936 resultados para Community-based social services -- Victoria -- Melbourne
Resumo:
Maintaining the alignment between the dynamic development of health and social services and the rapidly advancing scientific evaluation literature is a central challenge facing service administrators. We describe “program explication,” a consulting method designed to assist services to identify and review implicit program logic assumptions against the evaluation literature. Program explication initially facilitates agency staff to identify and document service components and activities considered critical for improving client outcomes. Program assumptions regarding the relationship between service activities and client outcomes are then examined against available scientific evidence. We demonstrate the application of this method using an example of its use in reviewing a service for homeless young people operating in Melbourne, Australia, known as the Young People's Health Service (YPHS). The YPHS involved 21 activities organized within 4 components. The intended benefits of each of the activities were coherently articulated and logically consistent. Our literature search revealed moderate to strong evidence for around 1 quarter of the activities. The program explication method proved feasible for describing and appraising the YPHS service assumptions, thereby enhancing service evaluability.
Resumo:
Background
Childlessness among Australian women is increasing. Despite this, little is known about the physical and mental health and wellbeing of childless women, particularly during the reproductive years. The aims of this exploratory study were to: 1) describe the physical and mental health and wellbeing and lifestyle behaviours of childless women who are currently within the latter part of their reproductive years (30 – 45 years of age); and 2) compare the physical and mental health and wellbeing and lifestyle behaviours of these childless women to Australian population norms.
Methods
A convenience sample of 50 women aged between 30 and 45 years were recruited to participate in a computer assisted telephone interview. The SF-36 Health Survey v2 and lifestyle indicators were collected in regards to women’s health and wellbeing. Data were analysed using descriptive statistics, t-tests for independent sample means and 95% confidence intervals for the difference between two independent proportions.
Results
Childless women in this study reported statistically significant poorer general health, vitality, social functioning and mental health when compared to the adult female population of Australia. With the exception of vegetable consumption, lifestyle behaviours were similar for the childless sample compared to the adult female population in Australia.
Conclusions
Childless women may be at a greater risk of experiencing poor physical and mental health when compared to the Australian population. A woman’s health and wellbeing during her reproductive years may have longer term health consequences and as such the health and wellbeing of childless women requires further investigation to identify and address implications for the provision of health (and other social) services for this growing population group.
Resumo:
Previous research in Australia and overseas has shown that young offenders serving community-based orders are at high-risk for undetected but clinically significant oral language difficulties. However, this phenomenon has received little attention in incarcerated samples, and links with offending severity, mental health, and other markers of early risk have not previously been systemically examined. A cross-sectional examination of 100 young offenders (mean age 19.03 years) completing custodial sentences in Victoria, Australia was conducted. A range of standardized oral language, IQ, mental health, and offending severity measures was employed. Forty-six per cent of participants were classified as language impaired (LI), and these were compared with the non-LI sub-group on background and offending variables. When the sub-group with high scores on a measure of offending severity was compared with those with (relatively) lower offending scores, significant differences on a range of language measures were identified. A range of early risk indicators (such as placement in Out of Home Care) was also examined with respect to language impairment in this high-risk group. Results are discussed with respect to policy and practice pertaining to early intervention for vulnerable children, and implications for service delivery within the justice system. In particular, emphasis is placed on the need to closely examine the oral language skills of children who struggle with the transition to literacy and then display behavioural difficulties in the classroom. Once a young person is engaged with youth justice services, a high index of suspicion should be maintained with respect to their oral language skills; for example, in relation to forensic interviewing and the ability to benefit from verbally mediated interventions.
Resumo:
Most existing work on learning community structure in social network is graph-based whose links among the members are often represented as an adjacency matrix, encoding direct pairwise associations between members. In this paper, we propose a method to group online communities in blogosphere based on the topics learnt from the content blogged. We then consider a different type of online community formulation - the sentiment-based grouping of online communities. The problem of sentiment-based clustering for community structure discovery is rich with many interesting open aspects to be explored. We propose a novel approach for addressing hyper-community detection based on users' sentiment. We employ a nonparametric clustering to automatically discover hidden hyper-communities and present the results obtained from a large dataset.
Resumo:
Jim Hyde suggests that the research on building the capacity of communities and the accumulation of social capital shows that how we organize our health systems - in both micro and macro contexts - is important. He argues that collaboration, flexibility and community participation must become central in health structures.
