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Biomedical subjects

R J Donovan

Publications and source records attributed to R J Donovan.

At least 37 records · Page 2Linked to original sources
PubMed1999

Targeting male perpetrators of intimate partner violence: Western Australia's "Freedom from Fear" campaign.

Violence against women by their partners is now recognized as a major international public health problem, in both developed and developing countries. For example, it is estimated that each year in the US, 4 million women experience a serious assault by their partner and that the victim-related economic cost of partner violence is about US$67 billion. Traditional domestic violence campaigns focus on legal threats and sanctions in an attempt to stop men from being violent. While incarcerating violent men and issuing protection orders are necessary components of domestic violence prevention interventions, they do not--and cannot--remove women's fear of the man reappearing at some future time or place, often with tragic consequences. Furthermore, many women do not want to leave the relationship, nor do they want the man incarcerated; they simply want the violence to stop. The Western Australian "Freedom From Fear" campaign is an innovative social marketing initiative that acknowledges these factors and aims to reduce the fears of women (and children) by motivating perpetrators and potential perpetrators to voluntarily attend counseling programs.

Australia↗
PubMed1998

Assessing the reliability of a stage of change scale.

The purpose of this study was to assess the test-retest reliability of a scale measuring Prochaska's stages of change. Although structured questionnaire items are being increasingly used to segment target audiences according to Prochaska and DiClemente's stages of change, we could find only one report in the literature assessing the reliability of such scales. The unreliability of single-item or algorithm questionnaire scales might be why a number of studies show only minimal differences on some variables between individuals in different stages of change. A survey of the Perth metropolitan general population aged 16-69 years (N = 2629) was completed in August-September 1992 as part of a 3 year evaluation of the Western Australian Health Promotion Foundation. The consistency of respondents' responses was assessed across two questions measuring stages of change for the behaviours quitting smoking (n = 404), reducing alcohol consumption (n = 57) and doing more exercise (n = 704). Given the immediacy of the test-retest situation, the reliability results are moderately encouraging: kappa = 0.72, 0.73 and 0.52 for quitting smoking, reducing alcohol and doing more exercise, respectively. Health researchers should be aware of the probable moderate level of reliability if using the type of scale assessed in this study, when interpreting differences between individuals in different stages. In practice, several questionnaire items for classification purposes should be used so that internal reliability measures can be calculated. It is recommended that research be undertaken to devise more reliable scales for stages of change for the various health behaviours. It is noted that the attitude literature with respect to context and time specific intentions could be helpful in devising such scales.

Adolescent↗
PubMed1998

Nurses screening for skin cancer: an observation study.

Skin cancer rates in Australia are the highest in the world and it is an important cause of mortality and morbidity. Screening is a method of control for skin cancer/melanoma through early diagnosis and prompt referral and treatment. To date, there have been no controlled trials evaluating the impact of screening on morbidity and mortality, and hence insufficient evidence to recommend for or against routine screening for skin cancer/melanoma by primary care providers. Australian health authorities have called for studies that investigate the viability of using trained observers apart from medical practitioners--such as nurses, pharmacists and physiotherapists--in opportunistic screening for skin cancer in populations that have a high prevalence of these skin cancers, largely on the basis of cost arguments. We conducted a double blind observation screening study comparing the performance of nurses to those plastic surgeons participating in a skin cancer screening program. The role of the nurse in this program was not to diagnose skin cancer, but to not miss lesions that required further specialist examination. Measurements were recorded for 256 screenees. Plastic surgeons issued 77 (30%) individual referrals for lesions suspicious of being skin cancer. Nurse observations noted 73 (95%) of these 77 cases. The case for the pre-screening of large populations for skin/cancer by trained nurses warrants further attention.

Clinical Competence↗
PubMed1997

Towards guidelines for survey research in remote Aboriginal communities.

Based on our experience in developing and evaluating community-based health promotion programs in Aboriginal and Torres Strait Islander communities, we offer guidelines to assist nonindigenous health and public policy professionals whose information gathering in these communities includes the use of unstructured interviewing or survey questionnaires. The guidelines primarily apply to research among mainland remote Aboriginal communities, but are placed in a cultural context such that those dealing with Torres Strait Islanders and rural or urban community Aborigines also may benefit from the guidelines. The major aims of these guidelines are to facilitate communication between interviewers and indigenous interviewees and to ensure that interviewing is done with maximum sensitivity to cultural differences and with minimum discomfort to the respondents.

Australia↗
PubMed1997

Face-to-face household interviews versus telephone interviews for health surveys.

