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Parry YK, Abbott S, Ankers MD, Willis L, O'Brien T. Beyond Kayaking - A qualitative investigation of parents and facilitators views regrading an outdoor, activity-based, multi-session parenting intervention program. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:529-537. [PMID: 32896060 DOI: 10.1111/hsc.13154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Revised: 06/30/2020] [Accepted: 08/06/2020] [Indexed: 06/11/2023]
Abstract
The Beyond Kayaking program is a free, outdoor activity-based, parenting intervention delivered across multiple sessions to vulnerable families in regional South Australia. Current literature on outdoor activity-based interventions have demonstrated improvements in family communication, problem-solving, bonding and trust. However, these studies are mostly based on single session interventions from the United States. This study explored the subjectively reported benefits of a multi-session intervention delivered in an Australian setting including how families perceived their relationships had changed (if at all) through participation in the program. This was accomplished through the use of open-ended, qualitative interviews with 20 parents who participated in the Beyond Kayaking program between 2016 and 2017. Additionally, a one-off focus group with three members of Beyond Kayaking staff was conducted to give context to the research. Thematic analysis of the data identified three dominant themes regarding participants' experiences of the Beyond Kayaking program. The first theme was 'building family capacity' and identified how kayaking produced an environment that helped families to communicate and problem solve together, which improved family understanding overall. The second theme was 'local culture' which discussed how education on local Indigenous culture helped build awareness in non-Indigenous people while helping Indigenous families to connect. The final theme 'support and shared circumstances' discussed the benefits of participants meeting people in similar circumstance, which helped them both improve, and feel better about, their own situation. Importantly, this study demonstrates that learning a new skill while being unsure and vulnerable in front of others strengthens family relationships - thus improving understanding of how activity-based interventions aid families. However, longitudinal research that follows up with participants is needed to better understand the lasting impacts of the improvements witnessed in this research.
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Affiliation(s)
- Yvonne K Parry
- College of Nursing and Health Sciences, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Shelly Abbott
- College of Nursing and Health Sciences, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Matthew David Ankers
- College of Nursing and Health Sciences, Flinders University of South Australia, Adelaide, South Australia, Australia
| | - Lyall Willis
- Centacare Catholic Family Services, Murray Bridge, South Australia, Australia
| | - Teresa O'Brien
- Communities for Children Programs, ac.care Murraylands, Murray Bridge, South Australia, Australia
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Burgemeister FC, Crawford SB, Hackworth NJ, Hokke S, Nicholson JM. Place-based approaches to improve health and development outcomes in young children: A scoping review. PLoS One 2021; 16:e0261643. [PMID: 34941941 PMCID: PMC8700019 DOI: 10.1371/journal.pone.0261643] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2020] [Accepted: 12/08/2021] [Indexed: 11/24/2022] Open
Abstract
This scoping review examines the strength of evidence for the effectiveness of public policy-led place-based initiatives designed to improve outcomes for disadvantaged children, their families and the communities in which they live. Study designs and methods for evaluating such place-based initiatives were assessed, along with the contexts in which initiatives were implemented and evaluated. Thirty-two reports relating to 12 initiatives were included. Eleven initiatives used a quasi-experimental evaluation to assess impact, although there were considerable design variations within this. The remaining initiative used a pre- and post- evaluation design. Place-based initiatives by definition aim to improve multiple and interrelated outcomes. We examined initiatives to determine what outcomes were measured and coded them within the five domains of pregnancy and birth, child, parent, family and community. Across the 83 outcomes reported in the 11 studies with a comparison group, 30 (36.4%) demonstrated a positive outcome, and all but one initiative demonstrated a positive outcome in at least one outcome measure. Of the six studies that examined outcomes more than once post baseline, 10 from 38 outcomes (26.3%) demonstrated positive sustained results. Many initiatives were affected by external factors such as policy and funding changes, with unknown impact on their effectiveness. Despite the growth of place-based initiatives to improve outcomes for disadvantaged children, the evidence for their effectiveness remains inconclusive.
