Relevanz von Werbeeinstellungen zur Kontrolle langfristiger Werbewirkung im Fall etablierter Konsumgüter

Die Werbeeinstellung gilt als besonders verhaltensprägend und zugleich beeinflussbar durch die werbliche Kommunikation. Damit wird ihr eine zentrale Rolle als Vermittler von Werbewirkung zugesprochen. Allerdings wurde diese Vermittlerrolle bisher nur bei neuen Produkten mit unbekannten Werbereizen und auf Basis von Querschnittsdaten empirisch nachgewiesen. Für etablierte Konsumgüter, für die bereits ein stabiles Markenkonzept besteht, ist die Rolle der Werbeeinstellung nach wie vor ungewiss. Bei steigenden Werbeinvestitionen für Konsumgüter ist die Relevanz der Werbeeinstellung unter dem Gesichtspunkt adäquater Wirkungskontrolle auch heute noch von großer Bedeutung. Marisa Schlichthorst präsentiert ein geeignetes Modell für die Kontrolle von langfristiger TV-Werbewirkung bei etablierten Konsumgütern. Bereits bestehende Wirkungshypothesen zur Rolle der Werbeeinstellung werden gegeneinander getestet und um relevante exogene Einflussgrößen, wie die Werbevariationen über die Zeit, erweitert. Anhand kovarianzbasierter Analysen auf Basis von Werbe-Trackingdaten verdeutlicht sie damit die langfristigen Wirkungszusammenhänge unter realistischen Werbebedingungen. Entgegen bisheriger Annahmen spielen allgemeine Erinnerungen und Gefühle bezüglich der Werbung eine bedeutendere Rolle für die Beeinflussung des Kaufverhaltens als die Werbeeinstellung und eignen sich daher besser zur kontinuierlichen Wirkungskontrolle. Die Intensität von Werbevariationen beeinflusst die Werbeeinstellung positiv. Je häufiger allerdings starke Variationen durchgeführt werden, desto instabiler werden die Veränderungen in den Werbeeinstellungen

Cost-effectiveness of installing barriers at bridge and cliff sites for suicide prevention in Australia

Importance: Installation of barriers has been shown to reduce suicides. To our knowledge, no studies have evaluated the cost-effectiveness of installing barriers at multiple bridge and cliff sites where suicides are known to occur. Objective: To examine the cost-effectiveness of installing barriers at bridge and cliff sites throughout Australia. Design, Setting, and Participants: This economic evaluation used an economic model to examine the costs, costs saved, and reductions in suicides if barriers were installed across identified bridge and cliff sites over 5 and 10 years. Specific and accessible bridge and cliff sites across Australia that reported 2 or more suicides over a 5-year period were identified for analysis. A partial societal perspective (including intervention costs and monetary value associated with preventing suicide deaths) was adopted in the development of the model. Interventions: Barriers installed at bridge and cliff sites. Main Outcomes and Measures: Primary outcome was return on investment (ROI) comparing cost savings with intervention costs. Secondary outcomes included incremental cost-effectiveness ratio (ICER), comprising the difference in costs between installation of barriers and no installation of barriers divided by the difference in reduction of suicide cases. Uncertainty and sensitivity analyses were undertaken to examine the association of changes in suicide rates with barrier installation, adjustments to the value of statistical life, and changes in maintenance costs of barriers. Results: A total of 7 bridges and 19 cliff sites were included in the model. If barriers were installed at bridge sites, an estimated US $145 million (95$90 to $160 million) could be saved in prevented suicides over 5 years, and US$270 million (95% UI, $176 to$298 million) over 10 years. The estimated ROI ratio for building barriers over 10 years at bridges was 2.4 (95% UI, 1.5 to 2.7); the results for cliff sites were not significant (ROI, 2.0; 95% UI, -1.1 to 3.8). The ICER indicated monetary savings due to averted suicides over the intervention cost for bridges, although evidence for similar savings was not significant for cliffs. Results were robust in all sensitivity analyses except when the value of statistical life-year over 5 or 10 years only was used. Conclusions and Relevance: In an economic analysis, barriers were a cost-effective suicide prevention intervention at bridge sites. Further research is required for cliff sites

The ongoing impacts of hepatitis C - a systematic narrative review of the literature

