Improving centre-based group exercise participation of older adults using the behaviour change wheel

An emphasis on active ageing could help to delay the onset of frailty. In Singapore, Senior Activity Centres provide free and guided group exercise sessions for older adults. However, one such centre had very low participation rates among community-dwelling older adults despite running standardised programmes. Based on a needs analysis from a prior project, this paper reports on strategies implemented to improve the daily centre-based group exercise participation rate among community-dwelling older adults. Using the behaviour change wheel model, participant motivation domains were identified as primary gaps, while the psychological capability and physical opportunity were categorised as secondary gaps. A logic model was used to design a project to respond to these identified gaps and guide the evaluation approach. Three strategies were implemented over a 4-week period and reviewed at 6 months: (1) promotion of the exercise classes, (2) delayed rewards for participation and (3) health ambassadors. Evaluation findings highlighted that more resources were needed for the training of community-dwelling older adult healthcare ambassadors in the use of motivational interviewing. The interventions were found to be efficacious in increasing daily group exercise participation rate at the centre, from an average of three to nine participants per day over the 4 weeks. Furthermore, more than 60% of these participants achieved the WHO's weekly minimum exercise recommendation for older adults (150 min moderate-intensity physical activity). To increase the engagement of older adults in physical activity or exercise participation, we recommend the use of behaviour change wheel model and the use of community-based health ambassadors. In conclusion, the project found improved daily centre-based group physical exercise participation rates when all the domains in the behaviour change wheel model were addressed. © 2021 Copernicus GmbH. All rights reserved

Framing Collaborative Behaviors: Listening and Speaking in Problem-based Learning

PBL is described as small-group collaborative learning; however, literature on how collaboration is enacted in PBL contexts is limited. A two-year ethnographic study examined the experiences and responses of Asian students to the obligations of PBL in a Western context. Participant-observation, videotape data, and video-stimulated recall interviews provided insights into collaborative behaviors in PBL classrooms. Even though students recognized that listening and speaking were important to collaboration, speaking was clearly privileged over listening in this PBL setting. A framework was developed that incorporated both collaborative and noncollaborative listening and speaking behaviors. This Collaborative Listening/Speaking (CLS) framework provides a structure for tutors to scaffold the novice learners’ collaborative skills, and therefore more effectively facilitate the group’s learning through collaboration

Health professional workforce education in the Asia Pacific

Objective. To design and implement an international and interprofessional Global Learning Partnership Model, which involves shared learning between academics and students from Universitas 21 network with other universities with United Nations Millennium Development Goal needs. Design. Two literature reviews were conducted to inform ethical aspects and curriculum design of the GLP model. Feedback from conference presentations and consultation with experts in education and public health has been incorporated to inform the current iteration of the GLP model. Intervention. The pilot group of 25 students from U21 universities and Kathmandu University, representing six health disciplines will meet in Nepal in April 2016 for a shared learning experience, including a one week university based workshop and three week community based experience.Outcome measures. A multi-phase, mixed method design was selected for the evaluation of the GLP model, utilising a combination of focus groups and questionnaires to evaluate the efficacy of the placement through student experience and learning outcomes in cultural competency, UN SDG knowledge, community engagement and health promotion skills. Results. The literature review demonstrated that cultural awareness and cultural knowledge were improved through participation in cultural immersion programs that incorporated preparatory workshops and clinical experiences. Data will be gathered in April 2006 and the results of the evaluation will be published in the future. Conclusions. The GLP model proposes a project around the fundamental concept of engagement and sharing between students and academics across universities and cultural contexts to build capacity through education, while capitalising on strengths of existing global health placements. Further the inclusion of host-country students and academics in this learning exchange will promote the establishment of an international and interprofessional network for ongoing health promotion

Do health service waiting areas contribute to the health literacy of consumers? A scoping review

