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Social work makes an important contribution to child protection practice and policy in Australia, but data are limited about the discipline's contribution to research. The aim of this scoping review was to examine the quantity and nature of Australian social work child protection research for the period 2007-14. A comprehensive search of nine bibliographic data bases identified 255 peer-reviewed articles. The papers were authored by 287 researchers, most of whom published only one paper during the period. The research was published in seventeen Australian and thirty-five international journals. Non-empirical papers and those using qualitative methodologies were most prevalent, and there was a lack of research depth and quantum on particular child protection topics. The findings indicate that developing more sustained programmes of research, underpinned by a balanced portfolio of methods and approaches, would maximise the potential for research impact on child protection policy and practice. [ABSTRACT FROM AUTHOR]

Dental caries, a non-communicable disease, is one of the most prevalent diseases globally and share common modifiable risk factors with obesity such as excess sugar intake. However, prioritization by governments to improve population oral health has been limited and is typically excluded from the discourse of public health policy development. Therefore, interventions that target dental caries can have other co-benefits including obesity prevention. In Victoria, Australia, local government authorities have a regulatory requirement to develop their Municipal Health and Wellbeing Plans. The aim of this paper is to identify whether prioritization for oral health by local government authorities in Victoria has changed through the subsequent renewal of the Victorian Public Health and Wellbeing Plans 2011–2015 and 2019–2023. Three desktop audits for all publicly available Municipal Health and Wellbeing Plans by local government authorities in Victoria were conducted between 2014 and 2022. Key terms related to oral health was searched within these policy documents and categorized into six indicators: (i) included oral health as a priority, (ii) linked healthy eating and oral health, (iii) supported the Achievement Program, (iv) included the Smiles 4 Miles program, (v) advocated for fluoridated drinking water, and (vi) included other strategies related to oral health. Overall, there was statistically significant reduction in five of the six indicators, with the exception for prioritization of other strategies related to oral health such as targeting excess sugar intake and smoking. A multi-sectoral approach, that includes oral health would be advantageous to address the growing burden of non-communicable diseases. [ABSTRACT FROM AUTHOR]

Risk management and empowerment have become key features of social work practice. Despite their increasing salience, relatively little is known about the perspectives of mental health social workers regarding how they navigate competing risk management approaches in modern practice that supports empowerment. The socio-cultural influences on risk management have also received insufficient attention in social work research. Focusing on these issues, this paper explored the perspectives of social workers in two geographically and culturally distinctive settings (i.e. Hong Kong and Sydney). Data were collected through semi-structured interviews with frontline social workers and were analysed using thematic analysis. Similar views were expressed by participants in both settings regarding assessment of clients' readiness for risk-taking. Differences were identified in their practices of negotiating the perspectives of other key stakeholders and can be attributed to the influences of distinctive cultural and socio-political contexts. These insights may contribute to the development of more systematic, localised and practice-based risk assessment guidelines for mental health practitioners working towards the empowerment of clients. [ABSTRACT FROM AUTHOR]

Alcohol consumption by Australian women during midlife has been increasing. Health promotion efforts to reduce alcohol consumption in order to reduce alcohol-related disease risk compete with the social contexts and value of alcohol in women's lives. This paper draws on 50 qualitative interviews with midlife women (45–64 years of age) from different social classes living in South Australia in order to gain an understanding of how and why women might justify their relationships with alcohol. Social class shaped and characterized the different types of relationships with alcohol available to women, structuring their logic for consuming alcohol and their ability to consider reducing (or 'breaking up with') alcohol. We identified more agentic relationships with alcohol in the narratives of affluent women. We identified a tendency for less control over alcohol-related decisions in the narratives of women with less privileged life chances, suggesting greater challenges in changing drinking patterns. If classed differences are not attended to in health promotion efforts, this might mitigate the effectiveness of alcohol risk messaging to women. [ABSTRACT FROM AUTHOR]

Popular commercial meal kit subscription services (MKSSs) may support families to overcome barriers to cooking and eating at home, and facilitate improved vegetable consumption. The global meal kit market has expanded rapidly creating a gap in our understanding of the health-promoting potential of MKSSs. This paper describes the contemporary MKSS market in Australia and provides a vegetable-specific content analysis of a sample of recipes. A 1-week subscription was purchased for all Australian-based MKSSs (n  = 9) and websites were systematically reviewed to document key characteristics and recipe features. Vegetable content of all available recipes within a 1-week period were analysed. Our findings highlight the rapid expansion and evolution of MKSS market offerings over the past decade and their potential to support family vegetable consumption. Across all analysed recipes (n  = 179), MKSSs provided a median of 2.5 vegetable serves per person (range 0.7–7.5 serves) and a median of 3 different types of vegetables from 2 vegetable subgroups (i.e. dark green, red and orange, starchy, legumes and all other vegetables). This suggests that MKSSs may support family vegetable consumption if families select recipes with a greater number and variety of vegetables. However, an opportunity remains for MKSSs to improve both vegetable quantity and variety to positively influence population health. Further research is required to describe how families use meal kits promoting a greater understanding of their potential to improve family nutrition. [ABSTRACT FROM AUTHOR]

In 2020, social workers across the world responded to the global COVID-19 pandemic and the consequent strict lockdown procedures over several months. In many countries, including Australia and New Zealand, this virtual shutdown period necessitated a reframing of social work practice to incorporate factors including delivery of services via virtual means and more limited access for vulnerable clients. This article draws on the integration of two methods designed to address the research question: 'How has social work practice in Australia and New Zealand been affected by COVID-19?' These include (i) a narrative review of papers published during 2020 on social work practice and the COVID-19 pandemic and (ii) an online survey, undertaken from October to December 2020, of Australian and New Zealand social workers. The questionnaire data were analysed using Statistical Package for the Social Sciences (SPSS) and thematic analysis. The findings of this article details include the significant impacts of COVID-19 on practice, the increased needs of clients, including a rise in health issues, violence, homelessness and financial concerns, and the resulting critical changes to social work workloads. Social workers also reported greater use of technologies to deliver services and fears for their families and themselves if exposed to COVID-19. [ABSTRACT FROM AUTHOR]

Although rising rates of obesity are recognized as a major concern for Australian public health, debate on what (if any) responsive action should be undertaken is conceptually and normatively complex. It is shaped by diverse values and interests; different representations of the problem; and many options for action by government, the private sector or individuals. This paper presents research documenting arguments for and against implementing a sugar tax in Australia. It is based on semi-structured interviews with representatives from industry (n  = 4), public health (n  = 4), policy think tanks (n  = 2); and document and media analyses. The research design was informed by framing and agenda setting theory with results reported under four main themes: framing economic impacts, framing equity, framing obesity and framing the 'nanny state' versus individual liberty argument. We found that proposals for a sugar tax as part of policy responses to the issue of overweight and obesity in Australia are framed very differently by actors who either support or oppose it. A conclusion is that policy makers and public health advocates involved in policy debates on a sugar tax need to understand the role of problem and 'solution' framing, and develop positions based on protecting the public interest as a basic ethical responsibility of governments and public agencies. [ABSTRACT FROM AUTHOR]

Background: There has been little research on the economic status of those with multiple health conditions, particularly on the relationship between multiple health conditions and wealth. This paper will assess the difference in the value and type of wealth assets held by Australians who have multiple chronic health conditions. Methods: Using Health & WealthMOD, a microsimulation model of the 45-64-year-old Australian population in 2009, a counterfactual analysis was undertaken. The actual proportion of people with different numbers of chronic health conditions with any wealth, and the value of this wealth was estimated. This was compared with the counterfactual values had the individuals had no chronic health conditions. Results: There was no change in the proportion of people with one health condition who actually had any wealth, compared to the counterfactual proportion had they had no chronic health conditions. Ninety-four percent of those with four or more health conditions had some accumulated wealth; however, under the counterfactual, 100% would have had some accumulated wealth. There was little change in the value of non-income-producing assets under the counterfactual, regardless of number of health conditions. Those with four or more chronic health conditions had a mean value of $17 000 in income-producing assets; under the counterfactual, the average would have been $78 000. Conclusion: This study has highlighted the variation in the value of wealth according to number of chronic health conditions, and hence the importance of considering multiple morbidities when discussing the relationship between health and wealth. [ABSTRACT FROM AUTHOR]

