Getting the complete picture : combining parental and child data to identify the barriers to social inclusion for children living in low socio-economic areas

Background: Childhood mental health problems are prevalent in Australian children (14–20%). Social exclusion is a risk factor for mental health problems, whereas being socially included can have protective effects. This study aims to identify the barriers to social inclusion for children aged 9–12 years living in low socio-economic status (SES) areas, using both child-report and parent-report interviews.

Methods: Australian-born English-speaking parents and children aged 9–12 years were sampled from a low SES area to participate in semi-structured interviews. Parents and children were asked questions around three prominent themes of social exclusion; exclusion from school, social activities and social networks.

Results: Many children experienced social exclusion at school, from social activities or within social networks. Overall, nine key barriers to social inclusion were identified through parent and child interviews, such as inability to attend school camps and participate in school activities, bullying and being left out, time and transport constraints, financial constraints and safety and traffic concerns. Parents and children often identified different barriers.

Discussion: There are several barriers to social inclusion for children living in low SES communities, many of which can be used to facilitate mental health promotion programmes. Given that parents and children may report different barriers, it is important to seek both perspectives.

Conclusion: This study strengthens the evidence base for the investments and action required to bring about the conditions for social inclusion for children living in low SES communities.

Assessing cultural and linquistic appropriateness of the Rose Angina questionnaire in three ethnic groups

Introduction. Meeting the needs of migrant groups in Europe requires cross-culturally valid questionnaires, a substantial challenge to researchers. The Rose Angina Questionnaire (RAQ) is an important measure of coronary heart disease prevalence. It consists of seven items that collectively yield a diagnosis of angina. It has been shown to perform inconsistently across some ethnic groups in Britain. This study aimed to assess the need for modifying the RAQ for cross-culturally valid use in the three main ethnic groups in Scotland.

Methods. Interviews were carried out with Pakistani Punjabi speakers (n=26), Chinese Cantonese speakers (n=29) and European-origin English speakers (n=25). Bilingual project workers interviewed participants and provided translation and commentary to the English-speaking researcher. Participants were asked about general and cardiovascular health beliefs and behaviours, and about attitudes to pain and chest pain. They were also asked to comment on their understanding of an existing version of the RAQ in their language.

Results. No dominant themes in the cultural construction of health, pain or cardiovascular knowledge emerged that may significantly influence RAQ response between language groups. Problems were encountered with the Punjabi and Cantonese translations of the RAQ. For example, the translation for “chest” was interpreted by some Pakistani and fewer Chinese women to mean “breasts”. “Walking uphill” was translated in Chinese as “walking the hill”, without stipulation of the direction, so that some Cantonese speakers interpreted the question as meaning walking downhill. In addition, many Chinese interpreted RAQ items to be referring to breathlessness rather than chest pain due to ambiguous wording.

Conclusion. Existing Punjabi and Cantonese versions of the RAQ should be modified before being used in multi-ethnic surveys. Current versions are unlikely to be yielding data that is comparable across groups. Other language versions also require similar investigation to study the cardiovascular health of Europe’s migrant groups.

Social democracy in northern Europe : its relevance for Australia

Social democrats in English-speaking countries have frequently looked to Sweden and its neighbours as offering a policy model that combines economic prosperity with social equality. In recent decades this admiration has dissipated due to a sense that comprehensive welfare provision in the Nordic nations is in retreat and that policy options for small states have been reduced by ‘globalisation’. Yet there remains strong evidence of economic and social achievement in various northern European nations, maintained by policies which continue to be more recognisably social democratic than elsewhere. This article examines Australian policy interest in Scandinavia, especially the 1986 union mission that produced the report, Australia Reconstructed. The article situates that mission in the history of interest in the Swedish model in the wider English-speaking world, with the aim of exploring the extent to which social democracy in the north of Europe remains intact and relevant.

Modelling dimensionality of cultural experience attitudes for international tourists

This empirical research of tourists’ cultural experiences aims to advance theory by developing a measurement model of attitudes towards attending cultural experiences for a sample of international tourists visiting Melbourne, Australia. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to cross-validate the underlying dimensionality structure of cultural experience attitudes in the model. A five-factor model was extracted from the EFA and some further modifications were required to establish discriminant validity. A four-factor model was retained in the CFA, which included three factors based on a liking for different types of cultural experiences and one factor indicating that social interaction was the most liked socio-psychological attitude towards attending cultural experiences. Although the sample were all English-speaking international tourists, cross-cultural validation of the model was also examined for factor configural and metric invariance of the measurement model as there were three different groups of international tourists within the sample: North Americans; New Zealanders; and tourists from United Kingdom and Ireland. This measurement structure was found to be relatively invariant for the factor loadings across the three groups of international tourists.

