Faculty of Education - Research Publications
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ItemPredictors of learning outcomes for children with and without chronic illness: An Australian longitudinal study(WILEY, 2018-11)BACKGROUND: Chronically ill children are at increased risk of poor learning outcomes. Knowledge of the predictors of learning outcomes for this group of people is important to inform the development of education supports that stand the best chance of being effective. This study explored the child, family, and school risk and protective factors during the child's transition to elementary school (aged 6-7 years) that were associated with learning outcomes when children were aged 10-11 years for both children with and without a chronic illness. METHODS: Data from the Longitudinal Study of Australian Children were used. Predictor variables were entered into separate multivariate regression models for children with and without a chronic illness. RESULTS: The strongest predictors of learning outcomes were the child's approach to learning, a consistent parenting style, and family socioeconomic position and were common for both children with and without a chronic illness but strongest for children with a chronic illness. CONCLUSION: A child's approach to learning and a consistent parenting style during the period of the child's transition to elementary school are important and potentially modifiable factors that are predictive of academic performance in later childhood. These factors are particularly relevant for children with a chronic illness, their parents/caregivers, teachers both hospital and school based, and pediatricians and can be used to inform interventions.
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ItemA cost-based equity weight for use in the economic evaluation of primary health care interventions: case study of the Australian Indigenous population(BMC, 2009-10-07)BACKGROUND: Efficiency and equity are both important policy objectives in resource allocation. The discipline of health economics has traditionally focused on maximising efficiency, however addressing inequities in health also requires consideration. Methods to incorporate equity within economic evaluation techniques range from qualitative judgements to quantitative outcomes-based equity weights. Yet, due to definitional uncertainties and other inherent limitations, no method has been universally adopted to date. This paper proposes an alternative cost-based equity weight for use in the economic evaluation of interventions delivered from primary health care services. METHODS: Equity is defined in terms of 'access' to health services, with the vertical equity objective to achieve 'equitable access for unequal need'. Using the Australian Indigenous population as an illustrative case study, the magnitude of the equity weight is constructed using the ratio of the costs of providing specific interventions via Indigenous primary health care services compared with the costs of the same interventions delivered via mainstream services. Applying this weight to the costs of subsequent interventions deflates the costs of provision via Indigenous health services, and thus makes comparisons with mainstream more equitable when applied during economic evaluation. RESULTS: Based on achieving 'equitable access', existing measures of health inequity are suitable for establishing 'need', however the magnitude of health inequity is not necessarily proportional to the magnitude of resources required to redress it. Rather, equitable access may be better measured using appropriate methods of health service delivery for the target group. 'Equity of access' also suggests a focus on the processes of providing equitable health care rather than on outcomes, and therefore supports application of equity weights to the cost side rather than the outcomes side of the economic equation. CONCLUSION: Cost-based weights have the potential to provide a pragmatic method of equity weight construction which is both understandable to policy makers and sensitive to the needs of target groups. It could improve the evidence base for resource allocation decisions, and be generalised to other disadvantaged groups who share similar concepts of equity. Development of this decision-making tool represents a potentially important avenue for further health economics research.
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ItemThe effects of an area-based intervention on the uptake of maternal and child health assessments in Australia: A community trial(BMC, 2009-03-25)BACKGROUND: Recognition of the importance of the early years in determining health and educational attainment and promotion of the World Health Organization Health for All (HFA) principles has led to an international trend towards community-based initiatives to improve developmental outcomes among socio-economically disadvantaged children. In this study we examine whether, Best Start, an Australian area-based initiative to improve child health was effective in improving access to Maternal and Child Health (MCH) services. METHODS: The study compares access to information, parental confidence and annual 3.5 year Ages and Stages visiting rates before (2001/02) and after (2004/05) the introduction of Best Start. Access to information and parental confidence were measured in surveys of parents with 3 year old children. There were 1666 surveys in the first wave and 1838 surveys in the second wave. The analysis of visiting rates for the 3.5 year Ages and Stages visit included all eligible Victorian children. Best Start sites included 1,739 eligible children in 2001/02 and 1437 eligible children in 2004/05. The comparable figures in the rest of the state were and 45, 497 and 45, 953 respectively. RESULTS: There was a significant increase in attendance at the 3.5 year Ages and Stages visit in 2004/05 compared to 2001/02 in all areas. However the increase in attendance was significantly greater at Best Start sites than the rest of the state. Access to information and parental confidence improved over the course of the intervention in Best Start sites with MCH projects compared to other Best Start sites. CONCLUSION: These results suggest that community-based initiatives in disadvantaged areas may improve parents' access to child health information, improve their confidence and increase MCH service use. These outcomes suggest such programmes could potentially contribute to strategies to reduce child health inequalities.
