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Men’s health and wellbeing: Learning through the lifecourseJohn MacdonaldIntroductionThis chapter draws on new data and insights from international research to provide a background to the question of why men’s health and well-being is a matter that deserves looking at in more depth. It also aims to offer some insights into men and learning in the context of their health and the ways in which a social determinants approach to health can enrich an understanding of men’s health and learning.For some time, thinking about men’s health, both in academic writ-ing and in policy and programmes, has been carried out within two main frameworks: a bio-medical one and what might be called a social-psychological one, based on notions of ‘masculinity’. While both of these approaches may have useful insights, they are increasingly being shown to be an inadequate basis for a comprehensive approach to men’s health, including the structuring of men’s health policies and of programmes aimed at ‘educating’ men about their health. The emergence on the world public health scene of the enormous amount of evidence concerning the social determinants of health (SDOH) presents a fresh way of thinking about men’s health. The World Health Organization (WHO) has led the field (WHO 2003, 2008) and many scholars throughout the world are adding to the available evidence of the impact of social and political environments on people’s health (Marmot, 2005; Macdonald, 2010). The systematic study of social determinants, Men’s health and wellbeing: Learning through the lifecourse 35social epidemiology (Berkman and Kawachi, 2000), is described as looking for the ‘causes of causes’, not just of disease but also of health. This approach calls for consideration of diverse local contexts, societies and populations. There is a considerable body of research on the social determinants of women’s health (Wuest et al., 2002; Anderson, 2006) as well as the inspirational Australian Longitudinal Study on Women’s Health (ALSWH, 2013), which has spent two decades looking at wom-en’s physical and psychosocial health over the lifespan.
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Objective: The objective is to investigate the influence of characteristics related to place of residence (self-reliance and stoicism) on men's intentions to use a telephone support service following radical prostatectomy. Methods: A community sample of 447 prostate cancer patients (31% response), recruited via Medicare Australia, completed a survey to assess levels of self-reliance and stoicism, and beliefs about addressing emotional distress through using telephone support services. Results: Results indicated that the model was a partially mediated model. Geographic remoteness was directly related to intention, and indirectly related through stoicism and subjective norms. Conclusion: Men from rural and remote areas in Australia might face particular challenges in seeking support following treatment for prostate cancer. These challenges appear to relate to the influence of stoic attitudes and normative expectations, than to issues of access and availability. Addressing stoic attitudes in the clinical setting, through normalising emotional reactions to cancer diagnosis and treatment, and the act of help-seeking for emotional support, may be beneficial.Sons, Ltd.
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Managers and staff in primary health care partnerships in local catchments, particularly in regional areas, are periodically required to work collaboratively to set health priorities. Setting priorities involves making decisions about which health needs are most important and what programs will be funded to address them. There is no universally agreed set of decision-making rules for setting priorities. Dominant approaches prioritise health economics, and have favoured expert knowledge drawn from technical-rational methodologies rather than consumer involvement and community action. However, research reveals that setting priorities is a complex, value laden, contested process buffeted by competing objectives and political interests. As such, an interdisciplinary, collaborative approach is called for. Using reflective practice from a priority setting project for a primary care partnership in a local, regional catchment in Victoria, Australia, a conceptual framework for priority setting is presented that identifies 13 interconnected factors spanning economic, political, policy, epidemiological, moral, evidentiary and evaluative domains. This interdisciplinary framework extends current knowledge about the considerations and trade-offs in setting priorities among collaborating primary health care agencies. It offers a potentially valuable heuristic tool for healthcare decision-makers in rural areas.
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Some of the biggest challenges that face gambling research in Australia are discussed. The need is for advocacy and action groups and researchers to work at shaping gambling as a public issue.
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Some of the biggest challenges that face gambling research in Australia are discussed. The need is for advocacy and action groups and researchers to work at shaping gambling as a public issue.
