Health risk behaviours and health care needs among people with psychiatric illness

This paper presents findings from two studies. Study 1 explored differences between people with psychiatric illness (PPI) (N=144) and the general population (N=151) in levels of low-fat diet, exercise and smoking. Study 2 investigated barriers and health care needs of PPI (N=60). The prevalence of overweight, cigarette smoking and sedentary lifestyle were significantly greater among PPI than the general population. Major predictors were limited social support, knowledge of correct dietary principles, lower self-efficacy, psychiatric symptomatology and various psychotropic drugs. The findings demonstrated that PPI over-used medical services but under-used preventive services due to inaccessibility, lower satisfaction and knowledge of services.

Priority setting in health: origins, description and application of the Australian Assessing Cost-Effectiveness initiative

This article reports on the ‘Assessing Cost–Effectiveness’ (ACE) initiative in priority setting from Australia. It commences with why priority setting is topical and notes that a wide variety of approaches are available. In assessing these various approaches, it is argued that a useful first step is to consider what constitutes an ‘ideal’ approach to priority setting. A checklist to guide priority setting is presented based on guidance from economic theory, ethics and social justice, lessons from empirical experience and the needs of decision-makers. The checklist is seen as an important contribution because it is the first time that criteria from such a broad range of considerations have been brought together to develop a framework for priority setting that endeavors to be both realistic and theoretically sound. The checklist will then be applied to a selection of existing approaches in order to illustrate their deficiencies and to provide the platform for explaining the unique features of the ACE approach. A case study (ACE-Cancer) will then be presented and assessed against the checklist, including reaction from stakeholders in the cancer field. The article concludes with an overview of the full body of ACE research completed to date, together with some reflections on the ACE experience.

Robustness in health research : do differences in health measures, techniques, and time frame matter?

Survey-based health research is in a boom phase following an increased amount of health spending in OECD countries and the interest in ageing. A general characteristic of survey-based health research is its diversity. Different studies are based on different health questions in different datasets; they use different statistical techniques; they differ in whether they approach health from an ordinal or cardinal perspective; and they differ in whether they measure short-term or long-term effects. The question in this paper is simple: do these differences matter for the findings? We investigate the effects of life-style choices (drinking, smoking, exercise) and income on six measures of health in the US Health and Retirement Study (HRS) between 1992 and 2002: (1) self-assessed general health status, (2) problems with undertaking daily tasks and chores, (3) mental health indicators, (4) BMI, (5) the presence of serious long-term health conditions, and (6) mortality. We compare ordinal models with cardinal models; we compare models with fixed effects to models without fixed-effects; and we compare short-term effects to long-term effects. We find considerable variation in the impact of different determinants on our chosen health outcome measures; we find that it matters whether ordinality or cardinality is assumed; we find substantial differences between estimates that account for fixed effects versus those that do not; and we find that short-run and long-run effects differ greatly. All this implies that health is an even more complicated notion than hitherto thought, defying generalizations from one measure to the others or one methodology to another.

Trust in mono-ethnic and mixed-ethnic association in Penang

Investigation into trust has become a topical issue in current social science research. This is, in large part, a result of a perception that trust in institutions has declined markedly in the past two decades. This paper investigates trust in some of Penang's civil associations as a way of measuring the health of social capital in Penang. It focuses on issues of trust and diversity since both are critical issues in Malaysian society in general and civil associations in particular. We began our analysis expecting higher forms of trust among members in the mono-ethnic associations, based on the power of bonding. However, findings from this study tend to suggest that rather than leading to lesser trust and infectiveness, involvement in mixed-ethnic associations have in fact generated higher trust among their members. These findings reveal an interesting corrective to more pessimistic view on the relationship between trust and diversity. Data from this study also provide important insight into how bridging between different people in associations marked by diversity can accentuate trust over and above the levels found in associations were bonding between like types is the dominant characteristic. The data also indicate that for both, mono-ethnic and mixed-ethnic associations, it is the extent of members' involvements in their associations that form trust and not vice versa.

Trust in mono-ethnic and mixed-ethnic associations in Penang

Investigation into trust has become a topical issue in current social science research. This is, in large part, a result of a perception that trust in institutions has declined markedly in the past two decades. This paper investigates trust in some of Penang’s civil associations as a way of measuring the health of social capital in Penang. It focuses on issues of trust and diversity since both are critical issues in Malaysian society in general and civil associations in particular. We began our analysis expecting higher forms of trust among members in the mono-ethnic associations, based on the power of bonding. However, findings from this study tend to suggest that rather than leading to lesser trust and infectiveness, involvement in mixed-ethnic associations have in fact generated higher trust among their members. These findings reveal an interesting corrective to more pessimistic view on the relationship between trust and diversity. Data from this study also provide important insight into how bridging between different people in associations marked by diversity can accentuate trust over and above the levels found in associations were bonding between like types is the dominant characteristic. The data also indicate that for both, mono-ethnic and mixed-ethnic associations, it is the extent of members’ involvements in their associations that form trust and not vice versa.

Rural primary health care workers and research : what is their present capacity?

Aims & rationale/Objectives : The main objectives of this project were to:
- conduct an audit of research skills and experience of primary health care staff in nine south western Victorian not-for-profit agencies
- identify capacity for research in five pre-identified areas
- investigate unpublished research endeavours/innovative projects taking place in the linked community organisations.
Methods : A 9-item survey was developed and will be distributed to all primary health care staff at the nine agencies via the internal email system of each organisation. The survey was developed after consultation with several agency directors, to obtain an organisational perspective on research capacity issues. Staff were also invited to take part in informal focus groups exploring key themes.
Principal findings : This study is in progress, and is expected to be completed at the end of March, 2007. Expected findings are the identification of primary health care staff's capacity for research, and discussion of relevant organisational assistance which would develop their research skills or enable continued participation in research.
Discussion : Phase 2 of the Australian PHC Research, Evaluation and Development Strategy aims to support the development and expansion of the primary health care research workforce. Findings from the current study will support this goal by assisting rural primary health care workers to identify the training and support they need to undertake quality research. The data could also be used to: a) assist the consortium to identify common research interests; b) to inform the consortium regarding the potential for collective research efforts; and c) to support funding submissions from the consortium or from individual agencies.
Implications : These findings will help to inform improved strategic planning in relation to building research capacity. The data could also be used by participating agencies to support applications for research grant funding.
Presentation type : Poster
Session theme : Building research capacity