An evaluation of a telephone-based postnatal support intervention for infant feeding in a regional Australian city

Background: Postnatal breastfeeding support in the form of home visits is difficult to accommodate in regional Australia, where hospitals often deal with harsh economic constraints in a context where they are required to provide services to geographically, dispersed consumers. This study evaluated a predominately telephone-based support service called the Infant Feeding Support Service. Methods: A prospective cohort design was used to compare data for 696 women giving birth in two regional hospitals (one public, one private) and participating in the support service between January and July 2003 with data from a cohort of 625 women who gave birth in those hospitals before the introduction of the support service. Each mother participating in the support service was assigned a lactation consultant. First contact occurred 48 hours after discharge, and approximately it weekly thereafter for 4 it weeks. Breastfeeding duration was measured at 3 months postpartum. Results: For women from the private hospital, the support service improved exclusive breastfeeding duration to 4.5 weeks postpartum, but these improvements were not evident at 3 months postpartum. No effects were observed for mothers from the public hospital. Quantitative and qualitative data demonstrated high levels of client satisfaction with the support service. Conclusions: This small-scale, predominately telephone-based intervention provided significant, although apparently context-sensitive, improvements to exclusive breastfeeding duration.

Using fear appeals to promote cancer screening - are we scaring the wrong people?

There is debate regarding the use of fear appeals (emphasizing severe threats to health) in social marketing, to encourage preventive behaviours, such as screening for breast cancer. While it has been found that fear appeals may result in attitude and behaviour change there is also the risk of inciting inappropriate levels of fear, motivating the wrong audience or instigating maladaptive behaviour in the target group such as denial or defensive avoidance. This study examined the impact of an experimental threat manipulation for mammography screening on a group of women in regional Australia. The study found that varying the level of threat had no impact on stated intentions of the women to undergo mammographic screening. However, it also found that high-threat messages resulted in stronger negative emotional reactions and greater perceived susceptibility among younger women who are not the target group for screening in Australia. The results of this study emphasize the importance of limiting the use of high levels of threat in social marketing campaigns, and ensuring that campaigns are appropriately designed to specifically impact upon and motivate the target group. Copyright © 2006 John Wiley & Sons, Ltd.

Neoliberalism, individualisation and community: Regional restructuring in Australia

Since the early 1980s, Australian governments have embraced neoliberal policies as a means of improving the nation’s global economic competitiveness. The impacts of such policies in regional areas have been quite profound, leading to socio-economic polarisation, population loss, and the growth of anti-globalisation sentiments. In this paper, we examine the process of regional restructuring that arises from this trajectory in Australia, and examine current policy responses to change under the neoliberal regime. We argue that while many such responses are individualistic, and based upon policies of personal responsibility, self-advancement and entrepreneurship, others are imbued with the language of community, social capital and collective action. The existence of individualism and community within the same policy agenda may appear contradictory, yet it is suggested that neoliberalism brings together these two opposing discourses through a process of what Nikolas Rose calls ‘governing through community’. We explore how neoliberalism underpins community approaches to regional development in Australia, arguing that such strategies do little to counter the negative forces of globalisation in non-metropolitan parts of the country.