The purpose of this study was to compare response distributions in health surveys for two interview modes: face-to-face household interviews and telephone interviews. There were two samples of the Perth metropolitan general population aged 16 to 69 years: a face-to-face household sample (n = 1000) and a telephone sample (n = 222). The samples were generated by probability-based methods commonly used by commercial market research organisations. The surveys occurred in August-September 1992 as part of a larger statewide survey component of a three-year evaluation of the Western Australian Health Promotion Foundation. Respondents were drawn from a two-stage cluster sample based on private dwellings for personal interviews, and from randomly selected listed and unlisted private numbers for telephone interviews. Although the samples did not differ significantly on a number of variables, the telephone sample was significantly higher in residential social status; there was significantly lower reporting of smoking and lower unsafe alcohol consumption in the telephone sample: significantly higher proportions of the telephone sample were in Prochaska's 'action' stage of change for several health behaviours; and there was significantly greater recall of health messages in the telephone sample. Health researchers should treat comparisons between different survey modes with caution, and should be aware that campaign evaluations using telephone surveys and household surveys may yield substantially different results.

Adolescent↗
PubMed1997

Warning: attending a sport, racing or arts venue may be beneficial to your health.

Concerted efforts to create health-promoting sport, racing and arts venues have become possible since the advent of health promotion foundations in four of Australia's eight states and territories. Large numbers of Australians attend sport, racing and arts venues in pursuit of leisure activities. There is evidence that sport and racing participants and spectators, and certain subgroups of the arts community, have adverse risk-factor profiles that make them an ideal target for health promotion interventions. Through the use of sponsorship, health promotion foundations 'purchase' health-promoting policies in sport, racing and arts settings-policies that have the potential to become institutionalised once sponsorship dollars are depleted. This paper discusses the policies 'purchased' by the foundations and outlines a comprehensive surveillance and evaluation system developed for the Western Australian Health Promotion Foundation. The system monitors the implementation of health-promoting environments at the micro level (sponsorship project); intermediate level (sponsored group); and macro level (community). The article concludes by outlining some of the lessons learned in Western Australia. These provide the basis for development of best practice in working with sport, racing and arts groups, and other sectors outside health, to create health-promoting environments.

Advertising↗
PubMed1997

Banning tobacco sponsorship: replacing tobacco with health messages and creating health-promoting environments.

OBJECTIVE: To evaluate the replacement of Western Australian tobacco sponsorship with health promotion sponsorship by the Western Australian Health Promotion Foundation (known as "Healthway"), following the Tobacco Control Act 1990. DESIGN: Process measures of performance were collected from 25 tobacco replacement projects (sponsorship by Healthway of sport, racing, and arts groups previously supported by tobacco companies) and 727 other health sponsorship projects, that is, new sponsorship provided by Healthway to these groups. Cross-sectional survey data were obtained from 917 respondents at tobacco replacement and 2352 at other sponsorship venues. SETTING: Sport, racing, and arts venues sponsored by the Western Australian Health Promotion Foundation (Healthway) in 1991-95. MAIN OUTCOME MEASURES: Population reach, occasions of media publicity, healthy structural changes, cognitive/attitudinal impact of health messages, and the prevalence of five health-risk behaviours. RESULTS: Tobacco replacement and other sponsorship projects achieved comparable performance in publicity for health messages and in healthy structural change, but replacement projects achieved a fourfold higher level of direct population reach for a given amount of funding. Structural change towards a smoke-free environment occurred more often in tobacco replacement projects and a permanent smoke-free policy was achieved in 47% of projects, compared with 15% in other sponsorship projects. The prevalence ratio of current smoking at tobacco replacement venues was 1.86 (95% confidence interval 1.62 to 2.04) relative to other sponsorship venues. There was evidence of higher cognitive resistance to health messages at venues previously sponsored by tobacco companies. CONCLUSIONS: A comprehensive ban on tobacco sponsorship linked to health promotion activities funded by tobacco tax delivers potential public health benefits that exceed those achieved by prohibition of tobacco sponsorship alone. Tobacco replacement venues offer opportunities for environmental modification, promotion of anti-smoking messages, and targeting groups that are hard to reach.

Advertising↗
PubMed1997

Using sponsorship to promote health messages to children.

A survey of children aged 8 to 14 years attending a three-day football clinic was undertaken to examine the relative impact of different sponsorship strategies used to promote health messages. It was found that promotional clothing worn by role models was an effective method for promoting a specific health message (i.e., "Smoking? No Way!"). Personal endorsement of the health message by an external role model and, to a lesser extent, personal endorsement by clinic leaders and promotional clothing worn by clinic leaders and external role models were also effective in promoting a general health message (i.e., "Don't smoke"). The implications for health sponsorship and the promotion of commercial products to children are discussed.

Adolescent↗
PubMed1996

The use of targeted and non-targeted advertising to enrich skin cancer screening samples.

