A breakthrough in the search for indicators of child risk

A recent piece of research we completed in partnership between our Jack Brockhoff Child Health and Wellbeing Program and the Victorian Department of Education and Training has revealed a breakthrough in the search for risk indicators of child developmental, emotional and … Continue reading

An update from the Cochrane Public Health Group

Our work within Public Health Insight aims to generate evidence-informed solutions for decision makers. Public Health Insight incorporates the Cochrane Public Health Group (CPHG) and we thought it was time to provide an update on the work of CPHG and highlight the scope of our Cochrane reviews.

By way of background, in 2005 the World Health Organisation (WHO) convened the Commission on Social Determinants of Health to determine the available evidence globally on health inequities. The ultimate goal of the commission was to identify strategies to curb the increase in inequities.

The results suggested that inequities were not naturally occurring and could be avoidable by improving policy choices, i.e. acting on the social and structural determinants of population health.

In 2008, the Cochrane Public Health Group (CPHG) was registered as an editorial group with the international Cochrane Collaboration to address these challenges. Our mandate is to produce systematic reviews of interventions that seek to support decision-making involving the upstream determinants of health. Our group filled a crucial gap in the existing coverage of Cochrane review topics relevant to global population-level health evidence.

CPHG authors, guided by our editorial team, have utilised contemporary systematic review methods to identify not only whether interventions work, but the ability of these interventions to reduce inequities. Our reviews also seek to identify pointers to potential ineffectiveness or harm (including inequities) due to implementation or resource issues. We understand the need for decision-makers to have access to information about how to implement effective interventions in their own contexts. Review authors are also asked to highlight issues for low and middle income countries, often in the absence of good quality evidence in these countries.

The CPHG works with the Campbell and Cochrane Equity Methods Group to encourage authors to utilise the PROGRESS (Places of residence, race/ethnicity, occupation, gender, religion, socioeconomic status and social capital) tool for extracting data and reporting outcomes.

We currently have a wide range of reviews published or underway (see below). If you are interested in learning more visit our website and please join us on Twitter (@CochranePH), where you will be notified of exciting new reviews published and other news items of relevance to evidence-informed public health. If you are interested in being involved in any of the topics (for example, by commenting as a content expert) contact our Managing Editor (Jodie Doyle: jodied@unimelb.edu.au).

Education

  • Later school start times for supporting the education, health and well-being of high school students
  • Interventions for enhancing the implementation of school-based policies or practices targeting risk factors for chronic disease
  • Interventions for enhancing the implementation of policies or practices supportive of healthy eating, physical activity, and obesity
  • prevention in child care settings
  • Education support services for improving school engagement and academic performance of children and adolescents with a chronic health condition

Employment & the Work Environment

  • Flexible working conditions and their effects on employee health and wellbeing
  • Workplace-based organisational interventions to prevent and control obesity by improving dietary intake and/or increasing physical activity

Food Supply/Access and Public Health Nutrition

  • Staple crops biofortified with increased micronutrient content for improving vitamin and mineral status in populations
  • Interventions for preventing undernutrition in children (0-5 years) living in slum environments Portion, package or tableware size for changing consumption of food, alcohol and tobacco
  • Policy level and environmental interventions for reducing the consumption of non-alcoholic sweet drinks among children
  • Interventions for preventing obesity in children
  • Interventions for preventing obesity in children: an overview of systematic reviews
  • Iodine fortification of foods and condiments, other than salt, for preventing iodine deficiency disorders
  • Nutritional labelling to promote healthier food purchasing and consumption
  • Fortification of condiments and seasonings with iron for preventing anaemia and improving health
  • Community-level interventions to improve food security in developed countries
  • Community-level interventions for improving access to food in low- and middle-income countries
  • Fortification of rice with vitamins and minerals for addressing micronutrient malnutritition
  • Fortification of staple foods with vitamin A for preventing vitamin A deficiency
  • Wheat flour fortification with iron for reducing anaemia and improving iron status in whole and at-risk populations
  • Fortification of maize flour with iron for preventing anaemia and iron deficiency in populations
  • Fortification of wheat and maize flour with folic acid for population health outcomes
  • Population-level interventions in government jurisdictions for dietary sodium reduction
  • Food fortification with calcium and vitamin D: impact on health outcomes
  • Fortification of staple foods with zinc for improving health outcomes in the general population
  • Food fortification with multiple micronutrients: impact on health outcomes

