Young Crew and Severe Injury

I have spent some time working with young people on a program attempting to engage them on the concept of choices and consequences, particularly around partying and road safety. It was hard work. It was enjoyable work. Most importantly, it was work that allowed me to hang out with young people and hope that they cared about what I had to say. It sometimes felt a lot like high school.

When you’re in high school you are desperate for people to like you. To talk to you. To think that you are worthy of their attention and they you have something interesting and useful to say. There is so much at stake. What if they hate me? What if what I say sucks? My work allowed me to return to those anxieties, but at seemingly much higher stakes. I wasn’t just hanging out at lunchtime with young crew, I was trying to convince them that keeping their limbs on was worth their attention.

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Until recently I worked on a project that involved coordinating and delivering a program that focused on reducing youth trauma – particularly trauma resulting from drinking or high risk behaviour. I was basically trying to teach teenagers how to not be stupid. And really, the focus is predominately on young men not being stupid. In 2016, a staggering 71% of trauma patients through the major trauma centre in WA (15-24 year old age bracket) were young men. And primarily young men that had taken stupid, high risk choices. From my home region – young people accounted for 25% of people killed or seriously injured on our local roads between 2004 and 2013. The excuses of the excesses of youth, the difficulties in delivering programmes or vagrancies of funding can’t be excuses for not trying to educate this group.

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I was involved in a really fun program to deliver. I am also the first person to admit it wasn’t always perfect. It could always have been improved, expanded, built upon. Health promotion is most effective when delivered as part of a structured program that is embedded in to multiple areas; rather than one-off field trips – but when you only have the capacity to deliver the one-offs, you have to decide whether one-off interventions are better than no interventions. We endeavoured to ensure the program was delivered in conjunction with other projects and programs, but occasionally it was purely stand-alone. I know what the research says, but sometimes you can only do what you can do.

A major challenge involved in running a project like this, was stakeholder management. So many stakeholders, all very important to the project, all with different needs, goals and motivations for their involvement. There were tense moments during development and delivery that would have been easier to manage with less people to worry about, but that may have reduced the efficacy of the program or the internal and external support. It was a delicate balancing game.

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After navigating the stress of just getting the project up and running – my main joy was delivering the actual program days. Delivering programs to young people takes a significant amount of energy. You have to just go for it and second best will not do. Program days would first involve juggling presenters and pretending on top of everything; then once that was under control the real fun would begin. It would be my turn to hurtle head first in to an awaiting pack of rabid youths, desperate to make my mark, or at the very least, a smeary smudge against the windshield of their youthful egos.

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That is where when head back to high school. Now, this was not peer-education. I’m old. Like grey hair, married with children old. I am so not lit. Sure, I’ve met young people and some of them have even spoken to me in a consensual two way conversation – but I am O. L. D. The young crew I was speaking to were generally in the sticky, messy part of the teenage dream, where parties, booze, sex and risk taking come crashing together with awkwardness, naivety and acne. I’m old enough (if I’d made some dramatic life choices) to be their dad. Or at least their uncle. In fact, for one of the kids – I was their uncle. Now, that was a tough day of trying to balance role duality. The challenges of working in regional areas.

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So, how do you make yourself relevant when speaking to young people without making yourself a grade-A example of an epic toolie? The first step is to sincerely acknowledge that you are not their peer, you are old and you do not know what they are going through. Aside from the fact that this is 90% the truth, it helps establish that you aren’t trying to be cool – you’re trying to be useful.

One thing that was VERY successful for me and a I recommend to anyone working with young people: don’t be afraid to ridicule yourself. It helps reduce the feeling that you are holier than thou and preaching to the group. I never felt that I lost standing mixing strong messages with some self targeted ribbing. One of the most talked about slides from my presentations has been my then and now picture. I use it to introduce the concept of choices and consequences to the program – mainly my poor choices in hair style and fashion.

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Another tip: find a concept and deliver it well. We worked hard on the choices and consequences concept – reduce your risks, help your mates, beware the ripple effect. Trying to convince a group of young people that a potentially silly error could lead to ongoing and possibly lifelong effects is a tough sell – one that can be achieved through making what you are talking about real, relatable and raw. A participant has to be able to put themselves or someone they know in the picture.

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The ripple effect was one of the key tenements of the program. It sprung in to existence from almost nowhere one day and became a core principle of explaining the concept of road trauma to young people. We don’t give young people much credit – they can be portrayed as lazy and self-absorbed. An unfair generalisation that doesn’t allow for the fact that there is great compassion and empathy in amongst our young crew. I would often explain the concept that health workers – the paramedics, doctors and nurses that dealt with front-line trauma are not robots. They are people, with families, and friends and lives that went on beyond delivering emergency health care. The concept that their decisions may actually impact on me and my children’s lives proved to be surprisingly effective in gaining their attention.

