The emergence of integrated approaches to worker health, safety and wellbeing in Australia.

Integrated approaches to worker health, safety and wellbeing have been progressively developed and implemented internationally for over a decade; however, implementation in the Australian context is still in the early stages. Integrated workplace interventions recognise the interaction between health protection and health promotion to create a workplace culture in which health, safety and wellbeing are valued and managed efficiently, together with a view to improve organisational productivity. The present paper describes the progress of integrated approaches in six Victorian workplaces considered early adopters and identifies the drivers for further policy and program development in this area. Using a qualitative exploratory multiple case study design, organisational documents were systematically analysed and semi-structured interviews were conducted in six organisations that met criteria for an integrated approach. Key mechanisms to support this approach were observed, including active leadership, the development of an integrated committee for activities, clear strategies to engage employees and an existing commitment to safety practices. The prioritisation within a workplace to integrate health, safety and wellbeing, and ensure sustainability of these approaches, was detected as a gap for future development.

Compassion Fatigue among Healthcare, Emergency and Community Service Workers: A Systematic Review.

Compassion fatigue (CF) is stress resulting from exposure to a traumatized individual. CF has been described as the convergence of secondary traumatic stress (STS) and cumulative burnout (BO), a state of physical and mental exhaustion caused by a depleted ability to cope with one's everyday environment. Professionals regularly exposed to the traumatic experiences of the people they service, such as healthcare, emergency and community service workers, are particularly susceptible to developing CF. This can impact standards of patient care, relationships with colleagues, or lead to more serious mental health conditions such as posttraumatic stress disorder (PTSD), anxiety or depression. A systematic review of the effectiveness of interventions to reduce CF in healthcare, emergency and community service workers was conducted. Thirteen relevant studies were identified, the majority of which were conducted on nurses (n = 10). Three included studies focused on community service workers (social workers, disability sector workers), while no studies targeting emergency service workers were identified. Seven studies reported a significant difference post-intervention in BO (n = 4) or STS (n = 3). This review revealed that evidence of the effectiveness of CF interventions in at-risk health and social care professions is relatively recent. Therefore, we recommend more research to determine how best to protect vulnerable workers at work to prevent not only CF, but also the health and economic consequences related to the ensuing, and more disabling, physical and mental health outcomes.

A scoping review of end user involvement in disability research.

BACKGROUND: Involving clients and consumers of health care in research, policy and health service development has been widely advocated for across a number of different fields and disciplines. Despite some promising evidence, 'end users' have not been meaningfully involved in all stages of the research process in the area of disability research. OBJECTIVE: To conduct a scoping review on end user involvement in disability research, service and policy development. METHODS: Literature was searched using electronic databases, hand searching reference lists of papers and grey literature. Electronic databases searched included the Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, CINAHL, PsycINFO and Google Scholar. The search was restricted to articles published in English between January 2000 and April 2013. RESULTS: Two clear themes emerged from a review of twenty-seven articles. Firstly, end users can benefit research as 'experts of experience' through their role as a co-researcher. Secondly, evidence suggests end users add value at different stages of the research process in this role. However, less is understood about end user involvement in the latter stages of the research process. CONCLUSIONS: This review suggests that end users can meaningfully contribute to the quality of disability research. End users are likely to engage in research with differing perspectives, desires to be involved at distinct stages of the process, differing roles and different abilities to participate in the research. Academic rigor, however, must be maintained by the researcher.

Empowering vulnerable parents through a family mentoring program.

Evidence suggests that mentoring programs can foster positive relationships through role modelling, social support and opportunities to develop new skills. Home visiting programs, where a health professional or volunteer provides parenting support and companionship to at-risk families, have received attention from the health and welfare sector. These programs tend to focus on new mothers and immediate parenting concerns, and do not address broader social determinants of health that impact on the well being and functionality of the family. Herein we report on an evaluation of the Creating Opportunities and Casting Hope (COACH) program, a family mentoring program for vulnerable parents. COACH seeks to break cycles of generational poverty by addressing social determinants, such as housing, employment, health, finances and social support. A mixed-methods approach was used to evaluate the program, involving semistructured interviews with parents (n = 12), surveys with mentors (n = 27) and client case report review (n = 27). Parents experienced improvements in their housing and employment situations, family dynamics, social support and mental health, and decreased drug and alcohol use. Mentors described providing guidance on parenting strategies, financial management and domestic skills. Partnerships with local schools, health services and welfare agencies were vital in the referral processes for families, thereby building a community network of support and care. The COACH model of mentoring highlights the benefits of a flexible and long-standing program to address the social determinants of child health through the family environment and wider social and economic factors.

