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Andrew Joyce

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Papers by Andrew Joyce

Analysis of primary prevention services for cardiovascular disease in Australia's community pharmacies

Australian and New Zealand journal of public health, Dec 1, 2007

C ardiovascular diseases (CVD) remain the leading causes of m o r t a l i t y a n d m o r b i d i... more C ardiovascular diseases (CVD) remain the leading causes of m o r t a l i t y a n d m o r b i d i t y i n Australia. 1 Four of the preventable risk factors for cardiovascular disease are tobacco use, high blood cholesterol, high blood pressure, and overweight or obesity. 1 The cost of drugs for CVD in Australia is predicted to grow from $1.29 billion in 2001/02 to $17.7 billion annually by 2041/42. 2 A systematic review of the literature concluded that the community pharmacy is an accessible and resourceful site for targeting risk factors for CVD. 3 Studies conducted in community pharmacies in the United States of America (US) and Canada have demonstrated the efficacy of testing blood pressure and cholesterol levels for primary and secondary prevention. 4-7 In 2000, a screening program for CVD and diabetes was evaluated in community pharmacies in four rural towns in New South Wales (NSW). 8 The initial screening of each of the 389 participants each took approximately 30 minutes. Body Mass Index (BMI), blood pressure, cholesterol results, family medical history, smoking status, alcohol intake and diabetes risk factors were recorded. Pharmacists provided tailored

Application of theories of the policy process in research on consumption of sustainable diets: a systematic review

BMC Public Health

Background There is a significant global lack of policy action on consumption of sustainable diet... more Background There is a significant global lack of policy action on consumption of sustainable diets. Application of political science theories such as theories of the policy process can help in understanding policy inaction. Applying these theories could provide a more in-depth understanding of how various influences on the policy process shape decision making for consumption of sustainable diet policy. Methods A systematic review to examine application of eight key political science theories of the policy process to research on consumption of sustainable diets was conducted. Results The review identified no papers applying a theory of the policy process although 17 papers did mention or discuss influences on the policy process that are common elements within theories of the policy process. Most notably these elements were the influence of coalitions/networks, evidence use, narratives and framing, institutional and political system factors, and the importance of value and belief syst...

Evaluation of the Giving Circles at Work pilot

Good2Give was supported by funding provided by the Australian Government Department of Social Ser... more Good2Give was supported by funding provided by the Australian Government Department of Social Services to deliver an innovative workplace giving trial with Westpac Group employees. The Giving Circles at Work pilot took a successful individual fundraising concept and trialled it in the corporate environment. This world-first pilot has demonstrated how the willingness of the Australian corporate sector can be leveraged to significantly grow giving in the workplace. The pilot brought together employees from Westpac Group to collectively raise funds through workplace giving for specific causes or charities that were strategically chosen by the giving circle to address a particular societal problem. The initiative provided an avenue for employee professional development particularly around leading through influencing, increasing their understanding of philanthropy and the charity sector, and delivering vital funds for communities in need. Westpac has a long history of helping employees support the charitable and grassroots organisations that strengthen communities. Their Matching Gifts workplace giving program has been matching employee donations to eligible Australian charities since 1998. Participation in the trial offered employees opportunities to explore new ways to make a difference to charities and causes that are important to them. This pilot is a demonstration of the commitment that companies make to engage their staff in giving and to further support this by matching their donations. This pioneering trial has paved the way for the development of a long-term, sustainable and replicable model to help companies grow their community giving programs even further. It is an exciting step forward to enable Australian workplaces to make a difference to the world in which we all work and live.

The health and well-being impacts of a work integration social enterprise from a systems perspective

Health Promotion International, 2021

Summary Recent research has drawn upon the social determinants of health (SDH) framework to attem... more Summary Recent research has drawn upon the social determinants of health (SDH) framework to attempt to systematize the relationship between social enterprise and health. In this article, we adopt a realist evaluation approach to conceptualize social enterprises, and work integration social enterprises in particular, as ‘complex interventions’ that necessarily produce differential health outcomes for their beneficiaries, communities and staff. Drawing upon the findings from four social enterprises involving a range of methods including 93 semi-structured interviews with employees, managers and enterprise partners, together with participant observation, we demonstrate that these health outcomes are influenced by a limitless mix of complex and dynamic interactions between systems, settings, spaces, relationships and organizational and personal factors that cannot be distilled by questions of causality and attribution found in controlled trial designs. Given the increased policy focus o...