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Another pointer: tell real stories. Scenarios are great. Real life is even better. I have, unfortunately, lost far too many friends and peers through road accidents. Some were drinking driving. Some were speeding. Some remain unexplained, many, many years later. All were young men. All were tragedies. All ripped the heart and soul out of families, communities, sporting groups. There is nothing like the jarring finality of the loss of a young life through road trauma. There is a jarring reality when you stand in front of a group of young people and speak candidly about how hard it can be to see the mother of a dead friend, even years later. Explain the times you catch yourself day dreaming about the possible children a mate could have had, what type of dad he may have been, what type of partner. Retelling the reality of a life lost aids with cut-through.

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There was great opportunities to learn from the groups. Not just from what they were saying, but their actions, their responses, their feedback. There is something really exposing about presenting to young people (if you care). You are putting yourself out there – and they will provide direct and cutting feedback if what you are serving up isn’t to standard. The groups I spoke to had no qualms in questioning what was presented, how it was presented. They were fair but harsh critics – and they demand the best of you as a presenter.

The content we delivered was hard going and the manner it was interactive, challenging and occasionally fun. There can be a misconception that if you are learning about a serious topic you can’t enjoy yourself. It is widely accepted that children learn best through play. Surely adults and young adults are the same. This week I was reading an article by Dorothy Lucardie, who highlights that having fun and experiencing enjoyment were recognised by adult learners and teachers as a significant motivators to attendance and learning the knowledge and skills; while fun and enjoyment were considered a mechanism that encouraged concentration by learners and helped in the absorption of learning. We shouldn’t be afraid of making learning about serious topics fun. Why not engage a group, have them invested and involved when talking about the challenges of managing a trauma patient?

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The element of fun, some self-depreciation and relatability and acknowledging that while I definitely wasn’t a peer, I was at least worth listening to – meant that I had a lot of fun delivering this program and excellent feedback from my harsh, teen critics. Delivering alongside some exceptional presenters made my job that little bit easier, and definitely ensured that we had maximum impact on participants. This project was heavily evaluated, and the feedback forms were always glowing – but the biggest things that I would take from delivering the program were the unexpected outcomes, the remembrances, and the relationships with my fellow presenters.

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The value in presenting that program was always the things on top of the content. The outcomes no-one knew would exist. Two male students chose to study nursing after attending the project, changing their study preferences in perhaps the biggest professional compliment I have ever received. One student spent the day seemingly ignoring the key points of the program, before everything clicked in the final 15 minutes of the day. He solemnly shook my hand at the end of the day, staying back explicitly to do so – and still welcomes me in the street 2 years after he attended the program. The young people who remind me they were participants as they serve me coffee in local cafes, thanking me for the program. The parents who approach me and tell me their child raved about the program at home and that they hope it continues. Those were the things that made it really worthwhile, and are the things that cannot be captured on an evaluation or wider expansion of a program. The intangibles, the connections you make, the moments of realisation in a participant’s eyes. You can’t capture that – but it makes it worth throwing so much of yourself in to it.

PITCH: A reality TV show that brings public health into our lounge rooms

This post is a thought bubble that has sat unreleased on my computer since the end of 2016. I received the wonderful opportunity to present a PHAIWA Opinion Piece Seminar and these were my post-presentation musings. Thank you to PHAIWA for the opportunity, and thank you for the audience that sat through my presentation after Megan had finished.

Pitch us a concept for a reality TV show that promotes public health. That was my mission, should I choose to accept the opportunity to present at the Public Health Advocacy Institute of WA (PHAIWA) Opinion Piece Seminar. I sat back in my study and considered the angles, the opportunities, the possibilities. This was going to be tough – while I had to bring humour, I also had to bring some research, some body, something worth hearing. I had to deliver something of substance. This was PHAIWA, not Comedy Central.

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There are plenty of obvious places you could go with reality TV and health. I assumed I wasn’t being asked to present the obvious and set about some seriously immersive research. Now, we all like to pretend that we are above reality TV, far too cerebral for it all – but I can tell you, the night Nick got voted off Survivor, my head was spinning. Who cares if someone can make their cucumber gel set to delight Gazza, Georgie and the Cravat? We all do – we just don’t know it. I went deeper and deeper in to the reality TV whirlpool. Could the Kardashian’s sell public health to the masses?

