Overview
Initiative type
Model of Care
Status
Deliver
Published
June 2026
Summary
Way to Wellness (WTW) aims to provide evidence-based support to women while they wait for gynaecological surgery or a specialist outpatient appointment.
Dates: August 2024 - October 2025
Implementation sites: Queensland statewide
This project was presented as a Poster at CEQ Showcase 2026 (PDF 559KB).
Aim
To optimise modifiable risk factors and wellbeing for women living with gynaecological conditions while they await care.
Outcomes
- 9,998 patients were offered (via SMS) the WTW intervention across multiple Queensland Hospital and Health Service catchments whilst on a waitlist.
- 1,457 completed the baseline risk assessment and 887 completed the final follow-up evaluation.
- The majority (61.9%) of participants reported making positive health changes after WTW participation.
- A number of referrals (1,212) were made to evidence-based behaviour-modification programs.
- Of the behaviour change indicators collected following their call with WTW: 92.9% reported they were likely to make health improvements, 88.9% reported feeling confident in applying knowledge, 86.2% reported actionable learning.
- Patients rated high satisfaction of their experience with WTW.
Background
Women awaiting gynaecological surgery or specialist outpatient appointments often experience delays in accessing care, potentially exacerbating health risks and compromising wellbeing. The Way to Wellness (WTW) service was developed to support people living with health conditions. These priority cohorts by promoting health optimisation and facilitating connections to evidence-based interventions during the wait period.
Women awaiting gynaecological surgery or specialist outpatient appointments frequently face prolonged wait times, which may range from weeks to several months depending on the urgency of their condition and geographic access to services. These delays can have significant physical, psychological, and social consequences. Gynaecological conditions are associated with chronic pain, reduced mobility, sleep disturbances, and fatigue, all of which negatively affect health-related quality of life (HRQOL). Extended waiting periods may also exacerbate comorbid conditions such as obesity, diabetes, cardiovascular disease, and mental health disorders, creating a compounded burden on patients and the healthcare system.
Modifiable risk factors including poor nutrition, physical inactivity, smoking, alcohol consumption, and limited engagement with preventive health services further increase morbidity in this population. Many women on waitlists, particularly those from rural or remote regions or Aboriginal and Torres Strait Islander communities, face barriers to accessing evidence-based interventions, including travel constraints, limited health literacy, and social determinants of health such as socioeconomic disadvantage. These inequities contribute to disparities in outcomes and highlight the need for proactive, and evidence-based interventions before patients receive definitive care.
This evaluation seeks to determine whether a patient-centred intervention delivered during the waiting period for gynaecological surgery or specialist outpatient care can effectively improve self-reported health behaviours, overall wellbeing, and health-related quality of life. A further aim is to assess whether the intervention facilitates meaningful connections to evidence-based programs and resources, thereby mitigating modifiable risk factors and enhancing patient readiness for surgery or specialist consultation. In addition, the evaluation examines patient-reported experiences, satisfaction, and perceived utility of the intervention, with attention to how these outcomes may differ across demographic, geographic, and clinical subgroups, including rural and remote populations and priority cohorts such as women who identify as Aboriginal and/or Torres Strait Islander. The Way to Wellness (WTW) service was developed to address these issues by providing comprehensive assessment and brief advice across key modifiable risk areas, a tailored health coaching session, behavioural goal-setting, and referral pathways to evidence-based interventions. The service targets priority cohorts, including those with heightened clinical or social vulnerability, and leverages telehealth modalities to overcome geographic and logistical barriers. By embedding structured support during the waiting period, WTW aims not only to improve individual health outcomes but also to reduce the downstream burden on healthcare services by preparing patients for optimal engagement with their subsequent care pathways.
This evaluation is critical for understanding the effectiveness, feasibility, and acceptability of pre-consultation interventions, providing evidence for scalable models that can enhance equity and quality care.
Methods
WTW aims to empower participating Queenslanders to understand their modifiable health risks and build the knowledge and confidence to make positive behaviour changes. The service provides brief advice, supports goal setting, and refers patients to evidence-based health programs. Modifiable health risk factors were assessed using validated tools and national guidelines, including:
- The Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK) (Australian Government 2024);
- Patient Health Questionnaire-4 (PHQ-4) (Lowe et al 2010); Australian Dietary Guidelines (Australian Government 2013);
- Australian physical activity guidelines (Australian Government 2021); Smoking Cessation Clinical Pathway (Queensland Health 2024);
- Australian guidelines to reduce health risks from drinking alcohol (Australian Government 2020); Australian guidelines for patient screening (Australian Government 2025). WTW offered a structured intervention to 9,998 women across multiple Hospital and Health Service (HHS) catchments in Queensland.
Participants underwent baseline risk assessments evaluating chronic conditions, nutrition, physical activity, weight status, smoking, alcohol use, emotional wellbeing, and cancer screening. A follow-up evaluation at six months assessed self-reported health changes, behaviour modifications, satisfaction and health-related quality of life (HRQOL; EQ-5D-5L).
Discussion
The Way to Wellness (WTW) service offered intervention to 9 998 women in Queensland awaiting gynaecological care. The WTW service engaged priority populations, including women from rural or remote areas (17.7%) and those identifying as Aboriginal and Torres Strait Islander peoples (6.9%), through virtual care, whilst women were awaiting care.
Lessons learned from the evaluation underscore the importance of early engagement with patients while they await care. Among participants completing follow-up (n=887), 61.9% reported making positive health changes, and 1,212 referrals were made to targeted behaviour-modification programs. Behavioural indicators demonstrated strong intention and confidence to change, with 92.9% likely to make health improvements, 88.9% confident applying knowledge, and 86.2% reporting actionable learning. High satisfaction and positive experience (>94% reporting clear communication, respect, and support) were also found.
