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1
Tabrizi, Sepehr N., Barbara A. Paterson, Christopher K. Fairley, Francis J. Bowden, and Suzanne M. Garland. "Comparison of tampon and urine as self-administered methods of specimen collection in the detection of Chlamydia trachomatis , Neisseria gonorrhoeae and Trichomonas vaginalis in women." International Journal of STD & AIDS 9, no. 6 (June 1, 1998): 347–49. http://dx.doi.org/10.1258/0956462981922386.
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1 Department of Microbiology, The Royal Women's Hospital, Victoria, 2 Menzies School of Health Research, Rocklands Drive, Tiwi, 3 Department of Epidemiology and Preventive Medicine, Alfred Hospital, Monash University, Prahran, Victoria and 4 AIDS/STD Unit, Centre for Disease Control, Territory Health Services, Darwin, Australia Summary: Self-administered sampling techniques for the detection of sexually transmitted diseases (STDs) are particularly useful due to their ease of collection and better patient compliance. Urine specimens, and recently tampons, have been described as methods of specimen collection for the detection of some STDs in women. In this study, 660 women had both first-void urine (FVU) and tampon specimens analysed by polymerase chain reaction (PCR) for the detection of Chlamydia trachomatis , Neisseria gonorrhoeae and Trichomonas vaginalis . Overall 6.5%, 10.1% and 17.9% of urine samples were positive whereas 7%, 21.2% and 22% of tampon specimens were positive for C. trachomatis , N. gonorrhoeae and T. vaginalis respectively. Tampon-collected specimens tested by PCR were more sensitive than urine specimens for the detection of N. gonorrhoeae and T. vaginalis ( P 0.001) and equally sensitive for the detection of C. trachomatis ( P =0.45). <
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Mitchell, Brian. "Preventative Child Welfare Services in Victoria." Children Australia 13, no. 1 (1988): 10–14. http://dx.doi.org/10.1017/s0312897000001752.
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The idea of prevention in child welfare is not new. The prevention of substitute placement of children whether on a temporary or long-term basis has been a fundamental principle of child welfare we have held to for many years in Victoria.However, it is only in the last decade that this principle is actually being carried out in practice by a number of voluntary agencies. For many children placement is still commonly used as a solution it is easier to place a child than to promote change within many multi-deficit families.
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Gelber, Harry. "The experience of the Royal Children's Hospital mental health service videoconferencing project." Journal of Telemedicine and Telecare 4, no. 1_suppl (March 1998): 71–73. http://dx.doi.org/10.1258/1357633981931542.
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In April 1995 the Royal Children's Hospital Mental Health Service in Melbourne piloted the use of videoconferencing in providing access for rural service providers and their clients to specialist child and adolescent psychiatric input. What began as a pilot project has in two years become integrated into the service-delivery system for rural Victoria. The experience of the service in piloting and integrating the use of videoconferencing to rural Victoria has been an important development for child and adolescent mental health services in Australia.
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Goddard, Christopher R. "Victoria's Protective services and the ‘Interim’ Fogarty Report: Is This the Right Road at Last?" Children Australia 15, no. 1 (1990): 12–15. http://dx.doi.org/10.1017/s1035077200002546.
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The history of the provision of child protection services in Victoria, and the lack thereof, is a long and complex one. Yet another twist in the tale occurred recently.A report by Mr Justice Fogarty and Mrs Delys Sargeant, entitled Protective Services for Children in Victoria: An Interim Report, was released in January 1989. This report (hereinafter the Fogarty Report) was commissioned by the Victorian Government in August 1988:“… to inquire into and advise it upon the operation of Victoria's child protection system and on measures to improve its effectiveness and efficiency.”
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Rodrigo, J., Hanny Calache, and Martin Whelan. "Socio-demographic profile of child and adolescent users of oral health services in Victoria, Australia." Cadernos de Saúde Pública 30, no. 9 (September 2014): 1903–11. http://dx.doi.org/10.1590/0102-311x00083613.
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The aim of this study was to investigate the socio-demographic characteristics of the eligible population of users of public oral health care services in the Australian state of Victoria, aged 17 years or younger. The study was conducted as a secondary analysis of data collected from July 2008 to June 2009 for 45,728 young clients of public oral health care. The sample mean age was 8.9 (SD: 3.5) years. The majority (82.7%) was between 6 and 17 years of age, and 50.3% were males. The majority (76.6%) was Australian-born and spoke English at home (89.1%). The overall mean DMFT was 1.0 (SD: 2.1) teeth, with a mean dmft of 3.16 (SD: 5.79) teeth. Data indicate that, among six year olds in the Significant Caries Index (SiC) category, the mean dmft was 6.82 teeth. Findings corroborate social inequalities in oral health outcome and provide suggestions for oral health services to develop strategies and priorities to reduce inequalities in health and well-being, and better coordinate and target services to local needs.
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Gelber, Harry. "The experience in Victoria with telepsychiatry for the child and adolescent mental health service." Journal of Telemedicine and Telecare 7, no. 2_suppl (December 2001): 32–34. http://dx.doi.org/10.1258/1357633011937065.
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In 1995, the Royal Children's Hospital Mental Health Service in Melbourne developed the first telepsychiatry programme in child and adolescent mental health services (CAMHS) in Australia. A survey of 25 CAMHS clinicians in five rural regions who had used videoconferencing showed that 64% had used the technology for more than 18 months, and 20% had used it for 7–12 months. Also, 60% had used the technology on over 30 occasions, and 24% had used it on 20–29 occasions. Respondents clearly recognized its benefits in terms of their increased knowledge and skills (96%), strengthening of relationships with colleagues (92%) and decreased sense of isolation (92%). To build on the success of telepsychiatry there are a number of challenges that health service managers will need to address. Telepsychiatry works most effectively as a tool to complement face-to-face contact. It cannot be promoted as the total solution to the issue of isolation from mainstream services.
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Keleher, Helen, and Kerreen Reiger. "Tensions in maternal and child health policy in Victoria: looking back, looking forward." Australian Health Review 27, no. 2 (2004): 17. http://dx.doi.org/10.1071/ah042720017.
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Helen Keleher is Associate Professor in the School of Health and Social Development, Deakin University.Kerreen Reiger is Associate Professor in the School of Social Sciences, La Trobe University.Since the late 1980s, Maternal and Child Health Services (MCHS) in Victoria have undergone significant change. This paper provides an historically-informed analysis of the complex intersection of policy, administrative restructuring and stakeholder interests. It draws on and extends the authors' previous research into MCH Service policy directions and administration, including the impact of Compulsory Competitive Tendering (CCT) on MCH nurses in the 1990s. Historically there has been little explicit debate about either organisational arrangements, or the policy objectives of the MCHS. The dominant focus on health surveillance of infants never adequately reflected nurses' wider role in the community and was not consistent with a wider social model of health. Tensions between professional, consumer and administrative stakeholders became heightened by the implementation of the 1990s neoliberal political agenda. During this period, when restructuring linked funding to service delivery through tendering arrangements, apolitical and policy settlement further institutionalised surveillance as the basis of the MCHS. The restructured Service has remained constrained by the dominance of health surveillance as the primary program goal even after more varied contracting arrangements replaced CCT. Although recent initiatives indicate signs of hange, narrow surveillancebased guidelines for Victorian MCH Services are not consistent, we argue, with recent early years of life policy which calls for approaches derived from socio-ecological models of health.
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Heilbrunn-Lang, Adina Y., Lauren M. Carpenter, Andrea M. de Silva, Lisa K. Meyenn, Gillian Lang, Allison Ridge, Amanda Perry, Deborah Cole, and Shalika Hegde. "Family-centred oral health promotion through Victorian child-health services: a pilot." Health Promotion International 35, no. 2 (April 21, 2019): 279–89. http://dx.doi.org/10.1093/heapro/daz025.
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Abstract Maternal and Child Health Services (MCHS) provide ideal settings for oral disease prevention. In Victoria (Australia), child mouth-checks (Lift-the-Lip) and oral health promotion (OHP) occur during MCHS child visits. This study trialled Tooth-Packs (OHP resources, toothbrushes, toothpastes) distribution within MCHS to (i) assess the impacts of Tooth-Packs distribution on child and family oral health (OH) behaviours and knowledge, including Maternal and Child Health Nurses (MCHN) child referral practices to dental services, and (ii) determine the feasibility and acceptability of incorporating Tooth-Packs distribution into MCHN OHP practices. A mixed-methods evaluation design was employed. MCHN from four high-needs Victorian Local Government Areas distributed Tooth-Packs to families of children attending 18-month and/or 24-month MCHS visits (baseline). Families completed a questionnaire on OH and dietary practices at baseline and 30-month follow-up. Tooth-Packs distribution, Lift-the-lip mouth-checks and child OH referrals were conducted. Guided discussions with MCHN examined intervention feasibility. Overall, 1585 families received Tooth-Packs. Lift-the-lip was conducted on 1493 children (94.1%). Early childhood caries were identified in 142 children (9.5%) and these children were referred to dental services. Baseline to follow-up behavioural improvements (n = 230) included: increased odds of children having ever seen an OH professional (OR 28.0; 95% CI 7.40–236.88; p < 0.001), parent assisted toothbrushing twice/day (OR 1.76; 95% CI 1.05–3.00; p = 0.030) and toothpaste use >once/day (OR 2.82; 95% CI 1.59–5.24; p < 0.001). MCHN recommendations included distribution of Tooth-Packs to at-risk children <12-months of age. MCHS provide an ideal setting to enable timely family-centred OHP intervention and adoption of good OH behaviours at an early age.
