The effectiveness of health education using the teach-back method on adherence and self-management in chronic disease: A systematic review protocol

Review question/objective What is the effect of using the teach-back method for health education to improve adherence to treatment regimen and self-management in chronic disease? Inclusion criteria Types of participants This review will consider all studies that include adult patients (aged 18 years and over) in any healthcare setting, either as inpatients (eg acute care, medical and surgical wards) or those who attend primary health care, family medical practice, general medical practice, clinics, outpatient departments, rehabilitation or community settings. Participants need to have been diagnosed as having one or more chronic diseases including heart failure, diabetes, cardiovascular disease, cancer, respiratory disease, asthma, chronic obstructive pulmonary disease, chronic kidney disease, arthritis, epilepsy or a mental health condition. Studies that include seriously ill patients, and/or those who have impairments in verbal communication and cognitive function will be excluded. Types of intervention This review will consider studies that investigate the use of the teach-back method alone or in combination with other supporting education, either in routine or research intervention education programs; regardless of how long the programs were and whether or not a follow-up was conducted. The intervention could be delivered by any healthcare professional. The comparator will be any health education for chronic disease that does not include the teach-back method. Types of outcomes Primary outcomes of interest are disease-specific knowledge, adherence, and self-management knowledge, behavior and skills measured using patient report, nursing observation or validated measurement scales. Secondary outcomes include knowledge retention, self-efficacy, hospital readmission, hospitalization, and quality of life, also measured using patient report, nursing observation, hospital records or validated measurement scales.

Democracy and the Project of Liberal Inclusion

Democracy is a multi-dimensional concept, ranging from definitions based exclusively on institutional frameworks (for example, Held, 2005, Przeworski, Alvarez, Cheibub and Limongi, 2000) to complex and integrated measures that include political and civil rights, democratic practices, values and, finally, a diverse set of institutional arrangements in society, including welfare, education, industrial relations and the legal system (Inglehart and Welzel, 2005, Jaggers and Gurr, 1995, O'Donnell, Cullel and Iazetta, 2004). This reflects the range of and distinction between merely formal electoral democracy and genuinely 'effective liberal democracy' (Inglehart and Welzel, 2005: 149), where democracy is firmly embedded not only in its institutions but in the values of its citizenry. Evidence from cross-national research confirms that formal democratic institutions, different dimensions of effective democracy, and democratic values are indeed strongly linked (Inglehart and Welzel, 2005: 154, Jaggers and Gurr, 1995: 446). Democracy is more than just a set of institutions, rules and mechanisms: it is a set of core values engrained in the 'lived experience' of its citizens. Core values of democracies are individual autonomy and egalitarianism, tolerance of diversity, and freedom from oppression for both individuals and institutions. Democracies restrain their governments by the rule of law and grant its citizens equal access to and equal treatment by legal institutions. Among these institutions, criminal justice and the treatment of those who violated rules and regulations represent sensitive seismographs for the quality of effective democracies, and the ways how democracies realise their core values.

Design thinking and management education : benefits for problem framing and problem solving

Design and design thinking are identified as making valuable contributions to business and management. The numbers of higher education programs that teach design thinking to business students and executives are growing, however to date little information about the outcomes of these initiatives has emerged. This paper presents the findings from the incorporation of design thinking and methods in one unit of an MBA program. All 90 participants from three MBA classes wholeheartedly expressed their support for this initiative. An evaluation of this experiment found positive reactions, learning, changes in behaviour and positive results for their companies. The challenges and future directions for the inclusion of design thinking and design methods in management education programs are proposed.

Students with AD/HD-related behaviours : Saudi mainstream teachers' knowledge and attitude towards inclusion

This study investigated Saudi mainstream primary teachers' knowledge of AD/HD and their attitudes towards the inclusion of students with AD/HD-related behaviours. The study also explored the relationships among teachers' attitudes towards inclusion, knowledge of AD/HD, efficacy beliefs for teaching students with behavioural problems, and relevant background factors such as teacher age, training and experience, and class size. In the first phase of the study, more than 200 Saudi teachers completed a four-part self-report questionnaire while in the second, 8 teachers completed semi-structured interviews. Findings from both phases of the study indicated that although teachers' knowledge of AD/HD was somewhat limited, they generally held positive attitudes towards the inclusion of students with AD/HD-related behaviours in regular classrooms. Additional significant influences on teachers' attitudes included class size as well as teachers' training and self-efficacy beliefs.

