The Health Education Impact Questionnaire (heiQ): An outcomes and evaluation measure for patient education and self-management interventions for people with chronic conditions

Objective: This paper describes the development and validation of the Health Education Impact Questionnaire (heiQ). The aim was to develop a user-friendly, relevant, and psychometrically sound instrument for the comprehensive evaluation of patient education programs, which can be applied across a broad range of chronic conditions.

Methods: Item development for the heiQ was guided by a Program Logic Model, Concept Mapping, interviews with stakeholders and psychometric analyses. Construction (N = 591) and confirmatory (N = 598) samples were drawn from consumers of patient education programs and hospital outpatients. The properties of the heiQ were investigated using item response theory and structural equation modeling.

Results: Over 90 candidate items were generated, with 42 items selected for inclusion in the final scale. Eight independent dimensions were derived: Positive and Active Engagement in Life (five items, Cronbach's alpha (α) = 0.86); Health Directed Behavior (four items, α = 0.80); Skill and Technique Acquisition (five items, α = 0.81); Constructive Attitudes and Approaches (five items, α = 0.81); Self-Monitoring and Insight (seven items, α = 0.70); Health Service Navigation (five items, α = 0.82); Social Integration and Support (five items, α = 0.86); and Emotional Wellbeing (six items, α = 0.89).

Conclusion:The heiQ has high construct validity and is a reliable measure of a broad range of patient education program benefits.

Practice Implications: The heiQ will provide valuable information to clinicians, researchers, policymakers and other stakeholders about the value of patient education programs in chronic disease management.

Education and training institutions : building social capital for regional development

Education and training institutions from schools through to universities have a vital role in supporting development in regional Australia. The interaction between these institutions and their rural communities influences the social capital of the community and the extent to which the community is a learning community, willing and able to manage change to the community’s advantage.

There are benefits to be had from a collaborative approach to planning and delivering training. This approach is consistent with theories of social capital that emphasise the crucial part played by networks, values and trust in generating superior outcomes for individuals, communities and regions. Research has found that education and training is most effective in building social capital and learning communities were there is attention to customising or targeting education and training provision to local needs. The key to matching provision with local needs, particularly in the more rural and remote areas, is collaboration and partnerships. Partners can be regional organisations, other educational institutions, businesses and government. The factors that enhance the effectiveness of the collaborations and partnerships are the elements of social capital: networks, shared values and trust, and enabling leadership.

Networks are most effective where there were opportunities and structures for interaction, which can be termed interactional infrastructure, that foster networks within the region, and networks that extended outside the region. Interactional infrastructure includes regional forums, committee structures, consultative processes and opportunities for informal discussion addressing the issues of education, training and employment in a community or region. Better outcomes are evident when there is an interactional infrastructure that is resourced with financial, physical and human resources of sufficient quantity and quality. Collaborations provide access to a greater range of external resources through extended external networks. Effective networks and shared visions, values and trust among the partners in a collaboration, are fostered by enabling leaders. Educational institutions are well placed to supply the ‘human infrastructure’ that makes collaborations and partnerships work, including enabling leadership.

Attention to factors associated with the quality of social capital, especially interactional infrastructure including leadership, shared vision and values and networks within and external to the community, can be expected to improve the effectiveness of education and training outcomes. More importantly, a collaborative approach to planning for education and training in rural regions will build the capacity of regions and their constituent communities to develop and change by building social capital resources. Leadership is an important driver of processes that build community and regional capacity and ultimately produce social and economic benefits through regional development. Educational providers in rural regions are well placed to act as enabling leaders.

Developing effective learning programs : what extension can learn from the fields of adult education and learning communities

Learning is an investment in capacity building that has and will continue to reap rewards for primary producers and government in terms of increased sustainable production, profitability, exports, jobs and sustainable rural communities. Primary production operates in a context of continual change and requires up to date, complex and varied skills of primary producers and land managers.

A recent national research project funded by the Department of Agriculture, Forestry and Fisheries Australia confirmed that application of best practice from the theory of adult education in designing and developing learning programs in primary industry results in learning activities that provide information that is relevant to farmers’ needs, delivered in an entertaining way, and that draws on examples directly relevant to the participants. As a result, the training often exceeds the expectations of the participants.

The project produced a self-assessment checklist to identify ways of improving the development and delivery of training for extension practitioners and training providers. The key issues include continuous monitoring of client’s needs, and actively seeking opportunities to meet and work with industry organisations, other training providers and funding bodies.

