Australian Health Promotion Association

by Ms Sam Battams, Flinders University Department of Public Health, SA Australia

Abstract: This paper is based on research which considered intersectoral collaboration and community participation in policy processes for housing people with a psychiatric disability, across a period of mental health reform in South Australia (2000-2005). As part of this study, participants were asked about problems and ideal solutions for housing this population group. This article will report on themes emerging from the responses of participants. Key problems in housing identified included access to housing and community based support resources, social isolation and a lack of community engagement, community and neighbourhood stigma, and the skills and attitudes of support workers. The findings had important implications for programmes and strategies. They highlighted the importance of ongoing disability support co-ordinated with housing; training for professionals working with people with psychiatric disability; working with local neighbourhoods and media strategies; developing ‘citizenship goals’ in service frameworks; developing a sense of community amongst residents and ensuring that housing is not geographically isolated.

by Mr Douglas Cummings, Griffith University, QLD

Co-Authors: F Rowe and N Harris

Abstract: One of Australia’s foremost public health challenges is to meet the unique health requirements of refugees settling in this country. There is compelling evidence that community gardens can enhance health and overall quality of life (QoL) by influencing physical activity, psychosocial fulfilment and food choices; particularly important among vulnerable populations such as refugees. This study explored how African refugee perceptions of QoL are influenced by participation in a campus-based community garden, the Griffith University Community Food Garden (GUCFG). This qualitative case study was underpinned by the theory of ethnography and involved six in-depth, semi structured interviews as the primary data collection method. Additionally, participant observations were used to inform data collection, interpretation, and analysis. Three key elements emerged as having an influence on perceptions of QoL: using the garden as a physical space, participation, and garden membership. Being a member of the garden contributed to participants’ trust, mutual aid and reciprocity among gardeners, and sense of belonging to the garden. Participation in the garden allowed for skills and knowledge sharing, meaningful labour, and increased physical activity. The garden space provided otherwise unavailable space to grow nutritious and culturally appropriate food. Garden participation improved perceived QoL in this group of African refugees, suggesting this as a valid mechanism to enhance QoL, and therefore health, of refugee populations and assist their settlement into Australian communities.

by Ms Liz de Plater, Queensland Health

Abstract: The SEEDS (social and emotional early development strategy) project, an initiative of Queensland Health’s Southern Area Population Health Services, has partnered with the early childhood education and care sector to develop a mental health promotion (MHP) framework which aims to enhance the social and emotional wellbeing of children, parents and staff in that care sector. Following a needs analysis with parents and staff of 15 child care centres, an action research approach was adopted to develop the framework. Parents were invited, and child care staff were subsidised, to attend three workshops which provided guest speakers and resources to trial. Feedback was collated and reviewed with all participants. This process led to the development of a holistic MHP framework and implementation model which proposes that social and emotional wellbeing of children, parents, and staff develops through nurturing and valuing relationships. It provides caregivers with a way to reflect on their own combination of knowledge (head), values (heart) and skills (hands) and how their particular combination supports the social and emotional wellbeing of the children and adults in their lives. Preliminary findings suggest the SEEDS approach can increase parents’ and professionals’ awareness of the need to promote universal positive mental health for children and adults. The developed MHP framework and resources are being trialled. The framework, based on the key components of Head, Heart and Hands, is being considered for inclusion in the curriculum for in-service and pre-service training of early childhood professionals A Statewide training organisation is developing a DVD, manual and training package modelled on the framework. Interest has been shown by the education sector.

Dr James Gillespie, Menzies Center for Health Policy, University of Sydney NSW

Co-Authors: L Yen and Y-H Jeon

Abstract: The growing burden of chronic illness has attracted a wide array of public interventions in Australian health systems. This paper compares policy responses in two urban regions, the Australian Capital Territory (ACT) and Sydney West Area Health Service (SWAHS). These regions have a similar mix of chronic illness, but contrasting systems of policy development and integration.

1. Analysis of interviews and focus groups with patients, carers and clinicians in both regions conducted as part of the Serious and Continuing Illness Policy and Practice Study (SCIPPS) identified poorly addressed areas of illness management.

2. Corresponding policy initiatives Identified through a review of existing policies.

3. Key informant interviews of policymakers used to construct a narrative of policy development and implementation. Patient interviews identified five major areas of policy concern: health literacy and self management, poor service coordination, balancing life and illness, dealing with economic hardship and co-morbidity. Both study areas had developed policies around the first two issues. Fragmentation of services within and between organisations and communication breakdowns among various disciplines were found as key barriers in both regions. Distance makes the heart less fond. Diffusing innovation from a central bureaucratic source must deal with issues of leadership, relevance and performance.

