Joshua Daniel Newton

How does the general public view posthumous organ donation? A meta-synthesis of the qualitative literature

BackgroundMany individuals are unwilling to become posthumous organ donors, resulting in a disparity between the supply and demand for organ transplants. A meta-synthesis of the qualitative literature was therefore conducted to determine how the general public views posthumous organ donation.MethodsThree online databases (PubMed, PsycINFO, Scopus) were searched for articles published between January 1990 and May 2008 using the following search terms: organ donation, qualitative, interview. Eligibility criteria were: examination of beliefs about posthumous organ donation; utilization of a qualitative research design; and publication in an English peer-reviewed journal. Exclusion criteria were examining how health professionals or family members of organ donors viewed posthumous organ donation. Grounded theory was used to identify the beliefs emerging from this literature. Thematically-related beliefs were then grouped to form themes.Results27 articles from 24 studies met the inclusion criteria and were reviewed. The major themes identified were: religion, death, altruism, personal relevance, the body, the family, medical professionals, and transplant recipients. An altruistic motivation to help others emerged as the most commonly identified motivator for becoming an organ donor, although feeling a sense of solidarity with the broader community and believing that donated organs are put to good use may be important preconditions for the emergence of this motivation. The two most commonly identified barriers were the need to maintain bodily integrity to safeguard progression into the afterlife and the unethical recovery of organs by medical professionals. The influence of stakeholder groups on willingness to become an organ donor was also found to vary by the level of control that each stakeholder group exerted over the donation recovery process and their perceived conflict of interest in wanting organ donation to proceed.ConclusionsThese findings afford insights into how individuals perceive posthumous organ donation.

Knowledge about sports-related concussion: is the message getting through to coaches and trainers?

Aim The need for accurate diagnosis and appropriate return-to-play decisions following a concussion in sports has prompted the dissemination of guidelines to assist managing this condition. This study aimed to assess whether key messages within these guidelines are reflected in the knowledge of coaches and sports trainers involved in community sport. Methods An online knowledge survey was widely promoted across Australia in May–August 2012 targeting community Australian Football (AF) and Rugby League (RL) coaches and sports trainers. 260 AF coaches, 161 AF sports trainers, 267 RL coaches and 228 RL sports trainers completed the survey. Knowledge scores were constructed from Likert scales and compared across football codes and respondent groups. Results General concussion knowledge did not differ across codes but sports trainers had higher levels than did coaches. There were no significant differences in either concussion symptoms or concussion management knowledge across codes or team roles. Over 90% of respondents correctly identified five of the eight key signs or symptoms of concussion. Fewer than 50% recognised the increased risk of another concussion following an initial concussion. Most incorrectly believed or were uncertain that scans typically show damage to the brain after a concussion occurs. Fewer than 25% recognised, and >40% were uncertain that younger players typically take longer to recover from concussion than adults. Conclusions The key messages from published concussion management guidelines have not reached community sports coaches and sports trainers. This needs to be redressed to maximise the safety of all of those involved in community sport.

Ethical evaluation of audience segmentation in social marketing

Purpose – The ethicality of using audience segmentation in social marketing contexts has typically been framed within either a consequentialist or non-consequentialist perspective, leading to a hitherto intractable debate. This paper seeks to shed new light on this debate using two alternative ethical frameworks: the theory of just health care (TJHC) and integrative social contracts theory (ISCT). Design/methodology/approach – The paper uses cross-sectional survey data from a Kenyan social marketing campaign that aimed to increase awareness and support for the use of anti-retroviral therapy (ART), a class of drugs that inhibit the development of HIV. Findings – Application of the TJHC and ISCT to the Kenyan social marketing campaign revealed the use of audience segmentation to be ethically justified. Moreover, the TJHC provided a useful framework for guiding decisions about the selection of target audience(s) in health-related contexts. Practical implications – In situations where there are known asymmetr...

Translating Guidelines for the Diagnosis and Management of Sports-Related Concussion Into Practice:

Sports injuries are a significant clinical and public health concern. There is a growing call to improve the translation of available evidence-based and expert-informed sports injury prevention interventions into sustained use in practice by physicians and others (eg, athletic trainers, coaches, and parents) who care for injured athletes. This article provides a brief overview of the current sport injury prevention implementation literature before focusing specifically on the translation of guidelines (including consensus and position statements) developed to assist physicians and others diagnose and manage athletes with sport-related concussion and the associated return-to-play decisions. The outcomes of more than 20 published studies indicate that physician, athletic trainer, coach, parent, and athlete knowledge, use of, and compliance with sport-related concussion guidelines are limited. More concerted, coordinated, and theory-informed efforts are required to facilitate the widespread dissemination, translation, and implementation of such guidelines. An example is provided of how implementation drivers could be used to inform the development of a comprehensive, multilevel implementation strategy targeting the individual, organizational, and system-level changes necessary to support the translation of available sport-related concussion guidelines in both the clinical and sports settings.

Conceptual overlap between moral norms and anticipated regret in the prediction of intention: Implications for theory of planned behaviour research

Moral norms and anticipated regret are widely used extensions to the theory of planned behaviour, yet there is some evidence to suggest that these constructs may conceptually overlap as predictors of intention. Two health-related behaviours with distinct moral implications (Study 1: organ donation registration, N = 352 and Study 2: condom usage, N = 1815) were therefore examined to ascertain whether moral norms and anticipated regret are indeed conceptually distinct. While evidence consistent with conceptual overlap was identified in Study 1, the evidence for such overlap in Study 2 was more ambiguous. In Study 3, a meta-analysis of existing literature revealed that the relationship between moral norms and anticipated regret was moderated by the extent of the moral implications arising from the behaviour under examination. Taken together, these findings suggest that conceptual overlap between moral norms and anticipated regret is more likely to occur among behaviours with obvious moral implications. Researchers wishing to examine the predictive utility of moral norms and anticipated regret among such behaviours would therefore be advised to aggregate these measures to form a composite variable (personal norms).