Cultural experience tourist motives dimensionality : a cross-cultural study

This empirical research of tourists’ cultural experiences aims to advance theory by developing a measurement model of tourists’ motives towards attending cultural experiences for samples of Western and Asian tourists visiting Melbourne, Australia. Drawing upon Iso-Ahola’s (1989) seeking/avoiding dichotomy theory for tourist motivation dimensions, the hypothesized dimensions primarily included escape and seeking-related dimensions, and some hedonic dimensions because of their relevance to aesthetic products (Hirschman & Holbrook, 1982; Holbrook & Hirschman, 1982), which are the context for this study. Exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) were used to crossvalidate the underlying dimensionality structure of cultural experience motives. A four-factor model was extracted from the EFA consistent with some theoretical formulations and was retained in the CFA. Specific cultural language group differences for the motive dimensions were also hypothesized between Western and Asian tourist samples, and within the Chinese- and Japanese-speaking Asian tourist samples, but not within the different cultural groups of English-speaking Western tourists. These cross-cultural hypotheses were tested for the motive dimension measurement model using invariance testing in CFA. The findings for the motive dimensions differing by cultural group were not as expected. Significant cultural differences between Western and Asian tourists were not found, but a new finding of this study was significant differences between English-speaking tourists in their motives for attending cultural experiences. Marketing implications of these findings are also presented.

A comparative analysis of Australian sex offender legislation for sex offender registries

Australia has followed the course taken by other English-speaking countries in recent years of enacting legislation that requires convicted sexual offenders to register personal details with law enforcement agencies. These laws have been enacted to protect the public from the perceived threat posed by sex offenders, but have been written with little apparent reference to the available research literature about the nature and extent of this threat. In addition, there is no empirical evidence supporting the effectiveness of legislatively based sex offender registries to either reduce sexual offending or to enable the police to investigate sex crimes and apprehend offenders. This article compares and contrasts the current laws governing sex offender registration enacted by the various states and territories in Australia, and offers a critical analysis of their provisions in light of the research literature on sexual offending.

Protocol for a randomized controlled trial of a specialized health coaching intervention to prevent excessive gestational weight gain and postpartum weight retention in women : the HIPP study

Background

Pregnancy is a time of significant physiological and physical change for women. In particular, it is a time at which many women are at risk of gaining excessive weight. We describe the rationale and methods of the Health in Pregnancy and Post-birth (HIPP) Study, a study which aims primarily to determine the effectiveness of a specialized health coaching (HC) intervention during pregnancy, compared to education alone, in preventing excessive gestational weight gain and postpartum weight retention 12 months post birth. A secondary aim of this study is to evaluate the mechanisms by which our HC intervention impacts on weight management both during pregnancy and post birth.
Methods/Design

The randomized controlled trial will be conducted with 220 women who have a BMI > 18.5 (American IOM cut-off for normal weight), are 18 years of age or older, English speaking, no history of disordered eating or diabetes and are less than 18 weeks gestation at recruitment. Women will be randomly allocated to either a specialized HC intervention group or an Education Alone group. Our specialized HC intervention has two components: (1) one-on-one sessions with a Health Coach, and (2) two by two hour educational group sessions led by a Health Coach. Women in the Education Alone group will receive two by two hour educational group sessions with no HC components. Body Mass Index, waist circumference, and psychological factors including motivation, readiness to change, symptoms of depression and anxiety, and body dissatisfaction will be assessed at baseline (14-16 weeks gestation), and again at follow-up: 32 weeks gestation, 6 weeks, 6 months and 12 months postpartum.
Discussion

Our study responds to the urgent need to design effective interventions in pregnancy to prevent excessive gestational weight gain and postpartum weight retention. Our pregnancy HC intervention is novel and innovative and has been designed to be easily adopted by health professionals who work with pregnant women, such as obstetricians, midwives, allied health professionals and health psychologists.