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ItemMusomagi; Artist-led personal development programmes for youth as viewed through a community music therapy lens(Intellect, 2017)Large (80+ participants) artist-led programmes with young people frequently take place in school settings, and the artist has limited background knowledge of those attending. This study examined the components of an artist-led programme to identify the nuanced behaviours of artists and volunteer helpers that support musical engagement, personal and social development, and promote social capital. From an analysis of videos and interviews, we examine the activities and outcomes of artist-led programmes as viewed through the lens of Community Music Therapy (CoMT). We found that the programmes were ecological, ethics-driven and participatory, and espoused activism, which are core features of CoMT thinking. We found that within this model, there was importance placed on the youth taking the music outside formal spaces and sharing it with the community in public places such as local cafes, residential care facilities and police stations. The role of the artist-facilitator goes beyond preparing the youth for this experience and extends to preparing the local community – an ecological approach.
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ItemEvaluating the health impacts of participation in Australian community arts groups(OXFORD UNIV PRESS, 2014-09)This study evaluates the impacts of three well-established community arts programmes in Victoria, Australia, on the mental health and well-being outcomes of participants typically from disadvantaged backgrounds during 2006-07. It employs a theoretical framework that reconciles evidence-based practice in health and the phenomenological nature of community arts practice. Self-determination theory (SDT) was used to do this with SDT-derived psychometric instruments [arts climate and Basic Psychological Needs Scales (BPNS)]. Self-administered surveys using these instruments as well as a measure of social support were undertaken on two occasions. Two overlapping but distinct samples were defined and analysed cross-sectionally. These were a (pre-)survey at the commencement of rehearsals for the annual performance (n = 103) and a (post-)survey following the performance (n = 70). The most significant change (MSC) technique was used to study the arts-making process and how it contributes to outcomes. Using these mixed-methods approach, impacts on the climate of the arts organizations, participant access to supportive relationships and participant's mental health and well-being were studied. There were positive changes in the BPNS (p = 0.00), as well as its autonomy (p = 0.04) and relatedness (p = 0.00) subscales. Social support increased from 65.3% in the pre-survey to 82.4% in the post-survey (p = 0.03). MSC data indicated that the supportive, collaborative environment provided by the arts organizations was highly valued by participants and was perceived to have mental health benefits.Overall, the study demonstrated the potential health promoting effects of community arts programmes in disadvantaged populations. Its multi-method approach should be further studied in evaluating other community arts programmes.
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ItemHow Significant is Partnership Formation in Area-Based Projects to Increase Parental Attendance at Maternal and Child Health Services?(LIFESCIENCE GLOBAL, 2013)Objectives: In this study, we assess the importance of area-based partnerships in an initiative to improve access to Maternal and Child Health (MCH) services (known as Best Start) in socially disadvantaged communities in Victoria, Australia. Methods: The study assessed changes in MCH attendance rates, parental attitudes and local partnership formation before and after the introduction of Best Start projects. Partners involved in Best Start projects were surveyed regarding the extent of local partnership formation (before 54; after 84). Data was collected for MCH attendance using routine records for Best Start with MCH projects (before 1,739; after 1437) and the rest of the State (before 45,497; after 45,953). Two cross-sectional surveys of parents of 3-year old children were used to assess changes in parent’s knowledge about, and confidence in using relevant services as well as parental confidence more generally (before 1666; after 1838). Results: Best Start was significantly associated with improving: levels of partnership formation (5 of 7 relevant factors) attendance at the 3.5 year MCH visit in Best Start Sites with MCH projects between 2001/02-2004/05. parent’s access to information (partnership effect); confidence about attending the 3.5 year MCH visits (partnership effect); and overall parental confidence (project effect only). Conclusion: Best Start improves participation in the MCH attendance. This is related most directly to improving parent’s access to information and overall parental confidence either through local partnership or direct project effects.