Changing the environment to improve population health: a framework for considering exposure in natural experimental studies

There is renewed optimism regarding the use of natural experimental studies to generate evidence as to the effectiveness of population health interventions. Natural experimental studies capitalise on environmental and policy events that alter exposure to certain social, economic or environmental factors that influence health. Natural experimental studies can be useful for examining the impact of changes to 'upstream' determinants, which may not be amenable to controlled experiments. However, while natural experiments provide opportunities to generate evidence, they often present certain conceptual and methodological obstacles. Population health interventions that alter the physical or social environment are usually administered broadly across populations and communities. The breadth of these interventions means that variation in exposure, uptake and impact may be complex. Yet many evaluations of natural experiments focus narrowly on identifying suitable 'exposed' and 'unexposed' populations for comparison. In this paper, we discuss conceptual and analytical issues relating to defining and measuring exposure to interventions in this context, including how recent advances in technology may enable researchers to better understand the nature of population exposure to changes in the built environment. We argue that when it is unclear whether populations are exposed to an intervention, it may be advantageous to supplement traditional impact assessments with observational approaches that investigate differing levels of exposure. We suggest that an improved understanding of changes in exposure will assist the investigation of the impact of complex natural experiments in population health.

Evaluation of phenomenological findings in IS research : a study in developing web-based IS

This paper presents a phenomenological investigation of project managers’ experiences with the implementation of web-based employee service systems (ESS), a domain that has witnessed sharp growth in Australia in recent times. The rich, multidimensional account of project managers’ experiences with the implementation of ESS revealed the social obstacles and fragility of intraorganizational relationships that demanded a cautious and tactful approach. While arriving at such findings usually concludes the cyclical process of phenomenological study, Information Systems (IS) research usually demands some independent assessment of the empirical discovery, which led us to conducting a further study focusing on the evaluation of the collected and packaged project managers’ experience. This phenomenological evaluation is in the focus of this paper. By means of a small case study, this project engaged a number of professional teams to reflect upon the previously captured problem-solving experience and determine its applicability, usefulness and relevance in developing new web-based ESS products and services.

Research designs and scientific identity in marketing journals: review and evaluation

Purpose - This research is based upon the assumption that the empirical research designs and the scientific identity of a journal are related. The objective is to review and evaluate the empirical research design of papers to determine the scientific identity of a selection of academic marketing journals. Design/methodology/approach – The journal sample consists of the Australasian Marketing Journal (AMJ), the European Journal of Marketing (EJM) and the Journal of Marketing (JM). The review and evaluation considers a six-year period, namely 2000-2005. The content analysis consisted of 811 papers. Findings – The scientific identity of JM may be seen as built upon quantitative research designs and the North American paradigm of research values. The scientific identity of AMJ is based upon a mix of empirical research designs and the Australian paradigm of research values. The scientific identity of EJM is also based upon a mix of empirical research designs, but a multi-continental paradigm of research values. Research limitations/implications – The leading continental journals in marketing maintain a scientific identity based upon the continental paradigm of research values. If it is driven to the extremes, a paradigmatic myopia and inertia of research designs may evolve that limit the scientific identity to be dogmatic and narrow-focused rather than variable and broad-focused. Originality/value – A cross-continental eview and evaluation of research designs and scientific identity of academic marketing journals is presented.

Regional trade agreements : performance evaluation and research agenda

This paper proposes a broad model for key success factors in Regional Trade Agreements (RTAs). Current literature is relatively limited in its focus on largely economic consequences of RTAs and the externalities are mostly ignored. This model incorporates five predictor dimensions forming the character of a RTA as follows: (1) Economic, (2) Socio-Cultural, (3) Negotiation, (4) Country Objectives and (5) Review process. It proposes a methodology for the empirical testing of the proposed model. The proposed model, potentially, facilitates the measurement of the character of a RTA and its association with various RTA objectives.

Mixed methods evaluation research for a mental health screening and referral clinical pathway

Rationale: This study is an exemplar of mixed method evaluation research for development of a clinical pathway.

Aim: To develop and evaluate an evidence-based, feasible mental health screening and referral clinical pathway for Department of Veterans’ Affairs-funded community nursing care of war veterans and war widows in the Australian context.

Methods: Mixed methods were applied to formulate and clinically evaluate an appropriate pathway. The pathway was applied at urban and rural sites for the nursing care of 97 war veteran and war widow clients. Evaluative data were collected from clients, their informal carers, community nurses, and general practitioners. Chart auditing and pre-post measures were undertaken. Collaboration occurred with an interdisciplinary design team.

Results: The final modified six-page pathway includes use of validated screening tools (Kessler Psychological Distress Scale [K10]) and Alcohol Use Disorder Identification Test, appropriate referral information, directions for support and health-promoting education, and evidence-based guidelines. Implications for Practice: The clinical pathway is a useful, tested, evidence-based guide for generalist community nurses to identify and suitably respond to common mental healthcare needs of war veterans and war widows. The pathway provides outcomes acceptable to clients and their carers, nurses and doctors.

