Health Promotion In Australia Research Articles

The past as present in health promotion: the case for a 'public health humanities'.

Health promotion is conceived as a unifying concept for improving the health of populations. This means addressing the socio-cultural, economic and commercial causes of ill-health, which are necessarily informed by past policies and socio-cultural contexts. However, historical scholarship has rarely figured in health promotion practice or scholarship. This gap resides in the determinants of health, and notably in the analyses of tobacco control and skin cancer prevention, two long-running campaigns that have shaped modern health promotion in Australia. Both highlight a need for understanding the profound impact of history on the present and the value of learning from past successes and failures. Doing so requires integrating historical analyses into existing health promotion scholarship. To achieve this aim, we present a new 'public health humanities' methodology. This novel interdisciplinary framework is conceived as a spectrum in which historical studies integrate with existing health promotion disciplines to solve complex health problems. We draw on the many calls for more interdisciplinarity in health promotion and derive this methodology from proposals in the medical humanities and cognate fields that have wrestled with combining history and present-focused disciplines. Using tobacco control and skin cancer prevention as case studies, we demonstrate how public health humanities uses interdisciplinary teams and shared research questions to generate valuable new knowledge unavailable with traditional methods. Furthermore, we show how it creates evaluation criteria to consider the powerful impact of issues like colonialism on current inequities that hinder health promotion strategies, and from which lessons may be derived for the future.

Oral health messages for Australia: A national consensus statement.

Oral health promotion initiatives must be evidence-based and consistent with broader health messaging. The Oral Health Messages for the Australian Public were first produced in 2009 and sought to enable a focused, and strategic approach to oral health promotion in Australia. As the evidence base and needs of the Australian population have since changed, this consensus statement was updated in 2022-2023. The process of updating the messages consisted of 3 phases (preparatory phase, the Delphi technique, final revision phase). The preparatory phase included public and expert consultation, an umbrella review of published scientific literature and review of available recommendations, policies and guidelines. The Delphi technique used in this study was guided by Guidance on Conducting and REporting DElphi Studies (CREDES) and included 2 voting rounds. There were 70 experts in round 1 and 60 experts in round 2. Delphi participants comprised of experts from a variety of fields to ensure diversity and inclusion, balance expertise and maximize stakeholder representation. Consensus was defined as 75% agreement. A total of 11 messages were included in the 2022 update of Oral Health Messages for Australia. The updated oral health messages will support oral health promotion policy and activity at both individual and population level to improve the oral health of Australians.

Advances in Gender-Transformative Approaches to Health Promotion.

Gender is an important determinant of health, but explicit attention to gender is often missing in health promotion. We build on Pederson and colleagues' gender-transformative framework for health promotion to propose four guiding principles for gender-transformative health promotion. First, health promotion must address gender norms directly if it is to improve health outcomes. Second, it should move beyond individual change to engage explicitly with structural and social determinants of health. Third, it should address underlying gender-related determinants in order to influence health outcomes. And fourth, it requires complexity-informed design, implementation, and evaluation. We provide background on key concepts that are essential for designing, implementing, and evaluating gender-transformative health promotion: gender norms, socioecological approaches, and the gender system. We give examples of the four principles in practice, using the case of postnatal mental health promotion in Australia and sexuality education in Mexico. These four principles can be applied to health promotion efforts across contexts and outcomes to address the harmful gender norms that contribute to poor health as a part of broader efforts to improve health and well-being.

Sports-based mental health promotion in Australia: Formative evaluation

ObjectivesFormative evaluation is critical in maximising the implementation strategies and processes of interventions. It is also critical to both providing contextual explanations for and maximising the success of such interventions. The purpose of this study was to undertake a comprehensive formative evaluation of the implementation process of a multi-component, sports-based mental health program for adolescent males (“Ahead of the Game”). MethodsPrimary outcomes included program reach, dose, fidelity and cost during initial piloting and two distinct implementation phases. The iterative formative evaluation process provided opportunities to adapt the program and its implementation strategy to optimise reach, dose and fidelity relative to implementation cost. ResultsFormative evaluation data showed that the program failed to achieve optimal reach in the initial pilot phase (Phase I), with low doses of the program received by stakeholders, and moderate fidelity. Bottom up implementation strategies improved dose and club ownership during Phase II but resulted in high costs and lower fidelity and was associated with implementation staff retention and management issues. Phase III with more streamlined staffing and club integrated implementation resulted in high reach, dose, fidelity and club ownership and an associated reduction in implementation cost per participant. Conclusion: Formative evaluation succeeded in maximising the Ahead of the Game program engagement over three distinct phases. Results are salient for informing cost-effective implementation strategies for sports-based health promotion.

