Measuring chronic condition self-management in an Australian community: factor structure of the revised Partners in Health (PIH) scale

Purpose To evaluate the factor structure of the revised Partners in Health (PIH) scale for measuring chronic condition self-management in a representative sample from the Australian community.

Methods A series of consultations between clinical groups underpinned the revision of the PIH. The factors in the revised instrument were proposed to be: knowledge of illness and treatment, patient–health professional partnership, recognition and management of symptoms and coping with chronic illness. Participants (N = 904) reporting having a chronic illness completed the revised 12-item scale. Two a priori models, the 4-factor and bi-factor models were then evaluated using Bayesian confirmatory factor analysis (BCFA). Final model selection was established on model complexity, posterior predictive p values and deviance information criterion.

Results Both 4-factor and bi-factor BCFA models with small informative priors for cross-loadings provided an acceptable fit with the data. The 4-factor model was shown to provide a better and more parsimonious fit with the observed data in terms of substantive theory. McDonald’s omega coefficients indicated that the reliability of subscale raw scores was mostly in the acceptable range.

Conclusion The findings showed that the PIH scale is a relevant and structurally valid instrument for measuring chronic condition self-management in an Australian community. The PIH scale may help health professionals to introduce the concept of self-management to their patients and provide assessment of areas of self-management. A limitation is the narrow range of validated PIH measurement properties to date. Further research is needed to evaluate other important properties such as test–retest reliability, responsiveness over time and content validity.

Development and evaluation of a computer-based, self-management tool for people recently diagnosed with type 2 diabetes

Aim. The purpose of this study was to develop and evaluate a computer-based, dietary, and physical activity self-management program for people recently diagnosed with type 2 diabetes. Methods. The computer-based program was developed in conjunction with the target group and evaluated in a 12-week randomised controlled trial (RCT). Participants were randomised to the intervention (computer-program) or control group (usual care). Primary outcomes were diabetes knowledge and goal setting (ADKnowl questionnaire, Diabetes Obstacles Questionnaire (DOQ)) measured at baseline and week 12. User feedback on the program was obtained via a questionnaire and focus groups. Results. Seventy participants completed the 12-week RCT (32 intervention, 38 control, mean age 59 (SD) years). After completion there was a significant between-group difference in the "knowledge and beliefs scale" of the DOQ. Two-thirds of the intervention group rated the program as either good or very good, 92% would recommend the program to others, and 96% agreed that the information within the program was clear and easy to understand. Conclusions. The computer-program resulted in a small but statistically significant improvement in diet-related knowledge and user satisfaction was high. With some further development, this computer-based educational tool may be a useful adjunct to diabetes self-management. This trial is registered with clinicaltrials.gov NCT number NCT00877851.

Spreading the word: using film to share research findings and knowledge about children with disabilities in Vanuatu and Papua New Guinea

While there is increasing international interest in disability inclusive development, people with disability largely remain ‘unseen, unheard and uncounted’ (UN ESCAP 2012:1). Children with disability, particularly, remain excluded from research informing development, and there is a paucity of information that is drawn directly from the self-report of children with disability living in developing countries. This exclusion occurs across all stages of research, including access to research findings. When child research is conducted in such countries, to gain further evidence to support disability inclusive development and advance human rights, researchers must question how findings will be reported back to participants and their communities, and seek a method that is both accessible and culturally relevant. This paper reports on the Voices of Pacific children with disability research project about the human rights of children with disability in Vanuatu and Papua New Guinea (PNG), and focuses on film as a dissemination method. Project researchers developed methods to enhance the participation of children with diverse disabilities as informants, and drew upon community development principles to disseminate research findings via film; a method that resonated with the aural and visual story telling traditions of participants.This medium also included accessibility features that have been utilised by local and international audiences.

Re-casting terra nullius design-blindness: better teaching of indigenous knowledge and protocols in Australian architecture education

This paper reviews the current status and focus of Australian Architecture programs with respect to Indigenous Knowledge and the extent to which these tertiary programs currently address reconciliation and respect to Indigenous Australians in relation to their professional institutions and accreditation policies. The paper draws upon the findings of a recently completed investigation of current teaching: Re-Casting terra nullius blindness: Empowering Indigenous Protocols and Knowledge in Australian University Built Environment Education. Three data sets from this investigation are analysed: a desktop survey of Australian Built Environment curricula; workshops with tertiary providers and students, professional practitioners and representatives of three Built Environment professional institutes; and an online survey of Australian Built Environment students (of which their discipline could be isolated) ascertaining what is currently being taught and learned and what changes would be feasible within the constraints of courses from their perspective. Detailed descriptions are also provided of pedagogic improvements informed by the project findings. The findings suggest minimal current exposure of Architecture students to Indigenous Knowledge content beyond voluntary engagement in self-chosen thesis projects and elective (including studio) subjects led by passionate but largely unsupported teachers championing Indigenous issues; a paucity of teaching echoed by practitioners and accreditors who acknowledge lack of expertise in this area across the profession. This paper discusses ways in which Indigenous Knowledge might be better acknowledged, respected and introduced to Australian Architecture students’ education. Also discussed are teaching strategies with global relevance.