Health Promotion Journal of Australia
Volume 27 Number 3 2016
Advancing Evaluation Practice
HE16057Reach, engagement, and effectiveness: a systematic review of evaluation methodologies used in health promotion via social networking sites
Social networking sites (SNS), such as Facebook, are popular platforms for health promotion. This systematic review describes previous studies’ methods for evaluating SNS health promotion. It found that few studies were able to both assess reach of an intervention in a real-life setting while using rigorous research designs.
HE16041Designing evaluation plans for health promotion mHealth interventions: a case study of the Milk Man mobile app
Mobile interventions are increasingly being incorporated into health promotion programs. As a result, practitioners are required to develop appropriate evaluation plans. This paper describes a number of evaluation tools and models, and provides a case study of the evaluation plan developed for the Milk Man app. The examples discussed can provide guidance for practitioners seeking to develop mHealth interventions.
HE16056Improving the translation of health promotion interventions using effectiveness–implementation hybrid designs in program evaluations
HE16050Assessing change in perceived community leadership readiness in the Obesity Prevention and Lifestyle program
Community leadership is important to the success of community-based health promotion programs. This study assessed perceived community-level leadership readiness for childhood obesity prevention, at two time-points, in 168 suburbs engaged in South Australia’s Obesity Prevention and Lifestyle initiative. The study found greater increases in readiness associated with longer intervention exposure and smaller populations. The use of an online tool holds promise for illuminating the role of readiness in large-scale intervention trials.
HE16053Validity of four measures in assessing school canteen menu compliance with state-based healthy canteen policy
Valid measures are needed to assess the impact of healthy canteen policies on the provision of foods in schools at a population level. Policy compliance was assessed using four different measures to identify the most valid method compared to observations. A quick menu audit was found to be a valid and potentially low-cost method of assessing policy implementation at scale.
HE16032The usefulness of GPS bicycle tracking data for evaluating the impact of infrastructure change on cycling behaviour
This study assessed the usefulness of a smartphone GPS tracking system for evaluating the impact of bicycle infrastructure improvements on behavioural outcomes. Findings suggested that smartphone GPS data can supplement, not replace, existing data sources, in evaluating the impact of bicycle infrastructure improvements.
Can evaluation methods influence and enhance complex prevention initiatives? This paper illustrates how evaluation feedback loops were a critical element in a school-based violence prevention initiative. The findings have implications for health promotion activities, where evaluation tools could be utilised to enhance, rather than simply measure, the effectiveness of an intervention.
HE16044Sectoral system capacity development in health promotion: evaluation of an Aboriginal nutrition program
This paper describes how an evidence-based Aboriginal health policy and program strategy that was initiated, developed and led by the peak Aboriginal community-controlled health organisation in Victoria established a collaborative network of government, non-government and local Aboriginal health agencies with a shared focus and increased capacity to engage with Aboriginal Victorians regarding healthy eating.
HE16039Evaluation of the implementation of Get Healthy at Work, a workplace health promotion program in New South Wales, Australia
This paper describes how routinely collected Get Healthy at Work program data was used alongside an online survey of businesses and semistructured interviews with service providers to identify areas for program improvement. The evaluation provides a real-world example of an evaluation of a large-scale workplace health program using routinely collected administrative data in combination with formal evaluation data.
HE16049Beyond fun runs and fruit bowls: an evaluation of the meso-level processes that shaped the Australian Healthy Workers Initiative
This qualitative study describes the translation of a complex national-level workplace obesity-prevention initiative to state-level programs across Australia. Interviews with state program coordinators aimed at critically examining this process revealed that programmatic choices were grounded in two interrelated goals of achieving meaningful change and program sustainability. Taking program development as an evaluation target can yield important insights into how context, theory and priorities affect that process.
It is important to holistically evaluate workplace health initiatives to understand what worked, how and why. Ecological Momentary Assessment (EMA) on a smartphone app was successfully used to collect in-the-moment responses on participants’ well being, activities and behaviour change. The novel use of EMA to measure workplace health outcomes was effective, acceptable and flexible, and can be used in future health promotion and program evaluation.
Evidence derived from research and evaluation is critical to inform policies and programs. This paper describes the range of evidence-based approaches taken by NSW Health to building research and evaluation capability within the organisation and the subsequent increase in activity, infrastructure and peer-reviewed papers. The outcomes support the value of organisations taking a structured, multistrategy approach to building research and evaluation capability.
