Providing information for business: government strategy for the online world

Governments assume a major role in providing information resources for business as a way of promoting national development. This has proven to be a much more demanding task than one might suppose, given the diversity and complexity of business needs and the limitation of government resources for undertaking the task. This chapter will: (1) identify the challenges posed for government online business information strategies, (2) discuss research relating to the information strategy of one Australian government agency to support export development among small business, and (3) set out a framework for government online information provision in a diverse industry context. Coordination of the many government information services remains a challenge, especially among different levels of government. Well-designed strategies can improve the usability of online information and the efficiency of government information services.<br />

Information warfare: using the viable system model as a framework to attack organisations

Information is the glue in any organization. It is needed for policy, decision-making, control, and co-ordination. If an organisation's information systems are disrupted or destroyed, then damage to the whole inevitably follows. This paper uses a proven systemic, analytic framework the Viable System Model (VSM) - in a functionalist mode, to analyse the vulnerabilities of an organisation's information resources to this form of aggression. It examines the tactics available, and where they can be used to effectively attack an organisation.<br />

Food and activity in out of school hours care in Victoria

<b>Objective:</b> To describe characteristics of the Victorian out of school hours care (OSHC) sector to assess its potential role in promoting healthy lifestyles to children and their families. <br /><br /><b>Design:</b> Written questionnaires were sent to 1100 Victorian OSHC programs to collect information about the services, foods and activities offered to children, the training and resources utilised by staff and the type of information sent home to parents/guardians. <br /><br /><b>Subjects: </b>A total of 426 Victorian OSHC coordinators completed questionnaires in the present descriptive study (39% response rate). <br /><br /><b>Setting: </b>Out of school hours care provides care for 5&ndash;12 years olds before school, after school and/or during school holidays. <br /><br /><b>Results:</b> Over 80% of coordinators reported offering fruit, breads, cereals, and milk and dairy products. One-third offer vegetables as part of meals or snacks. One-third reported offering cakes, biscuits and/or slices, and chips and/or pastries. About 17% reported offering water, whereas 24% reported offering cordial/soft drinks and fruit juice. Cooking was offered as an after-school activity by about half of those surveyed. Active games were common (62%) as were indoor active games and sports (36%). Sedentary activities were also commonplace (37&ndash;51%). Only about 30% of OSHC coordinators had participated in nutrition and/or physical activity training in the previous two years. Few OSHC programs sent home health information to parents/guardians. <br /><br /><b>Conclusion and application:</b> Opportunities exist to help Victorian OSHC programs with nutrition and physical activity information, resources and training. Although the findings of the present study are specific to Victoria, they highlight the potential role of the growing OSHC sector to help improve the health of Australian children.<br />

Parent-reported health status of overweight and obese Australian primary school children: a cross-sectional population survey

<b>Introduction</b>: Childhood overweight/obesity is associated with poor physical and psychosocial health in clinical samples. However, there is little information on the health status of overweight and obese children in the community, who now represent a large proportion of the child population. We examined parent-reported child health and well-being and parent concern about child weight by body mass index (BMI) category in a population sample of primary school children.<br /><br /><b>Design</b>: A stratified two-stage random cluster sample of 24 primary schools representative of the state of Victoria, Australia.<br /><br /><b>Measures</b>: BMI (weight/height2) transformed to normalised Z-scores using the 1990 UK Growth Reference; the Child Health Questionnaire (CHQ), a 13-scale 50-item parent-completed measure of health and well-being; parent self-reported height and weight; parent concern about child's weight.<br /><br /><b>Results</b>: Data were available for 2863 children aged 5-13 y (50.5% male), of whom 17% were overweight and 5.7% obese. Using logistic regression analyses with 'normal weight' as the referent category, obese boys were at greater risk of poor health (ie &lt;15th centile) on seven of the 12 CHQ scales: Physical Functioning (odds ratio (OR) 2.8), Bodily Pain (OR 1.8), General Health (OR 3.5), Mental Health (OR 2.8), Self Esteem (OR 1.8), Parent Impact&frac34;Emotional (OR 1.7) and Parent Impact&frac34;Time (OR 1.9). Obese girls were at greater risk of poor health on only two scales: General Health (OR 2.1) and Self Esteem (OR 1.8). Forty-two percent of parents with obese children and 81% with overweight children did not report concern about their child's weight. Parents were more likely to report concern if the child was obese (OR 21.3), overweight (OR 3.5) or underweight (OR 5.4) than normal weight (P&lt;0.05). Concern was not related to child gender, parental BMI or parental education after controlling for child BMI. Perceived health and well-being of overweight/obese children varied little by weight category of the reporting parent (overweight vs non-overweight).<br /><br /><b>Conclusions</b>: Parents were more likely to report poorer health and well-being for overweight and obese children (particularly obese boys). Parental concern about their child's weight was strongly associated with their child's actual BMI. Despite this, most parents of overweight and obese children did not report poor health or well-being, and a high proportion did not report concern. This has implications for the early identification of such children and the success of prevention and intervention efforts.<br />

Health literacy revisited : what do we mean and why does it matter?

