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Exploring the Role of Third Places in Shaping Health and Wellbeing: A Qualitative Study With Older Adults 探索第三个地方在塑造健康和幸福中的作用:一项对老年人的定性研究。
IF 1.5 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-30 DOI: 10.1002/hpja.70128
Sara Alidoust, Amy Kirkegaard, Emma Hennessey, Lauren Ball

Introduction

Environmental determinants of health influence the experience of ageing, yet the contribution of informal public spaces, known as third places, remains underexplored, preventing adequate policy and planning action. Third places, such as cafes, libraries and parks, provide opportunities for older adults to build social connections and engage in physical activity, both of which are crucial for maintaining health and wellbeing. This study explored how third places influence the health of older people living in Springfield, a rapidly growing, master-planned community in South-East Queensland, Australia.

Methods

A qualitative, cross-sectional design was applied, using semi-structured interviews with 15 older residents (aged 60 years and over). Interviews explored the experiences of using third places, including the perceived benefits and challenges for physical activity and social connections. Social connections were considered through the lens of four types of social ties: stranger, absent, weak, and strong ties. Data were thematically analysed to identify key environmental and social determinants relevant to healthy ageing.

Results

Third places were perceived as essential for forming social connections, particularly through the accumulation of weak, absent and stranger ties, which provided a sense of belonging and safety. However, access was limited by transport, walkability and the design of spaces that did not always encourage prolonged interaction. Physical activity opportunities were valued but were secondary to the perceived social benefits of third places.

Conclusions

Findings highlight the importance of third places as accessible, socially inclusive environments for older adults that play a key role in forming and strengthening four types of social ties, from encounters with strangers to enduring friendships.

So What?

The importance of stranger ties—alongside absent, weak, and strong ties—and the dynamic role that third places play in fostering these connections, especially for older people, has not been fully recognised. Insights from this research can inform urban planning and health policy to strengthen community design that supports healthy ageing.

导言:健康的环境决定因素影响老龄化的经历,但被称为第三场所的非正式公共空间的作用仍未得到充分探索,妨碍了适当的政策和规划行动。第三个地方,如咖啡馆、图书馆和公园,为老年人提供了建立社会联系和从事体育活动的机会,这两者对于保持健康和幸福至关重要。这项研究探讨了第三城市如何影响住在斯普林菲尔德的老年人的健康,斯普林菲尔德是澳大利亚昆士兰州东南部一个快速发展的总体规划社区。方法:采用定性、横断面设计,对15名年龄在60岁及以上的老年居民进行半结构化访谈。访谈探讨了使用第三个地方的经验,包括对身体活动和社会联系的感知好处和挑战。社会关系是通过四种类型的社会关系来考虑的:陌生关系、缺席关系、弱关系和强关系。对数据进行了专题分析,以确定与健康老龄化有关的主要环境和社会决定因素。结果:第三个地方被认为是形成社会联系的关键,特别是通过积累微弱的、缺席的和陌生人的关系,这提供了归属感和安全感。然而,交通、可步行性和空间设计并不总是鼓励长时间的互动,限制了访问。体育活动的机会是有价值的,但与第三名的社会效益相比,这是次要的。结论:研究结果强调了第三个地方作为老年人无障碍、社会包容的环境的重要性,它在形成和加强四种社会关系方面发挥着关键作用,从与陌生人的相遇到持久的友谊。那又怎样?当前位置陌生人关系的重要性——与缺席的、弱的和强的关系一样——以及第三者在促进这些联系中所起的动态作用,特别是对老年人来说,还没有得到充分认识。这项研究的见解可以为城市规划和卫生政策提供信息,以加强支持健康老龄化的社区设计。
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引用次数: 0
Seas the Day—Older Adults and People With Disability Seek Health and Wellbeing Benefits Through Beach Activities: An Australian Community Survey 海洋-老年人和残疾人通过海滩活动寻求健康和福利:澳大利亚社区调查。
IF 1.5 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-28 DOI: 10.1002/hpja.70123
Sasha Job, Luke Heales, Steven Obst

Objective

In Australia, the beach is a favoured destination for recreational activities linked to physical, psychological, and social health benefits. Unfortunately, older people and people with disability face barriers to beach access that limit their participation in recreational activities. This study aimed to identify beach use behaviours, preferred beach activities, and perceived benefits for older people and people with disability in Australia.

