Leanne Lester

Reaching perinatal women online: the Healthy You, Healthy Baby website and app.

Overwhelming evidence reveals the close link between unwarranted weight gain among childbearing women and childhood adiposity. Yet current barriers limit the capacity of perinatal health care providers (PHCPs) to offer healthy lifestyle counselling. In response, todays Internet savvy women are turning to online resources to access health information, with the potential of revolutionising health services by enabling PHCPs to guide women to appropriate online resources. This paper presents the findings of a project designed to develop an online resource to promote healthy lifestyles during the perinatal period. The methodology involved focus groups and interviews with perinatal women and PHCPs to determine what online information was needed, in what form, and how best it should be presented. The outcome was the development of the Healthy You, Healthy Baby website and smartphone app. This clinically-endorsed, interactive online resource provides perinatal women with a personalised tool to track their weight, diet, physical activity, emotional wellbeing, and sleep patterns based on the developmental stage of their child with links to quality-assured information. One year since the launch of the online resource, data indicates it provides a low-cost intervention delivered across most geographic and socioeconomic strata without additional demands on health service staff.

Three‐year results of the Friendly Schools whole‐of‐school intervention on children’s bullying behaviour

A group randomized controlled trial tested the efficacy of the Friendly Schools program to reduce student bullying behaviour. This socio‐ecological intervention targeted the whole school, classroom, family, and individual students to reduce bullying behaviour. Self‐report data were collected in 29 schools over three years from a cohort of 1968 eight to nine‐year‐olds. Surveys measured frequency of being bullied, bullying others, telling if bullied and observing bullying. Results indicate that intervention students were significantly less likely to observe bullying at 12, 24 and 36 months and be bullied after 12 and 36 months, and significantly more likely to tell if bullied after 12 months than comparison students. No differences were found for self‐reported perpetration of bullying. The findings suggest whole‐of‐school programs that engage students in their different social contexts appear to reduce their experiences of being bullied and increase their likelihood of telling someone if they are bullied.

Problem Behaviours, Traditional Bullying and Cyberbullying among Adolescents: Longitudinal Analyses.

Problem Behaviour Theory suggests that young peoples problem behaviours tend to cluster. This study examined the relationship between traditional bullying, cyberbullying and engagement in problem behaviours using longitudinal data from approximately 1500 students. Levels of traditional victimisation and perpetration at the beginning of secondary school (grade 8, age 12) predicted levels of engagement in problem behaviours at the end of grade 9 (age 14). Levels of victimisation and perpetration were found to moderate each others associations with engagement in problem behaviours. Cyberbullying did not represent an independent risk factor over and above levels of traditional victimisation and perpetration for higher levels of engagement in problem behaviours. The findings suggest that to reduce the clustering of cyberbullying behaviours with other problem behaviours, it may be necessary to focus interventions on traditional bullying, specifically direct bullying.

Drug education in victorian schools (DEVS): the study protocol for a harm reduction focused school drug education trial

BackgroundThis study seeks to extend earlier Australian school drug education research by developing and measuring the effectiveness of a comprehensive, evidence-based, harm reduction focused school drug education program for junior secondary students aged 13 to 15 years. The intervention draws on the recent literature as to the common elements in effective school curriculum. It seeks to incorporate the social influence of parents through home activities. It also emphasises the use of appropriate pedagogy in the delivery of classroom lessons.Methods/DesignA cluster randomised school drug education trial will be conducted with 1746 junior high school students in 21 Victorian secondary schools over a period of three years. Both the schools and students have actively consented to participate in the study. The education program comprises ten lessons in year eight (13-14 year olds) and eight in year nine (14-15 year olds) that address issues around the use of alcohol, tobacco, cannabis and other illicit drugs. Control students will receive the drug education normally provided in their schools. Students will be tested at baseline, at the end of each intervention year and also at the end of year ten. A self completion questionnaire will be used to collect information on knowledge, patterns and context of use, attitudes and harms experienced in relation to alcohol, tobacco, cannabis and other illicit drug use. Multi-level modelling will be the method of analysis because it can best accommodate hierarchically structured data. All analyses will be conducted on an Intent-to-Treat basis. In addition, focus groups will be conducted with teachers and students in five of the 14 intervention schools, subsequent to delivery of the year eight and nine programs. This will provide qualitative data about the effectiveness of the lessons and the relevance of the materials.DiscussionThe benefits of this drug education study derive both from the knowledge gained by trialling an optimum combination of innovative, harm reduction approaches with a large, student sample, and the resultant product. The research will provide better understanding of what benefits can be achieved by harm reduction education. It will also produce an intervention, dealing with both licit and illicit drug use that has been thoroughly evaluated in terms of its efficacy, and informed by teacher and student feedback. This makes available to schools a comprehensive drug education package with prevention characteristics and useability that are well understood.Trial registrationAustralia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000079842

Alcohol prevention: What can be expected of a harm reduction focused school drug education programme?

Aim: This pilot study investigated what alcohol prevention benefits could be achieved by a harm reduction focused school drug education intervention that addressed all drug use, both licit and illicit. Method: The study population comprised a cohort of 225 students in three intervention secondary schools and 93 students in a matched control school in Victoria, Australia. A classroom drug education programme, derived from evidence of effective practice and designed to reduce alcohol and other drug harm, was provided to the intervention students during years eight (13–14 year olds) and nine (14–15 year olds) by teachers trained in its delivery. The control students received the drug education programme normally provided by their school. Findings: The students, who received the intervention, were more knowledgeable about drug use issues, communicated more with their parents about alcohol, drank less, got drunk less, and experienced fewer alcohol related harms. They also remembered receiving more alcohol lessons. They were, however, no less likely to have tried alcohol. Conclusions: The findings are consistent with other studies that have demonstrated school alcohol education that focuses on harm reduction can be effective in reducing consumption, risk and harm. In this study, this was achieved even though the students were not persuaded against taking up drinking, and the intervention did not focus solely on alcohol. These findings have implications for both the goals and coverage of future school drug education programmes.

