Theories of the policy process in health promotion research: a review

The Ottawa Charter laid the ground work for a new research and practice agenda by urging health promoters to advocate for healthy public policies. After more than 20 years, it is now time to reflect on the state of policy research in health promotion and to examine how rigorously theories are applied. The review of the literature was
conducted on 11 peer-reviewed journals. The journals were selected for their solid track record in publishing health promotion articles and by using a set of predefined
inclusion and exclusion criteria. The articles, published between January 1986 and June 2006, were searched using Medline and CINAHL databases. The selected papers feature search terms related to ‘politics’, ‘policy’, ‘advocacy’ and ‘coalition’. We examined the theoretical grounding of each paper and whether it focuses on policy content (e.g. nature, impact, evolution of the policy), policy processes (e.g. advocacy capacity building and strategies) or theoretical/methodological issues in policy analysis. This review demonstrates that policy research in health promotion is still largely an a theoretical enterprise. Out of the 119 articles that were found eligible, 39 did apply to some degree a theoretical framework, of which 21 referred to a theoretical framework from political science. We conclude that the field has yet to acknowledge critical concepts that would help to shed light on the policy process, and that validated rigorous theoretical frameworks to inform research and practice are hardly applied. Recommendations are formulated to improve policy research in health promotion.

Is dietary management a responsibility of general practitioners? The views of Victorian general practitioners

Rationale : Australia is experiencing an evolving healthcare system, resulting in an aim of systematic managed care for patients with chronic disease. One outcome has been debate on doctors' dietary management responsibilities.
Aim : To identify general practitioners' perceptions of their dietary management responsibilities for adult cardiac patients.
Methods : A Two phase study was conducted. First, semi-structured interviews with 30 Melbourne general practitioners were conducted to gather preliminary information about dietary management. The results informed a questionnaire for the second phase. This was completed by 248 general practitioners (30%) in Victoria.
Principal findings : Themes arising in interviews, and also supported by cross-sectional survey showed that doctors perceive themselves as filling one or more of three roles. The majority (87.4%) endorsed an 'Influencing' role, 27.4% endorsed 'Dietary Educator' and 44.0% a 'Coordinator' role. The Influencer role was characterised by encouragement of dietary behaviour change, such as discussing benefits and consequences of inaction to dietary change. The Educator role was characterised by the provision of a range of behaviour change strategies- 'how to' achieve change. 'Coordinators' reported the provision of dietary counselling belonged to dietitians alone.
Implications : The results indicate doctors' awareness of need for patients' dietary education should be increased. This could be accomplished by one-on-one education. Patients' access to dietary education should also be facilitated by doctors' referring on. Embedding dietary management protocols in doctors' managed care templates could improve patients' access to dietary education and enhance doctor's collaborative roles.
Presentation type : Paper
Session theme : Getting Evidence into Practice 2

Trainers and transformation : facilitating the 'dark side' of vocational learning

'Transformative learning' is a term used by Mezirow (1991) and his followers to designate a specifically 'adult' kind of learning that involves shifts in how learners view the world and themselves. New research into learning in VET suggests that in some subject areas transformative learning may play more than an incidental role. Among the implications of this finding is that the trainer's practice may be more important in VET than it has been the custom to acknowledge. When transformative learning systematically contributes to VET, the trainer becomes a co-constructor of competence rather than a transmitter of skills and knowledge.

This paper reports on this new research and reflects on the role of the trainer in the process of VET-oriented transformative learning. Results indicate that some trainers of youth workers develop a practice that responds to the contours and dangers of transformative learning without necessarily being aware of the body of knowledge that has built up around this type of learning. The paper suggests that in some VET sectors, trainers and RTO's could enhance their work by taking stock of transformative learning research and theory.

Is education becoming irrelevant in our research?

It is argued in this paper that in a culture of ‘performativity’ research into ‘education’ is often avoided. It is observed in many research publications that attention is given to techniques of learning, teaching, management, social equity, identity formation, leadership and delivery of the curriculum, without a justification being offered as to why such instrumental approaches should be regarded as being ‘educational’. Often research quite unproblematically adopts rational economic justifications couched in terms of ‘efficiency’ and ‘effectiveness’. Such approaches are however identified as nihilistic and not educational (Blake et al., 2000).