Methods

A 39-item anonymous online survey was administered. Descriptive statistics reported beach use, preferences, and benefits.

Results

The survey had 350 respondents (69% female; mean age 52 years, range 2–90). Almost half (44.8%) could not visit the beach due to accessibility issues. Those who could visit did so year-round, with one third (34%) visiting weekly and 94% spending ≥ 30 min per visit. Factors for beach selection related to accessibility (95%) and the environment (76%). Preferred activities were swimming (56%), walking (51%), and socialising (49%). Perceived benefits included enjoyment/wellbeing (99%), reduced stress (95%), and physical benefits (86%).

Conclusion

Despite limited access, older people and people with disability engage or want to engage in beach-based activities and self-report a range of perceived health benefits.

So What?

Removing the barriers to beach access would improve participation in beach-based health-promoting activities for older people and people with disability.

目的:在澳大利亚,海滩是与身体、心理和社会健康益处相关的娱乐活动的首选目的地。不幸的是,老年人和残疾人面临着进入海滩的障碍,这限制了他们参与娱乐活动。本研究旨在确定澳大利亚老年人和残疾人的海滩使用行为、首选海滩活动以及感知到的好处。方法:采用39项匿名在线调查。描述性统计报告了海滩的使用、偏好和好处。结果:共有350名受访者(69%为女性,平均年龄52岁,范围2-90岁)。由于交通问题,近一半(44.8%)的人无法前往海滩。那些可以全年访问的人,三分之一(34%)每周访问,94%每次访问花费≥30分钟。选择泳滩的因素与可达性(95%)及环境(76%)有关。首选的活动是游泳(56%)、散步(51%)和社交(49%)。感知到的好处包括享受/幸福(99%)、减轻压力(95%)和身体上的好处(86%)。结论:尽管机会有限,但老年人和残疾人参与或希望参与海滩活动,并自我报告了一系列感知到的健康益处。那又怎样?消除进入海滩的障碍将改善老年人和残疾人参与海滩促进健康活动的情况。
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引用次数: 0
Long-Term Adoption of Health Promotion Policies and Practices in Early Childhood Education and Care in New South Wales, Australia: A Repeat Cross-Sectional Study 澳大利亚新南威尔士州早期儿童教育和护理中健康促进政策和实践的长期采用:一项重复横断面研究
IF 1.5 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-28 DOI: 10.1002/hpja.70126
Amy E. Anderson, Christophe Lecathelinais, John Wiggers, Luke Wolfenden, Melanie Lum, Alice Grady, Sze Lin Yoong

Issue Addressed

The early childhood and education care (ECEC) sector has faced substantial contextual changes over the years. It is unknown whether prevalence of adoption of health promotion policies and practices has been impacted over this time. This study aimed to assess the prevalence of these policies and practices within New South Wales (NSW) ECEC services between 2013 and 2021–2022.

Methods

A repeat cross-sectional survey was undertaken in 2013 and 2021–2022 with NSW ECEC services to assess their adoption of eight evidence-based healthy eating and physical activity practices. Separate logistic regression models were used to compare the difference in prevalence of adoption at the two time points.

Results

In 2013, 214 (85.3% consent rate) services participated, while 512 (49.9%) services completed the 2021–2022 survey (271 receiving healthy eating version and 241 physical activity version). The majority of services (> 60%) had adopted each of the practices at both time points. There was a significant increase in prevalence of adoption for five of the eight practices, no difference for two practices, and a reduction in one practice (providing staff professional development for physical activity) between 2013 and 2021–2022.

Conclusions

This study suggests that at a population level, services have maintained or increased their adoption of the majority of health promotion policies and practices over time.

So What?

State-funded implementation support provided to ECECs can result in the continued delivery of health-promoting policies and practices within ECEC services to create Healthy Settings for child health promotion.

