The process evaluation of it's your move!, an Australian adolescent community-based obesity prevention project

Background
Evidence on interventions for preventing unhealthy weight gain in adolescents is urgently needed. The aim of this paper is to describe the process evaluation for a three-year (2005-2008) project conducted in five secondary schools in the East Geelong/Bellarine region of Victoria, Australia. The project, 'It's Your Move!' aimed to reduce unhealthy weight gain by promoting healthy eating patterns, regular physical activity, healthy body weight, and body size perception amongst youth; and improve the capacity of families, schools, and community organisations to sustain the promotion of healthy eating and physical activity in the region.

Methods
The project was supported by Deakin University (training and evaluation), a Reference Committee (strategic direction, budgetary approval and monitoring) and a Project Management Committee (project delivery). A workshop of students, teachers and other stakeholders formulated a 10-point action plan, which was then translated into strategies and initiatives specific to each school by the School Project Officers (staff members released from teaching duties one day per week) and trained Student Ambassadors. Baseline surveys informed intervention development. Process data were collected on all intervention activities and these were collated and enumerated, where possible, into a set of mutually exclusive tables to demonstrate the types of strategies and the dose, frequency and reach of intervention activities.

Results
The action plan included three guiding objectives, four on nutrition, two on physical activity and one on body image. The process evaluation data showed that a mix of intervention strategies were implemented, including social marketing, one-off events, lunch time and curriculum programs, improvements in infrastructure, and healthy school food policies. The majority of the interventions were implemented in schools and focused on capacity building and healthy eating strategies as physical activity practices were seen by the teachers as already meeting students' needs.

Conclusions
While substantial health-promoting activities were conducted (especially related to healthy eating), there remain further opportunities for secondary schools to use a whole-of-school approach through the school curriculum, environment, policies and ethos to improve healthy eating, physical activity and healthy body perceptions in youth. To achieve this, significant, sustained leadership will be required within the education sector generally and within schools specifically.

Using clinical trial data and linked administrative health data to reduce the risk of adverse events associated with the uptake of newly released drugs by older Australians : a model process

Background
The study was undertaken to evaluate the contribution of a process which uses clinical trial data plus linked de-identified administrative health data to forecast potential risk of adverse events associated with the use of newly released drugs by older Australian patients.

Methods
The study uses publicly available data from the clinical trials of a newly released drug to ascertain which patient age groups, gender, comorbidities and co-medications were excluded in the trials. It then uses linked de-identified hospital morbidity and medications dispensing data to investigate the comorbidities and co-medications of patients who suffer from the target morbidity of the new drug and who are the likely target population for the drug. The clinical trial information and the linked morbidity and medication data are compared to assess which patient groups could potentially be at risk of an adverse event associated with use of the new drug.

Results
Applying the model in a retrospective real-world scenario identified that the majority of the sample group of Australian patients aged 65 years and over with the target morbidity of the newly released COX-2-selective NSAID rofecoxib also suffered from a major morbidity excluded in the trials of that drug, indicating a substantial potential risk of adverse events amongst those patients. This risk was borne out in post-release morbidity and mortality associated with use of that drug.

Conclusions
Clinical trial data and linked administrative health data can together support a prospective assessment of patient groups who could be at risk of an adverse event if they are prescribed a newly released drug in the context of their age, gender, comorbidities and/or co-medications. Communication of this independent risk information to prescribers has the potential to reduce adverse events in the period after the release of the new drug, which is when the risk is greatest.

Note: The terms 'adverse drug reaction' and 'adverse drug event' have come to be used interchangeably in the current literature. For consistency, the authors have chosen to use the wider term 'adverse drug event' (ADE).

Form versus function : a study into interactive learning process affecting the implementation of sustainability in commercial buildings

Owners and tenants of sustainable buildings are now realising the sustainable building that they own or occupy and also how they use the building have a significant impact on their work practices. These stakeholders are demanding sustainability outcomes such as improved occupant health and performance, lower energy and material consumption use as well as encouraging healthy ecosystem in their sustainable building. Clearly the level of user knowledge about a sustainable building and its technologies makes a difference about the actual behaviour towards sustainable buildings (Knott 2007, Stenberg 2007) There remains two major challenge faced by sustainable building occupants: (i) addressing the gap between an occupant's expectations of sustainable building outcomes and what the building actually provides and (ii) overcoming the lack of user knowledge about sustainability design and operation for a particular with regards to performance (Jailani et. al, 2011). This is an innovative study designed to address these challenges. It uses a focus group approach to investigate the gap between (a) user expectations and (b) sustainable building performance, with reference to the relationship between interactive learning process and the level of implementation of sustainability in commercial buildings. The outcome from the study will provide a post-occupancy evaluation of the perception of occupants in sustainable buildings. Most importantly, this information can then assist architects and designers in private and government organisations to successfully develop future sustainable design and policy which can fully capitalise on the original intention when delivering sustainable buildings, as well as providing an innovative feedback mechanism between occupiers and architects.

The Ophelia (OPtimise HEalth LIteracy and Access) process : using health literacy alongside grounded and participatory approaches to develop interventions in partnership with marginalised populations

This paper seeks to explore the potential of a newly developed, grounded and participatory approach to development of health-literacy and health-care access interventions for equity – the Ophelia (OPtimising HEalth LIteracy and Access) process (Batterham et al., 2014). The methodology involves undertaking a needs assessment of the target population using intensive qualitative and quantitative methods, developing vignettes of key sub-groups within the population based on their health literacy profile of strengths and weaknesses, and then engaging with frontline practitioners and community membersin developing realistic solutions (Batterham et al., 2014).