&lsquo;Health literacy&rsquo; refers to accessing, understanding and using information to make health decisions. However, despite its introduction into the World Health Organization's Health Promotion Glossary, the term remains a confusing concept. We consider various definitions and measurements of health literacy in the international and Australian literature, and discuss the distinction between the broader concept of &lsquo;health literacy&rsquo; (applicable to everyday life) and &lsquo;medical literacy&rsquo; (related to individuals as patients within health care settings). We highlight the importance of health literacy in relation to the health promotion and preventive health agenda. Because health literacy involves knowledge, motivation and activation, it is a complex thing to measure and to influence. The development of health literacy policies will be facilitated by better evidence on the extent, patterns and impact of low health literacy, and what might be involved in improving it. However, the current lack of consensus of definitions and measurement of health literacy will first need to be overcome. <br />

Community engagement and working with government

Community engagement in health care can occur from policy to local community levels. It is consistent with democracy. A systems perspective can see consumers engaged to legitimise government agendas. Often community participation is via consultation instead of partnership or delegation. A community development approach to engagement can empower communities to take responsibility for their own health care. Understanding rural place facilitates alignment between health programs and community, assists incorporate community resources into health care and provides information about health needs. Rural communities, health services and other community organisations need skills in working together to develop effective partnerships that transfer some power from health systems. Rural engagement with national/state agendas is a challenge. Community engagement takes time and resources, but can be expected to lead to better health outcomes for rural residents.<br />

Folate fortification : a case study of public health policy-making

Introducing Evidence Based Health Policy: Problems and Possibilities, Section 1: What is the Problem?, 1: Competing Rationalities: Evidence based Health Policy, 2: Beyond Two Communities, Section 2: What does Evidence Mean?, 3: Evidence based Medicine - The Medical Profession and Health Policy, 4: Mind The Gap: Assessing the Quality of Evidence for Public Health Problems, 5: Health Policy and Normative Analysis: Ethics, Evidence and Politics, 6: What is New in Health Information? Evidence for Health Consumers and Policy Making, 7: From Evidence based Medicine to Evidence based Public Health, Section 3: Policy Case Studies, 8: The Viagra Affair: Evidence as the Terrain for Competing Partners, 9: Folate Fortification: A Case Study of Public Health Policy-Making in a Food Regulation Setting, 10: The Supply and Safety of Blood and Blood Products - Evidence, Risk and Policy, 11: The Development of Nurse Practitioner Policy, 12: Creating Healthy Public Policy for Oral Health: How was the Evidence Used?, 13: Regulation of Traditional Chinese Medicine in Victoria, 14: The Victorian Primary Health Care Reforms: A Case Study of Evidence-based Policy Making, 15: Evidence-based Practice in the Australian Drug Policy Community, 16: Challenging the Evidence - Women's Health Policy in Australia, 17: Evidence and Aboriginal Health Policy, 18: The Limits to Technical Rationality in the Health Inequalities Policy Process, 19: Evidence-based policy: A Technocratic Wish in a Political World, Section 4: Is the transfer of evidence into policy possible?, 20: The Community Model of Research Transfer, 21: Getting Research Transfer into Policy and Practice in Maternity Care, 22: Improving the Research and Policy Partnership: An Agenda for Research Transfer and Governance, 23: Framing and Taming 'Wicked' Problems<br />

It's all a bit wishy washy : the challenge of building partnerships for effective mental health evaluation

Mental wellbeing and social connectedness is a key health priority in Victoria. Actions and interventions that may contribute to the promotion of community level mental wellbeing and social connectedness often occurs in other, non-health sectors. Including evidence from these sectors in evaluations of community based interventions around mental wellbeing and social connectedness is important to ensure comprehensive evaluation, and the development of best practice in this health priority area. However, published evaluation material of community based interventions around this health topic is limited, and rarely captures information from non-health sectors. This pilot study investigated the capacity of health promotion practitioners and other key stakeholders working in this area in Victoria to undertake evaluation of community based mental wellbeing and social connectedness interventions, issues and barriers faced in evaluation, and practitioners&rsquo; needs to be able to conduct effective and comprehensive evaluations.<br /><br />Qualitative methods including semi-structure interviews and document analysis were used. Data was coded and analysed inductively, and key themes developed.<br /><br />Results indicate that evaluating such interventions is challenging for practitioners due to the broad nature of the topic, and the measurement tools available. Many practitioners would like to conduct more comprehensive evaluation and include evidence from other sectors. Managerial and organizational support to develop partnerships both within the health sector and inter-sectorally was identified as a need in order to develop evaluation skills and facilitate more comprehensive evidence gathering.<br /><br />This study underscores the importance of inter-sectoral partnerships for developing best evidence-based practice in community health. Partnerships are necessary for conducting comprehensive and effective evaluation to contribute to the evidence base. However, developing effective partnerships is challenging, and acts as a barrier to effective evaluation in a key health area for some community health practitioners. The findings also highlight an agenda for more action by managers to facilitate the development of relevant inter-sectoral partnerships.<br />