所处理的问题:多年来,幼儿和教育护理(ECEC)部门面临着重大的背景变化。目前尚不清楚在这段时间内,健康促进政策和做法的普及程度是否受到了影响。本研究旨在评估2013年至2021-2022年期间新南威尔士州(NSW) ECEC服务中这些政策和实践的普遍性。方法:2013年和2021-2022年,对新南威尔士州ECEC服务机构进行了重复横断面调查,以评估他们采用8种循证健康饮食和体育活动方法的情况。使用单独的逻辑回归模型来比较两个时间点的采用率差异。结果:2013年共有214家(85.3%)服务机构参与了调查,512家(49.9%)服务机构完成了2021-2022年的调查,其中271家接受健康饮食版本,241家接受体育锻炼版本。大多数服务(60%)在两个时间点都采用了这两个实践。2013年至2021-2022年期间,八项实践中有五项的采用率显著增加,两项实践没有差异,一项实践(为员工提供体育活动专业发展)的采用率减少。结论:本研究表明,在人口水平上,随着时间的推移,服务部门维持或增加了对大多数健康促进政策和做法的采用。那又怎样?*国家资助的对儿童健康中心的执行支助可使儿童健康中心的服务部门继续执行促进健康的政策和做法,为促进儿童健康创造健康环境。
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引用次数: 0
Reporting Definitions of Health Literacy in Australian Aboriginal and Torres Strait Islander Health Resources: A Scoping Review 澳洲原住民和托雷斯海峡岛民健康资源的健康素养定义报告:范围审查
IF 1.5 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-28 DOI: 10.1002/hpja.70120
Jodi Brown, Tanya Langtree, Catrina Felton-Busch, Shaun Solomon, Cate Nagle
<div> <section> <h3> Issue Addressed</h3> <p>Australian Aboriginal and Torres Strait Islander (Indigenous) peoples experience many inequalities in health status and outcomes compared to non-Indigenous Australians. Given the strong association between health literacy and health status and outcomes, exploring definitions from an Indigenous perspective is critical to understanding what skills and attributes contribute to the development and maintenance of health literacy among Indigenous Australians. This scoping review sought to identify and describe definitions for health literacy found in health and wellbeing studies involving Indigenous Australians and how those definitions informed resource development in these populations.</p> </section> <section> <h3> Methods</h3> <p>A scoping review was conducted using Arksey and O'Malley's framework with the modifications recommended by Levac et al. MEDLINE, CINAHL, Emcare, ERIC, Informit and Scopus databases were searched for eligible studies with no restrictions on language or year of publication. The inclusion criteria were that studies required to be full-text peer-reviewed journal articles and empirical studies focused on culturally safe health literacy with Australian Indigenous peoples.</p> </section> <section> <h3> Results</h3> <p>Eighteen studies published between 2012 and 2022 met the inclusion criteria. Three of the studies defined health literacy and acknowledged how it assists Indigenous peoples to access and understand health-related information, aiding in their ability to make informed decisions about their health. In the remaining studies, no explicit definition of health literacy was provided; however, they each described various strategies Indigenous peoples learned to incorporate health information into decisions about health and wellbeing. Three themes within the included studies were identified: underlying health literacy problems, misaligned Western medical practices and difficulties accessing culturally appropriate services.</p> </section> <section> <h3> Conclusion</h3> <p>While many of the studies included in this review reported adaptations of health literacy resources for Indigenous Australians, none of the health literacy definitions reflect the worldview of Indigenous Australians. This review highlights the lack of culturally safe definitions of health literacy informing the development of resources for improving health literacy in Indigenous populations. Definitions of health literacy must include cultural perspectives for future health resource development, including the understanding of health literacy through an Indigenous lens.</p> </section>
与非土著澳大利亚人相比,澳大利亚土著和托雷斯海峡岛民(土著)在健康状况和结果方面存在许多不平等。鉴于卫生知识普及与健康状况和结果之间的密切联系,从土著角度探索定义对于了解哪些技能和属性有助于发展和保持澳大利亚土著居民的卫生知识普及至关重要。本次范围审查旨在确定和描述涉及澳大利亚土著居民的健康和福利研究中发现的健康素养定义,以及这些定义如何为这些人群的资源开发提供信息。方法采用Arksey和O'Malley的框架进行范围综述,并对Levac等人推荐的框架进行修改。在MEDLINE、CINAHL、Emcare、ERIC、Informit和Scopus数据库中检索符合条件的研究,没有语言和出版年份限制。纳入标准是,研究必须是全文同行评议的期刊文章和实证研究,重点关注澳大利亚土著人民文化上安全的健康素养。结果2012 - 2022年间发表的18项研究符合纳入标准。其中三项研究定义了卫生知识素养,并承认它如何帮助土著人民获取和了解与卫生有关的信息,帮助他们有能力就自己的健康作出知情决定。在其余的研究中,没有提供健康素养的明确定义;然而,他们各自描述了土著人民学会将健康信息纳入有关健康和福祉的决策的各种策略。在纳入的研究中确定了三个主题:潜在的卫生素养问题、不一致的西方医疗做法和难以获得与文化相适应的服务。虽然本综述中包括的许多研究报告了澳大利亚土著居民健康素养资源的适应性,但没有一项健康素养定义反映了澳大利亚土著居民的世界观。本综述强调缺乏文化上安全的卫生素养定义,为开发资源以提高土著人口的卫生素养提供了信息。卫生知识普及的定义必须包括未来卫生资源开发的文化视角,包括通过土著视角理解卫生知识普及。那又怎样?本综述概述了在报告澳大利亚土著居民卫生资源开发的文献中发现的卫生素养定义。这些定义仅限于西方卫生知识普及的概念,因此可能被认为在文化上对土著澳大利亚人不安全。为了提高这一人群的卫生知识,需要制定文化上安全的定义,以便为资源开发提供信息。有必要进一步共同设计研究,优先考虑土著澳大利亚人的观点,以提高这一人口的健康素养。
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引用次数: 0
Beyond Choice: Challenging Individualism in Public Health Narratives 超越选择:挑战公共卫生叙事中的个人主义。
IF 1.5 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-28 DOI: 10.1002/hpja.70125
Mark Robinson, Mark Chenery, James Smith
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引用次数: 0
Neighbourhood Socioeconomic Disadvantage and Body Mass Index Among Australian Apartment Dwellers 澳大利亚公寓居民的社区社会经济劣势与体重指数
IF 1.5 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-28 DOI: 10.1002/hpja.70121
Alexandra Kleeman, Gavin Turrell, Sarah Foster

