Design and ethics in digital mental health promotion

This chapter presents a case study of Participatory Design as a design framework for developing interactive digital tools for promoting children’s resilience. The author argues for a participatory methodology as an ethical approach that involves children as co-designers in the process from which they are traditionally excluded, namely the creative design process and the process of mental health promotion.

"But we’re already doing it!" Examining conceptual blurring between health promotion and palliative care

Over the past decade, an increasing number of palliative care service providers have attempted to integrate health promotion into their organisational practice. A key factor in the success of this endeavour has been the recognition by these providers of the conceptual ‘fit’ between two seemingly disparate approaches to health care. When informed of the elements of health promotion, palliative care professionals have expressed their recognition in their declaration: ‘But we’re already doing it!’ (Rosenberg 2007). Yet it appears that this association between the two suggests that health promotion in palliative care organisations is being understood in poorly defined ways. ‘Health promotion’ can be incorrectly assumed to be synonymous with ‘health education’; ‘death education’ can be understood to be synonymous with providing information about palliative care resources. Whilst these activities may be worthwhile within themselves, their presence in the activities of an organisation does not constitute the practice of health promoting palliative care (HPPC) (Kellehear 1999)...

We have a lot to learn yet : a postcolonial lens in health promotion

Health promotion progresses a social justice and empowerment agenda and thus emphasises working with people to increase their control over their health. Certainly, Australia has experienced much success in this endeavour and is internationally recognised as a leader. However, health promotion has failed Indigenous Australians; a fact that is echoed in the health outcomes that ironically provide us with the “moral imperative” to act. Further investigation has also revealed health promotion’s foundation in colonial imaginings. Thus, this paper calls for the culture of health promotion to be examined as a risk factor for poor Indigenous health. To complement this call, this paper presents findings of an ethnographic study of Indigenous health promotion practice, undertaken from a postcolonial and critical whiteness framework. These findings provide a narrative of strength and innovative approaches, highlighting the value of Indigenous knowledge. These findings also contradict the biomedical tendency to construct culture as illness-producing. More broadly, this study’s findings entail important lessons for health promotion to consider, if it is to move beyond the rhetoric, to truly increase people’s control over their health.

Health promotion

Subheadings: What is health promotion? Research and health promotion practice Planning and evaluation as the cornerstones of evidence

Deadly Choices or deadly choices? An ethnography of health promotion practice with Indigenous Australians

This presentation provides an overview of my PhD research, which links with the Institute for Urban Indigenous Health (IUIH) and its Deadly Choices team. In the presentation, I introduce my critique of mainstream health promotion practice, highlighting the need for decolonisation of health promotion and the opportunity to learn from health promotion practice that acknowledges Indigenous knowledge, skills and perspectives. I also overview my ethnographic research methodology, which enabled me to be a participant observer with IUIH health promotion practitioners. I canvas some of my findings to date, according to two key areas: the unique way Deadly Choices applies leadership as its model of health promotion practice; and the range of innovative engagement strategies they employed, including the Deadly Choices brand and social media. I conclude by highlighting the counter-narrative and contrast that Deadly Choices provides compared to traditional health promotion approaches with Indigenous people, and identify lessons for decolonisation of heath promotion more broadly.

Deadly Choices : better ways of doing health promotion

Editor's introduction: Mainstream health promotion has failed Aboriginal and Torres Strait Islander peoples, according to Karen McPhail-Bell, a PhD candidate at Queensland University of Technology. In the article below, she argues that those working in the field could learn from strengths-based programs like The Institute for Urban Indigenous Health’s Deadly Choices. It offers lessons for all health promotion practice, she says. Her challenge is timely, with the Public Health Association of Australia’s 43rd annual conference starting in Perth tomorrow (follow #PHAA2014 for Twitter news from the conference).

