Dietary diversity in Khon Kaen, Thailand, 1988 2006.
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Commerce↗
Biomedical subjects
Jane Dixon
Publications and source records attributed to Jane Dixon.
Palliative care program effectiveness research: developing rigor in sampling design, conduct, and reporting.
Research on palliative care presents some unique sampling challenges. The purpose of this paper is to articulate the sampling challenges that palliative care researchers face during phases of study design, conduct, and the reporting of results. Challenges include identifying a target population, avoiding selection bias in the face of clinician and patient denial of serious illness, developing eligibility criteria for a seriously ill population, minimizing high patient refusals due to illness, and accurate reporting of all screened and eligible participants. These challenges are explored within the context of a randomized clinical trial testing a palliative care intervention. Suggestions for improving scientific rigor in sampling design include 1) defining a target population that is consistent with research goals; 2) identifying eligibility criteria that are objective and understandable to clinicians to yield the desired sample; and 3) reporting results about the target population, sample eligibility/exclusions, and participation using standardized criteria.
Biomedical Research↗
Reflections on expert consensus: a case study of the social trends contributing to obesity.
BACKGROUND: In Australia, as elsewhere in the developed world, researchers and policy makers have expressed concern about rising rates of obesity. Explanations for the increasing weight of the Australian population have focused on both declining levels of physical activity and changes in food consumption patterns. METHODS: The primary aim of our study was to determine the views of obesity, dietary and physical activity experts, about the most important social trends that have contributed to Australia's obesogenic environment over the last 50 years. We used a modified Delphi technique to successfully contact 50 such experts to obtain their views on this topic. The process involved a semi-structured interview with each expert to identify the trends and then a round of ranking of the trends by these experts. A second aim was to comment on the utility of expert opinion in public policy. RESULTS: The experts identified the most important social trends as 'escalating car reliance', 'increasing "busy-ness" and lack of time' and 'rising use of convenience and pre-prepared food'. Because we asked experts to explain their responses, a diversity of opinion emerged on both the aetiology of these trends and how the environment is embodied to produce rising levels of obesity. CONCLUSION: We reflect on the implications of this dissensus for the utility of expert opinion in public policy and argue that one way through the smorgasboard of competing expert explanations for health differentials, including obesity levels, is practice-based evidence gathered through community level action research.
Australia↗
The GuideLine Implementability Appraisal (GLIA): development of an instrument to identify obstacles to guideline implementation.
BACKGROUND: Clinical practice guidelines are not uniformly successful in influencing clinicians' behaviour toward best practices. Implementability refers to a set of characteristics that predict ease of (and obstacles to) guideline implementation. Our objective is to develop and validate a tool for appraisal of implementability of clinical guidelines. METHODS: Indicators of implementability were identified from the literature and used to create items and dimensions of the GuideLine Implementability Appraisal (GLIA). GLIA consists of 31 items, arranged into 10 dimensions. Questions from 9 of the 10 dimensions are applied individually to each recommendation of the guideline. Decidability and Executability are critical dimensions. Other dimensions are Global, Presentation and Formatting, Measurable Outcomes, Apparent Validity, Flexibility, Effect on Process of Care, Novelty/Innovation, and Computability. We conducted a series of validation activities, including validation of the construct of implementability, expert review of content for clarity, relevance, and comprehensiveness, and assessment of construct validity of the instrument. Finally, GLIA was applied to a draft guideline under development by national professional societies. RESULTS: Evidence of content validity and preliminary support for construct validity were obtained. The GLIA proved to be useful in identifying barriers to implementation in the draft guideline and the guideline was revised accordingly. CONCLUSION: GLIA may be useful to guideline developers who can apply the results to remedy defects in their guidelines. Likewise, guideline implementers may use GLIA to select implementable recommendations and to devise implementation strategies that address identified barriers. By aiding the design and operationalization of highly implementable guidelines, our goal is that application of GLIA may help to improve health outcomes, but further evaluation will be required to support this potential benefit.
Benchmarking↗
Exploring the intersectoral partnerships guiding Australia's dietary advice.
In 1986, the Ottawa Charter alerted a new generation of health promotion practitioners to the benefits of working with the non-health sectors, including the commercial sector. Since then, the establishment of partnerships with government and non-government bodies has been advanced as a positive way of fostering policies that enhance health and well-being. The food and nutrition field has enthusiastically adopted partnerships between government, non-government and industry. In this article, we focus on the tactics employed by industry bodies to further their cause in a range of fields that are characterized by risk and contestation. We describe the nature of the alliances and interactions between commercial, scientific and government groups whose stated aim is to improve Australia's diet. Our analysis shows that these partnerships have been guided less by the ethos of the Ottawa Charter and more by the interests of the various parties: namely the food industry's need for credibility in making health claims, the financial imperatives of professional bodies and scientists whose public funding is inadequate, and government endorsement of public-private partnerships as the preferred mechanism for service delivery. The symbiotic relationship that is emerging between segments of the food industry and the nutrition professions raises questions about the independence of the dietary advice being given to consumers. We conclude by arguing for a research programme to investigate the consequences of intersectoral partnerships on the nutritional status of the population.
Australia↗
How can a government research and development initiative contribute to reducing health inequalities?
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Journal Article↗
Screening for pesticide exposure: a case study.
Pesticide use is ubiquitous in the United States in both agricultural and urban environments. Although pesticide exposure can occur anywhere, migrant and seasonal farmworkers in medically underserved communities are at particular risk. Health care providers often feel ill-equipped to recognize or manage pesticide exposure or pesticide-related illness. In 2002, the National Environmental Education Foundation published a series of reports that describe national goals for improving the recognition, management, and prevention of pesticide-related health conditions. This article illustrates how to diagnose and manage pesticide exposures by analyzing a pesticide exposure case using a framework suggested by the National Environmental Education Foundation. Basic screening techniques and available resources for use in the primary care setting are presented.
Agriculture↗
Instrument translation and evaluation of equivalence and psychometric properties: the Chinese Sense of Coherence Scale.
Translating well-established English instruments into target languages other than English and testing cross-cultural validity to prove that the same attributes are being measured in each cultural group or country are required before a multicultural or international study can be conducted and cross-cultural comparisons of study results can be applied. However, rigorous and systematic cross-cultural efforts to test the effectiveness of specific translation methods are rare. This article presents a model of translation processes and empirical validation of the translated instrument through description of the translation of a selected instrument--the Sense of Coherence (SOC) Scale--from English into Chinese. A cyclic process of forward translations, back translations, and expert evaluation of equivalence by bilingual and English speaking experts was conducted to achieve conceptual equivalence between the original and translated instruments. Empirical validation of the Chinese SOC scale data from a group of bilingual Chinese people demonstrated non-identical, but comparable, item and scale means and variances, internal consistency, and relationships to an external criterion. Advantages and difficulties of using multi-rounds, multi-experts, and multi-methods to establish translation equivalence and to validate the translated Chinese SOC scale are discussed.
Adaptation, Psychological↗