Evaluating user involvement in primary healthcare

Current health policies, both in the UK and internationally, call for a shift from secondary to primary healthcare, and for increased involvement of service users and communities in decisions about their own care and about the way in which health services are provided. This study investigated the way in which users were involved in two London-based primary healthcare projects. Two projects were selected from a broader sample. A case study approach was adopted and a range of methods used to identify the types of user involvement, users' views of the process and, in one case study, users' preferences for participation. Arnstein's conceptual framework for participation was used in the analysis. In this paper, the findings of the study are discussed in relation to Cohen's notions of breadth, depth and range of participation. The paper illustrates how these notions may provide a mechanism for providers and commissioners of health services to assess their strategies in relation to user or community involvement, and the degree of success they achieve in implementation.

Government involvement in entrepreneurship and new business creation in Australia : a quantitative analysis of public perceptions and opinions

In order to determine the range of Australian perceptions on new venture creation at the end of the decade of the 1980s, and in particular attitudes towards government involvement in fostering entrepreneurship, a major quantitative study was conducted. The survey involved more than 1500 Australians in face-to-face interviews (300 in each mainland capital city) chosen on a random basis.

An analysis of the data provides an assessment of the Australian general public&s perceptions in three key areas: their understanding of the word 'entrepreneur' their rating of importance of new venture creation; their belief in government involvement in fostering new venture creation.

It is believed to be the first study attempting to quantify an entire nation&s perceptions in three areas vital to creators of national economic and industry policies.

Internal audit involvement in enterprise risk management

Purpose – The purpose of this paper is to examine the impact of internal auditors’ involvement in enterprise risk management (ERM) on perceptions of their willingness to report a breakdown in risk procedures and whether a strong relationship with the audit committee affects such willingness to report. The study also investigates the use of ERM and the role of internal audit in ERM in Australian private and public sector entities.
Design/methodology/approach – The study uses an experimental design, manipulating the internal auditor’s involvement in ERM and the strength of the relationship between internal audit and the audit committee. Participants are 117 certified internal auditors. The study also gathers descriptive data on the use of ERM.
Findings – The study indicates that a high involvement in ERM impacts the perceptions of internal
auditors’ willingness to report a breakdown in risk procedures to the audit committee. However, a strong relationship with the audit committee does not appear to affect their perceived willingness to report. The study also finds that the majority of organisations have recently adopted ERM. Internal auditors are involved in ERM assurance activities but some also engage in activities that could compromise objectivity.
Research limitations/implications – There are internal and external validity threats associated with the experimental design.
Practical implications – The findings reinforce the need for organisations to adhere to the recommendations of the Institute of Internal Auditors and to ensure that internal auditors do not play an inappropriate role in ERM.
Originality/value – The paper contributes to our understanding of the impact of involvement in ERM on internal audit objectivity and of the current role of internal audit in ERM in Australia.

The influence of families on early adolescent school connectedness : evidence that this association varies with adolescent involvement in peer drinking networks

School connectedness is central to the long term well-being of adolescents, and high quality parent–child relationships facilitate school connectedness. This study examined the extent to which family relationship quality is associated with the school connectedness of pre- and early teenagers, and how this association varies with adolescent involvement in peer drinking networks. The sample consisted of 7,372 10–14 year olds recruited from 231 schools in 30 Australian communities. Participants completed the Communities that Care youth survey. A multi-level model of school connectedness was used, with a random term for school-level variation. Key independent variables included family relationship quality, peer drinking networks, and school grade. Control variables included child gender, sensation seeking, depression, child alcohol use, parent education, and language spoken at home. For grade 6 students, the association of family relationship quality and school connectedness was lower when peer drinking networks were present, and this effect was nonsignificant for older (grade 8) students. Post hoc analyses indicated that the effect for family relationship quality on school connectedness was nonsignificant when adolescents in grade 6 reported that the majority of friends consumed alcohol. The results point to the importance of family-school partnerships in early intervention and prevention.

Dietitians' interests in primary food production: opportunities for greater involvement in the promotion of environmental sustainability

Dietitians are food communication professionals. Little is known about their views of food sustainability and security or of their interest in learning more about these issues. Therefore, an online survey of members of the Dietitians’ Association of Australia was conducted during the first half of 2012 about these issues.

Unpacking black boxes: Mechanisms and theory building in evaluation

There is growing interest in the concept of ‘‘mechanism’’ across many areas of the social sciences. In the field of program and policy evaluation, a number of scholars have also emphasized the importance of causal mechanisms for explaining how and why programs work. However, there appears to be some ambiguity about the meaning and uses of mechanism-based thinking in both the social science and evaluation literature. In this article we attempt to clarify what is meant by mechanisms in the context of program evaluation by identifying three main characteristics of mechanisms and outlining a possible typology of mechanisms. A number of theoretical and practical implications for evaluators are also discussed, along with some precautions to consider when investigating mechanisms that might plausibly account for program outcomes.

Workers’ compensation and mental health : examining the mental health impacts of involvement in the Victorian Work Cover system from the perspective of long-­term injured workers

The project aimed to explore long--term injured workers’ experiences and perceptions of their mental health as they progressed through the Victorian WorkCover process. The purpose of the project was to assist in understanding these factors in order to identify how workers might be better supported, and to identify changes that compensation authorities, employers and unions can make to reduce mental distress amongst injured workers. As a project based on workers’ accounts of their experiences, it aimed to provide a narrative basis for the development of supportive policy and practice to reduce mental distress amongst people who are clients of the WorkCover system. The project was a qualitative study based on fifteen in--depth interviews with people who had been injured at work and who had been off work for at least six months. The workers who took part in the study were recruited with the assistance of their trade unions, using an advertisement that was distributed via the unions’ regular communication channels. Workers were asked to tell their story of injury and recovery with a particular focus on how they felt and the factors that affected them, both positively and negatively. They were also asked what could or should be changed to support workers’ recovery and improve their experience of the WorkCover system. The workers who took part in the study came from a variety of industry sectors (education, textile and clothing manufacturing and meat industries) and different occupational categories (professional, trade/technical and manual). They included people whose primary injury was physical and those whose primary injury was psychosocial.