Understanding barriers to attendance and non-attendance at Arts and Cultural Institutions: A Conceptual Framework

This paper draws together themes from within the leisure, arts and other literature related to why people might not attend cultural institutions and identifies eight barriers: 1) Physical; 2) Personal Access; 3) Cost; 4) Time and Timing; 5) Product; 6) Personal Interest; 7) Socialisation/Understanding; and 8) Information. Many of these barriers appear to be interrelated and as such strategies to address non-visitation will most likely need to be complex to allow the full range of barriers to be addressed.

Marketing cultural attractions : understanding non-attendance and visitation barriers

Purpose – The purpose of this paper is to draw together the previous academic and industry research on non-attendance of cultural attractions, followed by qualitative in-depth interviews to identify commonalities or gaps in the previous research on barriers, constraints and inhibitors, as well as to propose linkages between these.

Design/methodology/approach – A multi-method approach is used – where barriers, constraints and inhibitors are identified by means of thematic content analysis of the literature. A set of probing questions is developed based on these themes and is then examined in in-depth interviews with individuals that had not visited cultural attractions in the past two years, in an attempt to triangulate data, as well as to identify connections between barriers.

Findings – From the literature, eight interconnected barriers to visitation are identified: physical access; personal access; cost; time and timing; product; personal interest and peer group; socialisation and understanding; and information. The in-depth interviews generally support these, although it is also identified that there are complex interrelationships between the issues.

Originality/value – This paper addresses the neglected question of why people do not attend cultural attractions by triangulating thematic findings from the content analysis of diverse literature with in-depth interview responses from one non-visitor segment. This results in an interconnected model of barriers that can be used to assist managers to develop strategies addressing low visitation rates within targeted segments.

Cardiac rehabilitation in south west Victoria : factors influencing attendance

Background : The benefits of cardiac rehabilitation (CR) programs are well established. Despite these benefits their utilisation remains sub-optimal, with an average of 24% of eligible cardiac patients attending outpatient CR programs across Victoria.
Aims & rationale/Objectives : The objectives of this study were to (a) identify local barriers and enablers to the uptake of hospital-based CR programs, and (b) identify preferred alternatives for the delivery of CR.
Methods : Six hospital-based CR programs within the region agreed to participate in this study. A consecutive series of patients referred to the programs were surveyed by the CR coordinators to identify the local barriers and enablers influencing CR program attendance. In addition, focus groups with CR participants and health professionals were conducted at two hospitals in order to ascertain their views on current programs, suggestions for improvements and alternative methods of CR delivery.
Principal findings : Survey data was obtained from a total of 97 patients referred to the CR programs during the study period, 27 (28%) females and 70 (72%) males. Main reasons given for CR non-attendance were related to distance to travel, cost of petrol, reliance on others for transport and lack of interest or motivation to attend. For CR attenders, main enablers included encouragement by family, medical and other health professionals, and having someone else to drive them. Suggestions for alternative methods of CR delivery included more programs in outlying communities, home and GP based programs, telephone support and a patient manual or workbook.
Discussion : The results of this study provide valuable information for designing strategies to increase utilisation of existing CR programs as well as pilot testing alternative modes of CR program delivery for cardiac patients in rural areas unable to access hospital-based CR.
Implications : These findings suggest that many of the barriers identified could be addressed by a more creative use of existing resources and the provision of CR services in primary care settings.
Presentation type : Poster

A comparison of participants with non-participants in a population-based epidemiologic study: the Melbourne Visual Impairment Project

PURPOSE: Adequate participation in population-based studies in essential to ensure that the sample is representative of the population under investigation. Participants may differ from non-participants on important variables such as age, sex socioeconomic status, and general health factors. The Melbourne Visual Impairment Project (Melbourne VIP) is a population-based study designed to increase understanding of the prevalence and severity of common ocular disorders affecting people 40 years of age and over. AIM: The aim of this study was to determine the potential for any non-response bias by comparing data from participants and non-participants of the Melbourne VIP. METHODS: Specific demographic and general variables were compared between the two groups. The variables included age, sex, education level, and social status. The reason for non-attendance was also recorded. RESULTS: A total of 3271 (83%) eligible residents from the 9 sample areas were screened; 46% males and 54% females. Language spoken at home was significantly associated with participation. Residents whose main language at home was not English were less likely to attend the screening centre. (OR: 0.60; CI: 0.44-0.81). The main reasons given for non-attendance by eligible residents were lack of interest (6%), too busy to attend (4%), personal illness (2%), and attend own eye specialist (2%). CONCLUSION: We believe these results will not impact significantly on the interpretation of gender and age-specific data from the Melbourne VIP.

