A process evaluation of a comprehensive school based injury prevention program

A process evaluation enables understanding of critical issues that can inform the improved, ongoing implementation of an intervention program. This study describes the process evaluation of a comprehensive, multi-level injury prevention program for adolescents. The program targets change in injury associated with violence, transport and alcohol risks and incorporates two primary elements: an 8-week, teacher delivered attitude and behaviour change curriculum for Grade 8 students; and a professional development program for teachers on school level methods of protection, focusing on strategies to increase students’ connectedness to school.

Evaluation of the skills for preventing injury in youth program : impact on health risk behaviors, injury and school connectedness

Injury is the leading cause of death among young people, and involvement in health risk behaviors, such as alcohol use and transport-related risks, is related to increased risk for injury. Effective health promotion programs for adolescents focus on multiple levels, including relationships with peers and parents, student knowledge, behavior and attitudes, and school-level factors such as school connectedness. This study describes the pilot evaluation of a comprehensive, multi-level injury prevention program for 13-14 year old adolescents, targeting change in injury associated with transport and alcohol risks. The program, called Skills for Preventing Injury in Youth (SPIY), incorporates two primary elements: an 8-week, teacher delivered attitude and behavior change curriculum with peer protection and first aid messages; and professional development for program teachers focusing on strategies to increase students’ connectedness to school. Five Australian high schools were recruited for the pilot evaluation research, with three being assigned to receive intervention components and two assigned as curriculum-as-usual controls. In the intervention schools, 118 Year 8 students participated in surveys at baseline, with 105 completing surveys at follow up, six months following the intervention. In the control schools, 196 Year 8 students completed surveys at baseline and 207 at follow up. Survey measures included self-reported injury, risk taking behavior and school connectedness. Results showed that students in the control schools were significantly more likely to report riding bikes without helmets, riding with dangerous drivers, having driven cars on the road, and using alcohol six months after the program, while the intervention group showed no such increase in these behaviors. Additionally, students in the control schools were significantly more likely to report having had pedestrian-related injuries at follow up than they were at the baseline measurement, while intervention school students showed no change. There was also a trend observed in terms of a decrease in bicycle related injuries among intervention school students, compared with a slight increasing trend in bicycle injuries among control students. Overall, scores on the school connectedness scale decreased significantly from baseline to follow up for both intervention and control students, however measurement limitations may have impacted on results relating to students’ connectedness. Overall, the SPIY program has shown promising results in regards to prevention of students’ health risk behavior and injuries. Evidence suggests that the curriculum component was important; however there was limited evidence to suggest that teacher training in school connectedness strategies contributed to these promising results. While school connectedness may be an important factor to target in risk and injury prevention programs, programs may need to incorporate whole-of-school strategies or target a broader range of teachers than were selected for the current research.

Selected elements of housing affordability impacting otherwise potentially sustainable communities

It is widely held that strong relationships exist between housing, economic status, and well being. Therefore, recent events emerging from the United States, culminating in widespread housing stock surpluses in that country and others, threaten to destabilise many aspects related to individuals and community. However, despite global impact, the position of housing demand and supply is not consistent. The Australian position provides a strong contrast whereby continued strong housing demand generally remains a critical issue affecting the socio-economic landscape. Underpinned by strong levels of immigration, and further buoyed by sustained historically low interest rates, increasing income levels, and increased government assistance for first home buyers, this strong housing demand ensures elements related to housing affordability continue to gain prominence. A significant, but less visible factor impacting housing affordability – particularly new housing development – relates to holding costs. These costs are in many ways “hidden” and cannot always be easily identified. Although it is only one contributor, the nature and extent of its impact requires elucidation. In its simplest form, it commences with a calculation of the interest or opportunity cost of land holding. However, there is significantly more complexity for major new developments - particularly greenfield development. Analysis suggests that even small shifts in primary factors impacting holding costs can appreciably affect housing affordability. Those factors of greatest significance not only include interest rates and the rate of inflation, but even less apparent factors such as the regulatory assessment period. These are not just theoretical concepts but real, measurable price drivers. Ultimately, the real impact is felt by the one market segment whom can typically least afford it – new home, first home buyers. They can be easily pushed out of affordability. This paper suggests the stability and sustainability of growing, new communities require this problem to be acknowledged and accurately identified if the well being of such communities is to be achieved.

