ORCID Profile
0000-0002-5410-1072
Current Organisation
University of South Australia
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Publisher: Oxford University Press (OUP)
Date: 05-06-2010
Abstract: Despite decades of concern about reducing health inequity, the Commission on the Social Determinants of Health (CSDH) painted a picture of persistent and, in some cases, increasing health inequity. It also made a call for increased evaluation of interventions that might reduce inequities. This paper describes such an intervention-the Social Inclusion Initiative (SII) of the South Australian Government-that was documented for the Social Exclusion Knowledge Network of the CSDH. This initiative is designed to increase social inclusion by addressing key determinants of health inequity-in the study period these were education, homelessness and drug use. Our paper examines evidence from a rapid appraisal to determine whether a social inclusion initiative is a useful aspect of government action to reduce health inequity. It describes achievements in each specific area and the ways they can be expected to affect health equity. Our study highlighted four factors central to the successes achieved by the SII. These were the independent authority and influence of the leadership of the SII, the whole of government approach supported by an overarching strategic plan which sets clear goals for government and the clear and unambiguous support from the highest level of government. We conclude that a social inclusion approach can be valuable in the quest to reduce inequities and that further research on innovative social policy approaches is required to examine their likely impact on health equity.
Publisher: Springer Science and Business Media LLC
Date: 03-2008
DOI: 10.1007/BF03031938
Publisher: Elsevier BV
Date: 10-2011
Publisher: Informa UK Limited
Date: 05-2009
Publisher: Elsevier BV
Date: 06-0007
DOI: 10.1016/J.SOCSCIMED.2013.03.033
Abstract: The articulation of strong evidence and moral arguments about the importance of social determinants of health (SDH) and health equity has not led to commensurate action to address them. Policy windows open when, simultaneously, an issue is recognised as a problem, policy formulation and refinement happens and the political will for action is present. We report on qualitative interviews with 20 former Australian Federal, State or Territory health ministers conducted between September 2011 and January 2012 concerning their views about how and why the windows of policy opportunity on the SDH did or did not open during their tenure. Almost all ex-health ministers were aware of the existence of health inequalities and SDH but their complexity meant that this awareness rarely crystalised into a clear problem other than as a focus on high needs groups, especially Aboriginal people. Formulation of policies about SDH was assisted by cross-portfolio structures, policy entrepreneurs, and evidence from reviews and reports. It was hindered by the complexity of SDH policy, the dominance of medical power and paradigms and the weakness of the policy community advocating for SDH. The political stream was enabling when the general ideological climate was supportive of redistributive policies, the health care sector was not perceived to be in crisis, there was support for action from the head of government and cabinet colleagues, and no opposition from powerful lobby groups. There have been instances of Australian health policy which addressed the SDH over the past twenty five years but they are rare and the windows of opportunity that made them possible did not stay open for long.
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/PY13133
Publisher: Bristol University Press
Date: 2011
Abstract: This paper describes a partnership between researchers and policy actors that was developed within a short timeframe to produce a rapid appraisal case study of a government policy initiative – South Australia’s Social Inclusion Initiative – for the Social Exclusion Knowledge Network of the international Commission on Social Determinants of Health. The paper does not focus on the case study findings or content, but rather on the researcher–policy actor partnership that developed in the process of producing the case study and its report. The paper is set against the broader literature on researcher–policy collaboration and is written to share lessons that may help others quickly establish or improve researcher–policy partnerships. It sets out six key elements for success in a framework for partnership that can meet policy rather than academic timeframes and which can effectively co-produce knowledge that meets both research and policy objectives.
Publisher: SAGE Publications
Date: 06-09-2013
Abstract: Job loss has negative consequences for health and evidence shows that the agency of workers experiencing job loss is affected by labour market and welfare policy. The policy environment into which workers emerge after losing their jobs strongly influences the way job loss and its aftermath is experienced. This article draws on findings from two waves of in-depth semi-structured interviews with 33 retrenched South Australian automotive workers. It discusses how, within the context of Australian welfare and industrial policy, workers experienced the consequences of mass job losses that occurred at Mitsubishi Motors during 2004 and 2005. Key findings include largely negative experiences associated with negotiating welfare-to-work policy, and a more precarious employment environment further entrenched under industrial relations policy. Job loss is both a personal and a structural story and we use an agency and structure perspective to examine how workers’ agency was enabled, but more often constrained, by policy.
