Objective: Using a multivariate extension of the mediation framework, we examined the simultaneou... more Objective: Using a multivariate extension of the mediation framework, we examined the simultaneous effect of variables hypothesized to mediate the relationship between a motivationally tailored physical activity intervention, and 6-month physical activity behavior in 239 healthy, underactive adults (M age ϭ 47.5; 82% women). Design: Participants were randomly assigned to (a) print-based feedback; (b) telephone-based feedback; or (c) contact control. Main Outcome Measures: Psychosocial variables, including self-efficacy, decisional balance, and processes of change. Results: All mediation criteria were satisfied for both intervention arms. A moderate indirect effect of print (0.39, 95% CI ϭ 0.21, 0.57) was found due to increases in behavioral processes (0.54, 95% CI ϭ 0.29, 0.80) being attenuated by decreases due to cognitive processes (Ϫ0.17, 95%CI ϭ Ϫ0.31,-.03). A moderate indirect effect was observed for telephone (0.47, 95% CI ϭ 0.28, 0.66), with increases due to behavioral processes (0.61, 95% CI ϭ 0.34, 0.87) attenuated by decreases due to cognitive processes (0.15, 95% CI ϭ Ϫ0.27, Ϫ0.02); self-efficacy and decisional balance mediational paths did not attain statistical significance. Conclusions: These findings highlight the importance of studies that deconstruct the theoretical components of interventions to determine which combination produces the greatest behavior changes at the lowest cost.
Background: Currently, there is limited empirical validation of feminist-informed or individualis... more Background: Currently, there is limited empirical validation of feminist-informed or individualised interventions for the treatment of eating disorders. The aim of this study was to examine the effectiveness of a feminist-informed, individually delivered counselling intervention for the treatment of eating disorders at a community-based eating disorder treatment service. Methods: Eighty individuals aged between 17 and 64 years presenting to an outpatient eating disorder service were examined in a case series design at baseline, session 10, session 20 and end of treatment (session 30). Changes in eating disorder symptomology, depression, anxiety, stress, and mental health recovery over the course of treatment were examined in linear mixed model analyses. Results: The treatment intervention was effective in reducing eating disorder symptomology and stress and improving mental health recovery after 10 sessions in a sample of 80 eating disorder participants engaged with the treatment service. Reductions in eating disorder symptomology and stress and improvements to mental health recovery were maintained at session 20 and session 30. Conclusions: The findings of this study provide preliminary support for feminist-informed and individualised interventions for the treatment of eating disorders in community-based settings.
Mixed messages: Competing Discourses on Information, Choice and Control in Women’s Experience of Shared Decision-Making in Antenatal Care [Conference poster abstract]
Mental health in the workplace is a major concern, with rising rates of depression and stress imp... more Mental health in the workplace is a major concern, with rising rates of depression and stress impacting productivity and well-being. Resilient adults are adaptable and able to manage their working and personal lives, as well as the demands of the workplace and technological change. The pilot for an innovative, prevention program, the Promoting Adult Resilience (PAR) program, was conducted in a resource-sector company over 11 weeks. 20 employees took part and a comparison group was drawn from a parallel on-line study on adult well-being. The sessions synthesized cognitive behavioural and mental health promotion strategies with work-life balance to promote mental health and well-being amongst working adults. Participant outcomes and treatment integrity were assessed throughout the duration of the program. Process evaluation assessed the manualised program, the facilitator, the volunteers as participants and diary notes from the facilitator on each session, and found that treatment integrity was maintained throughout the program. Pre and post testing of the participants of the PAR program showed significantly reduced levels of depression and stress and improved levels of coping selfefficacy, in relation to the comparison group.
Objectives: In this systematic review, we aimed to identify the full extent of cost-effectiveness... more Objectives: In this systematic review, we aimed to identify the full extent of cost-effectiveness evidence available for evaluating alternative Maternity Models of Care (MMC) and to summarize findings narratively. Methods: Articles that included a decision tree or state-based (Markov) model to explore the cost-effectiveness of an MMC, and at least one comparator MMC, were identified from a systematic literature review. The MEDLINE, Embase, Web of Science, CINAHL and Google Scholar databases were searched for papers published in English, Arabic, and French. A narrative synthesis was conducted to analyse results. Results: Three studies were included; all using cost-effectiveness decision tree models with data sourced from a combination of trials, databases, and the literature. Study quality was fair to poor. Each study compared midwife-led or doula-assisted care to obstetrician- or physician-led care. The findings from these studies indicate that midwife and doula led MMCs may provide...