Resolving the theory of planned behaviour's ‘expectancy-value muddle’ using dimensional salience

The theory of planned behaviour is one of the most widely used models of decision-making in the health literature. Unfortunately, the primary method for assessing the theorys belief-based expectancy-value models results in statistically uninterpretable findings, giving rise to what has become known as the ‘expectancy-value muddle’. Moreover, existing methods for resolving this muddle are associated with various conceptual or practical limitations. This study addresses these issues by identifying and evaluating a parsimonious method for resolving the expectancy-value muddle. Three hundred and nine Australian residents aged 18–24 years rated the expectancy and value of 18 beliefs about posthumous organ donation. Participants also nominated their five most salient beliefs using a dimensional salience approach. Salient beliefs were perceived as being more likely to eventuate than non-salient beliefs, indicating that salient beliefs could be used to signify the expectancy component. The expectancy-value term was therefore represented by summing the value ratings of salient beliefs, an approach that predicted attitude (adjusted R 2 = 0.21) and intention (adjusted R 2 = 0.21). These findings suggest that the dimensional salience approach is a useful method for overcoming the expectancy-value muddle in applied research settings.

Social marketing: why injury prevention needs to adopt this behaviour change approach

Government agencies, public health organisations and the private sector are increasingly funding campaigns to encourage participation in sport. These campaigns frequently achieve moderate levels of success,1 yet many of the individuals who heed these calls to action may be ill prepared for the physical rigours of sport, especially when campaigns do not address how to participate in sport safely. This is not an idle concern; individuals with limited experience in their sport of choice are at increased risk of developing a sports injury, as are those who have recently returned to sport after a prolonged absence.2 Public health campaigns aimed at encouraging sport participation should therefore take into account the findings from the sports injury prevention literature so that those who adopt the campaign messages will be less susceptible to experiencing sports injuries. One approach that could be used to transfer the learnings from the sports injury prevention literature to the broader population is social marketing. Social marketing refers to ‘the adaptation of commercial marketing technologies to programs designed to influence the voluntary behaviour of target audiences to improve their personal welfare and that of the society of which they are …

A profile of Australian adults who have discussed their posthumous organ donation wishes with family members.

Next of kin who are aware of the deceaseds organ donation wishes usually will honor those wishes, while next of kin who are unaware of these wishes typically withhold consent for posthumous donation. Encouraging individuals to communicate or register their organ donation wishes is therefore important. Using a sample of 409 participants, the current study sought to develop a profile of Australian adults who had communicated their organ donation wishes to family members. Christian participants and those who had a higher income were more likely to have communicated their donation wishes. Conversely, participants were less likely to have communicated their donation wishes if they were unregistered and undecided/opposed to organ donation, unregistered but willing to donate, or fearful of death. Finally, whether participants had communicated, registered, or communicated and registered their donation wishes was associated with their age, religion, attitude toward organ donation, and recall of media content about organ donation. Messages encouraging the communication of organ donation wishes to family members should therefore be targeted toward those individuals who are most likely to be receptive toward enacting this behavior.

Evaluating social marketing’s upstream metaphor: does it capture the flows of behavioural influence between ‘upstream’ and ‘downstream’ actors?

ABSTRACT Metaphors are powerful forms of communication that can both facilitate and constrain disciplinary discourse, so the choice of metaphor used to explain concepts of disciplinary importance should not be undertaken lightly. A single case study methodology involving an ‘upstream’ firm considering whether to manufacture products with environmental attributes was consequently used to test three previously unexamined assumptions associated with the upstream/downstream metaphor, a metaphorical distinction that continues to have sway within the social marketing discipline. Contrary to these assumptions, the flows of behavioural influence between ‘upstream’ and ‘downstream’ actors were found to be bidirectional (rather than unidirectional), interactive (rather than independent), and distinctive (rather than non-distinctive). These findings suggest the need for alternative models that can better reflect the complex, multidirectional relationships responsible for the emergence of many social issues.

When nutritional guidelines and life collide: family fruit and vegetable socialisation practices in low socioeconomic communities

Abstract Parents play a critical role in promoting fruit and vegetable consumption, for eating patterns established early in life tend to persist into adulthood. Despite this, the factors that facilitate or inhibit parents’ capacity to socialise fruit and vegetable consumption into their children’s daily diets remain poorly defined. Thirty-eight semi-structured interviews with residents, allied healthcare professionals, community leaders, community programme leaders and a local government leader living or working in two low socioeconomic suburbs were consequently conducted to ascertain factors exogenous and endogenous to the family unit that shaped parental food socialisation practices. Budgetary and time constraints emerged as exogenous factors that constrained fruit and vegetable socialisation. Constraining effects were also found for a range of endogenous factors, including commensal experiences, children’s food fussiness and the feeding styles employed by parents. As such, while many caregivers may wish to socialise fruit and vegetable consumption into their children’s daily diets, their capacity to do so is often inhibited by factors beyond their volitional control. Failure to take heed of these factors could therefore result in the development of social marketing campaigns that are ineffective at best or give rise to unintentionally harmful outcomes at worst.