Introduction: Quality of life is included in the economic evaluation of health services by measuring the preference for health states, i.e. health state utilities. However, most intervention studies include a disease-specific, not a utility, instrument. Consequently, there has been increasing use of statistical mapping algorithms which permit utilities to be estimated from a disease-specific instrument. The present paper provides such algorithms between the MacNew Heart Disease Quality of Life Questionnaire (MacNew) instrument and six multi-attribute utility (MAU) instruments, the Euroqol (EQ-5D), the Short Form 6D (SF-6D), the Health Utilities Index (HUI) 3, the Quality of Wellbeing (QWB), the 15D (15 Dimension) and the Assessment of Quality of Life (AQoL-8D). Methods: Heart disease patients and members of the healthy public were recruited from six countries. Non-parametric rank tests were used to compare subgroup utilities and MacNew scores. Mapping algorithms were estimated using three separate statistical techniques. Results: Mapping algorithms achieved a high degree of precision. Based on the mean absolute error and the intra class correlation the preferred mapping is MacNew into SF-6D or 15D. Using the R squared statistic the preferred mapping is MacNew into AQoL-8D. Implications for research: The algorithms reported in this paper enable MacNew data to be mapped into utilities predicted from any of six instruments. This permits studies which have included the MacNew to be used in cost utility analyses which, in turn, allows the comparison of services with interventions across the health system. [ABSTRACT FROM AUTHOR]

This study explored how social workers located in Sydney and Hong Kong conceptualised client empowerment. Further, it investigated these professionals' perceived facilitators and barriers to their empowerment practices, based on an ecological framework. A cross-sectional online survey was used, where the original Empowerment Scale for clients with mental health issues was adapted to measure conceptualisation of client empowerment from social workers' perspectives. Eighty-three social workers serving people with mental health issues (MHIs) in Sydney and eighty in Hong Kong responded. A two-factor model was generated suggesting that practitioners tend to conceptualise client empowerment into two aspects: a relation-based dimension and a resource-oriented one. Compared with their Sydney counterparts, the Hong Kong practitioners considered resource-oriented empowerment as more integral to client empowerment (t (161) = 4.17, p  < 0.001). Several key factors were found to be independently associated with endorsement of the two-factor client-empowerment model by practitioners: perceived less support from medical specialists but more support from teams serving the same client, perceived benefits of social work training and, finally, beliefs in the importance of social workers' role in client empowerment. The study highlights the multiple dimensions of client empowerment and a wide range of inter-professional and sociostructural factors enabling social workers' practices that support empowerment. Our paper highlights the role of professional empowerment as a stepping stone to enable their client-empowerment practices through policy support and inter-professional collaboration. [ABSTRACT FROM AUTHOR]

Recently, many programs have been funded to tackle Indigenous Australian smoking. This study assessed what challenges and unexpected responses could occur when developing anti-tobacco messages for Indigenous communities. A cross-sectional telephone survey of organizations involved in making anti-tobacco messages for the target population was conducted in 2012-2013. Open-ended questions explored cultural challenges to message development and unexpected outcomes. Responses were noted and these qualitative data were independently coded by two researchers using an inductive analysis. Non-parametric tests explored associations between organization orientation, whether target group feedback about messages was sought (pre-tests) and the presence of the above factors. The 47 organizations represented included: 22 Aboriginal Medical Services (AMS), 13 government organizations (GO), eight non-government organizations (NGO) and four universities. The response rate was 83%. Cultural challenges were reported equally by organizations oriented towards Aboriginal communities and those oriented towards the general population. Organizations conducting target group pre-tests of the messages were more likely to report cultural challenges (p=0.002). Four main themes were revealed: the diversity of Aboriginal and Torres Strait Islander cultures; the selection of rolemodels; conflicts and delays; and unexpected outcomes. Nearly 60% of organizations reported better-than-expected outcomes e.g. community appreciation and pride. A further 40% reported negative responses, e.g. messages being misunderstood or confronting. Cultural challenges and unexpected outcomes are reported by Australian organizations when developing anti-tobacco messages for Indigenous Australians warranting attention to improve the salience of anti-tobaccomessages for Indigenous peoples. NB. In this paper, Indigenous Australians is a term used to refer to Aboriginal and Torres Strait Islander peoples, the first inhabitants of Australia. No offence is intended. The authors acknowledge and respect that Aboriginal and Torres Strait Islander people are diverse populations with different language and cultural groups. [ABSTRACT FROM AUTHOR]

Reducing the burden of postnatal maternal mental health problems is an international public health priority. We developed What Were We Thinking (WWWT), a psychoeducation programme for primary postnatal health care that addresses known but neglected risks. We then demonstrated evidence of its effects in a before-and-after controlled study in preventing maternal postnatal mental health problems among women without a psychiatric history participating in the intervention compared to usual care (AOR 0.43; 95% CI 0.21, 0.89) when conducted by specialist nurses. Testing its effectiveness when implemented in routine primary care requires changes at practitioner, organizational and health system levels. This paper describes a programme of translational formative evaluation to inform the protocol for a cluster RCT. Following the UK Medical Research Council (MRC) Guidance for evaluating complex interventions, we conducted a translational formative evaluation using mixed methods. Collection and analysis of postnatal health service documents, semi-structured interviews, group discussions and an online survey were used to investigate service provision, consumers' needs and expectations, clinicians' attitudes and clinical practice, and the implications for health service delivery. Participants were expectant parents, health care providers, health service managers and government policy makers. Results documented current clinical practice, staff training needs, necessary service modifications to standardize advice to parents and include fathers, key priorities and drivers of government health policy, and informed a model of costs and expected health and social outcomes. Implementation of WWWT into routine postnatal care requires adjustments to clinical practice. Staff training, modifications to service opening hours and economic implications for the health system also need to be considered. The MRC Guidance for developing and evaluating complex interventions is a useful framework for conceptualizing and reporting translational formative evaluation, which is an essential step in the evidence trajectory. The results of the evaluation will inform the protocol for a cluster RCT of WWWT and associated health economic evaluation. [ABSTRACT FROM AUTHOR]

This paper draws on findings from an Australian study of mental health service users' perspectives on service user participation to examine the challenges for translating recovery policy into practice. It considers the ways in which national mental health policies and developing welfare reforms reflect and/or contradict the highly personal mode of recovery important to service users; though they seemingly signal potential wins for service user empowerment, they are accompanied by losses for those who do not fit neatly into clinical categorisations. The service users (n = 11) and service providers (n = 6) interviewed for this exploratory qualitative study revealed that recovery was a lifelong process of fluctuating capacity and described a system poorly equipped and often unwilling to move beyond tokenistic modes of participation. The analysis of service user perspectives against the backdrop of policy reform reveals the ongoing tensions between personal and clinical definitions of recovery. [ABSTRACT FROM AUTHOR]

