Archived: Prevention Centre research shines at Menzies conference

22 July 2016

Six Prevention Centre researchers presented their work at a recent conference held by the Menzies Centre for Health Policy.

The annual Emerging Health Policy Research Conference showcases the work in progress of masters, doctoral and early career researchers, as well as those new to the field of health policy research.

The Prevention Centre researchers presented on wide variety of work, from measuring the implementation of chronic disease interventions to how Indigenous communities use public health law to control alcohol. Here is a snapshot of their presentations.

 

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Dr Katie Conte, Research Fellow,
Menzies Centre for Health Policy and The Australian Prevention Partnership Centre

Topic: What’s measured and what’s not? Dynamics of policy implementation monitoring
Prevention Centre project: Policy and program implementation and the role of context in explaining prevention effectiveness

Katie and colleagues are examining an innovative IT system that the NSW Ministry of Health has developed to help track the Healthy Children Initiative.

The Population Health Intervention Management System (PHIMS) is a single IT system that enables NSW Health to set up, manage and report against the aims of the Initiative, which targets early childcare and primary schools in NSW to promote healthy eating and physical activity.

Katie said PHIMS was unique in that it combined data reporting with project management, making it a good vehicle for studying implementation of a prevention intervention. The research project is trying to better understand how PHIMS fits into day-to-day practice.

In collaboration with the NSW Ministry of Health and local health districts, the project involves practice observations, interviews and focus groups that will explore questions including:

  • How often do staff use the PHIMS system and how do they use it?
  • How does it inform or guide their actions?
  • How do they view the system?
  • How do these elements differ across local health districts?

“We think that the data reflect the tip of the iceberg and that, below the surface, there’s a mound of important work about local practice,” Katie said. “If we can expose this work and better understand the full story, this information can help us better design monitoring systems that more accurately reflect the amount and type of work that goes into gaining a “tick”, or reaching a goal.”

Katie said the information may help to better direct and tailor resources to help those areas that appear to be underperforming, but may actually be over performing with fewer resources.

 

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Jan Muhunthan: PhD candidate,
The George Institute for Global Health and The Australian Prevention Partnership Centre

Topic: How do Indigenous communities use public health law to control alcohol?
Prevention Centre project: The role of public health law in preventing chronic disease

As part of her PhD project with the Prevention Centre, Jan examined the effectiveness and acceptability of community-led alcohol controls in Indigenous communities. While the harmful use of alcohol disproportionately affects Indigenous communities around the world, local knowledge and ways to control alcohol are a neglected area of research, Jan said.

She conducted a global systematic review of quantitative evaluations of community-led legal interventions designed to reduce harmful use of alcohol. The review found 15 evaluations in rural and remote populations in high-income countries: Australia, the US, Canada and Greenland. Examples of community-led interventions included prohibition or restrictions of sale of alcohol, local excise tax and Indigenous controlled liquor licensing.

The review, which Jan has submitted for publication in a journal, shows a widespread preference in Indigenous peoples globally to contribute to the design and implementation of strong, legal responses to the harmful use of alcohol. The findings also suggest such community-centric policy models can be effective in improving health and social outcomes. We will cover Jan’s study in more detail after publication.

 

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Eloise O’Donnell, Research Officer
The Australian Prevention Partnership Centre

Topic: Dynamic simulation modelling: Supporting decisions to reduce alcohol-related harms in NSW
Prevention Centre project: Simulation modelling of alcohol consumption and the effectiveness of harm-reduction policies

Eloise described a Prevention Centre project that has used dynamic simulation modelling to explore possible solutions to the complex problem of alcohol-related harm in NSW.

Working with NSW Health, the Prevention Centre project developed a simulation model of alcohol use in NSW. Dynamic simulation modelling brings together a variety of evidence sources, such as research, expert knowledge, practice experience and data, to capture the complexity of a problem. That model is then used to simulate various policy scenarios to see which is likely to have the most effect.

“In this way, the model provides a ‘what-if’ tool for examining a range of policy scenarios in a low risk and low cost way,” Eloise said. “It can also test a whole range of scenarios that we would be unable to test in the real world.”

Eloise described how the model was developed and showed how it could be used to test various interventions and reveal unintended consequences. “For example, when we tested the impact of raising drink prices in licensed venues to try to decrease consumption and violence, the model actually produced an increase in consumption, acute alcohol-related harms, ED presentations and hospitalisations,” Eloise said.

“When we looked into why this was the case we found that in the model, if licensed venues became too expensive, individuals shifted their behaviour to preloading before big nights out and increased drinking at home parties.”

Eloise said dynamic simulation modelling increased the possibility that policy options would be taken up because policy makers and practitioners helped to define the model scope and boundaries from the beginning and were involved throughout the process.

 

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Claire Pearce, PhD candidate,
Menzies Centre for Health Policy and The Australian Prevention Partnership Centre

Topic: Why aren’t health professionals telling us we’re fat? The role of health services in overweight and obesity prevention
Prevention Centre project: The role of non-admitted health services in the prevention of overweight and obesity: a systems approach to supporting the translation of evidence into practice

Claire is bringing 20 years’ experience as a health professional to her PhD, which is examining the role of health services in preventing overweight and obesity.

