Melbourne Graduate School of Education - Research Publications

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    Asking for a friend: seeking teacher help for the homophobic harassment of a peer
    Molina, A ; Shlezinger, K ; Cahill, H (SPRINGER, 2023-04-01)
    Homophobic name-calling is one of the most common forms of gender-based violence that occurs among young people at school. Yet students are reluctant to seek teacher help when homophobic bullying occurs. We investigated what enables bystanders to seek help from teachers when they witness the homophobic harassment of a peer who may be unwilling to seek help for themselves. Respondents were a sample of 2119 secondary students from 11 Australian schools. Data analysed using generalised mixed linear modelling demonstrated that student connectedness to teachers at the individual and school level were the strongest predictors of the likelihood of reporting the homophobic harassment of a peer. Findings suggest that above and beyond the effects of student relationships with teachers, a culture of teacher care at the school level is crucial in enabling students who witness homophobic bullying to seek teacher help.
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    The responsibility of knowledge: Identifying and reporting students with evidence of psychological distress in large-scale school-based studies
    Kern, ML ; Cahill, H ; Morrish, L ; Farrelly, A ; Shlezinger, K ; Jach, H (SAGE PUBLICATIONS INC, 2021-04)
    The use of psychometric tools to investigate the impact of school-based wellbeing programs raises a number of ethical issues around students’ rights, confidentiality and protection. Researchers have explicit ethical obligations to protect participants from potential psychological harms, but guidance is needed for effectively navigating disclosure of identifiable confidential information that indicates signs of psychological distress. Drawing on a large-scale study examining student, school, and system-based factors that impact the implementation of a school-based social and emotional learning program, we describe patterns of distress attained from quantitative and qualitative questions and describe the process that we evolved to monitor and disclose sensitive mental health information, providing one example of how researchers might effectively address the responsibilities that emerge when collecting sensitive information from students within an education system. The patterns and processes that emerged illustrate that the inclusion of mental distress information can elicit important insights, but also brings responsibilities for minimising risks and maximising benefits.
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    Drug education in victorian schools (DEVS): the study protocol for a harm reduction focused school drug education trial
    Midford, R ; Cahill, H ; Foxcroft, D ; Lester, L ; Venning, L ; Ramsden, R ; Pose, M (BMC, 2012-02-10)
    BACKGROUND: This 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/DESIGN: A 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. DISCUSSION: The 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 REGISTRATION: Australia and New Zealand Clinical Trials Register (ANZCTR): ACTRN12612000079842.
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    Enhancing Social and Emotional Wellbeing of Aboriginal Boarding Students: Evaluation of a Social and Emotional Learning Pilot Program
    Franck, L ; Midford, R ; Cahill, H ; Buergelt, PT ; Robinson, G ; Leckning, B ; Paton, D (MDPI, 2020-02-01)
    Boarding schools can provide quality secondary education for Aboriginal students from remote Aboriginal Australian communities. However, transition into boarding school is commonly challenging for Aboriginal students as they need to negotiate unfamiliar cultural, social and learning environments whilst being separated from family and community support. Accordingly, it is critical for boarding schools to provide programs that enhance the social and emotional skills needed to meet the challenges. This study evaluated a 10-session social and emotional learning (SEL) program for Aboriginal boarders and identified contextual factors influencing its effectiveness. The study combined a pre-post quantitative evaluation using diverse social and emotional wellbeing measures with 28 students between 13-15 years (10 female, 11 male, 7 unidentified) and qualitative post focus groups with 10 students and episodic interviews with four staff delivering the program. Students' social and emotional skills significantly improved. The qualitative findings revealed improvements in students seeking and giving help, working in groups, managing conflict, being assertive and discussing cultural issues. The focus groups and interviews also identified program elements that worked best and that need improvement. Secure relationships with staff delivering the program and participation in single sex groups stood out as critical enablers. The findings lend evidence to the critical importance of collaborative design, provision and evaluation of SEL programs with Aboriginal peoples.
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    An Integrative Approach to Evaluating the Implementation of Social and Emotional Learning and Gender-Based Violence Prevention Education
    Cahill, H ; Kern, M ; Dadvand, B ; Walter Cruickshank, E ; Midford, M ; Smith, C ; Farrelly, A ; Oades, L (University of Malta, 2019)
    Evaluation studies often use stand-alone and summative assessment strategies to examine the impacts of Social and Emotional Learning (SEL) and Gender-based Violence (GBV) prevention education programs. However, implementation research is yet to offer an integrative framework that can be used to investigate the implementation drivers that lead to the uptake of programs that pursue SEL and GBV prevention agendas. We address this gap in research by presenting a framework developed to investigate factors affecting the implementation of the Resilience, Rights and Respectful Relationships program, an SEL and GBV prevention education program developed for primary and secondary schools in the state of Victoria, Australia. Drawing upon and advancing a conceptual framework for implementation fidelity proposed by Carroll and colleagues we discuss the iterative process designed to investigate the individual, school and system level factors within the wider political and ideological setting(s) of the program that impact on its implementation. Within this iterative process, we highlight the need to focus on ‘the ecology of relations’ that exists between various implementation elements, and their possible mediating impact on program delivery, uptake and outcomes.