Publisher: Springer Science and Business Media LLC
Date: 25-09-2012
DOI: 10.1007/S10995-011-0887-5
Abstract: Breastfeeding policies and practices were analysed in childcare settings in the metropolitan area of Adelaide, South Australia. Childcare centres were purposively selected based on their geographical location, type and socioeconomic score of the area. Qualitative inquiry approach was employed by undertaking interviews with childcare centres' director or baby house coordinator to explore their perception towards breastfeeding practice and support within their centre. Breastfeeding related policy documents, where available, were also collected during the interviews to triangulate data. A total of 15 face-to-face interviews were conducted. Six childcare centres had a written policy specifically on breastfeeding support, although the technical issues of handling breastmilk were included in most centres' food and nutrition guidelines. Most participants believed that decision to breastfeed is the personal choice of parents, and hence saw the childcare centre's role as supporting parental choice whether it is breastfeeding or not. The provision of physical space to breastfeed and facilities to store the expressed breast milk were the most common practices in support of parents who had chosen to continue breastfeeding. Participants perceived mothers' work-related issues such as distance from the centre, time, and unsupportive workplace the most important barriers that led to early introduction of bottle feeding or breastfeeding cessation. Most childcare centres support breastfeeding in a more passive than active way. Breastfeeding promotion needs to be an integral part of childcare centres training, policy and practice if an increased rate of breastfeeding is to be achieved particularly amongst working mothers.
Publisher: BMJ
Date: 02-01-2014
Abstract: This paper offers lessons to in-coming health ministers on how they can act to reduce inequities and take action on social determinants. It draws on an interview study of twenty former Australian State, Territory and Federal health ministers about the extent to which they were able to do these things during their tenure. In order to take effective health equity action the health ministers advised: ensure evidence is used to develop a strong party policy platform for health equity install policy entrepreneurs for health equity and social determinants in the health ministry build popular constituencies through processes of deliberative democracy establish context appropriate cross-department mechanisms to co-ordinate action on social determinants and be elected in the context of a political party which values social justice and redistribution.
Publisher: Elsevier BV
Date: 04-2012
Publisher: Wiley
Date: 19-08-2010
Publisher: Springer Science and Business Media LLC
Date: 10-01-2009
Publisher: Informa UK Limited
Date: 10-2013
DOI: 10.1080/08959420.2013.816194
Abstract: Internationally, public policies encourage "aging in place," and the majority of older Australians requiring care in the community receive informal care, supplemented by publicly subsidized formal services. The effect of contemporary social changes on informal care in aging migrant communities is poorly understood. This articles explores the perceptions of older Greek-Australians toward changes in the nature of family support. Bicultural and bilingual researchers carried out in-depth interviews (n = 27) and five focus groups (n = 63 total participants) with older Greek-Australians in modern Greek. While "cultures of care" remain among Greek-Australian families, the means for a family to assist have shifted, and these compromises are met with considerable powerlessness among older Greek-Australians. Implications for policy include the need to better involve older migrants and their families in decisions about their care needs, potentially involving consumer-directed care models. Service providers may also need to adopt the use of new technologies to communicate with increasingly time-pressured family members.
Publisher: SAGE Publications
Date: 20-03-2013
Abstract: The beneficial effects of breastfeeding for mothers and babies are well recognized. When maternal breast milk is not available in sufficient quantity, donor breast milk is recommended as an alternate source of nutrition, particularly in preterm and other high-risk infants. Australia lags behind the rest of the developed world in establishing and promoting human milk banks there is no human milk bank in South Australia and little is known concerning mothers’ perceptions of using human milk banks in that state. This study explored mothers’ knowledge of and attitudes toward human milk banks, to inform the development of human milk banking policies and guidelines in South Australia should a milk bank be established. In-depth semistructured interviews were conducted with 12 mothers who were breastfeeding and/or had preterm or sick babies. In addition, 2 focus groups were conducted—1 with breastfeeding mothers as potential donors (n = 5) and the other with mothers of preterm or high-risk infants (n = 4)—to answer questions raised by early analysis of the in idual interview data. Breastfeeding mothers, as potential donors, unanimously supported donating their breast milk to a human milk bank, provided it would be easy (especially if required to drop off milk) and not overly time consuming. Mothers of preterm or sick infants would use a human milk bank if they were assured the milk was safe and appropriate for their babies. Study participants would welcome having access to a human milk bank for both donating and receiving milk in South Australia.
