Margaret Thomas

Home Visits by an Occupational Therapist for Assessment and Modification of Environmental Hazards: A Randomized Trial of Falls Prevention

OBJECTIVE: To determine whether occupational therapist home visits targeted at environmental hazards reduce the risk of falls.

The cost effectiveness of a home hazard reduction program to reduce falls among older persons

BACKGROUND: The effectiveness of individual components (other than exercise) of multifactorial intervention packages aimed to reduce the incidence of falls in older people is uncertain. There have been no randomised trials of home modifications alone for the prevention of falls.

A protocol for evidence-based targeting and evaluation of statewide strategies for preventing falls among community-dwelling older people in Victoria, Australia

Background Falls are a significant threat to the safety, health and independence of older citizens. Despite the now substantial evidence about effective falls prevention interventions, translation into falls reductions has not yet been fully realised. While the hip fracture rate is decreasing, the number and rate of fall-related hospital admissions among older people is increasing. The challenge now is to deliver the most effective interventions efficiently at a population level, and for these interventions to be taken up by older people. Objective To support the development, and evaluation of, effective falls prevention policy and practice in the state of Victoria, Australia. Methods The RE-AIM model (Reach, Efficacy, Adoption, Implementation, Maintenance) was used to identify strategies for an effective programme. Research objectives were developed to support the strategies. These include: (1) identification of subgroups of older people most frequently admitted to hospital for falls; (2) examining the acceptability of established falls interventions; (3) identification of factors that encourage and support relevant lifestyle changes; (4) identifying opportunities to incorporate confirmed interventions in existing programmes and services; (5) developing guidelines for sustainability. The research results will subsequently guide strategy details for the falls prevention plan. RE-AIM will provide the framework for the evaluation structure. Outcome measures Measures to monitor the implementation of the selected interventions will be determined for each intervention, based on the five key factors of the RE-AIM model. The overall effect of the falls prevention plan will be monitored by time series analysis of fall-related hospital admission rates for community-dwelling older people.

“First Aid for Scalds” campaign: reaching Sydney's Chinese, Vietnamese, and Arabic speaking communities

Objectives—As a serious yet preventable problem, scald injuries in children have been a priority for prevention in Australia and other developed countries. Not only can the occurrence of scalds be prevented, but immediate first aid treatment offers an effective method for secondary prevention, reducing the severity of scalds. Despite the success of scald prevention initiatives, local evidence suggested that first aid knowledge was lacking in some minority ethnic groups. To redress this gap, the “First Aid for Scalds” campaign for those from a non-English speaking background was specifically targeted to three ethnic groups (Vietnamese, Chinese, and Arabic), with the aim of increasing the proportions of parents and caregivers who had correct knowledge of first aid treatment for scalds. The primary strategy was a media campaign, including advertisements on ethnic radio and in ethnic newspapers. Methods—The evaluation design included formative research and impact evaluation. The impact evaluation study involved random population based telephone surveys with each of the three language groups, before and after the campaign, to assess the reach and effectiveness of the campaign. Results—After the campaign, there were significant increases in the proportion of people who knew the correct first aid treatment for scalds. There were substantial variations in campaign recall and knowledge between each of the three language groups. The largest improvement was found in the Vietnamese group. Conclusion—The association between campaign recall and increase in correct knowledge, and the absence of any similar interventions during the campaign period, give credence to the conclusion that the changes observed were a result of the campaign. The results demonstrate the value of community based injury prevention campaigns specifically targeting linguistically diverse communities.

Awareness of message source and its association with the impacts of sun protection campaigns in Australia

Purpose – To examine whether awareness of the source of sun protection campaigns in New South Wales, Australia was associated with message recall and sun protection knowledge and behaviours.Design/methodology/approach – Telephone surveys of random samples (n=800) of parents and other carers of children under 12 years of age were conducted before and after the first two campaigns and after the third campaign.Findings – Recognition of the NSW Cancer Council (NSWCC) as the message source increased after each campaign. Cross‐sectional analyses revealed that after the first and third campaigns those who could identify the NSWCC were 1.4‐1.7 times more likely than those who could not to demonstrate knowledge about child sun protection practices (p<0.05). After the first campaign those with accurate message source awareness were 1.4 times more likely to report using sunscreen or clothing to protect their children, while after campaign three this awareness was associated with a greater likelihood (OR 1.6, p<0.05)...

Rural Research Capacity Building Program: capacity building outcomes

The Rural Research Capacity Building Program commenced in 2006 with the aim of developing research skills in rural health workers. The program was based on the capacity building principles of workforce development, organisational development, resource allocation, partnership and leadership. Qualitative methods were used to assess capacity building outcomes. A sample of candidates from the 2006 and 2007 cohorts were selected for interview using stratified random sampling and supplemental purposive sampling. Twenty-five individual semi-structured interviews were conducted with candidates, their managers and mentors. Interviews were thematically analysed. The program components of teaching, mentoring and networking led to the development of research skills in candidates undertaking the program. This workforce development resulted in workplace change, particularly where the candidates project was close to practice and they had management support. The leadership shown and partnerships developed by the program managers enhanced the workforce development and organisational change outcomes. Resources, such as backfill and incidentals, were useful for candidates, but practicalities, such as availability of replacement staff, limited effectiveness. This study showed the value of using a capacity building framework and demonstrated that undertaking research on a topic close to practice positioned candidates to drive change within their organisation.

