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Happy 21st Birthday SACHRU

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Happy 21st Birthday SACHRU

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									                                                                                                                    volume 14
                                                                                                                    number    2
                                                                                                                    july   2005
                                     newsletter of the south australian community health research unit

Happy 21st Birthday SACHRU
On 3rd June 2005, over 70 people gathered
at Tandanya to help SACHRU celebrate
21 years of community health research in
SA and to launch the Australian Health
Inequities Program.

For 21 years SACHRU, and its forerunners,
the Southern and Northern Research
Units, have produced an impressive
collection of research, reports, resources
and academic papers. Some of the
highlights are featured in our 21st
birthday publication (available online).

The celebration was chaired by Sir Eric
Neal, Chancellor of Flinders University
and opened by Josie Agius, a Kaurna
Aboriginal elder.

Catherine Sumner performed a number
                                             Helma Hooper , Adair Garrett , Professor Roy Goldie, Professor Fran
of beautiful songs and this was followed     Baum and Hon Lea Stevens, Minister for Health
by Adair Garrett, chair of SACHRU’s
management advisory committee, paying
tribute to SACHRU’s achievements.

Professor Fran Baum introduced the AHIP
and Professor Sue Richardson described                                                        What’s Inside
the social importance of the program.
                                                                                              Director’s Comments……..………...…………….2
The Minster for Health, Honourable Lea                                                        AHIP launch in Melbourne………...…………….2
Stevens, then spoke about SACHRU’s                                                            Workshop for Tullawon Health Service………..2
contribution to health research and
                                                                                              Arts SA ‘Partnerships for Healthy Communities
officially launched the AHIP (see page 4
for extracts from the Minister’s speech).                                                     Program’…………………………………………...3
                                                                                              Health Services Governance and Reform…………3
The Minster was assisted in cutting the                                                       Minister’s Speech………………………….…......4
SACHRU birthday cake by Fran
                                                                                              Congratulations on academic achievements….5
Baum, Adair Garrett, Helma Hooper
and Professor Roy Goldie.                                                                     Impact of retrenchment of Mitsubishi workers in
                                                                                              Southern Adelaide ………………………............5
We would like to acknowledge all our                                                          Byron Bay Workshop .......................................5
past and current staff, supporters and                                                        News on WHO Commission…...………………..5
friends in the community health sector,
                                                                                              Evaluation of ELF…………………………….....7
the Department of Health, Flinders
University and elsewhere and we look                                                          Evaluation of the Women’s Healthline………..7
forward to another 21 years!
                                                                                                                                                Page 1
Director’s comments
The past few months have been an eventful time for SACHRU. Most significantly we celebrated our 21st birthday in conjunction
with the launch of the Australian Health Inequities Program at a morning tea held at Tandanya. Lea Stevens, the South Australian
Minister of Health made very complimentary comments about SACHRU and the role it has played in educating the health
system about appropriate forms of research for community based studies and evaluations. In the past month the contract
between the Department of Health and Flinders University was also signed and so now SACHRU is under new governance.
This consolidates the close relationship SACHRU already had with the University and we are looking forward to being an
effective and contributing member of the Flinders University family, while maintaining our close links with community health
services across South Australia.

This is a good time to thank all the people who have worked for SACHRU over the years of its operation. SACHRU’s success
reflects the contribution of all these people who have been prepared to work hard and show a commitment to SACHRU’s core
values of achieving equity in health status through action on the social determinants of health and the provision of community
health services. Good team work is the best work experience and SACHRU has given me much of this over the years.

Rather sadly Helma Hooper has left SACHRU after 20 years of service. Helma has been known as the friendly administrative
face of SACHRU for this time and has developed close working ties with many community health workers. In particular, she
has worked closely with our Management Advisory Committee over most of that time. I would personally like to thank Helma
for the wonderful support and friendship she has given me over the years and to wish her well in her new role at Noarlunga
Health Services.

SACHRU and the Department of Public Health are experiencing a rapid growth in research staff because of the joint success
in winning a number of national research grants. These are reported on in this newsletter and demonstrate the synergies
between an academic Department and a community-focussed Research Unit.

