Fiona Cocker

Using New Technologies to Improve the Prevention and Management of Chronic Conditions in Populations

Lifestyle factors are important in the development of chronic diseases, such as heart disease, respiratory disease, and diabetes, and chronic disease risk can be reduced by changes in lifestyle behaviors linked to these conditions. The use of mass media and community-wide strategies targeting these behaviors has been extensively evaluated since the 1970s. This review summarizes some examples of interventions and their use of media conducted within the old communications landscape of the 1970s and 1980s and the key lessons learned from their design, implementation, and evaluation. We then consider the potential and evidence base for using contemporary technology applications and platforms-within the new communications landscape-to improve the prevention and management of lifestyle-related chronic diseases in the future. We discuss the implications and adaptation of lessons derived from the ways in which new technologies are being used in commercial and political contexts and their relevance for public health. Finally, we consider some recent examples of applying new technologies to public health issues and consider some of the challenges in this rapidly developing field.

Psychological Distress, Related Work Attendance, and Productivity Loss in Small-to-Medium Enterprise Owner/Managers

Owner/managers of small-to-medium enterprises (SMEs) are an under-researched population in terms of psychological distress and the associated health and economic consequences. Using baseline data from the evaluation of the Business in Mind program, a mental health promotion intervention amongst SME owner/managers, this study investigated: (i) prevalence of high/very high psychological distress, past-month sickness absenteeism and presenteeism days in SME owner/managers; (ii) associated, self-reported lost productivity; and (iii) associations between work, non-work and business-specific factors and work attendance behaviours. In our sample of 217 SME owner/managers 36.8% reported high/very high psychological distress. Of this group 38.7% reported past-month absenteeism, 82.5% reported past-month presenteeism, and those reporting presenteeism were 50% less productive as than usual. Negative binomial regression was used to demonstrate the independent effects of socio-demographic, work-related wellbeing and health-related factors, as well as various individual and business characteristics on continuous measures of absenteeism and presenteeism days. Health-related factors (self-rated health and treatment) were the strongest correlates of higher presenteeism days (p < 0.05). Work-related wellbeing factors (job tension and job satisfaction) were the strongest correlates of higher absenteeism days (p < 0.05). Higher educational attainment, treatment and neuroticism were also correlated with more absenteeism days. SME-specific information about the occurrence of psychological distress, work attendance behaviour, and the variables that influence these decisions, are needed for the development of guidelines for managing psychological distress within this sector.

A shared framework for the common mental disorders and Non-Communicable Disease: key considerations for disease prevention and control

BackgroundHistorically, the focus of Non Communicable Disease (NCD) prevention and control has been cardiovascular disease (CVD), type 2 diabetes mellitus (T2DM), cancer and chronic respiratory diseases. Collectively, these account for more deaths than any other NCDs. Despite recent calls to include the common mental disorders (CMDs) of depression and anxiety under the NCD umbrella, prevention and control of these CMDs remain largely separate and independent.DiscussionIn order to address this gap, we apply a framework recently proposed by the Centers for Disease Control with three overarching objectives: (1) to obtain better scientific information through surveillance, epidemiology, and prevention research; (2) to disseminate this information to appropriate audiences through communication and education; and (3) to translate this information into action through programs, policies, and systems. We conclude that a shared framework of this type is warranted, but also identify opportunities within each objective to advance this agenda and consider the potential benefits of this approach that may exist beyond the health care system.

Understanding first year university students: personal epistemology and learning

Whilst participation in higher education has increased dramatically over the last two decades, many universities are only now beginning to pay more attention to the learning experiences of first year students. It is important for universities to understand how first year students conceive of learning and knowing in order to promote effective approaches to learning. Even though an extensive body of research demonstrates that beliefs about learning and knowing influence student approaches to learning and learning outcomes, there has been no Australian research that has investigated this critical learner characteristic across first year university students. This paper reports on preliminary data from an ongoing longitudinal study designed to investigate first year students’ beliefs about knowing and learning (epistemological beliefs). Students from teacher education and creative industry faculties in two Australian universities completed the Epistemological Beliefs Survey (EBS) in the first week of their first semester of study. A series of one‐way ANOVA using key demographics as independent variables and the EBS factor scores as dependent variables showed that epistemological beliefs were related to the course of study, previous post‐school education experience, family experience at university, gender, and age. These data help us to understand students’ beliefs about learning and knowing with a view to informing effective learning in higher education.

Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review

Compassion fatigue (CF) is stress resulting from exposure to a traumatized individual. CF has been described as the convergence of secondary traumatic stress (STS) and cumulative burnout (BO), a state of physical and mental exhaustion caused by a depleted ability to cope with one’s everyday environment. Professionals regularly exposed to the traumatic experiences of the people they service, such as healthcare, emergency and community service workers, are particularly susceptible to developing CF. This can impact standards of patient care, relationships with colleagues, or lead to more serious mental health conditions such as posttraumatic stress disorder (PTSD), anxiety or depression. A systematic review of the effectiveness of interventions to reduce CF in healthcare, emergency and community service workers was conducted. Thirteen relevant studies were identified, the majority of which were conducted on nurses (n = 10). Three included studies focused on community service workers (social workers, disability sector workers), while no studies targeting emergency service workers were identified. Seven studies reported a significant difference post-intervention in BO (n = 4) or STS (n = 3). This review revealed that evidence of the effectiveness of CF interventions in at-risk health and social care professions is relatively recent. Therefore, we recommend more research to determine how best to protect vulnerable workers at work to prevent not only CF, but also the health and economic consequences related to the ensuing, and more disabling, physical and mental health outcomes.

Psychological distress and related work attendance among small-to-medium enterprise owner/managers: literature review and research agenda

Small-to-medium enterprises (SMEs) may experience the antecedents and consequences of depression more acutely than larger organizations. Managing depression-related sickness absenteeism and presenteeism, and associated productivity loss may also be more challenging because the SMEs size and structure make administration, finance, and responsibilities of human resources difficult. This may diminish the growth and long-term sustainability of SME. However, the mental health of the SME workforce is a neglected sector in occupational health research and practice, despite the contribution it makes to developed economies worldwide. This study aims to review the literature on current stress, burnout, and depression, and uses existing knowledge of SME structure and characteristics to propose a theory as to why this may be the case. Further, using the information garnered, it developed a model to guide future research designed to test these assumptions, and inform the development of workplace mental health promotion programmes tailored to the needs of the SME sector.

Estimating the Economic Benefits of Eliminating Job Strain as a Risk Factor for Depression

Objective: The aim of this study was to quantify the economic benefits of eliminating job strain as a risk factor for depression, using published population-attributable risk estimates of depression attributable to job strain (13.2% for men, 17.2% for women). Methods: Cohort simulation using state-transition Markov modeling estimated costs and health outcomes for employed persons who met criteria for lifetime DSM-IV major depression. A societal perspective over 1-year and lifetime time horizons was used. Results: Among employed Australians,

Managerial understanding of presenteeism and its economic impact

890 million (5.8%) of the annual societal cost of depression was attributable to job strain. Employers bore the brunt of these costs, as they arose from lost productive time and increased risk of job turnover among employees experiencing depression. Conclusions: Proven, practicable means exist to reduce job strain. The findings demonstrate likely financial benefits to employers for expanding psychosocial risk management, providing a financial incentive to complement and reinforce legal and ethical directives.

A Systematic Review of Cost-of-Illness Studies of Multimorbidity

Purpose – The economic impact of ill‐health in employed individuals is largely experienced via absenteeism‐related and presenteeism‐related productivity loss. Using cognitive interviewing, the purpose of this paper is to evaluate a recently published interview method by which managers determine key job characteristics and their relationship to the cost of acute and chronic illness‐related absenteeism and presenteeism in the workplace: the team production approach.Design/methodology/approach – Managers (n=20) from various industries in Australia completed the team production interview by telephone. Quantitative items measured replaceability, team production, time sensitivity of output and illness‐related absenteeism and presenteeism costs. Concurrent verbal probes followed five items which assessed the productivity impact of illness‐related presenteeism, identified as cognitively challenging.Findings – Content analysis of interview outputs examined cognitive processes underlying managers’ responses and rev...

Public Health Perspectives on the Co-Occurrence of Non-Communicable Diseases and Common Mental Disorders

ObjectivesThe economic burden of multimorbidity is considerable. This review analyzed the methods of cost-of-illness (COI) studies and summarized the economic outcomes of multimorbidity.MethodsA systematic review (2000–2016) was performed, which was registered with Prospero, reported according to PRISMA, and used a quality checklist adapted for COI studies. The inclusion criteria were peer-reviewed COI studies on multimorbidity, whereas the exclusion criterion was studies focusing on an index disease. Extracted data included the definition, measure, and prevalence of multimorbidity; the number of included health conditions; the age of study population; the variables used in the COI methodology; the percentage of multimorbidity vs. total costs; and the average costs per capita.ResultsAmong the 26 included articles, 14 defined multimorbidity as a simple count of 2 or more conditions. Methodologies used to derive the costs were markedly different. Given different healthcare systems, OOP payments of multimorbidity varied across countries. In the 17 and 12 studies with cut-offs of ≥2 and ≥3 conditions, respectively, the ratios of multimorbidity to non-multimorbidity costs ranged from 2–16 to 2–10. Among the ten studies that provided cost breakdowns, studies with and without a societal perspective attributed the largest percentage of multimorbidity costs to social care and inpatient care/medicine, respectively.ConclusionMultimorbidity was associated with considerable economic burden. Synthesising the cost of multimorbidity was challenging due to multiple definitions of multimorbidity and heterogeneity in COI methods. Count method was most popular to define multimorbidity. There is consistent evidence that multimorbidity was associated with higher costs.