Resumo:
The Ecomusée, as emerged in France in the 1970s, is a form of open-air museum that aims to maintain collections in their original environments with local communities serving as curators and managing their own heritage. This approach and philosophy implies and is dependent upon democratic principles in the conservation and interpretation processes. Since the 1990s, China has adopted the ecomusée concept for the conservation of selected ethnic villages to relieve tensions between poverty and heritage conservation. However, does this concept really work in China? To answer this question, the Suojia Ecomuseum, the first such initiative - has been selected as a case study and assessed using the mixed methodologies of on-site observation, documentation and semistructured interviews. This process has identified several issues and problems associated with this ecomuseum. It demonstrates that Suojia Ecomuseum has not achieved international benchmarks, neither philosophical nor practical expectations have been met. This conclusion challenges the internationally acknowledged notion that all ecomuseums develop and are operated using a bottom-up approach, that they were all community-based and democratic. These discrepancies lead to other questions about the differences between ecomuseums in China and elsewhere. In order to map and compare the differences between ecomuseums in China and in Western democracies, a detailed survey was undertaken using Melbourne’s Living Museum of the West, Australia. Applying the same methodologies as in China, a comparable examination was undertaken as to its background, objectives, management structures, programs and activities, and project outcomes as well as problems. The differences between Suojia Ecomuseum and Melbourne’s Living Museum are then explained and shown. They demonstrate quite diverse organisations with different objectives and management structures relating to different cultural and natural resources. However, the unexpected finding was that the futures of both ecomuseums relied on the financial support and passion of younger generations and hence were vulnerable.
Resumo:
Background:
Health and social care practitioners collaborate in discharge planning for older people. Difficulties securing timely and quality discharge information and unclear role boundaries can be challenging. There are limited reports in the literature describing community-based practitioners' roles communicating client information.
Aim:
To describe the roles of community-based practitioners in communication of older clients' information in an Australian context.
Design:
A descriptive and exploratory qualitative research design was applied.
Methods:
Four focus groups were conducted in 2009 with a small sample (n = 16) of district nurses, practice nurses and aged care case managers.
Results:
All participants described communication as a core characteristic of their role focused on minimising risks for older people. Participants valued dialogue with other health and social care providers in real time with an emphasis on telephone communication, face-to-face meetings, and case conferences. Telephone communication was considered important where there was an urgent need to problem solve. Written communication was noted as less effective.
Conclusions:
There is an increasing need for stronger models of communication in community-based settings to facilitate safe, efficient and sustainable health and social outcomes for older people.
Implications for practice:
There is limited available research with this focus to guide practice. Findings from this exploratory study indicate a number of important areas for further research: (i) to understand how communication feedback systems and pathways between community and inpatient providers could improve information exchange and (ii) to describe community nurses' roles in communication and medication risks for older people.
Resumo:
Background
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.
Methods
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.
Discussion
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.
Resumo:
Objective. To improve understanding of barriers to participation in community-based arthritis self-management programmes and patient preferences for self-management education.
Methods. Individuals with hip or knee OA referred to orthopaedic surgeons or rheumatologists at six public and private hospitals in Victoria, Australia, were recruited for a randomized controlled trial (RCT) of the Stanford Arthritis Self-Management Programme (ASMP). As part of the study design, potential participants were asked during the screening and recruitment process about reasons for being unable to attend the course, reasons for not participating in the study and individual preferences for course scheduling.
Results. Of 1125 individuals assessed, 216 (19%) were unable to attend six ASMP sessions. This was commonly due to physical limitations, including illness, restricted mobility and pain (22%), difficulty getting to or from courses (22%), work commitments (22%), the time commitment required (17%) and family roles (12%). Among those who did not want to participate in the study (n = 258), the overwhelming reason was disinterest (74%). Specific preferences for course scheduling were frequent, confirming the practical challenges faced in organizing courses for the RCT.
Conclusion. Incorporating patients from public and private settings, this study has elicited new insights into barriers to ASMP participation. Many people with hip or knee OA have limited capacity and motivation to attend community-based group programmes. Future self-management programmes and research should include more accessible options for those who cannot attend group-based programmes.
Resumo:
Childhood obesity is a complex issue and needs multistakeholder involvement at all levels to foster healthier lifestyles in a sustainable way. ‘Ensemble Prévenons l'ObésitéDes Enfants’ (EPODE, Together Let's Prevent Childhood Obesity) is a large-scale, coordinated, capacity-building approach for communities to implement effective and sustainable strategies to prevent childhood obesity. This paper describes EPODE methodology and its objective of preventing childhood obesity.
At a central level, a coordination team, using social marketing and organizational techniques, trains and coaches a local project manager nominated in each EPODE community by the local authorities. The local project manager is also provided with tools to mobilize local stakeholders through a local steering committee and local networks. The added value of the methodology is to mobilize stakeholders at all levels across the public and the private sectors. Its critical components include political commitment, sustainable resources, support services and a strong scientific input – drawing on the evidence-base – together with evaluation of the programme.
Since 2004, EPODE methodology has been implemented in more than 500 communities in six countries. Community-based interventions are integral to childhood obesity prevention. EPODE provides a valuable model to address this challenge.
Resumo:
Introduction: The motor and non-motor symptoms associated with idiopathic Parkinson’s disease (PD) may compromise the health-related quality of life (HRQOL) of some individuals living with this debilitating condition. Although growing evidence suggests that PD may be more prevalent in rural communities, there is little information about the life quality of these individuals. This study examines whether HRQOL ratings vary in relation to rural and metropolitan life settings.