Process evaluation is valuable in guiding development of effective intervention programmes but rare in adolescent weight management. This paper presents a process evaluation of the Loozit® randomized controlled trial, a community-based behavioural lifestyle intervention for obese 13-16 year olds. Adolescents were randomized to receive the two-phase Loozit® group programme, with (n = 73) or without (n = 78), additional therapeutic contact (telephone coaching, short message service and/or emails) in Phase 2. Quantitative and qualitative process data were collected. Facilitators used a standardized evaluation form to document participant attendance, and comment on lesson adherence and process delivery. Adolescents and parents completed satisfaction questionnaires at 2-, 12- and 24-month follow-ups. Following the intervention, 14 adolescents who provided informed written consent were interviewed about their experience with additional therapeutic contact. Data were analysed using descriptive statistics, parametric and non-parametric tests to compare group means, and thematic analyses. Group attendance rates averaged 85 and 47% during Phases 1 (0-2 months) and 2 (3-24 months), respectively. Facilitators frequently noted that participants reported making healthy lifestyle changes. Elements enjoyed in the sessions included practical activities, fun active games, resistance training and forming new friendships. Adolescents struggled with setting specific, measurable, achievable, realistic and timely (SMART) goals. Overall, participants were satisfied with the help received including the telephone and electronic contact. More than 80% of participants found the programme changed adolescents' eating and physical activity habits, and 89% of parents reported changing parenting strategies. Future adolescent group-based programmes may enhance participant engagement and programme effectiveness by including more interactive and frequent telephone and electronic contact. [ABSTRACT FROM AUTHOR]

This paper reports on findings from a national survey (n = 364) of social workers' views on what impedes and supports evidence-based practice (EBP) implementation. In contrast to some prior research, support for EBP was found to be strong among the social workers surveyed. Open-ended responses, however, reflected some reservations a bout the formalisation, relevance, usability and applicability of EBP in social work. A range of barriers to EBP implementation for social workers were identified at individual and organisational levels, which is largely supportive of findings from prior research. An interesting distinction was discerned between those respondents who preferred to engage in the whole EBP process themselves (locating, appraising and applying research) and those who preferred to adopt practice guidelines based on appraisal of research evidence by other experts. This finding has implications for the way organisations and the social work profession approach the implementation of EBP. [ABSTRACT FROM AUTHOR]

Inter-agency partnerships are critical for addressing the interrelated circumstances associated with the social and health determinants of health inequalities. However, there are many challenges in evaluating partnership processes and outcomes. We discuss a mixed methods study that explored partnership processes in an innovative program that aims to promote social and economic inclusion for young newly arrived refugees. A theoretically informed evaluation was designed and data collected in three ways: an organizational ethnographic approach; a partnership self-assessment tool and semi-structured interviews. Partnership assessments and interviews were collected at two points in time providing progressive process data. Analyses explore divergent levels of staff satisfaction with the partnership's operations, particularly between staff working in program development (strategic management) and program delivery (service provision) roles. Follow-up data collection indicated satisfaction with partnership processes had improved. The partnership did achieve its aim of increasing the level of cooperation between service providers to support young people from refugee backgrounds. This paper presents insights into how to evaluate inter-agency partnerships and reports both methodological and empirical findings. It provides an approach for a better understanding of the levels at which individuals operate within such partnerships, indicates areas where support and attention is needed. [ABSTRACT FROM AUTHOR]

To inform public health policy implementation in Australia, our study investigated the level of public support for six policy initiatives addressing unhealthy diet. The policy initiatives included taxing soft drinks and energy drinks, taxing less healthy food and beverage purchases, zoning to restrict the supply of junk foods near schools, prohibiting advertising and promotion of less healthy food and beverages to children under the age of 16 and restricting sugar-sweetened beverages from vending machines in schools, and public places. Data from a cross-sectional population-based study for 4040 Australians aged 15+ years, were analysed. A high overall support across all policy initiatives was observed. Nearly three-quarter of public support was observed for policy initiatives targeting children (zoning to restrict the supply of junk food near schools, prohibiting advertising and promotion of less healthy food and beverages to children under the age of 16 and restricting sugars-sweetened beverages from vending machines in schools), and half of Australians supported policy initiatives of taxing soft drinks and energy drinks and taxing less healthy food and beverage purchases. Australian women and those with tertiary level of education were more likely to support public health initiatives targeting children and all policy initiatives respectively. Interestingly, young adults expressed low level of support for all policy initiatives. The study demonstrated considerable public support for policy initiatives focussed on protecting children from unhealthy diet in Australia. Framing, designing and implementing policies targeting children is potentially a good starting point for policymakers to create a health promoting food environment. [ABSTRACT FROM AUTHOR]

Summary: We aimed to understand the process of setting or varying food standards related to non-nutritive sweeteners (NNS) in Australia and New Zealand. Overconsumption of added sugars is a risk factor for non-communicable diseases. Limiting added sugar consumption is recommended by the World Health Organization. NNS are sweet substances with little to no energy that can be used to maintain the sweetness of packaged food when added sugar is reduced. The health and dietary pattern impacts of NNS are contested. Understanding how and why applications for NNS are submitted, assessed and approved within food regulatory systems is important to contextualize the increasing availability of NNS in the food supply. We completed an interpretive content analysis of applications to change the Food Standards Australia and New Zealand (FSANZ) Code, risk assessments and stakeholder submissions. Literature used in risk assessments were drawn from a mixture of documents supplied by industry and peer-reviewed studies. Risk assessments were primarily focussed on toxicological outcomes, while broader public health outcomes were not explicitly considered. Consumption data available to FSANZ were collected several years prior to dietary exposure assessments, and thus may not accurately represent current intakes. The study findings raise questions about whether the scope of what constitutes a 'risk' to public health in the setting of food standards needs to extend beyond immediate toxicological and food safety concerns, to include longer-term dietary balance considerations. [ABSTRACT FROM AUTHOR]

Objective. Chronic pain is experienced by one in five Australians and is estimated to be the nation's third most costly health problem. In 2013, a chronic pain treatment outcomes registry was established, with the goals of evaluating treatment of chronic pain in multidisciplinary centers, establishing a benchmarking system to drive quality improvement and providing answers to important questions regarding types of treatment ("dose," intensity, and response) and which treatment is appropriate for different patients. This paper describes the development and the first-phase implementation of the registry. Methods.A minimum data set of primarily patient-rated measures was developed for use within pain management services. Governance structures and protocols for data collection were established, and software and resources created, to support pain management services. Results. Data collection commenced in 21 centers in Australia and is being implemented in over 20 others across Australia and New Zealand within the first two years. Feedback in the initial phase has already resulted in improvements to the software and reports, as well as minor changes to the data set. Centers have submitted high-quality data describing the demographic and clinical characteristics of patients referred to specialist pain services. Conclusions. The electronic Persistent Pain Outcomes Collaboration has been established for Australasia and is strongly supported by specialist societies and consumer groups. The next phase will increase the proportion of follow-up data in order to realize the registry's goals of evaluation, benchmarking, and research to improve outcomes and services for patients experiencing persistent pain. [ABSTRACT FROM AUTHOR]

Aims We extended follow-up of a heart failure (HF) prevention study to determine if initially positive findings of improved cardiac recovery were translated into less de novo HF and/or all-cause mortality (primary endpoint) in the longer term. Methods and results The Nurse-led Intervention for Less Chronic HF (NIL-CHF) study was a single-centre randomized trial of nurse-led prevention involving cardiac inpatients without HF. At 3 years, 454 survivors (aged 66 ± 11 years, 71% men and 68% coronary artery disease) had the following: (i) a normal echocardiogram (128 cases/28.2%), (ii) structural heart disease (196/43.2%), or (iii) left ventricular diastolic dysfunction/left ventricular systolic dysfunction (LVDD/LVSD: 130/28.6%). Outcomes were examined during median 8.3 (interquartile range 7.8–8.8) years according to these hierarchal groups and change in cardiac status from baseline to 3 years. Overall, 109 (24.0%) participants had a de novo HF admission or died while accumulating 551 cardiovascular-related admissions/3643 days of hospital stay. Progressively worse cardiac status correlated with increased hospitalizations (P < 0.001). The mean rate (95% confidence interval) of cardiovascular admissions/days of hospital stay being 0.09 (0.05–0.12) admissions/0.33 (0.13–0.54) days vs. 0.27 (0.20–0.34) admissions/2.20 (1.36–3.04) days per annum for those with a normal echocardiogram vs. LVDD/LVSD at 3 years. With progressively higher event rates, the adjusted hazard ratio for a de novo HF admission and/or death associated with a structural abnormality (24.5% of cases) and LVDD/LVSD (36.2%) at 3 years was 1.57 (0.82–3.01; P = 0.173) and 2.07 (1.05–4.05; P = 0.035) compared with a normal echocardiogram (10.9%). Mortality also mirrored the direction/extent of cardiac status/trajectory. Conclusions These data suggest the positive initial effects of NIL-CHF intervention on cardiac recovery contributed to better long-term outcomes among patients at high risk of HF. However, prevention of HF remains challenging. [ABSTRACT FROM AUTHOR]

