Laura Robinson

Implementing a virtual community of practice for family physician training: a mixed-methods case study

Background GP training in Australia can be professionally isolating, with trainees spread across large geographic areas, leading to problems with rural workforce retention. Virtual communities of practice (VCoPs) may provide a way of improving knowledge sharing and thus reducing professional isolation. Objective The goal of our study was to review the usefulness of a 7-step framework for implementing a VCoP for general practitioner (GP) training and then evaluated the usefulness of the resulting VCoP in facilitating knowledge sharing and reducing professional isolation. Methods The case was set in an Australian general practice training region involving 55 first-term trainees (GPT1s), from January to July 2012. ConnectGPR was a secure, online community site that included standard community options such as discussion forums, blogs, newsletter broadcasts, webchats, and photo sharing. A mixed-methods case study methodology was used. Results are presented and interpreted for each step of the VCoP 7-step framework and then in terms of the outcomes of knowledge sharing and overcoming isolation. Results Step 1, Facilitation: Regular, personal facilitation by a group of GP trainers with a co-ordinating facilitator was an important factor in the success of ConnectGPR. Step 2, Champion and Support: Leadership and stakeholder engagement were vital. Further benefits are possible if the site is recognized as contributing to training time. Step 3, Clear Goals: Clear goals of facilitating knowledge sharing and improving connectedness helped to keep the site discussions focused. Step 4, A Broad Church: The ConnectGPR community was too narrow, focusing only on first-term trainees (GPT1s). Ideally there should be more involvement of senior trainees, trainers, and specialists. Step 5, A Supportive Environment: Facilitators maintained community standards and encouraged participation. Step 6, Measurement Benchmarking and Feedback: Site activity was primarily driven by centrally generated newsletter feedback. Viewing comments by other participants helped users benchmark their own knowledge, particularly around applying guidelines. Step 7, Technology and Community: All the community tools were useful, but chat was limited and users suggested webinars in future. A larger user base and more training may also be helpful. Time is a common barrier. Trust can be built online, which may have benefit for trainees that cannot attend face-to-face workshops. Knowledge sharing and isolation outcomes: 28/34 (82%) of the eligible GPT1s enrolled on ConnectGPR. Trainees shared knowledge through online chat, forums, and shared photos. In terms of knowledge needs, GPT1s rated their need for cardiovascular knowledge more highly than supervisors. Isolation was a common theme among interview respondents, and ConnectGPR users felt more supported in their general practice (13/14, 92.9%). Conclusions The 7-step framework for implementation of an online community was useful. Overcoming isolation and improving connectedness through an online knowledge sharing community shows promise in GP training. Time and technology are barriers that may be overcome by training, technology, and valuable content. In a VCoP, trust can be built online. This has implications for course delivery, particularly in regional areas. VCoPs may also have a specific role assisting overseas trained doctors to interpret their medical knowledge in a new context.

Sleep quality subtypes and obesity

OBJECTIVE Poor sleep quality could be a risk factor for obesity. This article utilized a person-centered approach to investigate whether distinct sleep quality subtypes were associated with obesity directly, and indirectly via physical activity. METHOD The sample included 8,932 Australian employees who participated in the Household, Income and Labor Dynamics in Australia Survey. Structured interviews and self-report questionnaires collected information on sleep quality, obesity, and relevant demographic, health, and work-related variables. Latent class analysis identified distinct subtypes of sleep quality. General linear modeling examined the associations of sleep quality subtypes with body mass index (BMI) and waist circumference. Multicategorical mediation models examined indirect paths linking sleep quality classes with obesity via physical activity. RESULTS Five distinct sleep quality subtypes were identified: Poor Sleepers (20.0%), Frequent Sleep Disturbances (19.2%), Minor Sleep Disturbances (24.5%), Long Sleepers (9.6%), and Good Sleepers (26.7%). BMI, waist circumference, and physical activity differed among the sleep quality subtypes, with similar results observed for males and females. For example, Poor Sleepers had the highest BMIs, followed by Frequent Sleep Disturbances and Minor Sleep Disturbances; Long Sleepers and Good Sleepers had the lowest BMIs. Mediation analyses indicated that low levels of physical activity linked the Poor Sleep, Frequent Sleep Disturbance, and Long Sleep classes with higher BMI. CONCLUSIONS These results provide new insights into the nature of sleep quality in employees. In particular, distinct sleep quality patterns had differing associations with measures of obesity, suggesting the need for tailored workplace interventions. (PsycINFO Database Record