Interventions for preventing obesity in children (review)

Background

Prevention of childhood obesity is an international public health priority given the significant impact of obesity on acute and chronic diseases, general health, development and well-being. The international evidence base for strategies that governments, communities and families can implement to prevent obesity, and promote health, has been accumulating but remains unclear.
Objectives

This review primarily aims to update the previous Cochrane review of childhood obesity prevention research and determine the effectiveness of evaluated interventions intended to prevent obesity in children, assessed by change in Body Mass Index (BMI). Secondary aims were to examine the characteristics of the programs and strategies to answer the questions "What works for whom, why and for what cost?"
Search methods

The searches were re-run in CENTRAL, MEDLINE, EMBASE, PsychINFO and CINAHL in March 2010 and searched relevant websites. Non-English language papers were included and experts were contacted.
Selection criteria

The review includes data from childhood obesity prevention studies that used a controlled study design (with or without randomisation). Studies were included if they evaluated interventions, policies or programs in place for twelve weeks or more. If studies were randomised at a cluster level, 6 clusters were required.
Data collection and analysis

Two review authors independently extracted data and assessed the risk of bias of included studies. Data was extracted on intervention implementation, cost, equity and outcomes. Outcome measures were grouped according to whether they measured adiposity, physical activity (PA)-related behaviours or diet-related behaviours. Adverse outcomes were recorded. A meta-analysis was conducted using available BMI or standardised BMI (zBMI) score data with subgroup analysis by age group (0-5, 6-12, 13-18 years, corresponding to stages of developmental and childhood settings).
Main results

This review includes 55 studies (an additional 36 studies found for this update). The majority of studies targeted children aged 6-12 years. The meta-analysis included 37 studies of 27,946 children and demonstrated that programmes were effective at reducing adiposity, although not all individual interventions were effective, and there was a high level of observed heterogeneity (I2=82%). Overall, children in the intervention group had a standardised mean difference in adiposity (measured as BMI or zBMI) of -0.15kg/m2 (95% confidence interval (CI): -0.21 to -0.09). Intervention effects by age subgroups were -0.26kg/m2 (95% CI:-0.53 to 0.00) (0-5 years), -0.15kg/m2 (95% CI -0.23 to -0.08) (6-12 years), and -0.09kg/m2 (95% CI -0.20 to 0.03) (13-18 years). Heterogeneity was apparent in all three age groups and could not explained by randomisation status or the type, duration or setting of the intervention. Only eight studies reported on adverse effects and no evidence of adverse outcomes such as unhealthy dieting practices, increased prevalence of underweight or body image sensitivities was found. Interventions did not appear to increase health inequalities although this was examined in fewer studies.
Authors' conclusions

We found strong evidence to support beneficial effects of child obesity prevention programmes on BMI, particularly for programmes targeted to children aged six to 12 years. However, given the unexplained heterogeneity and the likelihood of small study bias, these findings must be interpreted cautiously. A broad range of programme components were used in these studies and whilst it is not possible to distinguish which of these components contributed most to the beneficial effects observed, our synthesis indicates the following to be promising policies and strategies:

· school curriculum that includes healthy eating, physical activity and body image

· increased sessions for physical activity and the development of fundamental movement skills throughout the school week

· improvements in nutritional quality of the food supply in schools

· environments and cultural practices that support children eating healthier foods and being active throughout each day

· support for teachers and other staff to implement health promotion strategies and activities (e.g. professional development, capacity building activities)

· parent support and home activities that encourage children to be more active, eat more nutritious foods and spend less time in screen based activities

However, study and evaluation designs need to be strengthened, and reporting extended to capture process and implementation factors, outcomes in relation to measures of equity, longer term outcomes, potential harms and costs.

Childhood obesity prevention research must now move towards identifying how effective intervention components can be embedded within health, education and care systems and achieve long term sustainable impacts.

Characteristics of participants in Australia's Get Healthy telephone-based lifestyle information and coaching service : reaching disadvantaged communities and those most at need

To address increasing rates of overweight and obesity, a population-based telephone intervention was introduced in New South Wales, Australia. The Get Healthy Information and Coaching Service® (GHS) offered participants a 6-month coaching program or detailed self-help information. Determining the population reach of GHS is of public health importance to ensure that the program reaches disadvantaged groups. This paper describes the socio-demographic and risk profile of participants (n = 4828) in the first 18 months of operations, determines how representative they are of the population, assesses changes in participants’ socio-demographic profile and compares ‘information-only’ and ‘coaching’ participants. The results show that GHS users are representative of the adult population in relation to education, employment status, Aboriginal status, fruit and vegetable consumption and alcohol use. However, more female, middle-aged, English-speaking, rural and socially disadvantaged adults participated in GHS. Coaching Participants were more likely to be overweight and to be ex-smokers than the general population. There was substantial variability in GHS recruitment, when mass-reach television advertising was used, participants enrolled from a major city and from more disadvantaged communities. The GHS has broader population reach than many local interventions, but further efforts are needed to increase reach by Aboriginal communities, other minorities and men.

The influence of cultural orientations on cross-cultural negotiation

This study analysed a series of negotiation simulations conducted between English-speaking background Australians and Arabic-speaking background Gulf Cooperation Council (G.C.C.) nationals. The processes and behaviours of participants within their own cultures and across the two cultures were mapped and explained using prevalent cross-cultural communication theories.