Mr John Glover, Public Health Information Development Unit, SA Australia

Co-Author: Sarah Tennant

Abstract: There are strong associations across Australia’s cities between the population’s use of health and welfare services, health outcomes and socioeconomic disadvantage. A recent study in South Australia has gone beyond these measures, to include direct expenditure by Federal and State agencies across a range of health and welfare services, and assessments of community strength. This provides more accurate information to underpin policy debates about how much money is spent on health and welfare services, where it is spent and for whom, and what changes might be needed to improve equity of access and outcome. Cost and service use data were collected for a large number of services. Costs were allocated at the Statistical Local Area (SLA) level to the area of address of the patient or client in the records of the service agency. Datasets included hospital inpatients and outpatients; MBS and PBS expenditure; community health; community mental health (including child and adolescent mental health); domiciliary care, home nursing services and other agencies covered by the Home and Community Care program; State Government emergency financial assistance; and Federal Government income support payments. Data from a telephone survey provided estimates for SLAs (or groupings where SLAs had small populations) of community strength, in Adelaide and regional country SA. The data were mapped and graphed (by socioeconomic groupings), and a correlation analysis showed the strength of association between the datasets. The results (here limited to metropolitan Adelaide) show that there are high levels of health and welfare expenditure and service use, and low levels of community strength, in areas where the most disadvantaged populations live. These are also the areas of poorest health, and highlight the urgent need for an intersectoral policy approach to improve outcomes for disadvantaged populations.

Dr Fiona Imlach Gunasekara, University of Otago, New Zealand

Co-Authors: T Blakely, K Carter

Abstract: Despite an enormous literature documenting the association between income and health, little is known about their dynamic relationship – whether changing income has a significant impact on health outcomes. This is surprising considering that individual and household incomes are known to fluctuate substantially over time, and an assessment of whether change in health follows change in income should not be as prone to confounding as the cross-sectional association of income with health. In this paper, I present a systematic literature review of longitudinal studies that included measures of income change and change in the health outcome of self-rated health.

Dr Sansnee Jirojwong, University of Western Sydney, School of Nursing

Co-Authors: D Hay, T Ferdous and R Harreveld

Abstract: After September 11, 2001, increasingly negative images of Muslims have been widely presented through the media. Muslims have been subjected to violence and vilification at different locations. This paper will describe the identity of young Muslims in Queensland. Research mixed methods were used to collect quantitative and qualitative data from 117 youths. They took part in a group discussion and completed a short questionnaire. Social, cultural and political environments that influence the identity of young people were explored.

Almost half of the children (48%) were born in Australia. Many were bilingual and used English at school. They had more than one identity. Almost all (93%) were proud to be a Muslim, but only half (58%) were proud to be an Australian. A number of participants said that there was a lack of understanding by some non-Muslims about their pray, dress and food. Almost half were verbally or physically abused by some people at public places because they were Muslims. The same percentage had also witnessed their family members being verbally or physically abused. Many of the children commented on negative impacts of the media on Muslims. Young Muslims have multiple identities and develop social inclusion; however, due to the lack of knowledge about Islam and Muslims by others, many experience challenges to their identities. Few are at risk of social exclusion by wider communities. Long-term impacts on the young people are not known. Various individuals and organisations need to support young Muslim people for their identity development. 

Dr Shanti Raman, Sydney South West Area Health Service

Co-Authors: N Wood, M Weber, M Smith, D Isaacs and K Taylor

Abstract: Refugee children are known to be at risk of poor health outcomes, poor immunisation status, and limited access to healthcare. Of the 13,000 refugees accepted to settle each year in Australia, 50% are children and youth. Our objectives were to document the health needs of refugee children accessing comprehensive refugee health services in New South Wales (NSW), and match needs with available services.

Mrs Judith Stewart, Australian Research Centre for Population, University of Adelaide

Co-Authors: KF Roberts-Thomson, AJ Spencer and GD Slade

Abstract: Australians living outside capital cities have poorer oral health. This study aims to compare differences in oral health status and dental visiting behaviour among young adult capital city dwellers (CCD) and non-CCDs.

Ms Helen Viggers, Housing and Health Research Programme, University of Otago, New Zealand

Co-Authors: P Howden, N Pierse, J Gillespie-Bennett, M Cunningham, R Phipps and J Crane

Aim: To assess whether non-polluting, more effective home heating reduced children’s winter asthma symptoms and improved lung function.

Sample: 409 children in households in five communities in New Zealand.

Method: Randomised community trial [NCT00489762]

Dr Zhiqiang Wang, School of Medicine, University of Queensland

Abstract: Randomised trials stopped early for benefit are increasingly common. The aims of this study are to use computer simulations to demonstrate how often randomised trials can be terminated early for benefit given the proposed effect is true, and to assess the impact of early termination on effect estimates.