Do calcium antagonists contribute to gastro-oesophageal reflux disease and concomitant noncardiac... more

Barriers to policy action on social determinants of health for people with disability in Australia

Disability & Society, 2020

It is well established that social determinants are crucial to health outcomes. However, the link... more It is well established that social determinants are crucial to health outcomes. However, the link between how social determinants contribute to health inequalities for people with disability has often failed to be acknowledged. For example, Australian disability policy has paid little attention to social determinants of health, despite people with disability faring particularly badly on a range of outcomes. This paper identifies barriers to policy action on the social determinants of health for people with disability in Australia. Data obtained from interviews with key disability policy stakeholders are analysed using a micro, meso, macro level policy analysis framework. Our analysis identifies a "services drift" acting as an important barrier to policy action, where attention is focused on health service access rather than broader social determinants such as housing, employment and education. We also identify issues in how disability policy is made that hinders action on social determinants of health.

Respectful relationships education in schools: the beginnings of change

Children and young people have become one of the most important populations for the prevention of... more Children and young people have become one of the most important populations for the prevention of gender-based violence. The unacceptably high rates of gender-based violence, in particular, violence against women and their children, are well established and there is a clear opportunity to change the story for future generations via the education system. There is no single cause of gender-based violence, however, the latest international evidence shows that it is primarily driven by a range of social norms, institutional structures, and organizational or community practices relating to gender inequality. Gender inequality manifests in every aspect of life, from our relationships through to our institutions, including schools. Shifting the pattern of violence will require cultural transformation- and new research shows that this change is possible. Governments have seized this opportunity, and through the Australian Curriculum, schools have been directed to consider their role in the ...

The Cow in the Room: Public Knowledge of the Links between Dietary Choices and Health and Environmental Impacts

Environmental Health Insights, 2008

Issue Addressed This paper describes results of a survey comparing people's knowledge of heal... more Issue Addressed This paper describes results of a survey comparing people's knowledge of health and environmental impacts of dietary choices. Dietary choice is one of the key ways in which individuals can reduce their environmental impact in relation to water use and greenhouse gas emissions but this may not be widely known amongst the public due to limited press coverage. Methods A street intercept survey was conducted asking open ended questions on how people can help the environment, maintain or improve health and basic demographics. The sample size was 107 with a refusal rate of 51%. Results Only 3.2% of the sample made a link between dietary choice and environmental impact whereas 85.6% of the sample referred to dietary choice in relation to personal health. Transport options and keeping active were popular responses to both health and environmental categories. Conclusions It seems that very few people are aware that the livestock sector is the second largest contributor to...

Social marketing and social movements: creating inclusive social change coalitions

Journal of Social Marketing, 2018

Purpose This paper contributes to emerging discourse about social movements in social marketing b... more Purpose This paper contributes to emerging discourse about social movements in social marketing by examining how tensions, issues and challenges may arise in areas of social change that have attracted social movements and the ways actors can come together to drive inclusive social change agendas. Design/methodology/approach Through the lens of new social movement theory, a case study of the interactions and dynamics between fat activists and obesity prevention public health actors is examined. This is undertaken through a multi-method qualitative analysis of interview and archival blog data of fat activists located in Australia, which was compared with the campaign materials and formative and evaluative research related to two high profile Australian Government funded anti-obesity campaigns. Findings The case analysis highlights the disconnect between public health actors and the marginalized voices of those they are meant to be representing. Whilst public health actors characterise...

Primary schools: opportune settings for changing attitudes and promoting mental health

Health Promotion Journal of Australia, 2003

Issue addressed: Reducing the prejudice towards mental illness in a primary school setting and cr... more Issue addressed: Reducing the prejudice towards mental illness in a primary school setting and creating a supportive environment for families where a parent has a mental illness. Methods: Teacher workshops and classroom sessions for grades 5 and 6 children on mental illness. Results: Significant increase in teachers' confidence to support a child whose parent has a mental illness. Reduced prejudice towards people with schizophrenia among the children. Conclusion: The primary school setting appears to be an effective environment to promote mental health literacy and reduce the likelihood of negative stereotype formation.