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    'I wouldn't get that feedback from anywhere else': learning partnerships and the use of high school students as simulated patients to enhance medical students' communication skills
    Cahill, H ; Coffey, J ; Sanci, L (BIOMED CENTRAL LTD, 2015-03-07)
    This article evaluates whether the use of high school students as simulated patients who provide formative feedback enhances the capacity of medical students in their fifth year of training to initiate screening conversations and communicate effectively with adolescents about sensitive health issues.Focus group interviews with medical students (n = 52) and school students aged 15-16 (n = 107) were conducted prior to and following involvement in Learning Partnerships workshops. Prior to workshops focus groups with school students asked about attitudes to help-seeking in relation to sensitive health issues, and following workshops asked whether the workshop had made a difference to their concerns. Prior to workshops focus groups with medical students asked about their needs in relation to initiating conversations with adolescents about sensitive health issues, and following workshops asked whether the workshop had made a difference to their concerns. Surveys were also completed by 164 medical students and 66 school students following the workshops. This survey featured 19 items asking participants to rank the usefulness of the workshops out of 10 (1 = not at all useful, 10 = extremely useful) across areas such as skills and understanding, value of learning activities and overall value of the workshop. SPSS software was used to obtain mean plus standard deviation scores for each item on the survey.The Learning Partnerships workshops assisted medical students to improve their skills and confidence in communicating with adolescents about sensitive health issues such as mental health, sexual health and drug and alcohol use. They also assisted young people to perceive doctors as more likely potential sources for help.These findings suggest that the innovative methods included in Learning Partnerships may assist in broader education programs training doctors to be more effective helping agents and aid the promotion of adolescent friendly health care. This research provides evidence that a new way of teaching may contribute to enhancing doctors' capacity and willingness to initiate screening conversations and enhance adolescents' preparedness to seek help. This has implications for educational design, content and communication style within adolescent health.
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    Learning with and from: positioning school students as advisors in pre-service teacher education
    Cahill, H ; Coffey, J ; McLean Davies, L ; Kriewaldt, J ; Freeman, E ; Acquaro, D ; Gowing, A ; DUGGAN, S ; Archdall, V (Taylor & Francis, 2016)
    This article reports on an innovative pedagogical approach within the Learning Partnerships program in which school students help to ‘teach the teachers’ within pre-service teacher education. Classes of school students join with classes of pre-service teachers to provide input on how teachers can enhance school students’ engagement and wellbeing. The article draws on data collected from 125 students (aged 13–16) and 120 pre-service teachers in these workshops. Findings generated from a mixed methods study combining pre-workshop focus groups (n = Students: 38, Teachers: 33) and post-workshop focus groups (n = Students: 69, Teachers: 15) and post-workshop surveys (n = Students: 96; Teachers: 101) demonstrated that the workshops were mutually beneficial for both students and pre-service teachers. Participants found that workshopping together enhanced their belief in the possibility of positive student–teacher relationships. The pre-service teachers reported greater confidence in communicating with young people about the issues that affect student engagement and wellbeing. The school students reported that they were more willing to use teachers as a source of help. Implications include the need for increased attention to a ‘third space’ for learning in teacher development which provides opportunity for learning with and from young people about how to foster their engagement and wellbeing.
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    Responding to Young People's Health Risks in Primary Care: A Cluster Randomised Trial of Training Clinicians in Screening and Motivational Interviewing
    Sanci, L ; Chondros, P ; Sawyer, S ; Pirkis, J ; Ozer, E ; Hegarty, K ; Yang, F ; Grabsch, B ; Shiell, A ; Cahill, H ; Ambresin, A-E ; Patterson, E ; Patton, G ; Nishi, D (PUBLIC LIBRARY SCIENCE, 2015-09-30)
    OBJECTIVE: To evaluate the effectiveness of a complex intervention implementing best practice guidelines recommending clinicians screen and counsel young people across multiple psychosocial risk factors, on clinicians' detection of health risks and patients' risk taking behaviour, compared to a didactic seminar on young people's health. DESIGN: Pragmatic cluster randomised trial where volunteer general practices were stratified by postcode advantage or disadvantage score and billing type (private, free national health, community health centre), then randomised into either intervention or comparison arms using a computer generated random sequence. Three months post-intervention, patients were recruited from all practices post-consultation for a Computer Assisted Telephone Interview and followed up three and 12 months later. Researchers recruiting, consenting and interviewing patients and patients themselves were masked to allocation status; clinicians were not. SETTING: General practices in metropolitan and rural Victoria, Australia. PARTICIPANTS: General practices with at least one interested clinician (general practitioner or nurse) and their 14-24 year old patients. INTERVENTION: This complex intervention was designed using evidence based practice in learning and change in clinician behaviour and general practice systems, and included best practice approaches to motivating change in adolescent risk taking