Health service waiting areas commonly provide health information, resources and supports for consumers; however, the effect on health literacy and related outcomes remains unclear. This scoping review of the literature aimed to explore the use of waiting areas as a place to contribute to the health literacy and related outcomes of consumers attending health appointments. Articles were included if they focussed on health literacy or health literacy responsiveness (concept) in outpatient or primary care health service waiting areas (context) for adult consumers (population) and were published after 2010. Ten bibliographic databases, one full-text archive, dissertation repositories and web sources were searched. The search yielded 5095 records. After duplicate removal, 3942 title/abstract records were screened and 360 full-text records assessed. Data were charted into a standardized data extraction tool. A total of 116 unique articles (published empirical and grey literature) were included. Most articles were set in primary and community care (49%) waiting areas. A diverse range of health topics and resource types were available, but results demonstrated they were not always used by consumers. Outcomes measured in intervention studies were health knowledge, intentions and other psychological factors, self-reported and observed behaviours, clinical outcomes and health service utilization. Intervention studies overall demonstrated positive trends in health literacy-related outcomes, although the benefit declined after 3-6 months. Research on using waiting areas for health literacy purposes is increasing globally. Future research investigating the needs of consumers to inform optimal intervention design is needed. © 2023 The Author(s). Published by Oxford University Press

Exploring learning goals and assessment approaches for Indigenous health education : a qualitative study in Australia and New Zealand

In higher education, assessment is key to student learning. Assessments which promote critical thinking necessary for sustained learning beyond university are highly valued. However, the design of assessment tasks to achieve these types of thinking skills and dispositions to act in professional practice has received little attention. This research examines how academics design assessment to achieve these learning goals in Indigenous health education. Indigenous health education is an important area of learning for health practitioners to help address worldwide patterns of health inequities that exist for Indigenous people. We used a constructivist qualitative methodology to (i) explore learning goals and assessment strategies used in Indigenous health tertiary education and (ii) examine how they relate to higher education assessment ideals. Forty-one academics (from nine health disciplines) involved in teaching Indigenous health content participated in a semi-structured interview. Thematic analysis revealed learning goals to transform students’ perspectives and capacities to think critically and creatively about their role in Indigenous health. In contrast, assessment tasks encouraged more narrowly bounded thinking to analyse information about historical and socio-cultural factors contributing to Indigenous health. To transform students to be critical health practitioners capable of working and collaborating with Indigenous people to advance their health and well-being, the findings suggest that assessment may need to be nested across many aspects of the curriculum using a programmatic approach, and with a focus on learning to think and act for future practice. These findings accord with more recent calls for transformation of learning and assessment in health education. © 2017, Springer Science+Business Media Dordrecht

Exploring learning goals and assessment approaches for Indigenous health education : a qualitative study in Australia and New Zealand

In higher education, assessment is key to student learning. Assessments which promote critical thinking necessary for sustained learning beyond university are highly valued. However, the design of assessment tasks to achieve these types of thinking skills and dispositions to act in professional practice has received little attention. This research examines how academics design assessment to achieve these learning goals in Indigenous health education. Indigenous health education is an important area of learning for health practitioners to help address worldwide patterns of health inequities that exist for Indigenous people. We used a constructivist qualitative methodology to (i) explore learning goals and assessment strategies used in Indigenous health tertiary education and (ii) examine how they relate to higher education assessment ideals. Forty-one academics (from nine health disciplines) involved in teaching Indigenous health content participated in a semi-structured interview. Thematic analysis revealed learning goals to transform students’ perspectives and capacities to think critically and creatively about their role in Indigenous health. In contrast, assessment tasks encouraged more narrowly bounded thinking to analyse information about historical and socio-cultural factors contributing to Indigenous health. To transform students to be critical health practitioners capable of working and collaborating with Indigenous people to advance their health and well-being, the findings suggest that assessment may need to be nested across many aspects of the curriculum using a programmatic approach, and with a focus on learning to think and act for future practice. These findings accord with more recent calls for transformation of learning and assessment in health education. © 2017, Springer Science+Business Media Dordrecht

