John McDonald’s research while affiliated with Federation University and other places

Objective The objective is to investigate the influence of characteristics related to place of residence (self-reliance and stoicism) on men's intentions to use a telephone support service following radical prostatectomy.MethodsA community sample of 447 prostate cancer patients (31% response), recruited via Medicare Australia, completed a survey to assess levels of self-reliance and stoicism, and beliefs about addressing emotional distress through using telephone support services.ResultsResults indicated that the model was a partially mediated model. Geographic remoteness was directly related to intention, and indirectly related through stoicism and subjective norms.Conclusion Men from rural and remote areas in Australia might face particular challenges in seeking support following treatment for prostate cancer. These challenges appear to relate to the influence of stoic attitudes and normative expectations, than to issues of access and availability. Addressing stoic attitudes in the clinical setting, through normalising emotional reactions to cancer diagnosis and treatment, and the act of help-seeking for emotional support, may be beneficial. Copyright © 2014 John Wiley & Sons, Ltd.

The current study examined how sociodemographic, psychological, physical and social support variables predict participation in formal support services. Cross-sectional study. Participants were recruited from oncology clinics, cancer specialist clinics and cancer support groups. Seventy-six men living outside major Australian cities, the majority with prostate cancer (n=55). Participants completed the Brief Symptom Inventory, the List of Physical Complaints, the Social Support Subscale of the Coping Resources Inventory and questionnaires related to levels of awareness of, and participation in support services. Most (82%) of the men were aware of at least one formal service offering emotional support, and 49% of the men had used such a service. Telephone- and Internet-based services were the most used type of support. The only predictor of participation in a formal service was lower age. Use of a support service was not predicted by psychological or physical symptoms, levels of social support or distance from service centres. Attitudes to different types of services, and support services in general, might be more predictive of actual use. The current findings point to the potential of telephone- and Internet-based support as an acceptable means of formal support for rural and regional men who experience cancer-related distress.

Little research has investigated formal psychosocial support use among men with cancer living in rural areas. The current study investigated perceived barriers to support service use among such men, within the framework of the Behavioral Model of Health Service Use. In a mixed methodology study, 82 men with cancer living in rural Australia were surveyed, and nine of these men, plus three health professionals, participated in semi-structured interviews. Reasons for not participating in formal support were sufficient informal support and subjective judgements about perceived need. Service availability was rarely endorsed by the men as a reason for non-participation, but was emphasised by health professionals. Identifying factors that impede or facilitate service use might enable rural men experiencing cancer-related distress to seek the extra psychosocial support they need.

Managers and staff in primary health care partnerships in local catchments, particularly in regional areas, are periodically required to work collaboratively to set health priorities. Setting priorities involves making decisions about which health needs are most important and what programs will be funded to address them. There is no universally agreed set of decision-making rules for setting priorities. Dominant approaches prioritise health economics, and have favoured expert knowledge drawn from technical-rational methodologies rather than consumer involvement and community action. However, research reveals that setting priorities is a complex, value laden, contested process buffeted by competing objectives and political interests. As such, an interdisciplinary, collaborative approach is called for. Using reflective practice from a priority setting project for a primary care partnership in a local, regional catchment in Victoria, Australia, a conceptual framework for priority setting is presented that identifies 13 interconnected factors spanning economic, political, policy, epidemiological, moral, evidentiary and evaluative domains. This interdisciplinary framework extends current knowledge about the considerations and trade-offs in setting priorities among collaborating primary health care agencies. It offers a potentially valuable heuristic tool for healthcare decision-makers in rural areas.

To determine the number of projects, and level of funding, for rural health research from the Australian Research Council (ARC). Analyses of ARC searchable datasets of completed, and new and ongoing projects from 2001 to 2008. Number of rural health research projects as a proportion of total funding; level of funding for rural health research projects as a proportion of total funding. Only 46 of 6498 ARC completed projects were classified as rural health research projects. This represents 0.7% of the total number of projects, and 0.39% of the total funding allocated. Only 25 of 4659 ARC new and ongoing projects were classified as rural health research projects. This represents 0.54% of the total number of projects, and 0.27% of the total funding allocated. None of the 832 completed fellowships were classified as rural health. Only five (0.52%) of the 953 new and ongoing fellowships were classified as rural health. The level of under-funding for rural health research could be partially addressed by directing applications towards the ARC, in addition to the National Health and Medical Research Council. With a few exceptions, rural health researchers are not yet competitive in the national funding arena.