Housing and the Built Environment

  • Housing improvements for health and associated socio-economic outcomes
  • Built environment interventions for physical activity in adults and children
  • Interventions to improve water quality and supply, sanitation and hygiene practices, and their effects on the nutritional status of children
  • Slum upgrading strategies and their effects on health and social outcomes
  • Interventions to reduce ambient particulate matter air pollution and their effect on health

Income Distribution and Financial Interventions

  • Welfare to work interventions and their effects on the health and wellbeing of lone parents and their children
  • In-work tax credits for families and their impact on health status in adults
  • Unconditional cash transfers for assistance in humanitarian disasters: effect on use of health services and health outcomes in low and middle income countries
  • Unconditional cash transfers for reducing poverty and vulnerabilities: effect on use of health services and health outcomes in low and middle income countries
  • Livestock development programs: effects on indicators of livelihood and health status for families in low and middle income countries

Natural Environment

  • Interventions for reducing adverse health effects of high temperature and heatwaves
  • Participation in environmental enhancement and conservation activities for health and well-being in adults
  • Participation in outdoor education programs in natural environments and children’s health

Public Safety

  • Interventions for preventing abuse in the elderly

Social Networks/Support

  • Social cohesion and community building interventions in local communities for improving health and quality of life
  • Interventions for promoting reintegration and reducing harmful behaviour and lifestyles in street-connected children and young people
  • Community coalition-driven interventions to reduce health disparities among racial and ethnic minority populations
  • Individual-, family-, and school-level interventions for preventing multiple risk behaviours in individuals aged 8 to 25 years
  • Population-level intervention for preventing multiple risk behaviours in 8 to 25 year olds

Systems for Health

  • Interventions implemented through sporting organisations for increasing participation in sport
  • Policy interventions implemented through sporting organisations for promoting healthy behaviour change
  • Interventions for enhancing the implementation of school-based policies or practices targeting risk factors for chronic disease
  • Interventions for enhancing the implementation of policies or practices supportive of healthy eating, physical activity, and obesity prevention in childcare services
  • Portion, package or tableware size for changing consumption of food, alcohol and tobacco
  • Collaboration between local health and local government agencies for health improvement
  • Service brokerage for improving health outcomes in ex-prisoners (previously entitled, Population level interventions for improving health outcomes in ex-prisoners)
  • Community-based, population level interventions for promoting child oral health
  • Knowledge translation strategies for facilitating evidence-informed public health decision making among managers and policymakers
  • Interventions for improving the use of the oral healthcare services by adults

Transport, Active Transport and Physical Activity

  • Legislative and engineering interventions for preventing road traffic injuries and fatalities among vulnerable road users (nonmotorised road users and motorised two-wheel road users) in low and middle income countries
  • Community wide interventions for increasing physical activity
  • Environmental and behavioural interventions for reducing sedentary behaviour in community dwelling older adults
  • Public health interventions for increasing physical activity in adults, adolescents and children: an overview of systematic reviews
  • Workplace based organisational interventions to prevent and control obesity by improving dietary intake and/or increasing physical activity
  • Interventions for enhancing the implementation of policies or practices supportive of healthy eating, physical activity, and obesity prevention in child care settings
  • Built environment interventions for physical activity in adults and children
  • Incentive-based interventions to increase physical activity
  • Interventions for preventing obesity in children
  • Interventions for preventing obesity in children: an overview of systematic reviews

Highlights from a rookie researcher’s first conference.

A few weeks ago I attended the conference Progress 2013 (http://progress2013.org.au/). The first of its kind in Australia, it brought together progressive left thinkers with not-for profit organizations, unions, private industry and experts in the health and environment sector. Its aim was to talk about the issues that will define Australia’s not-for profits and social movements for the years to come. As a recent graduate, this was my first ever conference and a chance to understand how people from all over the workforce come together to share skills, nut out ideas and most importantly – network. This blog post will cover some of the major highlights from the conference and touch on some of the lessons I learnt, from the perspective of a budding young researcher.