The influence of contextual factors on implementation fidelity in a whole school approach to prevention of violence against women

Health Promotion Journal of Australia, 2018

Issue addressedImplementation fidelity relates to the degree of adherence to implementation proto... more Issue addressedImplementation fidelity relates to the degree of adherence to implementation protocols and content and helps to guide replication of evidence‐based programs. In settings‐based research, notions of fidelity have been applied more often to delivery of education content rather than whole of setting change. The aims of this paper were firstly, to analyse how contextual factors influenced implementation of a whole school program on respectful relationships education, and secondly given the findings, discuss whether a more flexible approach to implementation fidelity may have yielded increased school engagement.MethodsThe project was conducted in 19 secondary schools in Victoria in 2015. This paper reports on focus groups and interviews which were conducted with 81 school staff and 28 staff from the lead agency, community agency partners, and departmental staff to understand the contextual factors influencing implementation.ResultsThe program followed a traditional implemen...

Alignment and political will: upscaling an Australian respectful relationships program

Health promotion international, Jan 29, 2018

Many small scale efficacious programs and interventions need to be 'scaled-up' in order t... more Many small scale efficacious programs and interventions need to be 'scaled-up' in order to reach a larger population. Although it has been argued that interventions deemed suitable for upscaling need to have demonstrated effectiveness, be able to be implemented cost-effectively and be accepted by intended recipients, these factors alone are insufficient in explaining which programs are adopted more broadly. Upscaling research often identifies political will as a key factor in explaining whether programs are supported and up-scaled, but this research lacks any depth into how political will is formed and has not applied policy theories to understanding the upscaling process. This article uses a political science lens to examine the key factors in the upscaling process of a Respectful Relationships in Schools Program. Focus groups and interviews were conducted with project staff, managers and community organizations involved in the program. The results reveal how a key focusing...

Applying systems theory to the evaluation of a whole school approach to violence prevention

Health Promotion Journal of Australia, 2016

Issue addressed: Our Watch led a complex 12-month evaluation of a whole school approach to Respec... more Issue addressed: Our Watch led a complex 12-month evaluation of a whole school approach to Respectful Relationships Education (RRE) implemented in 19 schools. RRE is an emerging field aimed at preventing gender-based violence. This paper will illustrate how from an implementation science perspective, the evaluation was a critical element in the change process at both a school and policy level. Methods: Using several conceptual approaches from systems science, the evaluation sought to examine how the multiple systems layersstudent, teacher, school, community and governmentinteracted and influenced each other. A distinguishing feature of the evaluation included 'feedback loops'; that is, evaluation data was provided to participants as it became available. Evaluation tools included a combination of standardised surveys (with pre-and post-intervention data provided to schools via individualised reports), reflection tools, regular reflection interviews and summative focus groups. Results: Data was shared during implementation with project staff, department staff and schools to support continuous improvement at these multiple systems levels. In complex settings, implementation can vary according to context; and the impact of evaluation processes, tools and findings differed across the schools. Interviews and focus groups conducted at the end of the project illustrated which of these methods were instrumental in motivating change and engaging stakeholders at both a school and departmental level and why. Conclusion: The evaluation methods were a critical component of the pilot's approach, helping to shape implementation through data feedback loops and reflective practice for ongoing, responsive and continuous improvement. Future health promotion research on complex interventions needs to examine how the evaluation itself is influencing implementation. So what? The pilot has demonstrated that the evaluation, including feedback loops to inform project activity, were an asset to implementation. This has implications for other health promotion activities, where evaluation tools could be utilised to enhance, rather than simply measure, an intervention. The findings are relevant to a range of health promotion research activities because they demonstrate the importance of meta-evaluation techniques that seek to understand how the evaluation itself was influencing implementation and outcomes.

Evaluating for impact: what type of data can assist a health promoting school approach?

Health Promotion International, 2016

There is debate within the health promoting school (HPS) movement on whether schools should monit... more There is debate within the health promoting school (HPS) movement on whether schools should monitor health behaviour outcomes as part of an evaluation or rely more on process type measures, such as changes to school policies and the physical and social environment which yield information about (in) effective implementation. The debate is often framed around ideological considerations of the role of schools and there is little empirical work on how these indicators of effective implementation can influence change at a policy and practice level in real world settings. Information has potentially powerful effects in motivating a change process, but this will vary according to the type of information and the type of organizational culture into which it is presented. The current predominant model relies on process data, policy and environmental audit monitoring and benchmarking approaches, and there is little evidence of whether this engages school communities. Theoretical assertions on the importance of monitoring data to motivate change need to be empirically tested and, in doing so, we can learn which types of data influence adoption of HPS in which types of school and policy contexts.