There appear to be two drivers for the development of learning programs. One is problems or opportunities identified by people and organisations that could be termed ‘scanners’ and who tend not to be potential participants, the other is learning needs expressed by individuals or enterprises who want to participate in learning activities (participants). Scanners are typically industry organisations, government agencies and researchers, but may include providers and participants. Extension practitioners are well-placed to act as scanners.

It is very important that farmers and farmer organisations contribute to the development of new learning programs. Without industry input and support, extension practitioners and training providers cannot be expected to ensure they meet client needs. In other words, to develop effective learning programs, there must an industry learning community of producers, industry organisations, extension practitioners and training providers and other stakeholders such as supply chain enterprises, government and researchers.

Restructuring of education and training in Vietnam : a development and application of arts management training in Australia to Vietnam

The adoption of a more market-oriented economy under doi moi has paved the way for Vietnam to record remarkable human development achievements in the past decades. The Vietnamese education system has been undergoing continuous changes for almost twenty years. Key reforms have been implemented in the education and training sector such as privatising the sector; expanding the schooling system, the vocational education and training (VET) system, and higher education. This paper examines: (1) key reforms implemented in the education and training sector, placed in a broader context of economic reforms in Vietnam; (2) a development of arts management training courses in Vietnam to assist cultural organisations to adjust to social changes, as Vietnamese education institutions have not had much experience in designing training courses in arts and culture management; (3) several arts management training courses in Australian institutions to see the possibility to apply training in arts management in Australia to Vietnam. The findings indicate that a variety of management training modes in Australia can be adapted and applied to the Vietnamese training context. Some factors such as differences in culture, education and training systems, shortages in training staff and resources are also considered in this paper.

International education and challenges for Australia (case study)

The content of this 3rd edition marketing research textbook is practical and up to date and is based on an applied and managerially focused approach. Australian an New Zealand research and examples have been thoroughly intergrated into every chapter.

Education and the colonial construction of whiteness

European imperialism spawned settlements of invasive white communities throughout Asia and Africa. Stoler and Cooper (1997: 27) argue these evolving colonial societies became subject to what amounts to an extended bourgeois project such that "we can not understand the construction of whiteness without exploring its class dimensions". If in terms of that project, nineteenth-century metropolitan society was deemed vulnerable to the ravages of a brutish and unruly working class, these white colonial outposts, whether constituted as settler colonies or colonies of exploitation, were even more vulnerable to the more insidious danger of miscegenation. Racial intermingling became simultaneously an issue of class and race. Imperialism therefore added a further dimension to the on-going detinition of "bourgeois-ness": the discourse of whiteness transforming a national discourse into a discourse on civilisation.

In focusing on education as the colonial authorities' response to what they perceived of as the danger of mixed parentage, this article develops a comparative framework that links coloniai settlements in Asia and Australia. It examines the discourse surrounding miscegenation, education and the "rising generation" in the late nineteenth and early twentieth centuries in the Dutch East Indies British India, French Indo China and (British) Australia. In so doing, I demonstrate the universality of a linked discourse of whiteness and class across Imperial Asia.

The education and information needs of young adults with type 2 diabetes : a qualitative study

Aims and objectives. To identify the preferred content and delivery mode of education information for people aged 25 to 45 with type 2 diabetes to enable them to effectively self-manage their diabetes.

Background. People with type 2 diabetes are required to manage their own health and initiate behavioural changes. Self-management education and resources have typically been targeted at people aged 50 years and older. Little is known about the concerns and needs of younger people in managing type 2 diabetes, which are likely to be different from those of older people.

Design. A qualitative design was considered the most appropriate to elicit participants' views and perceptions of their type 2 diabetes information needs.

Methods. Data were obtained from one focus group (n = 9) and telephone interviews (n = 4) with people aged 25 to 45 with type 2 diabetes conducted in 2008.

Results. Implicit in participants' responses was their need to be active partners in managing their diabetes. Participants wanted information that is easy to understand, brief, consistent, age-specific and about a number of topics that are not adequately covered at present. They wanted a centralised source of information and a range of delivery mode options. Participants expressed some ambivalence about the Internet as a source of information. Participants also wanted age-specific group sessions, support from peers, psychological support, increased understanding of type 2 diabetes in the community, and a focus on preventing diabetes.

