Self-help organisations: A qualitative study of successful collaboration with general practice

Thousands of self-help organisations (SHOs) exist in Australia but little is known about how they relate to the mainstream health care system. This qualitative study, based in south-east Queensland, aimed to identify examples of collaboration between general practitioners (GPs) and SHOs in order to examine the attributes of successful partnerships. Representatives of six SHOs, identified by key informants as having good collaborative links with GPs, and seven GPs with whom they collaborated, completed semi-structured interviews. The interviews focused on evidence of collaboration and perceptions of benefits and barriers experienced. Maximum variation sampling enabled a cross-section of SHOs in terms of size, funding, and health issue. Although GPs readily identified SHO benefits, they referred patients to them only rarely. SHO credibility, evidence of tangible benefits for patients, ease of contacting the SHO, and correspondence between the SHO?s focus and the GP?s personal and professional interests appear to contribute to the success of partnerships. We conclude that mutually beneficial partnerships between GPs and SHOs exist but are under-utilised. A more coordinated effort is needed to strengthen links between the two sectors.

Perceptions of self and group in the context of a threatened national identity: A field study

Previous research indicates that people who are highly identified with their groups tend to remain committed to them under threat. This study examines the generalizability, of this effect to (a) a real-life context involving the perception that others view the ingroup (Australians) as intolerant of minorities and (b) various dimensions of social identification. The sample comprised 213 respondents to a random mail survey. Perceived threat was inversely related to self-stereotyping (i.e. perceptions of self-ingroup similarity), but only for individuals with weak subjective ties to other group members. Threat perceptions were also predictive of enhanced judgments of within-group variability on threat-relevant dimensions, particularly for individuals with weaker ingroup ties. Various strategies for coping with a threatened social identity are linked to different facets of social identification.

Protection against group A streptococcal infection by vaccination with self-adjuvanting lipid core M protein peptides

We have investigated the lipid polylysine core peptide (LCP) system as a self-adjuvanting group A streptococcal (GAS) vaccine delivery approach. LCP constructs were synthesised incorporating peptides from the M protein conserved carboxy terminal C-repeat region, the amino terminal type-specific region and from both of these regions. Immunisation with the constructs without adjuvant led to the induction of peptide-specific serum IgG antibody responses, heterologous opsonic antibodies, and complete protection from GAS infection. These data indicate that protective immunity to GAS infection can be evoked using the self-adjuvanting LCP system, and point to the potential application of this system in human mucosal GAS vaccine development. (c) 2005 Elsevier Ltd. All rights reserved.

Trial of print and telephone delivered interventions to influence walking

Background. Both self-help print materials and telephone-assisted counseling have generally proved useful strategies to increase physical activity. This study examined their effectiveness in an intervention aimed specifically at promoting walking for specific purposes. Methods. Participants (n = 399) were randomly allocated to one of two 3-week intervention programs. The Print program comprised multiple mailing of brochures that emphasized walking within the local community environments. The Print plus Telephone program received the same brochures plus three telephone calls. Data collected via mailed self-completed surveys were analyzed by exploring outcomes related to walking for specific purposes. Results. There were no significant differences between the two programs in any of the walking measures. Both groups significantly increased time reported walking for exercise per week [Print: t(1,277) = -3.50, P < 0.001; Print plus telephone: t(1,106) = -2.44, P < 0.016]. Significantly, more participants in the Print plus Telephone group reported receiving and reading the materials (chi(2) = 20.11, P < 0.0001). Conclusions. The intervention programs were more successful at increasing walking for exercise than for any other purpose. The addition of brief telephone support was successful in focusing participants' attention on the print materials, but did not result in any additional increase in walking. (C) 2004 The Institute For Cancer Prevention and Elsevier Inc. All rights reserved.

Randomized control trial of a smoking cessation intervention directed at men whose partners are pregnant

Background. Although smoking cessation programs significantly reduce smoking rates in the general population, some sectors are poorly motivated by them, especially healthy men from lower socioeconomic classes. Methods. By using a significant life event (approaching birth of a child) we exploited a time of increased receptiveness to smoking cessation influences. A multicomponent intervention was conducted and evaluated using a stratified, randomised control trial, with an intention to treat analysis. Results. Five hundred and sixty-one men were enrolled and 505 (90%) followed to the end of their partners' pregnancy. At 6-month follow-up 16.5% of 291 smokers of the intervention group and 9.3% of 270 in the control group reported they had stopped smoking (P = 0.011, OR = 0.52, 95% CI 0.31 - 0.86). The strongest predictors of smoking cessation were being in a skilled occupation, having a higher number of quit attempts in the previous year and having the first cigarette of the day relatively later. Conclusions. The number of smoking men who had to be treated to achieve one stopping smoking (NNT) during their partner's pregnancy was 13 to 14. Innovative antismoking population health measures for the partners of antenatal patients are effective and perhaps should be more widely adopted. (C) 2003 American Health Foundation and Elsevier Inc. All rights reserved.

Some economic dimensions of the mental health jigsaw in Australia

The purpose of this paper is to demonstrate that, although there are some unique features associated with mental illness, such special features do not preclude economic analysis. As a mechanism for understanding how individual economic studies fit into the mental health sector, a conceptual framework of the components of mental health service provision is outlined. Emphasis is placed on, not simply institutional and market resources, but also on the services provided by relatives, self-help groups, etc. Australian data on parts of the mental health sector are employed to illustrate that some (and different) economic analyses can be undertaken in mental health. First, time-series data on public psychiatric hospitals are employed to demonstrate trends associated with deinstitutionalisation. Other data (for Queensland alone) indicate that there are state-based differences in the provision of such services. Second, attention is then directed to the analysis of time-series data on private fee-for-service psychiatric services. Various concepts and measures from industrial economics are applied to analyse the relative size of this service industry, the pricing behaviour of the profession, the service-mix of "the psychiatry firms" operating in Australia.

Expanding the scope of the social response context model

Descriptive models of social response are concerned with identifying and discriminating between different types of response to social influence. In a previous article (Nail, MacDonald, & Levy, 2000), the authors demonstrated that 4 conceptual dimensions are necessary to adequately distinguish between such phenomena as conformity, compliance, contagion, independence, and anticonformity in a single model. This article expands the scope of the authors' 4-dimensional approach by reviewing selected experimental and cultural evidence, further demonstrating the integrative power of the model. This review incorporates political psychology, culture and aggression, self-persuasion, group norms, prejudice, impression management, psychotherapy, pluralistic ignorance, bystander intervention/nonintervention, public policy, close relationships, and implicit attitudes.

Smoking and parenting among males in low socio-economic occupations

The role of fatherhood in family life has been accentuated as a consequence of societal change. This change, combined with knowledge about the harmful consequences of passive smoking, has focused attention on males who smoke and are the partners of pregnant women. Of particular interest are low socio-economic groups because of their higher smoking rates. This study examines smoking and parenting in a sample of 561 males in semi-skilled and unskilled occupations (with pregnant partners) who were recruited into a self-help smoking cessation programme. Parenting related variables predicted smoking cessation, particularly knowledge about passive smoking. A high level of knowledge about the effects of passive smoking on a baby was associated with one or more quit attempts early in the partner's pregnancy and smoking cessation. Confidence to quit during the pregnancy was also associated with smoking cessation. These results could be incorporated into smoking cessation and antenatal programmes to improve the health of families.