Melbourne Graduate School of Education - Research Publications
Now showing items 1-12 of 2115
National religiosity eases the psychological burden of poverty
(NATL ACAD SCIENCES, 2021-09-28)
Lower socioeconomic status (SES) harms psychological well-being, an effect responsible for widespread human suffering. This effect has long been assumed to weaken as nations develop economically. Recent evidence, however, has contradicted this fundamental assumption, finding instead that the psychological burden of lower SES is even greater in developed nations than in developing ones. That evidence has elicited consternation because it suggests that economic development is no cure for the psychological burden of lower SES. So, why is that burden greatest in developed nations? Here, we test whether national religiosity can explain this puzzle. National religiosity is particularly low in developed nations. Consequently, developed nations lack religious norms that may ease the burden of lower SES. Drawing on three different data sets of 1,567,204, 1,493,207, and 274,393 people across 156, 85, and 92 nations, we show that low levels of national religiosity can account for the greater burden of lower SES in developed nations. This finding suggests that, as national religiosity continues to decline, lower SES will become increasingly harmful for well-being-a societal change that is socially consequential and demands political attention.
The of effect of partnership-based education on adherence to the treatment plans in open heart surgery.
BACKGROUND: Adherence to the treatment plans is one of the most effective conducts to prevent and reduce postoperative side effects. Partnership-based education is one of the most efficient ways to shape health behaviors. The aim of the present study was to determine the effect of partnership-based education on adherence to the treatment plans in open heart surgery. MATERIALS AND METHODS: This quasi-experimental study was conducted in 2019-2020 on the patients undergoing open heart surgery in Tehran (Capital of Iran). Sampling was done in one educational hospital. A total of 86 patients and their caregivers participated in the study. Sampling was done nonrandomly by tossing a coin, and patients were allocated into the odd week in the intervention group and the even week in the control group (n = 43 in each group), and data were collected before and after intervention using the Treatment Adherence Questionnaire concerning dietary, physical activity, and medication aspects. The educational intervention was carried out after the pretest analysis in five 20-45 min sessions (two individual and three group educations). Data were analyzed with Chi-square, independent t-test, and paired t-test using SPSS 19 at a significance level of P < 0.05. RESULTS: Patients and caregivers in both groups did not have a significant difference in terms of demographic variables (P > 0. 05). In addition, there was no significant difference in the mean of dietary, physical activity, and medication plans before the intervention in both groups; however, after the intervention, the mean of the three aspects in the intervention group was significantly higher than that of control (P < 0.001). CONCLUSION: Implementing partnership-based education with participation of patients and caregivers is influential in improving patients' adherence to the treatment plans and it is recommended as a clinical dynamic educational strategy.
Economic evaluation of an Australian nurse home visiting programme: a randomised trial at 3 years
(BMJ PUBLISHING GROUP, 2021-12-01)
OBJECTIVES: To investigate the additional programme cost and cost-effectiveness of 'right@home' Nurse Home Visiting (NHV) programme in relation to improving maternal and child outcomes at child age 3 years compared with usual care. DESIGN: A cost-utility analysis from a government-as-payer perspective alongside a randomised trial of NHV over 3-year period. Costs and quality-adjusted life-years (QALYs) were discounted at 5%. Analysis used an intention-to-treat approach with multiple imputation. SETTING: The right@home was implemented from 2013 in Victoria and Tasmania states of Australia, as a primary care service for pregnant women, delivered until child age 2 years. PARTICIPANTS: 722 pregnant Australian women experiencing adversity received NHV (n=363) or usual care (clinic visits) (n=359). PRIMARY AND SECONDARY OUTCOME MEASURES: First, a cost-consequences analysis to compare the additional costs of NHV over usual care, accounting for any reduced costs of service use, and impacts on all maternal and child outcomes assessed at 3 years. Second, cost-utility analysis from a government-as-payer perspective compared additional costs to maternal QALYs to express cost-effectiveness in terms of additional cost per additional QALY gained. RESULTS: When compared with usual care at child age 3 years, the right@home intervention cost $A7685 extra per woman (95% CI $A7006 to $A8364) and generated 0.01 more QALYs (95% CI -0.01 to 0.02). The probability of right@home being cost-effective by child age 3 years is less than 20%, at a willingness-to-pay threshold of $A50 000 per QALY. CONCLUSIONS: Benefits of NHV to parenting at 2 years and maternal health and well-being at 3 years translate into marginal maternal QALY gains. Like previous cost-effectiveness results for NHV programmes, right@home is not cost-effective at 3 years. Given the relatively high up-front costs of NHV, long-term follow-up is needed to assess the accrual of health and economic benefits over time. TRIAL REGISTRATION NUMBER: ISRCTN89962120.