Systems science and systems thinking for public health: a systematic review of the field

BMJ Open, 2015

et al. Systems science and systems thinking for public health: a systematic review of the field.

The Greenhouse Gas Emissions of Various Dietary Practices and Intervention Possibilities to Reduce This Impact

Impact of Meat Consumption on Health and Environmental Sustainability

This chapter examines the link between dietary choices and greenhouse gas (GHG) emissions and pos... more This chapter examines the link between dietary choices and greenhouse gas (GHG) emissions and possible interventions to reduce this impact. The connections between climate change, food systems and public health are explored. It is shown that there is variance in the impact of different food types on GHG emissions, with animal products having the greatest impact. The role of food system activities in the production of GHG emissions is also explored. Dietary choices and GHG emissions are examined using case studies from a variety of countries. Results show that reduced animal food production has increased potential to reduce GHG emissions compared to technological mitigation or increased productivity measures. Finally, a systems science approach is used to explore possible interventions aimed at reducing consumption of animal products.

Community Pharmacy's Role in Promoting Healthy Behaviours

Journal of Pharmacy Practice and Research, 2007

ABSTRACTMany have commented on the potential of community pharmacy as a health promotion setting,... more ABSTRACTMany have commented on the potential of community pharmacy as a health promotion setting, due to accessibility, high level of use, and the respect afforded to pharmacists. Community pharmacy could be a setting through which to address risk and protective health behaviours relevant to Australia's National Health Priority Areas. However, apart from some studies on smoking cessation, there is scant evidence on its involvement in other healthy behaviours. This paper discusses how to increase research and interventions on healthy behaviours in community pharmacy. This includes placing community pharmacy's role within a broader health promotion context, expanding community expectations of pharmacists, and addressing barriers to performing a health promotion role.

The impact of nutritional choices on global warming and policy implications: examining the link between dietary choices and greenhouse gas emissions

Energy and Emission Control Technologies, 2014

Research over the past 10 years has illustrated an important connection between dietary choices, ... more Research over the past 10 years has illustrated an important connection between dietary choices, the food systems required to produce them, and the subsequent impact on greenhouse gas (GHG) emissions. Several recent studies have used data on the GHG contribution of different food types to model the impact of different dietary patterns on GHG emissions; these studies have most commonly compared the average diet for a particular country to healthier dietary options and vegetarian options. We present a systematic review of this research that models different dietary choices and the associated GHG emissions with the main aim in this paper of contrasting the research implications for policy and practice. A database search of CINAHL, ScienceDirect, Scopus, Web of Science, ProQuest, Cochrane Database of Systematic Reviews, and Mednar in July 2014 identified 21 primary studies modeling the GHG emissions related to a dietary pattern published since 1995. Diets containing a higher ratio of plant to animal products were generally associated with lower GHG emissions; however, the results varied across countries and studies, as did the recommendations by the study authors. Some authors proposed leading with health messages that have a dual environmental gain, whereas others proposed messaging around environmental impact. These inconsistencies in recommended approaches to reduce diet-related GHG emissions relate not just to differences in research findings but also to assumptions about community and political support for action, and there is little empirical evidence on community knowledge, attitudes, and behavioral intention at present to support these recommendations. The paper concludes with a commentary on the policy implications and the need for further research on how to frame the issue so as to garner community and political support to address the leading recommendations of this research.

Reducing the Environmental Impact of Dietary Choice: Perspectives from a Behavioural and Social Change Approach

Journal of Environmental and Public Health, 2012

Climate change is recognised as a significant public health issue that will impact on food securi... more Climate change is recognised as a significant public health issue that will impact on food security. One of the major contributors to global warming is the livestock industry, and, relative to plant-based agriculture, meat production has a much higher environmental impact in relation to freshwater use, amount of land required, and waste products generated. Promoting increased consumption of plant-based foods is a recommended strategy to reduce human impact on the environment and is also now recognised as a potential strategy to reduce the high rates of some chronic diseases such as cardiovascular disease and certain cancers. Currently there is a scant evidence base for policies and programs aiming to increase consumption of plant-based diets and little research on the necessary conditions for that change to occur and the processes involved in such a change. This paper reviews some of the environmental and health consequences of current dietary practices, reviews literature on the de...

