Application of an appearance-based intervention to improve sun protection outcomes of outdoor workers in Queensland, Australia

Outdoor workers are exposed to high levels of ultraviolet radiation (UVR) and may thus be at greater risk to experience UVR-related health effects such as skin cancer, sun burn, and cataracts. A number of intervention trials (n=14) have aimed to improve outdoor workers’ work-related sun protection cognitions and behaviours. Only one study however has reported the use of UV-photography as part of a multi-component intervention. This study was performed in the USA and showed long-term (12 months) improvements in work-related sun protection behaviours. Intervention effects of the other studies have varied greatly, depending on the population studied, intervention applied, and measurement of effect. Previous studies have not assessed whether: - Interventions are similarly effective for workers in stringent and less stringent policy organisations; - Policy effect is translated into workers’ leisure time protection; - Implemented interventions are effective in the long-term; - The facial UV-photograph technique is effective in Australian male outdoor workers without a large additional intervention package, and; - Such interventions will also affect workers’ leisure time sun-related cognitions and behaviours. Therefore, the present Protection of Outdoor Workers from Environmental Radiation [POWER]-study aimed to fill these gaps and had the objectives of: a) assessing outdoor workers’ sun-related cognitions and behaviours at work and during leisure time in stringent and less stringent sun protection policy environments; b) assessing the effect of an appearance-based intervention on workers’ risk perceptions, intentions and behaviours over time; c) assessing whether the intervention was equally effective within the two policy settings; and d) assessing the immediate post-intervention effect. Effectiveness was described in terms of changes in sun-related risk perceptions and intentions (as these factors were shown to be main precursors of behaviour change in many health promotion theories) and behaviour. The study purposefully selected and recruited two organisations with a large outdoor worker contingent in Queensland, Australia within a 40 kilometre radius of Brisbane. The two organisations differed in the stringency of implementation and reinforcement of their organisational sun protection policy. Data were collected from 154 male predominantly Australian born outdoor workers with an average age of 37 years and predominantly medium to fair skin (83%). Sun-related cognitions and behaviours of workers were assessed using self-report questionnaires at baseline and six to twelve months later. Variation in follow-up time was due to a time difference in the recruitment of the two organisations. Participants within each organisation were assigned to an intervention or control group. The intervention group participants received a one-off personalised Skin Cancer Risk Assessment Tool [SCRAT]-letter and a facial UV-photograph with detailed verbal information. This was followed by an immediate post-intervention questionnaire within three months of the start of the study. The control group only received the baseline and follow-up questionnaire. Data were analysed using a variety of techniques including: descriptive analyses, parametric and non-parametric tests, and generalised estimating equations. A 15% proportional difference observed was deemed of clinical significance, with the addition of reported statistical significance (p<0.05) where applicable. Objective 1: Assess and compare the current sun-related risk perceptions, intentions, behaviours, and policy awareness of outdoor workers in stringent and less stringent sun protection policy settings. Workers within the two organisations (stringent n=89 and less stringent n=65) were similar in their knowledge about skin cancer, self efficacy, attitudes, and social norms regarding sun protection at work and during leisure time. Participants were predominantly in favour of sun protection. Results highlighted that compared to workers in a less stringent policy organisation working for an organisation with stringent sun protection policies and practices resulted in more desirable sun protection intentions (less willing to tan p=0.03) ; actual behaviours at work (sufficient use of upper and lower body protection, headgear, and sunglasses (p<0.001 for all comparisons), and greater policy awareness (awareness of repercussions if Personal Protective Equipment (PPE) was not used, p<0.001)). However the effect of the work-related sun protection policy was found not to extend to leisure time sun protection. Objective 2: Compare changes in sun-related risk perceptions, intentions, and behaviours between the intervention and control group. The effect of the intervention was minimal and mainly resulted in a clinically significant reduction in work-related self-perceived risk of developing skin cancer in the intervention compared to the control group (16% and 32% for intervention and control group, respectively estimated their risk higher compared to other outdoor workers: , p=0.11). No other clinical significant effects were observed at 12 months follow-up. Objective 3: Assess whether the intervention was equally effective in the stringent sun protection policy organisation and the less stringent sun protection policy organisation. The appearance-based intervention resulted in a clinically significant improvement in the stringent policy intervention group participants’ intention to protect from the sun at work (workplace*time interaction, p=0.01). In