Cluster randomized controlled trial of a peer support program for people with diabetes: study protocol for the Australasian peers for progress study

<b>Background</b><br />Well managed diabetes requires active self-management in order to ensure optimal glycaemic control and appropriate use of available clinical services and other supports. Peer supporters can assist people with their daily diabetes self-management activities, provide emotional and social support, assist and encourage clinical care and be available when needed.<br /><b>Methods</b><br />A national database of Australians diagnosed with type 2 diabetes is being used to invite people in pre-determined locations to participate in community-based peer support groups. Peer supporters are self-identified from these communities. All consenting participants receive diabetes self-management education and education manual prior to randomization by community to a peer support intervention or usual care. This multi-faceted intervention comprises four interconnected components for delivering support to the participants. (1) Trained supporters lead 12 monthly group meetings. Participants are assisted to set goals to improve diabetes self-management, discuss with and encourage each other to strengthen linkages with local clinical services (including allied health services) as well as provide social and emotional support. (2) Support through regular supporter-participant or participant-participant contact, between monthly sessions, is also promoted in order to maintain motivation and encourage self-improvement and confidence in diabetes self-management. (3) Participants receive a workbook containing diabetes information, resources and community support services, key diabetes management behaviors and monthly goal setting activity sheets. (4) Finally, a password protected website contains further resources for the participants. Supporters are mentored and assisted throughout the intervention by other supporters and the research team through attendance at a weekly teleconference. Data, including a self-administered lifestyle survey, anthropometric and biomedical measures are collected on all participants at baseline, 6 and 12 months. The primary outcome is change in cardiovascular disease risk using the UKPDS risk equation. Secondary outcomes include biomedical, quality of life, psychosocial functioning, and other lifestyle measures. An economic evaluation will determine whether the program is cost effective.<br /><b>Discussion</b><br />This manuscript presents the protocol for a cluster randomized controlled trial of group-based peer support for people with type 2 diabetes in a community setting. Results from this trial will contribute evidence about the effectiveness of peer support in achieving effective self-management of diabetes.

Using quantitative and qualitative unit profiling for identifying the contribution of library resources to teaching quality

This paper presents the development and application of a new methodology incorporating both quantitative and qualitative profiling to help discern the characteristics of units of study that are the differentiators of student ratings of library resource quality. From the sub-set of those units with an &lsquo;unremarkable&rsquo; rating for teaching quality, those units with the &lsquo;extreme&rsquo; library resource quality ratings were selected for investigation. Examination of the handbook descriptions for those units suggests that units of study which explicitly incorporate student interaction with the wider literature and other information resources beyond those provided within the unit environment may lead students to engage with the library in deeper ways that highlight the value of library resources, and hence lead to higher mean ratings of library resource quality. This finding suggests potential areas for intervention to enhance student perceptions of the quality of library resources.

Managing post-discharge care at home: an analysis of patients' and their carers' perceptions of information received during their stay in hospital

This small-scale study carried out in a Melbourne metropolitan hospital explored patients&rsquo; and their carers&rsquo; perceptions of information, adequacy of information, and their utilization of information concerning post-discharge care received from health professionals during their stay in hospital. The research design consisted of two stages. Stage one involved a qualitative approach using focused interviews of five pairs of patients and their carers, 2 weeks after discharge from hospital. Five main themes emerged from the content analysis of the interview transcripts: information given by health professionals to patients and carers, patients&rsquo; and carers&rsquo; psychological well-being, activities of daily living, caring tasks of the patients, and community linkages. A quantitative approach was used for stage two involving two sets of questionnaires, one for the patient and one for the carer, developed from the themes identified in stage one. A pilot study was conducted on three pairs of patients and their carers, 2 weeks after discharge from hospital. The main study consisted of a convenience sample of 40 pairs of patients and their carers who completed the questionnaires 2 weeks post-discharge. Data analysis of stage two of the study consisted of descriptive statistics and cross-tabulations. The main findings suggested that carers received very little information from health professionals concerning their patients&rsquo; health problems and care at home. The carers&rsquo; health and employment states were often not considered in their patients&rsquo; discharge plan. Carers who were present with their patients when they received information concerning post-discharge care experienced a decrease in anxiety during their patients&rsquo; convalescence at home, greater satisfaction with the information they received, and their patients experienced fewer medical problems post-discharge. The implications for nursing practice and research include recommendations for a more effective system of discharge planning, and further research to include a larger population with a more varied group of participants.

