Rae Walker

Making Partnerships Work: Issues of Risk, Trust and Control for Managers and Service Providers

Trust is widely recognised is a core feature of partnership relationships and one that facilitates joint work. It is an issue that must be addressed if partnerships are to enhance service system integration. In recent literature trust has been linked to concepts of risk and control. In this study of trust within a Primary Care Partnership (PCP) in Australia the experiences of risk and uncertainty, and control, of participants in different structural positions, were explored in detail. The data used in this paper was qualitative, derived from 63 interviews with managers and service providers participating in committees of the PCP. This paper reports on the differences in the experience of risk and uncertainty, trust and control, of managers and service providers working as boundary spanners through the committees of a PCP. For managers there were significant risks and uncertainties, and trust and control were important. For service providers there were few risks and uncertainties, and trust and control were of much less importance. Some policy implications of the differences in perspective are discussed, as are important areas for further research.

Social connectedness and mobile phone use among refugee women in Australia

The aim of this research was to inform the development of mobile phone-assisted health promotion programmes that support social connectedness among refuge women to enhance their mental, physical and social health. For refugees, relationship development during the early stages of resettlement is often difficult. Enhancing personal skills, and resources, can enhance relationships that provide social support. It can also contribute to the development of social relationships in communities and thence acculturation. Communication technologies can assist refugees, if their particular needs and capacities are taken into account. This paper reports a study of refugee womens experience of an intervention based on principles of empowerment and using peer support training and the provision of free mobile phones, and free calls, for at least 1 year. Potential participants were invited by the Afghan, Burmese and Sudanese community leaders to an information session, where the study was explained and invitations to participate extended. A snowball sampling technique was also used, where the first group of participants invited people they had relationships with to join the programme. One hundred and eleven participants were recruited from the three groups. All were from refugee backgrounds. Data collection consisted of: a pre- and post-intervention questionnaire; a log of outgoing phone calls; and in-depth interviews with a subgroup of the study population. The call logs described the patterns of interpersonal relationships facilitated by the mobile phones. In the interviews, characteristics of interpersonal social support, and relationships with heritage and host communities, were described. The quantitative data were analysed using descriptive statistics and the qualitative data using thematic analysis. By describing the conditions under which mobile phone technology can enhance interpersonal and community connectedness, we strengthen the evidence base for the use of mobile phone technology in health promotion programmes with refugee groups.

Burmese refugee young women navigating parental expectations and resettlement

Abstract Young refugee women have to navigate life in a new country, learn a new language and adapt to a new culture while juggling parental role, behavioural and academic expectations. This qualitative study explored how 10 Burmese refugee young women experience parental expectations pre-and post-migration, and the effect of resettlement on the parent–child relationship. The data was gathered using the semi-structured in-depth interview technique and thematically analysed The findings revealed changes in parental expectations as a result of resettlement leading to both role reduction and expansion. While playing the linguistic brokering role post-migration has tilted the power dynamics in favour of the young women, this was undermined by increased social restrictions imposed by parents, resulting in intergenerational acculturation conflict among some participants and their parents. Other implicit factors in causing intergenerational rifts are exposure to an egalitarian style of education and increased access to technology.

Emergency Department Presentations of Victorian Aboriginal and Torres Strait Islander People

This paper explains how routinely collected data can be used to examine the emergency department attendances of Victorian Aboriginal and Torres Strait Islander people. The data reported in the Victorian Emergency Minimum Dataset (VEMD) for the 2006/2007 financial year were analysed. The presentations of Aboriginal and Torres Strait Islander and non-Aboriginal people were compared in terms of age, gender, hospital location (metropolitan and rural) and presenting condition. Aboriginal and Torres Strait Islander people were found to attend the emergency department 1.8 times more often than non-Aboriginal people. While the emergency department presentation rates of metropolitan Aboriginal and Torres Strait Islander and non-Aboriginal people were similar, rural Aboriginal and Torres Strait Islander people presented to the emergency department 2.3 times more often than non-Aboriginal people. The injuries or poisonings, respiratory conditions and mental disorders presentation rates of the Aboriginal and Torres Strait Islander and non-Aboriginal population were compared. No previous studies have assessed the accuracy of the Indigenous status and diagnosis fields in the VEMD; therefore the quality of this data is unknown.