addition to a reduction in their willingness to tan both at work (will tan at baseline: 17% and 61%, p=0.06, at follow-up: 54% and 33%, p=0.07, stringent and less stringent policy intervention group respectively. The workplace*time interaction was significant p<0.001) and during leisure time (will tan at baseline: 42% and 78%, p=0.01, at follow-up: 50% and 63%, p=0.43, stringent and less stringent policy intervention group respectively. The workplace*time interaction was significant p=0.01) over the course of the study compared to the less stringent policy intervention group. However, no changes in actual sun protection behaviours were found. Objective 4: Examine the effect of the intervention on level of alarm and concern regarding the health of the skin as well as sun protection behaviours in both organisations. The immediate post-intervention results showed that the stringent policy organisation participants indicated to be less alarmed (p=0.04) and concerned (p<0.01) about the health of their skin and less likely to show the facial UV-photograph to others (family p=0.03) compared to the less stringent policy participants. A clinically significantly larger proportion of participants from the stringent policy organisation reported they worried more about skin cancer (65%) and skin freckling (43%) compared to those in the less stringent policy organisation (46%,and 23% respectively , after seeing the UV-photograph). In summary the results of this study suggest that the having a stringent work-related sun protection policy was significantly related to for work-time sun protection practices, but did not extend to leisure time sun protection. This could reflect the insufficient level of sun protection found in the general Australian population during leisure time. Alternatively, reactance caused by being restricted in personal decisions through work-time policy could have contributed to lower leisure time sun protection. Finally, other factors could have also contributed to the less than optimal leisure time sun protection behaviours reported, such as unmeasured personal or cultural barriers. All these factors combined may have lead to reduced willingness to take proper preventive action during leisure time exposure. The intervention did not result in any measurable difference between the intervention and control groups in sun protection behaviours in this population, potentially due to the long lag time between the implementation of the intervention and assessment at 12-months follow-up. In addition, high levels of sun protection behaviours were found at baseline (ceiling effect) which left little room for improvement. Further, this study did not assess sunscreen use, which was the predominant behaviour assessed in previous effective appearance-based interventions trials. Additionally, previous trials were mainly conducted in female populations, whilst the POWER-study’s population was all male. The observed immediate post-intervention result could be due to more emphasis being placed on sun protection and risks related to sun exposure in the stringent policy organisation. Therefore participants from the stringent policy organisation could have been more aware of harmful effects of UVR and hence, by knowing that they usually protect adequately, not be as alarmed or concerned as the participants from the less stringent policy organisation. In conclusion, a facial UV-photograph and SCRAT-letter information alone may not achieve large changes in sun-related cognitions and behaviour, especially of assessed 6-12 months after the intervention was implemented and in workers who are already quite well protected. Differences found between workers in the present study appear to be more attributable to organisational policy. However, against a background of organisational policy, this intervention may be a useful addition to sun-related workplace health and safety programs. The study findings have been interpreted while respecting a number of limitations. These have included non-random allocation of participants due to pre-organised allocation of participants to study group in one organisation and difficulty in separating participants from either study group. Due to the transient nature of the outdoor worker population, only 105 of 154 workers available at baseline could be reached for follow-up. (attrition rate=32%). In addition the discrepancy in the time to follow-up assessment between the two organisations was a limitation of the current study. Given the caveats of this research, the following recommendations were made for future research: - Consensus should be reached to define "outdoor worker" in terms of time spent outside at work as well as in the way sun protection behaviours are measured and reported. - Future studies should implement and assess the value of the facial UV-photographs in a wide range of outdoor worker organisations and countries. - More timely and frequent follow-up assessments should be implemented in intervention studies to determine the intervention effect and to identify the best timing of booster sessions to optimise results. - Future research should continue to aim to target outdoor workers’ leisure time cognitions and behaviours and improve these if possible. Overall, policy appears to be an important factor in workers’ compliance with work-time use of sun protection. Given the evidence generated by this research, organisations employing outdoor workers should consider stringent implementation and reinforcement of a sun protection policy. Finally, more research is needed to improve ways to generate desirable behaviour in this population during leisure time.