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Highlight no 1.
To begin, one of the major highlights for me was listening to rock star academic and expert on the social determinants of health, Richard Wilkinson (http://www.ted.com/talks/richard_wilkinson.html), speak about the importance of understanding how income inequality affects health and wellbeing. Wilkinson, author of ‘The Spirit level’ and co-founder of The Equality Trust (http://www.equalitytrust.org.uk), researches the problems of inequality in society and produces evidence-based arguments to support social movements for change. In particular, Wilkinson drew attention to the problem that health and wellbeing in high and middle income countries is worse for all when the gap between the rich and poor is greater. Data was collated to demonstrate that even in high income countries as measured by Gross Domestic Product (GDP), population levels of health and wellbeing are influenced by income inequality. Therefore, the average wellbeing of societies is not dependent on gross national income and the rhetoric of economic growth but rather the relation between each other within society itself. This trend also occurs in child health and wellbeing, mental health, drug abuse and obesity – proving the tangible effect that inequality has in society. Some factors Wilkinson attributed as the drivers of negative health in unequal societies include status anxiety, stress, mistrust and dominance caused by a competitive consumer based economy. Wilkinson therefore advocated for a more inclusive society where value is placed on the way we relate to one another and where possible to harness positive social relations, such as friendship. Although these insights seem somewhat intuitive, I was taken aback by how relevant it is to continue to produce evidence that highlights this problem. When considering health and wellbeing, Wilkinson makes us think about the less visible effects of how we relate to one another and re-establishes the importance of family, friendship and positive social interaction to maintaining a sustainable quality of life.

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Highlight no 2.

Another highlight was the talk given by Anat Shenker-Osorio, a communications expert and researcher who authored the book ‘Don’t Buy It: The Trouble with Talking Nonsense about the Economy’. Her work looks at how people understand issues, such as the economy or climate change, through the words used to narrate them. Without getting too bogged down in detail, the gist of her research suggests that you can reliably persuade or change a person’s thinking about an issue depending on the words used to describe it. For example, immigration. A study was conducted to measure how people responded to immigrants depending on whether they were framed as either a burden or a resource. The findings showed that when immigrants were talked about in a positive framing, by expressing what they bring to society and not what they lack, people’s acceptance of immigrants were overall more favourable. Shenker-Osorio argues that by literally changing the words we use to speak about an issue, we can also influence how people think about it, having repercussions for politics and policy. Something to think about when writing the next report or talking at a conference about a sticky issue. Frame it positively and you will have people receive it much more favorably.

Highlight no 3.

Arguably one of the best parts of Progress 2013 however, was the chance to mingle with those I consider some of my professional role models. As I mentioned above, this was my first ever conference, so the task of introducing yourself to those you admire is quite daunting. However, after a few awkward first conversations I learnt the following things;

  1. Go with a plan. Since time is scarce at these events and the professionals you meet talk to so many different individuals every day, working out a plan of who you want to speak to and what you want to speak to them about prior to the meeting is essential. This way, you won’t get caught in a conversation about the weather and how good the muffins are, but instead get to use your limited time to your best advantage.
  2. Don’t be scared to introduce yourself. As daunted as you might be about shaking hands with someone you find just a huge bit intimidating because of their greatness, it never hurts to just introduce yourself and say you are a huge admirer of their work. A few times I saw rock star academics on their lonesome at the coffee table, probably because everyone was too in awe to say hi.
  3. When in doubt ask questions. When you have reached your small talk capacity and feel like the conversation is drying out, ask questions of them. People love to talk about themselves and asking them questions about themselves shows that a) you have a strong interest and b) that you are engaged in what they do.

Written by Hannah Morrice
Research Assistant, Jack Brockhoff Child Health & Wellbeing Program
The University of Melbourne
e: hannah.morrice@unimelb.edu.au

Large reductions in child overweight and obesity in intervention and comparison communities 3 years after a community project

Research paper title: Large reductions in child overweight and obesity in intervention and comparison communities 3 years after a community project
 
Between 2003-2006 the Be Active Eat Well (BAEW) Obesity prevention programme was implemented in Colac, a rural township in the Barwon South West region of Victoria. The programme used a multi-setting, mutli-strategy approach to reduce unhealthy weight gain in children aged 4-12 years. Three years after completion in 2009, an evaluation was undertaken to measure the impacts of the intervention.
 
Working with our colleagues at Deakin Univeristy we are delighted that the findings of the study have now been published.
 
The paper discusses the significant results identified 3 years post completion of the BAEW intervention and the spillover effect in the surrounding areas. The main and interesting finding of the papers is that,compared with 2003, the 2009 prevalence of overweight/obesity was significantly lower.

The paper can be viewed here: http://goo.gl/HQYszV  

Is PowerPoint dead? No but your presentation just might be!

