Implementing the Flinders Model of self-management support with Aboriginal people who have diabetes : findings from a pilot study

A pilot program for Aboriginal people with diabetes on Eyre Peninsula, South Australia, aimed to test the acceptability and impact of using the Flinders model of self-management care planing to improve patient self-management. A community development approach was used to conduct a twelve-month demonstration project. Aboriginal health workers (AHWs) conducted patient-centred, self-management assessment and care planning. Impacts were measured by patient-completed diabetes self-management assessment tool, goal achievement, quality of life and clinical measures at baseline and 12 months. Impact and acceptability were also assessed by semi-structured interviews and focus groups of AHWs. Sixty Aboriginal people with type 2 diabetes stated their main problems as family and social dysfunction, access to services, nutrition and exercise. Problems improved by 12% and goals by 26%, while quality of life scores showed no significant change. Self-management scores improved in five of six domains. Mean HbA1c reduced from 8.74-8.09 and mean blood pressure was unchanged. AHWs found the process acceptable and appropriate for them and their patients. It was concluded that a diabetes self-management program provided by AHWs is acceptable, improves self-management and is seen to be useful by Aboriginal communities. Barriers include lack of preventative health services, social problems and time pressure on staff. Enablers include community concern regarding the prevalence and mortality associated with diabetes.

Healthy nature healthy people: 'contact with nature' as an upstream health promotion intervention for populations

Whilst urban-dwelling individuals who seek out parks and gardens appear to intuitively understand the personal health and well-being benefits arising from `contact with nature', public health strategies are yet to maximize the untapped resource nature provides, including the benefits of nature contact as an upstream health promotion intervention for populations. This paper presents a summary of empirical, theoretical and anecdotal evidence drawn from a literature review of the human health benefits of contact with nature. Initial findings indicate that nature plays a vital role in human health and well-being, and that parks and nature reserves play a significant role by providing access to nature for individuals. Implications suggest contact with nature may provide an effective population-wide strategy in prevention of mental ill health, with potential application for sub-populations, communities and individuals at higher risk of ill health. Recommendations include further investigation of `contact with nature' in population health, and examination of the benefits of nature-based interventions. To maximize use of `contact with nature' in the health promotion of populations, collaborative strategies between researchers and primary health, social services, urban planning and environmental management sectors are required. This approach offers not only an augmentation of existing health promotion and prevention activities, but provides the basis for a socio-ecological approach to public health that incorporates environmental sustainability.

Stakeholder involvement in the EMS adoption process

This paper summarises the findings of the qualitative part of a large study aimed at exploring the extent of involvement of organisational stakeholders (employees and suppliers) during the environmental management system (EMS) adoption process. Interviews with nine senior/middle managers from Australian manufacturing and service organisations revealed the growing awareness of the impact of their products and processes on the ecological and social environments. Moreover, implementation of an EMS or waste management system (WMS) is accepted as a learning curve by both the organisation and its stakeholders, including its employees. Organisations at the same time are also contemplating the need for certifying their existing EMS against international standards such as ISO 14001 based on the cost-benefits resulting from the certification.

'Green' treatment of acid mine drainage - a step towards sustainability

Sustainability is becoming increasingly important in the mining and mineral processing industries and must incorporate the associated waste products. Acid mine drainage (AMD) is one such by-product and is one of the most serious environmental problems facing the minerals industry today. The oxidation of sulphidic mine wastes often continues for a substantial period of time after mine closure, resulting in difficult and costly remediation and rehabilitation works. Mining companies are often reluctant to spend increasing amounts of money on waste treatment when the mine life is limited or even finished. Hence a simple, low maintenance and low-cost method of treating AMD is required. Whilst this paper does not address the issue of AMD, it does propose methods for removal of individual species from AMD with potential benefits, including raising AMD pH.

A novel concept of using biosolids as a biological adsorbent, or ‘biosorbent’, of metals from AMD is being investigated at a laboratory/pilot scale level. Biosolids are a by-product resulting from the biological treatment of wastewater, and have been previously shown to adsorb metals from aqueous solutions. This could lead to an environmentally sustainable or ‘green’ method for treating both AMD discharges and disposing/reusing the biosolids.

