Citizen science as a vehicle to address multiple policy objectives: Case studies from Australia.

ISSUE ADDRESSED: Despite increasing interest in citizen science as an approach to engage members of the public in research and decision making about health and wellbeing, there is a lack of practical evidence to guide policy and practice organisations to utilise these approaches. In this study we investigated how and why citizen science came to be incorporated into the work of two policy organisations. METHODS: We offer two in-depth case studies of Australian government organisations which have utilised citizen science in environmental and healthy ageing policy. Interviews with organisational informants and relevant documents were analysed inductively to explore how citizen science came to be adopted, legitimised and supported. RESULTS: Citizen science was utilised to address multiple organisational objectives, including increasing community participation in science; enhancing individuals' wellbeing, learning, and skills, and generating data to support research and policy in a relatively cost-effective manner. In both cases, grant funding was a mechanism to support citizen science, with project delivery facilitated through academic-policy partnerships and led by external academic or community partners. CONCLUSION: Although citizen science is relatively new in policy and practice settings, this study underscores the value of these approaches in realising co-benefits for organisations, academics, and community members. The support and advocacy of senior managers as 'champions', and a willingness to invest in trialling new approaches to address policy problems are necessary ingredients to foster acceptance and legitimacy of citizen science. SO WHAT?: Citizen science initiatives can be strategically utilised by health promotion organisations to enact priorities related to genuine community involvement, support research and innovation and facilitate collaboration and partnerships between academic, policy and community stakeholders.

Harnessing citizen science in health promotion: perspectives of policy and practice stakeholders in Australia.

Citizen science is rapidly gaining momentum as a means of involving members of the public in research and decision-making in disease prevention and health promotion. However, citizen science projects have predominantly been led by academic researchers and there is limited understanding of how to support the application of citizen science approaches in policy and practice settings. This study aimed to understand the perceptions, motivations and early experiences of applying citizen science approaches in policy and practice settings. Semi-structured interviews were conducted with policy and practice stakeholders who were leading citizen science projects (project partners, n = 7), and their implementation partners (project implementers, n = 11). Participants viewed citizen science as an opportunity to access hard-to-reach data and to enhance engagement with community members to support policy and practice change. Barriers and facilitators of citizen science in policy and practice settings included navigating collaborative relationships, team capacity and resources available to deliver projects, recruitment and engagement of citizen scientists and ethical considerations in the design and implementation of citizen science projects. Findings support the feasibility and wider application of citizen science approaches in health promotion and are being used to inform the development of tools and resources to build capacity in these approaches in policy and practice settings.

The case for citizen science in public health policy and practice: a mixed methods study of policymaker and practitioner perspectives and experiences.

BACKGROUND: Citizen science (CS) is increasingly being utilised to involve the public in public health research, but little is known about whether and how CS can address the needs of policy and practice stakeholders in health promotion and chronic disease prevention. METHODS: Using a mixed methods approach we conducted an online survey (n = 83) and semi-structured interviews (n = 21) with policy and practice stakeholders across Australia to explore how CS approaches are perceived and applied in chronic disease prevention, how CS aligns with existing approaches to community engagement, and how the uptake of CS can be supported within policy and practice settings. RESULTS: Most participants had heard of CS, and while few had experience of using CS, there was widespread support for this approach, with many seeing it as complementary to other community engagement approaches. CS was seen as providing: (a) a robust framework for engagement; (b) access to rich data; (c) opportunities for more meaningful engagement; and (d) a mutually beneficial approach for stakeholders and community members. However, stakeholders identified a need to weigh benefits against potential risks and challenges including competing organisational priorities, resourcing and expertise, data quality and rigour, governance, and engagement. CONCLUSIONS: To expand the use of CS, stakeholders identified the need for increased awareness, acceptance, and capacity for CS within public health organisations, greater access to supporting tools and technology, and evidence on processes, feasibility and impacts to enhance the visibility and legitimacy of CS approaches.

Building capacity for citizen science in health promotion: a collaborative knowledge mobilisation approach.

