Background: Up to 6 years after the 2011 Christchurch earthquakes, approximately one-third of parents in the Christchurch region reported difficulties managing the continuously high levels of distress their children were experiencing. In response, an app named Kākano was co-designed with parents to help them better support their children’s mental health. Objective: The objective of this study was to evaluate the acceptability, feasibility, and effectiveness of Kākano, a mobile parenting app to increase parental confidence in supporting children struggling with their mental health. Methods: A cluster-randomized delayed access controlled trial was carried out in the Christchurch region between July 2019 and January 2020. Parents were recruited through schools and block randomized to receive immediate or delayed access to Kākano. Participants were given access to the Kākano app for 4 weeks and encouraged to use it weekly. Web-based pre- and postintervention measurements were undertaken. Results: A total of 231 participants enrolled in the Kākano trial, with 205 (88.7%) participants completing baseline measures and being randomized (101 in the intervention group and 104 in the delayed access control group). Of these, 41 (20%) provided full outcome data, of which 19 (18.2%) were for delayed access and 21 (20.8%) were for the immediate Kākano intervention. Among those retained in the trial, there was a significant difference in the mean change between groups favoring Kākano in the brief parenting assessment (F1,39=7, P=.012) but not in the Short Warwick-Edinburgh Mental Well-being Scale (F1,39=2.9, P=.099), parenting self-efficacy (F1,39=0.1, P=.805), family cohesion (F1,39=0.4, P=.538), or parenting sense of confidence (F1,40=0.6, P=.457). Waitlisted participants who completed the app after the waitlist period showed similar trends for the outcome measures with significant changes in the brief assessment of parenting and the Short Warwick-Edinburgh Mental Well-being Scale. No relationship between the level of app usage and outcome was found. Although the app was designed with parents, the low rate of completion of the trial was disappointing. Conclusions: Kākano is an app co-designed with parents to help manage their children’s mental health. There was a high rate of attrition, as is often seen in digital health interventions. However, for those who did complete the intervention, there was some indication of improved parental well-being and self-assessed parenting. Preliminary indications from this trial show that Kākano has promising acceptability, feasibility, and effectiveness, but further investigation is warranted. Trial Registration: Australia New Zealand Clinical Trials Registry ACTRN12619001040156; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=377824&isReview=true
A video of a presentation by Bridget Tehan and Sharon Tortonson during the Community and Social Recovery Stream of the 2016 People in Disasters Conference. The presentation is titled, "Community and Social Service Organisations in Emergencies and Disasters in Australia and New Zealand".The abstract for this presentation reads as follows: What happens when support services for issues such as mental health, foster care or homelessness are impacted by a disaster? What happens to their staff? What happens to their clients? The community sector is a unique, valuable and diverse component of Australasian economy and society. Through its significant numbers of employees and volunteers, its diversity, the range of service and advocacy programs it delivers, and the wide range of people it supports, it delivers value to communities and strengthens society. The community and social services sector builds resilience daily through services to aged care, child welfare and disability, domestic violence, housing and homelessness, and mental health care. The sector's role is particularly vital in assisting disadvantaged people and communities. For many, community sector organisations are their primary connection to the broader community and form the basis of their resilience to everyday adversity, as well as in times of crisis. However, community sector organisations are particularly vulnerable in a major emergency or disaster. Australian research shows that the most community sector organisations are highly vulnerable and unprepared for emergencies. This lack of preparedness can have impacts on service delivery, business continuity, and the wellbeing of clients. The consequences of major disruptions to the provision of social services to vulnerable people are serious and could be life-threatening in a disaster. This presentation will review the Victorian Council of Social Service (Australia) and Social Equity and Wellbeing Network (formerly the Christchurch Council of Social Services) records on the impacts of emergencies on community sector organisations, staff, and clients. From the discussion of records, recommendations will be presented that could improve the resilience of this crucial sector.
A video of the keynote presentation by Alexander C. McFarlane during the third plenary of the 2016 People in Disasters Conference. McFarlane is a Professor of Psychiatry at the University of Adelaide and the Heady of the Centre for Traumatic Stress Studies. The presentation is titled, "Holding onto the Lessons Disasters Teach".The abstract for this presentation reads as follows: Disasters are sentinel points in the life of the communities affected. They bring an unusual focus to community mental health. In so doing, they provide unique opportunities for better understanding and caring for communities. However, one of the difficulties in the disaster field is that many of the lessons from previous disasters are frequently lost. If anything, Norris (in 2006) identified that the quality of disaster research had declined over the previous 25 years. What is critical is that a longitudinal perspective is taken of representative cohorts. Equally, the impact of a disaster should always be judged against the background mental health of the communities affected, including emergency service personnel. Understandably, many of those who are particularly distressed in the aftermath of a disaster are people who have previously experienced a psychiatric disorder. It is important that disaster services are framed against knowledge of this background morbidity and have a broad range of expertise to deal with the emerging symptoms. Equally, it is critical that a long-term perspective is considered rather than short-term support that attempts to ameliorate distress. Future improvement of disaster management depends upon sustaining a body of expertise dealing with the consequences of other forms of traumatic stress such as accidents. This expertise can be redirected to co-ordinate and manage the impact of larger scale events when disasters strike communities. This presentation will highlight the relevance of these issues to the disaster planning in a country such as New Zealand that is prone to earthquakes.
A video of a presentation by David Meates, Chief Executive of the Christchurch District Health Board and the West Coast District Health Board, during the first plenary of the 2016 People in Disasters Conference. The presentation is titled, "Local System Perspective".The abstract for this presentation reads as follows: The devastating Canterbury earthquakes of 2010 and 2011 have resulted in challenges for the people of Canterbury and have altered the population's health needs. In the wake of New Zealand's largest natural disaster, the health system needed to respond rapidly to changing needs and damaged infrastructure in the short-term in the context of developing sustainable long-term solutions. Canterbury was undergoing system transformation prior to the quakes, however the horizon of transformation was brought forward post-quake: 'Vision 2020' became the vision for now. Innovation was enabled as people working across the system addressed new constraints such as the loss of 106 acute hospital beds, 635 aged residential care beds, the loss of general practices and pharmacies as well as damaged non-government organisation sector. A number of new integration initiatives (e.g. a shared electronic health record system, community rehabilitation for older people, community falls prevention) and expansion of existing programs (e.g. acute demand management) were focused on supporting people to stay well in their homes and communities. The system working together in an integrated way has resulted in significant reductions in acute health service utilisation in Canterbury. Acute admission rates have not increased and remain significantly below national rates and the number of acute and rehabilitation bed days have fallen since the quakes, with these trends most evident among older people. However, health needs frequently reported in post-disaster literature have created greater pressures on the system. In particular, an escalating number of people facing mental health problems and coping with acute needs of the migrant rebuild population provide new challenges for a workforce also affected by the quakes. The recovery journey for Canterbury is not over.
A natural disaster will inevitably strike New Zealand in the coming years, damaging educational facilities. Delays in building quality replacement facilities will lead to short-term disruption of education, risking long-term inequalities for the affected students. The Christchurch earthquake demonstrated the issues arising from a lack of school planning and support. This research proposes a system that can effectively provide rapid, prefabricated, primary schools in post-disaster environments. The aim is to continue education for children in the short term, while using construction that is suitable until the total replacement of the given school is completed. The expandable prefabricated architecture meets the strength, time, and transport requirements to deliver a robust, rapid relief temporary construction. It is also adaptable to any area within New Zealand. This design solution supports personal well-being and mitigates the risk of educational gaps, PTSD linked with anxiety and depression, and many other mental health disorders that can impact students and teachers after a natural disaster.
