Guest Blog: Challenges for health promotion practice in the digital age

Working in health promotion is tough. With so many skilled practitioners, job hunting is competitive and job security is increasingly hard to find. Have you seen a permanent health promotion job advertised lately?

Health promoters need to be skilled at working with multiple stakeholders, keep up to date with best practice, and continually chip away to improve policy and environments. It can take decades to see population health changes. Of course there are lots of rewards, from seeing communities thrive, achieving positive and meaningful engagement and making huge differences to the world that negate the need for ‘miracle cures’ and expensive treatments that consume government health budgets.

The challenges and rewards of working in health promotion have not really changed over time. But as we move more and more into a digital age, what are the emerging challenges for health promotion practice?

As a reader of the Research Connect blog, there’s a good chance you are a researcher rather than practitioner. If so, as you read on keep in mind what role you think researchers can play to generate the evidence that supports practitioners in relation to the outlined issues.

I believe the challenges for health promotion practitioners in the digital age are as follows:

Professional development and competencies. Understanding how to apply social media to health promotion practice can require a new set of skills. When it comes to use in health promotion, social media expertise is often borrowed from, or outsourced to disciplines such as communications, public relations or marketing rather than from practitioners themselves. Whilst the current health promotion competencies touch upon technology, they do not incorporate the seismic shift in communication that web 2.0 technologies and social media have introduced.

Comparison paralysis. When you consider that Coca-Cola has more likes on Facebook than Harry Potter, Justin Bieber and Lady Gaga, and that there is a tweet a second made directly to McDonalds, it’s easy for health promotion programs to get sucked into believing that they need to compete with the private sector. It is unrealistic to think that small scale health promotion programs can compete with the resources of the private sector. That said, health promotion programs should choose social media strategies that are consistent with their populations/target groups and in line with their overall program objectives.

Finding evidence. Social media platforms and their nuances change frequently, much faster than traditional research cycles. How are practitioners meant to know how and what they should be doing health promotion work using social media if evidence can’t keep up? The answer may lie in social media! It’s really important that practitioners who are using social media work together to share their experiences, lessons and findings. The Australian Health Promotion Association in several jurisdictions offer online groups via LinkedIn or Facebook which create a great opportunity for professionals to exchange advice and ask questions.

Lure of social media as a tool for behaviour change. One of my key messages is that social media is another tool in a health promotion practitioner’s toolbox. Remember, a tool is just that and it should not be a case of ‘the tail wagging the dog’. With shareables, images and quotes being popular content on social media, it’s tempting to piggy-back on this trend and use social media purely as an intervention tool for behaviour change and promotion of social marketing messages. It’s important to think about how social media could be used for broader health promotion objectives, including creating new cultural norms. Organisations like GetUp and Obesity Policy Coalition are experts at this. Similarly there are some fantastic examples of promoting positive mental health and reducing mental illness stigma on social media.

Despite these new challenges, health promoters are a resilient and resourceful lot. With the support of research institutes and knowledge brokers, I am confident that there will be a growing baseline of technology literacy and competency in the health promotion workforce.

Given the range of challenges, how do you think researchers can generate evidence and support practitioners? Share your thoughts in the comments below.

 

Written by Kristy Schirmer

Kristy Schirmer worked as health promotion practitioner for more than a decade prior to starting Zockmelon, a consultancy that focuses on health promotion and social media strategy.

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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.

On the conference circuit – from Melbourne to Thailand and back again

In an academic work environment you could say that one of the ‘perks’ is representing your work, or collaborative work, at academic and topic-focused conferences (However in comparison to my days working in the private health industry, business travel in the University signals a more economically responsible mode, namely frequenting the back of the plane rather than the upper deck on long haul flights!). This year has been no exception for me, being fortunate to attend a range of conferences on topics of public health, health promotion, knowledge translation and exchange, and obesity prevention.

So we pack our bags, roll up our posters and prepare our presentation slides at the eleventh hour – but what for? What motivates researchers and practitioners to scramble to find funding so we can run laps of the conference circuit? What benefit does our research and its end-users gain from us attending these forums?

Recently I attended with colleagues what might be considered seminal conferences in public health research/practice/policy: The World conference on Health Promotion by the International Union for Health Promotion and Education (IUHPE) – in Pattaya, Thailand, followed by the Public Health Association of Australia annual conference – in Melbourne. We’ve also attended emerging conferences in our field of interest: The “FUSE 2nd Conference on Knowledge Exchange in Public Health: How to get practice into science” – in Noordwijkerhout, The Netherlands; and the “2nd Annual NHMRC research translation symposium: from Bench to Bourke” – in Sydney. Note the similar style of the long-winded titles on the last two conferences on knowledge translation… For people interested in communicating and doing ‘real world’ research, you’d think we’d have more succinct event titles!

Aside from enjoying a working week near a sandy beach or among fields of tulips, I believe that conference attendances (and active participation obviously) are a necessary perk if we want our research to be useful and utilised, and if we want to link our ideas to a broader national and international dialogue. At these conferences, I took away a few points about the issues being explored and debated, as well as some reflections on what we gain from attending, and thus what we offer as research practitioners. Here’s a wrap-up, fresh from my suitcase.