The result of a laboratory-scale study of the biosorption of Zn(II) is presented in this paper. Physical parameters including reaction kinetics, mixing speed and solution pH were investigated. Solution pH also rose an average of 2 pH units over the 24 hour equilibrium time – a valuable side effect when treating acid mine drainage. The outcome of the study highlights the usefulness of biosolids as a biosorbent for the removal/recovery of metal ions from acid mine drainage. A simple, low-cost treatment technology requiring low maintenance would be beneficial to the mining industry to address some issues relating to AMD and would help integrate environmental and economic considerations into sustainable environmental management.

Community participation in HIA: discords in teleology and terminology

Core HIA documents, researchers and practitioners assert the significance of community participation in health impact assessment. Despite the rhetoric, there has been little critical examination of the role of community participation in HIA. Knowledge and debate regarding what constitutes community participation and how it may best be achieved is often confused and opinion is divided as to its usefulness and appropriateness for HIA. This paper does not seek to argue the merits or drawbacks of community participation; rather, the authors explore the origins and character of the current discord around public participation in HIA and provide a lexicon for moving practice and discussion forward. The authors argue that the origins of the participation problem stem from: (1) unexplored tensions within the Gothenburg consensus paper and other formative documents in the development of HIA; (2) inherent tensions arising from the dual origins of HIA, specifically Environmental Impact Assessment (EIA) and Healthy Public Policy (HPP); and (3) a lack of rigour and clarity relating to the terminology of community participation where community participation is used as a 'catch all' phrase for every situation without critical examination. In order to move debate forward, the authors advance a model, the Typology of Public Involvement in HIA, for guiding discussion of community participation. This model comprises a set of context-specific HIA approaches with varying degrees of public involvement. The model also presents a suite of defined terms for understanding and discussing participation.

The MOA framework and behavioural response

This paper discusses the application of a conceptual social marketing model, the MOA (motivation, opportunity and ability) framework, in the context of an environmental management case study relating to land management. The main objectives involved examination of the relationships between the MOA constructs and the relationships between these constructs and socially desirable behaviour. Structural Equation Modelling was chosen to examine the relationships in data collected from a telephone survey. The results from the analysis of the data revealed that the relationships between the MOA components could be used to explain changes in durable socially desirable behaviour. In particular, intrinsic motivation is more likely than extrinsic motivation to produce a durable socially desirable behaviour change.

Effects of clay amendment on adsorption and desorption of copper in water repellent soils

Copper is an important micronutrient and trace amounts are essential for crop growth. However, high concentrations of copper will produce toxic effects. Australia is increasingly developing production of crops in water repellent soils. Clay amendment, a common amelioration techniques used in Australia, has demonstrated agronomic benefits in increased crop or pasture production. The sorption and desorption of copper and the effect of clay treatment on copper behaviour in a water repellent soil collected from an experimental farm in South Australia is studied. We found that the water repellent soils amended with clay have an increased adsorption capacity of copper. Also the clay-amended soils had an increased ratio of specific sorption to total sorption of copper. The implications of this study to the sustainable agro-environmental management of water repellent soils is discussed.

Competitive sorbtion of metals in water repellent soils: implications for irrigation recycled water

Australia is a water-stressed nation and demand on potable water supply is increasing. Consequently water conservation and reuse are increasingly becoming important. Irrigation of recycled wastewater on water repellent soils is a technology that is being trialled as a means of improving crop production and conserving potable supply. However, recycled water contains potentially harmful heavy metals. This paper reports the competitive sorption and desorption of several common heavy metals found in soils collected from a farm located in the south-east of South Australia. The soil from this location is severely water repellent, but some sites were amended with kaolinite clay (Si₄Al₄O₁₀(OH)₈) about 7 and 15 years ago. The metals studied were Cu, Pb, Cd, Cr, Ni, and Zn. Competitive sorption of the metals was distinctly observed. For all heavy metals, the quantity of metal sorbed was higher in amended soil, and there was a strong correlation between the specific sorption to total sorption ratio and the amount of clay in the soil. The sorption intensities varied with metal, Cr, Pb, and Cu having a high sorption tendencies and Zn, Cd, and Ni having comparatively low sorption tendencies. The total sorption capacity for all metals increased in clay-treated soils compared with non-treated soils. On average, clay-amended water repellent soils had a 20–40% increased capacity to adsorb total metals; however, this increase was largely caused by the increased capacities to adsorb Zn, Cd, and Ni. The effect of clay treatment largely enhanced the sorption capacity of relatively weakly adsorbing heavy metals. The implications for using recycled wastewater on the long-term sustainable agro-environmental management of these soils are discussed.

