Perspectives on Health Inequity 1999.

Elizabeth Harris, Peter Sainsbury and Don Nutbeam (eds.)
$ 25.00 (incl. GST) within Australia (30.00AUD outside)

Equity means fairness - that all people have an equal and fair opportunity to enjoy life's benefits including maintaining and improving their health. Inequities occur as a consequence of differences in opportunities, for example, to access health services, to eat nutritious food, to live in adequate housing and so on.

Perspectives on Health Inequity presents unique data from the NSW Health Promotion Survey which illustrate differences in health between different population groups and show that these difference are not fair and are avoidable. This is followed by a series of commentaries in which experts from a range of professions present their ideas about why inequities in health exist, what they tell us about Australia today, and what can be done about them.

Health care workers, researchers and students will find the varied perspectives presented in this book will help them understand more fully the causes of inequity and what can be done to address the problem.

Perspectives on Health Inequity is a joint publication of the Centre for Health Equity Training Research & Evaluation, the Social Health Research Unit and the Australian Centre for Health Promotion.

The idea for the book arose from discussion on ways data from the NSW Health Promotion Survey 1994 could be presented in a way that advanced debate on action to address health inequity.

To purchase this publication please contact the Centre.

 

Theory in a Nutshell: A guide to health promotion theory. 2nd edition.2004.

Don Nutbeam and Elizabeth Harris.

The publisher is McGraw Hill (Aust).

Not all health promotion programs are equally successful in achieving their aims and objectives. Experience tells us that programs are most likely to be successful with the determinants of a health problem or issue are well understood, where the needs and motivations of the target population are addressed, and the context in which the program is being implemented has been taken into account. That is, the program ‘fits’ the problem.

Although many health promotion projects and programs are developed and implemented without overt reference to theory, there is substantial evidence from the literature on health promotion to suggest that the use of theory will significantly improve the chances of success in achieving pre-determined program objectives. The use of theory can help us understand better the nature of the problem being addressed, the needs and motivations of the target population, and/or the context for intervention, thus helping to achieve a better fit between problem and program.

This monograph is intended to provide practitioners and students of health promotion with an overview of several of the most influential theories and models which have guided health promotion practice in the recent past, and remain influential in the present.

In each case, an explanation of the main elements of the theory is provided, followed by a commentary on its relative strengths and weaknesses, and some idea on how it can be related to the real world.

Through this monograph, we hope to demonstrate that, when used prudently, theories can greatly enhance the effectiveness and sustainability of health promotion programs.

To purchase this publication you should contact your bookstore or the publisher.

 

From Research into Practice in Health Promotion: a review of the literature on dissemination. April 1996.

Lesley King, Penelope Hawe and Marilyn Wise.

$ 16.50 (incl. GST) within Australia (20.00AUD outside)
This report is based on a report commissioned by and presented to the Health Advancement Standing Committee of the National health and Medical Research Council of Australia.

The effective dissemination of new knowledge in health promotion and its application to practice is a vital component of Australia's effort to improve the health of the population. Yet effective and cost-effective health advancement practices are not always adopted as widely and as often as the evaluative research suggests they should be. In other cases programs remain popular despite the existence of evidence that they are not as cost-effective as available alternatives.

This report describes the findings from a literature search on dissemination between health promotion researchers and practitioners. The search found a substantial number of descriptive articles and case studies which discussed strategies for linking researchers and practitioners and increasing the impact of programs and research findings. On this basis this report describes a framework for understanding the issue of dissemination and sets out a guide for action.

The complexity of dissemination can easily be underestimated, and in the absence of deliberate and systematic approaches it is not surprising to find insufficient dissemination. It appears that in some cases health promotion programs of established effectiveness have not been widely disseminated and implemented, and in other cases that dissemination occurs prematurely, before there is sufficient evidence of effectiveness. Part of the complexity relates to differing judgements about the level of evidence that is needed to warrant the dissemination of a program.

Dissemination is an active, purposeful process which requires resources, infrastructure and planning. Effective dissemination depends on linkages between researcher and practitioner groups, where these links operate so as to ensure the development of practicable programs, the accumulation of a sound body of evidence on effectiveness, and technical and policy support for widespread implementation. Dissemination involves deliberate effort by both researchers and practitioners, as set out in the checklist on the following page.

There is a repertoire of strategies which have been used to support the dissemination of programs to practitioners, and these include mass and interpersonal communication, protocols, training, consultancy, policy and organisational changes. Dissemination strategies often depend on substantial organisational change in order to introduce new practices. Understanding the dissemination process requires a framework or system which recognises factors affecting the roles of researchers and practitioners, as well as characteristics of the program itself.

Little of the research and commentary on dissemination comes from Australia. More research is needed, not only to make research and programs ready for dissemination, but also to investigate the most effective methods to use in disseminating health promotion programs and research results. So far the ideas and experience in dissemination themselves appear to be very poorly disseminated.

The implications of these findings for health promotion in Australia are discussed. Most urgently we need to go beyond the limitations of this literature review and investigate the situation in Australia from both researcher and practitioner perspectives. It is important to identify current barriers, potential linkage systems and dissemination strategies which could work in this context, and to test the effectiveness of different methods.

To purchase this publication please contact the Centre.

 

Working together: intersectoral action for health. June 1995 Commonwealth of Australia.

Elizabeth Harris, Marilyn Wise, Penelope Hawe, Penelope Finlay, Don Nutbeam.

$ 25.00 (incl. GST) within Australia (30.00AUD outside)

This report was commissioned by the Commonwealth Department of Human Services and Health as part of a strategy to develop the infrastructure for health promotion in Australia. Based on a review of the literature and extensive consultation with the many people who have experience in working with other sectors to promote health, the report identifies conditions for successful intersectoral action for health. It represents a further step toward turning the rhetoric of working intersectorally into effective action.

Working with other sectors to improve population health is not always as straightforward as it may first appear. However, the new national health policy redefines the core business of the health sector to include improving the health of the population and reducing health inequalities. This will mean that it is crucial for the health sector to work with other sectors if it is to meet its organisational goals.

• The review has demonstrated that intersectoral action is complex and difficult – but it can be understood. Steps can be taken to minimise risk and to increase the chances of success if the participants understand and create conditions for effective intersectoral action. Results from the review indicate that these include:
• Necessity for the health sector to work with other sectors and organisations on this issue, rather than in some other way;
• That the proposed action is supported by the wider community and builds on existing policy initiatives – opportunities;
• That the sectors/organisations involved have the capacity to undertake the proposed action - that is, that the organisations have committed themselves to the action and that they have made sure that the necessary knowledge and resources are available;
• That the relationships between those involved are established and strong enough to enable the participants to undertake and sustain action;
• That the planned action is well conceived, and can be implemented and evaluated; and
• That provision has been made to sustain outcomes.

These conditions appear to be important for all types of intersectoral action carried out by all levels of the health sector.

To improve the health of the population it will be essential for the health sector to work with others. This report is intended to assist the health sector to build its capacity to do this successfully.

To purchase this publication please contact the Centre.