Objective: Evaluate the Family Wellbeing (FWB) program delivered in July 2012 to Act for Kids Saf... more Objective: Evaluate the Family Wellbeing (FWB) program delivered in July 2012 to Act for Kids Safe House staff and provide benchmark data that can be used, within this cohort, for comparing the concepts of empowerment and wellbeing over time. Methods: Qualitative evaluation pathway: Two facilitated focus groups pre- and post-FWB program. Quantitative evaluation pathway: Develop a survey instrument to capture the concepts of empowerment and wellbeing. The resulting questionnaire was administered in a single survey with Safe House staff. Results: Nineteen Safe House staff were invited to the FWB program and 17 attended. For the focus groups, the first was conducted with 17 participants and the second with 14 participants. Seventeen people completed the quantitative survey. Participants felt the FWB should be delivered with collaborative planning at the Safe House sites in remote Queensland. Participants who undertook the program felt, on balance, that they could pass on the FWB messag...
As demonstrated in previous chapters, cultural competence is a broad intervention approach that i... more As demonstrated in previous chapters, cultural competence is a broad intervention approach that includes diverse practices operating on multiple levels of health systems. Health systems and the cultural competence approaches they take are situated in complex community, social, cultural, political and economic contexts. Because of the inherent complexities, we argue that a multilevel systems approach is necessary for the advancement of cultural competence outcomes in healthcare. Multilevel interventions aim to improve intervention effectiveness by addressing multiple levels of a relevant social system and capitalising on the synergistic effects of interacting intervention components. In this chapter, we present the first evidence-based, peer-reviewed framework for multilevel interventions to improve cultural competence in healthcare systems. We also discuss some key issues in the design and evaluation of multilevel interventions.
Cultural competence in healthcare is designed to ensure that health professionals are able to pro... more Cultural competence in healthcare is designed to ensure that health professionals are able to provide quality healthcare to culturally and ethnically diverse populations. Cultural competence can be effective for improving health professionals’ knowledge, attitudes and skills as well as patient satisfaction. The impact of cultural competence education and training included in university-based professional training of health and medical students, however, is relatively unclear. This study aims to describe the characteristics and assess the methodological quality of published evaluations of cultural competence education and training interventions targeting health and medical students.
An analytical overview of the current status of cultural competence interventions across Canada, ... more An analytical overview of the current status of cultural competence interventions across Canada, Australia, New Zealand and the USA (CANZUS) was provided in the previous chapters. This chapter outlines the main findings of the review in terms of reported outcomes. The review findings are discussed in relation to the two drivers of cultural competence outlined at the beginning of the book: sociocultural factors impacting healthcare and healthcare and health disparities. It looks at the extent to which current cultural competence interventions achieve outcomes consistent with the core drivers of cultural competence. Suggestions are made for future directions to improve cultural competence intervention and evaluation approaches to better assess their impact on these drivers.
Six months after the end of a complex pilot Indigenous health promotion intervention, six members... more Six months after the end of a complex pilot Indigenous health promotion intervention, six members of the implementation and evaluation team met to reflect on our practice of working on the program. The discussion was structured using the Four Rs model and reflects our learning from the challenges of working as a team in developing the tobacco brief intervention program for primary health care workers.
'Managers and Clinical and Allied Health Staff'. BOP Evaluation interview guide. (DOCX 21... more 'Managers and Clinical and Allied Health Staff'. BOP Evaluation interview guide. (DOCX 21 kb)
The Australian and International Journal of Rural Education, 2019
School completion has been hailed by many as the 'holy grail' of Indigenous education, an... more School completion has been hailed by many as the 'holy grail' of Indigenous education, and 42% remote-living Indigenous students now attain year 12 completion each year. But for a range of complex reasons, only 60% of these graduates translate this achievement into further engagement in study, training or employment. This systematic literature review examined the evidence for strategies that support the post-schooling transitions of these students. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, it examinedthe scope and quality of the existing evidence and appliedqualitative meta-synthesis to elucidate the conditions that enable or hinder, and strategies that support post-schooling transitions. Findings suggested that lower rates of post-schooling study or employment uptake are influenced by: historical misalignment of education approaches with community values and aspirations; limited opportunities in remote communities...
Indigenous men’s support groups are designed to empower men to take greater control and responsib... more Indigenous men’s support groups are designed to empower men to take greater control and responsibility for their health and wellbeing. They provide health education sessions, counselling, men’s health clinics, diversionary programs for men facing criminal charges, cultural activities, drug- and alcohol-free social events, and advocacy for resources. Despite there being ~100 such groups across Australia, there is a dearth of literature on their strategies and outcomes. This paper is based on participatory action research involving two north Queensland groups which were the subject of a series of five ‘phased’ evaluative reports between 2002 and 2007. By applying ‘meta-ethnography’ to the five studies, we identified four themes which provide new interpretations of the data. Self-reported benefits included improved social and emotional wellbeing, modest lifestyle modifications and willingness to change current notions of ‘gendered’ roles within the home, such as sharing housework. Our ...