Spot the differences in traditional and social entrepreneurial intention : highlighting the role of human and social capital

There is general agreement in the scientific community that entrepreneurship plays a central role in the growth and development of an economy in rapidly changing environments (Acs & Virgill 2010). In particular, when business activities are regarded as a vehicle for sustainable growth at large, that goes beyond mere economic returns of singular entities, encompassing also social problems and heavily relying on collaborative actions, then we more precisely fall into the domain of ‘social entrepreneurship’(Robinson et al. 2009). In the entrepreneurship literature, prior studies demonstrated the role of intentionality as the best predictor of planned behavior (Ajzen 1991), and assumed that the intention to start a business derives from the perception of desirability and feasibility and from a propensity to act upon an opportunity (Fishbein & Ajzen 1975). Recognizing that starting a business is an intentional act (Krueger et al. 2000) and entrepreneurship is a planned behaviour (Katz & Gartner 1988), models of entrepreneurial intentions have substantial implications for intentionality research in entrepreneurship. The purpose of this paper is to explore the emerging practice of social entrepreneurship by comparing the determinants of entrepreneurial intention in general versus those leading to startups with a social mission. Social entrepreneurial intentions clearly merit to be investigated given that the opportunity identification process is an intentional process not only typical of for profit start-ups, and yet there is a lack of research examining opportunity recognition in social entrepreneurship (Haugh 2005). The key argument is that intentionality in both traditional and social entrepreneurs during the decision-making process of new venture creation is influenced by an individual's perceptions toward opportunities (Fishbein & Ajzen 1975). Besides opportunity recognition, at least two other aspects can substantially influence intentionality: human and social capital (Davidsson, 2003). This paper is set to establish if and to what extent the social intentions of potential entrepreneurs, at the cognitive level, are influenced by opportunities recognition, human capital, and social capital. By applying established theoretical constructs, the paper draws comparisons between ‘for-profit’ and ‘social’ intentionality using two samples of students enrolled in Economy and Business Administration at the University G. d’Annunzio in Pescara, Italy. A questionnaire was submitted to 310 potential entrepreneurs to test the robustness of the model. The collected data were used to measure the theoretical constructs of the paper. Reliability of the multi-item scale for each dimension was measured using Cronbach alpha, and for all the dimensions measures of reliability are above 0.70. We empirically tested the model using structural equation modeling with AMOS. The results allow us to empirically contribute to the argument regarding the influence of human and social cognitive capital on social and non-social entrepreneurial intentions. Moreover, we highlight the importance for further researchers to look deeper into the determinants of traditional and social entrepreneurial intention so that governments can one day define better polices and regulations that promote sustainable businesses with a social imprint, rather than inhibit their formation and growth.

Do drivers respond emotionally and behaviourally differently to an intentionally anger provoking driving situation than to an ambiguous, but potentially provocative, one? Results of a self-report survey.