Publisher: Oxford University Press (OUP)
Date: 06-12-2012
Publisher: Wiley
Date: 10-2008
Publisher: American Society of Hematology
Date: 14-04-2011
DOI: 10.1182/BLOOD-2010-10-312793
Abstract: B cells require signals delivered through B-cell activating factor of the TNF family receptor (BAFF-R) and CD40 to survive and produce antibody responses in vivo. In vitro data indicate that these signals are controlled by the homologous RING finger proteins cIAP1 and cIAP2, in collaboration with TRAF2 and TRAF3. There is also mounting evidence that all 4 of these signaling molecules can act as tumor suppressors in human B-lineage malignancies. However, it has not been possible to identify the roles of cIAP1 and cIAP2 in controlling B-cell physiology because of the absence of an appropriate in vivo model. Here we describe a unique genetically modified mouse in which the linked cIap1 and cIap2 genes can be independently inactivated. Deletion of cIAP1 plus cIAP2 (but not either protein alone) rendered primary B cells independent of BAFF-R for their survival and led to their uncontrolled accumulation in vivo. B cells deficient in cIAP1 and cIAP2 were also incapable of forming germinal centers, a key step in antibody-mediated immunity. These data define a fundamental role for cIAP1/cIAP2 in regulating B-cell survival and responsiveness, show this requires direct binding to TRAF2, and suggest how mutations of TRAF2, TRAF3, and cIAP1/cIAP2 contribute to B-lineage malignancies, such as multiple myeloma.
Publisher: Hindawi Limited
Date: 25-09-2013
DOI: 10.1111/HSC.12000
Abstract: In most developed nations, ageing migrants represent a growing proportion of the older population. Policies that emphasise care in the community depend on older migrants having access to formal services along with informal support, yet little is known about how older migrants experience community-based formal services. By examining the views of both Greek elders in Australia and those of formal service providers, this research fills an important gap in the literature around access to and acceptability of formal community-based services for older migrants. A research team including two Greek background researchers used existing social groups and a snowball s ling method to conduct face-to-face interviews and focus groups with seventy older Greeks in Adelaide, Australia. In addition, 22 community-based service providers were interviewed over the telephone. Results from users and providers showed that while many older Greeks experience service access issues, they also relied heavily on family for support and assistance at home. Reliance on family was both in preference to formal services or where formal services were used, to locate, negotiate and monitor such services. Common barriers identified by both groups included cost, transport and availability, but additional challenges were posed by language, literacy and cultural attitudes. Demographic changes including greater employment mobility and female workforce participation among adult children will have implications for both formal and informal care providers. Formal service providers need to ensure that services are promoted and delivered to take account of the important role of family in informal support while also addressing the access challenges posed by language and literacy. Research conducted by researchers from the same cultural background in the respondent's native language can further advance knowledge in this area.
Publisher: Oxford University Press (OUP)
Date: 09-11-2014
Abstract: Digital technologies are increasingly important as ways to gain access to most of the important social determinants of health including employment, housing, education and social networks. However, little is known about the impact of the new technologies on opportunities for health and well-being. This paper reports on a focus group study of the impact of these technologies on people from low socio-economic backgrounds. We use Bourdieu's theories of social inequities and the ways in which social, cultural and economic capitals interact to reinforce and reproduce inequities to examine the ways in which digital technologies are contributing to these processes. Six focus group discussions with 55 people were held to examine their access to and views about using digital technologies. These data are analysed in light of Bourdieu's theory to determine how people's existing capitals shape their access to and use of digital technologies and what the implications of exclusion from the technologies are likely to be for the social determinants of health. The paper concludes that some people are being caught in a vicious cycle whereby lack of digital access or the inability to make beneficial use reinforces and lifies existing disadvantage including low levels of reading and writing literacy. The paper concludes with a consideration of actions health promoters could take to interrupt this cycle and so contribute to reducing health inequities.