“Health professionals have a duty of care to help prevent chronic disease, yet we know they are uncomfortable raising the issue of weight and diet with their patients,” she said.

Routinely weighing all patients and asking about nutrition and physical activity would help to normalise weight as a clinical indicator rather than it being a social judgement. “Yet we don’t routinely weigh people in health services and we don’t routinely ask them about food and physical activity,” she said.

Claire’s qualitative study involves interviews and observations with clinicians in the ACT. Her study is examining two key issues:

  • Why aren’t health professionals telling us we’re getting fat? What are the key organisational, professional, cultural and attitudinal factors influencing the incorporation of obesity prevention interventions in a health care setting?
  • How do we get health professionals to include prevention in what they do? How do these factors interact with each other to limit or enable the uptake of obesity prevention?

“I want to get to the bottom of why health professionals won’t ask people what they eat,” Claire said. “Is it too personal, or don’t they think it’s their responsibility?”

 

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Tala Barakat, MPhil student,
Menzies Centre for Health Policy and The Australian Prevention Partnership Centre

Topic: Corrupting the nanny state. A content analysis of the Sydney lockout laws
Prevention Centre project: Communicating prevention – approaches to prevention framing and story telling

Tala investigated the evidence and arguments presented in the news media in the debate about the NSW lockout laws using a content analysis of 400 articles published between 1 February and 9 March this year looking at how arguments were formulated for and against the lockout laws.

Her study also looked at whether there were more or less convincing ways of communicating public health policy that affects private sector interests.

Tala studied media reporting after an article by entrepreneur and founder of Freelancer.com, Matt Barrie, was published on LinkedIn: ‘Would the last person in Sydney please turn the lights out? The article, which railed against the lockout laws, was viewed almost one million times, and helped to galvanise the Keep Sydney Open movement.

The content analysis is the first part of Tala’s MPhil project with the Prevention Centre, which will look at the framing of prevention messages in social media.

 

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Dr Samantha Rowbotham, Research Fellow,
Menzies Centre for Health Policy and The Australian Prevention Partnership Centre

Topic: Media framing of preventive health. A scoping review
Prevention Centre project: Communicating prevention – approaches to prevention framing and story telling

Samantha is working with Professor Penny Hawe and others to explore ways of increasing public demand for prevention policy. “One way we are approaching this is to explore how issues related to chronic diseases and their prevention are portrayed within the media, and how these portrayals may influence public feeling and support for prevention initiatives,” Samantha said.

This work builds on pioneering work in media framing and public health advocacy at the University of Sydney, particularly the work of Professor Simon Chapman, Dr Becky Freeman and Dr Julie Leask.

The study, a scoping review, is a ‘stocktake’ of the literature to see how issues related to prevention are depicted in the media. “Many research programs focus on the framing of a single issue, such as tobacco,” Samantha said. “We are trying to find out what is going on across the field as a whole draw out parallels and lessons across issues.”

The team searched three databases to identify peer-reviewed articles that considered the framing of issues related to chronic disease in the media (newspaper, TV, radio, online, social media) and/or explored the impact of different kinds of messages related to chronic disease prevention on recipients’ attitudes or behaviours.

“Initial analysis suggests that the review will provide insights into the dominant frames used within media reporting on issues related to chronic disease and their prevention, and how such framing might influence public support for policy initiatives,” Samantha said. “We hope the work will provide us with more insights into how best to set up issues and solutions to increase the likelihood of public support for prevention policies.”

 

Dr Samantha Rowbotham, Senior Research Fellow,
Menzies Centre for Health Policy and The Australian Prevention Partnership Centre

Topic: Operationalising ‘dose’ in public health interventions. A scoping review
Prevention Centre project: Policy and program implementation and the role of context in explaining prevention effectiveness

We’re all familiar with the concept of dose in medicine – how much of a drug is needed to treat or prevent illness – but how well does this concept translate to public health interventions?

Samantha and colleagues are exploring how dose is defined and understood in relation to public health interventions. “Dose is key aspect of intervention delivery that those involved within intervention implementation and research are concerned with,” Samantha said.

But measuring ‘how much’ of an intervention is not straightforward, especially when delivered at the population level and when there are multiple components. Samantha described the example of a built environment intervention, where a local council builds walking and cycle paths, plants trees and improves lighting to increase physical activity.

“How do we measure the dose of the intervention?” Samantha said. “Is it the number of trees planted, lights installed and metres of walkways and bike paths built? Would capturing dose in this way really tell us anything about the important aspects of ‘how much’?”

The project involves a scoping review to identify how dose has been defined in relation to health promotion/disease prevention interventions. The team searched four databases to identify relevant articles and 170 papers have been identified for a full text review.

Preliminary analyses suggest considerable variation in how dose is defined and used across studies. “How dose is conceptualised and measured has implications for how interventions are understood and resourced,” Samantha said. “This review will inform new ways of defining and capturing dose in population health in order to better monitor such interventions and influence their effectiveness.”

– Marge Overs, Communications Manager