Claire Drummond

Combining Case Study Research and Systems Theory as a Heuristic Model

The combined use of case study and systems theory is not often seen in the literature. The use of both approaches enables the specifics of the case to consider the influence of broader systems and external environments, offering in-depth exploration as well as comparative analysis between cases in the context of the system. Health care has obvious systems operating that may have developed from organizational hierarchies, funding mechanisms, or traditional service delivery of health care. Systems theory is ideally suited to examine health care and health promotion sites, such as hospitals or universities. Sites can use the principles of systems theory to explore innovation, change, and complexity of service delivery in the context of a case study approach. This article discusses how the combination of the two can act as a heuristic model, offering its application to emergency department physiotherapy as an example, to further bolster the evidence base for using such a methodology.

Examining primary and secondary school canteens and their place within the school system: a South Australian study

In Australia, school canteens are an integral part of the school environment and an ideal site to encourage healthy eating. However, when the canteen is not supported within the school system, healthy menus may be difficult to implement. The aim of this study was to investigate school canteens and their place within the school system in primary and secondary schools in South Australia. Using a systems approach, 14 schools and their canteens located throughout metropolitan and rural South Australia are discussed. A range of qualitative interviews was conducted with school principals (n = 14), canteen managers (n = 14), parents (n = 50), teachers (n = 10) and focus group interviews were held with students (n = 450). This study showed that although school canteens were located on school grounds and should be supported as an integral part of the school system, in many cases they were not. A range of influences such as: maintaining profit, reduced volunteer support and student choice negatively impacted what was sold on the canteen menu. This study indicated that offering a sustainable healthy school canteen menu largely depended on the support and resources provided to the canteen by the school system in which it belonged.

Using Goffman’s Theories of Social Interaction to Reflect First-Time Mothers’ Experiences With the Social Norms of Infant Feeding:

Infant feeding, particularly breastfeeding, is an important public health issue because early feeding methods have been shown to influence health throughout childhood. We investigated how social norms influence first-time mothers’ decisions around feeding methods. We conducted two in-depth interviews with 11 first-time mothers, the first 3 weeks after birth and the second 3 months following birth. We analyzed interview data using a third-level, thematic analysis, using Goffman’s theories of social interaction to guide our analysis. Our results highlighted several issues surrounding breastfeeding in modern society. We propose that nursing mothers are conscious of adhering to social norms of being a good mother, but must also cope with societal views about presenting normal appearances when they need to feed their babies in public.

Interviews with Boys on Physical Activity, Nutrition and Health: Implications for Health Literacy

Abstract This paper draws on focus groups with young Australian males across a range of social demographics and ages in primary school years (5–12 years). It investigates the role of physical activity and dietary behaviours in the lives of young males. The paper will articulate the way in which young males come to perceive physical activity and dietary behaviours, including broader constructions of health, within the context of their lives. Understanding the decision making of young males’ around physical activity and dietary behaviours will play a significant role in the health outcomes of adult men by through improved targeted health education and health promotion programs for this cohort.

It’s all about the six-pack Boys’ bodies in contemporary Western culture

This is an article about boys and their construction of masculinities. It draws on 5 years of qualitative research data from the same group of boys from early childhood through to 10 years of age in an attempt to articulate the way in which boys come to view their bodies, and other male bodies, in contemporary Western culture. The research is based on focus groups and is a part of a longitudinal study with the same cohort of boys, at a school in Adelaide, Australia. The data were analysed using inductive thematic analysis to identify key emergent themes. The results indicate that there is an emerging trend among boys from early childhood through to middle primary school surrounding the acknowledgement of male body aesthetics as a signifier of being male. The use of terminology such as ‘six-pack’ is now commonplace among all of the groups. The consistency around muscularity as a signifier of being a man was very high among the boys of all ages. It is clear that greater emphasis needs to be placed on younger males’ and boys’ awareness of the meaning of the male body in contemporary Western society.