Apartments are often located in dense, mixed-use neighbourhoods designed to encourage walking and support healthier lifestyles; however, the extent to which these environments benefit all population groups equally with respect to weight-related outcomes is unclear. We investigated the association between neighbourhood disadvantage (ND) and body mass index (BMI) amongst urban Australian apartment dwellers and the extent to which their local neighbourhood environment, apartment building environment, and health behaviours contributed to this relationship. We surveyed residents (n = 955) from recently constructed apartment complexes (n = 108) in areas of low, mid, and high disadvantage across Sydney, Melbourne, and Perth. Residents in more disadvantaged neighbourhoods had higher BMIs than those in more advantaged areas, with BMI differences of 0.80 kg/m2 (95% CI: 0.18, 1.42) and 0.98 kg/m2 (95% CI: −0.01, 1.98) for middle and high disadvantage groups, respectively. Apartment building characteristics and neighbourhood characteristics contributed only marginally to this association, whilst meal consumption practises and physical activity behaviours emerged as key influences. The findings further underscore the entrenched relationship between ND and BMI, with a socioeconomic gradient present even for a population group that lives in more urban, higher density neighbourhoods. To address obesity-related inequities in Australia, there is a need for multifaceted interventions that support healthier energy-balance related behaviours amongst disadvantaged populations.