July will be an exciting month for me because I will be attending the Second People’s Health Assembly
(www.phmovement.org) to be held in Cuenca, Ecuador and teaching on the International People’s Health University. I have
been part of a group working towards these events for a few years so am looking forward greatly to them happening. I’m sure
they will be a time of solidarity and optimism about the potential for people to change the world for the better! I will report
back on these events in the next Research Matters. Meanwhile see the “Voices from South Australia” publication on
SACHRU’s website.

Fran Baum


AHIP Launch in Melbourne                                                               Workshop for Tullawon
                                            Harvard Dr. S. V. Subramanian, Fran        Health Service
                                            Baum and Anne Kavanagh spoke.
                                                                                       Fran Baum co-facilitated a workshop
                                            The event was attended by 130              on primary health care for the staff and
                                            people. Prof. Kawachi is one of the        board of the Tullawon Health Service
                                            world’s leading researchers on social      which services the Yalata community,
                                            capital. He is one of the named            on the 16th and 17th June. David
                                            international collaborators on the         Scrimageour was the co-facilitator.
                                            Australian Health Inequities Program       About 12 people attended the
                                            grant and we will look forward to          workshop. It covered the background
                                            welcoming him as a visitor to              to primary health care and the social
AHIP launch in Melbourne
                                            Adelaide during the life of the grant.     determinants of health and also
                                            Our strong link with A/Prof Anne           allowed for planning work by the
                                            Kavanagh and her team at the               health service. New ideas for health
The Australian Health Inequity
                                            University of Melbourne is                 promotion emerged from the two day
Program was also launched in
                                            continuing to develop, especially in
Melbourne on Friday 10th June by                                                       session. Fran also visited the Yalata
                                            respect of the similar work we are         community and hopes that this will be
Professor Ichiro Kawachi (Harvard
                                            doing on location, social capital and      the start of an on-going relationship
School of Public Health) at an event
                                            health.                                    between SACHRU and the community.
hosted by VicHealth. The launch was
followed by a seminar at which
Professor Kawachi, his colleague from