Background Assignment to a community treatment order (CTO) has been associated with reduced mortality risk. In Victoria Australia civil-rights enhancements involving capacity to refuse involuntary treatment have contributed to a 15% reduction between 2010 and 2019 in CTO assignments among first hospitalized patients with Schizophrenia diagnoses. Has this change impacted patient mortality risk? Study Design This study considered mortality-risk between 2010 and 2019 for 3 patient groups with schizophrenia diagnoses: All 4848 hospitalized patients who were assigned to a CTO for the first time in the period; 3988 matched and randomly selected patients, who were first hospitalized in the decade, without CTO assignment; and 1675 never hospitalized or CTO-assigned outpatients. Deaths of Schizophrenic patients in each group were evaluated against expected deaths given standardized mortality ratios for Victoria. Logistic regression was used to evaluate mortality risk for each treatment group while taking account of race, demographics, differential access to initial diagnoses of life-threatening physical illness, mental health service resources, and indicators of social disadvantage. Study Results A total of 78% of the 777 deaths of schizophrenia patients in all 3 groups were premature. The 2 hospitalized groups did not differ in mortality risk. Among Victoria's 2010–2019 outpatients (inclusive of treatment refusers with a recorded service contact), 16.2% had a Schizophrenia diagnosis—up from 0.2% in 2000–2009, the prior decade. Outpatients with Schizophrenia were at 48% greater risk of death than individuals in the hospitalized groups, taking all the afore mentioned risk factors into account. Conclusions Reductions in CTO utilization associated with potential treatment refusals of involuntary community-treatment supervision, seem to have increased mortality risk for this vulnerable population. The line between civil-rights protection and abandonment has been blurred. [ABSTRACT FROM AUTHOR]

Objective The shift toward patient-centered care in physical therapy fostered a deeper consideration of power-sharing in clinical interactions. Elements of reciprocity may enhance such power considerations between physical therapist and patients, but there has been little investigation into how reciprocity is enacted in physical therapy, its value, and how to improve it if required. This study investigates forms of reciprocity during physical therapist–patient interactions in low back pain (LBP) care with the aim of enhancing patient-centered approaches. Methods The qualitative design involved (1) ethnographic observations at a fee-for-service practice in Australia, and (2) reflexive discussions between researchers and participating clinicians. To understand reciprocity, the analysis drew from the concepts of "accepting'"(or "blocking") "offers" that have been previously applied to physical therapy interactions. The analysis is a sub-study using a larger dataset and analyses in which we partnered with physical therapists and people living with LBP. Results Forty-nine observations and 13 reflexive discussions were undertaken with 42 people with LBP and 10 physical therapists. Analysis developed 3 themes suggesting that forms of reciprocity depended on physical therapists accepting or blocking patients' offers, inviting patients to make an offer, and offering personal stories. These elements of reciprocity are relevant to power-sharing during interactions and may impact patient-centered care. Conclusion Our results suggest that attending to forms of reciprocity can help physical therapists shift power in clinical interactions. By inviting and accepting "offers," physical therapists may build collaborative interactions, support individuals to guide the treatment narrative, and shift away from biomedically centered management approaches. Such recommendations create reciprocal environments that might enhance patient-centered care. Impact This is one of the few studies to explore how reciprocity is enacted in interactions between physical therapists and s with LBP. Our findings highlight how engaging with the concept of reciprocity could assist with sharing power, improving physical therapist–patient relationships, and enhancing patient-centered care. [ABSTRACT FROM AUTHOR]

Mass media campaigns can change attitudes and behaviours to improve population health. However, a key challenge is achieving share of voice in a complex and cluttered media environment. The aim of this study was to compare advertising expenditure on public health campaigns for obesity prevention (and related healthy eating and physical activity campaigns) with competing commercial categories of (a) sugary drinks, (b) artificially sweetened drinks and (c) diet/weight loss products and programmes. These commercial products may either undermine or dilute public health messages by directly contributing to poor health or confusing the public about the best ways to sustain a healthy lifestyle. Monthly estimates of advertising expenditure in Australian media (television, outdoor, cinema, radio, newspapers, magazines and digital) were obtained from Nielsen Media for 2016–18. Eligible public health advertising expenditure for the entire period (total AUD$27M) was vastly outweighed by the commercial categories of sugary drinks (AUD$129M) and diet/weight loss products and services (AUD$122M). Artificially sweetened drinks accounted for an additional AUD$23M of expenditure. These results highlight the need to rebalance the ratio of advertising to support public health in Australia through increased funding for obesity prevention and related campaigns, and critically, through government regulation to limit competing commercial advertising. [ABSTRACT FROM AUTHOR]

There are a range of stereotypes and assumptions associated with women's gambling behaviours. While researchers have demonstrated that the practices associated with women's gambling are changing and becoming increasingly normalized, there is a limited understanding of how younger women ascribe meanings to these practices. This study explored the gambling practices of younger women. Forty-one women (20–40 years) participated in qualitative telephone interviews. Participants were asked open-ended questions about personal engagement in gambling, including experiences of gambling, gambling engagement, and experiences with different gambling products and environments. Data interpretation was guided by reflexive thematic analysis. Three themes were constructed from the data: (i) gambling infrastructures, including both products and the embedding of gambling in community environments, contributed to the convenient and regular consumption of gambling, with gambling easy to access and engage with; (ii) social networks and intergenerational gambling practices impacted the perceived social value and competencies related to gambling; and (iii) technology facilitated new gambling practices, routinizing gambling behaviours through automation and building perceived competencies with a range of gambling products. Gambling regulation and public health responses to gambling often focus on either individual behaviours or product characteristics. This study suggests that this focus is too narrow and excludes important influences on younger women's gambling practices, which include the infrastructure that supports the provision and consumption of gambling products. Public health research, policy and practice must consider the full range of determinants that may contribute to the initiation and continuation of gambling in younger women. [ABSTRACT FROM AUTHOR]

Background and Objectives The care and well-being of an increasing number of older prisoners living with dementia require an adequate care continuum. Longstanding barriers, including limited resources and relevant expertise, necessitate an interdisciplinary approach and incorporation of external organizations in supporting prisoners with dementia. However, little is known about their perspectives and experiences. This study aimed to explore the role of external organizations in providing care for prisoners with dementia in Australia. Research Design and Methods In this qualitative descriptive study, 27 participants from legal, health, and social services rendering services in Australian prisons were recruited. Qualitative data were generated by applying the Nominal Group Technique in research group discussions. Demographic/background data were used to generate descriptive statistics through Qualtrics. Results Inductive thematic analysis of qualitative data revealed challenges and opportunities for future dementia care in Australian prisons. Six research discussion groups represented participants from Victoria, Queensland, New South Wales, Western Australia, and Tasmania. Identified themes included (a) possible models of care for prisoners with dementia, (b) uncovering the invisible issues of dementia care in prisons, and (c) proposed next steps for improved care of prisoners with dementia. Discussion and Implications This study provided recommendations for multiple stakeholders to overcome barriers in providing dementia care to prisoners. Increased collaboration between corrective services and external organizations was recommended, with a clear delineation of custodial and care priorities. External organizations highlighted the wider community's responsibility to care for older prisoners and the need to explore emerging areas of practice in this regard. [ABSTRACT FROM AUTHOR]