Policymakers and practitioners in health promotion (e.g. those working for local, state or federal government organisations or community and non-government organisations with a focus on health and wellbeing) are increasingly interested in citizen science as a means of involving the public in research and decision making. The potential benefits of citizen science approaches in health promotion include increased research capacity, incorporation of community perspectives on problems and solutions, and improved public awareness and acceptance of actions to improve health. However, health promotion practitioners and policymakers report having limited familiarity and experience with citizen science and a desire to build their capacity in these approaches. The Citizen Science in Prevention (CSP) project aims to build capacity for citizen science in health promotion by: 1) supporting the development and implementation of citizen science projects by policymakers and practitioners, 2) establishing a network of health promotion stakeholders with familiarity and interest in citizen science approaches, and 3) co-designing resources to support the use of citizen science in policy and practice contexts. A comprehensive mixed methods evaluation will establish the reach, satisfaction, and impacts that can be attributed to the capacity building intervention. This paper describes the first known initiative to build capacity in the application of citizen science approaches in health promotion and we hope that this work will assist others in the development and implementation of capacity building activities for citizen science in health promotion and beyond.

Citizen science, the active involvement of members of the public in undertaking research, is gaining attention as a means of involving the public in research and decision making in health promotion. However, despite increasing interest in citizen science, policymakers and practitioners in health promotion (e.g. those working for local, state or federal government organisations or community and non-government organisations with a focus on health and wellbeing), lack the knowledge, skills and confidence to apply these approaches within their work. Knowledge mobilisation is a process designed to ensure research is useful for society, underpinned by researchers and non-academic partners working together to ensure that the knowledge produced is relevant and useful to those responsible for making decisions in practice. Within this paper we describe how we have used a knowledge mobilisation approach to work in partnership with health promotion agencies to develop, implement and evaluate a suite of activities aimed at building capacity in the use of citizen science approaches in health promotion.

Understanding academic readiness for kindergarten: The interactive role of emotion knowledge and teacher-child closeness.

One goal of this study was to test the role of emotion knowledge and teacher-child closeness and conflict in predicting academic readiness for kindergarten over and above demographic factors and executive functioning skills (especially inhibitory control) known to predict readiness. Another goal was to test teacher-child closeness as a moderator of the association between emotion knowledge or executive functioning and academic readiness. A total of 141 4- and 5-year-old children completed emotion knowledge, academic readiness, and inhibitory control measures. Preschool teachers reported their perceived relationship closeness and conflict with individual students. Accounting for child age in months, family income, and inhibitory control, emotion knowledge and teacher-child closeness were positively associated with academic readiness. Teacher-child closeness moderated the relationship between emotion knowledge and academic readiness, suggesting that teacher-child closeness may be especially important in promoting academic readiness for preschool students with low emotion knowledge.

Health and service needs, priorities and initiatives of primary health networks related to chronic pain.

BACKGROUND: Chronic pain is a major and growing public health issue. Multidisciplinary tertiary pain services cannot meet patient demand and greater involvement of primary care is needed. The aims of this study were to understand the needs and priorities of Australian primary health networks (PHNs) related to the management and secondary prevention of chronic pain; map current PHN chronic pain initiatives and identify gaps; highlight key enablers to implementation; and highlight solutions identified by PHNs to increase capacity to commission initiatives. METHODS: Mixed methods were used, including: a review of PHN needs assessments; and consultation with PHN executive-level staff and program managers from 27 out of the 28 PHNs, and the WA Primary Health Alliance (WAPHA - a state alliance between three Western Australian PHNs) via telephone interviews, online surveys, a workshop, a deliberative dialogue and email consultation. RESULTS: Chronic pain was identified as a health and/or service need by approximately half of PHNs. Barriers for PHNs to identifying chronic pain as a need or priority are highlighted. Gaps identified by the mapping included: initiatives related to the secondary prevention of chronic pain (post-surgery or post-injury), digitally enabled consumer and health professional chronic pain initiatives, and chronic pain initiatives for specific populations groups such as Aboriginal and Torres Strait Islander people. Among existing PHN practice, two exemplar evidence-based initiatives suitable for scale-up across PHNs in Australia were identified: multidisciplinary community-based pain programs, and an online health professional capacity-building initiative, Project ECHO (chronic pain). Solutions identified by PHNs to increase capacity to commission initiatives included: co-funding initiatives across different PHN funding streams, collaborative initiatives between PHNs, and co-commissioning with government and non-government partners. CONCLUSIONS: Chronic pain has been classified as a disease in itself through the World Health Organization. PHNs recognising chronic pain as a distinct condition in PHN needs analysis and data collection would lead to more dedicated funding. PHNs could do more to improve the secondary prevention and management of chronic pain. A self-identified need for greater collaboration across PHNs and co-commissioning with local and state governments and non-government partners would help to build PHN capacity.