公寓通常位于密集的混合用途社区,旨在鼓励步行和支持更健康的生活方式;然而,就体重相关的结果而言,这些环境对所有人群平等受益的程度尚不清楚。我们调查了澳大利亚城市公寓居民的邻里劣势(ND)和身体质量指数(BMI)之间的关系,以及他们当地社区环境、公寓楼环境和健康行为在多大程度上促成了这种关系。我们调查了来自悉尼、墨尔本和珀斯低、中、高劣势地区新近建成的公寓大楼(n = 108)的居民(n = 955)。较弱势社区的居民BMI高于较有利地区,中等和高度弱势群体的BMI差异分别为0.80 kg/m2 (95% CI: 0.18, 1.42)和0.98 kg/m2 (95% CI: -0.01, 1.98)。公寓建筑特征和社区特征对这种联系的贡献很小,而饮食习惯和体育活动行为则是关键的影响因素。研究结果进一步强调了ND和BMI之间根深蒂固的关系,即使对于生活在更城市化、密度更高的社区的人群来说,也存在社会经济梯度。为了解决澳大利亚与肥胖相关的不平等问题,需要采取多方面的干预措施,支持弱势群体更健康的与能量平衡相关的行为。
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引用次数: 0
“It's Like Damocles' Sword”: Australian Service Provider Perspectives on the Impact of Temporary Visas on Mental and Physical Health for Refugees and Asylum Seekers “这就像达摩克利斯之剑”:澳大利亚服务提供商对临时签证对难民和寻求庇护者身心健康影响的看法。
IF 1.5 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-28 DOI: 10.1002/hpja.70119
Clemence Due, Moira Walsh, Sue Conaghty, Anna Ziersch

Issue Addressed

It has been well documented that refugees with temporary visa status have poorer physical and mental health than immigrants on permanent visas. This study aimed to investigate the perspective of service providers on temporary visa experiences of refugees and asylum seekers, to examine the pathways between visa-related post-migration difficulties and poor health and implications for health promotion. Working across refugees and asylum seekers with multiple and varying pre-migration experiences and cultural influences, service providers contribute an important perspective of client experiences within the temporary visa system.

Methods

A mixed-methods design was utilised with a quantitative survey of service providers working with refugees and asylum seekers (n = 36) and in-depth interviews (n = 12). Participants were recruited through service networks and snowball sampling. Survey data were analysed descriptively with R, and interview data were thematically analysed.

Results

Temporary visas, particularly short-term bridging visas, were identified as negatively affecting both mental and physical health through uncertainty, inconsistencies, service access transitions and family separation, with impacts via a range of social determinants and psychological states and behaviours.

Conclusions

This study highlights the debilitating impacts of temporary visas on both mental and physical health, and the necessity to provide greater certainty to asylum seekers and refugees.

So What?

Although the current Australian government has transferred many humanitarian temporary visa holders to permanent visas, temporary humanitarian visas remain available for use in the future. Moreover, many asylum seekers will remain on short-term bridging visas. The findings from this study stress the imperative of considering the mental and physical health consequences of immigration policy decisions for asylum-seeker and refugee populations. A deeper understanding of the interplay of components within the temporary visa pathway highlights multiple foci for future research and preventative intervention priorities.

所处理的问题:有充分证据表明,持有临时签证的难民的身心健康状况比持有永久签证的移民差。本研究旨在调查服务提供者对难民和寻求庇护者临时签证经历的看法,以检查与签证相关的移民后困难与健康状况不佳之间的途径及其对健康促进的影响。服务提供者与具有多种不同移民前经历和文化影响的难民和寻求庇护者合作,为临时签证制度下的客户体验提供了重要的视角。方法:采用混合方法设计,对难民和寻求庇护者服务提供者进行定量调查(n = 36)和深度访谈(n = 12)。参与者是通过服务网络和滚雪球抽样招募的。使用R对调查数据进行描述性分析,对访谈数据进行主题分析。结果:临时签证,特别是短期过桥签证,被确定为通过不确定性、不一致性、服务获取过渡和家庭分离对身心健康产生负面影响,并通过一系列社会决定因素以及心理状态和行为产生影响。结论:本研究强调了临时签证对身心健康的不利影响,以及为寻求庇护者和难民提供更大确定性的必要性。那又怎样?虽然目前澳大利亚政府已经将许多人道主义临时签证持有人转为永久签证,但临时人道主义签证仍然可以在未来使用。此外,许多寻求庇护者将继续持有短期过桥签证。这项研究的结果强调,必须考虑移民政策决定对寻求庇护者和难民人口的身心健康后果。更深入地了解临时签证途径中各组成部分的相互作用,突出了未来研究和预防性干预优先事项的多个重点。
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引用次数: 0
“The Poorer You Are, the Harder It Is”: Perspectives on Community Health Promotion in Tasmania “越穷越难”:对塔斯马尼亚州社区健康促进的看法。
IF 1.5 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-28 DOI: 10.1002/hpja.70116
Amy Coates, Emma Lea, Hannah Fair, Kathleen Doherty

Issue Addressed

This study explores how community health and social service providers in Tasmania perceive local health challenges, navigate system barriers, and support socioeconomically disadvantaged populations. In the context of Tasmania's ongoing public health reform, these perspectives are critical for shaping equitable strategies grounded in lived experience.