National Competition Policy (NCP), legislated in Australia in 1995, has arguably been the single most consequential economic policy over the past decade. Yet it has largely escaped sociological analysis. This article investigates how the concept of the public interest in NCP has actually had the effect of legitimizing neo-liberal ideologies concerning private, individual, economic interests. Using critical policy analysis, this article examines how this legitimization has occurred through: (1) the policy language of the public interest, and how this discourse has shifted over time; (2) the implementation of NCP, particularly the application of the public interest test; and (3) evidence proffered by dominant institutions about the social and economic distributional outcomes of NCP. This analysis demonstrates that the policy language and public discourse of the public interest has been used to secure hegemonic control to legitimate the interests of dominant groups.

The ageing population and associated burgeoning health care costs have resulted in a shift of care from institutional settings to home and community-based care. As one example, rehabilitation-in-the-home (RITH) programs are becoming increasingly prevalent. These programs either substitute or supplement in-hospital treatment by providing multidisciplinary rehabilitation and support services in the client's own home. This paper investigates the impact of RITH programs on informal carers. Semi-structured interviews carried out with caregivers and staff revealed a complex and contradictory interpretation of informal caring. Analysis of carers' interviews revealed: an assumption by themselves and others (including RITH staff) that they would provide care; the intimate, arduous and relentless work of caring; lack of consultation about discharge; lack of recognition and reimbursement; and low levels of program support for them as carers. Carers are integral to the successful rehabilitation of the client, but they occupy a marginal status within the program. An invisible contract consigns to them substantial care-work that was previously provided by the hospital. Informal carers in RITH programs can be seen as disenfranchised care contractors. This has implications for policy makers, program managers and researchers.

Therapeutic prevention and/or early intervention programs for children at risk of developing disruptive behaviour disorders are increasingly being implemented in schools. One such Australian school-based program is CAST: CAMHS (Child and Adolescent Mental Health Service) and Schools Together, an evidenced-based program treating children with emerging disruptive behaviour disorders in the early primary school years. The current evaluation examines the process of implementation of the CAST program in primary schools. By using a conceptual model of school-based implementation (developed by Greenberg, Domitrovich, Graczyk & Zins, 2005) the wide array of factors that can affect successful implementation at the school level were identified, and those elements critical to implementation quality were examined. Semi-structured individual and group interviews were conducted with a sample of 69 school personnel across 16 schools in the City of Ballarat and wider Grampians region of Victoria, in both government and Catholic primary schools. Results showed that schools were highly satisfied with the quality of CAST resources and personnel, and the implementation and delivery of sessions as planned. Aspects that impacted negatively on the implementation process were the lack of parental engagement; the lack of classroom follow-up in some schools; the level of readiness and pre- planning by the schools; and the availability of technical support. Greenberg's conceptual model appears to be a useful framework to utilise in examining the implementation of the CAST model, as it allowed close examination of how the program was implemented within naturally occurring constraints. It allowed the identification of elements within the CAST model and the associated support system that must be maintained and nurtured by the collaborating parties, in addition to the factors at a school level that are potential barriers to effective implementation. Identification and examination of such factors assist in ensuring quality outcomes for school-based interventions in the future.

Lifeline Australia Inc. provides a free 24-hour telephone counselling and referral service to all Australians. The trained telephone counsellors of the service record information on many of their calls in Lifeline's Client Service Management Information System (CSMIS). This paper presents a descriptive summary of a national CSMIS data set, which was compiled during a 3-month period in 2003. The CSMIS data provided a clear national profile of the callers to the service. The results of this study support the hypothesis that callers are generally seeking social support from the service. The discussion explores the implications of this finding for Lifeline and other generalist counselling and referral services and their capacity to offer suicide intervention to the community.

This paper investigates the health and welfare needs of students (n = 15,806) and the current service model in Catholic schools in the Ballarat Diocese of Victoria, Australia. Catholic schools use a service model underpinned by an ethos of pastoral care; there is a strong tradition of self-reliance within the Catholic education system for meeting students' health and welfare needs. The central research questions are: What are the emerging health and welfare needs of students? How does pastoral care shape the service model to meet these needs? What model/s might better meet students? primary health care needs? The research methods involved analysis of (1) extant databases of expressed service needs including referrals (n = 1,248) to Student Services over the last 2.5 years, (2) trends in the additional funding support such as special needs funding for students and the Education Maintenance Allowance for families, and (3) semi-structured individual and group interviews with 98 Diocesan and school staff responsible for meeting students' health and welfare needs. Analysis of expressed service needs revealed a marked increase in service demand, and in the complexity and severity of students' needs. Thematic analysis of qualitative interview data revealed five pressing issues: the health and welfare needs of students; stressors in the school community; rural isolation; role boundaries and individualised interventions; and self-reliant networks of care. Explanations for many of these problems can be located in wider social and economic forces impacting upon the church and rural communities. It was concluded that the pastoral care model - as it is currently configured - is not equipped to meet the escalating primary health care needs of students in rural areas. This paper considers the implications for enhanced primary health care in both rural communities and in schools.