Aggressive driving is considered an important road-safety concern for drivers in highly motorised countries. However, understanding of the causes and maintenance factors fundamental to aggressive driving is limited. In keeping with theoretical advances from general aggression research such as the General Aggression Model (GAM), research has begun to examine the emotional and cognitive antecedents of aggressive driving in order to better understand the underlying processes motivating aggressive driving. Early findings in the driving area have suggested that greater levels of aggression are elicited in response to an intentionally aggressive on-road event. In contrast, general aggression research suggests that greater levels of aggression are elicited in response to an ambiguous event. The current study examined emotional and cognitive responses to two hypothetical driving scenarios with differing levels of aggressive intent (intentional versus ambiguous). There was also an interest in whether factors influencing responses were different for hostile aggression (that is, where the action is intended to harm the other) versus instrumental aggression (that is, where the action is motivated by an intention to remove an impediment or attain a goal). Results were that significantly stronger negative emotion and negative attributions, as well as greater levels of threat were reported in response to the scenario which was designed to appear intentional in nature. In addition, participants were more likely to endorse an aggressive behavioural response to a situation that appeared deliberately aggressive than to one where the intention was ambiguous. Analyses to determine if greater levels of negative emotions and cognitions are able to predict aggressive responses provided different patterns of results for instrumental aggression from those for hostile aggression. Specifically, for instrumental aggression, negative emotions and negative attributions were significant predictors for both the intentional and the ambiguous scenarios. In addition, perceived threat was also a significant predictor where the other driver’s intent was clearly aggressive. However, lower rather than higher, levels of perceived threat were associated with greater endorsement of an aggressive response. For hostile aggressive behavioural responses, trait aggression was the strongest predictor for both situations. Overall the results suggest that in the driving context, instrumental aggression is likely to be a much more common response than hostile aggression. Moreover, aggressive responses are more likely in situations where another driver’s behaviour is clearly intentional rather than ambiguous. The results also support the conclusion that there may be different underlying mechanisms motivating an instrumental aggressive response to those motivating a hostile one. In addition, understanding the emotions and cognitions underlying aggressive driving responses may be helpful in predicting and intervening to reduce driving aggression. The finding that drivers appear to regard tailgating as an instrumental response is of concern since this behaviour has the potential to result in crashes.

The role of mindfulness in an extended TPB framework to understand drivers’ speeding intentions in school zones.

Many researchers have demonstrated the applicability of the Theory of Planned Behaviour (TPB) in predicting both intention to speed and actual speeding behaviour. However, there remain shortcomings in the explanatory power of the TPB, with research suggesting that even when drivers had reported an intention to not speed approximately 25% of drivers report behaviour that does not align with their intentions (i.e., they engaged in speeding, Elliott & Armitage, 2006). This research explores the role of a novel and promising construct, mindfulness, in enhancing the explanatory utility of the TPB for the understanding of drivers’ speeding behaviour in school zones. Mindfulness is a concept which has been widely used in studies of consciousness, but has recently been applied to the understanding of behaviour in other areas, including clinical psychology, physical activity, education and business. It has been suggested that mindfulness can also be applied to road safety, though its application within this context currently remains limited. This study was based on an e-survey of the general driving public (N=240). Overall, the results identified mindfulness as a construct which may aid understanding of the relationship between drivers’ intentions and behaviour. Theoretically, the findings may have implications in terms of identifying mindfulness as an additional explanatory construct within a TPB framework. In road safety practice, the findings suggest that efficacious countermeasures around school zones may be those that function to heighten drivers’ mindfulness, such as flashing lights and physical speed reduction measures.

Predictive modelling : parents’ decision making to use online child health information to increase their understanding and/or diagnose or treat their child’s health

Abstract Background The quantum increases in home Internet access and available online health information with limited control over information quality highlight the necessity of exploring decision making processes in accessing and using online information, specifically in relation to children who do not make their health decisions. Objectives To understand the processes explaining parents’ decisions to use online health information for child health care. Methods Parents (N = 391) completed an initial questionnaire assessing the theory of planned behaviour constructs of attitude, subjective norm, and perceived behavioural control, as well as perceived risk, group norm, and additional demographic factors. Two months later, 187 parents completed a follow-up questionnaire assessing their decisions to use online information for their child’s health care, specifically to 1) diagnose and/or treat their child’s suspected medical condition/illness and 2) increase understanding about a diagnosis or treatment recommended by a health professional. Results Hierarchical multiple regression showed that, for both behaviours, attitude, subjective norm, perceived behavioural control, (less) perceived risk, group norm, and (non) medical background were the significant predictors of intention. For parents’ use of online child health information, for both behaviours, intention was the sole significant predictor of behaviour. The findings explain 77% of the variance in parents’ intention to treat/diagnose a child health problem and 74% of the variance in their intentions to increase their understanding about child health concerns. Conclusions Understanding parents’ socio-cognitive processes that guide their use of online information for child health care is important given the increase in Internet usage and the sometimes-questionable quality of health information provided online. Findings highlight parents’ thirst for information; there is an urgent need for health professionals to provide parents with evidence-based child health websites in addition to general population education on how to evaluate the quality of online health information.