The Implications of an Evolutionary Perspective on Mental Health Promotion

International Journal of Mental Health Promotion, 2005

Analysis of primary prevention services for cardiovascular disease in Australia's community pharmacies

Australian and New Zealand journal of public health, Dec 1, 2007

C ardiovascular diseases (CVD) remain the leading causes of m o r t a l i t y a n d m o r b i d i... more C ardiovascular diseases (CVD) remain the leading causes of m o r t a l i t y a n d m o r b i d i t y i n Australia. 1 Four of the preventable risk factors for cardiovascular disease are tobacco use, high blood cholesterol, high blood pressure, and overweight or obesity. 1 The cost of drugs for CVD in Australia is predicted to grow from $1.29 billion in 2001/02 to $17.7 billion annually by 2041/42. 2 A systematic review of the literature concluded that the community pharmacy is an accessible and resourceful site for targeting risk factors for CVD. 3 Studies conducted in community pharmacies in the United States of America (US) and Canada have demonstrated the efficacy of testing blood pressure and cholesterol levels for primary and secondary prevention. 4-7 In 2000, a screening program for CVD and diabetes was evaluated in community pharmacies in four rural towns in New South Wales (NSW). 8 The initial screening of each of the 389 participants each took approximately 30 minutes. Body Mass Index (BMI), blood pressure, cholesterol results, family medical history, smoking status, alcohol intake and diabetes risk factors were recorded. Pharmacists provided tailored

Application of theories of the policy process in research on consumption of sustainable diets: a systematic review

BMC Public Health

Background There is a significant global lack of policy action on consumption of sustainable diet... more Background There is a significant global lack of policy action on consumption of sustainable diets. Application of political science theories such as theories of the policy process can help in understanding policy inaction. Applying these theories could provide a more in-depth understanding of how various influences on the policy process shape decision making for consumption of sustainable diet policy. Methods A systematic review to examine application of eight key political science theories of the policy process to research on consumption of sustainable diets was conducted. Results The review identified no papers applying a theory of the policy process although 17 papers did mention or discuss influences on the policy process that are common elements within theories of the policy process. Most notably these elements were the influence of coalitions/networks, evidence use, narratives and framing, institutional and political system factors, and the importance of value and belief syst...

Evaluation of the Giving Circles at Work pilot

Good2Give was supported by funding provided by the Australian Government Department of Social Ser... more Good2Give was supported by funding provided by the Australian Government Department of Social Services to deliver an innovative workplace giving trial with Westpac Group employees. The Giving Circles at Work pilot took a successful individual fundraising concept and trialled it in the corporate environment. This world-first pilot has demonstrated how the willingness of the Australian corporate sector can be leveraged to significantly grow giving in the workplace. The pilot brought together employees from Westpac Group to collectively raise funds through workplace giving for specific causes or charities that were strategically chosen by the giving circle to address a particular societal problem. The initiative provided an avenue for employee professional development particularly around leading through influencing, increasing their understanding of philanthropy and the charity sector, and delivering vital funds for communities in need. Westpac has a long history of helping employees support the charitable and grassroots organisations that strengthen communities. Their Matching Gifts workplace giving program has been matching employee donations to eligible Australian charities since 1998. Participation in the trial offered employees opportunities to explore new ways to make a difference to charities and causes that are important to them. This pilot is a demonstration of the commitment that companies make to engage their staff in giving and to further support this by matching their donations. This pioneering trial has paved the way for the development of a long-term, sustainable and replicable model to help companies grow their community giving programs even further. It is an exciting step forward to enable Australian workplaces to make a difference to the world in which we all work and live.

The health and well-being impacts of a work integration social enterprise from a systems perspective

Health Promotion International, 2021

Summary Recent research has drawn upon the social determinants of health (SDH) framework to attem... more Summary Recent research has drawn upon the social determinants of health (SDH) framework to attempt to systematize the relationship between social enterprise and health. In this article, we adopt a realist evaluation approach to conceptualize social enterprises, and work integration social enterprises in particular, as ‘complex interventions’ that necessarily produce differential health outcomes for their beneficiaries, communities and staff. Drawing upon the findings from four social enterprises involving a range of methods including 93 semi-structured interviews with employees, managers and enterprise partners, together with participant observation, we demonstrate that these health outcomes are influenced by a limitless mix of complex and dynamic interactions between systems, settings, spaces, relationships and organizational and personal factors that cannot be distilled by questions of causality and attribution found in controlled trial designs. Given the increased policy focus o...