Important health warning:

Have you ever been presenting at a seminar or conference and noticed your audience exhibiting one or more of the following symptoms?

  • Constant yawning
  • Slumping in their chair
  • Excessive mobile phone texting, tweeting and/or Facebooking
  • Sleeping, and in some cases snoring
  • In the worst case scenario, not even showing up at all

If you answered yes to one or more of these symptoms, your audience is exhibiting Soporific Seminar Syndrome (SSS). This is a very serious yet common disorder with one in five people in Australia suffering from it. The scary part is YOU may be the cause of this!

But how you ask? Your research is interesting, you are a great presenter and use more than one tone in your voice, you have accompanying slides… so why are you making your audience suffer?

Well luckily, I’m here to help!

Researchers have discovered the reason for SSS is Poorly Designed PowerPoint Presentations (or PDPPP). Luckily the condition can be reversed with a straightforward treatment – effective design. Please follow these simple tips so together we can rid the world of SSS.

1. Cut down on clutter

It is a common misconception presenters have that they need to put EVERY single word they are saying into their PowerPoint presentation. If it’s not every single word, it’s lines and lines of dot points. Your audience is trying to listen to you and read your slides at the same time. They are going to get distracted and confused if you have too much information and your slides are too cluttered. It’s even worse if you flick through your slides so quickly, they don’t even finish reading! Solution, cut down on the clutter. Chose one dot point that complements what you are talking about and stick with that! Better still use a photo. Your audience will have your full attention, and hopefully better understand and absorb what you are speaking about.

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2. Use large readable words

This point goes hand in hand with the last. There is no point having small text that people won’t be able to see at the back of the room. Instead of losing their attention, lose the clutter and write with large readable words. The text below is size 18 compared to size 90. As a rule of thumb, never go under size 24 pt.

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3. Pick the right colours

Colours that look good on your computer screen don’t always look effective on the big screen. Avoid using light colours on a white background and vise versa. Use contrasting colours for your background and text and avoid using more than 4-5 colours in total. If in doubt, stick with the basics – black and white! Finally, if you have the facilities, go and test your presentation on the projector.

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4. Maximise the use of photos.

I can’t stress this point enough. Do as the late Steve Jobs would of done.

Have you ever watched one of his presentations and seen the screen full of dot point and sentences? No. He uses one image to illustrate exactly what he is talking about. And it’s memorable!

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Image curiosity of http://www.smh.com.au/digital-life

If you do intend to use photos, don’t crop it and place it in the corner, squeezed in amongst your dot points, maximize its use. Make it a full screen image and incorporate minimal text around it, if at all.

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5. Use simple fonts.

This one is pretty self-explanatory. Steer away from detailed and fancy fonts. They look messy and cluttered on screen and make it harder for your audience to read. Stick with a sans serif font like Gill Sans, Geneva or Arial to name a few.

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One last piece of advice, if you want your audience to engage more, set up a hashtag (for example #endingSSS) and encourage people to tweet with the hashtag during your seminar. People will be engaged (and not falling asleep), asking questions and promoting your research and research program.   

This special concoction of remedies will hopefully ameliorate the symptoms of SSS, acting through the PDPPP pathway. By eradicating Poorly Designed PowerPoint Presentations we will be free to live in a world where all presentations are engaging, enabling us to be inspired by our new learnings and tackle some real life health issues!

 

Written by Alana Pirrone-Savona
Media & Communications Officer for the Jack Brockhoff Child Health & Wellbeing Program
The University of Melbourne
apirrone@unimelb.edu.au

 

Connect with us on

Facebook: http://www.facebook.com/BrockhoffChildResearch

Twitter: https://twitter.com/BrockhoffTeam

 

Health in Orphanages Project (HOPe)

A few years ago while studying the oral health of school children in Kerala, India, one of the schools I visited was a boarding school for orphaned children. It was obvious from just observing these children and through dental examinations that the health of these orphaned children was a lot worse than children from the non-orphanage schools in my study. While at the time I was doing my masters degree and did not have the liberty to pursue this issue further, I made a mental note that when I had settled down in my career I would re-visit this issue. Fast forward to 2013 (five years since I visited the orphanage in Kerala) and we (my wife and I) have set up the Health in Orphanages Project (HOPe), with support from University researchers and community partners, to explore the health of children residing in orphanages in India.