Health promotion in Australia: Dealing with a reluctant industry

Health promotion in Australia: Dealing with a reluctant industry

Health promotion in Australia: Dealing with a reluctant industry

Health promotion in Australia: Dealing with a reluctant industry

Perceptions of cardiac care providers towards oral health promotion in Australia

BackgroundThere is increasing evidence linking poor oral health with cardiovascular disease and it is recommended that health professionals managing people with cardiac disease (cardiac care providers) promote oral health in their practice. However, the current perceptions of cardiac care providers regarding this aspect of clinical practice are unknown in Australia. AimTo explore oral health perceptions, knowledge and practices of cardiac care providers and their role in promoting oral health. MethodsA qualitative study involving focus groups and semi-structured telephone interviews was undertaken with cardiac care providers (27 nurses, two physiotherapists, one exercise physiologist) across Australia between January–March 2016. Interviews/focus groups were transcribed and thematically analysed. FindingsMost participants encountered a number of patients with poor oral health and highlighted barriers seeking dental care, including access, cost and lack of awareness. However, oral health was not routinely discussed with patients except when cardiac valve surgeries were required. Many participants were unaware of the relationship between oral health and cardiovascular disease. Overall, participants were comfortable with promoting oral health if barriers such as training, time constraints and referral pathways were addressed. Practical suggestions regarding timing of training, preferred content and delivery format were also provided. DiscussionCardiac care providers have limited oral health knowledge and are not routinely promoting oral health. However, they are receptive to promoting oral health with adequate support. ConclusionCardiac care providers need to be adequately trained and supported to promote oral health to their patients. Supportive strategies could include training, resources and formalised referral pathways.

Response to Editorial: Children, poverty and health promotion in Australia.

Response to Editorial: Children, poverty and health promotion in Australia.

Children, poverty and health promotion in Australia

Children, poverty and health promotion in Australia

Applying a performance monitoring framework to increase reach and adoption of children's healthy eating and physical activity programs.

The allocation of a significant amount of new funding for health promotion in Australia through the National Partnership Agreement on Preventive Health (2009-14) created a unique opportunity to implement a comprehensive approach to the prevention of chronic diseases and demonstrate significant health improvements. Building on existing health promotion infrastructure in Local Health Districts, the NSW Ministry of Health adopted a scaled-up state-wide capacity-building model, designed to alter policies and practices in key children's settings to increase healthy eating and physical activity among children. NSW also introduced a performance monitoring framework to track implementation and impacts. This paper describes the model that NSW developed for monitoring state-wide programs in the Children's Healthy Eating and Physical Activity Program and presents the model's application to early childhood education and care and primary school settings, including current results. This approach to monitoring the scaling up of program implementation at the state-wide level has potential for more widespread application in other policy areas in NSW.

Exploring health promotion practitioners' experiences of moral distress in Canada and Australia.

This article introduces moral distress - the experience of painful feelings due to institutional constraints on personal moral action - as a significant issue for the international health promotion workforce. Our exploratory study of practitioners' experiences of health promotion in Australia and Canada during 2009-2010 indicated that practitioners who work in upstream policy- and systems-level health promotion are affected by experiences of moral distress. Health promotion practitioners at all levels of the health promotion continuum also described themselves as being engaged in a minority practice within a larger dominant system that does not always value health promotion. We argue that health promotion practitioners are vulnerable to moral distress due to the values-driven and political nature of the practice, the emphasis on systems change and the inherent complexity and diversity of the practice. This vulnerability to moral distress poses significant challenges to both workers and organisations and the communities they seek to benefit. We propose that further research should be undertaken to fully identify the causes and symptoms of moral distress in health promotion. Extensive existing research on moral distress in nursing provides ample resources to conduct such research.