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Clout, Peter, Sue Clout, Jenny Apps, and Jacinta Cook. "The Family Support Innovation Projects in Victoria: A progress report from Ballarat Family Services." Children Australia 31, no. 4 (2006): 29–35. http://dx.doi.org/10.1017/s1035077200011329.
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Ballarat Family Services is the service that has evolved in Ballarat, Victoria as a result of a Department of Human Services initiative, the Family Support Innovation Projects. More than two years after the commencement of the program, Ballarat Family Services is leading a major re-orientation of the service system for families who have borderline involvement with the statutory Child Protection system. This re-orientation involves all parts of the service system, including the nature of the collaborative relationships between non-government agencies and the statutory Child Protection Agency. It has also led to Ballarat Family Services revisiting the nature and purpose of the practice of family support work. This paper will give an overview of the development of Ballarat Family Services and go on to outline the lessons learned in practice, placing them in the context of current theory and research.
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Breach, Rayleen, and Linda K. Jones. "Victorian maternal child health nurses’ knowledge, attitudes and beliefs towards national registration changes." Journal of Hospital Administration 6, no. 3 (March 26, 2017): 1. http://dx.doi.org/10.5430/jha.v6n3p1.
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In 2010 National Registration for nurses was established which was likely to impact the role of the maternal and child health nurses (MCH) in Victoria. This study explored the perceived impact of the national changes to the MCH nurse workforce in Victoria following the implementation of national registration and a proposed national service framework. A qualitative exploratory descriptive design was employed with the purpose of exploring the knowledge, attitudes and beliefs of Key Stakeholders (KSH) to the recent changes and perceived impact to Victorian MCH nurses. The significance of this study lies with understanding the gaps in current knowledge of KSH to the national changes. Outlined briefly in this paper will be main findings from the KSH. This involved interviewing 12 KSH from management positions, including Local Government Coordinators, Policy Advisors to the Department of Education and Early Childhood Development, the Municipal Association of Victoria, along with academics from Universities that provide postgraduate Child and Family Health education programs for the MCH nurse qualification. Date was transcribed verbatim and content analysis used. Categories were developed by identifying recurrent patterns from the data, labels were then chosen which reflected the participant’s words: “common standard”; “losing our identity”; “universal service”; “we do it well” and “imposed from above”. Overall the KSH were concerned how the disparity in education and qualifications would be resolved and the effect this would have on the service. Findings from this study highlight the importance of comprehensively investigating services offered by all jurisdictions and using collaboration, communication and leadership to effectively introduce change.
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Adams, Catina, Leesa Hooker, and Angela Taft. "The Enhanced Maternal and Child Health nursing program in Victoria: a cross-sectional study of clinical practice." Australian Journal of Primary Health 25, no. 3 (2019): 281. http://dx.doi.org/10.1071/py18156.
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The Maternal and Child Health (MCH) service in Victoria comprises a universal service, an enhanced program providing additional support for vulnerable families (EMCH) and a 24-h MCH telephone line. There is anecdotal evidence of variation in EMCH programs between Local Government Areas, and this study aims to explore the variation in EMCH programs to inform future EMCH policy and practice. An online survey was sent to MCH coordinators in Victoria in December 2016 (n = 79), with a response rate of 70% (55/79). Quantitative data have been analysed using descriptive statistics, with open-ended questions examined using content analysis. The data confirms that EMCH programs vary significantly across the state. Differences include a variation in referral and intake criteria, different models of service and modes of delivery, differences in EMCH nurse working conditions, issues with data collection and a lack of systematic clinical tools. Variation in the EMCH program is greatest between urban and rural services and between advantaged and disadvantaged urban councils. Lack of consistent service delivery and data collection impairs program evaluation, including outcome measurement and evidence of program effectiveness.
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McDonald, Paul. "Through the wall: An address to practitioners at a forum on the Working Together Strategy." Children Australia 25, no. 1 (2000): 27–32. http://dx.doi.org/10.1017/s1035077200009585.
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This address was given at a forum in November J999 for practitioners in the juvenile justice, alcohol and drug, mental health and child protection services in Victoria as part of the Department of Human Services’ Working Together Strategy’ (WTS). The WTS is a quality improvement initiative of the DHS in partnership with adolescent mental health and drug treatment service providers.WTS provides an organisational framework for the Community Care Division, the Aged, Community and Mental Health Division and the Public Health Division (specifically in reference to the mental health, child protection and care, juvenile justice and drug treatment services programs) to achieve better outcomes for shared clients. WTS is a response to perceived deficits in cross-program collaboration and communication in cases involving high need adolescent clients.
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Mendes, Philip. "From minimal intervention to minimal support: Child protection services under the neo-liberal Kennett Government in Victoria 1992-1999." Children Australia 26, no. 1 (2001): 4–11. http://dx.doi.org/10.1017/s103507720001004x.
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This article examines the politics and ideology of Victorian child protection services during the Kennett years. The argument advanced is that the Kennett Liberal/National Party Coalition Government viewed child abuse in narrow, individualistic terms. In contrast to the previous Labor Government, which emphasized a philosophy of minimal intervention based on a partnership of family, community and the state, the Kennett philosophy was one of minimal support. The key emphasis was on the reporting of child abuse to statutory child protection authorities, and the treatment and punishment of individual offenders. Spending on broader structural prevention and support services which actually help the victims of abuse was not a priority.A number of examples of this neo-liberal agenda are given, including the poorly timed introduction of mandatory reporting and the associated diversion of resources from support services to investigation; the early cuts to accommodation and non-government support services; the inadequate response to demonstrated links between child abuse and poverty; the censorship of internal and external critics; and the appalling handling of the strike by child protection workers. Attention is focused primarily on the broader macro-political debates, rather than specific micro-service delivery issues.
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Liamputtong Rice, Pranee. "Childhood Health and Illness: Cultural Beliefs and Practices among the Hmong in Victoria." Australian Journal of Primary Health 4, no. 4 (1998): 44. http://dx.doi.org/10.1071/py98060.
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This paper examines the cultural construction of childhood illness among Hmong refugees from Laos who are living in Australia. It focuses on traditional patterns of beliefs and practices related to health and illness of newborn infants and young children. The Hmong treat childhood health and illness seriously, and for them there are several causes of childhood illness, including nature, souls, supernatural beings and human aggression. The roles of traditional healers who play an important part in childhood health and illness are also discussed. Lastly, the paper attempts to make clear some implications for child health services for immigrants such as the Hmong in Australia and elsewhere. The paper intends to contribute an anthropological perspective on child health which is particularly important in a multicultural society. A clear understanding by health professionals of cultural beliefs and expectations is essential if misunderstanding is to be avoided, and culturally appropriate and sensitive health care for immigrant children, such as the Hmong to be available.
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Ban, Paul, and Phillip Swain. "Family Group Conferences, part two: Putting the ‘family’ back into child protection." Children Australia 19, no. 4 (1994): 11–14. http://dx.doi.org/10.1017/s103507720000417x.
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This is the second of two articles examining the establishment of Family Decision Making in Victoria. The first ‘Family Group Conferences – Part One: Australia's first Project in Child Protection’ was presented in the previous edition of Children Australia. This article builds upon the first by presenting an overview of the evaluation of the Victorian Family Decision Making Project, and pointing to practice and other implications of the development of this Project for child welfare services generally.
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Tierney, Len, and Meryl McDowell. "Child Welfare: Reception Centres, Regionalization, and Deinstitutionalization." Children Australia 15, no. 1 (1990): 3–9. http://dx.doi.org/10.1017/s1035077200002522.
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Between 1972 - 1980, eighteen regional offices were opened by state welfare authorities in Victoria, with the long term prospect that a comprehensive set of programmes would be developed in each region. This is part of an extensive policy change in which the reception of children into care will proceed by more diverse and local arrangements. Safe custody options already include small residential units and foster care and the very term “reception centre” is no longer part of official language. Substantial progress has been made along these lines and of the two central reception centres, Allambie (25-150 residents) is in the process of being closed and Baltara (45-70 residents) is to be redeveloped. In the most recently published planning documents redevelopment of these facilities had been anticipated by December 1990.1 However, not a great deal is known about the population of these two centres, about reception processes and why some children proceed quickly through the process and others do not. This paper examines the present status of reception centres in Victoria and reports upon a preliminary study of the reception centre population for the period 1986-1987. An argument is made that there is a case for revising reception policy and practice not only in existing centres but, in proposed new facilities and for giving more attention to services, for children and families who present with unusual difficulties.
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Nilaweera, Irosha, Heather Rowe, Hau Nguyen, Joanna Burns, Frances Doran, and Jane Fisher. "Sri Lankan-born women who have given birth in Victoria: a survey of their primary postpartum health-care needs." Australian Journal of Primary Health 22, no. 2 (2016): 133. http://dx.doi.org/10.1071/py14067.