E-motion diaries : blogging emotional responses to online learning in higher education

Emotions are inherently social, and are central to learning, online interaction and literacy practices (Shen, Wang, & Shen, 2009). Demonstrating the dynamic sociality of literacy practice, we used e-motion diaries or web logs to explore the emotional states of pre-service high school teachers’ experiences of online learning activities. This is because the methods of communication used by university educators in online learning and writing environments play an important role in fulfilling students’ need for social interaction and inclusion (McInnerney & Roberts, 2004). Feelings of isolation and frustration are common emotions experienced by students in many online learning environments, and are associated with the success or failure of online interactions and learning (Su, et al., 2005). The purpose of the study was to answer the research question: What are the trajectories of pre-service teachers’ emotional states during online learning experiences? This is important because emotions are central to learning, and the current trend toward Massive Open Online Courses (MOOCs) needs research about students’ emotional connections in online learning environments (Kop, 2011). The project was conducted with a graduate class of 64 high school science pre-service teachers in Science Education Curriculum Studies in a large Australian university, including males and females from a variety of cultural backgrounds, aged 22-55 years. Online activities involved the students watching a series of streamed live lectures for the first 5 weeks providing a varied set of learning experiences, such as viewing science demonstrations (e.g., modeling the use of discrepant events). Each week, students provided feedback on learning by writing and posting an e-motion diary or web log about their emotional response. Students answered the question: What emotions did you experience during this learning experience? The descriptive data set included 284 online posts, with students contributing multiple entries. Linguistic appraisal theory, following Martin and White (2005), was used to regroup the 22 different discrete emotions reported by students into the six main affect groups – three positive and three negative: unhappiness/happiness, insecurity/security, and dissatisfaction/satisfaction. The findings demonstrated that the pre-service teachers’ emotional responses to the streamed lectures tended towards happiness, security, and satisfaction within the typology of affect groups – un/happiness, in/security, and dis/satisfaction. Fewer students reported that the streamed lectures triggered negative feelings of frustration, powerlessness, and inadequacy, and when this occurred, it often pertained to expectations of themselves in the forthcoming field experience in classrooms. Exceptions to this pattern of responses occurred in relation to the fifth streamed lecture presented in a non-interactive slideshow format that compressed a large amount of content. Many students responded to the content of the lecture rather than providing their emotional responses to this lecture, and one student felt “completely disengaged”. The social practice of online writing as blogs enabled the students to articulate their emotions. The findings primarily contribute new understanding about students' wide range of differing emotional states, both positive and negative, experienced in response to streamed live lectures and other learning activities in higher education external coursework. The is important because the majority of previous studies have focused on particular negative emotions, such as anxiety in test taking. The research also highlights the potentials of appraisal theory for studying human emotions in online learning and writing.

Curricula integration : identifying and locating engineering education across the Australian curriculum

Science, technology, engineering and mathematics (STEM) has become an educational package emerging throughout the world (e.g. UK, China, US & Australia). Although science, technology and mathematics are taught in schools and engineering education occurs in universities, there appear to be few if any explicit engineering education programs in primary and junior secondary schools. A stronger inclusion of engineering education at these levels could assist students to make informed decisions about career opportunities in STEM-related fields. This paper suggests how engineering education can be integrated with other key learning areas such as English, mathematics, science, history and geography within the new Australian Curriculum.

Neoliberal social inclusion? The agenda of the Australian Universities Community Engagement Alliance

University–community engagement (UCE) represents a hybrid discourse and a set of practices within contemporary higher education. As a modality of research and teaching, ‘engagement’ denotes the process of universities forming partnerships with external communities for the promised generation of mutually beneficial and socially responsive knowledge, leading to enhanced economic, social and cultural developments. A critical discourse analysis (Fairclough 2003. Analysing Discourse: Textual analysis for social research. London: Routledge) of the Australian Universities Community Engagement Alliance’s (AUCEA) ‘Position Paper’(2008 Universities and community engagement (Position paper 2008–2010)), as reported in this article, suggests that its uneasy synthesis of neoliberal, social inclusion and civic engagement discourses into a hybrid UCE discourse semantically privileges neoliberal forms of engagement. Perhaps, as a result, the AUCEA seems to have missed an opportunity to influence the Australian ‘widening participation’ debate on securing access and opportunity for marginalised students at universities and building social and cultural capital within their communities of origin.

A little learning is a dangerous thing: Factors influencing the increased identification of special educational needs from the perspective of education policymakers and school practitioners

This article considers the increased identification of special educational needs in Australia’s largest education system from the perspectives of senior public servants, regional directors, principals, school counsellors, classroom teachers, support class teachers, learning support teachers and teaching assistants (n = 30). While their perceptions of an increase generally align with the story told by official statistics, participants’ narratives reveal that school-based identification of special educational needs is neither art nor science. This research finds that rather than an objective indication of the number and nature of children with SEN, official statistics may be more appropriately viewed as a product of funding eligibility and the assumptions of the adults who teach, refer and assess children who experience difficulties in school and with learning.

Inclusion?