Addressing climate change through health promotion in Australia

Climate change is arguably the biggest global health threat of the 21st Century. While the spread of vector-borne diseases and the health impacts of extreme weather events dominate discussions about health and climate change, there are also a range of other issues that are central to the health promotion community. Concerns such as food security; mental health; Indigenous health; and water quality are increasingly familiar. It is also undeniable that a shared vision of most health promoters to achieve environmental sustainability and to promote health equity is challenged by the threat of climate change. Health professionals are well positioned to address this threat, but action needs to be swift and sustained.

Die Handlungsqualifikationen der Ergotherapie im Rahmen der Gesundheitsförderung in Österreich

INTRODUCTION: This publication deals with the prerequisites and qualifications of occupational therapists within the health promotion programme in Austria. The master thesis focused on investigating current health promotion projects of occupational therapy in Australia and evaluated how they may be implemented into the Austrian health promotion concept. An additional goal was to identify possible future areas of specialty for occupational therapists as a result of implementing these projects in Austria. METHOD: A systematic review of existing literature was performed in order to address the question of this research. The results were analysed qualitatively with SMART-criteria - an analysis tool of project management. RESULTS: The results revealed six areas of specialization for occupational therapists within the field of health promotion in Australia. These occupational therapy work fields were then analyzed according to their possibility of implementation into the Austrian health promotion concept. CONCLUSION: In conclusion three settings were found to be appropriate to meet the research question: working with children of migrants and asylum seekers in kindergarten and schools, working within workplace health promotion, as well as working with caretakers of elderly dependants suffering from dementia.

Health promotion and secondary prevention: response to Milat, O'Hara and Develin

This paper responds to a recent HPJA article by Milat, O'Hara and Develin, which called for health promotion practitioners to be more closely involved in secondary prevention of Type 2 diabetes. It considers the resources currently available to health promotion in Australia, and examines and critiques the terminology of prevention used by Milat et al. The paper argues that Milat et al. give insufficient attention to the central role of social determinants of health in preventing Type 2 diabetes and in reducing health inequalities in the population. The paper agrees that increased health promotion involvement in Type 2 diabetes prevention programs may be beneficial, but argues that funds for such programs should come from the services that run them, not from the tiny health promotion budget. Given the current and projected scale of Type 2 diabetes in Australia, there is value in applying the concept of 'moving upstream' to this health issue. The paper concludes that, given current resources, the best use of Australia's specialist health promotion workforce is in 'upstream' programs that can benefit the whole population as well as those at risk of Type 2 diabetes.

Funding illness prevention and health promotion in Australia: a way forward.

BackgroundUnlike pharmaceuticals and private medical services there is no single source of funding for illness prevention and health promotion and no systematic process for setting priorities in public health. There is a need to improve the efficiency of access to health funding across prevention and treatment.DiscussionWe discuss a number of reforms to existing funding arrangements including the creation of a national Preventative Priorities Advisory Committee (PrePAC) to set priorities. We propose the establishment of a PrePAC to provide evidence and set priorities across health promotion and illness prevention, with a national dedicated fund for health promotion.ConclusionA national evidence-based funding system for illness prevention and health promotion would legitimise a substantial and sustained budget for health promotion, breaking down some of the barriers in a fragmented federal health care system.

Health promotion in Australia: Reviewing the past and looking to the future

Over the last three decades Australia has very successfully adopted and applied the values, methods, and practice of health promotion to improve the average life expectancy and health of the population. Australia has, also, been part of and contributed to the global evolution of the field of health promotion. There is, now, substantial organisational capacity (including a specialist workforce) within the health sector (including the non-government and community sectors), although total financial investment as a proportion of total recurrent health expenditure remains consistently below 2%. However, despite its significant successes, health promotion in Australia has had little impact on improving the health of Indigenous Australians. Closing the 17-year gap in life expectancy is one of the greatest challenges facing health promotion in the future–necessitating a much more substantial investment in working across sectors to redistribute the social determinants of health, including political power.