The purpose of this study was to determine whether the risk factor profile of persons attending skin cancer screening clinics could be enriched by appropriate advertising prior to the screening events. Eleven screening clinics were held in eight rural and three suburban communities. Matched communities were randomly assigned to either a target or non-target condition. Targeted communities received an advertisement designed to attract high-risk individuals. The advertisement listed a number of risk factors and encouraged readers with one or more of the listed risk factors to attend the screening. Non-targeted communities received a general advertisement requesting individuals who felt they were at risk of skin cancer to attend the clinic. Risk factor profiles of all participants were measured on the factors listed in the targeted advertisement. The risk factor profiles of screenees and the referral rates for skin lesions requiring attention were significantly higher in the targeted communities than in the non-targeted communities. Lesions suspicious of malignant melanoma or Hutchinson's melanotic freckle also were higher, but not statistically significant, in the targeted communities. Population samples attending community-based skin cancer screening clinics can be enriched by appropriate targeted advertising prior to the screening events. This has important implications for determining the potential cost-effectiveness of population screening programmes.

Adolescent↗
PubMed1995

Misclassification of social disadvantage based on geographical areas: comparison of postcode and collector's district analyses.

BACKGROUND: Analysis of socioeconomic status (SES), defined on the basis of geographical area, will always be subject to misclassification of individuals. We studied the relationship between SES and selected health-related measures when SES was defined firstly on the basis of postcode and secondly on the basis of the smaller spatial area of collector's district (CD). METHOD: A Census population of 1.4 million was used to investigate the misclassification of individuals to SES group using postcode as opposed to CD. A field survey of 1000 respondents and a mortality register of 1756 deaths were used to compare the relationship between SES and certain outcome variables, when SES group was assigned using postcode and CD. Misclassification probability matrices were used to try to adjust the postcode-based results to approximate CD-based results. RESULTS: The Census data showed that nearly 50% of residents were misclassified into SES groups by the postcode-based system compared with a CD-based system. In comparing the most socially disadvantaged group with the least disadvantaged group, the postcode analysis underestimated the absolute effects of SES by 58% for the increased prevalence of smoking, by 19% for the reduced prevalence of participation in junior sporting clubs and by 13% for the increased mortality rate at ages 0-64 years. Adjustment of postcode-based results using misclassification matrices proved fruitless due to differential misclassification and technical difficulties. CONCLUSIONS: Misclassification of individuals to SES groups on the basis of postcode has caused an underestimation of the true relationship between SES and health-related measures. A reduction of this misclassification by using smaller spatial areas, such as CD or census enumeration districts, will provide improved validity in estimating the true relationship.

Adolescent↗
PubMed1995

Epidemiological measures of participation in community health promotion projects.

BACKGROUND: The paper is concerned with the use of epidemiological methods to measure the rates at which different strata of a defined population participate in community health promotion projects. The specific aim was to estimate the incidence rates of participation in projects sponsored by the Western Australian Health Promotion Foundation (Healthway), separately for sociodemographic and health-related behavioural subgroups. METHODS: Data were drawn from Healthway sponsorship projects in 1992. Each sport, arts and racing project was associated with promotion of a health message and creation of a health promoting environment. The study used a two-stage sampling design. Thirteen of 57 large sponsorship projects and 30 of 129 small projects were selected. In the second stage, respondents were randomly surveyed from among project participants. A total of 4060 respondents aged > or = 10 years was sampled from the 43 selected projects. Population-based incident participants were estimated and were related to person-years at risk. RESULTS: The total participation rate was 4.01 per person-year. The rate was very high at ages 10-14 years and thereafter declined with increasing age. Compared with the least socially disadvantaged 25% of population, the participation rate fell by around one-third in the medium and high disadvantage groups, but exceeded the baseline by a ratio of 1.85 (95% confidence interval: 1.57-2.18) in the most disadvantaged 10% of population. The effect was most pronounced at ages 10-19 years. Participation was higher in those who smoked, drank alcohol unsafely, reported sunburn and reported low consumption of fruit and vegetables. However, participation was reduced in people who were sedentary. CONCLUSIONS: Epidemiological methods can be used to evaluate the distribution of participation of a population in community health promotion projects. The Western Australian Health Promotion Foundation has been successful in reaching disadvantaged youth.

Adolescent↗
PubMed1992

Recall of AIDS public service announcements and their impact on the ranking of AIDS as a national problem.

The efficacy of two public service announcements from Phase V of the "America Responds to AIDS" (ARTA) campaign was assessed at two sites. Participants were randomly assigned to view a local news program, one with an ARTA public service announcement appearing six times and the other with no AIDS public service announcements. During telephone interviews with 907 participants 1 to 3 nights after viewing, 21% at Site A and 59% at Site B could correctly recall the ARTA public service announcements. Absolute mentions of AIDS as an important national issue increased.

Acquired Immunodeficiency Syndrome↗