Understanding the Components in Social Behavioural Change: Implications for Non-profit Organisations

In this paper we investigate the relationship between intrinsic motivation, extrinsic motivation and government influence with the over riding objective of developing more effective and efficient social behavioural change programs that have been instigated by public sector environmental management organisations. Based on the notion of intrinsic and extrinsic motivation, which has previously been shown to explain altitudes and behaviour associated with environmental issues, we extend the analysis in this paper to include the influence of government. A survey of a random sample of 566 landmanagers in South-eastern Australia was conducted and the data collected subsequently analysed using a structural equation modelling approach. The model that was developed identified the relationship between intrinsic motivation, extrinsic motivation and government influence.

Towards the confirmation of the MOA model : an applied approach

The aim of this paper is to develop a grounded understanding of the role that the MOA constructs play in influencing environmentally responsible  behaviour. Data collected is used to qualitatively confirm the MOA Model (Rothschild, 1999) in an environmental management application and provide a basis to inform the development of a comprehensive quantitative causal investigation. This study will seek to determine the specific contributions of each MOA factor in the study context. The case study chosen for this investigation is representative of other social marketing applications for the MOA framework. The case study concerns the behaviour of agrarian land managers with respect to the rabbit pest problem affecting rural Australia. The paper concludes by confirming the appropriateness of the constructs within the MOA Model.

Sustainability and health : supporting global ecological integrity in public health

Radical changes in the biosphere and human interaction with the environment are increasingly impacting on the health of populations across the world. Diseases are crossing the species barrier, and spreading rapidly through globalized transport systems. From new patterns of cancer to the threat of global pandemics, it is imperative that public health practitioners acknowledge the interdependence between the sustainability of the environment and the sustainability of the human species.* Why are issues of global and local sustainability of increasing importance to the public's health?* Why do issues of sustainability require new practices within the professions of public health?* How can future and current public health practitioners develop those new practices?Drawing on scientific evidence of global and local environmental changes, Sustainability and Health offers a thorough background and practical solutions to the overlapping issues in environment and health. It examines potential and existing responses to global and local environment and health issues, involving individuals, community, industry and government. The authors introduce a range of emerging conceptual frameworks and theoretical perspectives, link IT and epidemiology and explain how scoping can link program design, delivery, data collection and evaluation in projects from their very beginning. Public health practitioners need to be able to manage health issues that cut across environmental, economic and social systems and to develop the capacity for leadership in facilitating change. Incorporating learning activities, readings, international case studies and an open learning approach, this is a valuable resource for students of public and environmental health, as well as medical, environmental and health science professionals.

People, places and public health : evaluating the benefits of civic environmentalism in an urban local government context