Changes in outdoor workers' sun-related attitudes, beliefs, and behaviors : a pre-post workplace intervention

OBJECTIVE To evaluate changes in outdoor workers' sun-related attitudes, beliefs, and behaviors in response to a health promotion intervention using a participatory action research process. METHODS Fourteen workplaces across four outdoor industry types worked collaboratively with the project team to develop tailored sun protection action plans. Workers were assessed before and after the 18-month intervention. RESULTS Outdoor workers reported increases in workplace support for sun protection (P < 0.01) and personal use of sun protection (P < 0.01). More workers reported seeking natural shade (+20%) and wearing more personal protective equipment, including broad-brimmed hats (+25%), long-sleeved collared shirts (+19%), and long trousers (+16%). The proportion of workers reporting sunburn over the past 12 months was lower at postintervention (-14%) (P = 0.03); however, the intensity of reported sunburn increased. CONCLUSIONS This intervention was successful in increasing workers' sun protective attitudes, beliefs, and behaviors.

Mothers and health promotion : closing the gap for 100% measles immunization in North Vietnam

Objectives This study aims to develop a better understanding of mothers’ knowledge, understanding, and attitude towards children’s measles immunization and explore the relationship between mothers’ understanding of measles immunization and health promotion programs in North Vietnam. Methods Semi-structured interviews were conducted with 15 mothers of children aged 1 or 6 years old between 2006 and 2010 in two provinces in North Vietnam. Ten interviews were transcribed and analysed to explore themes while other five interviews were cross-referenced for congruency. Among the ten mothers whose interviews were analysed, there were five mothers whose children received the full measles immunization schedule (two doses) and five mothers whose children received one or none of measles vaccination. Results Mothers had different levels of understanding and a strong positive attitude towards measles immunization. Mothers considered health officers at the commune health centres who played an important role in the promotion of measles immunization, as the main source of information. The relationship between the mother’s understanding about measles immunization and health promotion programs was found to be both positive and negative. Conclusion Mothers whose children received the full measles immunization schedule paid more attention to measles immunization and health promotion programs compared with mothers whose children received one or none of measles vaccination. Mothers’ misunderstanding about the measles immunization schedule was the main reason for choosing not to receive the measles immunizations. These findings help to improve communication with mothers about measles immunization and close the gap for 100% measles immunization in North Vietnam.

Beyond the dotted drawings : the Aboriginal Health Worker and health promotion practice

Aboriginal and Torres Strait Islander health workers' roles have changed over the years as the profession has shifted far beyond the mere provision of a cultural brokerage service. Important achievements have been made in enhancing the biomedical role of the Aboriginal and Torres Strait health worker, even though this is not the only area of expertise they need to possess.

Past, present and the evolving future of public health and health promotion: Reflections on dismantling in Queensland Australia

Objective For more than ten years the public health and health promotion workforce in the Australian state of Queensland grew dramatically. This growth was most pronounced in the disciplines of Health Promotion and in Public Health Nutrition, both regionally and corporately. In 2012 political change led to an abrupt dismantling of its public and preventive health services across the state. Individual responsibility was declared. Method This presentation provides a qualitative narrative description of past achievements and activities, the current situation and provides a perspective towards the future. Findings Government reports over several years described the growing burden of chronic disease arising from conditions such as obesity, physical inactivity, and poor nutrition in Queensland. By 2008, obesity had overtaken smoking as the single greatest risk factor to the health of Queenslanders. In 2010, the Chief Health Officer called for an increased focus on prevention to address the continuing need for more beds in hospitals. However, with political change in 2012 resulted in the dismantling and dismissal of preventive health services across the state. The following year, despite outcry, sexual health services were also axed. At present, outbreaks of vaccine preventable diseases such as measles are occurring. The epidemics of chronic disease, obesity and physical inactivity continue to grow. Conclusion The evolution of public health is not necessarily progressive, but cyclic. Challenges include political change, health practice and the interplay of health policy. A lack of an embedded emphasis on systematic review translation is one potential contributor. Perhaps the warning of Lang & Rayner should be heeded: “public health proponents have allowed themselves to be corralled into the narrow language of individualism and choice”.