The conceptualisation, sensitivity and measurement of holding costs and other selected elements impacting housing affordability (Literature review and research methodology for confirmation of PhD candidature)

It is widely held that strong relationships exist between housing, economic status, and well being. This is exemplified by widespread housing stock surpluses in many countries which threaten to destabilise numerous aspects related to individuals and community. However, the position of housing demand and supply is not consistent. The Australian position provides a distinct contrast whereby seemingly inexorable housing demand generally remains a critical issue affecting the socio-economic landscape. Underpinned by high levels of immigration, and further buoyed by sustained historically low interest rates, increasing income levels, and increased government assistance for first home buyers, this strong housing demand ensures elements related to housing affordability continue to gain prominence. A significant, but less visible factor impacting housing affordability – particularly new housing development – relates to holding costs. These costs are in many ways “hidden” and cannot always be easily identified. Although it is only one contributor, the nature and extent of its impact requires elucidation. In its simplest form, it commences with a calculation of the interest or opportunity cost of land holding. However, there is significantly more complexity for major new developments - particularly greenfield property development. Preliminary analysis conducted by the author suggests that even small shifts in primary factors impacting holding costs can appreciably affect housing affordability – and notably, to a greater extent than commonly held. Even so, their importance and perceived high level impact can be gauged from the unprecedented level of attention policy makers have given them over recent years. This may be evidenced by the embedding of specific strategies to address burgeoning holding costs (and particularly those cost savings associated with streamlining regulatory assessment) within statutory instruments such as the Queensland Housing Affordability Strategy, and the South East Queensland Regional Plan. However, several key issues require investigation. Firstly, the computation and methodology behind the calculation of holding costs varies widely. In fact, it is not only variable, but in some instances completely ignored. Secondly, some ambiguity exists in terms of the inclusion of various elements of holding costs, thereby affecting the assessment of their relative contribution. Perhaps this may in part be explained by their nature: such costs are not always immediately apparent. Some forms of holding costs are not as visible as the more tangible cost items associated with greenfield development such as regulatory fees, government taxes, acquisition costs, selling fees, commissions and others. Holding costs are also more difficult to evaluate since for the most part they must be ultimately assessed over time in an ever-changing environment, based on their strong relationship with opportunity cost which is in turn dependant, inter alia, upon prevailing inflation and / or interest rates. By extending research in the general area of housing affordability, this thesis seeks to provide a more detailed investigation of those elements related to holding costs, and in so doing determine the size of their impact specifically on the end user. This will involve the development of soundly based economic and econometric models which seek to clarify the componentry impacts of holding costs. Ultimately, there are significant policy implications in relation to the framework used in Australian jurisdictions that promote, retain, or otherwise maximise, the opportunities for affordable housing.

Fiji pre-service primary teachers' understanding of physical science : a cultural perspective

