disease. His work focuses on implementing evidence-based offloading strategies, including non-removable knee-high devices, to improve patient outcomes in regional Australia. Ife has presented at national conferences, including Diabetic Foot Australia and the ANZ Society for Vascular Surgery. He serves on the LEAP 2024 Scientific Committee and has secured competitive research funding. Passionate about improving service delivery, he integrates clinical expertise with behavioural change models to enhance podiatry practice and promote sustainable, high-quality care for people with diabetes-related foot disease.
Abstract:
Background:
Australian guidelines recommend a non-removable knee-high device as the first-line treatment for offloading plantar diabetes-related foot ulcers. However, its use within North Queensland High-Risk Foot services remains rare. This project implements Instant Total Contact Casting(iTCC), a non-removable knee-high offloading alternative, at a regional health service. Guided by the COM-B model, this intervention aims to overcome barriers and leverage facilitators identified in previous research.
Objective:
To optimise capability, opportunity and motivation (COM-B) for effective implementation of iTCC, focusing on sustainable behaviour change and integration within the regional health service.
Methods:
Semi-structured interviews were conducted with 11 clinicians within the podiatry department to assess their perceptions of the proposed implementation. Findings were synthesised using the COM-B model, identifying key capabilities, opportunities, and motivations for successful implementation.
Results:
Clinicians identified a lack of exposure to gold standard offloading in university and clinical practice. This will be addressed by increasing awareness for podiatry students and clinical staff. Limited clinic time and workforce transience emerged as key barriers, prompting adjustments to clinic schedules and mandating training competencies to ensure continuity of care. Strong clinician enthusiasm was evident, with many recognising the benefits of the iTCC. Motivation will be sustained by engaging ‘change champions’ and aligning the intervention with evidence-based care.
Conclusion:
By focusing on the core concepts of COM-B, this project aims to successfully integrate the iTCC into routine clinical practice, ensuring sustainability. Future evaluations will assess the long-term impact of iTCC on DFU healing rates and patient outcomes at the regional health service.