The peer-reviewed and edited version of record published online before inclusion in an issue
HE16065Public attitudes to government intervention to regulate food advertising, especially to children
HE16119Cyclists’ perceptions of motorist harassment pre- to post-trial of the minimum passing distance road rule amendment in Queensland, Australia
Cyclists’ perceptions of harassment by motorists discourages cycling. This study compared the percentage of cyclists reporting harassment pre- to post-introduction of a minimal passing distance road rule amendment. The study found that cyclists continued to perceive harassment by motorists after the road rule was introduced, which indicates that minimum passing distance rules may not improve cyclists’ perceptions of motorists’ behaviours.
HE16070Behaviours and attitudes of recreational fishers toward safety at a ‘blackspot’ for fishing fatalities in Western Australia
Fishers in Western Australia were surveyed to investigate differences in behaviours and attitudes towards personal safety while fishing. Fishers born in Asia were poorer swimmers than other groups yet were more likely to have fished from rocks than those born elsewhere. Although most respondents agreed that wearing a life jacket would make fishing safer, 78% ‘never’ wore a life jacket while fishing. Activities aimed at reducing rock fishing fatalities need to be directed towards improving survivability when a fisher is unexpectedly washed into the sea. These could include making the wearing of life jackets mandatory while rock fishing.
Valuing the voices of community and stakeholders is vital to the evaluation of childhood community-based obesity prevention programs, especially to understand what works and why. This paper reports qualitative research about community partnerships in a program called OPAL (Obesity Prevention and Lifestyle) in South Australia. A key finding is that partnerships based on relationships and co-benefits were more likely to be viewed as making a difference.
HE16090Are regional and remote Western Australian children eating for good health? An investigation into fruit and vegetable consumption
This study used caregiver–child dyads ((n = 256) and 24-hour dietary diaries ((n = 196) to ascertain Australian Dietary Guideline (ADG) adherence among regional/remote Western Australian children. More children met fruit (65.8%) than vegetable (15.4%) recommendations, which were not impacted by remoteness. Fruit and vegetable types and varieties significantly differed between regional/remote locations.
HE16036A snapshot of physical activity programs targeting Aboriginal and Torres Strait Islander people in Australia
Promoting physical activity is a promising strategy to reduce chronic disease and social disparities between Aboriginal and Torres Strait Islanders and non-Indigenous Australians. This study identified and documented 13 key aspects of physical activity programs targeting Aboriginal and Torres Strait Islander people, finding 110 current and recent programs. Examining current program practice represents an important initial step in informing future directions and evaluation.
HE16052Barriers and facilitators to participation in workplace health promotion (WHP) activities: results from a cross-sectional survey of public-sector employees in Tasmania, Australia
It is important to better understand how organisations can maximise employee engagement in workplace health promotion (WHP). This study identified WHP implementation strategies that were associated with participation in more types of WHP activities, and the barriers associated with less participation. The findings provide evidence from the ‘real-world’ delivery of WHP by a large public-sector organisation across many different work settings.
HE16054Sitting ducks face chronic disease: an analysis of newspaper coverage of sedentary behaviour as a health issue in Australia 2000–2012
This study examines how sedentary behaviour was covered as a health issue in Australian newspapers between 2000 and 2012 and how physical activity was framed within this newspaper coverage. Adults who sat a lot were portrayed as ‘sitting ducks’ for ill health. Benefits of physical activity independent of sedentary behaviour were neglected. It is important that the entire ‘move more, sit less, every day!’ message is communicated.
HE16081Informing health promotion in rural men’s sheds by examination of participant health status, concerns, interests, knowledge and behaviours
Despite the mushrooming of men’s sheds in Australia in recent years, little is known about the health status, knowledge or health behaviours of shed members, particularly in rural areas. This study found that rural sheds in South Australia primarily cater for older, retired, lesser educated men from lower socioeconomic strata with one or more age-related chronic conditions and health knowledge deficits in reproductive and psychological health. GPs are the preferred source of health advice and hands-on formats for health education are preferred.
Infrequent monitoring has led to uncertainty about trends in childhood obesity prevalence. Our aim was to establish a sustainable childhood obesity monitoring system in regional Australia using a passive (opt-out) consent process and employing a census-style sampling technique. This system has the potential to provide sustainable monitoring of childhood obesity, which is vital to understanding the problem of childhood obesity in this region.