Integrating proven falls prevention interventions into government programs

Objective: To identify Department of Health programs with high potential to integrate evidence‐based interventions to prevent falls among older people.

Overcoming disparities in organized physical activity: findings from Australian community strategies

Organized physical activity through sport and recreational activities is beneficial for physical and psychosocial well-being and community connectedness. However, many who could gain significantly from this have lower participation, especially the socioeconomically disadvantaged, Indigenous people, culturally diverse communities and people with a disability. This study examined barriers to participation by these underserved groups and the success of strategies for overcoming these used in 22 community projects over 3 years in the VicHealth Participation in Community Sport and Recreation Program, in Victoria, Australia. Each year, in-depth interviews were undertaken with 50-60 activity providers and 30-40 project partners. Major barriers to participation were cost, lack of transport, cultural differences, the environment of sporting groups and inaccessible facilities for people with disabilities. Projects that overcame these selected one or two priority groups, put significant effort into communication and building partnerships with community organizations, provided training to staff and volunteers and created new or modified forms of activity. Strategies were put in place to reduce cost and provide transport, but these did not appear to be sustainable. Many organizations found engaging the underserved was more difficult than anticipated and require information and support about how to develop acceptable, accessible and flexible opportunities for disadvantaged groups. Cost and lack of transport are persistent barriers to participation that need to be addressed by the sport and recreation sector and policy-makers.

30-year changes in Australian children’s standing broad jump: 1985–2015

OBJECTIVESnMuscular strength is an important component of fitness that enables the execution of a range of daily activities across the lifespan including sport participation. The purpose of this study was to examine changes in childrens standing broad jump, an indicator of muscular strength, between 1985 and 2015.nnnDESIGNnTwo representative cross-sectional population surveys of Australian children age 9-15 years (n=7051).nnnMETHODSnIn 1985 and 2015 childrens standing broad jump (SBJ; cm) and anthropometry were measured by trained field teams. General linear regression examined the temporal change in SBJ by sex and age adjusting for height, weight, socioeconomic status, and linguistic background.nnnRESULTSnOver a 30-year period, the height, weight, and BMI of children significantly increased and muscular strength decreased. Among boys, the adjusted SBJ distance declined -4.5cms (95%CI -8.8, -0.10) in 9-11 year olds and 7.6cms (95%CI -12.5, -2.7) in 12-15 year olds. Among girls, the adjusted SBJ distance declined 8.5cms (95%CI -12.9, -4.2) in 9-11 year olds and 9.3cms (95%CI -14.1, -4.6) in 12-15 year olds. Larger declines in the distance jumped were observed among children and adolescents from non-English speaking backgrounds, than English speaking peers and children from low socioeconomic neighbourhoods than the declines among children from high SES neighbourhoods.nnnCONCLUSIONSnOverall, the distance children and adolescents jumped in 2015 was lower than the distance their peers jumped in 1985. The declines differed by sex and sociodemographic characteristics, which suggests targeted sub-population interventions to improve childrens muscular strength should be considered.

Is this health campaign really social marketing? A checklist to help you decide

ISSUE ADDRESSEDnSocial marketing (SM) campaigns can be a powerful disease prevention and health promotion strategy but health-related campaigns may simply focus on the promotions communication activities and exclude other key characteristics of the SM approach. This paper describes the application of a checklist for identifying which lifestyle-related chronic disease prevention campaigns reported as SM actually represent key SM principles and practice.nnnMETHODSnA checklist of SM criteria was developed, reviewed and refined by SM and mass media campaign experts. Papers identified in searches for social marketing and mass media for obesity, diet and physical activity campaigns in the health literature were classified using the checklist.nnnRESULTSnUsing the checklist, 66.6% of papers identified in the SM search and 39% of papers identified from the mass media search were classified as SM campaigns. Inter-rater agreement for classification using the abstract only was 92.1%.nnnCONCLUSIONSnHealth-related campaigns that self-identify as social marketing or mass media may not include the key characteristics of a SM approach. Published literature can provide useful guidance for developing and evaluating health-related SM campaigns, but health promotion professionals need to be able to identify what actually comprises SM in practice. SO WHAT?: SM could be a valuable strategy in comprehensive health promotion interventions, but it is often difficult for non-experts to identify published campaigns that represent a true SM approach. This paper describes the application of a checklist to assist policy makers and practitioners in appraising evidence from campaigns reflecting actual SM in practice. The checklist could also guide reporting on SM campaigns.