Do calcium antagonists contribute to gastro-oesophageal reflux disease and concomitant noncardiac... more

Barriers to policy action on social determinants of health for people with disability in Australia

Disability & Society, 2020

It is well established that social determinants are crucial to health outcomes. However, the link... more It is well established that social determinants are crucial to health outcomes. However, the link between how social determinants contribute to health inequalities for people with disability has often failed to be acknowledged. For example, Australian disability policy has paid little attention to social determinants of health, despite people with disability faring particularly badly on a range of outcomes. This paper identifies barriers to policy action on the social determinants of health for people with disability in Australia. Data obtained from interviews with key disability policy stakeholders are analysed using a micro, meso, macro level policy analysis framework. Our analysis identifies a "services drift" acting as an important barrier to policy action, where attention is focused on health service access rather than broader social determinants such as housing, employment and education. We also identify issues in how disability policy is made that hinders action on social determinants of health.

Respectful relationships education in schools: the beginnings of change

Children and young people have become one of the most important populations for the prevention of... more Children and young people have become one of the most important populations for the prevention of gender-based violence. The unacceptably high rates of gender-based violence, in particular, violence against women and their children, are well established and there is a clear opportunity to change the story for future generations via the education system. There is no single cause of gender-based violence, however, the latest international evidence shows that it is primarily driven by a range of social norms, institutional structures, and organizational or community practices relating to gender inequality. Gender inequality manifests in every aspect of life, from our relationships through to our institutions, including schools. Shifting the pattern of violence will require cultural transformation- and new research shows that this change is possible. Governments have seized this opportunity, and through the Australian Curriculum, schools have been directed to consider their role in the ...

The Cow in the Room: Public Knowledge of the Links between Dietary Choices and Health and Environmental Impacts

Environmental Health Insights, 2008

Issue Addressed This paper describes results of a survey comparing people's knowledge of heal... more Issue Addressed This paper describes results of a survey comparing people's knowledge of health and environmental impacts of dietary choices. Dietary choice is one of the key ways in which individuals can reduce their environmental impact in relation to water use and greenhouse gas emissions but this may not be widely known amongst the public due to limited press coverage. Methods A street intercept survey was conducted asking open ended questions on how people can help the environment, maintain or improve health and basic demographics. The sample size was 107 with a refusal rate of 51%. Results Only 3.2% of the sample made a link between dietary choice and environmental impact whereas 85.6% of the sample referred to dietary choice in relation to personal health. Transport options and keeping active were popular responses to both health and environmental categories. Conclusions It seems that very few people are aware that the livestock sector is the second largest contributor to...

Social marketing and social movements: creating inclusive social change coalitions

Journal of Social Marketing, 2018

Purpose This paper contributes to emerging discourse about social movements in social marketing b... more Purpose This paper contributes to emerging discourse about social movements in social marketing by examining how tensions, issues and challenges may arise in areas of social change that have attracted social movements and the ways actors can come together to drive inclusive social change agendas. Design/methodology/approach Through the lens of new social movement theory, a case study of the interactions and dynamics between fat activists and obesity prevention public health actors is examined. This is undertaken through a multi-method qualitative analysis of interview and archival blog data of fat activists located in Australia, which was compared with the campaign materials and formative and evaluative research related to two high profile Australian Government funded anti-obesity campaigns. Findings The case analysis highlights the disconnect between public health actors and the marginalized voices of those they are meant to be representing. Whilst public health actors characterise...

Primary schools: opportune settings for changing attitudes and promoting mental health

Health Promotion Journal of Australia, 2003

Issue addressed: Reducing the prejudice towards mental illness in a primary school setting and cr... more Issue addressed: Reducing the prejudice towards mental illness in a primary school setting and creating a supportive environment for families where a parent has a mental illness. Methods: Teacher workshops and classroom sessions for grades 5 and 6 children on mental illness. Results: Significant increase in teachers' confidence to support a child whose parent has a mental illness. Reduced prejudice towards people with schizophrenia among the children. Conclusion: The primary school setting appears to be an effective environment to promote mental health literacy and reduce the likelihood of negative stereotype formation.