Investigating combination HIV prevention: isolated interventions or complex system
(JOHN WILEY & SONS LTD, 2015-12-14)
INTRODUCTION: Treatment as prevention has mobilized new opportunities in preventing HIV transmission and has led to bold new UNAIDS targets in testing, treatment coverage and transmission reduction. These will require not only an increase in investment but also a deeper understanding of the dynamics of combining behavioural, biomedical and structural HIV prevention interventions. High-income countries are making substantial investments in combination HIV prevention, but is this investment leading to a deeper understanding of how to combine interventions? The combining of interventions involves complexity, with many strategies interacting with non-linear and multiplying rather than additive effects. DISCUSSION: Drawing on a recent scoping study of the published research evidence in HIV prevention in high-income countries, this paper argues that there is a gap between the evidence currently available and the evidence needed to guide the achieving of these bold targets. The emphasis of HIV prevention intervention research continues to look at one intervention at a time in isolation from its interactions with other interventions, the community and the socio-political context of their implementation. To understand and evaluate the role of a combination of interventions, we need to understand not only what works, but in what circumstances, what role the parts need to play in their relationship with each other, when the combination needs to adapt and identify emergent effects of any resulting synergies. There is little development of evidence-based indicators on how interventions in combination should achieve that strategic advantage and synergy. This commentary discusses the implications of this ongoing situation for future research and the required investment in partnership. We suggest that systems science approaches, which are being increasingly applied in other areas of public health, could provide an expanded vocabulary and analytic tools for understanding these complex interactions, relationships and emergent effects. CONCLUSIONS: Relying on the current linear but disconnected approaches to intervention research and evidence we will miss the potential to achieve and understand system-level synergies. Given the challenges in sustaining public health and HIV prevention investment, meeting the bold UNAIDS targets that have been set is likely to be dependent on achieving systems level synergies.
Identifying and Shifting Disempowering Paradigms for Families of Children With Disability Through a System Informed Positive Psychology Approach.
(Frontiers Media SA, 2021)
Despite the emergence of socio-ecological, strength-based, and capacity-building approaches, care for children with disability remains primarily grounded in a deficit-based perspective. Diagnoses and interventions primarily focus on what children and families cannot do, rather than what might be possible, often undermining the competence, mental health, and functioning of both the children and their families. We first critically examine typical approaches to disability care for families of young children, describe the importance of a systems-informed positive psychology (SIPP) approach to care, and identify the existence of two dominant paradigms, disability is a disadvantage and experts know best. Then, we present a case study investigating families' experiences with these two paradigms and whether shifts to alternative perspectives could occur through participation in a SIPP-based program co-designed by professionals and families. Of program participants, nine parents and five early intervention professionals participated in two separate focus groups, and ten e-books were randomly selected for review. Thematic analysis of the e-books and focus group data identified two primary themes representing alternative perspectives that arose through the intervention: we will start with our strengths and we've got this. Participant comments indicated that they developed a greater sense of hope, empowerment, engagement, and wellbeing, enabled by embedding wellbeing concepts and practices in their routines and communications with their children. We suggest that benefits arose in part from the structure of the program and the development of wellbeing literacy in participants. While care needs to be taken in generalizing the results, the case study provides clear examples of shifts in perspectives that occurred and suggests that the incorporation of SIPP principles within early intervention approaches provides a potential pathway for shifting the problematic paradigms that dominate disability care.
New ways of seeing: Tumblr, young people and mental illness
(University of Michigan Press, 2020)
In this essay, I advocate for alternative, more user-based approaches to understanding mental health and its circulation on social media. I focus on young people’s use of Tumblr because of its popularity among my participants during this period. The platform’s affordances offered them new forms of expression and, therefore, new ways of seeing for me, allowing me to shift my focus away from images of self-injury to consider the wider array of “visibilities” the platform indicated. I share two conceptual frames based on my work with young people: visibility as recognition and representation, and visibility as emotional authenticity and recovery. The first example explains how “chat” posts, memes and hashtags provide opportunities to make socially visible experiences of borderline personality disorder (BPD) that are otherwise hidden or misrecognized. The second example relies less on platform vernacular and more on how Tumblr provides a safe space for users to engage in emotionally authentic visual practices, even if reblogged images are not explicitly or directly related to mental illness (and therefore can remain inscrutable to outsiders). I found that users experiencing anxiety often affectively connect with images in therapeutic ways that do not directly refer to mental illness. My findings demonstrate that the way in which young people use Tumblr to express their mental illness is far more complex than most researchers and practitioners have considered, and encourage us to think more broadly about how mental illness is made visible and circulated on social media. As researchers and practitioners, we need to understand how individual platforms work; we must more closely investigate text and platform-based communication networks rather than simply decontextualize individual images for analysis. By engaging with young people and the multiplicity of visual practices they use to share their experiences of mental illness and distress, we can consider how such expressions may, in fact, offer us important therapeutic insights and opportunities for greater care and understanding.
Health education, social media, and tensions of authenticity in the 'influencer pedagogy' of health influencer Ashy Bines
(ROUTLEDGE JOURNALS, TAYLOR & FRANCIS LTD, 2021-11-23)
Health and wellness influencers are often criticised as dubious and unqualified sources of health education, presenting highly curated, commercialised lifestyles via social media platforms such as Instagram. While these critiques are important, they also present a narrow reading of complex digital cultures. In this paper, we examine a digital ethnographic case study of Australian entrepreneur and health influencer, Ashy Bines. We argue that Bines’ pedagogical expertise is made possible through her seemingly contradictory media practices and messages, whereby she cultivates an ‘authentic’ personal experience for her followers. We frame these productive tensions in her social media practices as a form of ‘influencer pedagogy’- the indirect, mediated processes of education produced through relatable interactions between influencers and their followers on social media platforms. We do not assess whether influencer pedagogy is ‘good’ or ‘appropriate’ but instead explore how influencers like Bines cultivate authenticity and expertise, and thus pedagogical potential