Constant connections: piloting a mobile phone-based peer support program for Nuer (southern Sudanese) women

Refugee women have poor psychosocial health as a result of past trauma and difficulties associated with settlement. This study was a pilot to find out how to use mobile phone-based peer support to improve the psychosocial health of, and facilitate settlement in a group of nine Nuer refugee women in Melbourne, Australia. Nine participants recruited by a community leader received peer support training over two five-week periods. They were further provided with mobile phone recharge vouchers to call one another to practice peer support techniques. The fifth and final sessions were focus groups to evaluate the intervention. Notes from the focus groups were thematically analysed. The women reported greater confidence and empowerment as they received more support, had better connections within the group and better access to information. Relationships with friends, family and the community became richer as they adopted and experienced more functional communication patterns. Using mobile phones for peer support helped to re-create community by bridging the geographical distance that separates refugee women. It allowed the women, from similar backgrounds and with similar experiences, to provide mutual support and exchange information through a verbal channel, the form of communication they are most comfortable with. The program demonstrates the positive psychosocial effect of peer support in a refugee community, and provides a viable model for using mobile phones in health promotion interventions. The successful outcomes, as perceived by the participants, are indicative of the potential of using technology to bridge health inequities in a marginalised group.

Climate change and primary health care intervention framework

Climatechangehasbeendescribedastheissueofourtimes.TheWorldHealthOrganizationarguesthatit will result in both beneficial and harmful effects for human populations and that the harms are likely to outweigh the benefits. Climate scientists can sketch an outline of the probable changes by country, and even region within a country. The effect of climate change on communities is much harder to predict. However, it can be argued with some confidence that the effects will be unequally distributed across communities and that the ways in which communities respond will make a substantial difference to their wellbeing. This paper uses the predictions for climate change in Victoria, Australia, as the background to a discussion of primary health care principles and how they might translate into coping, adaptation and mitigation activities within the primary health care sector. The major primary health care agencies are linked to one another through Primary Care Partnership structures and processes,whichprovideafoundationforsector-wideresponsestoclimatechange.Theconceptofastoryline,abrief scenario capturing the logic of changes and potential responses, is used to link evidence of climate change effects on communities and individuals to potential responses by primary health care agencies.

Time-sensitive clinical management : A case study of acute asthma care

This paper emerged from a study of change in a major teaching hospital subsequent to the introduction of casemix-based funding--a management tool designed to support the development of industrial practices in hospital management. A clinical unit had been advised to become more financially efficient. The unit staff redefined the task as becoming more clinically effective, as well as more efficient. One of the important themes to emerge was the importance of time. The resultant changes in the provision of care reflected a sophisticated approach to time.

The Development of Educational Computing Policy in the Victorian School System, 1976-1985.

This paper is a critical historical review of the development of school computing policy primarily in the Victorian secondary state school system. As Victoria is linked to the national computer education program, relevant developments at that level are also explored. Computer technology is conceptualised as a social phenomenon and policy development as both a historical and political process. Policy development is located within the context of the development of microcomputer technology and of teacher relationships to that technology. In the early stages of policy development, the rudiments of a critical social perspective on technology are apparent. In the Victorian policy, this perspective became marginalised during the policy process. The orientation towards a broad social concept of technology was displaced by an instrumental framework in which computers were conceived as an unproblematic set of tools and associated techniques.

Peer support groups, mobile phones and refugee women in Melbourne

In this article, we discuss qualitative findings basing on the experiences of refugee women living in Melbourne, Australia, who participated in a peer support training programme and received a free mobile phone. We pay attention to social support as a health enhancing strategy and empowerment that occurred among the participants. Participation in peer support groups and access to a mobile phone were beneficial for the women. Peer support functioned as social support among group members. The programme allowed the women to be connected to their families and the wider communities and assisted them to access health care and other settlement aspects with greater ease. It also increased personal empowerment among the women. Our programme shows that by tapping on community resources to ameliorate personal or resettlement issues, the burden on service providers can be reduced. Our findings also offer a model for future research and programmes regarding refugee people elsewhere.

Inter‐agency collaboration: the North East Health Promotion Centre

Objective: The management of inter‐agency collaborations needs to be approached in particular, but not well defined, ways. In this paper the management and ways of working of a successful co‐ordinating unit are discussed and located in the context of inter‐agency partnerships.