So what is an orphan – United Nations Children’s Fund (UNICEF) defines an orphan as not only a child who has lost one or both parents but also those who have lost a father but have a surviving mother or have lost their mother but have a surviving father (1, 2). It is estimated that, as of 2010, there were 132 million orphaned children across the globe (about 2% of the world’s population), a shocking number. Of these children, 69 million were located in Asia, 53 million in Sub-Saharan Africa, and 10 million in Latin America and the Caribbean. India alone is home to 32 million orphaned children (~ 2.6% of India’s population or 7.5% of India’s child population). Yet it is quite rare for the local populace in India to encounter these children in their normal lives. The social structure in India has ensured that these children are a hidden and socially stigmatised community.

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Photo of an orphanage from my last trip to India

In spite of such large numbers the available information on the health of children residing in orphanages, particularly in India, is very limited. The available information gave us some insight into the health of these children but again highlighted the need to work with this hidden section of the community that we call the ‘disadvantaged among the disadvantaged’. A parent-child relationship is important for the mental and physical development of the child and the absence of this relationship can be detrimental to their health. Such a separation can negatively impact on various aspects of their development, particularly in relation to their psychosocial, emotional and cognitive skills. The social disadvantage is due to the lack of social and cultural identity that growing up in a family would provide. A joint report by UNICEF, UNAIDS & USAID on orphaned children state that institutional care such as orphanages can be detrimental to the child’s development as they socially isolate the children, discourage autonomy, put the children at risk of losing their family and community identities, and fail to provide any mechanism to support a child’s emotional or mental needs (1). As a result of these issues, orphaned children generally have poor oral health; poor mental health; are malnourished; have low immunity; are prone to medical conditions such as HIV, cardiomyopathy, fetal alcohol syndrome, hepatitis C, otitis media & congenital adrenal hyperplasia; and recurrent episodes of diarrhoea, fever & cough (3, 5-10). These children, particularly girls, are at a high sexual risk which includes having sex at an earlier age, pregnancy and the risk of contracting HIV/AIDS (11-15). Also common among orphaned children are behavioural and cognitive issues such as thought problems, rebellious nature, aggression and being withdrawn (6, 7, 17). A study of children in Romanian orphanages found that due to ‘global neglect’ (when deprivation occurs in more than one domain of child development, such as language, touch and family support) the brain size of orphaned 3-year-olds was significantly smaller when compared to that of a normal child of the same age (16).

So it is quite evident that these children face additional challenges that impact on their health and wellbeing. However, without sufficient country/location specific evidence local program planners and policy makers will not be able to make a case for targeted interventions. We aim to provide this evidence and use the information from this research to determine the future direction of the project. Our first stage will be to explore the health issues affecting children residing in orphanages in the State of Kerala, which is located on the south-west coast of India. At present there are approximately 400 registered orphanages in the State of Kerala alone, with on average 100 children per orphanage (18). We envisage that through HOPe we will be able to provide the evidence needed to progress towards healthier and more socially inclusive environments for these children.

About the author: Bradley Christian is a Research Fellow at the Jack Brockhoff Child Health and Wellbeing Program, working on Teeth Tales – a community based oral health promotion intervention for pre-school children from a refugee and migrant background. Brad is a dentist with specialist training in Dental Public Health whose research interests are around social disadvantage, children and oral health.

 