Burnout and the work-family interface: A two-wave study of sole and partnered working mothers

Purpose – The purpose of this paper is to examine whether work-to-family conflict (WFC) and work-to-family enrichment (WFE) predicted burnout in working mothers using conservation of resources theory. The authors also examined whether these relationships varied between sole and partnered working mothers. Design/methodology/approach – In total, 516 partnered and 107 sole mothers in paid employment completed an online survey twice, six months apart. Findings – WFC was significantly positively related to burnout, and WFE significantly negatively related to burnout. Marital status moderated the inverse relationship between WFE and personal burnout, and this relationship was significant for partnered mothers only. Research limitations/implications – Limitations include self-report data, and the sample being highly educated thereby limiting generalizability. Practical implications – Providing an enriching and supportive work environment may be an important strategy for minimizing burnout in mothers, particularl...

Polysubstance use in treatment seekers who inject amphetamine: Drug use profiles, injecting practices and quality of life

BACKGROUND The injection of amphetamine is becoming increasingly common. However, there has been a lack of research examining people who inject amphetamine as the primary drug of use, limiting the potential to ensure services address the unique needs of this group. The current study used latent class analysis to identify classes of polydrug use among people who report injecting amphetamine during the past 12months. It also examined differences between classes and drug use patterns, injecting practices, quality of life and psychological distress. METHODS Participants who were attending non-government specialist alcohol and other drug treatment across New South Wales, Australia and had identified amphetamine as their principle drug of concern and reported injecting amphetamine in the previous 12months were included in the current study (N=827). Latent class analysis was performed to identify polydrug profiles of participants. RESULTS The large majority of people in the current study (85%) demonstrated low probability of heroin or other opiate use. Three distinct classes of polydrug use were identified: (1) Low-polydrug (n=491), (2) Opiates-polydrug (n=123), and (3) Alcohol-polydrug (n=213). There was a trend for the Low-polydrug class to demonstrate better functioning and safer injecting practices than the Opiates-polydrug and Alcohol-polydrug classes. CONCLUSION The results suggest that the majority of people accessing treatment who inject amphetamine as their primary drug of choice have a low probability of heroin or other opiate use. It is important that future research consider whether traditional harm minimisation strategies are appropriate for people who primarily inject amphetamine.

Work-to-family profiles, family structure and burnout in mothers

Purpose The purpose of this paper is to identify work-to-family profiles in working mothers, test whether profiles differ between sole and partnered mothers, and examine whether the work-to-family profiles are associated with burnout. Design/methodology/approach Data on work-to-family conflict (WFC), work-to-family enrichment (WFE), burnout, and relevant socio-demographic covariates were collected via a self-report online survey. Latent profile analysis on WFC and WFE items was used to identify profiles in 179-sole and 857-partnered mothers in paid employment. Regression analyses were performed to examine whether profiles were associated with burnout. Findings Five distinct work-to-family profiles were identified: Harmful, Negative Active, Active, Beneficial, and Fulfilled. Profile membership differed significantly between sole and partnered mothers, with sole mothers more likely to be in the harmful profile. The five profiles had differing implications for burnout. Practical implications WFC and WFE can co-occur, and have differing implications for health and well-being. It is important to consider both WFC and WFE when addressing employee burnout. Furthermore, sole mothers may need greater assistance in reducing WFC and increasing WFE in order to minimize burnout. Originality/value This study contributes to existing research by demonstrating differences in work-to-family profiles between sole and partnered mothers, and highlights the need for future research on diverse family types.

Parental Employment and Child Behaviors: Do Parenting Practices Underlie These Relationships?.

This study examined whether hours of parental employment were associated with child behaviors via parenting practices. The sample included 2,271 Australian children aged 4–5 years at baseline. Two-wave panel mediation models tested whether parenting practices that were warm, hostile, or characterized by inductive reasoning linked parent’s hours of paid employment with their child’s behavior at age 6–7 years. There were significant indirect effects linking mother employment to child behavior. No paid employment and full-time work hours were associated with more behavioral problems in children through less-warm parenting practices; few hours or long hours were associated with improved behavioral outcomes through less-hostile parenting practices. These findings may have implications for developing policies to enable parents to balance work and family demands.