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Women who migrate are vulnerable after giving birth. Normal postpartum adaptive challenges are heightened by separation from family and lack of familiarity with local services. The aim was to investigate primary care needs among Sri Lankan-born women with at least one Victorian-born child aged under 2 years. Health care, information and support needs and unmet needs were assessed in a structured Sinhala or English survey offered in print, online or by telephone. Fifty women provided data. Most (80%) had at least one relative from Sri Lanka to stay for postpartum support. Despite this, many had difficulties settling (62%), feeding (58%) and soothing (42%) their babies. They used significantly fewer health services on average (2.3) than mothers in the general community (2.8) (P < 0.004). Only 32% of primiparous women attended at least one First-Time Parents’ group session. Of women experiencing infant care difficulties, only two-thirds accessed care from a Maternal and Child Health Nurse and only one-third from a General Practitioner. Sri Lankan-born mothers have significant unmet needs for primary care, which are not reduced by informal support. A two-pronged approach is indicated in which women are informed about primary care availability, and the cultural competence and client friendliness of services is strengthened.
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Bauleni, Esther M., Leesa Hooker, Hassan P. Vally, and Angela Taft. "Intimate-partner violence and reproductive decision-making by women attending Victorian Maternal- and Child-Health services: a cross-sectional study." Australian Journal of Primary Health 24, no. 5 (2018): 422. http://dx.doi.org/10.1071/py17183.
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The reproductive years are a critical period where women experience greater risk of intimate-partner violence (IPV). Most studies investigating the association between IPV and reproductive health have been completed in low- and middle-income countries. This study aimed to examine the relationship between IPV and women’s reproductive decision-making in Victoria, Australia. We analysed secondary data from a cluster-randomised trial of IPV screening that surveyed new mothers attending Maternal- and Child-Health centres in Melbourne. Survey measures included the experience of partner abuse in the past 12 months using the Composite Abuse Scale and four reproductive decision-making indicators. Results showed that IPV affects reproductive decision-making among postpartum women. Women who reported abuse were less likely to plan for a baby (adjusted Odds Ratio 0.48, 95% CI: 0.31–0.75) than were non-abused women, significantly more likely to have partners make decisions for them about contraception (Risk ratio (RR) 4.09, 95% CI: 1.31–12.75), and whether and when to have a baby (RR 12.35, 95% CI: 4.46–34.16), than they were to make decisions jointly. Pregnant and postpartum women need to be screened for partner violence that compromises women’s decision-making power regarding their reproductive rights.
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Campbell, Lynda. "The Families First Pilot Program in Victoria: Cuckoo or contribution?" Children Australia 19, no. 2 (1994): 4–10. http://dx.doi.org/10.1017/s1035077200003898.
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The Families First Pilot Program in the then Outer East metropolitan region of Melbourne began in mid-1991 as an intensive family preservation and reunification service for children on the verge of state care. The service offered was brief (4-6 week), intensive (up to 20 hours per week), home-based and flexible (24 hour a day, 7 day a week availability) and all members of the household or family were the focus of service even though the goals were clearly grounded in the protection of the child. This paper begins with some of the apprehension expressed both in the field and in Children Australia in 1993, and reports upon the now completed evaluation of the pilot, which covered the first 18 months of operation. The evaluation examined implementation and program development issues and considered the client population of the service against comparative data about those children at risk who were not included. The paper concludes that there is room for Families First in the Victorian system of protective and family services and points to several developmental issues.
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Nancarrow, Susan A., Gretchen Young, Katy O'Callaghan, Mathew Jenkins, Kathleen Philip, and Kegan Barlow. "Shape of allied health: an environmental scan of 27 allied health professions in Victoria." Australian Health Review 41, no. 3 (2017): 327. http://dx.doi.org/10.1071/ah16026.
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Objective In 2015, the Victorian Department of Health and Human Services commissioned the Victorian Allied Health Workforce Research Program to provide data on allied health professions in the Victorian public, private and not-for-profit sectors. Herein we present a snapshot of the demographic profiles and distribution of these professions in Victoria and discuss the workforce implications. Methods The program commenced with an environmental scan of 27 allied health professions in Victoria. This substantial scoping exercise identified existing data, resources and contexts for each profession to guide future data collection and research. Each environmental scan reviewed existing data relating to the 27 professions, augmented by an online questionnaire sent to the professional bodies representing each discipline. Results Workforce data were patchy but, based on the evidence available, the allied health professions in Victoria vary greatly in size (ranging from just 17 child life therapists to 6288 psychologists), are predominantly female (83% of professions are more than 50% female) and half the professions report that 30% of their workforce is aged under 30 years. New training programs have increased workforce inflows to many professions, but there is little understanding of attrition rates. Professions reported a lack of senior positions in the public sector and a concomitant lack of senior specialised staff available to support more junior staff. Increasing numbers of allied health graduates are being employed directly in private practice because of a lack of growth in new positions in the public sector and changing funding models. Smaller professions reported that their members are more likely to be professionally isolated within an allied health team or larger organisations. Uneven rural–urban workforce distribution was evident across most professions. Conclusions Workforce planning for allied health is extremely complex because of the lack of data, fragmented funding and regulatory frameworks and diverse employment contexts. What is known about this topic? There is a lack of good-quality workforce data on the allied health professions generally. The allied health workforce is highly feminised and unevenly distributed geographically, but there is little analysis of these issues across professions. What does this paper add? The juxtaposition of the health workforce demographics and distribution of 27 allied health professions in Victoria illustrates some clear trends and identifies several common themes across professions. What are the implications for practitioners? There are opportunities for the allied health professions to collectively address several of the common issues to achieve economies of scale, given the large number of professions and small size of many.
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Thornton, Katherine, Susan Webster, and Meredith Temple-Smith. "Is immunisation for children and young people in statutory care in Victoria 'all too hard'? A qualitative study with health professionals." Australian Journal of Primary Health 25, no. 2 (2019): 131. http://dx.doi.org/10.1071/py18096.
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This formative study aimed to identify health professionals’ perspectives on vaccination issues among children in statutory out-of-home care in Victoria. Eight health professionals, drawn from a purposive Victorian sample known to be proactive in addressing the vaccination needs of children in out-of-home care, took part in semi-structured interviews. Questions addressed participants’ views about roles and responsibilities, barriers and enabling factors affecting vaccination, and ideas about systems improvements. Interview transcripts were analysed thematically. The main themes that emerged were health professionals’ observations about vaccine hesitancy among significant adults in the out-of-home care sector, the paucity of child medical history information available and diffuse responsibility for the provision of legal consent to vaccination. More accurate immunisation status monitoring appears warranted for children in out-of-home care. Unless the collection and maintenance of child medical records improves and vaccination consent processes are streamlined, health professionals will be limited in their capacity to provide efficient vaccination services to these children. Research on vaccine hesitancy among staff and carers in the statutory care sector may be of value. This study supports other Australian research that indicates these children may require more targeted, inter-sectoral immunisation approaches.
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Townsend, Michelle. "Educational outcomes of children on guardianship or custody orders: A pilot study: Australian Institute of Health and Welfare." Children Australia 32, no. 3 (2007): 4–5. http://dx.doi.org/10.1017/s1035077200011603.
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The Australian Institute of Health and Welfare (AIHW) has recently released a report on the educational outcomes for children and young people on guardianship or custody orders. This report, four years in the making, represents one of the first comprehensive Australian assessments based on educational performance data from multiple jurisdictions for children on guardianship or custody orders. Developed for the National Child Protection and Support Services data group, the study was funded by the Community and Disability Services Ministers’ Advisory Council (AIHW 2007).This pilot study examines how children on guardianship/custody orders are performing compared with all Australian children in education department-based testing for reading and numeracy in years 3, 5 and 7. Mean test scores were examined in addition to the achievement of national benchmarks for reading and numeracy. These nationally agreed benchmarks are designed to assess whether children have achieved the minimum standards for years 3, 5 and 7 (AIHW 2007). Data on 895 children on guardianship or custody orders were collected from five jurisdictions - Queensland, Victoria, South Australia, Tasmania and the Australian Capital Territory - for August 2003 (AIHW 2007). The data were linked through collaborative efforts by state and territory education and community services departments.
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Mendes, Philip, and Badal Moslehuddin. "Moving out from the state parental home: A comparison of leaving care policies in Victoria and New South Wales." Children Australia 29, no. 2 (2004): 20–29. http://dx.doi.org/10.1017/s1035077200005976.
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Young people leaving care are arguably one of the most vulnerable and disadvantaged groups in society. Compared to most young people, they face numerous barriers to accessing educational, employment and other developmental and transitional opportunities.Using information from interviews and a range of documents, this study compares the leaving care supports currently available in two Australian states, Victoria and New South Wales. Attention is drawn to the history of the leaving care debate in both states, the nature of the existing legislative and program supports for care leavers in each state, the key political and policy actors that have either helped or hindered the development of leaving care policies and services in each state, and the principal unmet needs of care leavers in each state.The findings suggest that NSW leads the way in terms of providing effective legislative and program supports to care leavers. The differences between Victoria and NSW are attributed to a number of factors including particularly the different relationships between the respective government bureaucracies and non-government child welfare sectors.
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Hiscock, Harriet, Ann‐Siobhan Connolly, Katie Dunlop, Prescilla Perera, Rachel O'Loughlin, Stephanie J. Brown, David M. Krieser, et al. "Parent perspectives on children and young people's mental health services in Victoria – What's wrong and how to fix it: A multi‐site qualitative study." Journal of Paediatrics and Child Health 56, no. 7 (February 26, 2020): 1114–20. http://dx.doi.org/10.1111/jpc.14835.