Concessivity in scholarly prose : an intercultural study

Miscommunication has always intrigued researchers in and outside linguistics. This book takes a different perspective from what has been proposed so far and postulates a case for intercultural miscommunication as a linguistically-based phenomenon in various intercultural milieus. The contributions address cases of intercultural miscommunication in potentially confrontational contexts, like professional communities of practice, intercultural differences in various English-speaking countries, political discourse, classroom discourse, or the discourse of the past. The frameworks employed include cultural scripts, critical discourse analysis, lexicographic analysis, glosses of untranslatable terms, and diachronic pragmatics. The book shows the omnipresence of miscommunication, ranging from everyday exchanges through classroom discourse, professional encounters, to literary contexts and political debates, past and present.

Elaborative relational structures in the research prose of sociology : an intercultural study

This paper investigates elaborative relational structures utilised by native English speaking and native Polish speaking scholars in sociology research articles written in English. The examined texts have been produced in American, Australian and Polish academic discourse communities. The study utilised the framework of the analysis of the rhetorical structure of tests (FARS) as an analytical tool (Golebiowski 2009, 2011). The following types of elaboration relations are discussed : amplification, extension, reformulation, explanation, instantiation and addition. Elaboration is analysed with respect to its textual function, frequency of employment, hierarchical location, recursiveness, discoursal prominence and explicitness. The elaborative systems in the examined texts are shown to be complex, with pervasive presence of multi-stage recursive structures. It is suggested that elaborativeness may be a general characteristic of the style of writing sociology, which, as a relatively new discipline, requires establishing of wide grounds for the proposed claims, where writers persuade their readers not only of the specific claims of their text, but also of frameworks of thought in which the claims are placed. It is hypothesized that the similarities in the elaborativeness across texts result from the shared stylistic conventions and traditions of the disciplinary research community of sociology, while differences in the mode of employment of elaboration relations are attributed to cultural norms and conventions as well as educational systems prevailing within the discourse communities constituting the social contexts of the studied texts.
Golebiowski, Z. (2011). Scholarly criticism across discourse communities. In Salager-Meyer, Françoise and Lewin, Beverly A. (eds), Crossed words : Criticism in scholarly writing, pp. 203-224, Peter Lang International Academic Publishers, Berlin, Germany.
Golebiowski Z. (2009). The use of contrastive strategies in a sociology research paper: A cross-cultural study. In Suomela-Salmi, Eija and Dervin, Fred (eds), Cross-linguistic and cross-cultural perspectives on academic discourse, pp. 165-186, John Benjamins Publishing Company, Philadelphia.

A psychometric evaluation of the Learning Styles Questionnaire : 40-item version

Sixty-six English-speaking postgraduate distance-education medical students completed the Learning Styles Questionnaire (LSQ: 40-item version). This was completed while attending a residential workshop at the beginning of the semester, and 44 of these students completed the same LSQ questionnaire 5 months later at the completion of the semester. The psychometric properties of the LSQ were assessed using Cronbach’s alpha (internal consistency), test-retest, correlational analyses and factor analysis. The results indicated that the LSQ (40-item version) has poor reliability and validity, and therefore requires further development and psychometric evaluation.

The potential for measuring ethnicity and health in a multicultural milieu - the case of type 2 diabetes in Australia

Objective
Ethnicity influences health in many ways. For example, type 2 diabetes (T2DM) is disproportionately prevalent among certain ethnic groups. Assessing ethnicity is difficult, and numerous proxy measures are used to capture its various components. Australian guidelines specify a set of variables for measuring ethnicity, and how such parameters should be categorised. Using T2DM data collections as an illustrative example, this study sought to examine how ethnicity is measured in Australian health databases and, by comparing current practice with Australia’s existing benchmark recommendations, to identify potential areas for improvement of the health data landscape.

Australian police officers' perceptions of sex offender registries

Sex offender registration schemes exist in most English speaking countries to assist police in the investigation of new crimes and to deter known offenders. To date, however, very little research has examined the efficacy of these registers. This study addresses this issue by providing the first qualitative analysis of police officers' perceptions of registration schemes. Twenty-four Australian police professionals (whose jobs were primarily associated with the operation of sex offender registration schemes) participated in focus groups in groups of 2–5 officers. Officers were recruited across three jurisdictions where quite distinct registration schemes operated. They were asked to reflect on how their register operates, how effective and efficient it is, the challenges faced in its administration and how the registry process might be improved. The key challenges addressed included; limitations in risk assessment expertise, restriction in legislative powers, and inadequate opportunity for specialisation. The implications for current practice are discussed.