Planning and evaluation

- identify the importance of planning and evaluation in public health practice - recognise the links between planning and evaluation through the presentation of relevant models - identify the core concepts of needs assessment in public health - describe the evaluation cycle and the importance of an evaluation plan - understand evaluation designs and their application in practice.

Social and emotional determinants of health

- describe what is meant by socioeconomic differences in health, and the social and emotional determinants of health - understand how health inequalities are affected by the social and economic circumstances that people experience throughout their lives - discuss how factors such as living and working conditions, income, place and education can impact on health - identify actions for public health policy-makers that have the potential to make a difference in improving health outcomes within populations - appreciate the concept of social cohesion and social capital, and their role as potential protective factors in health - understand conceptual models that can assist in analysing these issues.

Health promotion

The ‘promotion of health’ has become everybody’s business: from the marketers of ‘healthy’ products and lifestyles, and gym memberships; government media campaigns to ‘Go for 2&5®’ (fruit and vegetables every day), special ‘extra’ benefits for joining a private health insurance fund and workplace ‘wellness’ programs that include yoga and pilates. For consumers, the list is endless. Health professionals need to understand the background to this growth in the promotion of ‘health’ and the place health promotion plays in public health. We begin this chapter with a discussion on health education, we then trace the evolution of health promotion from health education, the strategies and settings for health promotion, and conclude with challenges for health promotion. Case studies, activities and reflections on the material are presented to assist you.

Defining health and public health

- define health and public health - discuss how the concept of ‘health’ means different things to different individuals and be able to consider the range of factors that influence these definitions - identify and describe the principles of public health - recognise and describe how public health is defined and how each definition has shaped the development and implementation of public health approaches - describe the relationship between public health and other disciplines - discuss the nature and scope of public health - describe the varying roles of the public health workforce

History and development of public health

- briefly describe the importance of public health history to contemporary public health - briefly describe the ancient history of public health - outline the key periods and activities in the modern history of Western public health - describe and understand the important roles of political, social, environmental and economic factors as they impact on health - consider the major factors that have influenced an understanding of contemporary public health in the past 40 years.

Biological and environmental determinants

- describe the complex web of determinants as part of broad causal pathways that affect health - identify and discuss the range of physical, biological and environmental determinants that impact on health - suggest why it is important to the practice of public health that you understand how determinants contribute to health - understand the complexity of health and illness and the multifaceted role of health determinants - relate determinants of health to public health activity and realise the need for multisectoral action and multiple approaches when working to improve health

The future for public health

What is the future for public health in the twenty first century? Can we glean an idea about the future of public health from its past? As Winston Churchill once said ‘the further backward you look, the further forward you can see’. What then can we see in the history of public health that gives us an idea of where public health might be headed in the future? In the twentieth century there was substantial progress in public health in Australia. These improvements were brought about through a number of factors. In part, improvements were due to improved knowledge about the natural history of disease and its treatment. Added to this knowledge was a shifting focus from legislative measures to protect health, to the emergence of improved promotion and prevention strategies and a general improvement in social and economic conditions for people living in countries like Australia. The same could not, however, be said for poorer countries, many of whom have the most fundamental of sanitary and health protection issues still to deal with. For example, in sub-Saharan Africa and Russia, the decline in life expectancy may be an aberration or it may be related to a range of interconnected factors. In Russia, factors such as alcoholism, violence, suicide, accidents and cardiovascular disease could be contributing to the falling life expectancy (McMichael & Butler 2007). In sub-Saharan Africa, a range of issues such as HIV/AIDS, poverty, malaria, tuberculosis, undernutrition, totally inadequate infrastructure, gender inequality, conflict and violence, political taboos and a complete lack of political will, have all contributed to a dramatic drop in life expectancy (McMichael & Butler 2007).

Sociobiological Aspects of Resilience

The chapter approaches resilience from an evolutionary psychology perspective. In recent years scientific studies have revealed many of the biological processes associated with resilient behaviour. The authors argue that the internal constitution and mental toughness of the individual will provide a core protection for life's inevitable tests. A nurtured developing brain 'in-utero' and a physically close dyadic relationship in the early years of life, are crucial to the provision of a resilient personality. Many descriptors of the construct of resilience presented in various studies are explored in this chapter.