Citizen science connects academic researchers with the public through combined efforts in scientific inquiry. The importance of involving impacted populations in health research is well established. However, how to achieve meaningful participation and the methodological impact of citizen science needs further examination. We examined the feasibility of using citizen science to understand the impact of alcohol advertising on Australian women through a breast cancer prevention project. Two hundred and eighty-two ('participants') citizen scientists completed demographic and behavioural questions via an online survey. The research participants moved into the role of citizen scientists by completing the data collection tasks of capturing and classifying images of alcohol advertising they saw online. Interrater reliability tests found high levels of agreement between citizen scientists and academic researchers with the classification of alcohol advertising brand (Kappa = 0.964, p  < 0.001) and image type (Kappa = 0.936, p  < 0.000). The citizen scientists were women aged 18 and over, with 62% between 35 and 55 years old. The majority were from major cities (78%), had attained a bachelor's degree or higher-level education (62%) and were recruited via email or Facebook (86%). The use of citizen science provided methodological gains through the creation of a unique dataset with higher levels of validity than the existing literature, which employed traditional investigator-driven research methodologies. Citizen science enriched the dataset and provided a powerful methodological vehicle to understand an environmental determinant of health. The study illuminates how public participation benefitted the research process, the challenges and the potential for citizen science to improve public health. [ABSTRACT FROM AUTHOR]

In this article, the use of sport as a coping strategy by South Sudanese youth who have suffered the trauma of forced migration is examined. This article explores the relationship that has emerged between the young people and sport, in particular basketball, and how they use their participation in basketball and sports to cope with the stressors of their lives. The research intended to explore to what degree sport can play in improving mental health and what mental health interventions, in general, were being sought by this marginalized demographic. This qualitative study was underpinned by the psychosocial conceptual framework. We undertook semi-structured interviews with 23 South Sudanese youth aged 14–21 years, we also conducted focus groups of 11 South Sudanese elders and parents. The results of this research were feed back to the wider South Sudanese community through two forums. The data collected were analyzed using thematic analysis. The results of the study identified sport as an important coping strategy for the participants, both as a diversion from drug and alcohol misuse, potential criminal activity and as a way to self-manage the symptoms of anxiety and depression they were experiencing, and a mechanism to enhance self-worth. The study also indicated there was a lack of mental health interventions for these young people and that they had shown a great deal of resilience to develop their own ways to deal with the trauma they had experienced. The research reported positive associations of wellbeing and participation in sport, however more research needs to be conducted to ascertain the extent to which sport impacts mental health and how this can be incorporated into interventions for Sudanese youth and young people from similar forced migration and resettlement backgrounds. This study suggested that sport can be a driving force of good for many of the young people's lives, worthy of further research. [ABSTRACT FROM AUTHOR]

During disasters, the behaviour of pet owners and of pets themselves may compromise the ability of emergency responders to perform their duties safely. Furthermore, pet loss can have deleterious effects on personal and community recovery. To explore these issues and their implications for health promotion and disaster management practice, we conducted semi-structured interviews with 27 emergency responders in Australia, where disaster policy embraces shared responsibility yet does not acknowledge pets. We found that responders commit to being responsible for protecting human lives, especially members of their teams. Frontline emergency responders did not regard pets as their responsibility, yet decisions made with tragic consequences for pets exacted an emotional toll. Emergency managers consider community education as a pivotal strategy to support building people's capacity to reduce their own risk in disasters. While important, we question whether this is sufficient given that human life is lived in more-than-human contexts. Reformulating the parameters of the Ottawa Charter for Health Promotion as 'One Health Promotion' may help to account for the intermeshed lives of people and pets, while acknowledging human priority in public policy and programming. To acknowledge the influence of people's pets in disaster responses and recovery, we recommend five overlapping spheres of action: (i) integrate pets into disaster management practice and policy; (ii) create pet-friendly environments and related policies; (iii) engage community action in disaster management planning; (iv) develop personal skills by engaging owners in capacity building and (v) reorient health and emergency services toward a more-than-human approach. [ABSTRACT FROM AUTHOR]

Alcohol is a modifiable risk factor for cancer. Public awareness of the link between alcohol and cancer risk is poor; thus, alcohol consumers may be unknowingly putting themselves at increased risk of cancer. One way to raise awareness of alcohol-related cancer is through placing labels warning of cancer risk on alcoholic beverage containers; however, little is known about the impact of such labels. We conducted seven focus groups, comprising participants who self-identified as low-to-moderate alcohol consumers, to gauge public attitudes towards the labels and messages relating to alcohol-related cancer risk. Transcripts of discussions were coded to identify emergent themes. Participants expressed a negative response to the alcohol warning labels, and their talk worked to challenge the legitimacy of alcohol-related cancer messages, and the entities responsible for disseminating the information. These responses functioned to counter any implied recommendation for reduction in speakers' alcohol consumption. These findings illustrate how the general population make sense of information about health risks, using this knowledge to make decisions about personal behaviour. In combination with other public health initiatives, alcohol-warning labels have the potential to increase awareness of cancer risk and help in the fight against cancer, but any messaging will need to account for probable consumer resistance. [ABSTRACT FROM AUTHOR]

Background The frequency and impact of undiagnosed benign paroxysmal positional vertigo (BPPV) in people identified with high falls risk has not been investigated. Objective To determine the frequency and impact on key psychosocial measures of undiagnosed BPPV in adult community rehabilitation outpatients identified with a high falls risk. Design A frequency study with cross-sectional design. Setting A Community Rehabilitation Program in Melbourne, Australia. Subjects Adult community rehabilitation outpatients with a Falls Risk for Older People in the Community Screen score of four or higher. Methods BPPV was assessed in 34 consecutive high falls risk rehabilitation outpatients using the Dix–Hallpike test and supine roll test. Participants were assessed for anxiety, depression, fear of falls, social isolation and loneliness using the Hospital Anxiety and Depression Scale, Falls Efficacy Scale-International and De Jong Gierveld 6-Item Loneliness Scale. Results A total of 18 (53%; 95% confidence interval: 36, 70) participants tested positive for BPPV. There was no significant difference between those who tested positive for BPPV and those who did not for Falls Risk for Older People in the Community Screen scores (P  = 0.555), Hospital Anxiety and Depression Scale (Anxiety) scores (P  = 0.627), Hospital Anxiety and Depression Scale (Depression) scores (P  = 0.368) or Falls Efficacy Scale-International scores (P  = 0.481). Higher scores for the De Jong Gierveld 6-Item Loneliness Scale in participants with BPPV did not reach significance (P  = 0.056). Conclusions Undiagnosed BPPV is very common and associated with a trend towards increased loneliness in adult rehabilitation outpatients identified as having a high falls risk. [ABSTRACT FROM AUTHOR]

Objective: The longer-term impact of injury is increasingly recognized, but the early phases of recovery are less well understood. The best tools to measure early recovery of mobility and physical function following traumatic injury are unclear. The purpose of this study was to assess the clinical utility, validity, reliability, and responsiveness of 4 mobility and physical function measures in patients following traumatic injury. Methods: In this cohort, measurement-focused study (n = 100), the modified Iowa Level of Assistance Score, Acute Care Index of Function, Activity Measure for Post-Acute Care "6 Clicks" short forms, and Functional Independence Measure were completed during first and last physical therapy sessions. Clinical utility and floor and ceiling effects were documented. Known-groups validity (early vs late in admission and by discharge destination), predictive validity (using 6-month postinjury outcomes data), and responsiveness were established. Interrater reliability was assessed in 30 patients with stable mobility and function. Results: Participants had a median age of 52 years (interquartile range = 33–68 years), and 68% were male. The modified Iowa Level of Assistance Score, Acute Care Index of Function, and "6 Clicks" short forms were quick to administer (an extra median time of 30 seconds–1 minute), but the Functional Independence Measure took much longer (extra median time of 5 minutes). At the last physical therapy session, ceiling effects were present for all measures except the Functional Independence Measure (18%–33% of participants). All had strong known-groups validity (early vs late in admission and by discharge destination). All were responsive (effect sizes >1.0) and had excellent interrater reliability (intraclass correlation coefficients = 0.79–0.94). Conclusion: All 4 measures were reliable, valid, and responsive; however, their clinical utility varied, and ceiling effects were common at physical therapy discharge. Impact: This study is an important step toward evidence-based measurement in acute trauma physical therapy care. It provides critical information to guide assessment of mobility and physical function in acute trauma physical therapy, which may facilitate benchmarking across different hospitals and trauma centers and further progress the science and practice of physical therapy following traumatic injury. [ABSTRACT FROM AUTHOR]