Methods: An analytic cross-sectional study was conducted to compare the HRQOL of two separate samples of people with PD living in metropolitan Melbourne and rural Victoria. The metropolitan sample consisted of 210 individuals who had participated in the baseline assessment for an existing clinical trial. The rural sample comprised 24 participants who attended community-based rehabilitation programs and support groups in rural Victoria. Health-related quality of life was quantified using the Parkinson’s Disease Questionnaire-39 (PDQ-39).
Results: The HRQOL of participants in rural Australia differed from individuals living in a large metropolitan city (p=0.025). Participants in rural Australia reported worse overall HRQOL, after controlling for differences in disease duration. Their overall HRQOL was lower than for city dwellers. Rural living was also found to be a significant negative predictor of HRQOL (β=0.14; 95% CI -1.27 to -0.08; p=0.027).
Conclusion: The findings of this study suggest that some people with PD living in rural Victoria perceive their HRQOL to be relatively poor. In order to minimise the debilitating consequences of this disease, further studies examining the factors that may contribute to the HRQOL of individuals living in rural and remote areas are required.
Resumo:
Background: Falls are one of the most common health problems among older people and pose a major economic burden on health care systems. Exercise is an accepted stand-alone fall prevention strategy particularly if it is balance training or regular participation in Tai chi. Dance shares the ‘holistic’ approach of practices such as Tai chi. It is a complex sensorimotor rhythmic activity integrating multiple physical, cognitive and social elements. Small-scale randomised controlled trials have indicated that diverse dance styles can improve measures of balance and mobility in older people, but none of these studies has examined the effect of dance on falls or cognition. This study aims to determine whether participation in social dancing: i) reduces the number of falls; and ii) improves cognitive functions associated with fall risk in older people.
Methods/design: A single-blind, cluster randomised controlled trial of 12 months duration will be conducted. Approximately 450 participants will be recruited from 24 self-care retirement villages that house at least 60 residents each in Sydney, Australia. Village residents without cognitive impairment and obtain medical clearance will be eligible. After comprehensive baseline measurements including physiological and cognitive tests and self-completed questionnaires, villages will be randomised to intervention sites (ballroom or folk dance) or to a wait-listed control using a computer randomisation method that minimises imbalances between villages based on two baseline fall risk measures. Main outcome measures are falls, prospectively measured, and the Trail Making cognitive function test. Cost-effectiveness and cost-utility analyses will be performed.
Discussion: This study offers a novel approach to balance training for older people. As a community-based approach to fall prevention, dance offers older people an opportunity for greater social engagement, thereby making a major contribution to healthy ageing. Providing diversity in exercise programs targeting seniors recognises the heterogeneity of multicultural populations and may further increase the number of taking part in exercise.
Resumo:
‘More than a Game’ is a sport-based youth mentoring program developed and implemented by Western Bulldogs in partnership with Newport Islamic Society (NIS), the Australian Federal Police, Victoria Police and Hobsons Bay City Council, with funding from the Attorney General’s Department Building Community Resilience (BCR) grant scheme. The program aimed to develop a community-based resilience model that would use team-based sports to address issues of identity, sense of belonging and cultural isolation amongst young men of Islamic faith, all of which are identified as factors that may promote forms of violent extremism. The program involved 60 young men, aged 15-25, from the Newport Islamic Society in Melbourne’s Western suburbs. The boys were engaged in numerous activities where they were mentored by staff from Western Bulldogs, Victoria Police and Australian Federal Police, who worked in conjunction with community leaders from the Newport Islamic Society.
Through sports-based training, mentoring programs, and community dialogue, ‘More Than a Game’ aimed to develop participants’ leadership, communication, and cross-cultural engagement skills; to identify and facilitate the development of young role models in the community; to enhance greater understanding of the Muslim community in Melbourne’s West, and to foster greater intercultural contact and understanding between participants and other cultural groups. A number of activities were developed and implemented as a part of the program
Resumo:
Objectives:
Design and Methods:
This study involved a cross-sectional survey of 304 public health practitioners and policy-makers from government, non-government, and community organizations across Victoria, Australia. Participants reported their organizations' current obesity prevention programs and policies, their own perceptions of the feasibility and effectiveness of strategies to prevent obesity and their preferred settings for obesity prevention.
Results:
Thirty-nine percent had an obesity prevention policy, and 92% were implementing obesity prevention programs. The most common programs focused on education, skill-building, and increasing access to healthy eating/physical activity opportunities. School curriculum-based initiatives, social support for physical activity, and family-based programs were considered the most effective strategies, whereas curriculum-based initiatives, active after-school programs, and providing access to and information about physical activity facilities were deemed the most feasible strategies. Schools were generally perceived as the most preferred setting for obesity prevention.
Conclusion:
Many organizations had obesity prevention programs, but far fewer had obesity prevention policies. Current strategies and those considered feasible and effective are often mismatched with the empirical literature. Systems to ensure better alignment between researchers, practitioners, and policy-makers, and identifying effective methods of translating empirical evidence into practice and policy are required.