References

  1. UNAIDS, UNICEF, USAID. Children on the Brink 2004: A joint report of new orphan estimates and a framework for action2004.
  2. UNICEF. Orphans. UNICEF Press Centre; 2012 [cited 2012]; Available from: http://www.unicef.org/media/media_45279.html.
  3. Thielman N, Ostermann J, Whetten K, Whetten R, O’Donnell K, the Positive Outcomes for Orphans (POFO) Research Team. Correlates of Poor Health among Orphans and Abandoned Children in Less Wealthy Countries: The Importance of Caregiver Health. PLoS ONE 7(6) 2012;7(6):e38109.
  4. International Institute for Population Sciences (IIPS) and Macro International. National Family Health Survey (NFHS-3), 2005-2006 India. Mumbai IIPS2007.
  5. Watts H, Gregson S, Saito S, Lopman B, Beasley M, Monasch R. Poorer health and nutritional outcomes in orphans and vulnerable young children not explained by greater exposure to extreme poverty in Zimbabwe. Tropical Medicine and International Health. 2007;12(5):584-93.
  6. Erol N, Simsek Z, Munir K. Mental health of adolescents reared in institutional care in Turkey: challenges and hope in the twenty-first century. Eur Child Adolesc Psychiatry. [Research Support, N.I.H., Extramural]. 2010 Feb;19(2):113-24.
  7. Hermenau K, Hecker T, Ruf M, Schauer E, Elbert T, Schauer aM, et al. Childhood adversity, mental ill-health and aggressive behavior in an African orphanage: Changes in response to trauma-focused therapy and the implementation of a new instructional system. Child and Adolescent Psychiatry and Mental Health 2011, 5:29. 2011;5(29).
  8. Khare V, Koshy A, Rani P, Srilata S, Kapse SC, Agarwal A. Prevelance of Dental caries and Treatment needs among the orphan children and adolescents of Udaipur district, Rajasthan, India. The Journal of Contemporary Dental Practice. 2012;13(2):182-7.
  9. Lassi ZS, Mahmud S, Syed EU, Janjua NZ. Behavioral problems among children living in orphanage facilities of Karachi, Pakistan: comparison of children in an SOS Village with those in conventional orphanages. Soc Psychiatry Psychiatr Epidemiol 2011;46:787-96.
  10. Johnson DE, Traister M, Iverson S, Dole K, Hostetter MK, Miller LC. HEALTH STATUS OF US ADOPTED CHINESE ORPHANS. .  1996 Abstracts The American Pediatric Society and The Society for Pediatric Research (1996) 39, 135–135; doi:101203/00006450-199604001-008151996.
  11. Birdthistle I, Floyd S, Machingura A, Mudziwapasi N, Gregson S. From affected to infected? Orphanhood and HIV risk among female adolescents in urban Zimbabwe. AIDS 2008;2008:759-66.
  12. Dunbar M, Maternowska M, Kang K, Laver S, Mudekunye-Mahaka I. Findings from SHAZ!: a feasibility study of a microcredit and life-skills HIV prevention intervention to reduce risk among adolescent female orphans in Zimbabwe. J Prev Interv Community 2010;38:147-61.
  13. Gregson S, Nyamukapa C, GP GG, M MW, JJ JL, et al. HIV infection and reproductive health in teenage women orphaned and made vulnerable by AIDS in Zimbabwe. AIDS Care. 2005;17.
  14. S SK, Dunbar M, Minnis A, Medlin C, Gerdts C, NS Padian NS (2008) Poverty gi, and women’s risk of human immunodeficiency virus/AIDS. Ann N Y Acad Sci 1136: 101–110. Poverty, gender inequities, and women’s risk of human immunodeficiency virus/AIDS. Ann N Y Acad Sci. 2008;1136:101-10.
  15. Mmari K. Exploring the relationship between caregiving and health: Perceptions among orphaned and non-orphaned adolescents in Tanzania. Journal of Adolescence. 2011;34:301-9.
  16. Perry BD. Childhood experience and the expression of genetic potential: What childhood neglect tells us about nature and nurture. Brain and Mind. 2002;3(1):79-100.
  17. Baguma P.  Assessment of psychosocial support programmes for orphans/vulnerable children in Uganda. International Journal of Psychology. 2012;47(1):467-77.
  18. List of charitable institutions.  Thiruvananthapuram: Department of Social Welfare;  [cited 2011]; Available from: http://www.old.kerala.gov.in/dept_socialwelfare/Grant-in-aid.htm.

Research with culturally and linguistically diverse communities

Encouraging people to participate in research can be a tough gig. We are usually asking people to volunteer their time just for a small piece of information, which is sometimes only relevant and generalisable if large numbers provide this same, small piece of information. As researchers we know the enormous value that gathering this information can have to inform change at the policy, practice and the community level. But the general population sometimes does not place the same value on research or understand how important the research and outcomes can be. So, how do we encourage people to participate in research? And in particular, how do we encourage those from culturally and linguistically diverse backgrounds, where research may not be a common concept or practice.

I am currently working on a large scale child oral health research project entitled ‘Teeth Tales’, being conducted in partnership with government and community agencies  and Australian families from refugee and migrant backgrounds. Oral health is included in the Victorian Health and Wellbeing Plan 2011 – 2015 as a priority area for preventative health, as it is one of the most preventable diseases, particularly for children. Tooth decay is Victoria’s most prevalent health problem, with more than half of all children and almost all adults affected (1). Initial qualitative research was conducted with mothers from Lebanese, Iraqi and Pakistani backgrounds exploring oral health practices, beliefs and service needs. We learnt about many cultural differences and the real interest these communities have to learn more about keeping their children’s teeth healthy. From this earlier research, a community-based trial was developed to include an oral health education program for parents delivered by a trained educator from the same cultural background. This peer educator is able to talk about traditional beliefs and practices and introduce parents to the key Dental Health Services Victoria oral health messages of ‘Eat Well, Drink Well, Clean Well and Stay Well’. The program also included a site visit to local dental and family services. In addition to this education program, local services underwent a review of their practices to improve their competence in dealing with culturally diverse communities.