Beyond the 'at risk' individual : housing and the eradication of poverty to prevent homelessness

The 2008 White Paper on Homelessness (Australian Government 2008) constitutes a watershed initiative outlining the future for Australian homelessness policy. This contemporary homelessness policy is diverse and it continues to unfold and evolve during implementation. Nevertheless, it is characterised by the explicit intention to move beyond the former crisis based system, and the espousal of achieving measurable outcomes of permanently ending homelessness (Australian Government 2008).

The influence of neighbourhood disadvantage on smoking cessation and its contribution to inequalities in smoking status

Introduction and aims: Individual smokers from disadvantaged backgrounds are less likely to quit, which contributes to widening inequalities in smoking. Residents of disadvantaged neighbourhoods are more likely to smoke, and neighbourhood inequalities in smoking may also be widening because of neighbourhood differences in rates of cessation. This study examined the association between neighbourhood disadvantage and smoking cessation and its relationship with neighbourhood inequalities in smoking. Design and methods: A multilevel longitudinal study of mid-aged (40-67 years) residents (n=6915) of Brisbane, Australia, who lived in the same neighbourhoods (n=200) in 2007 and 2009. Neighbourhood inequalities in cessation and smoking were analysed using multilevel logistic regression and Markov chain Monte Carlo simulation. Results: After adjustment for individual-level socioeconomic factors, the probability of quitting smoking between 2007 and 2009 was lower for residents of disadvantaged neighbourhoods (9.0%-12.8%) than their counterparts in more advantaged neighbourhoods (20.7%-22.5%). These inequalities in cessation manifested in widening inequalities in smoking: in 2007 the between-neighbourhood variance in rates of smoking was 0.242 (p≤0.001) and in 2009 it was 0.260 (p≤0.001). In 2007, residents of the most disadvantaged neighbourhoods were 88% (OR 1.88, 95% CrI 1.41-2.49) more likely to smoke than residents in the least disadvantaged neighbourhoods: the corresponding difference in 2009 was 98% (OR 1.98 95% CrI 1.48-2.66). Conclusion: Fundamentally, social and economic inequalities at the neighbourhood and individual-levels cause smoking and cessation inequalities. Reducing these inequalities will require comprehensive, well-funded, and targeted tobacco control efforts and equity based policies that address the social and economic determinants of smoking.

Impact of information on intentions to vaccinate in a potential epidemic : Swine-origin Influenza A (H1N1)

Vaccination campaigns to prevent the spread of epidemics are successful only if the targeted populations subscribe to the recommendations of health authorities. However, because compulsory vaccination is hardly conceivable in modern democracies, governments need to convince their populations through efficient and persuasive information campaigns. In the context of the swine-origin A (H1N1) 2009 pandemic, we use an interactive study among the general public in the South of France, with 175 participants, to explore what type of information can induce change in vaccination intentions at both aggregate and individual levels. We find that individual attitudes to vaccination are based on rational appraisal of the situation, and that it is information of a purely scientific nature that has the only significant positive effect on intention to vaccinate.