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Affiliation(s)
| | | | - Naomi J. Hackworth
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia
- Parenting Research Centre, East Melbourne, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
| | - Stacey Hokke
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia
| | - Jan M. Nicholson
- Judith Lumley Centre, La Trobe University, Bundoora, Victoria, Australia
- Murdoch Children’s Research Institute, Parkville, Victoria, Australia
- Queensland University of Technology, Brisbane, Queensland, Australia
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Sport participation may protect socioeconomically disadvantaged youths with refugee backgrounds from experiencing behavioral and emotional difficulties. J Adolesc 2020; 85:148-152. [PMID: 33242671 DOI: 10.1016/j.adolescence.2020.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 11/11/2020] [Accepted: 11/12/2020] [Indexed: 11/20/2022]
Abstract
INTRODUCTION Youth with refugee backgrounds experience social and socioeconomic difficulties that arise following resettlement. Research has found that sport participation generally provides youth with a protective milieu that is especially beneficial for the most disadvantaged youth. Accordingly, the current study examines whether sport participation is related to positive psychosocial outcomes for resettled adolescent refugees, and if these effects are greater for those living in socioeconomically disadvantaged communities. METHOD Data were from a large, nationally representative cohort of refugees recently resettled in Australia (Building New Life in Australia study, BNLA). Self-reported social and emotional well-being was collected from 415 youth who entered the country as refugees (Mage = 14.04, SD = 1.99) at three years post settlement were used. RESULTS A moderated regression analysis indicated that refugee youth living in socioeconomically disadvantaged neighborhoods who participated in sports reported significantly better outcomes compared to those refugee youth in economically similar neighborhoods who did not participate in sport. In contrast, refugee youth residing in more socioeconomically advantaged communities had better developmental outcomes, regardless of sport participation. CONCLUSIONS Sport participation is a protective factor for youth with refugee backgrounds. Community socioeconomic disadvantage moderates this relationship, whereby stronger effects were observed for adolescents in more disadvantaged communities. Protecting the most disadvantaged in our society is a human rights imperative, and the current study indicates that sport participation could contribute to these efforts among resettled refugee populations.
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Lau W, Silove D, Edwards B, Forbes D, Bryant R, McFarlane A, Hadzi-Pavlovic D, Steel Z, Nickerson A, Van Hooff M, Felmingham K, Cowlishaw S, Alkemade N, Kartal D, O’Donnell M. Adjustment of refugee children and adolescents in Australia: outcomes from wave three of the Building a New Life in Australia study. BMC Med 2018; 16:157. [PMID: 30176864 PMCID: PMC6122776 DOI: 10.1186/s12916-018-1124-5] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2017] [Accepted: 07/11/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND High-income countries like Australia play a vital role in resettling refugees from around the world, half of whom are children and adolescents. Informed by an ecological framework, this study examined the post-migration adjustment of refugee children and adolescents 2-3 years after arrival to Australia. We aimed to estimate the overall rate of adjustment among young refugees and explore associations with adjustment and factors across individual, family, school, and community domains, using a large and broadly representative sample. METHODS Data were drawn from Wave 3 of the Building a New Life in Australia (BNLA) study, a nationally representative, longitudinal study of settlement among humanitarian migrants in Australia. Caregivers of refugee children aged 5-17 (N = 694 children and adolescents) were interviewed about their children's physical health and activity, school absenteeism and achievement, family structure and parenting style, and community and neighbourhood environment. Parent and child forms of the Strengths and Difficulties Questionnaire (SDQ) were completed by caregivers and older children to assess social and emotional adjustment. RESULTS Sound adjustment according to the SDQ was observed regularly among young refugees, with 76-94% (across gender and age) falling within normative ranges. Comparison with community data for young people showed that young refugees had comparable or higher adjustment levels than generally seen in the community. However, young refugees as a group did report greater peer difficulties. Bivariate and multivariate linear regression analyses showed that better reported physical health and school achievement were associated with higher adjustment. Furthermore, higher school absenteeism and endorsement of a hostile parenting style were associated with lower adjustment. CONCLUSIONS This is the first study to report on child psychosocial outcomes from the large, representative longitudinal BNLA study. Our findings indicate sound adjustment for the majority of young refugees resettled in Australia. Further research should examine the nature of associations between variables identified in this study. Overall, treating mental health problems early remains a priority in resettlement. Initiatives to enhance parental capability, physical health, school achievement and participation could assist to improve settlement outcomes for young refugees.