Understanding women's breast screening behaviour: a study carried out in South East London, with women aged 50-64 years

Objective To understand low uptake of breast cancer screening through exploring the personal reasoning underlying women's attendance or non-attendance, and identifying differences between those who attend and those who decline.

Design Cross-sectional survey.

Setting Community and home environments of women eligible for breast screening aged 50—64 years, living in South East London. Method Structured, self-completed or assisted-completion questionnaires.

Results The decision to attend or decline screening is rational and personally justifiable, engaging factors linked to emotions and attitude. Attitudes about breast screening and perceived personal importance of breast screening are the strongest predictors of attendance and non-attendance. There are differences between ethnic groups in perceptions of breast screening. Regular attendance at screening is associated with ethnicity, although consistent avoidance of mammography is not. Inconvenience is an important factor in missing appointments, and tends to be prolonged rather than specific to the time or day of the pre-booked invitation. GP and health worker advice are good persuaders towards attendance. Pain and anxiety during mammography are notable dissuaders against re-attending.

Conclusion Appropriate service provision requires consideration of local factors, as well as the medical needs of the population eligible for breast screening. Lay perceptions of potential personal costs of attending or not attending breast screening are important for guiding health promotion. Information providers should consider the language needs of a culturally and educationally mixed community. Health care professionals are well placed to encourage uptake of breast screening through disseminating information that promotes attendance, both within and outside the breast screening service.

Students use a 'just-in-time' approach to accessing online resources

Lecture notes and recordings, tutorial exercises, readings, study questions, revision quizzes, instructional videos and crosswords were provided online so that students who could not attend classes (flexible learners) were not disadvantaged. D2L's progress viewing tool was used to track student access to resources, class attendance was monitored, and a questionnaire asked about the value of the online resources for completing the unit. While students thought it was important to attend classes, attendance was low and centred on tutorials and practical's, rather than lectures. The main reason for non-attendance was employment. Students accessed most of the online resources immediately prior to tests rather than on a week-by-week basis. Both attenders and flexible learners indicated that lecture notes, readings, revision quizzes and study questions were the most useful resources. Attenders accessed online resources more than flexible learners. There was only a weak correlation between class attendance and successful completion of the unit.

Explaining non-renewal behaviour : an empirical investigation of recently lapsed NRL club members

This paper reports on a survey of lapsed members of an Australian professional National Rugby League (NRL) Club. Analysis of the 195 useable responses returned suggest that these lapsed members had originally joined as much for intangible aspects, such as seeking a greater level of involvement with the club, as for the functional aspects such as savings on game entry. Overall, these lapsed members were satisfied with the service they received whilst a member, and claimed it had been performed in line with expectations. The main drivers of satisfaction were also a mix of tangible and intangible factors such as feeling valued by the club and receiving discounts on entry costs. The members gave a number of reasons for not rejoining in 2002, but primarily cited an inability to attend games. Despite joining for intangible reasons, it seems that if these members could not get to games, they perceived that membership was not worth maintaining. That said, a large number of members indicated that as their circumstances change they will rejoin the club, supporting the theory that non-renewal is not driven by service failure, but rather the perception that attendance is still the core product (entertainment). The overall level of satisfaction had a weak but positive relationship with the likelihood of members rejoining in the future.

The prevalence and selected characteristics of non-fatal opioid overdoses attended by ambulance in Australia

Key Points
1. Ambulance attendance at non-fatal opioid overdose is a common event in mainland Australia (among heroin users in particular).
2. The monthly rate of non-fatal opioid overdose attended by ambulance was generally highest in Victoria (Melbourne) followed by NSW with the rates substantially lower in the remaining mainland states over the period Jan  1999 - Feb 2001.
3. Non-fatal opioid overdose victims were most likely to be male in all states with the proportion of males highest in Victoria (77%).
4. Non-fatal opioid overdose victims were aged around 28 years with ages lowest in WA (26) and highest in NSW (30).
5. The rates of transportation varied according to ambulance service practice across the states with around 94% of cases transported in WA and around 19% and 30% of cases transported in Melbourne and NSW respectively.