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Therapeutic prevention and/or early intervention programs for children at risk of developing disruptive behaviour disorders are increasingly being implemented in schools. One such Australian school-based program is CAST: CAMHS (Child and Adolescent Mental Health Service) and Schools Together, an evidenced-based program treating children with emerging disruptive behaviour disorders in the early primary school years. The current evaluation examines the process of implementation of the CAST program in primary schools. By using a conceptual model of school-based implementation (developed by Greenberg, Domitrovich, Graczyk & Zins, 2005) the wide array of factors that can affect successful implementation at the school level were identified, and those elements critical to implementation quality were examined. Semi-structured individual and group interviews were conducted with a sample of 69 school personnel across 16 schools in the City of Ballarat and wider Grampians region of Victoria, in both government and Catholic primary schools. Results showed that schools were highly satisfied with the quality of CAST resources and personnel, and the implementation and delivery of sessions as planned. Aspects that impacted negatively on the implementation process were the lack of parental engagement; the lack of classroom follow-up in some schools; the level of readiness and pre-planning by the schools; and the availability of technical support. Greenberg’s conceptual model appears to be a useful framework to utilise in examining the implementation of the CAST model, as it allowed close examination of how the program was implemented within naturally occurring constraints. It allowed the identification of elements within the CAST model and the associated support system that must be maintained and nurtured by the collaborating parties, in addition to the factors at a school level that are potential barriers to effective implementation. Identification and examination of such factors assist in ensuring quality outcomes for school-based interventions in the future.
Description:
Therapeutic prevention and/or early intervention programs for children at risk of developing disruptive behaviour disorders are increasingly being implemented in schools. One such Australian school-based program is CAST: CAMHS (Child and Adolescent Mental Health Service) and Schools Together, an evidenced-based program treating children with emerging disruptive behaviour disorders in the early primary school years. The current evaluation examines the process of implementation of the CAST program in primary schools. By using a conceptual model of school-based implementation (developed by Greenberg, Domitrovich, Graczyk & Zins, 2005) the wide array of factors that can affect successful implementation at the school level were identified, and those elements critical to implementation quality were examined. Semi-structured individual and group interviews were conducted with a sample of 69 school personnel across 16 schools in the City of Ballarat and wider Grampians region of Victoria, in both government and Catholic primary schools. Results showed that schools were highly satisfied with the quality of CAST resources and personnel, and the implementation and delivery of sessions as planned. Aspects that impacted negatively on the implementation process were the lack of parental engagement; the lack of classroom follow-up in some schools; the level of readiness and pre-planning by the schools; and the availability of technical support. Greenberg’s conceptual model appears to be a useful framework to utilise in examining the implementation of the CAST model, as it allowed close examination of how the program was implemented within naturally occurring constraints. It allowed the identification of elements within the CAST model and the associated support system that must be maintained and nurtured by the collaborating parties, in addition to the factors at a school level that are potential barriers to effective implementation. Identification and examination of such factors assist in ensuring quality outcomes for school-based interventions in the future.
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The ageing population and associated burgeoning health care costs have resulted in a shift of care from institutional settings to home and community-based care. As one example, rehabilitation-in-the-home (RITH) programs are becoming increasingly prevalent. These programs either substitute or supplement in-hospital treatment by providing multidisciplinary rehabilitation and support services in the client's own home. This paper investigates the impact of RITH programs on informal carers. Semi-structured interviews carried out with caregivers and staff revealed a complex and contradictory interpretation of informal caring. Analysis of carers' interviews revealed: an assumption by themselves and others (including RITH staff) that they would provide care; the intimate, arduous and relentless work of caring; lack of consultation about discharge; lack of recognition and reimbursement; and low levels of program support for them as carers. Carers are integral to the successful rehabilitation of the client, but they occupy a marginal status within the program. An invisible contract consigns to them substantial care-work that was previously provided by the hospital. Informal carers in RITH programs can be seen as disenfranchised care contractors. This has implications for policy makers, program managers and researchers.
Description:
The ageing population and associated burgeoning health care costs have resulted in a shift of care from institutional settings to home and community-based care. As one example, rehabilitation-in-the-home (RITH) programs are becoming increasingly prevalent. These programs either substitute or supplement in-hospital treatment by providing multidisciplinary rehabilitation and support services in the client's own home. This paper investigates the impact of RITH programs on informal carers. Semi-structured interviews carried out with caregivers and staff revealed a complex and contradictory interpretation of informal caring. Analysis of carers' interviews revealed: an assumption by themselves and others (including RITH staff) that they would provide care; the intimate, arduous and relentless work of caring; lack of consultation about discharge; lack of recognition and reimbursement; and low levels of program support for them as carers. Carers are integral to the successful rehabilitation of the client, but they occupy a marginal status within the program. An invisible contract consigns to them substantial care-work that was previously provided by the hospital. Informal carers in RITH programs can be seen as disenfranchised care contractors. This has implications for policy makers, program managers and researchers.
