Amanda O'COnnor

Global health inequities are worsening and exacerbated by climate change, global policy shifts, epidemics and pandemics, pervasive poverty, and inequitable distribution of wealth (Labonté, 2022; Lo...

Despite the many existing implementation methods, theories, and frameworks, implementation science is insufficiently closing the research-to-practice gap.

The evolution of trauma-informed care (TIC) since its inception has resulted in myriad models and frameworks across a variety of settings. However, there is a lack of a consistent definition and understanding of what constitutes TIC. We conducted an integrative review, using a rapid review methodology, concept and content analysis, and thematic synthesis to identify the existing models and frameworks of TIC and their common values, components and principles, and synthesise these to inform a contemporary understanding of TIC. Two-hundred and eighty-eight included sources from the academic and grey literature internationally were analysed, resulting in 10 values, 10 principles, and 28 components of TIC. Foundational components of TIC were identified as understanding trauma, ensuring safety and trust, empowerment and collaboration, supporting trauma recovery and emotional management, and taking a whole-of-organisation approach. We present a proposed integrated definition of TIC, core values, conceptual model, and framework for application across settings. The integrated model and framework have potential utility in the implementation of TIC and development of setting-specific practice strategies, particularly in new settings. It provides a contemporaneous description of TIC that has the potential to inform future research, policy development, and practice that can support its application.

There is a demand for new interventions to address complex social and political challenges arising from racism, colonisation, and oppression. To achieve this, equity must be at the forefront of program planning and decision making. Intervention Mapping is one of the most widely used program planning, design, implementation, and evaluation approaches. While the steps, tasks and core processes of Intervention Mapping provide a clear rationale and framework to develop programs that address equity, there is limited guidance and examples of how to operationalise this in practice. To address this gap, we conducted a qualitative study through a two-day workshop in Melbourne, Australia with multi-disciplinary practitioners and leaders from health, education and social care organisations and government departments, entitled “Equity in Program Development”. The workshop focused on Intervention Mapping Step 1: needs assessment, Step 2: define program outcomes and objectives, Step 3: program design and Step 4: program production. Using these steps the workshop aimed to: (1) explore how equity is considered and operationalised in participants’ organisations; (2) identify the enablers and barriers for developing and delivering equitable programs; and (3) generate practical guidance for program planners, including actions and guiding questions to embed equity within Intervention Mapping Steps 1 to 4. Transcribed data from small group discussions and individual written reflections were analysed thematically using a deductive approach guided by the research objectives. Actions to include equity in program planning included intentionally planning for equity, building equitable teams, skills and processes, generating ideas for embedding equity from other approaches, allowing time and space, leadership and organisational support, accessing resources and support, and shifting policy and funding processes. Based on the feedback and insights shared during this workshop, an initial Intervention Mapping - Equity (IM-Equity) Tool was developed for program planners.

Tracking, measuring, and reporting outcomes fosters improvement and adoption of best practices. It enables identification of what is and is not working and can contribute towards greater effectiveness and efficiency in the delivery and engagement of programs and interventions. The early years of a child’s life significantly influence life-long health and wellbeing, learning and behaviour outcomes. Due to the complexity of parenting during the early years of a child’s life many parents and caregivers seek support and guidance to improve their parenting knowledge and confidence. In Victoria, Australia, Early Parenting Centres support families with their parenting practices through a range of programs. Evidence of the impact of Early Parenting Centres programs has been limited with minimal data collected focusing on the outcomes of Early Parenting Centres program involvement and delivery. To gain a detailed understanding of the impact of Early Parenting Centres programs the development of a Victorian Early Parenting Centres Outcomes Framework was commissioned. This paper provides a methodological roadmap for Outcomes Framework and Implementation Plan development which is underpinned by co-creating Knowledge Translation Framework and Integrated Knowledge Translation and exchange approaches. Steps one to three of the co-creating Knowledge Translation Framework were utilised and resulted in the development of an Outcomes Framework and Implementation Plan for the Victorian Early Parenting Centres sector. Additionally, this blueprint of outcomes framework development addresses a significant gap in the literature—the lack of guidance, research, and clarity in developing an Outcomes Framework for Early Parenting Centres.

Background: Childhood obesity is associated with physical and psychological complications thus the prevention of excess weight gain in childhood is an important health goal. Relevant to the prevention of childhood obesity, Australian general practice-specific, preventive care guidelines recommend General Practitioners (GPs) conduct growth monitoring and promote a number of healthy behaviours. However, challenges to providing preventive care in general practice may impact implementation. In October and November, 2022, a series of three workshops focusing on the prevention of childhood obesity were held with a group of Australian GPs and academics. The objective of the workshops was to determine practical ways that GPs can be supported to address barriers to the incorporation of obesity-related prevention activities into their clinical practice, for children with a healthy weight. Methods: This paper describes workshop proceedings, specifically the outcomes of co-ideation activities that included idea generation, expansion of the ideas to possible interventions, and the preliminary assessment of these concepts. The ecological levels of the individual, interpersonal, and organisation were considered. Results: Possible opportunities to support childhood obesity prevention were identified at multiple ecological levels within the clinic. The preliminary list of proposed interventions to facilitate action included GP education and training, clinical audit facilitation, readily accessible clinical guidelines with linked resources, a repository of resources, and provision of adequate growth monitoring tools in general practice. Conclusions: Co-ideation with GPs resulted in a number of proposed interventions, informed by day-to-day practicalities, to support both guideline implementation and childhood obesity prevention in general practice.

Digital health interventions that specifically target working women across the preconception, pregnancy and postpartum (PPP) life stages may address the unique barriers to engaging in healthy lifestyle behaviours and self-care during this life phase. This paper describes the development of a workplace digital health intervention to promote healthy lifestyles and wellbeing for PPP women working at a community service organization in Australia. Intervention Mapping is a framework that guides program development, implementation, and evaluation. Steps 1 to 5 of Intervention Mapping methodology (needs assessment through to program implementation) were used, including identification of determinants and change objectives across socioecological levels (i.e., individual, interpersonal, and organisational) and iterative co-design and stakeholder engagement processes. The workplace digital health intervention was successfully developed and implemented as an online portal. Content included key strategies, information, and supports to promote health and wellbeing across PPP, including supporting the return to work in the postpartum period. Examples of resource pages included a parental leave checklist, process flows, Pride resources, and Aboriginal and Torres Strait Islander resources. Findings from a pilot feasibility study indicate the portal was accessible and beneficial for women in PPP life stages. The Intervention Mapping protocol may offer a valuable roadmap for collaborative design of interventions targeting PPP women’s behaviour and organisational work culture. Future work is needed to evaluate whether such interventions lead to improvements in women’s health and wellbeing.

A high prevalence of maltreatment, abuse, neglect and the onset of subsequent trauma has been well-documented among both young people with disability and young people residing in foster and kinship care. However, no uniform policies or guidelines currently exist for the delivery of trauma-informed models of care to build the capacity of foster and kinship carers in responding to and supporting the complex needs of children and young people in their care with disability who may have been exposed to trauma. While no evidence of the application of trauma-informed models of care for this cohort exists, some evidence of trauma-informed models of care to support people with disability beyond the scope of out-of-home care has recently emerged. The authors discuss this emerging work and recognise an opportunity to leverage this evidence to guide the practices of foster and kinship carers. Clearly, there is an opportunity to work towards improving the development and wellbeing of children and young people with disability in foster and kinship care through the development, implementation, and evaluation of a tailored trauma-informed model of care that is co-designed and grounded in the underlying theoretical principles of disability and trauma.