The influence of contextual factors on implementation fidelity in a whole school approach to prevention of violence against women

Health Promotion Journal of Australia, 2018

Issue addressedImplementation fidelity relates to the degree of adherence to implementation proto... more Issue addressedImplementation fidelity relates to the degree of adherence to implementation protocols and content and helps to guide replication of evidence‐based programs. In settings‐based research, notions of fidelity have been applied more often to delivery of education content rather than whole of setting change. The aims of this paper were firstly, to analyse how contextual factors influenced implementation of a whole school program on respectful relationships education, and secondly given the findings, discuss whether a more flexible approach to implementation fidelity may have yielded increased school engagement.MethodsThe project was conducted in 19 secondary schools in Victoria in 2015. This paper reports on focus groups and interviews which were conducted with 81 school staff and 28 staff from the lead agency, community agency partners, and departmental staff to understand the contextual factors influencing implementation.ResultsThe program followed a traditional implemen...

Alignment and political will: upscaling an Australian respectful relationships program

Health promotion international, Jan 29, 2018

Many small scale efficacious programs and interventions need to be 'scaled-up' in order t... more Many small scale efficacious programs and interventions need to be 'scaled-up' in order to reach a larger population. Although it has been argued that interventions deemed suitable for upscaling need to have demonstrated effectiveness, be able to be implemented cost-effectively and be accepted by intended recipients, these factors alone are insufficient in explaining which programs are adopted more broadly. Upscaling research often identifies political will as a key factor in explaining whether programs are supported and up-scaled, but this research lacks any depth into how political will is formed and has not applied policy theories to understanding the upscaling process. This article uses a political science lens to examine the key factors in the upscaling process of a Respectful Relationships in Schools Program. Focus groups and interviews were conducted with project staff, managers and community organizations involved in the program. The results reveal how a key focusing...

Applying systems theory to the evaluation of a whole school approach to violence prevention

Health Promotion Journal of Australia, 2016

Issue addressed: Our Watch led a complex 12-month evaluation of a whole school approach to Respec... more Issue addressed: Our Watch led a complex 12-month evaluation of a whole school approach to Respectful Relationships Education (RRE) implemented in 19 schools. RRE is an emerging field aimed at preventing gender-based violence. This paper will illustrate how from an implementation science perspective, the evaluation was a critical element in the change process at both a school and policy level. Methods: Using several conceptual approaches from systems science, the evaluation sought to examine how the multiple systems layersstudent, teacher, school, community and governmentinteracted and influenced each other. A distinguishing feature of the evaluation included 'feedback loops'; that is, evaluation data was provided to participants as it became available. Evaluation tools included a combination of standardised surveys (with pre-and post-intervention data provided to schools via individualised reports), reflection tools, regular reflection interviews and summative focus groups. Results: Data was shared during implementation with project staff, department staff and schools to support continuous improvement at these multiple systems levels. In complex settings, implementation can vary according to context; and the impact of evaluation processes, tools and findings differed across the schools. Interviews and focus groups conducted at the end of the project illustrated which of these methods were instrumental in motivating change and engaging stakeholders at both a school and departmental level and why. Conclusion: The evaluation methods were a critical component of the pilot's approach, helping to shape implementation through data feedback loops and reflective practice for ongoing, responsive and continuous improvement. Future health promotion research on complex interventions needs to examine how the evaluation itself is influencing implementation. So what? The pilot has demonstrated that the evaluation, including feedback loops to inform project activity, were an asset to implementation. This has implications for other health promotion activities, where evaluation tools could be utilised to enhance, rather than simply measure, an intervention. The findings are relevant to a range of health promotion research activities because they demonstrate the importance of meta-evaluation techniques that seek to understand how the evaluation itself was influencing implementation and outcomes.

Evaluating for impact: what type of data can assist a health promoting school approach?

Health Promotion International, 2016

There is debate within the health promoting school (HPS) movement on whether schools should monit... more There is debate within the health promoting school (HPS) movement on whether schools should monitor health behaviour outcomes as part of an evaluation or rely more on process type measures, such as changes to school policies and the physical and social environment which yield information about (in) effective implementation. The debate is often framed around ideological considerations of the role of schools and there is little empirical work on how these indicators of effective implementation can influence change at a policy and practice level in real world settings. Information has potentially powerful effects in motivating a change process, but this will vary according to the type of information and the type of organizational culture into which it is presented. The current predominant model relies on process data, policy and environmental audit monitoring and benchmarking approaches, and there is little evidence of whether this engages school communities. Theoretical assertions on the importance of monitoring data to motivate change need to be empirically tested and, in doing so, we can learn which types of data influence adoption of HPS in which types of school and policy contexts.

