Research

Current projects include:

Pharmacotherapy for smoking cessation during pregnancy and the inter-pregnancy period: a population-based cohort study

  • Researchers: Alys Havard, Louisa Jorm, Deborah Randall, Danielle Tran. Funded by NHMRC Project Grant $620,950.
This study will examine the use, effectiveness and safety of medications for smoking cessation prior to and during pregnancy. It will achieve this by linking routinely collected midwives data from NSW and WA to pharmaceutical data and records of other health service use. It will explore potential inequalities in the use and effectiveness of these medications in disadvantaged populations, including Aboriginal women, and it will investigate whether their use has changed in response to pharmaceutical policy reforms. Achievements to date include obtaining ethics approval and publication of the study protocol, a manuscript in which methods for identifying smoking during pregnancy in administrative datasets were examined, and a manuscript regarding changes in smoking status between pregnancies.  

 

An Investigation of the Geographic Variation in Primary Health Care

  • Researchers: Louisa Jorm, Federico Girosi. Funded by APHCRI, ANU ($379,400).  
In this project we investigate geographic patterns of primary health care in the New South Wales population aged 45 and older. The goal of the project is to provide more effective means of resource allocation and to improve both health equity and overall health outcomes. The first step toward this goal is the definition of appropriate geographic areas, called "catchment areas", that constitute the basis for the geographic analysis. Catchment areas are built by combining information on where patients live and where they access primary care, providing a useful insight on the pattern of interaction between patients and the health care system. Using the catchments areas we can study the geographic variation of health care need, utilization and cost. Disentangling the complex relation between these three measures is possible because the data we use (the 45 and Up survey) contains information on health conditions as well as on socio-economic status and it is linked to a variety of administrative data sets. The data will allow to compare patients with the same health and socio-economic status across different locations, and identify the components of the variation in utilization and costs that are not due to variation in need and individual characteristics. The results of the geographic analysis will be made available to stakeholders and researchers through an interactive web enabled mapping module that will allow to interrogate the data in a variety of ways. Once the status quo has been analysed we will then be able to model policy interventions that alter important determinants of outcomes such as funds distribution or access to care in order to understand how better allocation of resources can lead to improved health for all. More details

 

Obesity, overweight and hospitalisation: Identifying targets for interventions to prevent adverse health outcomes

  • Researchers: Emily Banks, Adrian Bauman, James Butler, Louisa Jorm, Vicki Wade, Debra Fernando, Hilary Bambrick, Mark Clements, Bette Liu, Rosemary Korda. Funded by NHMRC Project Grant ($581,750).
The project commenced in 2010 and is examining the burden of hospital use, and adverse hospital outcomes, associated with obesity and overweight, and identifying targets for interventions to preventing adverse health outcomes. Achievements as at March 2014 include: five peer-reviewed journal articles, and five conference presentations.

 

OSPREY (Outcomes, Services and Policy for the Reproductive and Early Years)

  • Researchers: Louisa Jorm, Christine Roberts, David Preen, Judy Simpson, Rachael Moorin, Mary Haines, Hilary Bambrick, Cashel D'Arcy Holman. Funded by an NHMRC Capacity Building Grant in Health Services Research ($2,261,542)
OSPREY is developing a new cadre of researchers skilled in methods for research using linked health datasets, and in applying these to address policy-relevant questions relating to the health of mothers, babies and children. OSPREY commenced in 2009 and team investigators (TIs) are based at UWS, the University of Sydney and the University of Western Australia. Current projects at UWS include investigation of otitis media and preventable hospitalisation in Indigenous and non-Indigenous children (TI: Kathleen Falster); childhood pertussis infection (TI: Lisa McCallum); meningococcal disease in childhood (TI: Amy Gibson) and unintentional injury in Aboriginal children (TI: Holger Moller). OSPREY has been very successful in achieving its capacity building aims: Alys Havard joined OSPREY as a postdoctoral TI in November 2010 and was awarded an NHMRC Training Fellowship in 2010 and an NHMRC project grant in 2011. The OPSREY program has produced more than 50 publications to date and has generated nationally-competitive grants and fellowships totalling $2.7m.

 

IHOPE (Indigenous Health Outcomes Patient Evaluation)

  • Researchers: Louisa Jorm, Alastair Leyland, Timothy Churches, Mary Haines, Sandra Eades, Sanja Lujic, Deborah Randall. Funded by an NHMRC Project Grant ($469,000)

IHOPE is using linked hospital and deaths data, and multilevel modelling, to investigate factors that influence health outcomes Aboriginal people compared with non-Aboriginal people. IHOPE is investigating outcomes for people who have been admitted to hospital for ischaemic heart disease, stroke, heart failure, type 2 diabetes, chronic obstructive pulmonary disease and asthma. Admission and event rates have been investigated for acute myocardial infarction, serious road traffic injuries, cataract surgery, potentially preventable hospitalisations, and childhood unintentional injury. A birth cohort has also been identified from the IHOPE data to investigate admission and procedure rates of interest for the early years of life such as surgery to treat otitis media.