Conclusions: This study provides an evaluated clinical pathway for generalist community nurses to screen for mental health difficulties, make appropriate referrals as required and to support war veteran and war widow clients. However, the study also shows how research can be used to develop and evaluate
practical, evidence-based clinical pathways.

Research my world: crowdfunding research pilot project evaluation

Report evaluating the pilot project Research My World: a collaboration between pozible.com and Deakin University to crowdfund Australian research

International sex offender registration laws : research and evaluation issues based on a review of current scientific literature

In many jurisdictions, anyone convicted of a sexual offense is required to register with police, often for life. Nine different countries have now implemented sex offender registries in an attempt to protect the public from the perceived threat posed by sexual offenders. Yet such laws have been criticized as being overly inclusive, tying up limited law enforcement resources to track many offenders who pose little risk of sexual reoffending. This paper considers the available research evidence relevant to the effectiveness of such laws for the deterrence of sexual offending and the investigation of sex crimes. It is concluded that significant gaps persist in our knowledge of whether existing laws effectively reduce sexual offending or reoffending and that large-scale, well-designed studies of the impact of sex offender registration on rates of offending, the collateral consequences to offenders and their families, and the costs of such laws are needed.

A virtuous circle: the positive evaluation phenomenon in arts audience research

Arts impact evaluation is the subject of widespread criticism, ranging from a detailed critique of methodology to a wholesale rejection of the very purpose of the endeavour. In particular, it is often identified that audience evaluations are almost always positive. Yet whatever the critique, arts impact evaluation is becoming more and not less prevalent as a condition of public and philanthropic funding. This article explores both the methodologicaland conceptual problems that contribute to the perceived positive characterof social impact research, in two parts: (1) an investigation of the critical literature on audience evaluation, particularly in relation to the argument that evaluation is inevitably positive and as such leads to a confusion between the goals of evaluation and arts advocacy; (2) a reflection on our practices as audience researchers in the performing arts and the practical factors that contribute to the dominance of the positive in audience evaluation.

Development, implementation and evaluation of a clinical research engagement and leadership capacity building program in a large Australian health care service

BACKGROUND: Health professionals need to be integrated more effectively in clinical research to ensure that research addresses clinical needs and provides practical solutions at the coal face of care. In light of limited evidence on how best to achieve this, evaluation of strategies to introduce, adapt and sustain evidence-based practices across different populations and settings is required. This project aims to address this gap through the co-design, development, implementation, evaluation, refinement and ultimately scale-up of a clinical research engagement and leadership capacity building program in a clinical setting with little to no co-ordinated approach to clinical research engagement and education.

METHODS/DESIGN: The protocol is based on principles of research capacity building and on a six-step framework, which have previously led to successful implementation and long-term sustainability. A mixed methods study design will be used. Methods will include: (1) a review of the literature about strategies that engage health professionals in research through capacity building and/or education in research methods; (2) a review of existing local research education and support elements; (3) a needs assessment in the local clinical setting, including an online cross-sectional survey and semi-structured interviews; (4) co-design and development of an educational and support program; (5) implementation of the program in the clinical environment; and (6) pre- and post-implementation evaluation and ultimately program scale-up. The evaluation focuses on research activity and knowledge, attitudes and preferences about clinical research, evidence-based practice and leadership and post implementation, about their satisfaction with the program. The investigators will evaluate the feasibility and effect of the program according to capacity building measures and will revise where appropriate prior to scale-up.

DISCUSSION: It is anticipated that this clinical research engagement and leadership capacity building program will enable and enhance clinically relevant research to be led and conducted by health professionals in the health setting. This approach will also encourage identification of areas of clinical uncertainty and need that can be addressed through clinical research within the health setting.

An evaluation of an action research nursing documentation project

AIMS AND OBJECTIVES: The aim of this study is to describe healthcare professionals' experiences and perceptions of an intervention implemented in an action research project conducted to improve nursing documentation practices in four municipalities in Norway.

BACKGROUND: Documentation of individualized patient care is a continuing concern in healthcare services and could impacts the quality and safety of healthcare. Use of electronic systems has made some aspects of documentation more comprehensive, but creation of an individualized care plan remains a pressing issue.

DESIGN: A qualitative descriptive design was used.

METHODS: An action research project was conducted between 2010 and 2012 to improve the content and quality of nursing documentation in community healthcare services in four municipalities. One year after the project was completed four focus group interviews were conducted with healthcare professionals, one for each involved municipality. Two unit managers were interviewed individually. Qualitative content analysis was used.

RESULTS: Three themes emerged: healthcare professionals perceived competing interest; they experienced that they had to manage complexity and changes; and they highlighted a clear and visible leader as important for success.

CONCLUSIONS: Quality improvement activities are essential. Healthcare professionals experience a complicated situation when electronic health record systems do not support workflow. Further research is recommended to focus on the functionality and user interface of EHR systems, and on the role of leadership when implementing changes in clinical practice. This article is protected by copyright. All rights reserved.