Conclusions. Young people with type 2 diabetes have specific diabetes needs and preferred information delivery modes. Participants felt current diabetes education programs do not cater specifically to their age group. Education and information resources need to be developed for the target group, addressing their content and format preferences.

Relevance to clinical practice. Health professionals need to utilise appropriate delivery modes and include information relevant to younger people when providing education information to young adults with type 2 diabetes.

A Foucauldian strategy for vocational education and training research

Vocational education and training (VET) is an area of research dominated by positivist approaches. Such approaches complement the behaviourist educational philosophy known as 'competency-based training' (CBT) that underpins Australia’s VET system. This paper reflects on a quandary encountered by researchers examining the history of competency based education at a TAFE institution in South Australia. The issue was how to account for a series of mutations in the way CBT was understood and practised that subverted the largely unquestioned expectation of progress. The researchers found that Foucault’s 'genealogical' approach allowed for the construction of a mode of intelligibility that lends the history a disturbing cogency. At the centre of this construction is an understanding of CBT as a highly permeable system whose configurability supports the reticulation of multiple forms of power.

Education and training as a social science : some empirical evidence in the Rosebank Business Precinct of Auckland New Zealand

Tertiary institutions should seek continuous feedback from industries to keep track of the needs of businesses to provide education and training. Academics should stay in touch with businesses by networking and consulting. Holland and De Cieri (2006) refer to theories of child learning (pedagogy) to inform their understanding of andragogy, the study of adult learning. Adult learners would be continuous learners and would move in and out of formal education according to individual needs or life circumstances, job requirements or career development. In designing programmes and up-grading curricula, these are important factors to bear in mind so that programmes “cater” for these learners as well.

This study was financed by Auckland City Council focussing on Auckland’s Rosebank Business Precinct (ARBP). The surrounding communities, particularly Mäori, Pacific peoples and recent migrants, experience disparities in employment. Our research questions were:
• Is there a skills match between the present-day workforce and actual business needs over the medium term?
• What can these data tell us about Rosebank’s trajectory as a skilled business cluster and about its future workforce requirements?
• What education and training will be necessary for these organisations to maintain their competitive advantage and profit margins?

The target population were the 500-600 businesses operating on Rosebank Road. A total of 529 businesses were identified. Interviews with 102 companies with a 36-question questionnaire were conducted. The sampling frame was owner-managers (senior, non-shareholding managers). Of the respondent firms, 68.75% had vacancies for up to 3 months and 31.24% vacancies for 6 months.

This paper highlights areas identified in the ARBP for developing programmes and curricula for tertiary institutions to provide employable students with the right knowledge, skills and attributes (KSAs) to grow existing ventures. A fine balance must be struck between human and organisational needs. In the analysis and discussion we point out what education or training is necessary for the ARBP to provide greater efficiencies and subsequent improvement to their profit levels by current and future employees entering the workforce; well “equipped” employees with knowledge and skills to add value in their organisations. Recommendations, future perspectives and conclusions form the last part of this paper

Collaboration : integrating education and clinical practice : The Case of La Trobe University/The Alfred Clinical School of Nursing

A Clinical School of Nursing combines resources, opportunities and benefits for hospital and university staff as well as students. Collaboration is essential in the partnership between the two institutions and aspects will be explored in this paper, including antecedent conditions of organisational commitment, cooperation and trust, identification of costs, and a formal agreement. Collaboration itself is built on cooperative endeavour, willing participation, shared planning and decision making, a team approach, and shared responsibility and power. These attributes are readily identifiable in this exciting initiative.

Integrating nursing research education and practice : safe administration of medications

The integration of the best available evidence into the delivery of safe patient care is a challenging but important task. Southern Health in partnership with Deakin University embarked on a joint initiative to develop a culture of inquiry and evidencebased nursing practice.