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Mendes, Philip. "Consumer groups in child protection: Enhancing the accountability of the system." Children Australia 23, no. 2 (1998): 33–38. http://dx.doi.org/10.1017/s1035077200008610.
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The theme of this paper is the central role of consumer groups in promoting greater accountability in child protection systems. In recent years, numerous Australian authors have drawn attention to the failings of our State child protection systems. Particular concern has been expressed about the potential ‘systems abuse’ of children in care, and the failure of statutory systems to engage or adequately consider the perspectives of biological parents. One of the principal reasons for these deficits appears to be the absence of formal consultation mechanisms with consumers of protection services. This paper considers the recent rise of consumer groups of both young people in protection and care, and their parents/caregivers, in relation to the above concerns, with particular reference to Victoria. Attention is drawn to both the strengths and weaknesses of the better known groups such as the Australian Association of Young People in Care and their State affiliates, and the Parent Inquiry into Child Protection. The author believes that the role of consumer groups as a ‘watchdog’ will become even more important with the intended privatization of some State child protection systems.
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Szwarc, Barbara. "Give them a break: A study of families’ perceptions of the supports available in the community for families with a child with a life-threatening illness." Children Australia 23, no. 2 (1998): 21–27. http://dx.doi.org/10.1017/s1035077200008592.
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The effectiveness of current support services for families who have a child with a progressive life-threatening illness seems to be a frequently overlooked issue. This paper, which is based on the findings of a recently conducted study, attempts to elucidate the critical issues in supporting this unique group of families. The study examined the perceptions of families regarding the value and effectiveness of the social supports available in the community for families caring for a child with a life-threatening illness in Victoria. Attention has been drawn to perceived gaps in support for these families. Also considered is the effectiveness of supports available for bereaved families who have lost children with life-threatening illnesses. The study was based on information provided by families who had been involved with a family support agency known as Very Special Kids.
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Western, Sally. "Preventing Childhood Injury: Developing a Home Safety Display in a Community Health Centre." Australian Journal of Primary Health 5, no. 1 (1999): 76. http://dx.doi.org/10.1071/py99009.
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Childhood injury is a major health issue, with approximately 20,000 children under five hospitalised each year in Australia. The home is a common site for childhood injuries, with some of the more frequent episodes including falls, poisoning, burns, cuts and crush injuries. A regional initiative to develop a coordinated approach towards minimising injuries sustained by children between 0-4 years, resulted in the development of 'Childsafe Now', a health promotion program which involved training of child care providers, and the establishment of several home safety displays in the Eastern metropolitan region of Victoria. One of the home safety displays was developed in a Community Health Centre, utilising a pre-existing child care facility and the multidisciplinary skills of the staff. Community Health Centres were established with a focus on health promotion - encouraging illness and injury prevention through a holistic combination of education, community involvement, behavioural and social modification and multi-disciplinary primary health care services - yet the opportunity to establish a permanent, functional display which combines all of these aspects of health promotion is becoming increasingly rare. However, the skills and knowledge which have traditionally been nurtured within the Community Health Program make Community Health Centres a particularly appropriate location for establishing a Home Safety Display.
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Cramer, Rhian L., Helen L. McLachlan, Touran Shafiei, Lisa H. Amir, Meabh Cullinane, Rhonda Small, and Della A. Forster. "Maternal and child health nurses’ experiences of implementing two community-based breastfeeding interventions in Victoria, Australia: A mixed methods process evaluation." Australian Journal of Child and Family Health Nursing 16, no. 1 (July 2019): 4–14. http://dx.doi.org/10.33235/ajcfhn.16.1.4-14.
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Despite high rates of breastfeeding initiation in Australia, there is a significant drop in breastfeeding rates in the early postpartum period, and Australian government breastfeeding targets are not being met. The Supporting breastfeeding In Local Communities (SILC) trial was a three-arm cluster randomised trial implemented in 10 Victorian local government areas (LGAs). It aimed to determine whether early home-based breastfeeding support by a maternal and child health nurse (MCH nurse) with or without access to a community-based breastfeeding drop-in centre increased the proportion of infants receiving ‘any’ breast milk at four months. Focus groups, a written questionnaire and semi-structured interviews were undertaken to explore the interventions from the perspective of the SILC-MCH nurses (n=13) and coordinators (n=6), who established and implemented the interventions. Inductive thematic analysis was used to identify themes, then findings further examined using Diffusion of Innovations Theory as a framework. SILC-MCH nurses and coordinators reported high levels of satisfaction, valuing the opportunity to improve breastfeeding in our community; and having focused breastfeeding time with women in their own homes. They felt the SILC interventions offered benefits to women, nurses and the MCH service. Implementing new interventions into existing, complex community health services presented unforeseen challenges, which were different in each LGA and were in part due to the complexity of the individual LGAs and not the interventions themselves. These findings will help inform the planning and development of future programs aimed at improving breastfeeding and other interventions in MCH.
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McLean, Karen, Harriet Hiscock, Dorothy Scott, and Sharon Goldfeld. "What is the timeliness and extent of health service use of Victorian (Australia) children in the year after entry to out-of-home care? Protocol for a retrospective cohort study using linked administrative data." BMJ Paediatrics Open 3, no. 1 (January 2019): e000400. http://dx.doi.org/10.1136/bmjpo-2018-000400.
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IntroductionChildren entering out-of-home care have high rates of health needs across all domains of health. To identify these needs early and optimise long-term outcomes, routine health assessment on entry to care is recommended by child health experts and included in policy in many jurisdictions. If effective, this ought to lead to high rates of health service use as needs are addressed. Victoria (Australia) has no state-wide approach to deliver routine health assessments and no data to describe the timing and use of health service visits for children in out-of-home care. This retrospective cohort data linkage study aims to describe the extent and timeliness of health service use by Victorian children (aged 0–12 years) who entered out-of-home care for the first time between 1 April 2010 and 31 December 2015, in the first 12 months of care.Methods and analysisThe sample will be identified in the Victorian Child Protection database. Child and placement variables will be extracted. Linked health databases will provide additional data: six state databases that collate data about hospital admissions, emergency department presentations and attendances at dental, mental and community health services and public hospital outpatients. The federal Medicare Benefits Schedule claims dataset will provide information on visits to general practitioners, specialist physicians (including paediatricians), optometrists, audiologists and dentists. The number, type and timing of visits to different health services will be determined and benchmarked to national standards. Multivariable logistic regression will examine the effects of child and system variables on the odds of timely health visits, and proportional-hazards regression will explore the effects on time to first health visits.Ethics and disseminationEthical and data custodian approval has been obtained for this study. Dissemination will include presentation of findings to policy and service stakeholders in addition to scientific papers.
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Lehmann, Jennifer, and Rachael Sanders. "Getting nowhere fast? Social work and its impact in the child, youth and family sector." Children Australia 42, no. 3 (September 2017): 131–36. http://dx.doi.org/10.1017/cha.2017.31.
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I was recently challenged by a colleague to think about the sticky question of what social work, as a discipline, has achieved over the last 40–50 years. Being challenged about the efficacy of social work and the discipline's capacity for lasting impacts is hardly a new experience. Many social workers will have confronted the opinions of clients, managers, family members and the public about the contributions or otherwise that they perceive social workers to offer. I have had these experiences too, but there are particular times when such comments remain in one's memories. After the elapse of many years I do not claim to have total accuracy of recall, but perhaps the first time I was shaken by a challenge to my noble presumptions was when Dr John Paterson, Secretary of the Department of Health and Community Services, Victoria, spoke at a meeting of child protection workers around 1989–90. He declared that he thought a mature accountant could do as well in the role. As others have recalled, Dr Paterson ‘did not blush to ignore traditional codes on the role of public servants in the policy process and overtly sought to participate in normative statements about policy’ (Barraclough & Smith, 1994, p. 16). He was known for making offensive remarks. He described disability advocacy bodies as ‘piss and wind’ groups, denigrating them as people more interested in talk than getting their hands dirty delivering services (Milburn, 1993, p. 1). He precipitated great angst amongst public servants.
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Paton, Kate, Lynn Gillam, Hayley Warren, Melissa Mulraney, David Coghill, Daryl Efron, Michael Sawyer, and Harriet Hiscock. "Clinicians’ perceptions of the Australian Paediatric Mental Health Service System: Problems and solutions." Australian & New Zealand Journal of Psychiatry 55, no. 5 (January 18, 2021): 494–505. http://dx.doi.org/10.1177/0004867420984242.