Is 'education' becoming irrelevant in our research?

It is argued in this paper that in a culture of ‘performativity’ research into ‘education’ is often avoided. It is observed in many research publications that attention is given to techniques of learning, teaching, management, social equity, identity formation, leadership and delivery of the curriculum, without a justification being offered as to why such instrumental approaches should be regarded as being ‘educational’. Often research quite unproblematically adopts rational-economic justifications couched in terms of ‘efficiency’ and ‘effectiveness’. Such approaches are however identified as nihilistic and not educational (Blake et al., 2000)

Fundamental elements in examining a child’s right to education : a study of home education research and regulation in Australia

Home education provides valuable educational and developmental opportunities for children. An examination of Australia’s research indicates many best educational practices, including more informed mediation, contextualised learning, and opportunities to exercise autonomy. Key features include learning embedded in communities and program modification in response to students’ needs. Current state and territory legal requirements are examined within the context of this research and Australia’s obligations to international human rights treaties. All jurisdictions accept home education as one way to meet compulsory education requirements. The extent to which respective laws then reflect understanding of home education research and practice varies. Most jurisdictions allow for a variety of educational approaches. Some oversight regulation could however be modified to reflect a better understanding of home education. Consultation with home educators and reference to research would assist the development of more uniform legislation and policy across Australia, and enable better regulatory practice.

A survey of combination antidepressant use in Australia

Objective: The aim of this study was to survey doctors working in psychiatry in Australia about the practice of using two antidepressants simultaneously.

Method: A postal survey was sent to all doctors in psychiatry in Australia enquiring about their prescribing history and their attitudes to combination antidepressants and related issues.

Results: Seventy-nine percent of respondents had used combination antidepressants. The most frequently reported combination was a selective serotonin reuptake inhibitor combined with a tricyclic antidepressant. Combinations of mirtazepine with venlafaxine and other antidepressants were the next most frequently used. Seventeen percent of respondents reported having seen a complication from combination antidepressants, 75% believed that Australian GPs should be given information on the use of combination antidepressants, 89% wished for more information on this topic, and 88% believed patients had a right to be informed of this option in their treatment. Use of combination antidepressants was more frequent than exceeding the recommended maximum dose of an individual antidepressant.

Conclusion: Combination antidepressants are used far more frequently in Australia than suspected previously. Research into safe and evidence-based practice is strongly indicated.

Standards-based accountability : reification, responsibility and the ethical subject

Over the last two decades, teachers in Australia have witnessed multiple incarnations of the idea of ‘educational accountability’ and its enactment. Research into this phenomenon of educational policy and practice has revealed various layers of the concept, particularly its professional, bureaucratic, political and cultural dimensions that are central to the restructuring of educational governance and the reorganization of teachers’ work. Today, accountability constitutes a core concept of neoliberal policy-making in education, both fashioning and normalizing what counts as teacher professionalism in the ‘audit society.’ This article focuses specifically on the recent introduction by the Australian Federal Government of standardised literacy testing in all states across Australia, and raises questions about the impact of this reform on the work practices of English literacy teachers in primary and secondary schools. We draw on data collected as part of a major research project funded by the Australian Research Council, involving interviews with teachers about their experiences of implementing standardised testing. The article traces the ways in which teachers’ work is increasingly being mediated by standardised literacy testing to show how these teachers grapple with the tensions between state-wide mandates and a sense of their professional responsibility for their students.

Assessing dietary intake in children and adolescents : considerations and recommendations for obesity research

Dietary intake and food habits are important contributors to the obesity epidemic. They are highly modifi able components of energy balance and are usually targeted in both obesity prevention and treatment programs. However, measurement of total diet creates challenges and can convey a large burden in terms of cost, technical expertise, impact on respondents and time. It is not surprising therefore that comprehensive reports of dietary intake in children are uncommon and, when reported, have limitations. The aim of this paper is to guide researchers and practitioners in selecting the most appropriate dietary assessment method for situations involving children and adolescents. This paper presents a summary of the issues to consider when choosing a method, a description of some of the more commonly used dietary assessment methods for young people and a series of case-studies to illustrate the range of circumstances faced when measuring dietary intake. We recommend that researchers consider the specifi c components of dietary intake addressed in their research and practice, and whether diet should be reported comprehensively or as targeted components. Other considerations include age, cognitive ability, weight status, physical activity level, respondent burden, and reliability and validity in the context of program goals and research questions. A checklist for selecting the appropriate dietary methodology is provided. This guide aims to facilitate the reporting of dietary intake and food habits in the context of obesity using valid and reliable measures, thus contributing to the evidence-base for nutrition policies and programs relating to obesity.