Smoking has been linked to an increased risk for cancers and cardiovascular disease. This study engaged hospital nurses to find out why routine smoking cessation care was not provided. Nurses did not have confidence in their knowledge and skills in smoking cessation to support patients to quit smoking. Education and training in smoking cessation best practice should be available to all nursing staff.
The Culture Health Communities Activity Challenge aims to encourage physical activity in primary students, with a focus on engaging Aboriginal students. Participation in the Challenge was associated with increased physical activity and decreased screen time. Students and teachers also reported positive social and educational outcomes. The findings demonstrate that school-based physical activity programs can be engaging for classes with high proportions of Aboriginal students.
Universities represent important settings for public health initiatives such as smoke-free policies; however, policy implementation does not necessarily result in a smoke-free environment. University students believe enforcement of smoke-free policies is necessary; however, staff do not see enforcement as part of their role. Explicit enforcement plans, and specific training and support for enforcement roles, are required to avoid pervasive policy non-compliance.
HE16013Acceptability of alcohol supply to children – associations with adults' own age of initiation and social norms
The age at which adults started drinking alcohol is strongly associated with the age at which they believe it is acceptable to introduce children to alcohol at home. This phenomenon has the potential to perpetuate a cycle of early initiation and risk of alcohol-related problems.
HE16017A survey of cervical screening among refugee and non-refugee African immigrant women in Brisbane, Australia
Regular cervical screening has lessened the burden of cervical cancer in developed countries; however, access to these practices is not readily available in these countries. This study examined screening practices among refugee and non-refugee women from Africa living in Brisbane. The evidence will help to develop screening interventions that meaningfully engage African immigrant women to enhance screening practices.
Social media use is on the rise, but we have little understanding of its impact on sitting time and body mass index (BMI). Our findings demonstrate that computer sitting in leisure time and total sitting on non-workdays increase with social media use. Social media use may therefore be negatively affecting health.
There is a potential for food labels to influence portion size selection of foods, and therefore affect weight status. This study aimed to examine whether two food labels (a kJ/100 g label and the Health Star Rating label) influenced portion size selection of young adults and found that neither label had an effect. These results indicate that current food labels may not be effective in assisting young people to make appropriate portion size selections. This, in turn, could affect weight status, nutrient intake and overall health.
HE15130Going up, going down: the experience, control and management of gestational diabetes mellitus among Southeast Asian migrant women living in urban Australia
The rate of gestational diabetes mellitus (GDM) for Asian-born women is higher than for other groups. A qualitative interpretive design was used to explore Southeast Asian migrant women’s experience and management of GDM at two Sydney hospitals. They likened their experience of GDM to an elevator ride, which was modulated by ‘insulin’ and ‘information’ to control the disease and manage blood glucose levels, dietary levels, exercise levels and anxiety levels. Better understanding of cultural interpretations may help health professionals support women with GDM.
HE16019Does on-site chaplaincy enhance the health and well being of fly-in, fly-out (FIFO) personnel?
Fly-in, fly-out (FIFO) work can be associated with mental-health, personal and family-related issues, challenging the well being of workers. This study evaluated whether a 24/7 onsite chaplaincy service can mitigate some of the adverse effects of FIFO work. We found that the proactive outreach approach of chaplains offered effective support, benefitting the health and well being of FIFO employees
HE16015The Strong Family Program: an innovative model to engage Aboriginal and Torres Strait Islander youth and Elders with reproductive and sexual health community education
Aboriginal young people may experience high rates of family violence and poorer reproductive and sexual health than their non-Aboriginal counterparts. To address some of the disparities, the Strong Family Program was developed, based on an extensive consultation process with Aboriginal communities, to deliver reproductive and sexual health promotion and education to Aboriginal communities in New South Wales. Participation increased reproductive and sexual health knowledge and positive attitudes. Health promotion and education with Aboriginal communities should be based on community consultations and carried out within a culturally appropriate framework to promote greatest success.
Parents of young children need opportunities to build community connections and social support networks where they live. Parents who participated in locally placed playgroups were more connected to their local community than parents who participated in playgroups outside their local residential area. Locally placed playgroups have the potential to foster local community connectedness for families with young children.
Torres Strait Islanders in the remote islands of Far North Queensland experience high rates of Type 2 Diabetes in Australia. This study aimed to assess the extent of self-reported depression using the PHQ-9 and clinical features, our study demonstrated low rates of depression compared to national samples. Increasing physical activity could improve mental and general well being in this population.