Experimental evidence for the influence of food availability on incubation attendance and hatching asynchrony in the Australian reed warbler Acrocephalus australis

The amount of time a bird allocates to incubation is likely to be limited by energetic constraints. If food is abundant, energetic constraints may be reduced and the time spent incubating (incubation attendance) may increase. Moreover, the onset of incubation in relation to clutch completion may be advanced, resulting in a higher degree of hatching asynchrony. We measured the effect of experimentally increased food availability on incubation attendance and an estimate of hatching asynchrony in the Australian reed warbler Acrocephalus australis. Supplementary food was provided every other day, from a few days before the start of egg laying until just prior to hatching. Incubation attendance was measured with temperature loggers at nests receiving supplementary food and control nests. Hatching asynchrony was inferred from mass and size differences between siblings shortly after hatching. We found that 1) food supplementation resulted in an increase in incubation attendance, when comparing both nests receiving supplementary food to control nests as well as feeding to non-feeding days in nests receiving supplementary food, and 2) food supplementation resulted in a greater hatching asynchrony, without affecting clutch size, average egg volume or the likelihood of eggs hatching. This suggests that food availability acts in a proximate way to modify the extent of incubation attendance and hatching asynchrony. We discuss the adaptive significance of increased incubation attendance and a shift in the degree of hatching asynchrony in relation to food availability.

Rates of common communicable illnesses in non-anaemic 12-24 month old South Island, New Zealand children

Aims : To describe the incidence of parentally reported illness in otherwise healthy South Island toddlers; characterise the predictors of illness; and determine whether there was a relationship between teething and illness in this population.

Methods : A 20-week randomised controlled trial was conducted on 1-year-old children (n=225) from Otago and Southland between February 2004 and December 2005. Information on symptoms of morbidity, occurrence of teething, and childcare attendance were recorded daily throughout the intervention period. Morbidity symptoms were categorised into respiratory illness (RI), gastrointestinal illness (GII), ear infection, and total illness, and the number and duration of events were determined.

Results : The mean (SD) number of total illnesses was 3.4 (2.3) per 20 weeks, with an average duration of 4.5 days. Episodes of RI were most common (50% of total illness events), and tended to be the longest in duration (mean of 3.7 days). Having siblings aged less than 5 years (23% increase, 95%CI 6%–42%, p=0.007) and attending childcare (72% increase, 95%CI 38%–113%, p<0.001)), were positively associated with the number of total illness events but not duration. In addition, teething was positively associated with total events (OR 1.94, 95%CI 1.45–2.60, p<0.001), RI events (OR 2.03, 95%CI 1.41–2.93, p<0.001) and GII events (OR 1.90, 95%CI 1.36–2.67, p<0.001).

Conclusion : This study has shown that illness (particularly RI) is common in the second year of life. It has also confirmed that attending childcare and having siblings aged under 5 years increases the number of illness events. An association between teething and the occurrence of illness was also seen but the exact nature of this relationship requires verification.

A prospective study of the effect of education on non-compliant behaviour in contact lens wear

The contact lens practitioner and patient present a specific case for the study of non-compliance in areas such as hygiene, solution use, appointment attendance and wearing times. Education is one of the factors thought to influence compliance among patients in general health care situations and contact lens practitioners are encouraged to educate patients in the care and maintenance of contact lenses. A prospective, randomized, controlled and double masked study was performed to assess the effect of a‘compliance enhancement strategy’ on levels of compliance among contact lens wearers over twelve months. Eighty experienced contact lens patients were randomly allocated to two experimental groups. A standard level of contact lens instruction was applied to the first group and in addition the compliance enhancement strategy was applied to patients assigned to the second group. The strategy consisted of extra education for patients using a video, booklets, posters, a checklist and a health care contract. Patients were given free supplies of RelMu multipurpose solution and Medalist 38 soft contact lenses IBausch and Lomb, Rochester. New York). Compliance levels were assessed at a twelve month aftercare appointment by demonstration and questionnaire. The results indicate that the compliance enhancement strategy had little significant effect on the compliance levels of the patients to whom it was applied. The population of contact lens wearers were generally very compliant and the contact lenses and care regimen were clinically successful. The possibility that the assessment of non–compliance was not adequately sensitive to highlight small differences in non-compliant, behaviour is discussed. The standard level of eduction applied to this sample of contact lens patients was adequate to ensure generally high levels of compliance with the simple care and maintenance regimen recommended.