Reframing health promotion research and practice in Australia and the Pacific: The value of arts-based practices

Arts-based research (ABR) practices have the potential to reframe research and practice in health promotion. In this chapter, four case studies are presented to foreground the ethical and methodological value of ABR practices in health promotion research and practice. The case studies describe a range of place-based ABR projects in Australia and the Pacific that were undertaken with hard-to-reach populations as part of practice or research activities that promote health and well-being. While ABR practices emphasize process, arts products, or both, the outcomes illustrated in these case studies amplify local knowledge and voices. Thus, ABR encompasses aesthetics of beauty and experience. Engaging with ABR practices enabled deeper understandings of health promotion and well-being research and reframed the more traditional role of researcher from objective observer to co-participant/co-facilitator. Central to the success of each of these activities was the use of iterative, organic research processes and practices to respond to the priorities of the communities. Like planting a seed, ABR practices involve growing and nurturing group potential and place-based knowledges, often within challenging social environments with little control over external or internal factors. Therefore, a primary focus of ABR is process and engagement. For the authors of this chapter, the value of using ABR practices in health promotion research lies in how it aligns with and reframes their own positions as health promotion practitioner-researchers. ABR’s value also lies in the way it critically challenges more traditional approaches to research, reasoning, validity, data construction, and interpretation practices

Point-of-care tests for syphilis and yaws in a low-income setting – A qualitative study of healthcare worker and patient experiences

<div><p>Introduction</p><p>The human treponematoses comprise venereal syphilis and the three non-venereal or endemic treponematoses yaws, bejel, and pinta. Serological assays remain the most common diagnostic method for all treponemal infections.</p><p>Point-of-care tests (POCTs) for syphilis and yaws allow testing without further development of infrastructure in populations where routine laboratory facilities are not available. Alongside the test’s performance characteristics assessed through diagnostic evaluation, it is important to consider broader issues when rolling out a POCT. Experience with malaria POCT roll-out in sub-Saharan Africa has demonstrated that both healthcare worker and patient beliefs may play a major role in shaping the real-world use of POCTs. We conducted a qualitative study evaluating healthcare worker and patient perceptions of using a syphilis/yaws POCT in clinics in the East Malaita region of Malaita province in the Solomon Islands. Prior to the study serology was only routinely available at the local district hospital.</p><p>Methods</p><p>The POCT was deployed in the outpatient and ante-natal departments of a district hospital and four rural health clinics served by the hospital. Each site was provided with training and an SOP on the performance, interpretation and recording of results. Treatment for those testing positive was provided, in line with Solomon Islands Ministry of Health and Medical Services’ guidelines for syphilis and yaws respectively. Alongside the implementation of the POCT we facilitated semi-structured interviews with both nurses and patients to explore individuals’ experiences and beliefs in relation to use of the POCT.</p><p>Results and discussion</p><p>Four main themes emerged in the interviews: 1) training and ease of performing the test; 2) time taken and ability to fit the test into a clinical workflow; 3) perceived reliability and trustworthiness of the test; and 4) level of the health care system the test was most usefully deployed. Many healthcare workers related their experience with the POCT to their experience using similar tests for malaria. Although the test was considered to take a relatively long time to perform the benefits of improved access to testing were considered positive by most healthcare workers. Qualitative data is needed to help inform better training packages to support the implementation of POCT in low-resource settings.</p></div