Publisher: Elsevier BV
Date: 10-2016
DOI: 10.1016/J.IJMEDINF.2016.05.006
Abstract: Despite evidence of benefits of telehealth networks in increasing access to, or providing, previously unavailable mental health services, care providers still prefer traditional approaches. For psychiatric assessment, digital technology can offer improvements over analog systems for the technical and, subsequently, the social quality of provider-client interaction. This is in turn expected to support greater provider uptake and enhanced patient benefits. Within the framework of Innovation Diffusion Theory, to study service providers' experiences of an existing regional telehealth network for mental health care practice twelve months after digitisation in order to identify the benefits of digital telehealth over an analog system for mental health care purposes in rural Australia. Qualitative interviews and focus groups were conducted with over 40 service providers from June to September 2013 in South Australia, ranging from the metropolitan central operations to health providers located up to 600km away in rural and remote areas of the same state. Participants included rural mental health teams, directors of nursing at rural hospitals, metropolitan-based psychiatrists and registrars, the metropolitan-based mental health team dedicated to rural provider support, rural GPs, administrative staff, and the executive group of the state rural health department. Fieldwork was conducted 12 months after the analog system was digitised. The interview and focus group data were analysed using thematic analysis, focusing on three key areas of innovation diffusion theory: relative advantage, technical complexity and technical compatibility. Five themes with 11 sub-themes were identified: (1) "Existing Uses", with three sub-themes: current mental health use, use by GPs, and use for staff support (2) "Relative Advantage", with four sub-themes: improved technical quality, improved clinical practice, time and cost benefits for providers, and improved patient care (3) "Technical Complexity" (4) "Technical Compatibility" with two sub-themes: technical-clinical and technical-administrative and (5) "Broader Organisational Culture", with two sub-themes: organizational policy support and 'digital telehealth' culture. The digitised telehealth network was generally well received by providers and adopted into clinical practice. Compared with the previous analog system, staff found advantages in better visual and audio quality, more technical stability with less "drop-out", less time delay to conversations and less confusion for clients. Despite these advantages, providers identified a range of challenges to starting or continuing use and they recommended improvements to increase uptake among mental health service providers and other providers (including GPs), and to clinical uses other than mental health. To further increase uptake and impact of telehealth-mediated mental health care in rural and remote areas, even with a high quality digital system, future research must design innovative care models, consider time and cost incentives for providers to use telehealth, and must focus not only on technical training but also how to best integrate technology with clinical practice and must develop an organization-wide digital telehealth culture.
Publisher: Wiley
Date: 03-2009
Publisher: Wiley
Date: 28-05-2009
Publisher: Springer Science and Business Media LLC
Date: 06-02-2013
Publisher: CSIRO Publishing
Date: 2012
DOI: 10.1071/AH11042
Abstract: Objective. To present research findings on access to, and use of, digital information and communication technologies (ICTs) by Australians from lower income and disadvantaged backgrounds to determine implications for equitable consumer access to digitally-mediated health services and information. Methods. Focus groups were held in 2008-09 with 80 residents from lower income and disadvantaged backgrounds in South Australia, predominantly of working- and family-formation age (25 to 55 years). Qualitative analysis was conducted on a-priori and emergent themes to describe dominant categories. Results. Access to, and use of, computers, the Internet and mobile phones varied considerably in extent, frequency and quality within and across groups due to differences in abilities, resources and life experience. Barriers and facilitators included English literacy (including for native speakers), technological literacy, education, income, housing situation, social connection, health status, employment status, and trust. Many people gained ICT skills by trial and error or help from friends, and only a few from formal programs, resulting in varied skills. Conclusion. The considerable variation in ICT access and use within lower income and disadvantaged groups must be acknowledged and accommodated by health initiatives and services when delivering digitally-mediated consumer-provider interaction, online health information, or online self-management of health conditions. If services require consumers to participate in a digitally-mediated communication exchange, then we suggest they might support skills and technology acquisition, or provide non-ICT alternatives, in order to avoid exacerbating health inequities. 1. What is known about the topic? Government and health provider use of digitally-mediated information and communication is rapidly increasing. However, national data show that ICT access is distributed unevenly across Australia’s population. Furthermore, this distribution mirrors the health gradient. There is little qualitative data on the extent to which, and ways in which, ICTs are used within lower income and disadvantaged groups - those with greater health need. 2. What does this paper add? This paper augments the scant literature to describe ICT access and use in a range of lower income and disadvantaged groups. It indicates barriers and facilitators, and highlights the need for formal supports to level up the whole population to have the skills, confidence and resources to use and benefit from ICT-mediated communication. 3. What are the implications for practitioners? As health services and governments increase the level of digitally-mediated information and communication connection with consumers atients, it is important to understand and find ways to address differential consumer access to and use of ICTs, so that equity of access to services and information is promoted. This is particularly important as lower income and disadvantaged groups are likely to have both poorer health and lower ICT use.