The social organisation of work, management styles and social relationships in the workplace all ... more The social organisation of work, management styles and social relationships in the workplace all matter for health. It is now well recognised that people who have control over their work have better health and that stress in the workplace increases the level of disease. In the context of organisational change, the potential benefits of empowerment strategies are two-fold: a positive impact on the organisation’s effectiveness and enhancements in staff health, wellbeing and sense of control. This case study describes the University of Queensland Empowerment Research Program’s experience working with the Apunipima Cape York Health Council in a change management process. Participatory action research and empowerment strategies were utilised to facilitate shifts in work culture and group cohesion towards achieving Apunipima’s vision of being an effective lead agency for Indigenous health reform in Cape York. As part of the project, staff morale and confidence were monitored using a picto...
Objectives: This paper provides an example of a mental health research partnership underpinned by... more Objectives: This paper provides an example of a mental health research partnership underpinned by empowerment principles that seeks to foster strength among community organizations to support better outcomes for consumers, families and communities. It aims to raise awareness among researchers and service providers that empowerment approaches to assist communities to address mental health problems are not too difficult to be practical but require long-term commitment and appropriate support. Methods: A collaborative research strategy that has become known as the Priority Driven Research (PDR) Partnership emerged through literature review, consultations, Family Wellbeing Program delivery with community groups and activities in two discrete Indigenous communities. Progress to date on three of the four components of the strategy is described. Results: The following key needs were identified in a pilot study and are now being addressed in a research-based implementation phase: (i) gainin...
Despite advocacy for systems-level approaches to cultural competence, the primary focus in the li... more Despite advocacy for systems-level approaches to cultural competence, the primary focus in the literature remains on competence strategies aimed at health promotion initiatives, workforce development and student education. This chapter aims to bridge the gap in available evidence about systems approaches to cultural competence by systematically searching, selecting and synthesising existing publications to map key concepts, types of evidence and gaps in research.
Objective: Evaluate the Family Wellbeing (FWB) program delivered in July 2012 to Act for Kids Saf... more Objective: Evaluate the Family Wellbeing (FWB) program delivered in July 2012 to Act for Kids Safe House staff and provide benchmark data that can be used, within this cohort, for comparing the concepts of empowerment and wellbeing over time. Methods: Qualitative evaluation pathway: Two facilitated focus groups pre- and post-FWB program. Quantitative evaluation pathway: Develop a survey instrument to capture the concepts of empowerment and wellbeing. The resulting questionnaire was administered in a single survey with Safe House staff. Results: Nineteen Safe House staff were invited to the FWB program and 17 attended. For the focus groups, the first was conducted with 17 participants and the second with 14 participants. Seventeen people completed the quantitative survey. Participants felt the FWB should be delivered with collaborative planning at the Safe House sites in remote Queensland. Participants who undertook the program felt, on balance, that they could pass on the FWB messag...
As demonstrated in previous chapters, cultural competence is a broad intervention approach that i... more As demonstrated in previous chapters, cultural competence is a broad intervention approach that includes diverse practices operating on multiple levels of health systems. Health systems and the cultural competence approaches they take are situated in complex community, social, cultural, political and economic contexts. Because of the inherent complexities, we argue that a multilevel systems approach is necessary for the advancement of cultural competence outcomes in healthcare. Multilevel interventions aim to improve intervention effectiveness by addressing multiple levels of a relevant social system and capitalising on the synergistic effects of interacting intervention components. In this chapter, we present the first evidence-based, peer-reviewed framework for multilevel interventions to improve cultural competence in healthcare systems. We also discuss some key issues in the design and evaluation of multilevel interventions.
Cultural competence in healthcare is designed to ensure that health professionals are able to pro... more Cultural competence in healthcare is designed to ensure that health professionals are able to provide quality healthcare to culturally and ethnically diverse populations. Cultural competence can be effective for improving health professionals’ knowledge, attitudes and skills as well as patient satisfaction. The impact of cultural competence education and training included in university-based professional training of health and medical students, however, is relatively unclear. This study aims to describe the characteristics and assess the methodological quality of published evaluations of cultural competence education and training interventions targeting health and medical students.