Science and technology are promoted as major contributors to national development. Consequently, improved science education has been placed high on the agenda of tasks to be tackled in many developing countries, although progress has often been limited. In fact there have been claims that the enormous investment in teaching science in developing countries has basically failed, with many reports of how efforts to teach science in developing countries often result in rote learning of strange concepts, mere copying of factual information, and a general lack of understanding on the part of local students. These generalisations can be applied to science education in Fiji. Muralidhar (1989) has described a situation in which upper primary and middle school students in Fiji were given little opportunity to engage in practical work; an extremely didactic form of teacher exposition was the predominant method of instruction during science lessons. He concluded that amongst other things, teachers' limited understanding, particularly of aspects of physical science, resulted in their rigid adherence to the text book or the omission of certain activities or topics. Although many of the problems associated with science education in developing countries have been documented, few attempts have been made to understand how non-Western students might better learn science. This study addresses the issue of Fiji pre-service primary teachers' understanding of a key aspect of physical science, namely, matter and how it changes, and their responses to learning experiences based on a constructivist epistemology. Initial interviews were used to probe pre-service primary teachers' understanding of this domain of science. The data were analysed to identify students' alternative and scientific conceptions. These conceptions were then used to construct Concept Profile Inventories (CPI) which allowed for qualitative comparison of the concepts of the two ethnic groups who took part in the study. This phase of the study also provided some insight into the interaction of scientific information and traditional beliefs in non-Western societies. A quantitative comparison of the groups' conceptions was conducted using a Science Concept Survey instrument developed from the CPis. These data provided considerable insight into the aspects of matter where the pre-service teachers' understanding was particularly weak. On the basis of these preliminary findings, a six-week teaching program aimed at improving the students' understanding of matter was implemented in an experimental design with a group of students. The intervention involved elements of pedagogy such as the use of analogies and concept maps which were novel to most of those who took part. At the conclusion of the teaching programme, the learning outcomes of the experimental group were compared with those of a control group taught in a more traditional manner. These outcomes were assessed quantitatively by means of pre- and post-tests and a delayed post-test, and qualitatively using an interview protocol. The students' views on the various teaching strategies used with the experimental group were also sought. The findings indicate that in the domain of matter little variation exists in the alternative conceptions held by Fijian and Indian students suggesting that cultural influences may be minimal in their construction. Furthermore, the teaching strategies implemented with the experimental group of students, although largely derived from Western research, showed considerable promise in the context of Fiji, where they appeared to be effective in improving the understanding of students from different cultural backgrounds. These outcomes may be of significance to those involved in teacher education and curriculum development in other developing countries.

Inquiry-based science in a primary classroom : professional development impacting practice

The critical factor in determining students' interest and motivation to learn science is the quality of the teaching. However, science typically receives very little time in primary classrooms, with teachers often lacking the confidence to engage in inquiry-based learning because they do not have a sound understanding of science or its associated pedagogical approaches. Developing teacher knowledge in this area is a major challenge. Addressing these concerns with didactic "stand and deliver" modes of Professional Development (PD) has been shown to have little relevance or effectiveness, yet is still the predominant approach used by schools and education authorities. In response to that issue, the constructivist-inspired Primary Connections professional learning program applies contemporary theory relating to the characteristics of effective primary science teaching, the changes required for teachers to use those pedagogies, and professional learning strategies that facilitate such change. This study investigated the nature of teachers' engagement with the various elements of the program. Summative assessments of such PD programs have been undertaken previously, however there was an identified need for a detailed view of the changes in teachers' beliefs and practices during the intervention. This research was a case study of a Primary Connections implementation. PD workshops were presented to a primary school staff, then two teachers were observed as they worked in tandem to implement related curriculum units with their Year 4/5 classes over a six-month period. Data including interviews, classroom observations and written artefacts were analysed to identify common themes and develop a set of assertions related to how teachers changed their beliefs and practices for teaching science. When teachers implement Primary Connections, their students "are more frequently curious in science and more frequently learn interesting things in science" (Hackling & Prain, 2008). This study has found that teachers who observe such changes in their students consequently change their beliefs and practices about teaching science. They enhance science learning by promoting student autonomy through open-ended inquiries, and they and their students enhance their scientific literacy by jointly constructing investigations and explaining their findings. The findings have implications for teachers and for designers of PD programs. Assertions related to teaching science within a pedagogical framework consistent with the Primary Connections model are that: (1) promoting student autonomy enhances science learning; (2) student autonomy presents perceived threats to teachers but these are counteracted by enhanced student engagement and learning; (3) the structured constructivism of Primary Connections resources provides appropriate scaffolding for teachers and students to transition from didactic to inquiry-based learning modes; and (4) authentic science investigations promote understanding of scientific literacy and the "nature of science". The key messages for designers of PD programs are that: (1) effective programs model the pedagogies being promoted; (2) teachers benefit from taking the role of student and engaging in the proposed learning experiences; (3) related curriculum resources foster long-term engagement with new concepts and strategies; (4) change in beliefs and practices occurs after teachers implement the program or strategy and see positive outcomes in their students; and (5) implementing this study's PD model is efficient in terms of resources. Identified topics for further investigation relate to the role of assessment in providing evidence to support change in teachers' beliefs and practices, and of teacher reflection in making such change more sustainable.