Publisher: Elsevier BV
Date: 10-2013
DOI: 10.1016/J.MIDW.2013.06.002
Abstract: to uncover local beliefs regarding pregnancy and birth in remote mountainous villages of Nepal in order to understand the factors which impact on women's experiences of pregnancy and childbirth and the related interplay of tradition, spiritual beliefs, risk and safety which impact on those experiences. this study used a qualitative methodological approach with in-depth interviews framework within social constructionist and feminist critical theories. the setting comprised two remote Nepalese mountain villages where women have high rates of illiteracy, poverty, disadvantage, maternal and newborn mortality, and low life expectancy. Interviews were conducted between February and June, 2010. twenty five pregnant ostnatal women, five husbands, five mothers-in-law, one father-in-law, five service providers and five community stakeholders from the local communities were involved. Nepalese women, their families and most of their community strongly value their childbirth traditions and associated spiritual beliefs and they profoundly shape women's views of safety and risk during pregnancy and childbirth, influencing how birth and new motherhood fit into daily life. These intense culturally-based views of childbirth safety and risk conflict starkly with the medical view of childbirth safety and risk. if maternity services are to improve maternal and neonatal survival rates in Nepal, maternity care providers must genuinely partner with local women inclusive of their cultural beliefs, and provide locally based primary maternity care. Women will then be more likely to attend maternity care services, and benefit from feeling culturally safe and culturally respected within their spiritual traditions of birth supported by the reduction of risk provided by informed and reverent medicalised care.
Publisher: SAGE Publications
Date: 15-03-2013
Abstract: Australia has high rates of breastfeeding initiation, with a consistent decline over the first year. Furthermore, there is a growing trend of maternal employment and rising numbers of children enrolled in different types of child care services, both of which can have a negative impact on breastfeeding. To provide evidence to better inform implementation of breastfeeding-friendly strategies in child care settings, this study examined breastfeeding policy and practice in child care centers in metropolitan Adelaide. The paper reports on a survey sent to 292 child care centers in metropolitan Adelaide in 2010. The survey collected information on center location and type, number of enrolled children under age 2, and number of breastfed babies. The survey also included questions about breastfeeding facilities and support, breastfeeding policies, staff training, and barriers to and recommendations to enhance breastfeeding support in child care centers. Of the 62 completed returned surveys (21% response rate), 43 centers (69.4%) reported that they currently have children who receive breast milk at the center however, in most centers, the total number of breastfed children was reported to be between 1 and 4 76% reported that the center was supportive of exclusive breastfeeding for 6 months and 80.6% had statements on breastfeeding as part of their food and nutrition policies or guidelines. Furthermore, 64.5% reported there was no formal or informal training for staff on breastfeeding support, but 50% reported that staff members do provide breastfeeding advice to mothers of children in their center. Despite some strategies in place to support breastfeeding, there are no standards on breastfeeding policies, practices, and training in child care settings. Therefore, the extent and scope of such support depend on parental request and the perceptions and attitudes of child care center staff toward breastfeeding.
Publisher: Wiley
Date: 13-06-2013
DOI: 10.1111/CCH.12048
Abstract: Youth use the Internet for a variety of purposes including social networking. Youth with disabilities are limited in their social networks and friendships with peers. The aim was to investigate the effectiveness of tailored one-on-one support strategies designed to facilitate social participation of youth with disabilities through the use of the Internet for social networking. Eighteen youth aged 10-18 years with cerebral palsy, physical disability or acquired brain injury received support, training and assistive technology at their home to learn to use the Internet for building social networks. The Canadian Occupational Performance Measure (COPM) and Goal Attainment Scale (GAS) were used to evaluate objective changes in performance and satisfaction. Interviews with the youth identified subjective changes they experienced through participation in the programme and to determine whether and how the intervention influenced their social participation. Youth showed an increase in performance and satisfaction with performance on identified goals concerning social networking on the COPM Paired T-test showed that these differences were statistically significant at P 50) for 78% of the youth. Interviews showed that youth were positive about the benefits of hands-on training at home leading to increased use of the Internet for social networking. The Internet could be a viable method to facilitate social participation for youth with disabilities. Youth identified the benefits of one-to-one support at home and training of the family compared with typical group training at school. Despite its success with this group of youth, the time and effort intensive nature of this approach may limit the viability of such programmes. Further longitudinal research should investigate whether Internet use is sustained post intervention, and to identify the factors that best support ongoing successful and safe use.
Publisher: Swinburne University of Technology
Date: 20-05-2013
No related grants have been discovered for Lareen Newman.