What factors affect implementation of early rehabilitation into intensive care unit practice? A qualitative study with clinicians

Purpose To identify the barriers and enablers that influence clinicians' implementation of early rehabilitation in critical care. Materials and methods Qualitative study involving 26 multidisciplinary participants who were recruited using purposive sampling. Four focus groups were conducted using semistructured questions to explore attitudes, beliefs, and experiences. Data were transcribed verbatim and thematic analysis was performed. Results Six themes emerged, as follows: (1) the clinicians' expectations and knowledge (including rationale for rehabilitation, perceived benefits, and experience), (2) the evidence for and application of rehabilitation (including beliefs regarding when to intervene), (3) patient factors (including prognosis, sedation, delirium, cooperation, motivation, goals, and family), (4) safety considerations (including physiological stability and presence of devices or lines), (5) environmental influences (staffing, resources, equipment, time, and competing priorities), and (6) culture and teamwork. Key strategies identified to facilitate rehabilitation included addressing educational needs for all multidisciplinary team members, supporting junior nursing staff, and potential expansion of physiotherapy staffing hours to closer align with the 24-hour patient care model. Conclusions Key barriers to implementation of early rehabilitation in critical care are diverse and include both clinician- and health care system–related factors. Research targeted at bridging this evidence-practice gap is required to improve provision of rehabilitation. © 2016 Elsevier Inc

Addressing the climate challenge

In 2021, colleagues from across the University of Birmingham community were invited to write articles about topics relevant to the COP26 climate change summit. In this series of articles, experts from across many different disciplines provide new insight and evidence on how we might all understand and tackle climate change

Learning with and from each other : promoting international and interprofessional collaborations in physiotherapy education research – a literature review

Background: Best practice in physical therapy education requires good quality and quantity of research based on authentic learning settings and teaching practices. Facilitating large multisite research and large data sets for analysis has the potential to contribute to a strong research base. Clinical research makes use of international and interprofessional consortiums to produce quantity and quality of research outcomes. Objectives: The paper aimed to investigate international and interprofessional co-authorship in educational research in a single journal and describe two collaborative models. Methods: The paper has two sections. (1) A review of co-authorship in 113 papers published in the Journal of Physical Therapy Education over a three and a half year period (2014 to 2017). (2) Two models of collaboration in educational research are described. Results: The literature review highlighted a pattern of almost no international collaborations but close to 27% of papers with interprofessional collaborations. Two collaborative models were presented, one an international and intraprofessional model and the second an international and interprofessional research approach. Conclusions: It is argued that creating consortiums with international and interprofessional health professionals will progress the quality of educational research in physical therapy, assisting with our educational decision-making and further improving on our learning and teaching practices

Classroom discourse in problem-based learning classrooms in the health sciences

Classroom discourse analysis has contributed to understandings of the nature of student-teacher interactions, and how learning takes place in the classroom; however, much of this work has been undertaken in teacher-directed learning contexts. Student-centred classrooms such as problem-based learning (PBL) approaches are increasingly common in professional disciplines such as the health sciences and medicine. With the globalisation of education, health science and medical education, PBL classrooms are often sites of considerable linguistic and cultural diversity, yet little is known from a classroom discourse perspective about the language demands of PBL. This paper examines the ways in which the students and tutor negotiate and construct meanings through language in one first year physiotherapy PBL tutorial at an Australian university, with a particular focus on the ways in which the discourse is regulated in a student-centred learning environment. The analysis of the classroom discourse is underpinned by Hallidays systemic functional linguistics. The findings provide a description of the linguistic resources students draw on to co-construct and negotiate knowledge, as well as show how the tutor, with minimal strategic interventions, scaffolds the students learning. The findings also suggest that the PBL environment can be a challenging one for students whose cultural and language backgrounds are different from that of the classroom