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Objectives: Despite substantial investment by governments, the prevalence of mental health disorders in developed countries remains unchanged over the past 20 years. As 50% of mental health conditions present before 14 years of age, access to high-quality mental health care for children is crucial. Barriers to access identified by parents include high costs and long wait times, difficulty navigating the health system, and a lack of recognition of the existence and/or severity of the child’s mental health disorder. Often neglected, but equally important, are clinician views about the barriers to and enablers of access to high-quality mental health care. We aimed to determine perspectives of Australian clinicians including child and adolescent psychiatrists, paediatricians, psychologists and general practitioners, on barriers and enablers within the current system and components of an optimal system. Methods: A total of 143 clinicians (approximately 35 each of child and adolescent psychiatrists, paediatricians, child psychologists and general practitioners) from Victoria and South Australia participated in semi-structured phone interviews between March 2018 and February 2019. Inductive content analysis was applied to address the broad study aims. Findings: Clinician-identified barriers included multi-dimensional family factors, service fragmentation, long wait times and inadequate training for paediatricians and general practitioners. Rural and regional locations provided additional challenges but a greater sense of collaboration resulting from the proximity of clinicians in rural areas, creating an opportunity to develop support networks. Suggestions for an optimal system included novel ways to improve access to child psychiatry expertise, training for paediatricians and general practitioners, and co-located multidisciplinary services. Conclusion: Within the current mental health system for children, structural, training and workforce barriers prevent optimal access to care. Clinicians identified many practical and systemic ideas to improve the system. Implementation and evaluation of effectiveness and cost effectiveness of these ideas is the next challenge for Australia’s children’s mental health.
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D’Cruz, Heather, and Philip Gillingham. "Participatory research ideals and practice experience: Reflections and analysis." Journal of Social Work 17, no. 4 (April 22, 2016): 434–52. http://dx.doi.org/10.1177/1468017316644704.
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Summary Consumer participation in decision making and evaluation of services has been a significant theme in social work and other caring professions for over 20 years. This article reflects on a qualitative research study that was conceptualised within participatory principles. It critically examines key features that emerged as challenges to the ideals of participatory research with parents and grandparents about their experiences with child protection services in Victoria, Australia. Findings The features examined are differentiated between the visible and familiar and the invisible, often emergent, aspects of social work research. We critically examine the ways in which the visible and invisible features as situated dimensions of social work research may shape how and whether the ideals of participatory research can be achieved. We discuss tensions in the process that have no clear ‘solutions’. Instead, we identify the importance of mindfulness and reflexive practice by researchers to find their way through these potential ethical and legal minefields. Applications We conclude that while social workers must continue to strive for participation by a range of service users in knowledge generation, we must also critically examine and theorise the meaning of participatory research and the idealised images of consumers and service users to improve such practice. An awareness of situated ethics as a location of the self in interaction with others is essential to promote ongoing reflexive practice throughout all stages of research.
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Hall, Teresa, Sharon Goldfeld, Hayley Loftus, Suzy Honisett, Hueiming Liu, Denise De Souza, Cate Bailey, et al. "Integrated Child and Family Hub models for detecting and responding to family adversity: protocol for a mixed-methods evaluation in two sites." BMJ Open 12, no. 5 (May 2022): e055431. http://dx.doi.org/10.1136/bmjopen-2021-055431.
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IntroductionIntegrated community healthcare Hubs may offer a ‘one stop shop’ for service users with complex health and social needs, and more efficiently use service resources. Various policy imperatives exist to implement Hub models of care, however, there is a dearth of research specifically evaluating Hubs targeted at families experiencing adversity. To contribute to building this evidence, we propose to co-design, test and evaluate integrated Hub models of care in two Australian community health services in low socioeconomic areas that serve families experiencing adversity: Wyndham Vale in Victoria and Marrickville in New South Wales.Methods and analysisThis multisite convergent mixed-methods study will run over three phases to (1) develop the initial Hub programme theory through formative research; (2) test and, then, (3) refine the Hub theory using empirical data. Phase 1 involves co-design of each Hub with caregivers, community members and practitioners. Phase 2 uses caregiver and Hub practitioner surveys at baseline, and 6 and 12 months after Hub implementation, and in-depth interviews at 12 months. Two stakeholder groups will be recruited: caregivers (n=100–200 per site) and Hub practitioners (n=20–30 per site). The intervention is a co-located Hub providing health, social, legal and community services with no comparator. The primary outcomes are caregiver-reported: (i) identification of, (ii) interventions received and/or (iii) referrals received for adversity from Hub practitioners. The study also assesses child, caregiver, practitioner and system outcomes including mental health, parenting, quality of life, care experience and service linkages. Primary and secondary outcomes will be assessed by examining change in proportions/means from baseline to 6 months, from 6 to 12 months and from baseline to 12 months. Service linkages will be analysed using social network analysis. Costs of Hub implementation and a health economics analysis of unmet need will be conducted. Thematic analysis will be employed to analyse qualitative data.Ethics and disseminationRoyal Children’s Hospital and Sydney Local Health District ethics committees have approved the study (HREC/62866/RCHM-2020). Participants and stakeholders will receive results through meetings, presentations and publications.Trial registration numberISRCTN55495932.
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Paton, Kate, Lynn Gillam, Hayley Warren, Melissa Mulraney, David Coghill, Daryl Efron, Michael Sawyer, and Harriet Hiscock. "How can the education sector support children’s mental health? Views of Australian healthcare clinicians." PLOS ONE 17, no. 1 (January 24, 2022): e0261827. http://dx.doi.org/10.1371/journal.pone.0261827.
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Objectives Policy makers in developed countries have long considered the education system an avenue for supporting mental health care for children. Whilst educators have identified many challenges to providing this support (e.g. non-core role, stigma, overcrowded curriculum), understanding clinicians’ views on the role of educators and schools and how clinicians and schools could work together to achieve good mental health outcomes are important questions. However, clinician voices in how schools and health should work together for children’s mental health care are frequently missing from the debate. We aimed to report clinicians’ views about how the education system could support student’s mental health and improve access to mental health care for children and adolescents. Methods 143 clinicians (approximately 35 each of child and adolescent psychiatrists, pediatricians, child psychologists and general practitioners (GPs)) from the states of Victoria and South Australia participated in semi-structured phone interviews between March 2018 and February 2019. Inductive content analysis was applied to address the broad study aims. Findings Key themes emerged: (1) The role of schools in supporting individual children; (2) School based programs to support children and families; and (3) Challenges of implementing these suggestions. Clinicians across all professional groups suggested the education system could play an important role in improving access to mental health services through harnessing existing staff or co-locating mental health clinicians. They also suggested schools could identify at risk children and implement coping and social skills programs. Conclusions Schools and educators could play a key role in prevention and early intervention of children’s mental health problems. However, before recommending exactly how to do this, key evidence gaps need to be addressed.
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Kempler, Jessica V., Penelope Love, Kristy A. Bolton, Margaret Rozman, and Alison C. Spence. "Exploring the Use of a Web-Based Menu Planning Tool in Childcare Services: Qualitative Cross-sectional Survey Study." JMIR Formative Research 6, no. 7 (July 18, 2022): e35553. http://dx.doi.org/10.2196/35553.
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Background Early childhood is a critical period for supporting the development of healthy eating habits, which may affect lifelong health. Childcare services are important settings for promoting early childhood nutrition; however, food provision in childcare frequently does not align with dietary guidelines. Web-based menu planning tools are well suited to support healthy food provision in childcare, although little is known about their use. Research is needed to understand how web-based menu planning tools are used in the childcare setting and how they can effectively support healthy menu planning and food provision for children in childcare. Objective We aimed to explore the use of a web-based menu planning tool called FoodChecker, which is available to childcare services in Victoria, Australia. We also aimed to gain insights and perspectives from childcare staff involved in menu planning about their use of the tool to plan healthy menus and guide healthy food provision for children. Methods We conducted a qualitative descriptive study using a cross-sectional web-based survey completed by the staff involved in menu planning in childcare services. Thematic analysis was performed using NVivo software. Emergent themes were mapped against constructs of the Technology Acceptance Model regarding perceived usefulness, perceived ease of use, and external variables influencing perceptions and use. Results The participants included 30 cooks and 34 directors from 53 childcare services. Participants perceived the web-based menu planning tool as useful for supporting child nutrition and health, improving organizational processes, and aiding the menu planner role. Perceptions regarding ease of use were mixed. External variables influencing perceptions and use included awareness of the tool, perceived need, time, resources, organizational support, and the food budget. Participants made recommendations to improve the tool, particularly the need to integrate functionality to make it easier and faster to use or to include more links to resources to support healthy menu planning. Conclusions The web-based menu planning tool was perceived as useful for cooks and directors in childcare services. Areas for improvement were identified; for example, the need for integrated digital features to make the tool easier and faster to use. As the first qualitative study to explore childcare staff experiences with a web-based menu planning tool, these findings inform future research and development of such tools to aid scalable and sustainable support for healthier food provision in the childcare sector.
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Bryson, Hannah, Fiona Mensah, Anna Price, Lisa Gold, Shalika Bohingamu Mudiyanselage, Bridget Kenny, Penelope Dakin, et al. "Clinical, financial and social impacts of COVID-19 and their associations with mental health for mothers and children experiencing adversity in Australia." PLOS ONE 16, no. 9 (September 13, 2021): e0257357. http://dx.doi.org/10.1371/journal.pone.0257357.