A Scoping Review of Citizen Science Approaches in Chronic Disease Prevention.

Background: Citizen science approaches, which involve members of the public as active collaborators in scientific research, are increasingly being recognized for their potential benefits in chronic disease prevention. However, understanding the potential applicability, feasibility and impacts of these approaches is necessary if they are to be more widely used. This study aimed to synthesize research that has applied and evaluated citizen science approaches in chronic disease prevention and identify key questions, gaps, and opportunities to inform future work in this field. Methods: We searched six databases (Scopus, Medline, Embase, PsycInfo, PubMed, and CINAHL) in January 2022 to identify articles on the use of citizen science in prevention. We extracted and synthesized data on key characteristics of citizen science projects, including topics, aims and level of involvement of citizen scientists, as well as methods and findings of evaluations of these projects. Results: Eighty-one articles reported on citizen science across a variety of health issues, predominantly physical activity and/or nutrition. Projects primarily aimed to identify problems from the perspective of community members; generate and prioritize solutions; develop, test or evaluate interventions; or build community capacity. Most projects were small-scale, and few were co-produced with policy or practice stakeholders. While around half of projects included an evaluation component, overall, there was a lack of robust, in-depth evaluations of the processes and impacts of citizen science projects. Conclusions: Citizen science approaches are increasingly being used in chronic disease prevention to identify and prioritize community-focused solutions, mobilize support and advocacy, and empower communities to take action to support their health and wellbeing. However, to realize the potential of this approach more attention needs to be paid to demonstrating the feasibility of using citizen science approaches at scale, and to rigorous evaluation of impacts from using these approaches for the diverse stakeholders involved.

Using citizen science to engage the public in monitoring workplace breastfeeding support in Australia.

ISSUE ADDRESSED: Returning to work is a major barrier to continued breastfeeding. While many large organisations in Australia have policies to support breastfeeding and expressing at work, it is not known how these are implemented in practice, what support is available in smaller workplaces or to what extent workplace support meets the needs of breastfeeding mothers. METHODS: This pilot study trialled a citizen science approach where members of the public provided photographs and descriptions of breastfeeding facilities and support within their workplaces. The study was promoted through community networks and social media, and data were submitted via an online survey. Data were analysed inductively to identify key themes. RESULTS: Thirty-seven participants provided data on breastfeeding support in their workplace. Three key themes were identified: physical features and facilities; workplace culture; and organisational and occupational characteristics. There was considerable variation in workplace support and around half of the participants indicated that they had to use communal, poorly equipped and/or unhygienic spaces to breastfeed or express at work. CONCLUSION: While some employers have taken important steps towards supporting mothers to combine breastfeeding and work, there is room for improvement. Through this pilot study, we have demonstrated the feasibility and value of using a citizen science approach to obtain data from a range of workplaces along with perceptions of workplace characteristics that support or hinder breastfeeding and expressing at work. SO WHAT?: Citizen science is a useful approach to capturing data on workplace support for breastfeeding and could be scaled up to enable ongoing monitoring. The findings raise important issues around the interpretation and implementation of current legislation to support mothers in the workplace.

Can an electronic monitoring system capture implementation of health promotion programs? A focussed ethnographic exploration of the story behind program monitoring data.