Objective This study aimed to explore the relationship between different complementary feeding (C... more Objective This study aimed to explore the relationship between different complementary feeding (CF) indicators and coexisting forms of malnutrition (CFM) in Pakistan. Methodology This study involves secondary data analysis of eight national and regional datasets of Pakistan, which were retrieved from the Demographic Health Survey (DHS) and UNICEF. From these datasets, data of children aged between 6 to 23.9 months was analysed after excluding incomplete and/or invalid data related to their feeding practices and anthropometry. Thus, data of 30,097 Pakistani children between the ages of 6 to 23.9 months was analysed in this study using Jamovi software. Results The prevalence of CFM in this sample of children was 28.1%. Cereals and dairy were chiefly used for CF. With the exception of continuation of breastfeeding and coadministration of breastmilk with solid/semi-solid/soft food, adherence to all other CF indicators (minimum dietary diversity, minimum meal frequency, iron & folate con...
Breastmilk is the only recommended source of nutrition for infants below six-months of age. Howev... more Breastmilk is the only recommended source of nutrition for infants below six-months of age. However, a significant proportion of children are either on supplemental breastfeeding(SBF) or weaned due to the early introduction of solid/semi-solid/soft food and liquids(SSF) before 6 months of age. There is good evidence that Exclusive Breastfeeding(EBF) in infants below six-months of age protects them from preventable illnesses, including malnutrition. The relationship between infant feeding practices and coexisting forms of malnutrition(CFM) has not yet been explored. This study examined the association of different feeding indicators(continuation of breastfeeding, predominant feeding, and SSF) and feeding practices(EBF, SBF, and complete weaning) with CFM in infants aged below six-months of age in Pakistan. National and regional datasets of Pakistan from the last ten years were retrieved from the Demographic Health Surveys(DHS) and UNICEF data repositories. In Pakistan, 34.5%(n=6131) ...
Embedding wellness: An evidence based training framework for community care workers
INTRODUCTION & OBJECTIVES Brisbane North PHN leads the healthy@home Commonwealth Home Support Pro... more INTRODUCTION & OBJECTIVES Brisbane North PHN leads the healthy@home Commonwealth Home Support Program (CHSP) consortium: - of 14 service providers delivering clinical and non-clinical in-home services across the Brisbane North and Caboolture Regions in Queensland: - who supported over 8,000 consumers in 2017/18 - with a workforce of over 1,000 health and care staff. Strong commitment to implementing a wellness model in service delivery and maximising learning outcomes from a limited training and development budget. Brisbane North PHN embarked on a multi-organisational human resource planning study.
Objective Coexisting Forms of Malnutrition (CFM) refers to the presence of more than one type of ... more Objective Coexisting Forms of Malnutrition (CFM) refers to the presence of more than one type of nutritional disorder in an individual. Worldwide, CFM affects more than half of all malnourished children, and compared to standalone forms of malnutrition, CFM is associated with a higher risk of illness and death. This review examined published literature for assessing the prevalence, trends, and determinants of CFM in neonates, infants, and children. Methods A review of community-based observational studies was conducted. Seven databases, (CINAHL, Cochrane Library, EMBASE, Medline, PubMed, Scopus, and Web of Science) were used in December-2021 to retrieve literature. Google, Google Scholar and TROVE were used to search for grey literature. Key stakeholders were also contacted for unpublished documents. Studies measuring the prevalence, and/or trends, and/or determinants of CFM presenting in individuals were included. The quality of included studies was assessed using the Joanna Briggs...
Background: Most studies examining determinants of rising rates of caesarean section have examine... more Background: Most studies examining determinants of rising rates of caesarean section have examined patterns in documented reasons for caesarean over time in a single location. Further insights could be gleaned from cross-cultural research that examines practice patterns in locations with disparate rates of caesarean section at a single time point. Methods: We compared both rates of and main reason for pre-labour and intrapartum caesarean between England and Queensland, Australia, using data from retrospective cross-sectional surveys of women who had recently given birth in England (n = 5,250) and Queensland (n = 3,467)
STUDY PROTOCOL Open Access Moving MobileMums forward: protocol for a
larger randomized controlled trial of an improved for women with young program is warranted. Mars... more larger randomized controlled trial of an improved for women with young program is warranted. Marshall et al. BMC Public Health 2013, 13:593
How healthcare provider communication about risk and decision making role affects decisions about birth after caesarean
Despite clinical and policy consensus that all eligible candidates for vaginal birth after a caes... more Despite clinical and policy consensus that all eligible candidates for vaginal birth after a caesarean should be presented with that option, there is controversy and mixed opinion among maternity care providers about the best approach to birth after caesarean and clinical superiority of one option over another has not been established. Shared decision making requires complex risk information for each option to be provided in a format that best facilitates understanding and promotes engagement in decision-making. There is qualitative evidence that sub-optimal risk communication by healthcare providers prohibits women with a history of caesarean section from making informed decisions about subsequent births, but this has not been confirmed in empirical research. Several features of healthcare provider communication may undermine effective shared decision-making, including selective communication of partial risk and benefit information to reflect/create a persuasive bias, providing inf...
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Papers by Yvette Miller