Method

Semi-structured interviews were conducted with leaders from diverse health and social service organisations in southern Tasmania. Analysis combined inductive thematic coding with a critical realist framework to map relationships between the local context, mechanisms of change, and outcomes.

Results

Health risks and chronic conditions are closely entwined with socioeconomic disadvantage, unmet basic needs, and systemic challenges. Providers responded with adaptive, community-based strategies emphasising trust, accessibility, and contextual sensitivity. Yet, these mechanisms were constrained by limited resources, low health literacy, and broader contextual barriers, producing mixed outcomes ranging from engagement and empowerment to persistent disengagement and cycles of poor health.

Conclusion

Community health and social service providers are essential intermediaries, bridging gaps through integrated, localised programs. Findings support Tasmania's vision for an integrated wellbeing approach and highlight the need for greater investments in prevention, stronger local governance and coordination, and strategies that address the structural determinants of health and enhanced community participation.

So What?

This study extends Tasmanian health promotion scholarship by foregrounding provider perspectives and provides a unique system-level account of how providers adapt to entrenched disadvantage. It also demonstrates the value of a critical realist lens for understanding cycles of disadvantage. Together, these insights offer practical guidance for equity-oriented public health reform.

解决的问题:本研究探讨了塔斯马尼亚州的社区卫生和社会服务提供者如何看待当地的卫生挑战,克服系统障碍,并支持社会经济弱势群体。在塔斯马尼亚正在进行的公共卫生改革的背景下,这些观点对于形成基于生活经验的公平战略至关重要。方法:对塔斯马尼亚南部不同卫生和社会服务组织的领导人进行了半结构化访谈。分析将归纳主题编码与批判现实主义框架相结合,以映射当地环境,变化机制和结果之间的关系。结果:健康风险和慢性疾病与社会经济劣势、未满足的基本需求和系统性挑战密切相关。供应商采取了适应性的、基于社区的策略,强调信任、可及性和上下文敏感性。然而,这些机制受到资源有限、卫生知识普及程度低和更广泛的背景障碍的制约,产生了从参与和赋权到持续脱离参与和健康状况不佳循环的混合结果。结论:社区卫生和社会服务提供者是必不可少的中介,通过综合的、本地化的方案弥合差距。调查结果支持塔斯马尼亚州综合福利方法的愿景,并强调需要加大对预防的投资,加强地方治理和协调,以及解决健康的结构性决定因素和加强社区参与的战略。那又怎样?本研究扩展了塔斯马尼亚健康促进奖学金的前景提供者的观点,并提供了一个独特的系统级帐户提供者如何适应根深蒂固的劣势。它还展示了批判现实主义视角对理解不利循环的价值。总之,这些见解为以公平为导向的公共卫生改革提供了实践指导。
{"title":"“The Poorer You Are, the Harder It Is”: Perspectives on Community Health Promotion in Tasmania","authors":"Amy Coates,&nbsp;Emma Lea,&nbsp;Hannah Fair,&nbsp;Kathleen Doherty","doi":"10.1002/hpja.70116","DOIUrl":"10.1002/hpja.70116","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Issue Addressed</h3>\u0000 \u0000 <p>This study explores how community health and social service providers in Tasmania perceive local health challenges, navigate system barriers, and support socioeconomically disadvantaged populations. In the context of Tasmania's ongoing public health reform, these perspectives are critical for shaping equitable strategies grounded in lived experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>Semi-structured interviews were conducted with leaders from diverse health and social service organisations in southern Tasmania. Analysis combined inductive thematic coding with a critical realist framework to map relationships between the local context, mechanisms of change, and outcomes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Health risks and chronic conditions are closely entwined with socioeconomic disadvantage, unmet basic needs, and systemic challenges. Providers responded with adaptive, community-based strategies emphasising trust, accessibility, and contextual sensitivity. Yet, these mechanisms were constrained by limited resources, low health literacy, and broader contextual barriers, producing mixed outcomes ranging from engagement and empowerment to persistent disengagement and cycles of poor health.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Community health and social service providers are essential intermediaries, bridging gaps through integrated, localised programs. Findings support Tasmania's vision for an integrated wellbeing approach and highlight the need for greater investments in prevention, stronger local governance and coordination, and strategies that address the structural determinants of health and enhanced community participation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> So What?</h3>\u0000 \u0000 <p>This study extends Tasmanian health promotion scholarship by foregrounding provider perspectives and provides a unique system-level account of how providers adapt to entrenched disadvantage. It also demonstrates the value of a critical realist lens for understanding cycles of disadvantage. Together, these insights offer practical guidance for equity-oriented public health reform.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47379,"journal":{"name":"Health Promotion Journal of Australia","volume":"37 1","pages":""},"PeriodicalIF":1.5,"publicationDate":"2025-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hpja.70116","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145393622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Using mHealth to Support Queensland Mothers and Children From Birth to Two Years: A Longitudinal Study of Connecting2u 使用移动医疗支持昆士兰州母亲和儿童从出生到两岁:连接2u的纵向研究。
IF 1.5 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-14 DOI: 10.1002/hpja.70117
Lisa Irene Jones, Brett Dyer, Amanda Wedemeyer, Lieke Vorage, Nicola Wiseman, Alanna Philipson, Skye Frazer-Ryan, Andrew Resetti, Neil Harris