Salient issues that resonated for me as a conference participant:

  1. Social justice concerns are high on the agenda in public health and health promotion.
    All the policy, practice and research communities represented at theses conferences appear to be very dedicated to chipping away at the systemic barriers to attainment of good health. Good thing.
  2.  Public health and health promotion decision-makers, advocates and researchers need to better articulate what we do, and what good it does.
    What is public health and health promotion anyway? Sure, we all know that the sum of our parts is more than water sanitation and quit-smoking campaigns, but try explaining that to a new acquaintance at a backyard barbeque. And what are the benefits of investing Government dollars in preventive health? Can anyone tell me the economic return on investment of health promotion partnership meetings, or the productivity gains from banning junk-food ads in kids TV viewing hours? Either way, a strong theme that continued to emerge for me was the sheer lack of public outrage when public health research funds are cut, or when a health promotion unit is shut down.
  3. Working across sectors means singing from the same song-sheet.
    I often go to conferences realising that I’m preaching to the converted. It’s not a new concept that public health and health promotion decision-makers need to be working with other sectors like planning, transport and education – this message has continued to come through, but more focused on tweaking our agendas and language, to make it easier to work together. Finding processes to allow cross-sectoral work are getting more focus too – like embedding health impact assessments into local government’s power. We might be a long way away from that but in the meantime we can at least coordinate the message.
  4. We keep on with research to know that we are doing the right things, and doing things fairly.
    Not all of the conferences I went to had an ‘academic’ or scholarly focus, but thankfully, I walked away from each and every session knowing that the majority of attendees valued the role of research and evaluation, rigorous methods, or evidence-informed decision-making – all of this is achieved by furthering research and academic inquiry.
  5. It takes specific skills to advocate, and without advocacy, our concerns won’t be heard.
    Like me, you might not always feel comfortable with the term advocacy so let’s call it leadership, or whatever you like – either way, see points #2 and #3 above. We need to find smarter ways of communicating evidence and knowledge to influence decision-making.
  6. We all love a framework!
    I think every conference session I went to had a ‘framework’, ‘model’ or ‘tool’ which was ‘guiding’ or ‘underpinning’ or ‘informing’ their approach. Hopefully this is more than jargon, and actually means rigor and systematic ways of conceptualising and working – whether you’re in research, practice, or somewhere in between. So I think it’s a good thing, as long as we don’t get lost in translation!

What I think we gain and can offer from active participation at conferences:

  1. Disseminating research and practice.
    This is an obvious benefit, and the one most often used by conference organisers to lure you into spending $900 of your precious budget to be out of the office for two days, subjected to death-by-powerpoint, and forced to catch up on all your emails late at night after the welcome reception. But in order to ‘keep it real’ and stay connected to the broader health and wellbeing dialogue, attendance and active participation at conferences are actually an efficient way to communicate your work. Ok, so I might not feel that way when I’m standing next to my poster watching conference delegates walk straight past, making a bee-line for the coffee stand without an interest in my glossy artwork and data. But if you’re proactive to network, interact, present and tweet, it really is an chance to build the profile of your/your team’s work, and get others to know who you are and what you do.
  2. Networking and engagement.
    By signing up for conferences, we open ourselves to public scrutiny of our work, and let’s not forget those awkward moments of introducing yourself to that esteemed Professor or Policy-maker who has no idea who you are. But this is almost always a positive outcome. We meet new people with similar passions, discuss different contexts and ways of working, and maybe even score a new collaboration, friend, or new LinkedIn connection. The use of social media is really growing at public health conferences, engaging both participants and those who couldn’t attend in person. I’ve come away from every conference with lots of new follows and followers, which also boosts engagement of the research group and links in our other collaborators.
  3. Broadened thinking, new perspectives.
    Sitting in an early morning plenary deciding what to tweet really makes you think about what you think about the topic. In my early days at conferences I probably didn’t reflect much, and was more focused on staying awake and when the next coffee break was. But as a more experienced practitioner, I find that I am continually thinking, appraising, analysing and reflecting on what’s being said. I ask more questions, and use the breaks to chat (to anyone who’ll listen) about the perspectives emerging at the conference.
  4. Confidence.
    After meeting such a range of different people from different contexts, doing different jobs and working in different ways – you realise that you’re all doing good stuff and sharing the goal to promote public health. It’s a nice confidence boost to have your work verified in an international or national context, and helps you feel like you’re on the right track.
  5.  A break from routine.
    I work in an office, and I can’t say I get regular tea-breaks with cake and tropical fruit, nor am I offered a selection of mini-baguettes for lunch. Conferences are good for this. But I do think it is good to get away from the desk and reflect on your practice within a broader context. I always enjoy catching up with colleagues old and new, who are equally as nerdy and equally keen to get out of the office for a few days. Another emerging trend at conferences which is a very welcome break in a workday routine is tea-break flash-mob dances. Enough said.

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