Systems science and systems thinking for public health: a systematic review of the field

BMJ Open, 2015

et al. Systems science and systems thinking for public health: a systematic review of the field.

The Greenhouse Gas Emissions of Various Dietary Practices and Intervention Possibilities to Reduce This Impact

Impact of Meat Consumption on Health and Environmental Sustainability

This chapter examines the link between dietary choices and greenhouse gas (GHG) emissions and pos... more This chapter examines the link between dietary choices and greenhouse gas (GHG) emissions and possible interventions to reduce this impact. The connections between climate change, food systems and public health are explored. It is shown that there is variance in the impact of different food types on GHG emissions, with animal products having the greatest impact. The role of food system activities in the production of GHG emissions is also explored. Dietary choices and GHG emissions are examined using case studies from a variety of countries. Results show that reduced animal food production has increased potential to reduce GHG emissions compared to technological mitigation or increased productivity measures. Finally, a systems science approach is used to explore possible interventions aimed at reducing consumption of animal products.

Community Pharmacy's Role in Promoting Healthy Behaviours

Journal of Pharmacy Practice and Research, 2007

ABSTRACTMany have commented on the potential of community pharmacy as a health promotion setting,... more ABSTRACTMany have commented on the potential of community pharmacy as a health promotion setting, due to accessibility, high level of use, and the respect afforded to pharmacists. Community pharmacy could be a setting through which to address risk and protective health behaviours relevant to Australia's National Health Priority Areas. However, apart from some studies on smoking cessation, there is scant evidence on its involvement in other healthy behaviours. This paper discusses how to increase research and interventions on healthy behaviours in community pharmacy. This includes placing community pharmacy's role within a broader health promotion context, expanding community expectations of pharmacists, and addressing barriers to performing a health promotion role.

The impact of nutritional choices on global warming and policy implications: examining the link between dietary choices and greenhouse gas emissions

Energy and Emission Control Technologies, 2014

Research over the past 10 years has illustrated an important connection between dietary choices, ... more Research over the past 10 years has illustrated an important connection between dietary choices, the food systems required to produce them, and the subsequent impact on greenhouse gas (GHG) emissions. Several recent studies have used data on the GHG contribution of different food types to model the impact of different dietary patterns on GHG emissions; these studies have most commonly compared the average diet for a particular country to healthier dietary options and vegetarian options. We present a systematic review of this research that models different dietary choices and the associated GHG emissions with the main aim in this paper of contrasting the research implications for policy and practice. A database search of CINAHL, ScienceDirect, Scopus, Web of Science, ProQuest, Cochrane Database of Systematic Reviews, and Mednar in July 2014 identified 21 primary studies modeling the GHG emissions related to a dietary pattern published since 1995. Diets containing a higher ratio of plant to animal products were generally associated with lower GHG emissions; however, the results varied across countries and studies, as did the recommendations by the study authors. Some authors proposed leading with health messages that have a dual environmental gain, whereas others proposed messaging around environmental impact. These inconsistencies in recommended approaches to reduce diet-related GHG emissions relate not just to differences in research findings but also to assumptions about community and political support for action, and there is little empirical evidence on community knowledge, attitudes, and behavioral intention at present to support these recommendations. The paper concludes with a commentary on the policy implications and the need for further research on how to frame the issue so as to garner community and political support to address the leading recommendations of this research.

Reducing the Environmental Impact of Dietary Choice: Perspectives from a Behavioural and Social Change Approach

Journal of Environmental and Public Health, 2012

Climate change is recognised as a significant public health issue that will impact on food securi... more Climate change is recognised as a significant public health issue that will impact on food security. One of the major contributors to global warming is the livestock industry, and, relative to plant-based agriculture, meat production has a much higher environmental impact in relation to freshwater use, amount of land required, and waste products generated. Promoting increased consumption of plant-based foods is a recommended strategy to reduce human impact on the environment and is also now recognised as a potential strategy to reduce the high rates of some chronic diseases such as cardiovascular disease and certain cancers. Currently there is a scant evidence base for policies and programs aiming to increase consumption of plant-based diets and little research on the necessary conditions for that change to occur and the processes involved in such a change. This paper reviews some of the environmental and health consequences of current dietary practices, reviews literature on the de...

The Implications of an Evolutionary Perspective on Mental Health Promotion

International Journal of Mental Health Promotion, 2005