Introduction

Connecting2u (C2u) is a mobile health (mHealth) intervention supporting Queensland families. The 2021–2023 iteration focused on the first 2 years of a child's life. This study evaluated whether C2u supported maternal and child well-being during this period.

Methods

This longitudinal study used a self-administered online survey at four points over 2 years. Survey items included the Karitane Parenting Confidence Scale, Modified Medical Outcome Social Support survey, child immunisation status, agreement statements, and open-ended questions on C2u support and satisfaction. Parenting confidence and social support were modelled using linear quantile mixed models; univariate and qualitative content analysis were applied to remaining items.

Results

Parenting confidence increased over the first 12 months, with faster improvements among first-time parents and modestly faster gains among parents with university-level education. Social support scores showed little change over the 2-year period, although qualitative data suggested C2u encouraged conversations between parents. Agreement statements indicated that C2u was well received and supported preventative health behaviours. Qualitative feedback reinforced these findings, with participants describing C2u as an extra layer of support, prompting self-care, encouraging bonding with their child, and offering timely guidance on introducing solids. By the end of the study, 100% of participants indicated their child had received the full schedule of age-appropriate immunisations.

Conclusions

C2u was well received by mothers. Enhancing its focus on partner support, expanding social support networks, guidance on sibling bonding, and self-care strategies could be beneficial. Queensland Health could consider implementing an online booking system to streamline child health appointments. So what? C2u is an innovative mHealth intervention. Our findings support refinement as C2u expands to include antenatal care messaging and support for children up to 5 years, helping to optimise outcomes for families.