Principals' perceptions of the use of total quality management concepts for school improvement in Mauritius : leading or misleading?

As a small island country, Mauritius is relying on its human capital and innovative hi-tech industry to ensure future economic viability in the global market. As such, Mauritian education authorities are seeking ways to raise educational standards. One idea being canvassed is that Total Quality Management (TQM) could provide the framework for Mauritian school leaders to deliver imperatives for change and improvement and to achieve the aim of ‘world- class quality education.’ This paper reports the findings of a research into Mauritian principals’ current practices in line with TQM tenets and their perceptions about the usefulness or otherwise of ideas implicit in TQM. The findings indicate that whilst principals agree with current progressive notions and thinking compatible with the TQM philosophy, they have not fully translated them into their practice. The paper identifies challenges and opportunities worthy of discussion for school improvement in twenty-first century Mauritius with its high-tech, world-class ambitions.

The personal selling and sales management ethics research : managerial implications and research directions from a comprehensive review of the empirical literature

Research into ethics in personal selling and sales management has increased substantially over the preceding decade by investigating complex dimensions of ethical decision-making in greater depth and with more analytical sophistication. This review of the recent conceptual and empirical literature provides insight into the extent and the direction of this knowledge, recommends managerial action, and discusses areas for future exploration. Future direction is also provided through research propositions. The type of sales practitioner investigated, the main variables examined, and the key findings are summarized in an Appendix.

The value of sustainability in real estate : a review from a valuation perspective

Purpose – The purpose of this paper is to synthesise the plethora of research that has been conducted into the relationship between sustainability and market value in real estate, by critically analysing the research and the applicability of sustainability and value research in valuation practice.

Design/methodology/approach – The research on the relationship between sustainability and market value in real estate is examined from the perspective of its usefulness to the valuation profession in providing guidance, information and evidence to be used in valuation practice.

Findings – Existing research conducted into the relationship between sustainability and market value has not provided the valuation profession with evidence which would allow the incorporation of normative theories on the value of sustainability in valuation practice. This review highlights the lack of evidence, and the applicability of current research into sustainability and value to the valuation profession in providing guidance and information in valuing real estate incorporating sustainability.

Practical implications – This paper highlights the limited applicability of research to date in regard to the relationship between sustainability and market value for the valuation profession. The lack of historical evidence, data or information on the quantifiable effects on market value of this new trend (sustainability), leaves the valuation profession uncertain as to the relationship between sustainability and market value. There is a probable risk of valuers interpreting strategic research incorrectly, and making inappropriate adjustments or comparisons because of their lack of knowledge and limited sustainability assessment skills. Although there is an evolving body of knowledge, there is a need for extensive analysis of unbiased, evidence-based research in individual and broader markets to provide guidance, evidence and knowledge of the implications of sustainability in the valuation of real estate.

Originality/value – The examination of research investigating the relationship between sustainability and value from a valuation perspective provides an alternative insight into the applicability of current research in valuation practice. The increasing profile and role of sustainability in the real estate sector needs to be addressed in valuation practice; however, the variety of research to date needs to be interpreted by valuers in the correct context. This paper brings to light the applicability of sustainability and value research for the broader valuation profession, and the potential implications of misuse or misunderstanding of that research.

A cross-national study of teaching and learning in primary science classrooms

This presentation reports on the methodological issues confronting an Australian-German-Taiwanese team planning comparative video ethnographic research into primary science classrooms. The issues that will be canvassed include: the benefits of cross-cultural comparisons in providing perspectives on local practice, the theoretical justifications of such comparisons, selection of cases for comparison and possibilities for claiming cultural representativeness, the planning of appropriate data sets, the different comparative stories offered by different analytical frames, practical issues of communication and data sharing, and issues of entanglement of language and culture in the analysis.