The evaluation also highlighted substantial baseline health risks, including high prevalence of obesity (43.7% BMI-30 kg/m²), inadequate physical activity (42.1% below guideline-recommended levels), chronic disease (22.7% with at least one condition), and elevated risk for type 2 diabetes (30.8%). Emotional wellbeing was a particular concern in the Specialist Outpatient (SOP) cohort (62.8% at risk versus 52.2% in the Gynaecological Surgery Patient (GSP) cohort, p=0.021). These findings reinforce the value of pre-consultation interventions to mitigate risk factors and prepare patients for surgery or specialist care.
Limitations include reliance on self-reported data, potential selection bias due to incomplete follow-up, and variable engagement across cohorts. Nevertheless, the intervention demonstrated feasibility, acceptability, and potential for measurable health impact.
The WTW model has clear applicability across Queensland Health, particularly for other elective surgical waitlists, and specialist outpatient services where patients experience extended wait times. The principles of early engagement, structured health coaching, culturally safe practice, and integration with evidence-based referral pathways can be adapted to diverse clinical contexts, including regional and remote populations.
Next steps include scaling the program to additional HHS sites, completing economic evaluation of the service using the EQ-5D-5L and implementing longitudinal evaluation to assess sustained health behaviour change and downstream clinical outcomes. Further refinement of referral pathways, particularly for vulnerable populations, and incorporation of objective health measures will strengthen the evidence base and support broader implementation of WTW. Ultimately, WTW demonstrates that structured, patient-centred interventions delivered during waiting periods can improve health behaviours, wellbeing, and readiness for care, while promoting equity in healthcare access and outcomes.
Conclusions:
The WTW intervention effectively engaged women awaiting gynaecological care, promoted self-reported health improvements, and facilitated access to evidence-based support. These findings highlight the beneficial role of the WTW service in preoperative and pre-consultation settings to optimise patient health, wellbeing, and readiness for care, particularly for those in rural or high-risk populations.
References
Australian Government. The Australian Type 2 Diabetes Risk Assessment Tool (AUSDRISK) [Internet]. Australian Government. Department of Health Disability and Aged Care. 2019 [cited 2026 Feb 19]. Available from: https://www.health.gov.au/resources/apps-and-tools/the-australian-type-2-diabetes-risk-assessment-tool-ausdrisk?language=en
Australian Government. The Australian Dietary Guidelines [Internet]. Australian Government. Department of Health Disability and Aged Care. 2019 [cited 2026 Feb 19]. Available from: https://www.health.gov.au/resources/publications/the-australian-dietary-guidelines?language=en
Australian Government. Australian Alcohol Guidelines revised [Internet]. Australian Government. Department of Health Disability and Aged Care. 2020 [cited 2026 Feb 19]. Available from: https://www.health.gov.au/news/australian-alcohol-guidelines-revised?language=en
Australian Government. Physical activity and exercise guidelines for all Australians [Internet]. Department of Health and Aged Care. Department of Health, Disability and Aged Care. 2021 [cited 2026 Feb 19]. Available from: https://www.health.gov.au/topics/physical-activity-and-exercise/physical-activity-and-exercise-guidelines-for-all-australians?language=en
Australian Government. Guidance for patient screening [Internet]. Australian Government. Department of Health Disability and Ageing. 2025 [cited 2026 Feb 19]. Available from: https://www.health.gov.au/topics/cancer/guidance-for-patient-screening?language=en
EuroQol. EQ-5D-5L [Internet]. EuroQol. 2025 [cited 2026 Feb 5]. Available from: https://euroqol.org/information-and-support/euroqol-instruments/eq-5d-5l/
Löwe, B., Wahl, I., Rose, M., Spitzer, C., Glaesmer, H., Wingenfeld, K., Schneider, A., & Brähler, E. (2010). A 4-item measure of depression and anxiety: validation and standardization of the Patient Health Questionnaire-4 (PHQ-4) in the general population. Journal of affective disorders, 122(1-2), 86-95. https://doi.org/10.1016/j.jad.2009.06.019
Queensland Government. (2017). Health and Wellbeing Strategic Framework 2017 to 2026 | Queensland Health. Queensland Government; Queensland Health. https://www.health.qld.gov.au/system-governance/strategic-direction/plans/health-wellbeing
Queensland Government. Queensland Treasury. Queensland's Aboriginal and Torres Strait Islander population, Census 2021 Snapshot [Internet]. Queensland Government Statistician's Office. 2022 [cited 2026 Feb 5]. Available from: https://www.qgso.qld.gov.au/issues/11586/qlds-aboriginal-torres-strait-islander-population-census-2021-snapshot.pdf
Queensland Government. Queensland Women and Girls Health Strategy [Internet]. Queensland Health. 2024 [cited 2026 Feb 4]. Available from: https://www.health.qld.gov.au/system-governance/strategic-direction/plans/women-and-girls-health-strategy
Queensland Government. Report of the Chief Health Officer Queensland [Internet]. Report of the Chief Health Officer Queensland. 2025 [cited 2026 Feb 4]. Available from: https://www.choreport.health.qld.gov.au/
Queensland Health. Smoking Cessation Clinical Pathway and Smoking Coding [Internet]. Statistical Services Branch; 2024 Aug [cited 2026 Feb 19].
Key contact
Clare Pekin
Preventive Health Team Leader
Department of Health