An application of an extended theory of planned behaviour to understand drivers' compliance with the school zones speed limit in Australia and Malaysia

This research investigated individual and situational factors that influence driver compliance with the school zones speed limit in Australia and Malaysia. Despite all the countermeasures implemented in these two countries, driver compliance with the speed limit in school zones is still poor. The findings of the research provided support for the application of the Theory of Planned Behaviour to understand and therefore influence drivers' intention to comply with the school zones speed limit in both Australia and Malaysia. The research also revealed that mindfulness, a construct rarely used in road safety before, directly influenced Australian drivers' intention to comply, while habit influenced intention to comply in Malaysia. The research raised important theoretical and cross-cultural issues for future research and highlighted the need to increase the visibility of school zones with the use of more noticeable traffic control devices.

Evaluation of emerging intelligent transport systems to improve safety on level crossings : an overview

Safety at railway level crossings (RLX) is one part of a wider picture of safety within the whole transport system. Governments, the rail industry and road organisations have used a variety of countermeasures for many years to improve RLX safety. New types of interventions are required in order to reduce the number of crashes and associated social costs at railway crossings. This paper presents the results of a large research program which aimed to assess the effectiveness of emerging Intelligent Transport Systems (ITS) interventions, both on-road and in-vehicle based, to improve the safety of car drivers at RLXs in Australia. The three most promising technologies selected from the literature review and focus groups were tested in an advanced driving simulator to provide a detailed assessment of their effects on driver behaviour. The three interventions were: (i) in-vehicle visual warning using a GPS/smartphone navigation-like system, (ii) in-vehicle audio warning and; (iii) on-road intervention known as valet system (warning lights on the road surface activated as a train approaches). The effects of these technologies on 57 participants were assessed in a systematic approach focusing on the safety of the intervention, effects on the road traffic around the crossings and driver’s acceptance of the technology. Given that the ITS interventions were likely to provide a benefit by improving the driver’s awareness of the crossing status in low visibility conditions, such conditions were investigated through curves in the track before arriving at the crossing. ITS interventions were also expected to improve driver behaviour at crossings with high traffic (blocking back issue), which were also investigated at active crossings. The key findings are: (i) interventions at passive crossings are likely to provide safety benefits; (ii) the benefits of ITS interventions on driver behaviour at active crossings are limited; (iii) the trialled ITS interventions did not show any issues in terms of driver distraction, driver acceptance or traffic delays; (iv) these interventions are easy to use, do not increase driver workload substantially; (v) participants’ intention to use the technology is high and; (vi) participants saw most value in succinct messages about approaching trains as opposed to knowing the RLX locations or the imminence of a collision with a train.

Preparing Queensland pharmacists to vaccinate – Australia’s first pharmacists immunisation pilot

In November 2013, the Queensland Department of Health announced its intention to pilot pharmacists vaccination for influenza in the 2014 Flu season. The Pharmaceutical Society of Australia Queensland Branch was tasked with development of an appropriate training program for the pilot.

Gen Y recruitment: Understanding graduate intentions to join an organisation using the Theory of Planned Behaviour

Purpose Using the Theory of Planned Behaviour (TPB) framework, this study explored whether the standard TPB constructs explained variance in Gen Y individuals’ intentions to join their ideal organisation. Design/methodology/approach A mixed methods approach was used featuring qualitative and quantitative methods. Findings The overall TPB model accounted for a significant 51.6% of the variance in intention to join one’s ideal organisation in the next six months with the significant predictors in the model being subjective norm and perceived behaviour control but not attitude. Research limitations/implications Using graduating students from a single Australian university sample may mean that the current findings may not extend to all Gen Y individuals. The current study has demonstrated the explanatory utility of the TPB in relation to graduate Gen Y’s intention to join their ideal organisation, providing further evidence of the robustness of the TPB framework in an organisational setting. Practical implications These findings have implications for enhancing understanding of the most effective recruitment processes for Gen Y students entering the workforce. The findings could inform recruitment policies and strategies to attract Gen Y applicants. Originality/value To our knowledge this study is the first application of the TPB to this topic. The current research extends the recruitment literature with a theoretically-based investigation. Identification of factors which inform organisational recruitment strategies, allow organisations to stand out from their competitors and potentially achieve a larger application pool from which to select the best human capital and sustain competitive advantage.