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Affiliation(s)
- Winnie Lau
- Phoenix Australia, Melbourne, Victoria Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria Australia
| | - Derrick Silove
- Liverpool Hospital, Sydney, NSW Australia
- School of Psychiatry, University of New South Wales, Sydney, NSW Australia
| | - Ben Edwards
- ANU Centre for Social Research and Methods, Australian National University, Canberra, Australian Capital Territory Australia
| | - David Forbes
- Phoenix Australia, Melbourne, Victoria Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria Australia
| | - Richard Bryant
- School of Psychology, University of New South Wales, Sydney, NSW Australia
| | - Alexander McFarlane
- Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, SA Australia
| | | | - Zachary Steel
- School of Psychiatry, University of New South Wales, Sydney, NSW Australia
- Black Dog Institute, Sydney, NSW Australia
- St John of God Hospital Richmond, Sydney, Australia
| | - Angela Nickerson
- School of Psychology, University of New South Wales, Sydney, NSW Australia
| | - Miranda Van Hooff
- Centre for Traumatic Stress Studies, University of Adelaide, Adelaide, SA Australia
| | - Kim Felmingham
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria Australia
| | - Sean Cowlishaw
- Phoenix Australia, Melbourne, Victoria Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria Australia
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | | | - Dzenana Kartal
- Phoenix Australia, Melbourne, Victoria Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria Australia
| | - Meaghan O’Donnell
- Phoenix Australia, Melbourne, Victoria Australia
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria Australia
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Townshend T, Lake A. Obesogenic environments: current evidence of the built and food environments. Perspect Public Health 2017; 137:38-44. [DOI: 10.1177/1757913916679860] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Aims: Obesity is one of the most significant global health and social problems, with rates rising dramatically over the past few decades. While the basic drivers of obesity are obvious (more energy consumed than expended), the causes are multifactorial and complex. A decade ago, it was suggested that exploring the ways in which the built environment influenced physical activity and dietary behaviours might provide fertile ground for investigation. This article overviews current evidence and, in particular, emergent themes that are of significance for the United Kingdom. Methods: This article is based on literature extracted from keyword searching of electronic databases. A timeframe of 2006–2016 was used. Results: In the past decade, the research base has grown significantly; while frustratingly some results are still inconclusive or contradictory, it might be argued enough evidence exists to act upon. Themes such as the importance of the journey to school for young people and the multiple environments in which people spend their time are examples of where real progress has been made in the evidence base. Conclusion: Progress towards real change in policy and practice may seem slow; however, the opportunities afforded for health and planning professionals to work together provide a step towards the whole systems approaches to tackle obesity that are desperately needed.
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Falster K, Jorm L, Eades S, Lynch J, Banks E, Brownell M, Craven R, Einarsdóttir K, Randall D. What factors contribute to positive early childhood health and development in Australian Aboriginal children? Protocol for a population-based cohort study using linked administrative data (The Seeding Success Study). BMJ Open 2015; 5:e007898. [PMID: 25986640 PMCID: PMC4442193 DOI: 10.1136/bmjopen-2015-007898] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
INTRODUCTION Australian Aboriginal children are more likely than non-Aboriginal children to have developmental vulnerability at school entry that tracks through to poorer literacy and numeracy outcomes and multiple social and health disadvantages in later life. Empirical evidence identifying the key drivers of positive early childhood development in Aboriginal children, and supportive features of local communities and early childhood service provision, are lacking. METHODS AND ANALYSIS The study population will be identified via linkage of Australian Early Development Census data to perinatal and birth registration data sets. It will include an almost complete population of children who started their first year of full-time school in New South Wales (NSW), Australia, in 2009 and 2012. Early childhood health and development trajectories for these children will be constructed via linkage to a range of administrative data sets relating to birth outcomes, congenital conditions, hospital admissions, emergency department presentations, receipt of ambulatory mental healthcare services, use of general practitioner services, contact with child protection and out-of-home care services, receipt of income assistance and fact of death. Using multilevel modelling techniques, we will quantify the contributions of individual-level and area-level factors to variation in early childhood development outcomes in Aboriginal and non-Aboriginal children. Additionally, we will evaluate the impact of two government programmes that aim to address early childhood disadvantage, the NSW Aboriginal Maternal and Infant Health Service and the Brighter Futures Program. These evaluations will use propensity score matching methods and multilevel modelling. ETHICS AND DISSEMINATION Ethical approval has been obtained for this study. Dissemination mechanisms include engagement of stakeholders (including representatives from Aboriginal community controlled organisations, policy agencies, service providers) through a reference group, and writing of summary reports for policy and community audiences in parallel with scientific papers.