Whilst inclusive education is a relatively recent advance in our thinking about schooling and pedagogy, it is rapidly establishing movement simultaneously reflected in and refracted by education policy, research, and scholarship. This is manifest in the proliferation of policy texts and programmes generated by education jurisdictions globally and locally, and in the burgeoning number of scholarly texts, academic conferences, and research grants dedicated to inclusive education.

Learning about inclusion from developing countries : using the index for inclusion

There is a need for a more critical perspective and reporting about the value of taking a model of inclusion developed in western countries and based upon the human rights ethos applying it in developing countries. This chapter will report firstly on how the Index for Inclusion (hereinafter referred to as the Index) was used in Australia as a tool for review and development; and secondly how the process of using the Index is adjusted for use in the Pacific Islands and other developing nations in collaborative and culturally sensitive ways to support and evaluate progress towards inclusive education. Examples are provided from both contexts to demonstrate the impact of the Index as an effective tool to support a more inclusive response to diversity in schools.

Linking pedagogical knowledge practices and student outcomes in STEM education for primary schools

STEM education is a new frontier in Australia, particularly for primary schools. However, the E in STEM needs to have a stronger focus with science and mathematics concepts aligned to the presiding curricula. In addition, pedagogical knowledge practices such as planning, preparation, teaching strategies, assessment and so forth need to be connected to key concepts for developing a STEM education. One of the aims of this study was to understand how a pedagogical knowledge practice framework could be linked to student outcomes in STEM education. Specifically, this qualitative research investigated Year 4 students’ involvement in an integrated STEM education program that focused on science concepts (e.g., states of matter, testing properties of materials) and mathematics concepts (such as 3D shapes and metric measurements: millilitres, temperature, grams, centimetres) for designing, making and testing a strong and safe medical kit to insulate medicines at desirable temperatures. Eleven pedagogical knowledge practices (e.g., planning, preparation, teaching strategies, classroom management, and assessment) were used as a framework for understanding how teaching may be linked to student outcomes in STEM education. For instance, “planning” involved devising a student booklet as a resource for students to understand the tasks required of them, which also provided space for them to record ideas, results and information. Planning involved linking national and state curriculum documents to the STEM education activities. More studies are required around pedagogical knowledge frameworks to understand what students learn when involved in STEM education, particularly with the inclusion of engineering education.

Sport development programmes for Indigenous Australians : innovation, inclusion and development, or a product of ‘white guilt’?

Under the legacy of neoliberalism, it is important to consider how the indigenous people, in this case of Australia, are to advance, develop and achieve some approximation of parity with broader societies in terms of health, educational outcomes and economic participation. In this paper, we explore the relationships between welfare dependency, individualism, responsibility, rights, liberty and the role of the state in the provision of Government-funded programmes of sport to Indigenous communities. We consider whether such programmes are a product of ‘white guilt’ and therefore encourage dependency and weaken the capacity for independence within communities and individuals, or whether programmes to increase rates of participation in sport are better viewed as good investments to bring about changes in physical activity as (albeit a small) part of a broader social policy aimed at reducing the gaps between Indigenous and non-Indigenous Australians in health, education and employment.

Early years national curriculum documents : revisiting inclusive education

Early years education encompasses early childhood education and care (ECEC) and the early years of school across the age range birth to eight years. The introduction of two national curriculum documents for early years education – the Early Years Learning Framework (Department of Education, Employment and Workplace Relations DEEWR, 2009) for ECEC programs and the Australian Curriculum (Australian Curriculum, Assessment and Reporting Authority ACARA, 2011a) – indicates a trend towards national coherence, yet highlights a gap between notions of inclusion in the ECEC and school sectors of early years education. These gaps have the potential to impact negatively on school transition experiences through reductions in continuity of pedagogy and partnerships with families. Australian definitions of inclusion have moved beyond integration (i.e., mainstream classroom placement with support services and accommodations to address disability or lack of English), to encompass curricular and pedagogic differentiation catering for the participation rights and sense of belonging of children with a diverse range of abilities and backgrounds. This paper considers improved curriculum alignment and pedagogic continuity through enactment of elements relevant to inclusion.

Towards inclusion: Provision for diversity in the transition to school

Policies of inclusion challenge the construct of readiness and require schools to prepare for the diversity of children as they transition to school. However, there is limited empirical evidence concerning how this challenge is met. This paper presents two Australian studies that investigate inclusive practices in the transition to school. Study 1 examined the predictors of child outcomes across a sample of 1831 children in 39 schools. The results indicate that both quantity and quality of programme provision influenced outcomes and that programme effects were particularly potent for children with diverse abilities and backgrounds. Study 2 focuses on pedagogy in three of the schools to highlight how this provision can be achieved. Results show that provisions were reactive, that saliency of children’s needs directed school practices and that professional knowledge impacted on measures of quality. Inclusive processes accounting for both child progress and broader family and teaching influences are necessary for improved transition to school.