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Background Australia has maintained low rates of SARS-COV-2 (COVID-19) infection, due to geographic location and strict public health restrictions. However, the financial and social impacts of these restrictions can negatively affect parents’ and children’s mental health. In an existing cohort of mothers recruited for their experience of adversity, this study examined: 1) families’ experiences of the COVID-19 pandemic and public health restrictions in terms of clinical exposure, financial hardship family stress, and family resilience (termed ‘COVID-19 impacts’); and 2) associations between COVID-19 impacts and maternal and child mental health. Methods Participants were mothers recruited during pregnancy (2013–14) across two Australian states (Victoria and Tasmania) for the ‘right@home’ trial. A COVID-19 survey was conducted from May-December 2020, when children were 5.9–7.2 years old. Mothers reported COVID-19 impacts, their own mental health (Depression, Anxiety, Stress Scales short-form) and their child’s mental health (CoRonavIruS Health and Impact Survey subscale). Associations between COVID-19 impacts and mental health were examined using regression models controlling for pre-COVID-19 characteristics. Results 319/406 (79%) mothers completed the COVID-19 survey. Only one reported having had COVID-19. Rates of self-quarantine (20%), job or income loss (27%) and family stress (e.g., difficulty managing children’s at-home learning (40%)) were high. Many mothers also reported family resilience (e.g., family found good ways of coping (49%)). COVID-19 impacts associated with poorer mental health (standardised coefficients) included self-quarantine (mother: β = 0.46, child: β = 0.46), financial hardship (mother: β = 0.27, child: β = 0.37) and family stress (mother: β = 0.49, child: β = 0.74). Family resilience was associated with better mental health (mother: β = -0.40, child: β = -0.46). Conclusions The financial and social impacts of Australia’s public health restrictions have substantially affected families experiencing adversity, and their mental health. These impacts are likely to exacerbate inequities arising from adversity. To recover from COVID-19, policy investment should include income support and universal access to family health services.
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Nguyen, Tan Minh, Utsana Tonmukayakul, and Hanny Calache. "A Cost Analysis of an Outreach School-Based Dental Program: Teeth on Wheels." Children 8, no. 2 (February 18, 2021): 154. http://dx.doi.org/10.3390/children8020154.
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Background: This study evaluated an outreach mobile dental service called Teeth on Wheels (TOW). The dental program targeted Australian children from low household income, who are eligible for the Child Dental Benefits Scheme (CDBS) in Victoria, Australia. The program is complemented with a school-based oral health promotion element. Methods: A retrospective cohort study was performed with a convenience sample. Children must have had at least three dental examinations during the 2016–2019 calendar years to be included in the study. Comparisons were made between the 2016–17 and 2018–19 calendar years. It was hypothesised that the program would result in reduced costs and the number of restorations and extractions in the latter period. Results: A total of 414 children were included in the analysis. The total mean costs of the program per child reduced from AU$605.3 in 2016–17 to AU$531.1 in 2018–19. The results showed an overall mean reduction in all restorations and extractions performed, but only statistical significance was noted for reductions of restored deciduous teeth. Conclusions: This outreach program, which is focused on prevention and minimally invasive dentistry, can be a promising alternative model of delivery for dental services in young children.
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Goldfeld, Sharon, Hannah Bryson, Fiona Mensah, Anna Price, Lisa Gold, Francesca Orsini, Bridget Kenny, et al. "Nurse home visiting to improve child and maternal outcomes: 5-year follow-up of an Australian randomised controlled trial." PLOS ONE 17, no. 11 (November 28, 2022): e0277773. http://dx.doi.org/10.1371/journal.pone.0277773.
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Objectives Nurse home visiting (NHV) is widely implemented to address inequities in child and maternal health. However, few studies have examined longer-term effectiveness or delivery within universal healthcare systems. We evaluated the benefits of an Australian NHV program (“right@home”) in promoting children’s language and learning, general and mental health, maternal mental health and wellbeing, parenting and family relationships, at child ages 4 and 5 years. Setting and participants Randomised controlled trial of NHV delivered via universal, child and family health services (the comparator). Pregnant women experiencing adversity (≥2 of 10 risk factors) were recruited from 10 antenatal clinics across 2 states (Victoria, Tasmania) in Australia. Intervention Mothers in the intervention arm were offered 25 nurse home visits (mean 23·2 home visits [SD 7·4, range 1–43] received) of 60–90 minutes, commencing antenatally and continuing until children’s second birthdays. Primary and secondary outcomes measured At 4 and 5 years, outcomes were assessed via parent interview and direct assessment of children’s language and learning (receptive and expressive language, phonological awareness, attention, and executive function). Outcomes were compared between intervention and usual care arms (intention to treat) using adjusted regression with robust estimation to account for nurse/site. Missing data were addressed using multiple imputation and inverse probability weighting. Results Of 722 women enrolled in the trial, 225 of 363 (62%) intervention and 201 of 359 (56%) usual care women provided data at 5 years. Estimated group differences showed an overall pattern favouring the intervention. Statistical evidence of benefits was found across child and maternal mental health and wellbeing, parenting and family relationships with effect sizes ranging 0·01–0·27. Conclusion An Australian NHV program promoted longer-term family functioning and wellbeing for women experiencing adversity. NHV can offer an important component of a proportionate universal system that delivers support and intervention relative to need. Trial registration 2013–2016, registration ISRCTN89962120
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Price, Anna M. H., Anna Zhu, Huu N. J. Nguyen, Diana Contreras-Suárez, Natalie Schreurs, Jade Burley, Kenny D. Lawson, et al. "Study protocol for the Healthier Wealthier Families (HWF) pilot randomised controlled trial: testing the feasibility of delivering financial counselling to families with young children who are identified as experiencing financial hardship by community-based nurses." BMJ Open 11, no. 5 (May 2021): e044488. http://dx.doi.org/10.1136/bmjopen-2020-044488.
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IntroductionPoverty and deprivation can harm children’s future health, learning, economic productivity and societal participation. The Australian Healthier Wealthier Families project seeks to reduce the childhood inequities caused by poverty and deprivation by creating a systematic referral pathway between two free, community-based services: universal, well-child nursing services, which provide health and development support to families with children from birth to school entry, and financial counselling. By adapting the successful Scottish ‘Healthier Wealthier Children’ model, the objectives of this Australian pilot are to test the (1) feasibility of systematising the referral pathway, and (2) short-term impacts on household finances, caregiver health, parenting efficacy and financial service use.Methods and analysisThis pilot randomised controlled trial will run in three sites across two Australian states (Victoria and New South Wales), recruiting a total of 180 participants. Nurses identify eligible caregivers with a 6-item, study-designed screening survey for financial hardship. Caregivers who report one or more risk factors and consent are randomised. The intervention is financial counselling. The comparator is usual care plus information from a government money advice website. Feasibility will be evaluated using the number/proportion of caregivers who complete screening, consent and research measures, and access financial counselling. Though powered to assess feasibility, impacts will be measured 6 months post-enrolment with qualitative interviews and questionnaires about caregiver-reported income, loans and costs (adapted from national surveys, for example, the Household, Income and Labour Dynamics in Australia Survey); health (General Health Questionnaire 1, EuroQol five-dimensional questionnaire, Depression, Anxiety, Stress Scale short-form); efficacy (from the Longitudinal Study of Australian Children); and financial service use (study-designed) compared between arms.Ethics and disseminationEthics committees of the Royal Children’s Hospital (HREC/57372/RCHM-2019) and South West Sydney Local Health District (2019/ETH13455) have approved the study. Participants and stakeholders will receive results through regular communication channels comprising meetings, presentations and publications.Trial registration numberACTRN12620000154909; prospectively registered. Pre-results.
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Nguyen, T. M., Y. S. Hsueh, M. V. Morgan, R. J. Mariño, and S. Koshy. "Economic Evaluation of a Pilot School–Based Dental Checkup Program." JDR Clinical & Translational Research 2, no. 3 (May 5, 2017): 214–22. http://dx.doi.org/10.1177/2380084417708549.
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The objectives of this study were to perform an economic evaluation of a targeted school-based dental checkup program in northern metropolitan Melbourne, Victoria. A 12-mo retrospective case-control cohort analysis using the decision tree method evaluated the incremental cost-utility and cost-effectiveness ratio (ICUR/ICER) for passive standard care dental services and an outreach pilot intervention completed in 2013. A societal perspective was adopted. A total of 273 children ( n = 273) aged between 3 and 12 y met the inclusion/exclusion criteria: 128 in the standard care group and 145 in the intervention group. The total society costs included health sector costs, patient/family costs, and productivity losses in 2014 Australian dollars. Outcome measures were evaluated using quality-adjusted tooth years (QATY) and the combined deciduous and permanent decayed, missing, and filled teeth prevented (DMFT-prevented). A generic outcome variable was created to determine the impact of the intervention to reach underserved populations based on government concession eligibility (cardholder status). Uncertainties were incorporated using 95% confidence intervals. The mean total society cost per child is $463 and $291 ( P = 0.002), QATY utility difference is 0.283 and 0.293 ( P = 0.937), effectiveness difference is 0.16 and 0.10 ( P = 0.756), and cardholder status is 50.0% and 66.2% ( P = 0.007), respectively, for the standard care and intervention groups. On average per child, there was a cost saving of $172 and improvement of 0.01 QATY, with an additional proportion of 16.2% of cardholder children reached. The calculated ICER was $3,252 per DMFT-prevented. The intervention dominates standard care for QATY and per 1% cardholder reached outcome measures. Our study found the pilot checkup program was largely less costly and more effective compared with the current standard care. Further research is needed to quantify the value of outreach interventions to prevent dental caries development and progression in populations from low socioeconomic status. Knowledge Transfer Statement: The findings of this research demonstrated that an outreach dental program can be less costly and more effective than standard models of dental care. It showed that a school-based dental checkup program is beneficial despite other opinions that dental screening is ineffective as a method to improve public dental health. There is fiscal economic evidence to support broader expansion of similar programs locally and internationally to reduce dental caries for children from low-income families.