Growing local participation through long term design

Our research explores the design of networked technologies to facilitate local suburban communications and to encourage people to engage with their local community. While there are many investigations of interaction designs for networked technologies, most research utilises small exercises, workshops or other short-term studies to investigate interaction designs. However, we have found these short-term methods to be ineffective in the context of understanding local community interaction. Moreover we find that people are resistant to putting their time into workshops and exercises, understandably so because these are academic practices, not local community practices. Our contribution is to detail a long term embedded design approach in which we interact with the community over the long term in the course of normal community goings-on with an evolving exploratory prototype. This paper discusses the embedded approach to working in the wild for extended field research.

Professional growth through working together : a study of reciprocal benefits for teacher and education advisor through classroom based professional development

Teacher professional development provided by education advisors as one-off, centrally offered sessions does not always result in change in teacher knowledge, beliefs, attitudes or practice in the classroom. As the mathematics education advisor in this study, I set out to investigate a particular method of professional development so as to influence change in a practising classroom teacher’s knowledge and practices. The particular method of professional development utilised in this study was based on several principles of effective teacher professional development and saw me working regularly in a classroom with the classroom teacher as well as providing ongoing support for her for a full school year. The intention was to document the effects of this particular method of professional development in terms of the classroom teacher’s and my professional growth to provide insights for others working as education advisors. The professional development for the classroom teacher consisted of two components. The first was the co-operative development and implementation of a mental computation instructional program for the Year 3 class. The second component was the provision of ongoing support for the classroom teacher by the education advisor. The design of the professional development and the mental computation instructional program were progressively refined throughout the year. The education advisor fulfilled multiple roles in the study as teacher in the classroom, teacher educator working with the classroom teacher and researcher. Examples of the professional growth of the classroom teacher and the education advisor which occurred as sequences of changes (growth networks, Hollingsworth, 1999) in the domains of the professional world of the classroom teacher and education advisor were drawn from the large body of data collected through regular face-to-face and email communications between the classroom teacher and the education advisor as well as from transcripts of a structured interview. The Interconnected Model of Professional Growth (Clarke & Hollingsworth, 2002; Hollingsworth, 1999) was used to summarise and represent each example of the classroom teacher’s professional growth. A modified version of this model was used to summarise and represent the professional growth of the education advisor. This study confirmed that the method of professional development utilised could lead to significant teacher professional growth related directly to her work in the classroom. Using the Interconnected Model of Professional Growth to summarise and represent the classroom teacher’s professional growth and the modified version for my professional growth assisted with the recognition of examples of how we both changed. This model has potential to be used more widely by education advisors when preparing, implementing, evaluating and following-up on planned teacher professional development activities. The mental computation instructional program developed and trialled in the study was shown to be a successful way of sequencing and managing the teaching of mental computation strategies and related number sense understandings to Year 3 students. This study was conducted in one classroom, with one teacher in one school. The strength of this study was the depth of teacher support provided made possible by the particular method of the professional development, and the depth of analysis of the process. In another school, or with another teacher, this might not have been as successful. While I set out to change my practice as an education advisor I did not expect the depth of learning I experienced in terms of my knowledge, beliefs, attitudes and practices as an educator of teachers. This study has changed the way in which I plan to work as an education advisor in the future.

A randomized trial of a telephone-delivered exercise intervention for non-urban dwelling women newly diagnosed with breast cancer : exercise for health

Physical activity is important following breast cancer. Trials of non-face-to-face interventions are needed to assist in reaching women living outside major metropolitan areas. This study seeks to evaluate the feasibility and effectiveness of a telephone-delivered, mixed aerobic and resistance exercise intervention for non-urban Australian women with breast cancer. A randomized controlled trial comparing an 8-month intervention delivered by exercise physiologists (n = 73) to usual care (n = 70). Sixty-one percent recruitment rate and 96% retention at 12 months; 79% of women in the intervention group received at least 75% of calls; odds (OR, 95% CI) of meeting intervention targets favored the intervention group for resistance training (OR 3.2; 1.2, 8.9) and aerobic (OR 2.1; 0.8, 5.5) activity. Given the limited availability of physical activity programs for non-urban women with breast cancer, results provide strong support for feasibility and modest support for the efficacy of telephone-delivered interventions.