Exploring the partnership networks of churches and church-affiliated organisations in health promotion.

Health promotion professionals often work with community organisations and voluntary associations, including churches and church-affiliated organisations, to reduce health inequities within communities. How voluntary and church-affiliated organisations form intersectoral relationships and partnerships, and the challenges they face in doing so, has been well researched. However, there is a need to investigate further the extent to which local churches collaborate or form partnerships with other actors, such as government, peak bodies and welfare organisations. This paper reports a Victorian-based mapping exercise of partnerships and funding involving document analysis of the annual reports from 126 organisations and 35 interviews conducted with church-affiliated organisations and local churches. The discussion begins with the exploration of the nature of, and the reason why churches partner with other sectors. The paper also examines funding sources and partnership pathways that churches access to undertake the activities and programs they conduct. Interview themes highlight the value to churches of the sharing of expertise and resources, the provision of support to communities, a shared ethos of social justice and the empowerment of vulnerable populations. The findings about the extent to which local churches are involved in partnerships across society, and the extent of public and private funds they draw on to provide resources and assistance to local communities, indicate that churches are now a key player not just in welfare provision but also in health promotion activities. The findings contribute to the understanding of church activities in relation to health promotion and will assist organisations who may be potential partners to consider their collaborative efforts in the health promotion field.

Partnership tools for health promotion: are they worth the effort?

In health promotion and community sector programs, working through partnerships has become a key strategy for capacity building and infrastructure development that is intended to achieve better health outcomes. Government and funding agencies are providing significant support for partnership work in the apparent belief that partnerships are more likely to improve sustainability of programs and their outcomes than single agencies working alone. Online partnership analysis tools are designed for organisations to measure the effectiveness of their collaborative endeavours, and to demonstrate to funding bodies that the partnership was worthwhile. The tools are predominantly self-assessment evaluation tools but there is a lack of clarity about what these tools actually set out to measure. Self-assessment tools assist partners to recognise strengths and weaknesses in their practice, but analysis of their intentions indicates that there are significant problems with the 'snapshot' data that is generated in terms of analysing effectiveness. Partnership work is complex, dynamic and context specific with varying synergistic rewards which cannot always be represented in survey tools. This article reports analysis of online self-assessment partnership tools which have data-generating capacity, to determine just what they measure and to understand how effective they can be in evaluating collaborative practice. Criteria for analysis were developed from a review of the existing literature. The review and analysis has highlighted that practitioners must consider what they are measuring and for what purpose they seek to evaluate before utilising and implementing a partnership analysis tool.

Workforce development to embed mental health promotion research and evaluation into organisational practice.

ISSUES ADDRESSED: This project engaged a mental health rehabilitation organisation in health promotion research and development to build its capacity in evaluation research. METHODS: Participatory research methods were used. Staff skills development occurred through training in research and evaluation methods applied to an evaluation project in mental health promotion that they conducted. RESULTS: All staff had some previous training in research but little, if any, experience of research practice. Staff demonstrated commitment to the idea of embedding research practice into the organisation to strengthen its ability to demonstrate program outcomes. However, the realities of work demands eventually took precedence over the tasks involved in the research process. Staff commitment, knowledge and skills are not sufficient if an organisation lacks the capacity to provide the resources or foster support for a research culture. CONCLUSIONS: The health promotion capacity-building framework is relevant for efforts to build health promotion research into mental health organisations. This project demonstrated that workforce development to build the capacity for mental health promotion is more likely to be successful if it is embedded into organisational strategy and culture, has sufficient resources allocated including staff time, and is supported by management.