Health promotion in Australia: twenty years on from the Ottawa Charter

Australia has a longstanding history of promoting health through programs that reflect the principles of the Ottawa Charter and recognising the importance of social determinants of health. Health promotion programs are delivered by a wide range of organisations, in a wide range of settings and sectors for, or with, multiple groups. Since the mid-1980s aspects of infrastructure and capacity for health promotion, such as human and financial resources, have been put in place including the establishment of health promotion foundations via tobacco hypothecation. Following neo-liberal reforms in the 1990s, however, government policies have increasingly focused more narrowly on specific diseases and risk factors. Chronic disease has become the new banner under which health promotion, social determinants and efforts to address health inequalities fit. While the importance of social determinants is often recognised within and outside the health sector, health promotion practitioners are seldom at the centre of policy development. (Promotion & Education,

Does theory inform practice in health promotion in Australia?

In recent years, there have been numerous papers discussing the importance of improving the link between health promotion researchers and practitioners. Several reviews have been undertaken to determine the extent to which health promotion research is disseminated to, and utilized by, practitioners in the development and implementation of health promotion programs. These studies have generally been limited to reviews of literature rather than directly gathering data from practitioners. This paper reports on a survey of Australian health promotion practitioners undertaken to investigate the extent to which they are aware of, understand and utilize the major health promotion theories and models derived from research in the areas of psychology and communication. We found that none of the theories or models included in this study-the 'standard' theories and models taught in health promotion courses, and included in the leading textbooks-were used by more than 50% of practitioners in their work. The only models being used by more than one-third of the practitioners were PRECEDE-PROCEED and the Transtheoretical (Stages of Change) Model. The paper concludes with possible explanations for the low level of utilization of theories and models, and suggestions for increasing their usage based on information sources accessed by these practitioners.

'Opportunity structures': urban landscape, social capital and health promotion in Australia.

This paper presents data from 40 in-depth interviews that were conducted as part of a study of social capital and health in relation to people's perceptions of the influence of 'place' on their participation levels and health. These data were used to examine features of the western suburbs of Adelaide that were perceived as health damaging and health promoting. The paper demonstrates that our Australian suburban respondents expressed a considerable concern about these features and the impact they have on their perception of community and their ability to participate in it. Safety, connectedness to the area, the reputation of an area and the extent and nature of community facilities are all seen as important to a healthy community. The research found that in the more deprived socioeconomic areas within the study area, there was a significant degree of dissatisfaction with features of the urban environment, such as availability of amenities, provision of public transport, and proximity of industry to private dwellings. The paper concludes by considering certain features of urban environments that might make them more supportive of health through encouraging contact between people. We conclude that these environments could be improved using the following measures: a subsidy scheme to support the viability of local shops and cafés (thereby providing meeting places and employment); parks with facilitators (who could play a role in increasing safety in the park but also encouraging community development); attractive places to walk; and a general environmental improvement program.

Policy- and system-level approaches to health promotion in Australia.

This issue of Health Education & Behavior presents articles from researchers and practitioners in Australia who are working to create supportive political and social environments for health. Much of what happens in health promotion in Australia at the individual, workplace, group, or community level shares similarities with interventions conducted by colleagues across the world. What differs, and what visitors to Australia often remark on, is the high degree of public acceptance of, and legislative-level support for, promotive and protective health practices. At a national level, these include, for example, extensive regulation of smoking in public spaces, vehicle passenger safety restraints, blood alcohol restrictions for drivers supported by random breath testing, bicycle helmet laws, private swimming pool fencing regulations, gun control legislation, and laws preventing the use of hand-held mobile phones in moving vehicles. In this editorial, we briefly describe the Australian context, give a brief overview of the articles in this special issue, and attempt to account for how and why health promotion in Australia has developed a strong policy and system-level focus. 1 Australia is roughly the size of the United States with a population of 19 million people. The population is culturally and linguistically diverse. Indigenous Australians make up 2% of the population. Currently, 8 million residents were born overseas or have parents who were born overseas. More than 280 languages are spoken, including 170 Australian indigenous languages. A language other than English is spoken at home by 16% of the population. Universal access to publicly funded health care has been provided through