Responsiveness of the Effective Consumer Scale (EC-17)

Objective. The Effective Consumer Scale (EC-17) comprises 17 items measuring the main skills and behaviors people need to effectively manage their healthcare. We tested the responsiveness of the EC-17. Methods. Participants, in 2 waves of a 6-week Arthritis Self-Management Program (ASMP) from Arthritis Ireland, received a questionnaire at the first and last week of the weekly ASMP. The questionnaire included the EC-17 and 10 other measures for arthritis. Deficits, mean change, and standard deviations were calculated at baseline and Week 6. The EC-17 scores were compared to the Arthritis Self-Efficacy (ASE) and Patient Activation Measure (PAM) scales. Results were presented at OMERACT 9. Results. There is some overlap between the EC-17 and the ASE and PAM; however, most items of greatest deficit in the EC-17 are not covered by those scales. In 327 participants representing both intervention waves (2006 and 2007), the EC-17 was more efficient than the ASE but less efficient than the PAM for detecting improvements after the ASMP, and was moderately correlated with the PAM. Conclusion. The EC-17 appears to measure different skills and attributes than the ASE and PAM. Discussions with participants at OMERACT 9 agreed that it is worthwhile to measure the skills and attributes of an effective consumer, and supported the development of an intervention (such as proposed online decision aids) that would include education in the categories in the EC-17.

Evolving a relationship for cross-cultural participatory innovation

Participatory design prioritises the agency of those who will be most affected by design outcomes. However in cross cultural innovation involving indigenous and non-indigenous communities there is much work to do to develop the cross cultural innovation practices that can best bring together different skills, perspectives and ways of knowing in order to realise the aspirations of indigenous peoples. In this short paper we outline a work-inprogress method based upon relationship development and reciprocity over practical, tangible and culturally appropriate activities. We argue that in a cross-cultural setting the participatory innovation process must be part of a larger relationship building process. The paper centres around a proposed design project with a remote indigenous community on the Groote Eylandt archipelago. A project proposal has evolved from a relationship built through ecological work between scientists and the local community to study native populations of animal species. We describe the context and history and our proposed approach to engaging indigenous knowledge in design.

Designerly analysis of a socio-physical design activity

The Making Design and Analysing Interaction track at the Participatory Innovation Conference calls for submissions from ‘Makers’ who will contribute examples of participatory innovation activities documented in video and ‘Analysts’ who will analyse those examples of participatory innovation activity. The aim of this paper is to open up for a discussion within the format of the track of the roles that designers could play in analysing the participatory innovation activities of others and to provide a starting point for this discussion through a concrete example of such ‘designerly analysis’. Designerly analysis opens new analytic frames for understanding participatory innovation and contributes to our understanding of design activities.

A child led participatory approach for technology-based intervention

There is significant interest in Human-computer interaction methods that assist in the design of applications for use by children. Many of these approaches draw upon standard HCI methods,such as personas, scenarios, and probes. However, often these techniques require communication and kinds of thinking skills that are designer centred,which prevents children with Autism Spectrum Disorders or other learning and communication disabilities from being able to participate. This study investigates methods that might be used with children with ASD or other learning and communication disabilities to inspire the design of technology based intervention approaches to support their speech and language development. Similar to Iversen and Brodersen, we argue that children with ASD should not be treated as being in some way “cognitively incomplete”. Rather they are experts in their everyday lives and we cannot design future IT without involving them. However, how do we involve them Instead of beginning with HCI methods, we draw upon easy to use technologies and methods used in the therapy professions for child engagement, particularly utilizing the approaches of Hanen (2011) and Greenspan (1998). These approaches emphasize following the child’s lead and ensuring that the child always has a legitimate turn at a detailed level of interaction. In a pilot project, we have studied a child’s interactions with their parents about activities over which they have control – photos that they have taken at school on an iPad. The iPad was simple enough for this child with ASD to use and they enjoyed taking and reviewing photos. We use this small case study as an example of a child-led approach for a child with ASD. We examine interactions from this study in order to assess the possibilities and limitations of the child-led approach for supporting the design of technology based interventions to support speech and language development.