BACKGROUND: There is a pressing need for policy makers to demonstrate progress made on investments in prevention, but few examples of monitoring systems capable of tracking population-level prevention policies and programs and their implementation. In New South Wales, Australia, the scale up of childhood obesity prevention programs to over 6000 childcare centres and primary schools is monitored via an electronic monitoring system, "PHIMS". METHODS: Via a focussed ethnography with all 14 health promotion implementation teams in the state, we set out to explore what aspects of program implementation are captured via PHIMS, what aspects are not, and the implications for future IT implementation monitoring systems as a result. RESULTS: Practitioners perform a range of activities in the context of delivering obesity prevention programs, but only specific activities are captured via PHIMS. PHIMS thereby defines and standardises certain activities, while non-captured activities can be considered as "extra" work by practitioners. The achievement of implementation targets is influenced by multi-level contextual factors, with only some of the factors accounted for in PHIMS. This evidences incongruencies between work done, recorded and, therefore, recognised. CONCLUSIONS: While monitoring systems cannot and should not capture every aspect of implementation, better accounting for aspects of context and "extra" work involved in program implementation could help illuminate why implementation succeeds or fails. Failure to do so may result in policy makers drawing false conclusions about what is required to achieve implementation targets. Practitioners, as experts of context, are well placed to assist policy makers to develop accurate and meaningful implementation targets and approaches to monitoring.

Equipping Learners to Evaluate Online Health Care Resources: Longitudinal Study of Learning Design Strategies in a Health Care Massive Open Online Course.

BACKGROUND: The digital revolution has led to a boom in the number of available online health care resources. To navigate these resources successfully, digital literacy education is required. Learners who can evaluate the reliability and validity of online health care information are likely to be more effective at avoiding potentially dangerous misinformation. In addition to providing health care education, massive open online courses (MOOCs) are well positioned to play a role in providing digital literacy education in this context. OBJECTIVE: This study focused on learners enrolled in a MOOC on cancer genomics. The aim of this study was to evaluate the efficacy of a series of digital literacy-related activities within this course. This was an iterative study, with changes made to digital literacy-related activities in 4 of the 8 runs of the course. METHODS: This mixed methods study focused on learner engagement with the digital literacy-related activities, including the final course written assignment. Quantitative data including the number of references listed in each written assignment were compared between successive runs. Qualitative data in the form of learner comments on discussion forums for digital literacy-related tasks were evaluated to determine the impact of these educational activities. RESULTS: Using the number of references included for each final course assignment as an indicator of digital literacy skills, the digital literacy-related activities in the final 2 runs were judged to be the most successful. We found a statistically significant increase in the number of references cited by learners in their final written assignments. The average number of references cited in Run 8 was significantly higher (3.5) than in Run 1 (1.8) of the MOOC (P=.001). Learner comments in Runs 7 and 8 showed that a poll in which learners were asked to select which of 4 online resources was reliable was effective in stimulating learner discussion about how to evaluate resource reliability. CONCLUSIONS: Similar to many health care MOOCs, the course studied here had a heterogeneous group of learners, including patients (and their families), the public, health care students, and practitioners. Carefully designing a range of digital literacy-related activities that would be beneficial to this heterogenous group of learners enabled learners to become more effective at evaluating and citing appropriate online resources within their written assignments.

MOOCs and Medical Education: Hope or Hype? .

This article was migrated. The article was marked as recommended. The use of Massive Open Online Courses (MOOCs) in medical education is evolving and the potential of these learning and teaching resources has not yet been fully explored. Having previously integrated MOOCs within our medical undergraduate curriculum in a variety of contexts, in this study we focused on the attitudes of staff and students to the perceived utility of MOOCs in both undergraduate and postgraduate medical education. The results of an online survey demonstrate an openness to, yet in many cases, an unfamiliarity with, this technology in both educators and students. Further exploration of the data reveals a desire for greater levels of guidance in this ever expanding field, and specific curricular areas were highlighted where potential for the use of MOOCs seems particularly enticing. These insights may be helpful in the ongoing debate as to the direction of the field as educators seek to maximise the effectiveness of a blended approach to medical education.

Student-Created Online Teaching Resources for Students.