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Now, as I say – we all, to some degree pretend we are above reality TV. I think everyone who has watched TV has ended up watching Reality TV. There is a social aspect to it, a familiarity. It has been on our TV’s forever. Now someone out there is reading this, shaking their heads (possibly their fists) and declaring they hate the format and have never watched it.

This may be true – but even if you haven’t seen it, you’d have to be aware of it. Think back – ever heard of the Seven Up! series, a lesson in Reality TV longevity? Watched an episode of Candid Camera or Australia’s Funniest Home Videos? Heard of Sylvania Waters or This Is Your Life? There are many different formats and styles of Reality TV – it’s not all competitions, Kimye and Jersey Shore.

Now, you can hate on Reality TV as much as you want; what you can’t ignore is its power, popularity and sustained success. Sure, its launched a few modelling and singing careers – but what about politics? Two of our Senators, Derryn Hinch and Pauline Hanson have enjoyed successful spells on Dancing with the Stars – managing to show a different side of themselves, and arguably softening their images. Donald Trump, portrayed a powerful and successful businessman in The Apprentice.

Suddenly, the reality of The Donald, is that he is now the President and leader of the free world. Surely The Donald’s current political success is more tied to his TV profile than his business acumen. Surely. George Galloway (UK politician), took time out of parliament to take part in Celebrity Big Brother. Perhaps Josh Frydenberg, could be convinced to do likewise?

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I was to present alongside Batchelor alumni, Megan. I wasn’t going to pretend that people were coming to listen to me. I was a side act to the big show. Megan was drawing the crowd – I was filler. Unperturbed, I threw myself in to my presentation. In the lead up, there was buzz about to content, the topic, (one of) the presenters. Everyone (except Mel Sweet) was hanging out to hear how we were going meld reality TV and public health; how we would fold them together in to a rich yet fluffy mousse to appease the Cravat. And Mel Stoneham.

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The day came and it was time for my pitch. Armed with the best PowerPoint I could ever put together, I watched as Megan wowed the crowd, answered questions about Batchie and the show, and nailed her presentation in general. It was my time to present. I waited long enough to give anyone wanting to leave straight after Megan the chance to go and then got cracking.

I wanted my audience to think about ways to break down barriers between Public Health and lounge rooms. What is the point of having fantastic brains doing amazing things and providing astounding insights if there is no one to listen. My pitch was for a surreal observational documentary that was about people, watching people watching Public Health related programming. Yes, my show to pitch: a Gogglebox-esque Public Health extravaganza.

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I learnt along the way that a show pitch needed a log line (thanks Google). My pitch was healthy for it and my pitch’s log line was: Gogglebox Health takes viewers into lounge rooms of everyday Australians and Public Health idols to watch their ideas, interpretations and criticisms of the nation’s best health shows, adverts and campaigns.

I wanted a show that controlled the content that was being delivered to people’s homes, but also delivered health messages in a way that ensured the message was getting through. I pitched the value of two steams – a stream of everyday stars, similar to the stars of the current shows, that provide general insights from the community, teaching points related to knowledge acquisition and criticism of our best (and worst) public health mass media. The second stream were new and old legends of public health – there to have a voice in the mainstream, the ability to connect with the audience and provide messages and teaching without lecturing, and without needing to be via a health-related press release.

I wanted us to give Australians what they didn’t know they already wanted – people sitting on their couches talking about Public health stuff! It would be low costs, yet high impact. Provide direct messaging opportunities. Be believable – but most importantly, relatable. It would give Public Health the chance to be famous, if only for 15 minutes.

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My presentation was well received and left me feeling like I’d achieved the brief, nailed the presentation and not disgraced myself (my three pre-presentation goals). People were very kind, giving me a moment of their time to shake my hand, before trying to find Megan and hope the conversation swung to the Bachelor. Now, this was a pitch for PHAIWA and fundamentally a bit of fun – but what if we could harness the power of reality TV for Public Health?

Why can’t we go beyond medical drama style reality TV (RPH, Kings Cross ED, Keeping Australia Alive) and think about subtly delivering our message via the format? Is there space in our lives for a team of celebrities trying to get an under-funded health promotion project off the ground in the face of funding cuts and a budget freeze? Could we get our health department heads on an island somewhere, battling it out for an increased budget? Why not follow the day to day lives of those heroes slogging it out in the Population Health Blocks around the country? There are definitely some colourful characters in some of those office buildings that would provide enough drama for an exec to get excited. Let’s give it a go.

Come on Australia – it’s time for a change, a challenge, a couch and a message.