Dementia Knowledge Assessment Tool Version Two: development of a tool to inform preparation for care planning and delivery in families and care staff.

Care for the person with dementia requires understanding of the person’s perspective and preferences, integrated with knowledge of dementia’s trajectory and appropriate care. Version One of the Dementia Knowledge Assessment Tool addressed such knowledge in care workers; Version Two is for families as well as staff. Content validity was established during development. Revisions addressed clarity, time for completion, and reliability. When 671 staff completed Version One before an education intervention, internal consistency reliability estimates exceeded 0.70. Validity was supported by higher scores in professional versus nonprofessional staff and following the education. Version Two was used with 34 family carers and 70 staff members. Internal consistency reliability (Cronbach’s alpha coefficient) was promising (0.79, both groups). Completion was within 15 minutes. Median correct responses (from 21) were 14 for families (range 4–20) and 16 for the staff (range 3–21). Eighteen staff members (26%) and two family carers (6%) reported substantive dementia education. Inclusion of the person with dementia in care planning is often limited because of a late diagnosis and the progressive impacts of the condition. Establishing a shared staff–family understanding of the dementia trajectory and care strategies likely to be helpful is therefore critical to embarking upon the development and implementation of collaborative long term and end-of-life care plans. Version Two can help establish needs for, and outcomes of, education programs and informational resources in a way that is feasible, minimises burden, and facilitates comparisons across family and staff carer groups.

Exploring the seasonal influences on elementary school children's enjoyment of physical activity during school breaks

Objectives: The purpose of this study was to explore the seasonal influences on elementary school childrens enjoyment of physical activity during school breaks. Methods: The Lunchtime Enjoyment of Activity and Play (LEAP) questionnaire and Physical Activity Childrens Enjoyment Scale (PACES) were used to measure childrens (N = 80) enjoyment of physical activity longitudinally during school breaks over 4 time points. Separate mixed regression models determined whether childrens enjoyment differed by sex and over time. Results: Childrens enjoyment of physical activity during school breaks was significantly higher in March (autumn in the southern hemisphere) in comparison with time points later in the school year. Conclusions: The findings suggest strategies could be implemented by schools to maintain and enhance childrens enjoyment of physical activity during school breaks later in the year.

Adolescent Bully-Victims: Social Health and the Transition to Secondary School.

This study aimed to investigate the causal pathways and factors associated with being involved in bullying behaviour as a bully-victim using longitudinal data from students aged 11–14 years over the transition time from primary to secondary school. Examination of bully-victim pathways suggest a critical time to intervene is prior to transition from the end of primary school to the beginning of secondary school to prevent and reduce the harm from bullying. Negative outcome expectancies from bullying perpetration were a significant predictor of being a bully-victim at the end of the first year of secondary school. The findings show an association between peer support, connectedness to school, pro-victim attitudes, outcome expectancies and level of bullying involvement. Implications for intervention programs are discussed.

A survey of patients’ experience of pain and other symptoms while receiving care from palliative care services

Context In Australia, patients at the end of life with complex symptoms and needs are often referred to palliative care services (PCSs), but little is known about the symptoms of patients receiving palliative care in different settings. Objective To explore patients’ levels of pain and other symptoms while receiving care from PCSs. Method PCSs registered through Australias national Palliative Care Outcomes Collaboration (PCOC) were invited to participate in a survey between 2008 and 2011. Patients (or if unable, a proxy) were invited to complete the Palliative Care Outcome Scale. Results Questionnaires were completed for 1800 patients. One-quarter of participants reported severe pain, 20% reported severe ‘other symptoms’, 20% reported severe patient anxiety, 45% reported severe family anxiety, 66% experienced depressed feelings and 19% reported severe problems with self-worth. Participants receiving care in major cities reported higher levels of depressed feelings than participants in inner regional areas. Participants receiving care in community and combined service settings reported higher levels of need for information, more concerns about wasted time, and lower levels of family anxiety and depressed feelings when compared to inpatients. Participants in community settings had lower levels of concern about practical matters than inpatients. Conclusions Patients receiving care from Australian PCSs have physical and psychosocial concerns that are often complex and rated as ‘severe’. Our findings highlight the importance of routine, comprehensive assessment of patients’ concerns and the need for Specialist Palliative Care clinicians to be vigilant in addressing pain and other symptoms in a timely, systematic and holistic manner, whatever the care setting.

Transition to secondary school: Expectation versus experience

Adolescence is a time of great physical, emotional and social development complicated by a key organisational change in schooling. This study investigated what young people in primary school reported being worried about with their impending move to secondary school, and how their expectations of the transition experience predicted their actual experience. A sample of 2078 students aged 12–13 years enrolled to attend 20 Perth metropolitan Catholic secondary schools was invited to complete two surveys six months apart, the first at the end of Grade 7, followed by Term 1 of Grade 8. The data indicate one half of all Grade 7 students anticipate a positive transition experience, yet almost 70% of students in Grade 8 report the transition was a positive experience for them, with boys reporting a more positive transition experience overall. Moreover, students who expected a positive transition were more than three times more likely to report an actual positive transition experience. These findings and information about what boys and girls are most looking forward to or worried about at secondary school are presented and implications for future interventions explored.