Churches have experience in addressing social disadvantage and are prepared to commit resources to meet the needs of people outside their congregations. The aim of this study was to explore the barriers and challenges that affect church involvement in promoting health and well being. Identified factors include perceived lack of relevance, community mistrust, conversion agendas and values that conflict with health promotion.
HE16027Process evaluation of the Albany Physical Activity and Nutrition (APAN) program, a home-based intervention for metabolic syndrome and associated chronic disease risk in rural Australian adults
This paper reports on the process evaluation of the Albany Physical Activity and Nutrition program, which aimed to improve the diet and physical activity of rural adults at risk of chronic disease. Health promotion practitioners planning and implementing similar interventions may learn from these findings, particularly for recruitment and retention of participants.
Local governments are uniquely placed to influence the food environment of their communities through healthy eating policies (HEPs) but few have done so. Using a community-based participatory approach, the capacity of 31 South Australian local governments to develop and implement a HEP was increased with 14 endorsed policies. HEPs provide important structural mechanisms to enable local governments to facilitate healthy eating.
This study evaluated the Veggycation® website and its appeal to Australian consumers. The website has a high level of acceptance overall; however, customisation of the site is recommended for low vegetable consumption groups. The study adds to the body of knowledge in e-health and informatics, promoting health education and literacy.
HE15098Indicators of a health-promoting local food environment: a conceptual framework to inform urban planning policy and practice
HE15096Evaluating the Sharing Stories youth theatre program: an interactive theatre and drama-based strategy for sexual health promotion among multicultural youth
This study evaluated the effectiveness of the Sharing Stories youth theatre program, which uses interactive theatre and drama-based strategies to engage and educate multicultural youth on sexual health. The study found that knowledge, confidence and attitudes of participants improved after participation in the program. These results suggest that incorporating arts-based strategies into sexual health promotion programs for multicultural youth is valuable.
HE15128Is there a relationship between primary school children’s enjoyment of recess physical activities and health-related quality of life? A cross-sectional exploratory study
Recess breaks can provide the greatest opportunities for children’s physical activity participation at school. This study explored the relationship between Australian primary school children’s enjoyment of recess physical activities and health-related quality of life (HRQOL). Provision of opportunities and facilities for more vigorous-intensity school recess physical activities were found to be a key strategy to enhance children’s HRQOL.
HE15136Smoking status and associated factors among male Chinese restaurant workers in metropolitan Sydney
This is the first study focusing on smoking behaviour among Chinese restaurant workers in Australia. The findings indicate that Chinese restaurant workers in metropolitan Sydney have a high smoking rate of 45%, with 50% of current smokers wanting to quit. These findings provide a sound basis to support the development of tailored health promotion strategies for this population.
HE15102Underestimation of homeless clients’ interest in quitting smoking: a case for routine tobacco assessment
The incidence of smoking among clients using homeless services is extraordinarily high. While nurses from an Australian homeless program were aware of their clients’ smoking habits, they underestimated the interest in quitting, which was expressed by many clients. With some simple organisational system changes to homeless services, appropriate cessation assistance could be provided to this vulnerable population.
HE15123Take Charge of Pain: evaluating a community-targeted self-management education program for people with musculoskeletal pain
Self-management is ubiquitous in a modern health system, in which the management of chronic conditions is a key challenge. Using a pre-post evaluation design, this study aimed to determine the effectiveness of a redesigned and shortened community-targeted program focusing on musculoskeletal pain.
HE15127How well are health information websites displayed on mobile phones? Implications for the readability of health information
Eighty-two percent of smartphone owners search for health information on their phones but is such information easy to read? This study explored how health information was displayed on mobile websites and found that only 15.93% were designed to optimise readability. Building mobile-responsive and easy-to-read websites should be a priority to capitalise on the potential of mobile phones in enhancing health literacy.
HE15095Online canteens: awareness, use, barriers to use, and the acceptability of potential online strategies to improve public health nutrition in primary schools
This telephone survey of 123 primary school principals suggests that online canteens have the potential to reach a large proportion of school communities across geographical and socioeconomic divides, and that the nutrition interventions which they have the capacity to deliver are considered acceptable.
These articles have been peer reviewed and accepted for publication. They are still in production and have not been edited, so may differ from the final published form.
Achieving equity in Crunch & SipÂ®: a pilot intervention involving supplementary, free fruit and vegetables, in NSW
Changes in smoking, drinking, overweight and physical inactivity in young Australian women from 1996 to 2013
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