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Affiliation(s)
- Kathleen Falster
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
- The Sax Institute, Sydney, Australia
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
| | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
- Centre for Health Research, School of Medicine, University of Western Sydney, Campbelltown, Australia
| | - Sandra Eades
- Baker IDI Heart and Diabetes Institute, Melbourne, Australia
| | - John Lynch
- School of Population Health, University of Adelaide, Adelaide, Australia
| | - Emily Banks
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
- The Sax Institute, Sydney, Australia
| | - Marni Brownell
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Canada
| | - Rhonda Craven
- Institute of Positive Psychology and Education, Australian Catholic University, Sydney, Australia
| | | | - Deborah Randall
- Centre for Big Data Research in Health, University of New South Wales, Sydney, Australia
- Centre for Health Research, School of Medicine, University of Western Sydney, Campbelltown, Australia
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Investigating 'place effects' on mental health: implications for population-based studies in psychiatry. Epidemiol Psychiatr Sci 2015; 24:27-37. [PMID: 25424460 PMCID: PMC6998143 DOI: 10.1017/s204579601400050x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Background. Interest in features of our local environments that may promote better mental health and wellbeing continues to rise among decision makers. Our purpose was to highlight a selection of these challenges and some promising avenues for enhancing the quality of evidence. Method. An analysis of approximately 267, 000 people was used to test the local relative deprivation hypothesis, wherein the shortfall of a person's socioeconomic circumstances from their neighbours is said to impact negatively upon mental health. This case was used to anchor further discussion of challenges to identifying and interpreting genuine 'place effects' from spurious correlations. Results. A Median Odds Ratio of 1.29 computed via multilevel logistic regression showed that the odds of experiencing psychological distress (as measured by the Kessler score) varied by geographical area. Approximately 67% of this was attributed to a cross-classified measure of household income and neighbourhood deprivation. Compared to people on high incomes living in affluent neighbourhoods, the odds ratio of psychological distress for people on low incomes in affluent areas was 4.73 (95% confidence interval (95% CI) 4.39, 5.09), whereas that for people on low incomes in deprived areas was significantly higher at 5.83 (95% CI 5.41, 6.28). Conclusions. While no evidence was found to support local relative deprivation hypothesis, the pattern suggests that more affluent areas may contain features that are conducive to better mental health. Selection of bespoke geographical boundaries, use of directed acyclic graphs and more evaluations of natural experiments are likely to be important in taking the field of enquiry onwards.