behaviours. The intervention involved training clinicians (nine hours) in health risk screening, use of a screening tool and motivational interviewing; training all practice staff (receptionists and clinicians) in engaging youth; provision of feedback to clinicians of patients' risk data; and two practice visits to support new screening and referral resources. Comparison clinicians received one didactic educational seminar (three hours) on engaging youth and health risk screening. OUTCOME MEASURES: Primary outcomes were patient report of (1) clinician detection of at least one of six health risk behaviours (tobacco, alcohol and illicit drug use, risks for sexually transmitted infection, STI, unplanned pregnancy, and road risks); and (2) change in one or more of the six health risk behaviours, at three months or at 12 months. Secondary outcomes were likelihood of future visits, trust in the clinician after exit interview, clinician detection of emotional distress and fear and abuse in relationships, and emotional distress at three and 12 months. Patient acceptability of the screening tool was also described for the intervention arm. Analyses were adjusted for practice location and billing type, patients' sex, age, and recruitment method, and past health risks, where appropriate. An intention to treat analysis approach was used, which included multilevel multiple imputation for missing outcome data. RESULTS: 42 practices were randomly allocated to intervention or comparison arms. Two intervention practices withdrew post allocation, prior to training, leaving 19 intervention (53 clinicians, 377 patients) and 21 comparison (79 clinicians, 524 patients) practices. 69% of patients in both intervention (260) and comparison (360) arms completed the 12 month follow-up. Intervention clinicians discussed more health risks per patient (59.7%) than comparison clinicians (52.7%) and thus were more likely to detect a higher proportion of young people with at least one of the six health risk behaviours (38.4% vs 26.7%, risk difference [RD] 11.6%, Confidence Interval [CI] 2.93% to 20.3%; adjusted odds ratio [OR] 1.7, CI 1.1 to 2.5). Patients reported less illicit drug use (RD -6.0, CI -11 to -1.2; OR 0.52, CI 0.28 to 0.96), and less risk for STI (RD -5.4, CI -11 to 0.2; OR 0.66, CI 0.46 to 0.96) at three months in the intervention relative to the comparison arm, and for unplanned pregnancy at 12 months (RD -4.4; CI -8.7 to -0.1; OR 0.40, CI 0.20 to 0.80). No differences were detected between arms on other health risks. There were no differences on secondary outcomes, apart from a greater detection of abuse (OR 13.8, CI 1.71 to 111). There were no reports of harmful events and intervention arm youth had high acceptance of the screening tool. CONCLUSIONS: A complex intervention, compared to a simple educational seminar for practices, improved detection of health risk behaviours in young people. Impact on health outcomes was inconclusive. Technology enabling more efficient, systematic health-risk screening may allow providers to target counselling toward higher risk individuals. Further trials require more power to confirm health benefits. TRIAL REGISTRATION: ISRCTN.com ISRCTN16059206.
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    The prevention access and risk taking in young people (PARTY) project protocol: A cluster randomised controlled trial of health risk screening and motivational interviewing for young people presenting to general practice
    Sanci, L ; Grabsch, B ; Chondros, P ; Shiell, A ; Pirkis, J ; Sawyer, S ; Hegarty, K ; Patterson, E ; Cahill, H ; Ozer, E ; Seymour, J ; Patton, G (BMC, 2012-06-06)
    BACKGROUND: There are growing worldwide concerns about the ability of primary health care systems to manage the major burden of illness in young people. Over two thirds of premature adult deaths result from risks that manifest in adolescence, including injury, neuropsychiatric problems and consequences of risky behaviours. One policy response is to better reorientate primary health services towards prevention and early intervention. Currently, however, there is insufficient evidence to support this recommendation for young people. This paper describes the design and implementation of a trial testing an intervention to promote psychosocial risk screening of all young people attending general practice and to respond to identified risks using motivational interviewing. MAIN OUTCOMES: clinicians' detection of risk-taking and emotional distress, young people's intention to change and reduction of risk taking. SECONDARY OUTCOMES: pathways to care, trust in the clinician and likelihood of returning for future visits. The design of the economic and process evaluation are not detailed in this protocol. METHODS: PARTY is a cluster randomised trial recruiting 42 general practices in Victoria, Australia. Baseline measures include: youth friendly practice characteristics; practice staff's self-perceived competency in young people's care and clinicians' detection and response to risk taking behaviours and emotional distress in 14-24 year olds, attending the practice. Practices are then stratified by a social disadvantage index and billing methods and randomised. Intervention practices receive: nine hours of training and tools; feedback of their baseline data and two practice visits over six weeks. Comparison practices receive a three hour seminar in youth friendly practice only. Six weeks post-intervention, 30 consecutive young people are interviewed post-consultation from each practice and followed-up for self-reported risk taking behaviour and emotional distress three and 12 months post consultation. DISCUSSION: The PARTY trial is the first to examine the effectiveness and efficiency of a psychosocial risk screening and counselling intervention for young people attending primary care. It will provide important data on health risk profiles of young people attending general practice and on the effects of the intervention on engagement with primary care and health outcomes over 12 months. TRIAL REGISTRATION: ISRCTN16059206.
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