简介:Connecting2u (C2u)是一个支持昆士兰家庭的移动健康(mHealth)干预。2021-2023年的迭代重点关注儿童生命的头两年。本研究评估了C2u在这一时期是否支持了孕产妇和儿童的福祉。方法:本纵向研究采用自我管理的在线调查,为期2年,分4个时间点进行。调查项目包括Karitane父母信心量表、改良医疗结果社会支持调查、儿童免疫状况、协议声明以及关于C2u支持和满意度的开放式问题。采用线性分位数混合模型对父母信心和社会支持进行建模;其余项目采用单因素和定性含量分析。结果:在最初的12个月里,父母的信心增加了,第一次父母的信心增加得更快,受过大学教育的父母的信心增加得更快。社会支持得分在两年期间几乎没有变化,尽管定性数据表明C2u鼓励父母之间的对话。协议声明表明,C2u受到欢迎并支持预防性健康行为。定性反馈强化了这些发现,参与者将C2u描述为额外的支持层,促进自我照顾,鼓励与孩子建立联系,并在引入固体时提供及时的指导。到研究结束时,100%的参与者表示他们的孩子已经接受了与年龄相适应的免疫接种。结论:C2u的使用效果良好。加强对伴侣支持的关注,扩大社会支持网络,对兄弟姐妹关系的指导,以及自我照顾策略可能是有益的。昆士兰州卫生局可以考虑实施一个在线预约系统,以简化儿童健康预约。那又怎样?C2u是一种创新的移动医疗干预。我们的研究结果支持改进,因为C2u扩展到包括产前保健信息和对5岁以下儿童的支持,有助于优化家庭的结果。
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引用次数: 0
Pilot Evaluation of Early Childhood Health Promotion Training for Primary Health Professionals in Australia 澳大利亚初级卫生专业人员幼儿健康促进培训试点评价。
IF 1.5 4区 医学 Q3 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH Pub Date : 2025-10-14 DOI: 10.1002/hpja.70113
Eve T. House, Erin Kerr, Sarah Taki, Elizabeth Denney-Wilson, Louise A. Baur, Heilok Cheng, Sharlene Vlahos, Li Ming Wen

Issue Addressed

This study evaluated the feasibility, acceptability and effectiveness of an online continuing professional development (CPD) program for primary health professionals (PHPs) regarding early childhood nutrition and associated health behaviours.

Methods

An action research approach was used. Process evaluation included webinar observation to identify behaviour change and adult learning techniques used and post-webinar acceptability surveys. Impact evaluation examined changes in knowledge, attitudes, practices and self-efficacy using online surveys before and 1 month following webinars. Interviews with PHPs and facilitators informed process and impact evaluation.

Results

Thirty-six webinars were delivered from 2022–24, 1246 PHPs registered, and 463 attended live. Facilitation style reflected adult learning principles and incorporated behaviour change techniques targeting knowledge and skill improvement. Facilitators and attendees valued the national scope of the program but highlighted challenges achieving national reach and meeting the needs of a broad audience. Over 90% of attendees provided positive feedback in acceptability surveys; this was reflected in qualitative feedback: attendees enjoyed the practical, interactive content and opportunity to review program material. There was low uptake of effectiveness surveys. In qualitative interviews, PHPs reported intent to change practice; however, the extent of implementation of program content into clinical practice varied.

Conclusions

CPD regarding early childhood health promotion and obesity prevention was well received by PHPs. Future programs should consider incorporating comprehensive impact evaluation.

So What?

Findings should inform future program design, including the need for interactive and practical education. Reach and sustainability of future programs may be enhanced through integration into existing education services for PHPs.

问题解决:本研究评估了初级卫生专业人员(PHPs)关于幼儿营养和相关健康行为的在线持续专业发展(CPD)计划的可行性、可接受性和有效性。方法:采用行动研究法。过程评估包括网络研讨会观察,以确定行为改变和使用的成人学习技术,以及网络研讨会后的可接受性调查。影响评估通过网络研讨会前后1个月的在线调查来检查知识、态度、行为和自我效能的变化。与php和促进者的访谈为过程和影响评估提供了信息。结果:从2022年到2024年共举办了36场网络研讨会,注册了1246名php, 463人参加了现场直播。促进风格反映了成人的学习原则,并结合了以知识和技能提高为目标的行为改变技术。主持人和与会者重视该计划的全国范围,但强调了实现全国覆盖和满足广大受众需求的挑战。超过90%的与会者在可接受性调查中给出了积极的反馈;这在定性反馈中得到了反映:与会者喜欢实用、互动的内容,并有机会回顾课程材料。对有效性调查的接受程度很低。在定性访谈中,php报告了改变实践的意图;然而,在临床实践中实施计划内容的程度各不相同。结论:CPD在促进儿童早期健康和预防肥胖方面的作用得到了小学生的认可。未来的方案应考虑纳入综合影响评价。那又怎样?研究结果应为未来的课程设计提供信息,包括互动性和实践性教育的需求。未来项目的覆盖面和可持续性可以通过整合到现有的PHPs教育服务中来增强。
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引用次数: 0
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Health Promotion Journal of Australia
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