Levy grant training scheme evolution : focus on Fiji and Singapore

This thesis examines the evolution of national training policy in Fiji since 1973 with a particular emphasis on the national levy-grant scheme that was introduced in Fiji in that same year. Developments in the Fiji National Training Council (FNTC) levy-grants scheme since its inception, including substantive amendments to the legislation in late 2002, form part of the scholarship. The thesis will provide an analytical narration of the training policy objectives and their transformation over a time span of almost three decades in the context of a small island nation. To inform this study, it was considered essential to compare the Fiji experience of levy grants schemes with other levy grants scheme. The author decided to use as the focal comparative benchmark the case of the Skills Development Fund (SDF) in Singapore. The SDF has been increasingly portrayed, by the World Bank, the International Labour Organisation and other influential agencies, as the best practice case when it comes to managing a training levy grants scheme. The thesis adopted a qualitative approach that utilized elements of case study, historical research, and key person interviews. The challenges of doing 'insider* research were explored because of its pertinence to the study. Because the study also involved the comparison of the policy experiences of two distinct countries, it was imperative to consider the issues and challenges of undertaking comparative research with particular reference to training matters- Given that training is often enmeshed with other human resources management issues, cognisance was taken of some of the broader debates in this regard. Following consideration of the methodological issues, the research paper explores the objectives of national training strategies and, in particular, issues relating to national competitiveness and skills development. The purpose is to situate the issue of training and skills development within the broader discourse of national development. Alternative approaches to the strategic role of training are considered both at the national and organisational level and some of the classic and current debates surrounding human capital investment are visited. The thesis then proceeds to examine the forms of, and rationale for government interventions in the area of training. One of the challenges both in practice and theoretically is to arrive at a consensual definition of training because of the constantly evolving context and boundaries in which training policies are fashioned. This provides the setting to examine the role that governments can and do play in skills development and how levy-grant schemes, in particular, contribute to the process. Three forms of levy grants schemes are identified and examined: levy-generating; levy-exemption; and levy-grant and reimbursement schemes. The levy-grant and reimbursement variant is the basic thrust of this thesis. In this regard, the UK experience with the levy-grant system from 1964 to 1981 is also reviewed. Some of the issues in relation to training levies are scrutinized including the levy as a sheltered source of training finance, levy rates, duration of levy, impact of levy on the quality and quantity of training, benefits to small businesses, links between training and strategic business objectives, repackaging of training to qualify for grants, and the process by which training levy policies are devised. In looking at the policy formulation, it was necessary to unpack the processes involved and explore the role of the state further. In relation to policy development and implementation, the consultation processes, role of bureaucrats, the policy context, and approaches to policy transfer are examined. In looking at the role of the state in policy development, the alternative roles of government are explored and the concepts of the 'developmental state' and the 'corporatist state* evaluated. The notion of the developmental state has particular relevance to this study given the emphasis placed by the Singaporean government on human resource development policies. This sets the scene for a detailed examination of the role of levy-grant training schemes in Fiji and Singapore. The Skills Development Fund in Singapore was developed as an integral component of national economic policy when the Singaporean government decided to break out of the 'low-skills' trap and move the economy towards a higher value adding structure. The levy-grant system was designed to complement the strategy by focusing on upgrading the skills of employees on lower incomes, the assumption being that employees on lower remuneration were more likely to need skills upgrading. The study notes that the early objectives of the SDF were displaced when it was revealed that the bulk of SDF expenditure was directed at higher level supervisory and management training. As a result, the SDF had to refocus its activities on small and medium enterprises and the workers who were likely to miss out on formal training opportunities. The Singaporean context also shows trade unions playing a significant role in worker education and literacy programmes financed under the SDF. To understand this requires some understanding of the historical linkages between the present Singaporean government and trade union leadership. Another aspect of the development of the SDF has been the constant shifting of the institutional responsibility for the scheme. As late as September 2003, the SDF was again moved, this time to the newly created Singapore Workforce Development Agency, with the focus turning to lifelong learning and assisting Singaporeans who are unemployed or made redundant as a result of the economic restructuring. The Fiji experience with the FNTC scheme is different. It evolved in the context of perceived skills shortages but there was a degree of ambiguity over its objectives. There were no specific linkages with economic policy. Relationships with other public training institutions and more recently, private training providers, have been fraught with difficulties. The study examines the origins of the policy, the early difficulties including perceived employer grievances, and the numerous external assessments of the Fiji levy-grant scheme noting that some of them were highly critical. The thesis also examines an attempted reform of the scheme in 1992-93 that proved unsuccessful and the more recent legislative reforms to the scheme in 2002 that have expanded the role of the scheme to encompass, inter alia, national occupational standards and accreditation activities. The thesis concludes by comparing the two schemes noting that the SDF is well entrenched as a policy instrument in Singapore whilst the FNTC is facing a struggle to assert its legitimacy in Fiji.