Sources, perceived usefulness and understanding of information disseminated to families who entered home quarantine during the H1N1 pandemic in Victoria, Australia: a cross-sectional study

Background Voluntary home quarantine of cases and close contacts was the main non-pharmaceutical intervention used to limit transmission of pandemic (H1N1) 2009 influenza (pH1N1) in the initial response to the outbreak of the disease in Australia. The effectiveness of voluntary quarantine logically depends on affected families having a clear understanding of what they are being asked to do. Information may come from many sources, including the media, health officials, family and friends, schools, and health professionals. We report the extent to which families who entered home quarantine received and used information on what they were supposed to do. Specifically, we outline their sources of information; the perceived usefulness of each source; and associations between understanding of recommendations and compliance. Methods Cross-sectional survey administered via the internet and computer assisted telephone interview to families whose school children were recommended to go into home quarantine because they were diagnosed with H1N1 or were a close contact of a case. The sample included 314 of 1157 potentially eligible households (27% response rate) from 33 schools in metropolitan Melbourne. Adjusting for clustering within schools, we describe self-reported 'understanding of what they were meant to do during the quarantine period'; source of information (e.g. health department) and usefulness of information. Using logistic regression we examine whether compliance with quarantine recommendations was associated with understanding and the type of information source used. Results Ninety per cent understood what they were meant to do during the quarantine period with levels of understanding higher in households with cases (98%, 95% CI 93%-99% vs 88%, 95% CI 84%-91%, P = 0.006). Over 87% of parents received information about quarantine from the school, 63% from the health department and 44% from the media. 53% of households were fully compliant and there was increased compliance in households that reported that they understood what they were meant to do (Odds Ratio 2.27, 95% CI 1.35-3.80). Conclusions It is critical that public health officials work closely with other government departments and media to provide clear, consistent and simple information about what to do during quarantine as high levels of understanding will maximise compliance in the quarantined population.

Outcomes of a knowledge translation strategy

In this paper we describe how an Australian health promotion agency combined short information sheets and &lsquo;micro-movies&rsquo; to encourage the uptake of evidence associated with a food security initiative. Although commended by intended users for being innovative, a follow up study of the dissemination approach produced few tangible examples of learnings being translated into action. The paper provides an overview of the general rationale underlying the mixed-media research dissemination strategy and identifies barriers that resulted in low engagement with the information resources. Furthermore, we offer some general lessons for program planners and researchers who are interested in applying novel reporting methods to encourage evidence uptake.

Bridging the copyright and licensing knowledge gap

Objectives: The purpose of this project was to examine the copyright and licensing knowledge gap of academic staff to identify their current understanding of, and attitudes towards, copyright, licensing and the open access movement in relation to the content they use, create, and share in their teaching and research practice. The motivation behind this study was to gather information to assist the Library in creating and providing effective information resources and training for academic staff.<br /><br />Methods: An anonymous online survey was distributed to Faculty of Health academic staff at Deakin University. Seventy individuals in the Faculty of Health completed the survey.<br /><br />Results: The results suggested that most of the academics have used content created by others in their teaching materials, but they are not confident about complying with copyright or licensing conditions whilst doing so. Most had not posted any of their own content online, but would generally be willing for it to be used by others, with attribution. Around half had never posted their published articles in an institutional or discipline repository, but again, would be willing for them to be used for educational purposes. Most academics have never shared their research data online, and some were very unwilling to do so - despite current pushes to broaden access to research data sets. Finally, most had never applied a Creative Commons licence to a piece of work, and over half were unaware of what rights they had retained under publishing agreements for their work. It was strongly indicated that an informational website would be very helpful in providing guidance around topics of copyright, licensing and sharing. <br /><br />Conclusions: Results were largely consistent with other similar studies conducted around these topics. There is a clear role for librarians to continue providing such training and resources as the push for Open Access resources, publishing, and data only gains momentum.

Co-morbid depression and chronic illness related to coping and physical and mental health status

A partial latent structural regression analysis was used to evaluate the role of coping resources, depression, diet and exercise on mental and physical health status. The sample consisted of 113 participants (59 females and 54 males) with a mean age of 59.38&thinsp;years (SD&thinsp;=&thinsp;10.52). Coping resources, depression and exercise explained 52 and 26% of the variance in mental and physical health status, respectively. Fewer coping resources predicted higher levels of depression and both predicted worse mental health. Only higher levels of depression predicted worse physical health status. There were also significant indirect effects of coping on mental and physical health status through depression. The development of cognitive, social and emotional coping strategies is important for managing depression and supporting positive mental health. These results highlight the important role of health psychologists in the care of individuals with chronic illness. Additionally, the management of depression is important in maintaining positive physical health.