Page 2
Health services governance and reform
Across the world, health services and           The premise of this review was that            can be used to assess progress. An
systems are constantly being reviewed           the current health system is not sustainable   advisory group made up of key
and reformed. Drivers of this change            and that strategies were required to           stakeholders and consumers will guide
process can be political, ideological or        address the following:                         the data collection, analysis and reporting.
financial (or a combination of any of
these). Key elements of reform echo                 growing demand for services                An application to the Australian Research
the ‘New Public Management’: cost                                                              Council will, if successful, allow us to
cutting or containment; decentralisation;           increasing community expectations          extend this research to the two
separation of purchaser and provider                                                           geographical metropolitan regions and
functions; performance management;                  workforce unable to meet demand            the population region for children,
increased focus on quality and                                                                 youth and women.
‘customers’. Seldom are they instigated             inappropriate and inefficient
or controlled by the citizens who pay               configuration of services and              As a group of community health
for and use services.                               infrastructure                             researchers we will be closely monitoring
                                                                                               the processes and outcomes from this
Little is known about the impact of                 State unable to meet cost burden           latest round of reform to the health
health reform efforts and reforms are               associated with increasing demand.         system in South Australia.
rarely evaluated against the goals of
the change process. This is because             Most of the recommendations from
reforms are seldom allowed to run their         the Review were accepted by the                Arts SA ‘Partnerships for
full course as new political or                 Government and the reform agenda               Healthy Communities Program’
organisational leaders enter the fray           set. The major themes were ‘Building
                                                                                               In April and May this year, SACHRU
and want to stamp their viewpoint on the        Better Governance’ including
                                                                                               was involved in an evaluation of the
service or system. Health reform is by          regionalisation of metropolitan public
                                                                                               first year of a number of three-year
nature a ‘movable feast’ undertaken in a        health services; ‘Building Better
                                                                                               projects, funded by Arts SA and
societal context and this adds to the           Services’ including better integration
                                                                                               auspiced by partnerships between arts
challenge for researchers attempting to         of hospitals with other systems of
                                                                                               and non-arts organisations. The aims
evaluate reforms. Another problem is            care, strengthening of primary health
                                                                                               of these projects are to support
that the goals for reform may not be            care, addressing health inequalities;
                                                                                               collaboration between the arts and
clearly articulated or agreed upon by           ‘Building Better Systems’ including
                                                                                               non-arts organisations in providing
all the stakeholders.                           population based funding, workforce
                                                                                               programs that involve community
                                                development, information management,
                                                                                               people in arts activities in a way that
In Australia, the demand for reform of          collaboration with other levels of
                                                                                               promotes social inclusion, community
the health system comes from many               government. The major changes so
                                                                                               links and networks and understanding
sources. The jurisdictional split of the        far are regionalisation and change of
                                                                                               of other cultures. The three partnerships
health sector across federal, state and,        governance for metropolitan health
                                                                                               involved are:
to a lesser extent, local government            services and the launch of a
makes for a complex mix of responsibilities     re-vitalised primary health care policy.
                                                                                                    The Parks Helix project based at
and funding mechanisms. There is the
                                                                                                    the Parks Community Centre and
potential for duplication or gaps in services   In light of the SA Government goal
                                                                                                    involving five other partners
as a result. In addition to public health       to strengthen primary health care,
                                                                                                    including Parks Community
services, most of the primary care sector       SACHRU is currently undertaking a
                                                                                                    Health Service, Ridley Grove
is delivered through fee-for-service            research project to monitor the
                                                                                                    school, Westwood developers, the
private practice, and a high proportion         regionalisation process in the southern
                                                                                                    Pt Adelaide/Enfield council and
of hospital services and aged care are          metropolitan region of Adelaide and
                                                                                                    Parenting Network.
also delivered in the private sphere or         its impact on primary health care. For
by not-for-profit community organisations.      this pilot project we will be conducting
                                                                                                    A Young Mermaids Guide to
Factors implicated in the ongoing demand        interviews with key stakeholders to
                                                                                                    Planet Earth project hosted by
for more resources in health include            determine their vision for primary
                                                                                                    Women’s Health Statewide and
the ageing population, the increased            health care and how the change process
                                                                                                    with partners Dale St Women’s
costs and availability of diagnosis,            will be implemented and assessed.
                                                                                                    Health and Vitalstatistix Theatre
treatments and pharmaceuticals, and             Focus groups with community health
                                                                                                    Company.
greater expectations by the community           service workers will explore the
for health care.                                goals for primary health care and the
                                                                                                    The Playford Partnership, hosted
                                                functioning of the new region from
                                                                                                    by the Playford Council and
The factors listed above were instrumental      the perspective of health workers.
                                                                                                    involving various arts, health and
in motivating the SA State Government to        These different perspectives will be
                                                                                                    other partners.
commission a ‘Generational Health               brought together in a workshop to
Review’.                                        establish a consensus set of goals and         Continued on page 7
                                                specific goal attainment measures that