Students have long been creating their own visualisations of concepts taught through presentations, posters, figures in essays etc. However, with the introduction of technology, the content created by students is now easily shared with future cohorts of students. This chapter explores the history and advantages of student-created resources for students, then describes the examples of e-tutorials and MOOCs in more detail. Finally, future challenges are identified and discussed.

Research on media framing of public policies to prevent chronic disease: A narrative synthesis.

Media coverage plays a key role in shaping public and political attitudes towards policy interventions to improve health. We reviewed studies of news media to identify the arguments used to frame policies that address risk factors for chronic disease, and the impact of different arguments on attitudes to policy. Drawing on a previous scoping review, we identified a subsample of 49 studies of media framing of policies to address risk factors for lifestyle-related chronic disease for further analysis. We extracted and synthesised data to explore key themes. Of the limited research that has been undertaken, most studies have focused on tobacco policy, followed by alcohol, with a small number of studies of food and beverage policies. Studies have primarily used content analysis. Our synthesis demonstrated that advocates and opponents draw on five frames: health, social, economic, practical and ideological. Only a small number of studies have examined the impact of framing on public attitudes towards policy interventions, although such studies have tended to focus on the impact of how problems, rather than solutions (i.e. policies) are framed. Media research is crucial to understanding the complex ways in which attitudes towards policy interventions shape, and are shaped by, public discourses and can provide public health advocates with insights into strategies to successfully position policy arguments. This review highlights key insights and gaps in the hope that this will stimulate further research that will enhance public health advocates' abilities to promote effective public health policy.

The genetic basis of disease.

Genetics plays a role, to a greater or lesser extent, in all diseases. Variations in our DNA and differences in how that DNA functions (alone or in combinations), alongside the environment (which encompasses lifestyle), contribute to disease processes. This review explores the genetic basis of human disease, including single gene disorders, chromosomal imbalances, epigenetics, cancer and complex disorders, and considers how our understanding and technological advances can be applied to provision of appropriate diagnosis, management and therapy for patients.

Endothelial activation and cell adhesion molecule concentrations in pregnant women living at high altitude.

OBJECTIVES: Maternal physiology at high altitude could be considered to resemble an intermediate state between preeclampsia and normal pregnancy. The objective of the current study was to determine if cell adhesion molecules, known to be increased in preeclampsia, are increased with chronic maternal and placental hypoxia (due to high-altitude residence) in the absence of preeclampsia. METHODS: Serum was collected from women residing at 3100 m or 1600 m in the three trimesters of pregnancy and postpartum. Vascular cell adhesion molecule-1 (VCAM-1), E-selectin, and intercellular adhesion molecule-1 (ICAM-1) were measured by enzyme-linked immunosorbent assay (ELISA). RESULTS: General linear model (GLM) repeated measures analysis of VCAM-1, E-selectin, and ICAM-1 data showed there were no statistically significant effects of gestation within either the high- or moderate-altitude groups or between the different altitudes. CONCLUSION: The increase in cell adhesion molecules reported in preeclampsia is not present in pregnant women at high altitude, suggesting that maternal systemic hypoxia is not responsible for this pathway of endothelial cell activation in preeclampsia.

Villous explant culture: characterization and evaluation of a model to study trophoblast invasion.

The mechanisms that control invasion of cytotrophoblast (CTB) cells into the maternal decidua and myometrium with transformation of the maternal spiral arteries are not fully understood, but oxygen is thought to be a key factor. We carried out a semiquantitative evaluation of an explant culture model for use in the study of trophoblast proliferation and invasion. Explants of human villous tissue (6-9 weeks of gestation) cultured on Matrigel in both standard culture conditions (18% O2) and in a low oxygen environment (2% O2) produced regions of outgrowth, of cytotrophoblast cells from villous tips and migration of cells into the Matrigel. The number of sites of outgrowth and migration, area of outgrowth, and extent of migration of cells into the Matrigel tended to increase throughout the culture period (144 h) but varied between explants from the same placenta and those from different placentas. There were no significant differences in the number of sites of outgrowth or migration scores in explants cultured in a low oxygen environment compared to those cultured in standard conditions. This study highlights the importance of careful validation, design and interpretation of experiments using in vitro culture systems, particularly those investigating the regulatory role of oxygen.