Ambitious World Health Organization targets for disease elimination require monitoring of epidemics using routine health data in settings of decreasing and low incidence. We evaluated 2 methods commonly applied to routine testing results to estimate incidence rates that assume a uniform probability of infection between consecutive negative and positive tests based on 1) the midpoint of this interval and 2) a randomly selected point in this interval. We compared these with an approximation of the Poisson binomial distribution, which assigns partial incidence to time periods based on the uniform probability of occurrence in these intervals. We assessed bias, variance, and convergence of estimates using simulations of Weibull-distributed failure times with systematically varied baseline incidence and varying trend. We considered results for quarterly, half-yearly, and yearly incidence estimation frequencies. We applied the methods to assess human immunodeficiency virus (HIV) incidence in HIV-negative patients from the Treatment With Antiretrovirals and Their Impact on Positive and Negative Men (TAIPAN) Study, an Australian study of HIV incidence in men who have sex with men, between 2012 and 2018. The Poisson binomial method had reduced bias and variance at low levels of incidence and for increased estimation frequency, with increased consistency of estimation. Application of methods to real-world assessment of HIV incidence found decreased variance in Poisson binomial model estimates, with observed incidence declining to levels where simulation results had indicated bias in midpoint and random-point methods. [ABSTRACT FROM AUTHOR]

Within Australia food insecurity affects an estimated 4 million people annually. Health promotion degrees traditionally prepare pre-service graduates to address food insecurity from a social determinants perspective, little consideration of integrating ecological determinants, however, has been noted. This is a significant problem considering unprecedented environmental challenges facing future food production. Education for sustainability (EfS) is purported to develop graduates who can respond to significant sustainability issues in the 21st century. This study examined the potential for health promotion degrees to utilize EfS to address food insecurity through an ecological lens. The study also illustrates why it might be valuable for academics to use such an approach. Semi-structured interviews with 15 Australian health and sustainability academics and document analysis of 26 associated teaching units was undertaken. Thematic analysis informed the data analysis process to provide meaning and insight into emerging themes. Academics were unaware of EfS or its potential for developing ecologically literate graduates. A lack of university commitment towards sustainability and knowledge and skills to implement EfS were identified as potential barriers. Academics, however, were ascribing to the central tenets used in EfS such as interdisciplinary thinking and reflective practice, demonstrating its potential use in health promotion. EfS, as a framework for incorporating an ecological perspective into health promotion degrees has not been fully realized. This study suggests capacity building of academics with regard to the use of EfS as an approach within health promotion degrees to address significant sustainability issues in the 21st century, such as food insecurity. [ABSTRACT FROM AUTHOR]

This study aimed to explore the experience of being a Community Foodies (CF) peer educator with respect to personal benefits, specifically, personal development, wellbeing and empowerment. Qualitative semi-structured telephone interviews conducted with metropolitan and country peer educators of the CF programme. The CF programme in South Australia (SA) delivers nutrition education to disadvantaged communities. Ten adult peer educators from the CF programme: seven from country SA and three from Adelaide. Phenomenon of interest is that peer educators' perceptions of personal growth and development from involvement in the CF programme. The interviews were audiotaped and analysed thematically. The experience of being a nutrition peer educator improved personal skills and knowledge, dietary habits, self-esteem, confidence, sense of belonging and civic engagement. Peer educators felt that the CF programme was run in a straightforward, easy to understand way, with a welcoming environment and abundant support from the coordinators. Apart from benefits to themselves, peer educators appeared to be most proud of their capacity to contribute to the nutritional health of the broader community. Peer education programmes in disadvantaged communities provide policy makers with valuable and cost-effective approaches to improve health, build self-efficacy, strengthen community engagement, and, foster active participation and trust. [ABSTRACT FROM AUTHOR]

To investigate factors that enable or challenge the initiation and actioning of health and wellbeing policy in Australian local governments using political science frameworks. An online survey was distributed to staff and elected members of Australian local governments. The survey sought responses to a range of variables as informed by political science frameworks. Data were analysed using descriptive statistics and results were compared between local governments of different geographical sizes and locations using Kruskal–Wallis non-parametric testing. There were 1825 survey responses, including 243 CEOs, representing 45% of Australian local governments. Enablers for local government policy initiation and action included the high priority given to health and wellbeing (44%), local leadership (56%) and an organizational (70%) and personal obligation (68%) to the community to act. Less true is a favourable legislative environment (33%), leadership from higher levels of government (29%) and sufficient financial capacity (22%). Cities are better positioned to initiate and action health policy, regardless of the broader legislative environment. Health and wellbeing is a high priority for Australian local governments, despite lack of funding and limited lobbying and support from other sectors and higher levels of government. The insights from political science frameworks assist to understand the policy process, including the interrelatedness of enablers and challenges to initiating and actioning health and wellbeing policy. Further understanding the policy drivers would support practitioners and researchers advocating to influence local health and wellbeing policy. [ABSTRACT FROM AUTHOR]

Rapid urbanization requires health promotion practitioners to understand and engage with strategic city planning. This policy analysis research investigated how and why health was taken up into strategic land use planning in Sydney, Australia, between 2013 and 2018. This qualitative study develops two case studies of consecutive instances of strategic planning in Sydney. Data collection was done via in-depth stakeholder interviews (n   =   11) and documentary analysis. Data collection and analysis revolved around core categories underpinning policy institutions (actors, structures, ideas, governance and power) to develop an explanatory narrative of the progress of 'health' in policy discourse over the study period. The two strategic planning efforts shifted in policy discourse. In the earlier plan, 'healthy built environments' was positioned as a strategic direction, but without a mandate for action the emphasis was lost in an economic growth agenda. The second effort shifted that agenda to ecological sustainability, a core aspect of which was 'Liveability', having greater potential for health promotion. However, 'health' remained underdeveloped as a core driver for city planning remaining without an institutional mandate. Instead, infrastructure coordination was the defining strategic city problem and this paradigm defaulted to emphasizing 'health precincts' rather than positioning health as core for the city. This research demonstrates the utility in institutional analysis to understanding positioning health promotion in city planning. Despite potential shifts in policy discourse and a more sophisticated approach to planning holistically, the challenge remains of embedding health within the institutional mandates driving city planning. [ABSTRACT FROM AUTHOR]

Limiting ultraviolet radiation exposure during early childhood can significantly reduce the risk of developing skin cancer, making early childhood a critical time for sun protection strategies. This study aimed to measure sun protection practices utilized in Australian early-childhood services over the past decade and evaluate the impact of Cancer Council Australia's SunSmart Early-Childhood Program. Results are presented from cross-sectional and repeated-measures survey data, completed by directors or other staff at randomly sampled early-childhood services in 2008, 2013 and 2018 (N  =   3243). Most sun protection practices were used by a significantly greater proportion of services in 2018 relative to earlier years, such as requiring the use of sunscreen (98.4%), and sun-protective hats (99.7%) and clothing (88.8%). However, only a small and declining proportion of services (16.3%–22.4%) required the use of specific items of sun-protective clothing. SunSmart program members reported enacting significantly more sun protection practices compared to non-members, while new members showed an increase in the use of those practices relative to services whose status did not change (d  =   0.48). The results demonstrate improvements in sun protection in Australian early-childhood settings, and highlight the benefits and limitations of the SunSmart program. [ABSTRACT FROM AUTHOR]