                                                                                                                                  Page 3
South Australian Community Health Research Unit (SACHRU) 21st Birthday Celebrations
and Launch of the Australian Health Inequities Program
Hon Lea Stevens Minister for Health
Well, what wonderful milestones we        Questions like…                            SACHRU’s work has been acknowledged
have to celebrate today….                   Are we really making a                   nationally and now internationally….
                                            difference?                              Most particularly with
…..A 21st birthday for SACHRU…..            Is this program positively impacting
….and the launch of the Australian          on people’s health?                         SACHRU’s recent success in
Health Inequities Program                   …what are the connections                   winning the $2.4 million National
                                            between these factors and health            Health and Medical Research Council
…And the opportunity to celebrate           outcomes?                                   grant for the Australian Health
Fran Baum’s appointment as Commissioner     And even the really big questions           Inequities Program, and
on the World Health Organisation            like….what is health?….what                 Fran’s appointment as Commissioner
Commission on Social Determinants of        does health mean in this society?...        for the World Health Organisation
Health.                                                                                 Commission on Social Determinants
                                          These questions challenge us in our           of Health.
SACHRU has come a long way over           daily practice and help us to improve
the past 21 years. SACHRU is on the       the effectiveness of our programs and      This reaffirms what we all know about
cutting edge of health inquiry which is   institutions.                              the South Australian Community
where it has been over its past 21                                                   Health Research Unit…it is a quality
years.                                    But above all SACHRU’S work                unit…recognised locally, nationally
                                          challenges us to think…and to think        and internationally for its excellent
Over these years SACHRU has provided      critically about what we do…               health research
the health system with a wealth of
information.                              In health we must never get comfortable    I think we can say that SACHRU has
                                          with what we do at any level…              well and truly come of age.
Their contribution to research has        y o u r s … o r mi n e … w e mu s t
helped us plan and develop better         constantly refine our work and             SACHRU’s contribution to addressing
services…                                 constantly redefine what it is that we     health inequities and developing a
                                          need to do… to advance health.             better understanding of some of the
It has helped us understand the impacts                                              social determinants of health has been
of our programs and services….            But SACHRU’s work is not simply            significant.
                                          the research product of 21 years… it
And it has helped us come to grips        is also their process and values that      And I have no doubt that their involvement
with how health is affected by social     they bring to their research effort.       in the Australian Health Inequities
factors.                                                                             Program will serve to further that
                                          SACHRU’s work teaches us that the          understanding.
I think SACHRU has proven that it is      process is as important as the
about tackling the hard issues            product.                                   I look forward to hearing the results
                                                                                     from the research and being informed
…there is nothing soft about their        It also teaches us that in health and in   about initiatives SA can undertake to
research…                                 this type of health research no-one is     address health inequity.
                                          the passive subject… we are all
It provides us with hard evidence and     actors. In health we must all have a
information about the hard issues in                                                 It is my pleasure to now officially
                                          say.
health…health care, health inequities                                                launch the Australian Health Inequities
and the social determinants of health                                                Program, and please join with me to
                                          So therefore the methods that
                                                                                     congratulate Professor Fran Baum and
                                          SACHRU has adopted have consistently
SACHRU challenges us to think about                                                  her team on winning this grant.
                                          been open…inclusive…participatory
what we are doing…                        and encouraging of people and
                                          communities to become involved in          SACHRU has much to celebrate on its
…Challenges us about the impacts of       their own health.                          21st birthday…it has come along
what we are doing…and why we are                                                     way…and as health researchers
doing it….                                And that is a very powerful lesson…        SACHRU is a service we can all
                                          it’s a lesson for the whole health         applaud.
SACHRU helps us challenge ourselves       system.
on a daily basis                                                                                   SACHRU’s 21st Birthday
And surely this is what good research     SACHRU has added to our knowledge,                       publication is available online
should do….it must compel us to ask       understanding and commitment to
the difficult questions…                                                                           www.sachru.sa.gov.au
                                          this work…

                                                                                                                            Page 4
              Congratulations                Impact of retrenchment of Mitsubishi workers in
              on academic                    southern Adelaide
              achievements
                                             Senior Research Officers Lisel           The research team was very pleased to
Two SACHRU staff members have                O’Dwyer and Gwyn Jolley are              learn that an application for an ARC
recently completed their academic            involved in a Health Services            Linkage grant has been successful.
studies. We offer our congratulations        Research and Innovation Program          This means that the current study can
to Michael and Tuesday on their              funded project examining the             be extended longitudinally to a series
achievements.                                impact of retrenchment on Mitsubishi     of three quantitative interviews over
                                             workers on their health, housing         two years, with both retrenched
Michael Bentley has just completed a         status and labour force position and     workers and a comparison group of
Master of Arts (Complexity, Chaos and        the implications for human               workers from another organisation.
Creativity) at the University of Western     services, policies and practices.        Qualitative interviews with a sub-set of
Sydney. This online (web-based) program      This project is multidisciplinary,       respondents will also be conducted in
covered the fundamentals and application     drawing together researchers from        three stages.
of the new paradigm of complexity and        community and public health,
looked at how to develop creative            housing studies, geography, labour       An initial focus group with children of
approaches for dealing with social           studies, and social administration. It   affected workers was held recently and
complexity in a wide range of practical      is being led by Professors Fran          data from this will inform the planned
situations. Michael looked particularly      B a u m ( P u b l i c H e a l th a n d   interviews with children about their
at social-environmental perspectives of      SACHRU), Andrew Beer (Southern           perceptions of what the changes have
health, ecology and organisations.           Research Centre of the Australian        brought to the family.
                                             Housing and Urban Research
Tuesday Udell submitted her Flinders
                                             Institute, Sue Richardson (National      A survey of health and community
University, Master of Science (by
                                             Institute of labour Studies) and Dr      services in the region is also underway
research) thesis entitled 'Linoleic acid
                                             Fiona Verity, School of Social           to help in assessment of the impact on
and alpha-linolenic acid in infant
                                             Administration and Social Work.          service organisations. It is hoped that
milks: long-chain polyunsaturated fatty
                                             Dr Anna Ziersch from the Department      this information will help in service
acid status, growth and development'.
                                             of Public Health is also contributing    planning for the region and for other
Linoleic acid (LA) and alpha-linolenic
                                             to the research.                         areas facing similar job losses.
acid (ALA) are essential short-chain
polyunsaturated fatty acids found in
breast milk, formula and cows' milk. LA
and ALA are endogenously converted to        Byron Bay Workshop                       News on WHO Commission
the fatty acids known as omega-6 and                                                  on Social Determinants of
omega-3, respectively. These long-chain      Colin MacDougall and Fran Baum
polyunsaturated fatty acids are vital for    ran a two day workshop for the
                                                                                      Health
healthy growth and development of            NSW North Coast Area Health
infants in the first 2 years of life. The    Service on 26th & 27th April on
research consisted of a systematic           participatory action research and                        Fran Baum attended the
review and meta analysis of randomised       translating research on the social                       second meeting of the
controlled trials where infants consumed     determinants of health into                              Commission which was
formula containing extra ALA, as well        practice. The evaluation showed                          held in Cairo in May.
as a cross-sectional study looking at        the workshop was very well
the fatty acid status of infants at 12 and   received indeed by the 30 participants
16 months of age consuming breast            who came from across NSW.                At the meeting the Commissioners
milk, cows milk or formula.                                                           discussed the emerging knowledge
                                                                                      networks and strategies for engaging
         Do you have any comments,                                                    with countries to encourage their work
          suggestions, or feedback?                                                   on policies to promote health through
                                                                                      action on social determinants.