Health literacy in substance use disorder treatment: A latent profile analysis

INTRODUCTION AND AIMS Health literacy refers to the degree to which people can access and understand health information, as well as communicate their health needs to service providers. Whilst health literacy is increasingly being examined within general community samples, there is limited research focused on substance use disorders where the need for health literacy is likely to be high. The aim of this study was to examine the health literacy profiles of people attending substance use disorder treatment and to examine how these profiles were related to measures of quality of life, mental health, and physical health. DESIGN AND METHODS Participants were attending specialist non-government substance use disorder treatment across New South Wales, Queensland, and the Australia Capital Territory, Australia (N = 298). Participants completed the Health Literacy Questionnaire, a multi-dimensional measure of health literacy. Latent profile analysis was conducted to identify profiles of health literacy within the sample. RESULTS Three distinct health literacy profiles were identified, and termed low (24.2%), moderate (62.8%) and high health literacy (13.1%). Participants with lower levels of health literacy had lower levels of social support in their home environment outside of treatment, as well as lower levels of quality of life, higher levels of psychological distress, and poorer mental health. There was no difference between the three profiles on measures of physical health. DISCUSSION AND CONCLUSION The current study found that low to moderate health literacy levels were common for those attending residential substance abuse treatment. Participants with lower health literacy tended to have poorer quality of life and mental health. Future research should examine strategies to improve health literacy amongst people attending alcohol and other drug treatment. It may also be useful for service providers to consider ways to minimise the impact of low health literacy on the health needs and outcomes of this vulnerable population.

The Work–Family Interface and Sleep Quality

ABSTRACT Objective: This article investigated whether work-to-family conflict (WFC) and work-to-family enrichment (WFE) were associated with employee sleep quality. WFC and WFE reflect the potential for experiences at work to negatively and positively influence nonworking life respectively, and may have implications for sleep quality. In this article, we examined whether WFC and WFE were linked with sleep quality via hedonic balance (i.e., positive affect relative to negative affect). Participants: The sample included 3,170 employed Australian parents involved in the Household Income and Labour Dynamics in Australia (HILDA) Survey. Methods: Information on WFC, WFE, hedonic balance, sleep quality, and relevant covariates was collected through a structured interview and self-completion questionnaire. Results: WFC was associated with poorer sleep quality (β = .27, p < .001), and this relationship was stronger in males than females and in dual parent–single income families. WFC was also found to be indirectly associated with poor sleep quality via a lower hedonic balance (β = .17, 99% confidence interval [.14, .20]). WFE was not directly associated with sleep quality, but was indirectly associated with better sleep quality via a higher hedonic balance (β = –.04 [–.07, –.02]). Conclusions: These results indicate that aspects of the work–family interface are associated with employee sleep quality. Furthermore, affective experiences were found to link WFC and WFE with sleep quality. Workplace interventions that target WFC and WFE may have implications for employee sleep.

Workplace bullying and absenteeism: The mediating roles of poor health and work engagement

Workplace bullying is a major problem that affects the well-being and productivity of employees. Some previous studies have found that workplace bullying is associated with absenteeism, which is a major contributor to lost workplace productivity. However, a comprehensive understanding of how different workplace bullying experiences are associated with absenteeism is currently lacking. In particular no previous studies have examined potential mediators of these relationships. The present article aimed to provide new insights into the relationship between workplace bullying and absenteeism. In a 12-month prospective study of 500 Australian employees, we identified 5 distinct subtypes of workplace bullying experiences using a person-centred approach. These bullying subtypes were found to be associated with absenteeism via health impairment and lower work engagement. The findings can be used to inform HR strategies to prevent and manage workplace bullying. © 2017 John Wiley & Sons Ltd

My friends Bundy, cruiser and VB: alcohol marketing on facebook

Abstract presented at the Australasian Professional Society on Alcohol and other Drugs Conference 2013, 24-27 November 2013, Brisbane, Australiapresented at the Australasian Professional Society on Alcohol and other Drugs Conference 2013, 24-27 November 2013, Brisbane, AustraliaAbstract presented at the Australasian Professional Society on Alcohol and other Drugs Conference 2013, 24-27 November 2013, Brisbane, AustraliaAbstract presented at the Australasian Professional Society on Alcohol and other Drugs Conference 2013, 24-27 November 2013, Brisbane, AustraliaAbstract presented at the Australasian Professional Society on Alcohol and other Drugs Conference 2013, 24-27 November 2013, Brisbane, Australia