Gambling is recognized as a significant public health problem. However, there is little research exploring community attitudes towards gambling and the development of advocacy initiatives. Engaging adults and young people in advocacy efforts is recognized as being beneficial to the successful implementation of harm prevention and reduction strategies. This study explored the attitudes of young people and their parents towards the alignment of gambling with sport, and the strategies they perceive could be used to prevent and reduce gambling related harm. Using a Constructivist Grounded Theory approach, 30 family groups from Melbourne, Australia participated in semi-structured interviews. Parents and young people were asked about gambling and its promotion, alignment with sporting codes, the potential impact on young people and strategies that may prevent or reduce gambling harm. Thematic analysis was undertaken to interpret the data. The sample comprised 29 parents, one grandparent and 48 young people. Themes emerging from the data related to the use of imagery and appeal strategies in advertisements, the normalization of betting in advertisements and the alignment of betting with sport. Parents and young people also identified a number of potential gambling harm prevention and reduction initiatives. Parents and young people were able to describe a range of strategies used by gambling companies to promote their products, understand the potential impact of these strategies, and recommend strategies to reduce harm. Given this level of understanding there is clearly an opportunity to engage young people and stakeholders in advocacy initiatives aimed at reducing and preventing gambling harm. [ABSTRACT FROM AUTHOR]

The concept of cultural safety (CS) has been developed as a critical perspective on healthcare provided to Indigenous service users in neo-colonial countries such as New Zealand, Australia and Canada. Unlike other frameworks for culturally competent healthcare, a CS approach recognizes impacts of colonization and power inequalities on Indigenous peoples and asks how these may manifest in healthcare settings. It has been argued that CS thinking is suited to critical analysis of public policy, but there has been limited work in this direction. Drawing on literature on CS in Australian healthcare, we defined a CS framework consisting of five concepts: reflexivity, dialogue, reducing power differences, decolonization and regardful care. Our research examined whether and in what terms this framework could be adapted as a tool for critical analysis of Australian public policy as it affects Aboriginal and Torres Strait Islander peoples. We used a collaborative inquiry process combining perspectives of an Aboriginal researcher and a non-Indigenous researcher. We developed a thematic analysis framework to examine how the five concepts might be reflected in contemporary writings on policy by leading Aboriginal or Torres Strait Islander thinkers. We found the framework is applicable as a tool for policy analysis; bringing together key concerns raised by Aboriginal and Torres Strait Islander leaders and critical concepts such as sovereignty and interface thinking. We concluded the framework is likely to be a useful tool for critical, systemic thinking about public policy as it affects Indigenous peoples and for specifying areas where performance can be improved to achieve culturally safe policy. [ABSTRACT FROM AUTHOR]

One-to-one supervision has been widely acknowledged in the social work literature as the gold-standard approach in field education. However, the sustainability of this approach has been challenged in recent decades amidst the managerial mandates permeating both education and health/human service sectors. Universities and placement organisations have experimented with alternative supervision approaches in response to these contextual pressures, although the research on these alternatives is limited at this point. In an attempt to contribute to the emerging research base, this article reports on a three-year trial of a multi-modal supervision approach involving the systematic application of individual and collective supervision modes within each student placement. The study explored the supervision experiences of 128 Master of Social Work students participating in the multi-modal supervision trial across five health networks in Melbourne, Australia. The study adopted a mixed-methods research design involving surveys followed by interviews. The findings suggest that, although one-to-one supervision is integral, students value the combination of one-to-one and collective supervision, provided that supervision content is student-centred; and that inter-personal trust and mutual engagement imbue the supervisory process. Ultimately, the study points to the importance of both content and relationships in the supervisory process, irrespective of the supervision mode employed. [ABSTRACT FROM AUTHOR]

Perinatal mental health is an important public health issue, and peer support is a potentially important strategy for emotional well-being in the perinatal period. PANDA Perinatal Anxiety & Depression Australia provides support to individuals impacted by perinatal mental health issues via the National Perinatal Anxiety & Depression Helpline. Callers receive peer support from volunteers and counselling from paid professional staff. The views and experiences of PANDA peer support volunteers have not previously been studied. We conducted two focus groups and an online survey to explore the experiences of women providing volunteer peer support on the Helpline. Data collection took place in October and November 2013. Two social theories were used in framing and addressing the study aims and in interpreting our findings: the Empathy–Altruism Hypothesis, and the Helper Therapy Principle. All PANDA volunteers were invited to participate (n  = 40). Eight volunteers attended a focus group, and 11 survey responses were received. Descriptive statistics were used to analyse quantitative data. All survey respondents 'strongly agreed' that they felt positive about being part of PANDA. Thematic analysis of data from focus groups and open-ended survey responses identified the following themes: motivated to help others, supported to support callers, helping to make a difference and emotional impacts for volunteers. Respondents described a strong desire to support others experiencing emotional distress as a motivator to volunteer. Although perinatal peer support services are designed to benefit those who receive support, this study suggests volunteers may also experience personal benefits from the role. [ABSTRACT FROM AUTHOR]

University years are a period of increased morbidity and mortality, associated with negative health behaviours and corresponding poor mental health (MH) status amongst students. With this said, the aim of this research was to determine the level of influence a number of predictive factors have on Australia's university students' MH status. A cross-sectional study design, consisting of an online survey was implemented. Psychometric measurement components were based on adopting Bronfenbrenner's socio-ecological model approach to collecting descriptive statistics. This approach was concerned with investigating patterns of association between three predictive factors [social emotional wellbeing (SEWB), physical activity (PA) levels and sporting club (SC) involvement], against four domains (personal, university, home and community). This study identified that 25% (n =  571) of participants (n =  2326) indicated that they have been diagnosed with a MH disorder. Specifically, gender, age, negative health behaviours, lower levels of PA and SC involvement and poor SEWB, were found to be significantly and positively associated (p <  0.05 *, p <  0.01 **) with a MH diagnosis. Importantly, findings from this study indicate that there are significant (positive/negative) associations between the identified predictive factors and participants' MH status. Findings from this study will go towards informing current and future Student Health Service policies, practices and infrastructure allocation that address MH status amongst university students. [ABSTRACT FROM AUTHOR]

This article reports the in-care and post-care experience of people who lived in Australian child-welfare systems as children from 1930 to 1989. The research utilised a mixed-methods design including surveys, interviews and focus groups, and the sample comprised over 700 care-leavers across Australia. This manuscript reports specifically on the experience of the British Child Migrant cohort within the study. Their experience was often characterised by oppressive child-rearing practices that paved the way for serious abuse of all types and gross neglect. The findings reveal that emotional, physical and sexual abuse perpetrated by predatory adults and by peers occurred frequently and concurrently. Educational neglect was pervasive, children being subject to hard physical labour from a young age. The consequences of maltreatment in care persist into adulthood. Despite resilience exhibited by many former child migrants, their mental health remained a serious concern. Implications of the findings for policy and practice are discussed. [ABSTRACT FROM AUTHOR]

Background Previous research has examined the role of early-life risk factors on childhood weight gain.The extent to which these factors drive socioeconomic differences in weight is unclear. We aimed to quantify the influence of early-life risk factors on the development of socioeconomic inequalities in children's body mass index (BMI) z -score at 10–11 years. Methods Overall, 2186 children from the Longitudinal Study of Australian Children were examined. Socioeconomic position (SEP) was measured as a continuous composite of parent's education, occupation and income. The Product of Coefficients mediation method was used to quantify the contribution of maternal smoking during pregnancy, gestational diabetes, prematurity, caesarean section, birthweight, not being breastfed, early introduction of solid food, maternal BMI and paternal BMI to the relationship between SEP and BMI z -score. Results Each increasing decile of SEP (higher SEP) was associated with a 0.05 unit lower (95% CI: −0.06, −0.03) BMI z -score at 10–11 years. In total, 83.5% of these differences in BMI z -score could be explained by socioeconomic differences in maternal smoking during pregnancy (26.9%), maternal BMI (39.6%) and paternal BMI (17.0%). Conclusions Interventions to reduce socioeconomic inequalities in excess weight gain during childhood should support the attainment of a healthy parental weight and prevent smoking during pregnancy. [ABSTRACT FROM AUTHOR]

