Maximising clinical trial participation - how important is the social context?

Individuals participate in clinical research for a variety of reasons, dependant not only on the trial phase and their own clinical status but also their sense of optimism, altruism, clinician influence, or financial gain. Practical factors influencing participation may include geographical access, motivation, availability, and language spoken. Widely-used health psychology models (e.g the Theory of Reasoned Action, the Health Belief Model) demonstrate that, in addition to these factors, the primary reason for non-participation in clinical research is social perception of risk. These models detail how beliefs and attitudes toward clinical research develop within, and are influenced by, an individual's social context. Perceived social benefits and barriers toward participation are considered alongside perceived susceptibility and severity of side-effects from participation, or symptoms of disease. A major factor in such models is the subjective norm i.e. individuals' beliefs that important others expect or wish him/her to perform this behaviour, and the motivation to act in accordance with their expectations or wishes. This includes, but is not limited to, the role of the media, peers and family members, clarification of risk associated with trial participation and discussion of comparative risk, and risk equivalence between trials and same treatment outside trials.
The workshop will involve a 30 minute presentation from the discussion leaders and a 30 minute group-work session to explore how an understanding of the social context of participation in clinical research can maximise appropriate clinical trial participation.

Is a social marketing framework the key to promoting volunteer participation?

This paper explores the suitability of a conceptual social marketing model, the MOA (motivation, opportunity and ability) framework (Rothschild, 1999), to volunteering to determine whether it has the potential to promote volunteering with its associated socially desirable benefits. In doing so, the individual components of the model are discussed from a social marketing perspective and communalities in the volunteering research highlighted. This discussion culminates in the presentation of an adapted MOA framework, the practical implications of which for volunteer involving organisations are briefly discussed and an agenda for future research proposed.

Social justice in Australian higher education policy : an historical and conceptual account of student participation

This article provides a synoptic account of historically changing conceptions and practices of social justice in Australian higher education policy. It maps the changes in this policy arena, beginning with the period following the Second World War and concluding with an analysis of the most recent policy proposals of the Bradley Review. Concurrently, it explores the different meanings ascribed to social justice, equity and social inclusion over this time span and what these have meant and will mean for students, particularly those from low socio-economic backgrounds. It concludes that a relational understanding of social justice – ‘recognitive justice’ – is yet to inform student equity policy in higher education, although this is now what is required in the context of the planned shift from mass to universal participation.

Parent participation in disadvantaged schools : moving beyond attributions of blame

Although facilitating community participation in disadvantaged schools can be difficult, this article argues that, given the structuring of schooling in contemporary western democracies, it is even more difficult than we might imagine. Drawing on Bourdieu, we attempt to elucidate the complex relations between schooling and socio·cultural contexts which can lead to inequalities of opportunity for parent participation in schooling and which work to maintain disadvantage for marginalised students. Recognitive justice, with its positive regard for social difference and centrality of social democratic processes, offers us another way of advancing this discussion beyond simplistic attributions of blame. In particular, a polities of recognition is concerned with opening up the processes of schooling to groups who often have been excluded. This article uses interview data from a small Australian secondary school located in a regional community with high welfare dependency and a large indigenous population.

Writing as capitulation : the shelter of being-responsible

This paper explores the notion of writing and its relationship to an always-existing responsibility. It asks the question of whether writing might necessarily be a kind of biographical undertaking, and then drawing on Heidegger, it inquires into how writing might provoke an ontological encounter for the writer. Via a close investigation of the definitions and etymologies of the word ‘capitulate’, the paper links the concepts of Derridean violence, Hellerian freedom and (post)modernity, non-infinite temporality and assumptions of a metaphysics of presence to a practice of reading/writing. By taking up the Heideggerian concept of Being’s as ex-istence and porosity, it attempts to argue that post-modernity, in coming to terms with the consequences of freedom, offers the subject the opportunity for an ontological encounter with responsibility, and subsequently how an acknowledgement of this thrownness might function in itself as a kind of shelter, albeit an open one.