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Callander, Emily Joy, Christine Andrews, Kirstine Sketcher-Baker, Michael Christopher Nicholl, Tanya Farrell, Shae Karger, and Vicki Flenady. "Safer Baby Bundle: study protocol for the economic evaluation of a quality improvement initiative to reduce stillbirths." BMJ Open 12, no. 8 (August 2022): e058988. http://dx.doi.org/10.1136/bmjopen-2021-058988.
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IntroductionStillbirth continues to be a public health concern in high-income countries, and with mixed results from several stillbirth prevention interventions worldwide the need for an effective prevention method is ever present. The Safer Baby Bundle (SBB) proposes five evidence-based care packages shown to reduce stillbirth when implemented individually, and therefore are anticipated to produce significantly better outcomes if grouped together. This protocol describes the planned economic evaluation of the SBB quality improvement initiative in Australia.Methods and analysisThe implementation of the SBB will occur over three state-based health jurisdictions in Australia—New South Wales, Queensland and Victoria, from July 2019 onwards. The intervention is being applied at the state level, with sites opting to participate or not, and no individual woman recruitment. The economic evaluation will be based on a whole-of-population linked administrative dataset, which will include the data of all mothers, and their resultant children, who gave birth between 1 January 2016 and 31 December 2023 in these states, covering the preimplementation and postimplementation time period. The primary health outcome for this economic evaluation is late gestation stillbirths, with the secondary outcomes including but not limited to neonatal death, gestation at birth, mode of birth, admission to special care nursery and neonatal intensive care unit, and physical and mental health conditions for mother and child. Costs associated with all healthcare use from birth to 5 years post partum will be included for all women and children. A cost-effectiveness analysis will be undertaken using a difference-in-difference analysis approach to compare the primary outcome (late gestation stillbirth) and total costs for women before and after the implementation of the bundle.Ethics and disseminationEthics approval for the SBB project was provided by the Royal Brisbane & Women’s Hospital Human Research Ethics Committee (approval number: HREC/2019/QRBW/47709). Approval for the extraction of data to be used for the economic evaluation was granted by the New South Wales Population and Health Services Research Ethics Committee (approval number: 2020/ETH00684/2020.11), Australian Institute of Health and Welfare Human Research Ethics Committee (approval number: EO2020/4/1167), and Public Health Approval (approval number: PHA 20.00684) was also granted. Dissemination will occur via publication in peer reviewed journals, presentation at clinical and policy-focused conferences and meetings, and through the authors’ clinical and policy networks.This study will provide evidence around the cost effectiveness of a quality improvement initiative to prevent stillbirth, identifying the impact on health service use during pregnancy and long-term health service use of children.
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Hayati, Nur, Muthmainah, and Rina Wulandari. "Children’s Online Cognitive Learning Through Integrated Technology and Hybrid Learning." JPUD - Jurnal Pendidikan Usia Dini 16, no. 1 (April 30, 2022): 116–32. http://dx.doi.org/10.21009/jpud.161.08.
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Cognitive learning during the COVID-19 pandemic encountered many obstacles, but the use of various gadgets could be an effective solution in early childhood learning, especially to prepare them to enter the elementary school level. This study aims to describe the online cognitive learning process (OCL) in early childhood during the COVID-19 and new era of the pandemic through integrated technology and hybrid learning. This study uses a qualitative approach with a case study involving two ECE teachers and one principal. Data analysis using Miles and Huberman models. The findings of this study explain the importance of the teacher's role in OCL and its constraints, how parent-teacher collaboration is the key to successful cognitive improvement through online learning, and the implementation of OCL through effective learning to prevent learning loss. Further research in distance and hybrid learning, especially for early childhood, is expected to give birth to various new learning models and methods that are integrated with technology towards online teaching-learning when needed.
Keywords: early childhood, cognitive online learning, integrated technology, hybrid learning
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LK, Breach R, Jones, and Sheeran L. "Management of Maternal and Child Health Services in Victoria Australia: Education or Health Portfolio." International Journal of Nursing 1, no. 2 (2014). http://dx.doi.org/10.15640/ijn.v1n2a8.
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Petrovic, Zvezdana, Olivia Clayton, Jan Matthews, Catherine Wade, Lina Tan, Denny Meyer, Antony Gates, Alex Almendingen, and Warren Cann. "Building the skills and confidence of early childhood educators to work with parents: study protocol for the Partnering with Parents cluster randomised controlled trial." BMC Medical Research Methodology 19, no. 1 (October 24, 2019). http://dx.doi.org/10.1186/s12874-019-0846-1.
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Abstract Background In the early years of life, the benefits of parental engagement in children’s learning are well documented. Early childhood educators are a potentially effective source of support, having opportunity to engage with parents on key issues related to children’s learning and development. Educators report a need for more practical strategies for building positive partnerships with the parents of children in their care. To address this need, we have developed a practice support system, Partnering with Parents, to guide educators in Early Childhood Education and Care (ECEC) through practical strategies for working with parents. Partnering with Parents is designed to be embedded in everyday service delivery. Methods Using a cluster randomised controlled trial (cRCT) with intervention and wait-list control groups, we aim to evaluate the effectiveness of the Partnering with Parents practice support system under normal service conditions. The intervention is being trialled in ECEC services across Victoria, Australia. Services in the intervention group implemented the 10-week intervention before the control group commenced the intervention. Educators and parents of children attending the participating services are taking part in evaluating the intervention by completing questionnaires online at three time points (before, immediately after, and 3 months after the intervention group received the intervention). Results One hundred eighteen educators and 302 parents recruited from 19 participating ECEC services have consented to take part in the trial. Conclusions There is considerable potential for ECEC services to improve everyday interactions with parents and potentially child outcomes, by implementing this practice support model. Future research in this field can examine long-term effects of improving the parent-educator relationship. The intervention has potential to be widely embedded in educator training or professional development. Trial registration Australian New Zealand Clinical Trials Registry (ANZCTR): ACTRN12619000488101. Prospectively registered 25 March 2019.
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Price, Anna, Hannah Bryson, Ashlee Smith, Fiona Mensah, and Sharon Goldfeld. "Processes for engaging and retaining women who are experiencing adversity in longitudinal health services research." BMC Health Services Research 19, no. 1 (November 14, 2019). http://dx.doi.org/10.1186/s12913-019-4698-5.
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Abstract Background Women and families experiencing socioeconomic and psychosocial adversity are the least likely to access health care but most likely to benefit. For health services to effectively meet the needs of individuals experiencing adversity, research involving the health services must be truly representative. However, individuals experiencing adversity are typically excluded from or underrepresented in health services research. This paper reports on the implementation of a quality improvement approach designed to support recruitment and retention of pregnant women experiencing adversity in a longitudinal, health services randomized controlled trial (“right@home”). Methods right@home recruited Australian women from 10 public maternity hospitals across the states of Victoria and Tasmania who were experiencing adversity (≥2 risk factors on screening survey). Regular follow-up assessments were conducted by phone or face-to-face to child age 2 years. Research processes were designed taking heed of previous research demonstrating effective strategies for recruiting and retaining minority groups (e.g. piloting the recruitment process; recruiting via the health service providing care to the subgroup; remunerating participants); however, we were concerned that important information was missing. Therefore, once recruitment began, we conducted a continuous evaluation of the research processes, testing and implementing changes to processes or new strategies to maximize recruitment and retention (e.g. using a suite of strategies to maintain contact with families, using flexible data collection methods, obtaining consent for data linkage for future health and education data). Results right@home enrolled a large cohort of women (N = 722) experiencing high levels of adversity according to socioeconomic status and psychosocial risk factors, and achieved excellent retention (83% completion at 2 years). Most strategies appeared to increase recruitment and retention. All required additional time from the research team to develop and test, and some required extra funding, which ranged from minor (e.g. printing) to substantial (e.g. salaries, remuneration). Conclusions By taking a quality improvement approach, supported by sufficient resourcing and flexible research processes, it is possible to recruit and retain a large cohort of women experiencing adversity who are typically missed or lost from longitudinal research.
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Levickis, Penny, Lisa Murray, Lynn Lee-Pang, Patricia Eadie, Jane Page, Wan Yi Lee, and Georgie Hill. "Parents’ Perspectives of Family Engagement with Early Childhood Education and Care During the COVID-19 Pandemic." Early Childhood Education Journal, August 5, 2022. http://dx.doi.org/10.1007/s10643-022-01376-5.
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AbstractThe COVID-19 pandemic has created significant challenges for Early Childhood Education and Care (ECEC) services and families, impacting family access to services and their communication and engagement with educators. This study aimed to examine parents’ perspectives of family engagement with ECEC services during the pandemic. Primary caregivers in Victoria at the time of recruitment (September–November 2020) were invited to participate. Of the 66 participants who completed an online survey, 25 also took part in semi-structured video call or phone interviews; qualitative findings from these interviews are reported in this paper. Four key themes were conceptualised using a reflexive thematic approach: (1) disruptions to ECEC access and attendance impacting on family routines and relationships, and child development; (2) barriers to family engagement; (3) ECEC educators’ support of families and children during the pandemic; and (4) increased parental appreciation of the ECEC profession. Findings revealed that disruptions to ECEC access and routines during the pandemic adversely impacted family engagement, and child learning and social-emotional wellbeing for some families. These were aggravated by other stressors, including increased parental responsibilities in the home, financial and health concerns, and changed work conditions. Findings also demonstrated successful methods used by educators to maintain communication and connections with families. Importantly, parents expressed increasing appreciation of the profession and an increased awareness of the value of family involvement in children’s learning. Learnings regarding strategies for effective and alternative ways of engaging families are discussed.
