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author:("Davis, elisae")
1.  ACHESS – The Australian study of child health in same-sex families: background research, design and methodology 
BMC Public Health  2012;12:646.
Background
There are an increasing number of children in Australia growing up with same-sex attracted parents. Although children from same-sex parent families do in general perform well on many psychosocial measures recent research is beginning to consider some small but significant differences when these children are compared with children from other family backgrounds. In particular studies suggest that there is an association between the stigma that same-sex parent families experience and child wellbeing. Research to date lacks a holistic view with the complete physical, mental and social wellbeing of children not yet addressed. In addition, most studies have focused only on families with lesbian parents and have studied only small numbers of children.
Methods/design
The Australian Study of Child Health in Same-Sex Families (ACHESS) is a national study that aims to determine the complete physical, mental and social wellbeing of Australian children under the age 18 years with at least one parent who self identifies as being same-sex attracted. There will be a particular focus on the impact that stigma and discrimination has on these families. Parent and child surveys will be used to collect data and will be available both online and in paper form. Measures have been chosen whenever possible that have sound conceptual underpinnings, robust psychometric properties and Australian normative data, and include the Child Health Questionnaire (CHQ), the Strengths and Difficulties Questionnaire (SDQ) and the Kessler Psychological Distress Scale (K10).
Discussion
ACHESS aims to be the largest study of its kind and will for the first time produce a detailed quantitative analysis of Australian children with same-sex attracted parents. By inviting participants to take part in further research it will also establish a valuable cohort of children, and their families, to launch future waves of research that will help us better understand the health and wellbeing of children with same-sex attracted parents.
doi:10.1186/1471-2458-12-646
PMCID: PMC3487744  PMID: 22888859
Child health; Gay parents; Lesbian parents; Same-sex parents; Homosexuality; Sexual orientation
2.  Accessing maternal and child health services in Melbourne, Australia: Reflections from refugee families and service providers 
Background
Often new arrivals from refugee backgrounds have experienced poor health and limited access to healthcare services. The maternal and child health (MCH) service in Victoria, Australia, is a joint local and state government operated, cost-free service available to all mothers of children aged 0–6 years. Although well-child healthcare visits are useful in identifying health issues early, there has been limited investigation in the use of these services for families from refugee backgrounds. This study aims to explore experiences of using MCH services, from the perspective of families from refugee backgrounds and service providers.
Methods
We used a qualitative study design informed by the socioecological model of health and a cultural competence approach. Two geographical areas of Melbourne were selected to invite participants. Seven focus groups were conducted with 87 mothers from Karen, Iraqi, Assyrian Chaldean, Lebanese, South Sudanese and Bhutanese backgrounds, who had lived an average of 4.7 years in Australia (range one month-18 years). Participants had a total of 249 children, of these 150 were born in Australia. Four focus groups and five interviews were conducted with MCH nurses, other healthcare providers and bicultural workers.
Results
Four themes were identified: facilitating access to MCH services; promoting continued engagement with the MCH service; language challenges; and what is working well and could be done better. Several processes were identified that facilitated initial access to the MCH service but there were implications for continued use of the service. The MCH service was not formally notified of new parents arriving with young children. Pre-arranged group appointments by MCH nurses for parents who attended playgroups worked well to increase ongoing service engagement. Barriers for parents in using MCH services included access to transportation, lack of confidence in speaking English and making phone bookings. Service users and providers reported that continuity of nurse and interpreter is preferred for increasing client-provider trust and ongoing engagement.
Conclusions
Although participants who had children born in Melbourne had good initial access to, and experience of, using MCH services, significant barriers remain. A systems-oriented, culturally competent approach to service provision would improve the service utilisation experience for parents and providers, including formalising links and notifications between settlement services and MCH services.
doi:10.1186/1472-6963-12-117
PMCID: PMC3424108  PMID: 22587587
Refugee; Maternal and child health; Access to health services; Cultural competence
3.  Cancer Patient Navigation Case Studies in Hawai‘i: The Complimentary Role of Clinical and Community Navigators 
Hawaii Medical Journal  2011;70(12):257-261.
This article describes the activities performed by cancer patient navigators in community-based and hospital settings. The case study demonstrates the depth and breadth of navigation activities and illustrates how hospital-based and community-based navigators work together to help individuals access cancer care and complete cancer treatment.
PMCID: PMC3242420  PMID: 22187512
access to health care; cancer patient navigation; case management; health disparities; barriers to cancer care; oncology; Native Hawaiian
4.  Building the capacity of family day care educators to promote children's social and emotional wellbeing: an exploratory cluster randomised controlled trial 
BMC Public Health  2011;11:842.