                                                                                      Fran’s appointment to the Commission
                                                                                      runs from 2005-08. See the website for
                                                                                      up dates on the work (http://
                                                                                      www.who.int/social_determinants/en/)

              Please email us at:
            sachru@fmc.sa.gov.au             Dr Sallie Newell, Fran Baum,     Colin
                                             MacDougall and Uta Dietrich.

                                                                                                                      Page 5
     What works? A systematic review of the evidence for
      the effectiveness of community health in Adelaide

Systematic Review has become a
common method to assess the value of a
body of evidence. This report applies the
method to 93 evaluations conducted in
Adelaide community health services over
a four year period.

The report documents the findings of the
review and highlights the strengths and
weaknesses of the evaluations. This
report has found that community health
services in Adelaide conduct a large
number of innovative programs, often
addressing complex health issues.

The views of staff in the services about
the barriers to doing more evaluation and
how these barriers might be overcome
are also reported.

Five of the top-ranking evaluations are
described in some detail. Recommendations are made regarding how the health system can better
support evaluation of community health initiatives.

The report is essential reading for anyone interested in the evaluation of community-based health
services.

To purchase a copy of this report, please contact SACHRU Tel: 8204 5988 Fax: 8374 0230.
Cost: $25.00 plus postage (GST included)




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                                       Telephone: (08) 8204 5988 or fax (08) 8374 0230

Page 6
Evaluation of the Early
Learning for Families
(ELF) project, 2003-2005                     Evaluation of the Women’s Healthline
The evaluation of the ELF program,           The Women’s Healthline is one of the services that Women’s Health Statewide
auspiced by the Southern Fleurieu            provides. It is a telephone and email service that provides information, counseling
Health Service and funded by the             and referral on any health issues that affect women’s lives. The line operates
Commonwealth Stronger Families and           Monday to Friday between 1pm and 4.30 pm. It is staffed by female Registered
Communities program, was completed           Nurses, who operate within a feminist framework.
in April, 2005. The ELF program
sought to provide transdisciplinary          This evaluation was undertaken as a collaborative project between Women’s
services to children from 0-8 years of       Health Statewide and the South Australian Community Health Research Unit.
age at risk of developmental delay, and
their families in the Fleurieu peninsula.    The evaluation included
The final report brought together the
findings from two years of evaluation          A telephone survey of users of the Healthline
activities including:
                                               A series of focus groups conducted with Healthline staff, WHS administrative
    Baseline, midpoint and endpoint            staff, an Indigenous advisory group, a women’s non-English speaking advisory
    client profile data                        group and a domestic violence action group.