Activity preferences and participation of school-age children living in urban and rural environments

It is important for therapists to be knowledgeable about the impact of the environment on children’s participation patterns and activity preferences. This study investigated the activity preference and participation among school-age children living in urban and rural locations. The participation patterns and preferences for activities of 58 typically developing children (32 males and 26 females; response rate of 38.7%) aged 8–12 years were assessed across both urban (n = 24) and rural (n = 34) regions of southwest Victoria, Australia. The participation patterns and preferences for activities were assessed using the Children’s Assessment of Participation and Enjoyment and Preferences for Activities of Children (CAPE/PAC).An independent samples t-test was used to determinewhether significant differences existed for theCAPE/PACscores for urban and rurally based children as well as boys and girls. Significant differences were found between the scores of children living in urban and rural areas on the following subscales: CAPE Diversity, CAPE Intensity, CAPE Whom, CAPE Where, PAC Physical Preference, and PACSocial Preference.Asignificant difference for rural and urban groups was found on the following CAPE activity types:Recreation Diversity,Recreation Intensity, Social Diversity, Social Intensity, Self-Improvement Diversity, and Self-Improvement Intensity. Rurally based children were engaged in a broader range of activities and did so more frequently than urban children. Differences in gender were identified with girls preferring to participate in social and skill-based activities and being more likely to participate with friends or people outside their home. However, there were no significant differences in the participation patterns of boys and girls. Physical, social, and structural aspects of the location where a child lives impact the frequency, type of activities, and whom a child participates with most frequently in out-of-school activities. The activity participation of boys and girls in Australia has become quite similar.

A comparative study of factors influencing participation in sport and physical activity for metropolitan and rural female adolescents

The aim of this research was to provide a comparative analysis of the influence of behavioural alternatives, autonomy, competence and relatedness on participation in sport and physical activity for female adolescents within metropolitan and rural settings. Eighteen focus groups were conducted with a cross section of schools within metropolitan Melbourne and rural Victoria, Australia, involving 12–13-year olds and 15–16-year olds, using a semi-structured format. Content and thematic analyses were conducted on the data. Findings supported the sport commitment model by demonstrating that, in both rural and metropolitan settings, participation was influenced by the strength of commitment to a range of behavioural alternatives. Our findings also extended self-determination theory by suggesting that autonomy, competence, and relatedness were interrelated and their strength and influence on participation varied between settings. This study also has practical implications, including the promotion of more inclusive and supportive sports environments for female adolescents and promoting sport and physical activities as activity that promotes wellness, complements academic endeavours and reduces the stress of academic study.

A conceptual multi-criteria mechanism for stakeholder participation in urban development

Australia is one of the world’s most urbanised nations, with 74.92% of the population living in 17 major cities of 100,000 people or more. To improve the productivity, liveability and sustainability of Australia’s cities, there is an increasing emphasis in urban management policies on democratic stakeholder participation. In order to obtain a full picture of stakeholders’ concerns efficiently, and manage antagonism, prejudice and conflicts between stakeholders effectively, it is important for participatory decision-making in urban development to be able to select and integrate stakeholder analysis and engagement methods. This paper investigates the characteristics of stakeholder participation approaches in urban development, and proposes criteria for approach selection and integration. The outcome is a multi-criteria mechanism for selecting and integrating approaches to stakeholder participation. This could enable effective, efficient and democratic participation in decision-making process of urban development. Meanwhile, the capacity of Australian state, territory and local governments can be largely enhanced to understand and unpack the complex challenges of urban-ecological conditions, and generate a compromise solution that best represents the preferences of stakeholders.

Better access to mental health : mapping the evidence supporting participation in meaningful occupations

Introduction: The purpose of this scoping and mapping project is to assess evidence for the use of focused psychological strategies (FPS) under the Better Access to Mental Health (BAMH) scheme to enable people with mental health problems to increase their functional performance and to participate in meaningful occupations. In particular, it aims to provide an accessible summary of evidence for practitioners who use FPS with their clients.

Methods: Evidence scoping and mapping is a relatively new technique, used to provide an overview of key findings in an area of practice. A five stage process of scoping and mapping was used in this project.

Results: A total of 81 studies which addressed the use of focused psychological strategies to promote functional performance and participation in meaningful occupations were found. Surprisingly, only three were published in occupational therapy journals with one further article being authored by occupational therapists. Three maps are provided showing this evidence by diagnosis, intervention and level of evidence.

Conclusion: Clinicians can say with some confidence that cognitive behavioural therapies are effective functional tools, particularly when working with people with depression or schizophrenia. They can also be confident that good quality evidence exists across a range of diagnoses, although there are many gaps where little to no research has been conducted. Suggestions for further research are provided which take into account the findings of these maps.