Background
Childhood mental health problems are highly prevalent, experienced by one in five children living in socioeconomically disadvantaged families. Although childcare settings, including family day care are ideal to promote children's social and emotional wellbeing at a population level in a sustainable way, family day care educators receive limited training in promoting children's mental health. This study is an exploratory wait-list control cluster randomised controlled trial to test the appropriateness, acceptability, cost, and effectiveness of "Thrive," an intervention program to build the capacity of family day care educators to promote children's social and emotional wellbeing. Thrive aims to increase educators' knowledge, confidence and skills in promoting children's social and emotional wellbeing.
Methods/Design
This study involves one family day care organisation based in a low socioeconomic area of Melbourne. All family day care educators (term used for registered carers who provide care for children for financial reimbursement in the carers own home) are eligible to participate in the study. The clusters for randomisation will be the fieldworkers (n = 5) who each supervise 10-15 educators. The intervention group (field workers and educators) will participate in a variety of intervention activities over 12 months, including workshops; activity exchanges with other educators; and focused discussion about children's social and emotional wellbeing during field worker visits. The control group will continue with their normal work practice. The intervention will be delivered to the intervention group and then to the control group after a time delay of 15 months post intervention commencement. A baseline survey will be conducted with all consenting educators and field workers (n = ~70) assessing outcomes at the cluster and individual level. The survey will also be administered at one month, six months and 12 months post-intervention commencement. The survey consists of questions measuring perceived levels of knowledge, confidence and skills in promoting children's social and emotional wellbeing. As much of this intervention will be delivered by field workers, field worker-family day care educator relationships are key to its success and thus supervisor support will also be measured. All educators will also have an in-home quality of care assessment at baseline, one month, six months and 12 months post-intervention commencement. Process evaluation will occur at one month, six months and 12 months post-intervention commencement. Information regarding intervention fidelity and economics will also be assessed in the survey.
Discussion
A capacity building intervention in child mental health promotion for family day care is an essential contribution to research, policy and practice. This initiative is the first internationally, and essential in building an evidence base of interventions in this extremely policy-timely setting.
Trial Registration number
343312
doi:10.1186/1471-2458-11-842
PMCID: PMC3219588  PMID: 22047600
5.  An Observational Study of Physical Activity in Parks in Asian and Pacific Islander Communities in Urban Honolulu, Hawaii, 2009 
Preventing Chronic Disease  2011;8(5):A107.
Introduction
Research on park use among Asians and Pacific Islanders is limited. This study examined use and conditions of 6 urban parks, varying in size, location, and neighborhood income level, in predominantly Asian and Pacific Islander communities in Honolulu, Hawaii. Sociodemographic predictors of park use were also identified.
Methods
Observations were conducted from June through October 2009. Raters used the System for Observing Play and Recreation in Communities to count the number of people in predesignated zones and to code their physical activity level as sedentary, moderate, or vigorous. Raters coded park conditions on the basis of accessibility and usability, whether equipment and supervision were provided, and whether organized activities were occurring. Differences associated with sex and age of park users and income level of the neighborhood were examined by using χ² and logistic regression.
Results
Raters observed 6,477 park users, most of whom were men. Approximately 60% of users were sedentary, 26% were engaged in moderate activities, and 14% performed vigorous activities. Women and girls were less active than men and boys. More users were present in the evenings, but morning users were more active. Although park users in low-income neighborhoods were more active than users in high-income neighborhoods, fewer people used the low-income parks. Most parks were accessible and usable but few provided equipment and supervision. Organized activities were rarely observed.
Conclusion
More efforts should be made to promote parks as a physical activity resource in Asian and Pacific Islander communities, particularly for women, girls, and low-income residents. More research should be conducted to identify barriers and facilitators to park use, especially among underrepresented populations.
PMCID: PMC3181180  PMID: 21843410
6.  Population health and wellbeing: Identifying priority areas for Victorian children 
Background
Population health information, collected using soundly-designed methodologies, is essential to inform policy, research, and intervention programs. This study aimed to derive policy-oriented recommendations for the content of a health and wellbeing population survey of children 0–12 years living in Victoria, Australia.
Results
Qualitative interviews were conducted with 54 academic and policy stakeholders, selected to encompass a wide breadth of expertise in areas of public health and inter-sectoral organisations relevant to child health outcomes, including universities, government and non-government agencies across Victoria. These stakeholders were asked to provide advice on strategic priorities for child health information (data) using a structured interview technique. Their comments were summarised and the major themes were extracted. The priority areas of health and wellbeing recommended for regular collection include obesity and its determinants, pregnancy and breastfeeding, oral health, injury, social and emotional health and wellbeing, family environment, community, health service utilisation, illness, and socioeconomic position. Population policy questions for each area were identified.
Conclusion
In contrast to previous population survey programs nationally and internationally, this study sought to extract contemporary policy-oriented domains for inclusion in a strategic program of child health data collection, using a stakeholder consultation process to identify key domains and policy information needs. The outcomes are a rich and relevant set of recommendations which will now be taken forward into a regular statewide child health survey program.
doi:10.1186/1743-8462-2-16
PMCID: PMC1180818  PMID: 16029511

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