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Photo from:  http://www.dshs.state.tx.us/dental/promo_oh.shtm

For this trial we recruited Lebanese, Iraqi and Pakistani families in metropolitan Melbourne with children aged 1 – 4 years. We wanted to make sure that the research was as useful and relevant to families as possible so we sought the advice and expertise of relevant cultural organisations. They provided guidance on the cultural practices and beliefs of the target cultural groups, and the cultural appropriateness of our research methodology. They also helped us to recruit families, conduct the trial, interpret the findings and they provided language assistance. If it wasn’t for these partnerships we may have been lucky to recruit 10 families rather than the over 500 families who ended up participating! The advice and support of these cultural partners is invaluable when trying to recruit families with a refugee or migrant background, some of whom may be unfamiliar with research conduct, health promotion and the Australian health system.

In order to evaluate the success of the program we needed to check children’s teeth before and after the trial, as well as ask parents to complete a questionnaire. The free dental screenings for the children proved to be a key incentive for parents to register for the study. Oral health is one of the most contentious current health issues in Australia as access to fast, affordable dental care is often not available. The private dental system is run as a business and many walk out of the service with an expensive bill. The public dental system has huge waiting lists and strict eligibility for access. We found that many parents were not aware that children and refugee and asylum seekers in Victoria are considered a priority group for public dental services access. So when our study offered a free dental screening for children many families jumped at the opportunity!

The strategies outlined above helped us to successfully recruit over 500 families into our study. Engaging culturally and linguistically diverse groups in research can be difficult, but is very important, particularly for health services that need to respond to the evolving health needs of refugee and migrant and groups.

To read more about the ‘Teeth Tales’ study please visit:  http://mccaugheycentre.unimelb.edu.au/research/current/intergenerational_health/teeth_tales

Blog by Dana Young

Research Fellow, Child Public Health

The University of Melbourne

e: dana.young@unimelb.edu.au

References

  1. NACOH. 2004, Healthy mouths healthy lives: Australia’s National Oral Health Plan 2004-2013. Adelaide, National Advisory Committee on Oral Health, Australian Health Ministers’ Advisory Council.

Using Social Media in a Research Environment.

Jack and Jill went up the hill to fetch a pail of water….but before they left, Jack logged onto Facebook to ask his friends where the best well was. Jill tweeted about their upcoming adventure with the hash tag #fetchingwater. They both checked in through their Facebook when they arrived on the hill and shared a photo of #fetchingwater through their Instagram accounts. Then Jack wrote a blog.

These days, it seems most of us can’t go through a day, or a couple of hours in my case, without using some form of social media. According to the Yellow Social Media Report 62% of internet users in Australia have a presence on social networking sites, with Facebook the clear leader. We are using social (social media) to catch up with family and friends, share photos, coordinate social events and one in five of us are using social for commercial purposes by following our favourite brands (Yellow Social Media Report). Given how powerful social is in connecting with others and sharing information, it was only natural that our research program here at The University of Melbourne should be on there!

So in late 2010, we jumped online.

One of our greatest challenges was finding our audience. We are a research only team funded by a philanthropic gift. We have a small number of PhD students but do not do any teaching or have much involvement with students at all. We have a niche research area of child health. Previous to any involvement on social our key outlet for completed research was journal articles, which would be published and circulated through academic contacts. If we were lucky we would get something published in a newspaper maybe once or twice a year. Journalists aren’t typically interested in anything that 1. They have heard before or 2. Doesn’t raise controversy or have an obvious dramatic impact.

So our aim was to firstly make ourselves known, create an online brand and raise awareness of our little program. Once we had done this we wanted to increase our engagement and interactions with our followers.

I have to admit, it hasn’t been all roses and daisies, and we still have a long way to go, but this is what we have learnt.