An analytical overview of the current status of cultural competence interventions across Canada, ... more An analytical overview of the current status of cultural competence interventions across Canada, Australia, New Zealand and the USA (CANZUS) was provided in the previous chapters. This chapter outlines the main findings of the review in terms of reported outcomes. The review findings are discussed in relation to the two drivers of cultural competence outlined at the beginning of the book: sociocultural factors impacting healthcare and healthcare and health disparities. It looks at the extent to which current cultural competence interventions achieve outcomes consistent with the core drivers of cultural competence. Suggestions are made for future directions to improve cultural competence intervention and evaluation approaches to better assess their impact on these drivers.
Six months after the end of a complex pilot Indigenous health promotion intervention, six members... more Six months after the end of a complex pilot Indigenous health promotion intervention, six members of the implementation and evaluation team met to reflect on our practice of working on the program. The discussion was structured using the Four Rs model and reflects our learning from the challenges of working as a team in developing the tobacco brief intervention program for primary health care workers.
'Managers and Clinical and Allied Health Staff'. BOP Evaluation interview guide. (DOCX 21... more 'Managers and Clinical and Allied Health Staff'. BOP Evaluation interview guide. (DOCX 21 kb)
The Australian and International Journal of Rural Education, 2019
School completion has been hailed by many as the 'holy grail' of Indigenous education, an... more School completion has been hailed by many as the 'holy grail' of Indigenous education, and 42% remote-living Indigenous students now attain year 12 completion each year. But for a range of complex reasons, only 60% of these graduates translate this achievement into further engagement in study, training or employment. This systematic literature review examined the evidence for strategies that support the post-schooling transitions of these students. Adhering to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) framework, it examinedthe scope and quality of the existing evidence and appliedqualitative meta-synthesis to elucidate the conditions that enable or hinder, and strategies that support post-schooling transitions. Findings suggested that lower rates of post-schooling study or employment uptake are influenced by: historical misalignment of education approaches with community values and aspirations; limited opportunities in remote communities...
Indigenous men’s support groups are designed to empower men to take greater control and responsib... more Indigenous men’s support groups are designed to empower men to take greater control and responsibility for their health and wellbeing. They provide health education sessions, counselling, men’s health clinics, diversionary programs for men facing criminal charges, cultural activities, drug- and alcohol-free social events, and advocacy for resources. Despite there being ~100 such groups across Australia, there is a dearth of literature on their strategies and outcomes. This paper is based on participatory action research involving two north Queensland groups which were the subject of a series of five ‘phased’ evaluative reports between 2002 and 2007. By applying ‘meta-ethnography’ to the five studies, we identified four themes which provide new interpretations of the data. Self-reported benefits included improved social and emotional wellbeing, modest lifestyle modifications and willingness to change current notions of ‘gendered’ roles within the home, such as sharing housework. Our ...
The social organisation of work, management styles and social relationships in the workplace all ... more The social organisation of work, management styles and social relationships in the workplace all matter for health. It is now well recognised that people who have control over their work have better health and that stress in the workplace increases the level of disease. In the context of organisational change, the potential benefits of empowerment strategies are two-fold: a positive impact on the organisation’s effectiveness and enhancements in staff health, wellbeing and sense of control. This case study describes the University of Queensland Empowerment Research Program’s experience working with the Apunipima Cape York Health Council in a change management process. Participatory action research and empowerment strategies were utilised to facilitate shifts in work culture and group cohesion towards achieving Apunipima’s vision of being an effective lead agency for Indigenous health reform in Cape York. As part of the project, staff morale and confidence were monitored using a picto...
Objectives: This paper provides an example of a mental health research partnership underpinned by... more Objectives: This paper provides an example of a mental health research partnership underpinned by empowerment principles that seeks to foster strength among community organizations to support better outcomes for consumers, families and communities. It aims to raise awareness among researchers and service providers that empowerment approaches to assist communities to address mental health problems are not too difficult to be practical but require long-term commitment and appropriate support. Methods: A collaborative research strategy that has become known as the Priority Driven Research (PDR) Partnership emerged through literature review, consultations, Family Wellbeing Program delivery with community groups and activities in two discrete Indigenous communities. Progress to date on three of the four components of the strategy is described. Results: The following key needs were identified in a pilot study and are now being addressed in a research-based implementation phase: (i) gainin...
Despite advocacy for systems-level approaches to cultural competence, the primary focus in the li... more Despite advocacy for systems-level approaches to cultural competence, the primary focus in the literature remains on competence strategies aimed at health promotion initiatives, workforce development and student education. This chapter aims to bridge the gap in available evidence about systems approaches to cultural competence by systematically searching, selecting and synthesising existing publications to map key concepts, types of evidence and gaps in research.
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Papers by Janya Mccalman