SACM - Australia

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    Heart disease, health outcomes, and healthcare utilisation among middle-aged and older Australians: a longitudinal study using HILDA survey data
    (The University of Queensland, 2024) Alkalabi, Meshal; Keramat, Syed Afroz
    STUDY 1 ABSTRACT Background Heart disease is a major public health concern globally, with substantial impacts on health outcomes among middle-aged and older adults. Understanding its influence on general health, mental health, self-assessed health, and health satisfaction is crucial for developing effective interventions tailored to this demographic in Australia. The study aims to investigate the longitudinal burden of heart disease on self-reported health outcomes among middle-aged and older Australians, focusing on general health, mental health, self-assessed health, and health satisfaction. Methods This study utilised longitudinal data from the Household, Income, and Labour Dynamics in Australia (HILDA) survey, focusing on individuals aged 40 years and older across four survey waves: 2009, 2013, 2017, and 2021. The study included 12,751 participants aged 40 and older, with 32,931 observations. Fixed-effects Generalised Least Squares (GLS) and fixed-effects ordered logistic regression models were applied to assess the association between heart disease and four health outcomes. Robustness checks were conducted using Generalised Estimating Equations (GEE) and random-effect GLS models. The analysis adjusted for sociodemographic, behavioural, and healthrelated variables. Results The results suggest that heart disease was negatively associated with general health, mental health, self-assessed health, and health satisfaction among middle-aged and older Australians. Specifically, participants with heart disease scored lower on general health (β = -4.67, 95% CI: -5.56 to -3.77, p < 0.001), mental health (β = -0.98, 95% CI: -1.84 to -0.12, p = 0.025), self-assessed health (β = -0.76, 95% CI: -0.94 to -0.58, p < 0.001), and health satisfaction (β = -0.50, 95% CI: -0.65 to - 0.35, p < 0.001) compared to those without heart disease. The heterogeneous analysis further revealed that gender differences influenced health outcomes, with females experiencing more pronounced declines across all health measures than males. Additionally, the marginal effects analysis indicated that heart disease reduced the likelihood of achieving the highest levels of self-assessed health and health satisfaction. Conclusion This study found that heart disease is linked to poorer health outcomes, including general health, mental health, self-assessed health, and health satisfaction among middle-aged and older Australians. To enhance the overall well-being of this population, communities, government and nongovernment organisations, and other stakeholders should prioritise routine healthcare prevention, targeted interventions, and treatment strategies, particularly for individuals affected by heart disease.. Keywords: Heart disease; general health; mental health; self-assessed health; health satisfaction STUDY 2 ABSTRACT Background Heart disease poses a significant burden on healthcare systems, particularly among middle-aged and older adults in Australia. Despite existing research on healthcare utilisation patterns, longitudinal studies focusing on how heart disease affects healthcare use over time among older Australians remain limited. The study aims to examine the longitudinal burden of heart disease on healthcare utilisation among middle-aged and older Australians, focusing on the number of doctor visits, hospital admissions, and nights spent in the hospital. Methods This longitudinal observational study utilised data from the Household, Income, and Labour Dynamics in Australia (HILDA) survey, covering the years 2009, 2013, 2017, and 2021. The study included 12,857 participants aged 40 and older, with 33,822 observations. The primary outcomes were the number of doctor visits, hospital admissions, and nights spent in the hospital. Heart disease status was the main exposure variable, and random-effects negative binomial regression models were used to examine associations, adjusting for socio-demographic, behavioural, and healthcare access factors. Results Participants with heart disease had significantly higher healthcare utilisation across all measures. The rate of doctor visits increased by 24% (IRR: 1.24, 95% CI: 1.20–1.28, p < 0.001), while hospital admissions nearly doubled (IRR: 1.91, 95% CI: 1.76–2.07, p < 0.001), and nights spent in the hospital were significantly longer (IRR: 1.89, 95% CI: 1.75–2.04, p < 0.001) compared to those without heart disease. Older age (≥ 70 years), female sex, multiple chronic conditions, and not being in the labour force were significant predictors of increased healthcare utilisation, indicating a compounded healthcare burden in these subgroups. Conclusion Heart This study shows that middle-aged and older Australians with heart disease have higher healthcare utilisation compared to those without the condition. Heart disease is a significant public health concern that necessitates comprehensive, long-term management strategies focused on prevention. Inadequate management of heart disease could lead to worsening health outcomes and place further strain on the healthcare system. Keywords: Heart disease, healthcare utilisation, longitudinal study, older adults, HILDA survey, doctor visits, hospital admissions, Australia.
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    Interactive Impact of EWOM Message Characteristics and Format on Brand Evaluation and Online Brand Engagement: Towards an Integrative Framework
    (Saudi Digital Library, 2023-12-15) Alqahtani, Abdulaziz; Sharma, Piyush; Kingshott, Russel; Davcik, Nebojsa
    With the rapid rise in the popularity and usage of social media platforms and the associated sharing of electronic word of mouth (EWOM), many questions about its impact on customers’ attitudes and behaviours still need to be answered. This research aims to explore the interactive effect of message characteristics (valence and credibility) and message formats (text, picture, audio-visual and audio) on brand evaluation and online brand engagement, utilising the elaboration likelihood model (ELM) of persuasion theory to elucidate the current research phenomenon. A causal research design was applied through web-based experiments using mock Facebook and Twitter accounts for a fictitious airline brand explicitly developed for this research using Qualtrics software. To attain the objectives of the research, the participants were randomly assigned to one of 16 conditions in a 2 (EWOM message valence: positive vs. negative) x 2 (EWOM message credibility: high and low) x 4 (message formats: text, picture, audio-visual and audio) format using between-subject factorial design. Therefore, this research utilises a multi-method quantitative, conducting the web experiment through an online survey to test all the hypotheses data from a simple random sample of Facebook (N=480) and Twitter (N=480) users from Australia. The data were analysed using confirmatory factor analysis (CFA) conducted with AMOS 26.0 to test the measurement model, variance analysis via ANOVA, and Hayes’ PROCESS Macro with SPSS software to test the moderated mediation model proposed in this research. The findings demonstrate that positive EWOM message valence has a more substantial impact on brand evaluation than negative EWOM message valence. Additionally, the research results indicate a positive effect of EWOM message valence on online brand evaluation that is positively moderated (strengthened) by message credibility. Moreover, the findings display that brand evaluation significantly impacts online brand engagement. Furthermore, the results exhibit significant differences in the impact of EWOM message valence (but not credibility) on brand evaluation across different message formats. In particular, EWOM message valence has a more substantial impact on brand evaluation for the text format than picture, audio-visual and audio formats. Lastly, the findings show brand evaluation fully mediates the effects of message valence (but not credibility) on online brand engagement. This research offers several considerable contributions to the literature on EWOM messages by emphasising the relationship between EWOM message characteristics (valence and credibility) and brand evaluation. Moreover, this study is the first to illustrate the interactive relationships of four different EWOM message formats (text, picture, audio-visual, and audio) as moderators and two EWOM message characteristics (valence and credibility) and the first to identify their influence on brand evaluation. Furthermore, this research is considered to be among only a few that deeply explain the role of brand evaluation as a mediator between EWOM message characteristics (valence and credibility) and online brand engagement on two different social media platforms (Facebook and Twitter) in the airline context. In addition, this study offers some practical implications to marketing practitioners and brand managers on improving their understanding of online customers to maximise their brand engagement online. Besides the theoretical and practical contributions, it also provides some methodological contributions to EWOM research by conducting an experimental strategy using a multi-quantitative method.
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