  1. Social is ALL about engagement. Yes you want to promote your brand but endless self-promotion without generating conversation can push people away. It is absolutely fine to post about projects and people but don’t forget to pose questions, reply to others’ posts, and share similar content. The rule of thumb is 20/80. 20% posting your content, 80% interacting with others. Before you post consider ‘Why do I care and why would they share?’ Search for people talking about you or your content and interact with them!Image
  2. ‘You must entertain in order to educate.’ Not all your content needs to be serious. This point goes hand in hand with point 1. Part of our social media strategy includes about 2-3 ‘fun’ posts related to research per week. Given that much of our audience are academics, this is something they can relate too. Some great examples that have worked for us are PhD comics and regular posts about ‘Why writing a thesis is harder than having a baby’ (Point 1. Three months before your due date, your doctor doesn’t say ‘’I want you to go back and re-do the first trimester’s work”).  It’s funny and when people can relate they like and share. And bingo, you have increased your reach! Any new fan obtained through a ‘fun’ post will be new eyes when the next informative post goes out.Image
    (Image thanks to phdcomics.com)
  3. Maintain a constant presence. You see, with Facebook’s algorithms, the less you are on Facebook, the less someone interacts with you. The less someone interacts with you, the less likely they will see your content in their news feed. If you are going to invest in social media, make sure you commit. At least 1 post per day (or two).
  4. Create a voice. Give your social a voice. Create a persona. People will relate to you and your content more if they feel it comes from a person and not a robot/machine. The reason we have entered into the blogosphere is to show people our personal side and share with people just why we love our job.  Right now you are learning about my job and the triumphs and tribulations of it. Hopefully this will make you take a look at our social pages too, maybe even our website? If I’m lucky you may just share! Bang, I’ve done my job.
  5. Plan, plan, plan. My final piece of advice is to plan. This way you can keep a constant presence on social without flipping out and resorting to posting nonsense just for the sake of it. Have a conversational calendar that outlines discussion topics for the next few weeks or months. This plan will reduce the burden on staff and they will be approached in advance for material that will be posted. Particular content can be allocated for particular days of the week to maintain consistency. Additional breaking news can be put up as an extra post/tweet.

What kind of content has worked for us? Photos of staff, project and participants (make sure you have consent!), short videos, ‘fun’ posts (as previously discussed), tips from PhD students, expert perspective, upcoming seminars, and conferences and publications.

Be prepared. Have a thick skin. Respond to everyone. Delete spam.

So don’t view social as a challenging hill to climb. Be like our modern day Jack and Jill. Use social as a means to an end. There is very little danger that you will fall down and break your crown – and if you do you can tweet for a doctor: #crackedskull

Facebook.com/BrockhoffChildHealth

Twitter.com/BrockhoffTeam

Pgh.unimelb.edu.au/childhealth

Written by Alana Pirrone-Savona
Media & Communications Officer for the Jack Brockhoff Child Health & Wellbeing Program
The University of Melbourne
apirrone@unimelb.edu.au

Welcome to Research Connect

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‘Before, I have a lot of problem you know. I have a lot of thinking about my family you know. But I came to Ucan2 and got a lot of friends came, talk and speak like that… Before I come I can’t laugh – because I can’t. After I come to Ucan2, yeah I can laugh with my friends’

(Afghan male 26)

Hearing inspirational quotes like the one above changes our lives. It reenergizes our passion for research and health promotion and we remember why we do this job and why we love it. Those countless hours of planning, ethics submissions, draft upon drafts of papers, and the acceptance or rejection from journals are all part of the life of an academic, and all worth it when you hear a quote like this.

Here at the Child Health & Wellbeing Program, we work towards a vision of every child having the opportunity for a fulfilling and healthy life. Our research, through partnerships and an evidence-informed approach, aims to significantly shift population health and reduce gaps in child health inequalities.

Through this blog, you will hear stories from our team about why we carry out research in this field. What motivates and inspires our team and why they take these approaches to their research. We encourage others to engage in friendly debate about our topics and ask questions, whether you are a fellow researcher, a colleague or are just interested in child health research and promotion.

We will be covering topics such as mental health, disability, wellbeing, quality of life, oral health, obesity, health eating, physical activity, learning, development, disadvantage, vulnerability, equity, human rights and children and families in the contexts of disasters.

Please do share your thoughts and comments by commenting on these pages. We hope you enjoy our blog.

Liz Waters

Professor Elizabeth Waters is the Jack Brockhoff Chair of Child Public Health at The University of Melbourne.