Extent: 13p.BackgroundMany countries have developed, or are developing, national strategies aimed at reducing the harms associated with hepatitis C infection. Making these strategies relevant to the vast majority of those affected by hepatitis C requires a more complete understanding of the short and longer term impacts of infection. We used a systematic approach to scope the literature to determine what is currently known about the health and psychosocial impacts of hepatitis C along the trajectory from exposure to ongoing chronic infection, and to identify what knowledge gaps remain.MethodsPubMed, Current Contents and PsychINFO databases were searched for primary studies published in the ten years from 2000-2009 inclusive. Two searches were conducted for studies on hepatitis C in adult persons focusing on: outcomes over time (primarily cohort and other prospective designs); and the personal and psychosocial impacts of chronic infection. All retrieved studies were assessed for eligibility according to specific inclusion/exclusion criteria, data completeness and methodological coherence. Outcomes reported in 264 included studies were summarized, tabulated and synthesized.ResultsInjecting drug use (IDU) was a major risk for transmission with seroconversion occurring relatively early in injecting careers. Persistent hepatitis C viraemia, increasing age and excessive alcohol consumption independently predicted disease progression. While interferon based therapies reduced quality of life during treatment, improvements on baseline quality of life was achieved post treatment--particularly when sustained viral response was achieved. Much of the negative social impact of chronic infection was due to the association of infection with IDU and inflated assessments of transmission risks. Perceived discrimination was commonly reported in health care settings, potentially impeding health care access. Perceptions of stigma and experiences of discrimination also had direct negative impacts on wellbeing and social functioning.ConclusionsHepatitis C and its management continue to have profound and ongoing impacts on health and social well being. Biomedical studies provided prospective information on clinical aspects of infection, while the broader social and psychological studies presented comprehensive information on seminal experiences (such as diagnosis and disclosure). Increasing the focus on combined methodological approaches could enhance understanding about the health and social impacts of hepatitis C along the life course.Emma R Miller, Stephen McNally, Jack Wallace, Marisa Schlichthors

Engaging men in conversations about masculinity and suicide – An evaluation of the Man Up social media campaign

© 2020 Marisa SchlichthorstMale suicide continues to be a major public health concern both internationally and in Australia. While a number of factors have been found to contribute to high suicide rates, little is known about what drives the much higher rates in men compared to women. Mostly, risk factors for suicide are considered in isolation, with little regard for the mechanisms that may underpin them. In more recent discussions on male health, masculinity has been highlighted as a potential driving force underpinning unhealthy male behaviors. In Australia, the “dominant masculinity” is one that endorses the norms of stoicism, independence, invulnerability and avoidance of negative emotions. Conformity to these masculine norms has been associated with suicidal thinking, poor mental health and reduced and delayed help-seeking. Men also describe experiencing stigma and how the fear of being alienated prevents them from seeking help for mental health issues. For these reasons, men are often described as a “hard-to reach” population group when it comes to mental health messaging. Suicide prevention interventions are needed that adopt a gendered approach and attend to the influence of masculine norms on mental health and suicide. The Man Up intervention was an innovative media-based male health promotion and suicide prevention intervention that featured a three part television documentary and digital campaign delivered via a website and five social media platforms (Facebook, Twitter, Instagram, YouTube and tumblr). It was funded by the Movember Foundation in Australia and its aim was to address the high suicide rate among men by promoting help-seeking for personal or emotional problems via an exploration of Australian masculinity. The documentary and digital campaign examined how society shapes the way men and boys see themselves and explored how this might affect mental health and, potentially, lead to thoughts of suicide. It was aired by the Australian Broadcasting Corporation (ABC), Australia’s national public free-to-air broadcaster, in October 2016. This thesis explores the potential for social media to be used in health promotion with the view to generate and increase engagement and influence conversations on the issue of male suicide and its link to masculinity. As such, this thesis focuses on the evaluation of the social media components of the digital campaign. The thesis is based on the idea that masculinity, the rules prescribed by society about how men should live their lives, is a fundamental determinant influencing how men negotiate their health throughout life. Following social constructionist theory, this thesis proposes that by challenging dominant masculinity social learning processes can take place that will support redefining restrictive behavior patterns and opening up alternative behaviors which in turn will help reducing stigma for men facing mental health problems, increasing male help-seeking and ultimately reducing male suicide rates. The above aim was addressed through two empirical studies that analyzed various data sources collected through two social media platforms: Facebook and Twitter. In Study 1, Twitter Insights data were used to assess reach and engagement with the campaign and to determine highest and lowest performing tweets. We also analyzed the volume of conversations over time by tracking the use of common campaign hashtags and conducted thematic analysis on a sub-set of tweets to determine most engaging campaign content themes. Study 2 was a qualitative study of comments published on the Man Up Facebook page with the aim to provide further insight into the conversations that were instigated by the campaign. Both studies have been published as peer-reviewed journal articles and together they demonstrated that the Man Up social media campaign was able to generate an impressive reach and exposure to campaign messages in the Australian population and beyond. Overall, the studies showed that the Man Up campaign messages were perceived positively across both Twitter and Facebook. Campaign content was widely shared on social media and positive feedback showed endorsement for the campaign. It highlighted the need to openly talk about male suicide and the stigma introduced by gendered practices. The increased use of the hashtag keywords of the Man Up campaign in line with the campaign phases and the fact that the hashtag MANUP was trending during the campaign signaled a strong uptake and sharing of campaign messages. Despite this, the hashtag analysis could not find a lasting increase of engagement. The analysis of Facebook comments confirmed that the social media campaign triggered conversations about masculinity and suicide that might otherwise not have happened. For some, this may have led to shifting attitudes towards expressing emotions and reaching out to others for help, however, this could not be formally investigated based on social media data alone. This thesis concludes that social media interventions can be used successfully in engaging men in discussions about male mental health, suicide and gender norms and therefore demonstrate potential for suicide protective properties of social media. However, more research is needed to better understand how and where on the internet to best engage men, particularly men at high risk of suicide. While gender-transformative campaigns such as Man Up can help to further destigmatize help-seeking for men, the longevity of changes needs further consideration. Addressing these issues will require high quality interventions and evaluation designs for social media campaigns which follow a systematic framework for measuring effectiveness

