Paper short abstract:

Health education materials are often seen as a trademark of the health promotion profession. This presentation explores the value and meaning of these objects beyond a behaviour change framework. We delve into how these materials are made valuable in an era of evidence-based health promotion.

Paper long abstract:

The profession of health promotion has long been associated with health education materials. Health promotion leaflets, educational resources (posters, videos, handbooks), tokens (balls, skipping ropes) and artefacts carrying program messages (water bottles, mugs, T-shirts) are often thought of as a trademark of the profession. Ostensibly, these materials are designed to raise awareness or prompt behaviour change. The longevity of these tools in health promotion invites better understanding of their value and meanings, particularly now in an era of evidence-based health promotion. We undertook a multi-sited ethnography of health promotion practice in the context of Australia's largest ever rollout of childhood obesity prevention programs in schools and child care centres in NSW. This provided a window to observe how informational materials and program resources were made valuable in scaled-up program implementation. In terms of state-wide program implementation, these objects were both a form of standardisation (controlling the form of the program across the state) and a means by which practitioners were encouraged to tailor the program to local contexts. We contend that the value of these tools was much broader than the transmission of health information. We argue that in a profession in which 'relationship-building' is highly valued, program materials were part of a gift economy in which the value of these objects was constituted through social interactions. Further, these objects played a crucial role in developing collaborative engagements between practitioners working in a range of local contexts across the state.

Paper short abstract:

This presentation explores the intersection of a holistic, culturally informed Aboriginal Transfer of Care model and the culture of 'we treat everybody the same.' Why does Aboriginal health and nursing practices sometimes achieve congruency within a hospital, but at other times do not?

Paper long abstract:

This presentation is an anthropologist's reflection on some of the qualitative findings from a mixed-methods evaluation of the Aboriginal Transfer of Care (ATOC) model at South Western Sydney Local Health District. Aboriginal people with chronic conditions are more likely to leave hospital with incomplete transfer of care arrangements and more likely to be readmitted after a recent hospitalisation. ATOC was designed to address this problem by considering an Aboriginal patient's medical, cultural and psychosocial needs as they leave hospital and return to the community.

The model involves the Aboriginal Liaison Officers and Transfer of Care nurses working as team to deliver a holistic patient-centred model of care, through comprehensive discharge planning. The values and knowledge systems underpinning the practice of the two roles sometimes achieve congruency within a hospital context, but at other times do not. Staff reflections coupled with ethnographic detail suggest that there is a clash between a nursing culture that wants to 'treat everybody the same' and a model of care that acknowledges Aboriginal patients with chronic conditions and their specific needs. This presentation seeks to understand this incongruity and its implications for care, alongside current anthropological literature that may shed light on this phenomenon. This is also an opportunity for the presenter to discuss with the panel how and why a 'treat everybody the same' culture might exist.

Paper short abstract:

Complementary and alternative medicine (CAM) practitioners provide services to Australians within a healthcare landscape dominated by biomedical beliefs, practices and policy imperatives. This paper summarises philosophical tenets of CAM, contrasting these with biomedicine's Cartesian perspective.

Paper long abstract:

Not every 'medical professional' practices 'western medicine' (known as biomedicine). Yet, worldviews espoused by biomedical professionals permeate healthcare policy and institutional landscapes, contributing to a defining narrowness of belief and practices accepted as 'conventional'. The overriding biomedical professional culture has purposefully contrived an ongoing marginalisation of non-mainstream health providers. Complementary and alternative medicine (CAM) practitioners continue to work both in formal and informal marketplaces. My anthropological research about poor consumers' use of CAM, and CAM providers treating 'non-financial' consumers, revealed that many non-normative health practices remain popular, for reasons referred to political beliefs, spiritual understandings, autonomy, and a desire for wellbeing that approximates a 'natural' or 'holistic' state. Here I summarise the underlying philosophical principles associated with several CAM approaches, including homeopathy, touch- and energy-based therapies, holistic and community nutrition, narrative-psychotherapy, Indigenous rituals, witchcraft and psychic healing (yes, in Australia), herbal, folk and Chinese medicine, and yoga and meditation used for healing and health promotion. Common strands of these beliefs are drawn from traditional cultures, many of which are increasingly 'westernised' and saturated with capitalist-consumer values, while their healthcare models are pressured to rely on costly biomedical services. Science-driven research invents avant-garde solutions, that are adopted as 'the best', normative standard for health policy, informed by biomedical imperatives. Traditional viewpoints - of CAM's wellbeing-focused healing - therefore stand in contrast to the generalised biomedical Cartesian perspective, and biomedicine's location among highly-profitable capitalist enterprises. I highlight some assumed but unsubstantiated beliefs espoused by biomedicine, to facilitate consideration and understanding of CAM.

Paper short abstract:

This paper draws together social research on experiences of chronic pain; interactions between physical & psychological pain; & pain management from the perspectives of sufferers, treatment providers & the broader public. What do these different parties value in the pain management process?

Paper long abstract:

A 2019 report by PainAustralia has estimated that there are 3.24 million Australians living with chronic pain (close to 15%, though other reports suggest these numbers are closer to 20%), with an accompanying annual financial cost of $73.2 billion. There is ample mainstream research demonstrating that chronic pain is a social phenomenon and should be approached using the biopsychosocial model of medicine (Moseley and Butler, 2015). Yet the biomedical approach is much more commonly used by medical professionals in discussions with patients, even when pain is not able to be biomedically explained (Kirby, Broom, Sibbritt, Refshauge and Adams, 2015). This is arguably also the case in news media discourses, which is important because, as Seale (2003, p. 514) points out, "[w]hen people get sick, or make decisions about health, or visit their health service providers, or decide what to think and vote about health care policy and finance, their behaviour may be formulated in large part from resources drawn from various mass media." In the digital era, these decisions are often augmented by information gleaned online, or from one's own body using digital tracking devices or apps (Maslen & Lupton, 2019), adding new layers of complexity to the relationship between healthcare providers and pain sufferers. This paper draws together social research on experiences of chronic pain; interactions between physical & psychological pain; & pain management from the perspectives of sufferers, treatment providers & the broader public, asking what these different parties value in the pain management process.