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Hu, Yanhong Jessika, Melissa Wake, Susan Clifford, and Jo Said. "1059Innovative epidemiological methods in a whole-of-state cohort of children and parents: Generation Victoria (GenV)." International Journal of Epidemiology 50, Supplement_1 (September 1, 2021). http://dx.doi.org/10.1093/ije/dyab168.290.
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Abstract Focus and outcomes for participants “Children are our future” - the wellbeing of our future adults will influence the future of the world. However, this generation of children and mid-life adults face increasing rates of complex health and development problems, and many of them are preventable. Traditional research approaches are not keeping pace with need. Discovery and testing of solutions is blocked by the lack of fast, cheap, large-scale, low burden and effective ways to conduct research for the population and its many subgroups. Innovation in epidemiological methods is required to deliver large scale studies of unprecedented scale and scope. These will support research that enables better prevention, prediction and treatment – all of which are needed to solve today’s pressing child and adult health problems. This 90-minute symposium will draw on the forthcoming Generation Victoria (GenV) to illustrate innovative epidemiological methods established in its foundation phase to enable large-scale studies. GenV is designed to address physical, mental and social issues experienced during childhood and mid-adulthood, as well as the antecedents of a wide range of diseases of ageing. Parents of all newborns (estimated. 170,000) in the state of Victoria (population 6.5 million), Australia, will be approached from 2021 for two full years. Following consent, GenV proposes to bank biosamples collected during routine care, link to administrative and clinical data, and directly collect parent and child data using interactive electronic interfaces with the potential for face-to-face assessment during the school years. Encompassing clinical trials, registries, health services and geospatial as well as discovery research, GenV’s initial focus will be on pregnancy and newborns, reaching into regional and rural communities and traditionally hard-to-reach groups in sizeable numbers. Permission will be sought to link trials, registries, and health services research with existing pre- and post-birth administrative and electronic health record datasets, and also to bank biospecimens collected during routine care. We will discuss why innovation is essential to the next wave of large-scale studies such as GenV, and share practical examples of method innovations being developed within GenV. We will forecast the opportunities and challenges of large-scale studies for improving wellbeing and reducing the disease burden with children and adults. Focus: Outcomes: Rationale for the symposium, including for its inclusion in the Congress The future wellbeing and productivity of our societies depend on wellbeing and good health of our children and adults. However, today’s children and mid-life adults are facing both old and new challenges. Traditional research approaches have largely failed to deliver progress towards solving these challenges. For example, most existing cohorts only allow for observational follow up, and children are greatly under-represented in gold-standard clinical trials, which leads to less evidence to children’s treatment and prevention. Multi-purpose, low burden, high up-take innovative large studies are required to address these gaps. GenV seeks to generate translatable evidence (prediction, prevention, treatments, and services) to improve future wellbeing and reduce the future disease burden of children and adults. It will allow researchers, clinicians and policy makers to better understand the issues affecting Victorian children and their families with greater speed and precision, and therefore outcomes be translated more quickly into practice. Also it will help facilitate an environment where researchers, clinicians, policy makers, and other organisations can come together to enact change for future generations’ wellbeing. With this symposium, we intend to share our reflections on how the scale of cohort studies is changing, and showcase new trends in research design. The GenV team will then show how we practically achieve innovation in large-study methodology and design, with the aim of encouraging others to think ambitiously at large-scale. We will share our intentions and rationale for these innovations as well as the challenges. The symposium is designed to spark a discussion with the audience, seeking their reflections and suggestions on shaping our innovations. Finally, we aim to encourage researchers (especially early career researchers) to exchange their vision and views on innovations and methods for cohort studies. Presentation program (90 minutes) Names of presenters Prof Melissa Wake, Dr Susan Clifford, Dr Yanhong Jessika Hu, A/Prof Jo Said, Dr Joan Leong, Dr Suzanne Mavoa.
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Barbaro, Josephine, Anne Masi, Melissa Gilbert, Radhika Nair, Ifrah Abdullahi, Joseph Descallar, Cheryl Dissanayake, et al. "A Multistate Trial of an Early Surveillance Program for Autism Within General Practices in Australia." Frontiers in Pediatrics 9 (April 23, 2021). http://dx.doi.org/10.3389/fped.2021.640359.
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Background: The early detection of developmental conditions such as autism is vital to ensure children can access appropriate and timely evidence-based supports, services, and interventions. Children who have undetected developmental conditions early in life are more likely to develop later health, developmental, learning, and behavioral issues, which in turn can have a cumulative effect over the life course.Methods: The current protocol describes a multi-site, cluster randomized control trial comparing a developmental surveillance pathway for autism to usual care, using opportunistic visits to general practitioners (GPs). Units of randomization are GP clinics across two Australian states (New South Wales and Victoria), with thirty clinics within each state, each of which will aim to recruit approximately forty children aged between ~18- and 24-months, for a total of ~2,400 participants. Children will be randomized to two clusters; namely, an autism surveillance pathway (ASP) or surveillance as usual (SaU). The screening process for the ASP arm involves primary and secondary screenings for developmental concerns for autism, using both parent and GP reports and observations. Children in both arms who show signs of developmental concerns for autism will be offered a full developmental assessment by the research team at 24 months of age to determine the efficacy of developmental surveillance in successfully identifying children with autism.Trial Registration: The trial is registered with ANZCTR (ACTRN12619001200178) and reporting of the trial results will be according to recommendations in the CONSORT Statement.
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Williams, Sharon, Kenneth Cheng, and Mark Sipthorp. "Providing A Person-Centred View: Applying Linked Data to Government Policy Reform and Service Design." International Journal of Population Data Science 5, no. 5 (December 7, 2020). http://dx.doi.org/10.23889/ijpds.v5i5.1602.
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The application of linked data by government has limited visibility due to complexities in publishing details of the analysis and interventions. The Victorian Department of Health and Human Services (DHHS) acknowledges the value of linked data in the department’s strategic plan, and linked data has been used in many policy reform and service design activities over the past three years.
IntroductionIn 2016 the Centre for Victorian Data Linkage (CVDL), located in DHHS, developed the Victorian Linkage Map (VLM) of 20 plus health and human services datasets linked with births and deaths data. The VLM has since been expanded to include education, justice and police data. DHHS has been an “early adopter” in applying linked data to policy development, service reforms and departmental operations to improve the health and wellbeing of the Victorian population.
Objectives and ApproachThe presentation will provide an overview of multi-sector data linkage in Victoria, and the value of frequent collaborations between CVDL and DHHS staff in applying linked data to priority projects and reforms. It will consider the challenges of cross-jurisdictional linkage in Australia, highlighting initiatives which are expanding linked datasets available to DHHS.
ResultsDHHS has undertaken a broad range of linked data projects which have provided an evidence base for departmental activities, including provision of hospital, housing, health surveillance and child protection services. Linked data has also been used to develop an integrated demand model, which forecasts impact of investment in one program area on other parts of the service system.
Conclusion / ImplicationsThe active use of linked data by DHHS provides a model for other government departments to improve service design and delivery to vulnerable populations. DHSS is expanding linked-data use to additional areas, and further imbedding in departmental operations.
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Cleary, Joyce, Catherine Nolan, Martin Guhn, Kimberly C. Thomson, Sophie Barker, Camille Deane, Christopher J. Greenwood, et al. "A study protocol for community implementation of a new mental health monitoring system spanning early childhood to young adulthood." Longitudinal and Life Course Studies, September 15, 2022, 1–20. http://dx.doi.org/10.1332/175795921x16599509057666.
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Findings from longitudinal research, globally, repeatedly emphasise the importance of a taking an early life course approach to mental health promotion; one that invests in the formative years of development, from early childhood to young adulthood, just prior to the transition to parenthood for most. While population monitoring systems have been developed for this period, they are typically designed for use within discrete stages (i.e., childhood or adolescent or young adulthood). No system has yet captured development across all ages and stages (i.e., from infancy through to young adulthood). Here we describe the development, and pilot implementation, of a new Australian Comprehensive Monitoring System (CMS) designed to address this gap by measuring social and emotional development (strengths and difficulties) across eight census surveys, separated by three yearly intervals (infancy, 3-, 6-, 9- 12-, 15-, 18 and 21 years). The systems also measures the family, school, peer, digital and community social climates in which children and young people live and grow. Data collection is community-led and built into existing, government funded, universal services (Maternal Child Health, Schools and Local Learning and Employment Networks) to maximise response rates and ensure sustainability. The first system test will be completed and evaluated in rural Victoria, Australia, in 2022. CMS will then be adapted for larger, more socio-economically diverse regional and metropolitan communities, including Australian First Nations communities. The aim of CMS is to guide community-led investments in mental health promotion from early childhood to young adulthood, setting secure foundations for the next generation.