Primary students’ interpretation of maps : gesture use and mapping knowledge

Maps are used to represent three-dimensional space and are integral to a range of everyday experiences. They are increasingly used in mathematics, being prominent both in school curricula and as a form of assessing students understanding of mathematics ideas. In order to successfully interpret maps, students need to be able to understand that maps: represent space, have their own perspective and scale, and their own set of symbols and texts. Despite the fact that maps have an increased prevalence in society and school, there is evidence to suggest that students have difficulty interpreting maps. This study investigated 43 primary-aged students’ (aged 9-12 years) verbal and gestural behaviours as they engaged with and solved map tasks. Within a multiliteracies framework that focuses on spatial, visual, linguistic, and gestural elements, the study investigated how students interpret map tasks. Specifically, the study sought to understand students’ skills and approaches used to solving map tasks and the gestural behaviours they utilised as they engaged with map tasks. The investigation was undertaken using the Knowledge Discovery in Data (KDD) design. The design of this study capitalised on existing research data to carry out a more detailed analysis of students’ interpretation of map tasks. Video data from an existing data set was reorganised according to two distinct episodes—Task Solution and Task Explanation—and analysed within the multiliteracies framework. Content Analysis was used with these data and through anticipatory data reduction techniques, patterns of behaviour were identified in relation to each specific map task by looking at task solution, task correctness and gesture use. The findings of this study revealed that students had a relatively sound understanding of general mapping knowledge such as identifying landmarks, using keys, compass points and coordinates. However, their understanding of mathematical concepts pertinent to map tasks including location, direction, and movement were less developed. Successful students were able to interpret the map tasks and apply relevant mathematical understanding to navigate the spatial demands of the map tasks while the unsuccessful students were only able to interpret and understand basic map conventions. In terms of their gesture use, the more difficult the task, the more likely students were to exhibit gestural behaviours to solve the task. The most common form of gestural behaviour was deictic, that is a pointing gesture. Deictic gestures not only aided the students capacity to explain how they solved the map tasks but they were also a tool which assisted them to navigate and monitor their spatial movements when solving the tasks. There were a number of implications for theory, learning and teaching, and test and curriculum design arising from the study. From a theoretical perspective, the findings of the study suggest that gesturing is an important element of multimodal engagement in mapping tasks. In terms of teaching and learning, implications include the need for students to utilise gesturing techniques when first faced with new or novel map tasks. As students become more proficient in solving such tasks, they should be encouraged to move beyond a reliance on such gesture use in order to progress to more sophisticated understandings of map tasks. Additionally, teachers need to provide students with opportunities to interpret and attend to multiple modes of information when interpreting map tasks.

Primary students' performance on map tasks : the role of context

This study investigated the longitudinal performance of 583 students on six map items that were represented in various graphic forms. Specifically, this study compared the performance of 7-9-year-olds (across Grades 2 and 3) from metropolitan and non-metropolitan locations. The results of the study revealed significant performance differences in favour of metropolitan students on two of six map tasks. Implications include the need for teachers in non-metropolitan locations to ensure that their students do not overly fixate on landmarks represented on maps but rather consider the arrangement of all elements encompassed within the graphic.

A conceptual framework for the cultural integration of cooperative learning : a Thai primary mathematics education perspective

The Thailand education reform adopted cooperative learning to improve the quality of education. However, it has been reported that the introduction and maintenance of cooperative learning has been difficult and uncertain because of the cultural differences. The study proposed a conceptual framework developed based on making a connection between Thai cultures and cooperative learning elements, and implemented a small-scale research project in a Thai primary mathematics class with a teacher and thirty-two Grade 4 students. The results uncovered that the three components including preparation of teachers, instructional strategies and preparation of students can be vehicles for the culture integration in cooperative learning.