Implementation of mandatory nutritional guidelines in South Australian primary school canteens: A qualitative study

Primary schools are identified as being in a primary position to offer nutrition education. Moreover, primary schools can offer an environment which is conducive to the promotion of healthy eating while influencing eating behaviours of children to benefit their health, well-being and academic development and performance. School canteens are one area where a healthy ethos can be encouraged and within Australia, canteens have been the target of recommended or mandated healthy eating state government policies. This is comparable to other Australian health policies mandated in schools in an effort to support good nutrition and physical health among students. Using a qualitative case study approach, this article discusses the implementation of the ‘Right Bite Healthy Food and Drinks Strategy for South Australian Schools and Preschools’ (Right Bite). The case study was undertaken in two primary schools to gain a thorough and in-depth investigation of emerging issues regarding the school canteen and used focus group and face-to-face interviews as well as observation. The data collected were coded and analysed into themes. Respondents claimed that Right Bite had merit although barriers such as: resistance from parents and children to purchase healthy options, difficulties associated with serving and preparing fresh food at school, inadequate canteen facilities, and counteracting heavy marketing of unhealthy foods to children impeded implementation. While Right Bite encourages South Australian school children to make better choices through education and support so as to improve their health, well-being and academic performance, more support must be provided to schools for greater uptake and implementation of policy.

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Sport and Children's Nutrition: What Can We Learn from the Junior Australian Football Setting?.

ABSTRACT There is a widely held belief that sport participation inherently enhances health among youth. Such a perception often motivates parents to encourage childrens initial and ongoing involvement in organised sport and physical activity. While sport certainly comprises an important vehicle for accruing physical activity, the sport environment may not necessarily enhance other health-related behaviours, including dietary practices. The literature identifies the influence of the physical environment in this regard, including the availability of energy-dense nutrient-poor foods in sport settings. In considering additional influences on childrens nutrition in sporting contexts, the role of parents is less understood. This is the first paper to emerge from a larger qualitative study, in which the basis of the investigation was to explore parental influence in the junior Australian football context. The naturalistic manner of qualitative inquiry led to a number of unintended yet highly pertinent emergent themes, including the role of parents in maintaining and reinforcing some contentious dietary behaviours among children post weekend sport. Drawing on individual interviews and focus groups with parents, children and coaches (n = 102), this paper discusses the role of parents in reinforcing a ‘food-as-reward’ culture in the junior Australian football setting. The findings indicate that while parents play a vital role in promoting good nutrition in the lead up to weekend sport, they also reinforce a culture that fosters unhealthy dietary practices in the post-game setting. This gives rise to the notion that we, in this paper, have coined the ‘binge-purge’ paradox. This paper discusses the implications of this health issue in relation to the ‘sport for health’ rhetoric, and in broader society and culture.

Boys and their teeth: a qualitative investigation of boys' oral health in early childhood.

This is a paper based on qualitative focus group interviews with 33 boys in early childhood (ages 5 to 7). The basis of the interviews was originally to understand the way in which boys come to perceive issues around masculinities, physical activity, sport and health. However, given the naturalistic manner of qualitative focus group interviews, additional themes were uncovered around boys’ understanding of oral health, in particular the relationship between their teeth and health. At an age where the boys are gaining increasing levels of autonomy in terms of personal hygiene and individual health it appears that dental health is being neglected. The need to address this concern through developing functional health literacy is imperative for boys at this age. Schools are the ideal site in which such an initiative can occur with concomitant knowledge transferred back to the family home.

Men’s physical activity and dietary behaviours on Kangaroo Island, South Australia:

Background: Men’s health has been subjected to diverse approaches to research over the past two decades. Much of the literature has focused on specific medical and health issues. Other contributions have focused more broadly on masculinities and its relationship to health. It is arguable that there has not been a lot of attention paid to Australian rural men’s health and even less on their understanding of health as it relates to physical activity and dietary behavior. Objectives: To gain a better understanding of these issues this paper provides rich, descriptive qualitative data from men living on Kangaroo Island, which is 13.5 kilometres off the South Australian mainland and is regarded as a rural and remote area. Methods: Qualitative data is used to develop greater understanding of the men’s attitudes and behaviours as they relate to physical activity and dietary behaviours. The semistructured interviews and focus groups were conducted with 40 men aged between 23–64. Conclusions: The results indicated that the locality in which the men lived provided them with an excellent opportunity to be physically active and eat fresh, locally produced, foods. However, it was identified that many of the men did not have a comprehensive understanding of health and seemingly displayed low levels of health knowledge. As a result for many of these men, their physical health was left to chance. There was little evidence of any planned health promotion to assist them with making improvements to their nutrition and physical activity levels as they aged. Recommendations and population-based strategies are provided to assist men living in remote rural settings to enhance not only their health ultimately their health knowledge. This will positively impact community health.