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Lifeline Australia Inc. provides a free 24-hour telephone counselling and referral service to all Australians. The trained telephone counsellors of the service record information on many of their calls in Lifeline's Client Service Management Information System (CSMIS). This paper presents a descriptive summary of a national CSMIS data set, which was compiled during a 3-month period in 2003. The CSMIS data provided a clear national profile of the callers to the service. The results of this study support the hypothesis that callers are generally seeking social support from the service. The discussion explores the implications of this finding for Lifeline and other generalist counselling and referral services and their capacity to offer suicide intervention to the community.
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This paper investigates the health and welfare needs of students (n = 15,806) and the current service model in Catholic schools in the Ballarat Diocese of Victoria, Australia. Catholic schools use a service model underpinned by an ethos of pastoral care; there is a strong tradition of self-reliance within the Catholic education system for meeting students' health and welfare needs. The central research questions are: What are the emerging health and welfare needs of students? How does pastoral care shape the service model to meet these needs? What model/s might better meet students' primary health care needs? The research methods involved analysis of(1) extant databases of expressed service needs including referrals (n = 1,248) to Student Services over the last 2.5 years, (2) trends in the additional funding support such as special needs funding for students and the Education Maintenance Allowance for families, and (3) semi-structured individual and group interviews with 98 Diocesan and school staff responsible for meeting students' health and welfare needs. Analysis of expressed service needs revealed a marked increase in service demand, and in the complexity and severity of students' needs. Thematic analysis of qualitative interview data revealed five pressing issues: the health and welfare needs of students; stressors in the school community; rural isolation; role boundaries and individualised interventions; and self-reliant networks of care. Explanations for many of these problems can be located in wider social and economic forces impacting upon the church and rural communities. It was concluded that the pastoral care model-as it is currently configured-is not equipped to meet the escalating primary health care needs of students in rural areas. This paper considers the implications for enhanced primary health care in both rural communities and in schools.
Description:
This paper investigates the health and welfare needs of students (n = 15,806) and the current service model in Catholic schools in the Ballarat Diocese of Victoria, Australia. Catholic schools use a service model underpinned by an ethos of pastoral care; there is a strong tradition of self-reliance within the Catholic education system for meeting students' health and welfare needs. The central research questions are: What are the emerging health and welfare needs of students? How does pastoral care shape the service model to meet these needs? What model/s might better meet students' primary health care needs? The research methods involved analysis of(1) extant databases of expressed service needs including referrals (n = 1,248) to Student Services over the last 2.5 years, (2) trends in the additional funding support such as special needs funding for students and the Education Maintenance Allowance for families, and (3) semi-structured individual and group interviews with 98 Diocesan and school staff responsible for meeting students' health and welfare needs. Analysis of expressed service needs revealed a marked increase in service demand, and in the complexity and severity of students' needs. Thematic analysis of qualitative interview data revealed five pressing issues: the health and welfare needs of students; stressors in the school community; rural isolation; role boundaries and individualised interventions; and self-reliant networks of care. Explanations for many of these problems can be located in wider social and economic forces impacting upon the church and rural communities. It was concluded that the pastoral care model-as it is currently configured-is not equipped to meet the escalating primary health care needs of students in rural areas. This paper considers the implications for enhanced primary health care in both rural communities and in schools.
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This project was funded by the Victorian Government Department of Human Services and the Moorabool Shire Council and is currently being used to inform future health and welfare service provision in the Moorabool Shire.
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This project was funded by the Victorian Government Department of Human Services and the Moorabool Shire Council and is currently being used to inform future health and welfare service provision in the Moorabool Shire.
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The aim of this paper is to consider the implications for rural social work practice of the widespread and severe drought coupled with the emergence of water markets in Australia. The National Water Initiative was signed at the June 2004 Council of Australian Governments meeting with the aim of producing a nationally-compatible, market, regulatory and planning-based system of managing water resources to optimise economic, social and environmental outcomes. The National Water Commission and the National Competition Council have since assessed progress on the implementation of the initiative: none of their reports gives adequate consideration to the impact of water reform on rural communities. In this paper, we draw upon previous research and written submissions made to the Commission and the Council to examine the social and political consequences of the drought and the emergence of water markets. We discuss the implications for rural practice, and conclude by proposing seven recommendations to assert the role of rural social workers as change agents. This role could encompass community education and advocacy, piloting schemes such as community water banks, reinstating community development in social work curriculum, and facilitating collaborative rural partnerships.