Recent political, economic and social trends pose threats to the sustainability both of ecosystems and of human health. Australia’s environmental management record is poor, and while by international standards Australians enjoy good health, this is variable (AIHW, 2000). Within developed nations, heart disease, depression, alcohol dependence and stroke are major health issues (Mathers et al. 2002). In Australia, mental disorder is the number one contributor to the disease burden (Vos & Mathers 2000). Recent research has highlighted the role of social capital as a key determinant of health (Kawachi et al., 1997). Despite this, Putnam (1995) observes that social connectedness and civic engagement are in decline. People have less time for leisure and for volunteering, as many juggle paid work and caring for children. Anecdotal evidence suggests that engagement in civic environmentalism has human health benefits, relating to a combination of exposure to natural environments and increased social capital (Maller, Brown, Townsend & St. Leger, 2002). This link is supported by Furnass (1996) who defines well-being as including: satisfactory human relationships, meaningful occupation, opportunities for contact with nature, creative expression, and making a positive contribution to human society. Research conducted by Deakin University confirms the efficacy of linking people and places through civic environmentalism for addressing both ecosystem sustainability and human health and wellbeing. The research has included a pilot study to explore the human health benefits of membership of a local parkland ‘Friends’ group, and a more detailed follow-up study. The aims of the pilot study included:- To identify the range of motivations for joining the Friends group;- To document members’ perceptions of the benefits gained from membership of the group;- To assess the potential for Friends groups to be used as an ‘upstream’ health promotion measure.Face-to-face interviews were conducted with eleven members of a ‘Friends’ group in the eastern suburbs of Melbourne. Data was analysed thematically and key findings included:- Motivations: environmental; social; and pragmatic.- General benefits: community belonging; personal satisfaction; learning opportunities; physical activity; and better environment.- Health benefits: physical health; mental health; and social support. There was unanimous support for the use of ‘Friends’ groups as a tool for health promotion.The follow-up study, in the western suburbs of Melbourne, expanded on the pilot study by measuring the group’s social capital and by collecting self-report data on levels of health service usage. Data was collected through face-to-face interviews and a questionnaire. The findings were similar to the pilot study in relation to the motivations, benefits and the health promotion potential of such groups. However, health service usage data highlighted an apparent anomaly: while respondents perceived significant health benefits, some were nevertheless utilising health services at a relatively high level. This poses some questions requiring further exploration: Is this due to the poorer baseline health of the high health service usage members compared with their fellow members? Does involvement in the group offer health benefits that enable people who would otherwise be too unhealthy to participate in community groups to continue such involvement?If this is the case, then we may do well to look to locally-based mechanisms for promoting ecological sustainability as a tool also for promoting human health. Instead of prescribing a pill, connecting people and places through engagement with a local friends group may address our health problems at the same time as addressing local environmental problems.

The impact of small business on the environment

Objectives: Small businesses are estimated to contribute a significant proportion of global pollution, yet there is little empirical evidence to support this claim. The main aim of this research was to conduct an exploratory analysis of small business’s environmental impact in terms of waste, water and energy.

Prior work: Due to the negative impact small businesses are reported to have on the environment, their disengagement in environmental management practices has caused international concern. Much of the literature has concentrated on identifying the barriers and drivers of small business engagement. Little empirical work being conducted on the actual impact of they have on the environment or on the influence of the local context on their environmental practices.

Approach: A survey was developed and distributed to 466 small businesses within two light industrial areas in Perth Western Australia, which achieved a response rate of 87%. This survey will be replicated after a 12 month intervention is conducted. The two light industrial areas were selected as their Local Government Authorities are looking for businesses within their boundaries to improve their environmental performance.

Results: Initial results suggest that the small businesses do have a considerable impact on the environment in terms of waste disposal. Moreover, their environmental management practices concerning waste, energy and water were found to differ depending on the local contexts in which the small businesses operate.

Implications: As small businesses are both economically and socially important to all major industrialised nations, empirical research that provides evidence of their impact on the environment is critical. The implication here is that if the context in which these businesses operate influences the practices employed, developing strategies that acknowledge the influence and consequences of context may be more effective than those currently available. Differences identified within practices suggest that greater awareness and education is needed on water management than energy or waste, as this is the area where small business owner-managers have shown they have less knowledge and/or active engagement.

Value: This research is valuable in three ways. First, it adds to the knowledge of small business impact on the environment. Second, it identifies that context may be a factor that needs to be considered when developing strategies to engage small businesses in environmental management. Finally, it shows that the environmental management of water is the least well established environmental priority of small businesses at this time.

Model of behavioural response in social marketing

This thesis contributes to the expanding area of non-profit and social marketing research. The research developed a new conceptual model that was applied to environmental management and provides an understanding of the components that contribute to durable behaviour change in social marketing applications.