Development and pilot study of the Primary Care Practice Improvement Tool (PC-PIT) : an innovative approach

Objective To assess the usability and validity of the Primary Care Practice Improvement Tool (PC-PIT), a practice performance improvement tool based on 13 key elements identified by a systematic review. It was co-created with a range of partners and designed specifically for primary health care. Design This pilot study examined the PC-PIT using a formative assessment framework and mixed-methods research design. Setting and participants Six high-functioning general practices in Queensland, Australia, between February and July 2013. A total of 28 staff participated — 10 general practitioners, six practice or community nurses, 12 administrators (four practice managers; one business manager and eight reception or general administrative staff). Main outcome measures Readability, content validity and staff perceptions of the PC-PIT. Results The PC-PIT offers an appropriate and acceptable approach to internal quality improvement in general practice. Quantitative assessment scores and qualitative data from all staff identified two areas in which the PC-PIT required modification: a reduction in the indicative reading age, and simplification of governance-related terms and concepts. Conclusion The PC-PIT provides an innovative approach to address the complexity of organisational improvement in general practice and primary health care. This initial validation will be used to develop a suite of supporting, high-quality and free-to-access resources to enhance the use of the PC-PIT in general practice. Based on these findings, a national trial is now underway.

Integrated chronic disease management in primary-secondary care : a systematic literature review of the evidence

Introduction: Diabetes has traditionally been managed as a single chronic disease state, but it exists with co-morbidities such as depression and metabolic syndrome. Treatment is multifaceted, requiring both primary and secondary care, however, the delivery of diabetes care is often fragmented. Integrated chronic disease management is a growing model of interest, and is underpinned by the chronic care model (CCM), devised as a guide for primary care management of patients with chronic conditions. The model identifies six key elements for effective care, and has shown promise in improving the management of diabetes. Aim: To find empirical evidence of integrated care interventions targeted at co-morbidities including diabetes, across primary/secondary care. Method: A systematic review of peer reviewed literature from PubMed, CINAHL, Embase, Cochrane Library and Joanna Briggs was performed. Studies were reviewed according to inclusion criteria- studies published in English, between 2004-2014, empirical studies, studies with evidence of primary/secondary implementation, and those dealing with chronic co-morbid disease states. Results: 51 studies met the inclusion criteria. Included studies were mostly from the US (38), with five from Australia, UK (2), Canada (2), Netherlands (1), Norway (1), Ireland (1), and one multi-country study. It was found that all interventions adopted at least one (average 3-4) of the chronic care model, with the majority implementing delivery system redesign activities within the primary care practice/s. We found evidence of interventions which significantly reduced emergency department and hospital admissions, improved processes of care, patient health outcomes such as HbA1c, improved patient satisfaction, and reduced costs. Conclusion/Implications for practice: Diabetes exists as a co-morbid disease, requiring both primary and secondary care. We found that integrated care interventions adopting elements of the chronic care model positively impacted on patient outcomes, service utilisation, as well as costs. This review has highlighted that it may not be necessary to adopt all CCM elements to improve clinical outcomes, patient satisfaction and costs.

Trial of the Primary Care Practice Improvement Tool: Building organisational performance in Australian general practice and primary health care

Objective: To nationally trial the Primary Care Practice Improvement Tool (PC-PIT), an organisational performance improvement tool previously co-created with Australian primary care practices to increase their focus on relevant quality improvement (QI) activities. Design: The study was conducted from March to December 2015 with volunteer general practices from a range of Australian primary care settings. We used a mixed-methods approach in two parts. Part 1 involved staff in Australian primary care practices assessing how they perceived their practice met (or did not meet) each of the 13 PC-PIT elements of high-performing practices, using a 1–5 Likert scale. In Part 2, two external raters conducted an independent practice visit to independently and objectively assess the subjective practice assessment from Part 1 against objective indicators for the 13 elements, using the same 1–5 Likert scale. Concordance between the raters was determined by comparing their ratings. In-depth interviews conducted during the independent practice visits explored practice managers’ experiences and perceived support and resource needs to undertake organisational improvement in practice. Results: Data were available for 34 general practices participating in Part 1. For Part 2, independent practice visits and the inter-rater comparison were conducted for a purposeful sample of 19 of the 34 practices. Overall concordance between the two raters for each of the assessed elements was excellent. Three practice types across a continuum of higher- to lower-scoring practices were identified, with each using the PC-PIT in a unique way. During the in-depth interviews, practice managers identified benefits of having additional QI tools that relate to the PC-PIT elements. Conclusions: The PC-PIT is an organisational performance tool that is acceptable, valid and relevant to our range of partners and the end users (general practices). Work is continuing with our partners and end users to embed the PC-PIT in existing organisational improvement programs.