Strategies for teaching evidence-based practice to undergraduate health students: A systematic review protocol

Review question/objective The objective of this review is to find, critically appraise and synthesize the available quantitative evidence on the effectiveness of interventions that promote successful teaching of the evidence-based practice process in undergraduate health students, in preparation for them to become professional evidence-based practitioners. More specifically, the question that this review seeks to answer is: What is the effectiveness of teaching strategies for evidence-based practice for undergraduate health students? Inclusion criteria Types of participants This review will consider studies that include undergraduate health students from any undergraduate health discipline, including but not limited to medicine, nursing and allied health. Post graduate and post-registration students will not be included. Types of interventions This review will consider studies that evaluate strategies or interventions aimed at teaching any or all of the five steps of evidence-based practice, namely asking a structured clinical question; collecting the best evidence available; critically appraising the evidence to ensure validity, relevance and applicability; applying or integrating the results into clinical practice, and evaluating outcomes. The strategy may take place solely within a tertiary education environment or may be combined with a clinical setting. Types of outcomes This review will consider studies that include the following outcome measures: evidence-based practice behavior, knowledge, skills, attitudes, self-efficacy (or self-confidence), beliefs, values, intention to use evidence-based practice (future use) and confidence levels. Tools used to measure these outcomes will be assessed for reported validity, reliability and generalizability. Outcomes will be measured during the student’s education period up to graduation. If studies are conducted across different year levels this will be taken into account during analysis and reported accordingly.

Preparing pharmacists to vaccinate in Australia’s first Pharmacist Immunisation Pilot

Background: In November 2013, the Queensland Department of Health announced its intention to pilot pharmacist vaccination for influenza in the 2014 flu season. The Pharmaceutical Society of Australia Queensland Branch was tasked with developing a training program for the pilot. Aim: The aim was to develop, implement and evaluate a training program for pharmacist vaccination relevant to the needs of Australian pharmacists. Method: Background content was delivered via two online modules, while training for practical injection skills and anaphylaxis management were provided in a face-to-face workshop. Participants were required to complete the Australasian Society of Clinical Immunology and Allergy (ASCIA) anaphylaxis e-training for pharmacists, and hold a current First-Aid and CPR certificate. On completion of the course, pharmacists were asked to evaluate the training program. Results: Overall, 157 pharmacists across Queensland completed the training. Participants rated the training highly on a 5-point Likert scale (>4.4 for all fields) for relevance to practice, comfort with the skill, confidence to do the task and relevance of the learning objectives to the training. Qualitative feedback indicated that a key component of the training was the ability to practice injections on each other. Conclusion: The findings demonstrate participants felt prepared for vaccination following completion of the training program, as reflected in the high level of confidence reported. A follow-up post-pilot will explore if this confidence was translated into practice during the implementation phase.

Moving from evaluation to trial: How do SMEs start adopting Cloud ERP?

The advent of cloud technology involving low subscription overheads cost has provided small and medium-sized enterprises (SMEs) with the opportunity to adopt new cloud-based corporate-wide systems (i.e., cloud ERP). This technology, operating through subscription-based services, has now provided SMEs with a complete range of IT applications that were once restricted to larger organisations. As anecdotal evidences suggest, SMEs are increasingly adopting cloud-based ERP software. The selection of an ERP is a complex process involving multiple stages and stakeholders, suggesting the importance of closer examination of cloud ERP adoption in SMEs. Yet, prior studies have predominantly treated technology adoption as a single activity and largely ignored the issue of ERP adoption in SMEs. Understanding of the process nature of the adoption and the factors that are important in each stage of the adoption potentially may result in guiding SMEs to make well-informed decisions throughout the ERP selection process. Thus, our study proposes that the adoption of cloud ERP should be examined as a multi-stage process. Using the Theory of Planned Behaviour (TPB) and Ettlie’s adoption stages, as well as employing data gathered from 162 owners of SMEs, our findings show that the factors that influence the intention to adopt cloud ERP vary significantly across adoptive stages.