Investigators in large-scale population health studies face increasing difficulties in recruiting representative samples of participants. Nonparticipation, item nonresponse, and attrition, when follow-up is involved, often result in highly selected samples even in well-designed studies. We aimed to assess the potential value of multilevel regression and poststratification, a method previously used to successfully forecast US presidential election results, for addressing biases due to nonparticipation in the estimation of population descriptive quantities in large cohort studies. The investigation was performed as an extensive case study using baseline data (2013–2014) from a large national health survey of Australian males (Ten to Men: The Australian Longitudinal Study on Male Health). Analyses were performed in the open-source Bayesian computational package RStan. Results showed greater consistency and precision across population subsets of varying sizes when compared with estimates obtained using conventional survey sampling weights. Estimates for smaller population subsets exhibited a greater degree of shrinkage towards the national estimate. Multilevel regression and poststratification provides a promising analytical approach to addressing potential participation bias in the estimation of population descriptive quantities from large-scale health surveys and cohort studies. [ABSTRACT FROM AUTHOR]

Younger mothers are categorised as an ‘at-risk’ group and targeted for early recognition and subsequent intervention to enhance children’s safety and well-being. However, younger mothers systematically endure stigma which can affect their willingness to engage with supportive services. This article reports on the findings from an Australian qualitative study of thirty-five interviews and two focus groups with younger mothers to explore their experiences of stigma and how this affects their engagement with services. We found that their interactions with services confirmed their feelings of being treated differently to other mothers. It led them to actively avoid supportive services because they had negative experiences or assumed that they would have a negative experience. This demonstrates the predictive power of stigma. Hearing from younger mothers about how these experiences play out in their lives and what they suggest would need to change for them to access services is critical for social workers and other practitioners to engage more effectively with this group of parents. We argue that the offer of early-intervention programmes may be more successful where there is capacity to establish a trusting relationship and where services convey an effective message to younger mothers that the special attention they receive at critical times is voluntary, normal and well deserved. [ABSTRACT FROM AUTHOR]

Workplaces are considered promising settings for protecting and promoting the health and wellbeing of employees. To date, few workplaces, particularly small and medium sized enterprises (SME), or their workers, have adopted Workplace Health Promotion (WHP), raising questions as to why. We conducted interviews in 10 SME in the Australian Capital Territory (ACT) asking managers and workers to reflect on the reasons for their participation (or not) in WHP activities. We qualitatively explored factors that managers consider important when deciding whether to offer WHP and compared these to worker considerations regarding participation. Both workers and managers identified time constraints as a major barrier for participation in WHP activities. If WHP was implemented, time constraints arose mainly from: difficulties scheduling and synchronising activities to include most staff, even then casual staff were mostly excluded; and the duration of time required by employees to participate in the offered activities, and whether this was in paid (work) or unpaid (worker) time. Workers struggled to participate in WHP in their scheduled breaks and were reluctant to use time outside of work hours. We have developed a model illustrating the emerging tension between managers' and workers' needs for WHP participation. WHP participation will likely remain low until this tension, and associated financial implications, are widely acknowledged and addressed. Our research indicates that time should be considered more explicitly and thoughtfully in the workplace engagement and WHP design, to actively respond to constraints from activity duration, scheduling and synchronisation. [ABSTRACT FROM AUTHOR]

This study investigated determinants of fruit and vegetable (F&V) consumption among regional and remote Western Australian (WA) children, using an Ecological Model of Health Behaviour. Semistructured interviews were conducted with 20 key informants (Health Workers, Food Supply Workers, and School/Youth Workers) purposively sampled from across regional and remote WA. Interviews were transcribed, analysed thematically using QSR-NVivo 10 software, and embedded within an Ecological Model of Health Behaviour to demonstrate the multiple levels of influence on health. Key determinants of F&V consumption at the intrapersonal level included attitude and food literacy among children. Key interpersonal level determinants included role modelling and parental food literacy. Institutional determinants included health service provision, school nutrition education and food skill programs. F&V availability, community networks and health-promoting spaces were key themes affecting families at the community level. The public policy level influencer included implementation of a store policy within local food outlets. Study findings suggested participatory programs with an emphasis on parental involvement and role modelling could increase F&V intake among children living in regional and remote areas; while school curriculum linkages were essential for school-based programs. Policy makers should consider further investment in school food literacy programs and family programs that are delivered collaboratively. Further, support of local food supply options and support for healthy food policies in food outlets are critical next steps. This study contributes new knowledge to build the evidence base and facilitate the development of targeted strategies to increase consumption of F&V among children living in regional and remote areas. [ABSTRACT FROM AUTHOR]

Background: A variety of educational interventions have been implemented to assist patients with heart failure to maintain their own health, develop self-care behaviours and decrease readmissions. Aims: The purpose of this study was to determine the effectiveness of a multimedia educational intervention for patients with heart failure in reducing unplanned hospital readmissions. Methods: The study, a randomised controlled trial in a large tertiary referral hospital in Australia, recruited 200 patients. Patients diagnosed with heart failure were randomly allocated 1:1 to usual education or a multimedia educational intervention. The multimedia approach began with an individual needs assessment to develop an educational plan. The educational intervention included viewing a DVD, and verbal discussion supported by a written manual with a teach-back evaluation strategy. The primary outcome was all-cause unplanned hospital readmission at 28 days, three months and 12 months post-recruitment. The secondary outcomes were changes in knowledge and self-care behaviours at three months and 12 months post-recruitment. Results: At 12 months, data on 171 participants were analysed. There were 24 participants who had an unplanned hospital readmission in the intervention group compared to 44 participants in the control group (p=0.005). The self-care educational intervention reduced the risk of readmission at 12 months by 30% (relative risk: 0.703; 95% confidence interval: 0.548–0.903). Conclusion: A targeted multimedia educational intervention can be effective in reducing all-cause unplanned readmissions for people with heart failure. [ABSTRACT FROM AUTHOR]

Background: Field exercise tests are a feasible alternative to the symptom-limited exercise test for measuring exercise capacity in patients attending cardiac rehabilitation. Aims: To evaluate the criterion validity of the 10 m incremental shuttle walk test (ISWT) as a useful tool for measurement of exercise capacity for patients eligible for cardiac rehabilitation. Methods: Fifteen patients eligible for cardiac rehabilitation completed a treadmill symptom-limited exercise test and two ISWTs with the order of testing randomised. Associations between the symptom-limited exercise test and the ISWT were explored and the ability of the ISWT to predict symptom-limited exercise test duration estimated. Results: There was a moderate to high association (r2 ⩾0.72) between ISWT duration and distance, and symptom-limited exercise test duration; and a moderate association between ISWT peak heart rate and end of test oxygen saturation and these outcomes on the symptom-limited exercise test (0.47⩽ r2 ⩽0.67). However, prediction of symptom-limited exercise test duration based on the ISWT produced wide 95% confidence intervals, for example, ranging from 9.1 to 16.3 minutes for an individual who completes the ISWT. Order of testing did not affect the results and the association between the ISWT and symptom-limited exercise test was similar for both the first (ISWT 1) and second test (ISWT 2) ISWT. Conclusions: The results provide support for the ISWT as a convenient field test of exercise capacity in a cardiac rehabilitation population, but not as a surrogate to predict symptom-limited exercise test duration for individuals. A single ISWT may provide as good an estimate of exercise capacity as repeating the test. [ABSTRACT FROM AUTHOR]