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Hayes SL, Mann MK, Morgan FM, Kelly MJ, Weightman AL. Collaboration between local health and local government agencies for health improvement. Cochrane Database Syst Rev 2012; 10:CD007825. [PMID: 23076937 PMCID: PMC9936257 DOI: 10.1002/14651858.cd007825.pub6] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
BACKGROUND In many countries, national, regional and local inter- and intra-agency collaborations have been introduced to improve health outcomes. Evidence is needed on the effectiveness of locally developed partnerships which target changes in health outcomes and behaviours. OBJECTIVES To evaluate the effects of interagency collaboration between local health and local government agencies on health outcomes in any population or age group. SEARCH METHODS We searched the Cochrane Public Health Group Specialised Register, AMED, ASSIA, CENTRAL, CINAHL, DoPHER, EMBASE, ERIC, HMIC, IBSS, MEDLINE, MEDLINE In-Process, OpenGrey, PsycINFO, Rehabdata, Social Care Online, Social Services Abstracts, Sociological Abstracts, TRoPHI and Web of Science from 1966 through to January 2012. 'Snowballing' methods were used, including expert contact, citation tracking, website searching and reference list follow-up. SELECTION CRITERIA Randomized controlled trials (RCTs), controlled clinical trials (CCTs), controlled before-and-after studies (CBAs) and interrupted time series (ITS) where the study reported individual health outcomes arising from interagency collaboration between health and local government agencies compared to standard care. Studies were selected independently in duplicate, with no restriction on population subgroup or disease. DATA COLLECTION AND ANALYSIS Two authors independently conducted data extraction and assessed risk of bias for each study. MAIN RESULTS Sixteen studies were identified (28,212 participants). Only two were considered to be at low risk of bias. Eleven studies contributed data to the meta-analyses but a narrative synthesis was undertaken for all 16 studies. Six studies examined mental health initiatives, of which one showed health benefit, four showed modest improvement in one or more of the outcomes measured but no clear overall health gain, and one showed no evidence of health gain. Four studies considered lifestyle improvements, of which one showed some limited short-term improvements, two failed to show health gains for the intervention population, and one showed more unhealthy lifestyle behaviours persisting in the intervention population. Three studies considered chronic disease management and all failed to demonstrate health gains. Three studies considered environmental improvements and adjustments, of which two showed some health improvements and one did not.Meta-analysis of three studies exploring the effect of collaboration on mortality showed no effect (pooled relative risk of 1.04 in favour of control, 95% CI 0.92 to 1.17). Analysis of five studies (with high heterogeneity) looking at the effect of collaboration on mental health resulted in a standardised mean difference of -0.28, a small effect favouring the intervention (95% CI -0.51 to -0.06). From two studies, there was a statistically significant but clinically modest improvement in the global assessment of function symptoms score scale, with a pooled mean difference (on a scale of 1 to 100) of -2.63 favouring the intervention (95% CI -5.16 to -0.10).For physical health (6 studies) and quality of life (4 studies) the results were not statistically significant, the standardised mean differences were -0.01 (95% CI -0.10 to 0.07) and -0.08 (95% CI -0.44 to 0.27), respectively. AUTHORS' CONCLUSIONS Collaboration between local health and local government is commonly considered best practice. However, the review did not identify any reliable evidence that interagency collaboration, compared to standard services, necessarily leads to health improvement. A few studies identified component benefits but these were not reflected in overall outcome scores and could have resulted from the use of significant additional resources. Although agencies appear enthusiastic about collaboration, difficulties in the primary studies and incomplete implementation of initiatives have prevented the development of a strong evidence base. If these weaknesses are addressed in future studies (for example by providing greater detail on the implementation of programmes; using more robust designs, integrated process evaluations to show how well the partners of the collaboration worked together, and measurement of health outcomes) it could provide a better understanding of what might work and why. It is possible that local collaborative partnerships delivering environmental Interventions may result in health gain but the evidence base for this is very limited.Evaluations of interagency collaborative arrangements face many challenges. The results demonstrate that collaborative community partnerships can be established to deliver interventions but it is important to agree goals, methods of working, monitoring and evaluation before implementation to protect programme fidelity and increase the potential for effectiveness.
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Affiliation(s)
- Sara L Hayes
- Abertawe Bro Morgannwg University Health BoardABM Headquarters1 Talbot GatewayPort TalbotUKSA12 7BR
| | - Mala K Mann
- Information Services, Cardiff UniversitySupport Unit for Research Evidence (SURE)1st Floor, Neuadd MeirionnyddHeath ParkCardiffWalesUKCF14 4YS
| | - Fiona M Morgan
- Information Services, Cardiff UniversitySupport Unit for Research Evidence (SURE)1st Floor, Neuadd MeirionnyddHeath ParkCardiffWalesUKCF14 4YS
| | - Mark J Kelly
- Cardiff University School of MedicineSouth East Wales Trials Unit, Institute of Translation, Innovation Methodologies & EngagementNeuadd MeirionnyddHeath ParkCardiffWalesUKCF14 4YS
| | - Alison L Weightman
- Information Services, Cardiff UniversitySupport Unit for Research Evidence (SURE)1st Floor, Neuadd MeirionnyddHeath ParkCardiffWalesUKCF14 4YS
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