Sexuality education in Australian secondary schools: results of the 1st national survey of Australian secondary teachers of sexuality education 2010

Executive summary The 1st National Survey of Secondary Teachers of Sexuality Education involved nearly 300 secondary school teachers from every jurisdiction in Australia including government, Catholic and independent schools. The key findings are arranged under the themes of teaching workforce, the content of sexuality education, barriers and support, teachers’ views and opinions and school policy requirements. Sexual Health Teachers According to this sample the vast majority of sexual health teachers in Australia are female Health and PE teachers aged 20 to 39. This indicates that sexuality education still is delegated to female teachers and therefore following the traditional context in which sexuality education was taught. Only a quarter of the teachers in this sample team-taught or engaged external organisations for delivering sexuality education. This means that most teachers in fact deliver sexuality education themselves without external support. However, sixteen per cent of the respondents had no training in teaching sexuality education and the majority of teachers in the sample relied on in-service training, which is often a one off session, of short duration and with a specific focus. Thus, this research supplies a strong argument for well designed pre-service teacher training which provides teachers with similar basic teaching skills and ensures that a consistent message will be delivered to students. Finally, one third of teachers in the sample did not assess their teaching against curriculum standards. This was either due to a lack of school support or a lack of knowledge that there were assessment criteria for this subject area

Modelling the cost-effectiveness of brief aftercare interventions following hospital-treated self-harm

Background Prior self-harm represents the most significant risk factor for future self-harm or suicide. Aim To evaluate the cost-effectiveness of a theoretical brief aftercare intervention (involving brief follow-up contact, care coordination and safety planning), following a hospital-treated self-harm episode, for reducing repeated self-harm within the Australian context. Method We employed economic modelling techniques to undertake: (a) a return-on-investment analysis, which compared the cost-savings generated by the intervention with the overall cost of implementing the intervention; and (b) a cost-utility analysis, which compared the net costs of the intervention with health outcomes measured in quality-adjusted life years (QALYs). We considered cost offsets associated with hospital admission for self-harm and the cost of suicide over a period of 10 years in the base case analysis. Uncertainty and one-way sensitivity analyses were also conducted. Results The brief aftercare intervention resulted in net cost-savings of AUD$7.5 M (95% uncertainty interval: -56.2 M to 15.1 M) and was associated with a gain of 222 (95% uncertainty interval: 45 to 563) QALYs over a 10-year period. The estimated return-on-investment ratio for the intervention's modelled cost in relation to cost-savings was 1.58 (95% uncertainty interval: -0.17 to 5.33). Eighty-seven per cent of uncertainty iterations showed that the intervention could be considered cost-effective, either through cost-savings or with an acceptable cost-effectiveness ratio of 50 000 per QALY gained. The results remained robust across sensitivity analyses. Conclusions A theoretical brief aftercare intervention is highly likely to be cost-effective for preventing suicide and self-harm among individuals with a history of self-harm

Cost-effectiveness of media reporting guidelines for the prevention of suicide

Introduction: Media guidelines for the responsible reporting of suicide are a recognized universal suicide prevention intervention. While implemented in numerous countries, including Australia, little is known about whether they are cost-effective. We aimed to determine the cost-effectiveness of Mindframe, the national initiative implementing media guidelines in Australia. Method: We conducted a modelled economic evaluation (5-year time-horizon) incorporating two types of economic analysis: (i) return-on-investment (ROI) comparing estimated cost savings from the intervention to the total intervention cost, and (ii) cost-effectiveness analysis comparing the net intervention costs to health outcomes: suicide deaths prevented and quality-adjusted life-years (QALYs). We also included uncertainty analyses to propagate parameter uncertainty and sensitivity analyses to test the robustness of the model outputs to changes in input parameters and assumptions. Results: The estimated ROI ratio for the main analysis was 94:1 (95% uncertainty interval [UI]: 37 to 170). The intervention was associated with cost savings of A$596M (95$228M to A$1,081M), 139 (95% UI: 55 to 252) suicides prevented and 107 (95% UI: 42 to 192) QALYs gained. The intervention was dominant, or cost-saving, compared with no intervention with results being robust to sensitivity analysis but varying based on the conservativeness of the parameters entered. Conclusion: Mindframe was found to be cost-saving, and therefore, worthy of investment and inclusion as part of national suicide prevention strategies