Melbourne School of Population and Global Health - Research Publications

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    Enhancing the use of research in health-promoting, anti-racism policy
    Ferdinand, AS ; Paradies, Y ; Kelaher, M (BIOMED CENTRAL LTD, 2017-07-11)
    BACKGROUND: The Localities Embracing and Accepting Diversity (LEAD) programme was established to improve the health of ethnic minority communities through the reduction of racial discrimination. Local governments in the state of Victoria, Australia, were at the forefront of LEAD implementation in collaboration with leading state and national organisations. Key aims included expanding the available evidence regarding effective anti-racism interventions and facilitating the uptake of this evidence in organisational policies and practices. METHODS: One rural and one metropolitan local government areas were selected to participate in LEAD. Key informant interviews and discussions were conducted with individuals who had participated in LEAD implementation and members of LEAD governance structures. Data were also collected on programme processes and implementation, partnership formation and organisational assessments. RESULTS: The LEAD model demonstrated both strengths and weaknesses in terms of facilitating the use of evidence in a complex, community-based health promotion initiative. Representation of implementing, funding and advisory bodies at different levels of governance enabled the input of technical advice and guidance alongside design and implementation. The representation structure assisted in ensuring the development of a programme that was acceptable to all partners and informed by the best available evidence. Simultaneous evaluation also enhanced perceived validity of the intervention, allowed for strategy correction when necessary and supported the process of double-loop organisational learning. However, due to the model's demand for simultaneous and intensive effort by various organisations, when particular elements of the intervention were not functional, there was a considerable loss of time and resources across the partner organisations. The complexity of the model also presented a challenge in ensuring clarity regarding roles, functions and the direction of the programme. CONCLUSIONS: The example of LEAD provides guidance on mechanisms to strengthen the entry of evidence into complex community-based health promotion programmes. The paper highlights some of the strengths and weaknesses of the LEAD model and implications for practical collaboration between policymakers, implementers and researchers.
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    Effects over time of self-reported direct and vicarious racial discrimination on depressive symptoms and loneliness among Australian school students
    Priest, N ; Perry, R ; Ferdinand, A ; Kelaher, M ; Paradies, Y (BIOMED CENTRAL LTD, 2017-02-03)
    BACKGROUND: Racism and racial discrimination are increasingly acknowledged as a critical determinant of health and health inequalities. However, patterns and impacts of racial discrimination among children and adolescents remain under-investigated, including how different experiences of racial discrimination co-occur and influence health and development over time. This study examines associations between self-reported direct and vicarious racial discrimination experiences and loneliness and depressive symptoms over time among Australian school students. METHODS: Across seven schools, 142 students (54.2% female), age at T1 from 8 to 15 years old (M = 11.14, SD = 2.2), and from diverse racial/ethnic and migration backgrounds (37.3% born in English-speaking countries as were one or both parents) self-reported racial discrimination experiences (direct and vicarious) and mental health (depressive symptoms and loneliness) at baseline and 9 months later at follow up. A full cross-lagged panel design was modelled using MPLUS v.7 with all variables included at both time points. RESULTS: A cross-lagged effect of perceived direct racial discrimination on later depressive symptoms and on later loneliness was found. As expected, the effect of direct discrimination on both health outcomes was unidirectional as mental health did not reciprocally influence reported racism. There was no evidence that vicarious racial discrimination influenced either depressive symptoms or loneliness beyond the effect of direct racial discrimination. CONCLUSIONS: Findings suggest direct racial discrimination has a persistent effect on depressive symptoms and loneliness among school students over time. Future work to explore associations between direct and vicarious discrimination is required.
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    Patterns of Intergroup Contact in Public Spaces: Micro-Ecology of Segregation in Australian Communities
    Priest, N ; Paradies, Y ; Ferdinand, A ; Rouhani, L ; Kelaher, M (MDPI, 2014-03)
    The use of public spaces can promote social cohesion and facilitate interpersonal interactions within the community. However, the ways racial and ethnic groups interact in public spaces can also reflect and influence informal segregation in the wider community. The present study aimed to examine patterns of intergroup contact within public spaces in Victoria, Australia through short-term observation in four localities. Data were collected on within-group, intergroup and absence of contact for people from minority and majority groups. A total of 974 contacts were observed. Findings indicate that in the observed public spaces, people from visible minority groups tended to have no contact with others or to interact with people from other ethnic/racial groups. In contrast, those from the majority group tended to interact predominately with other majority group members. This suggests that majority group members are more likely to ‘self-segregate’ in public spaces than those from minority groups.
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    Aboriginal health promotion through addressing employment discrimination
    Ferdinand, AS ; Paradies, Y ; Perry, R ; Kelaher, M (CSIRO PUBLISHING, 2014)
    The Localities Embracing and Accepting Diversity (LEAD) program aimed to improve the mental health of Aboriginal Victorians by addressing racial discrimination and facilitating social and economic participation. As part of LEAD, Whittlesea Council adopted the Aboriginal Employment Pathways Strategy (AEPS) to increase Aboriginal employment and retention within the organisation. The Aboriginal Cultural Awareness Training Program was developed to build internal cultural competency and skills in recruiting and retaining Aboriginal staff. Analysis of surveys conducted before (pre; n=124) and after (post; n=107) the training program indicated a significant increase in participant understanding across all program objectives and in support of organisational policies to improve Aboriginal recruitment and retention. Participants ended the training with concrete ideas about intended changes, as well as how these changes could be supported by their supervisors and the wider organisation. Significant resources have since been allocated to implementing the AEPS over 5 years. In line with principles underpinning the National Aboriginal and Torres Strait Islander Health Plan 2013-23, particularly the focus on addressing racism as a determinant of health, this paper explores the AEPS and training program as promising approaches to health promotion through addressing barriers to Aboriginal employment. Possible implications for other large organisations are also considered.
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    Experiences of Racism, Racial/Ethnic Attitudes, Motivated Fairness and Mental Health Outcomes Among Primary and Secondary School Students
    Priest, N ; Perry, R ; Ferdinand, A ; Paradies, Y ; Kelaher, M (SPRINGER/PLENUM PUBLISHERS, 2014-10)
    While studies investigating the health effects of racial discrimination for children and youth have examined a range of effect modifiers, to date, relationships between experiences of racial discrimination, student attitudes, and health outcomes remain unexplored. This study uniquely demonstrates the moderating effects of vicarious racism and motivated fairness on the association between direct experiences of racism and mental health outcomes, specifically depressive symptoms and loneliness, among primary and secondary school students. Across seven schools, 263 students (54.4% female), ranging from 8 to 17 years old (M = 11.2, SD = 2.2) reported attitudes about other racial/ethnic groups and experiences of racism. Students from minority ethnic groups (determined by country of birth) reported higher levels of loneliness and more racist experiences relative to the majority group students. Students from the majority racial/ethnic group reported higher levels of loneliness and depressive symptoms if they had more friends from different racial/ethnic groups, whereas the number of friends from different groups had no effect on minority students' loneliness or depressive symptoms. Direct experiences of racism were robustly related to higher loneliness and depressive symptoms in multivariate regression models. However, the association with depressive symptoms was reduced to marginal significance when students reported low motivated fairness. Elaborating on the negative health effects of racism in primary and secondary school students provides an impetus for future research and the development of appropriate interventions.