    A survey of parents whose children         A questionnaire sent to 7 selected rural Women’s Community Health Centre
    were receiving ELF services                Coordinators

    Case studies based on two                  Healthline statistics obtained from Community Health Information System (CHIS)
    interviews six months apart with
    parents of children receiving            The evaluation examined current usage of the Healthline, to qualify users’
    services from ELF.                       expectations and experiences of the Healthline and to explore whether the service
                                             is accessed by, and relevant to, women from identified communities of interest.
    A phone survey of local service
    providers involved in collaborative      The evaluation highlighted that the service remains a highly valued and
    programs with ELF.                       well-utilized service. However it also indicates that there is limited knowledge of
                                             the scope of services offered by the Healthline, the hours of operation and the
The evaluation showed that the ELF           accessibility features available.
program has achieved its aims of providing
services to support children with            For further information please contact Angela Lawless on (08) 8204 5976 or
developmental delay and their parents in     angela.lawless@flinders.edu.au or Louise Sibenaler on (08) 8239 9600 or
a way that maximises participation and       louise.sibenaler@health.sa.gov.au
provides understanding and strategies to
deal with difficulties being experienced     Arts SA ‘Partnerships for Healthy Communities Program’
by families as a result. ELFS has used its   Continued from page 3
transdisciplinary model and a range of
collaborative alliances with other local     Lisa Philip-Harbutt from the               Further information is available from
providers to provide not only individual     Community Arts Network SA (CAN)            Catherine Hurley, Research Officer at
therapy but also groupwork, early            and Christine Putland from the             SACHRU.
intervention and prevention screening        Department of Public Health at             catherine.hurley@flinders.edu.au
and changes in practice that have            Flinders University were engaged by
benefited children and families in the       Arts SA to provide project and
area. The high levels of satisfaction and    evaluation support and advice to the
support from the parents and service         program. SACHRU was contracted
providers suggest that their model is a      by CAN to undertake evaluation
successful one. The only concerns            activities including face to face
relate to sufficiency of resources and       interviews with art workers for each
the likelihood of ongoing funding in an      of the projects, telephone interviews
area where, it is agreed by these            with the partners and surveys of
groups, the need is likely to continue to    people attending a launch for the
be high.                                     Parks Helix project. This information
                                             is being collated and will be
Further information is available from        presented to the partners and the
Catherine Hurley, Research Officer at        funding body, Arts SA, in the near
                                                                                        A knitting pillar created by the Pt Adelaide/Enfield
SACHRU.                                      future. Work will also commence on         Seniors Helix project
catherine.hurley@flinders.edu.au             evaluation planning for the next two
                                             years of these projects.
Page 7
                                   SACHRU
                         Research Workshop Program 2005


Session 3                                                Making Community Health Services learning organisations
                                                         (morning workshop) Friday, September 16
                                                         Angela Lawless SACHRU & DPH and Anne Johnson, DPH

Session 4                                                Building evaluation into Practice
                                                         (morning workshop) Friday, October 7
                                                         Gwyn Jolley, SACHRU

Session 5                                                Consumer Feedback
                                                         (morning workshop) Friday, October 21
                                                         Anne Johnson and Catherine Palmer, DPH

Session 6                                                Critical Appraisal and Using Evidence for Best Practice
                                                         (morning workshop) Friday, November 11
                                                         Lisel O'Dwyer, SACHRU


Cost:

$100 per person per half-day session
(no charge for South Australian metro/country Community Health Services)

$200 per person for Session 1
(no charge for South Australian metro/country Community Health Services)

All prices include GST

Further information:

For further information on the SACHRU 2005 Research Workshop Program and other resources and services available
through the South Australian Community Health Research Unit, contact the Unit on (08) 8204 5988;
Fax: (08) 8374 0230; Email: sachru@fmc.sa.gov.au or visit our website on www.sachru.sa.gov.au




 Research Matters is a publication of the South Australian Community Health Research Unit (SACHRU)
 Research Matters was written and produced by the South Australian Community Health Research Unit.

 Layout by Rebecca Ramm.

 All enquiries should be referred to:
 South Australian Community Health Research Unit
 C/- Flinders Medical Centre
 Bedford Park, South Australia 5042
 Telephone (08) 8204 5988 Fax: (08) 8374 0230
 E-mail: sachru@fmc.sa.gov.au www.sachru.sa.gov.au



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