As at March 2014, six peer-reviewed papers from IHOPE have been published or accepted, with three more under review. Results have been presented at five Aboriginal community reference group meetings, five national and three international conferences, and meetings with policy agencies including the NSW Ministry of Health and Agency for Clinical Innovation. Findings have been cited in a NSW Ministry of Health policy document: "Better Cardiac Care for Aboriginal People". The IHOPE team includes a senior Aboriginal researcher and it has built significant new capacity in policy- and community-engaged Aboriginal health research. Five higher degree students have worked on the project, with three of these now having been awarded their degrees. Find out more about IHOPE.

 

CIPHER (Centre for Informing Policy through Evidence from Research)

  • Researchers: Sally Redman, Louisa Jorm, Sally Green, Kate D'Este, Jordan Louviere, Deborah Frew, Anthony Shakeshaft, Huw Davies. Funded as an NHMRC Centre for Research Excellence in Health Services Research ($2,500,000)
CIPHER is developing and testing strategies for increasing the use of evidence for research in policy agencies.  It is based on an integrated series of themes designed to: develop methods and measures; establish a community of practice of 20 policy agencies, examine their practice and test an integrated best practice intervention in four agencies using a step wedge design; develop and test a series of new strategies using a mix of methodologies including randomised trials and discrete choice experiments.  CIPHER commenced in 2011 and achievements to date include recruitment of Centre staff, development of three new tools to measure research utilisation in policy agencies, development of a protocol for Supporting Policy In health with Research: an Implementation Trial (SPIRIT), and design of the CIPHER Web Portal. The SPIRIT Trial is now underway in four policy agencies in NSW.

 

Health impacts of climate change on Indigenous Australians. Identifying climate thresholds to enable the development of informed adaptation strategies

  • Researchers: Donna Green, Hilary Bambrick, Lisa Alexander, Andy Pitman. Funded by an NHMRC Project Grant ($348,581). 
The health impacts of climate change will not be evenly distributed across the population. Some groups will be more adversely affected than others, especially those with a high prevalence of chronic disease and who are socioeconomically disadvantaged. This NHMRC-funded project is modelling the impacts of climate variability and change on Indigenous and non-Indigenous morbidity in Australia in order to better understand factors that may increase Indigenous vulnerability and to discover opportunities for prevention and adaptation. The impacts of climate change on the psychosocial health of people living in remote communities are also being explored.

 

The health impact of smoking in subgroups of Australians

  • Researchers: Alys Havard, Louisa Jorm. Funded by an NHMRC postdoctoral research fellowship ($290,032)
The aim of this fellowship is to use linked health services data to investigate smoking-related illness among high-risk subgroups of the Australian population. Achievements to date include publication of a manuscript in which the validity of identifying smoking  from administrative data was examined, as well as  presentation of the findings at local and international conferences. A study of patterns of dispensing of smoking cessation pharmacotherapies is currently underway.

 

Urban Thermal Stress and Climate Change 

  • Researchers: Hilary Bambrick, Pavla Vaneckova, Anthony Burton. Project funded as part of the CSIRO Flagship Collaboration on Urbanism, Climate Adaptation and Health ($1,700,000).
This project examines climate change vulnerability and adaptation in western Sydney, especially to extreme heat, models future health scenarios, and explores strategies for urban planning adaptation.

 

Evaluation of the relative efficacy and mechanisms of a couple based intervention for Premenstrual Syndrome through a randomised control trial using mixed methods

  • Researchers: Jane Ussher, Janette Perz (CI), & Edith Weisberg (PI). Funded by an ARC Discovery Grant ($430,000). 
Of 9,689 Australian women recently surveyed nationally, 33% reported moderate or severe premenstrual symptoms (PMS). Whilst relationships have been identified as a significant factor in the experience of premenstrual distress, to date, there has been no systematic description or evaluation of couple-based PMS interventions. This research study will do this, comparing couple-based support to both one-to-one and self-help support, helping health-care providers understand the experience and treatment of PMS in the context of family relationships, thereby reducing PMS, and the physical and psychological distress associated with it. This will lead to improved psychological wellbeing and quality of life for women and their families, a priority area for the ARC. More details

 

Multiple perspectives on sexuality and intimacy post-cancer, leading to the development and evaluation of supportive interventions

  • Researchers: Jane Ussher, Janette Perz, Emilee Gilbert (CI) Gerry Wain, Kendra Sundquist, Gill Batt, Kim Hobbs, Laura Kirsten (PI). Funded by an ARC Linkage Grant ($585,308). 
Sexuality and intimacy are key aspects of quality of life detrimentally affected by cancer, resulting in significant reductions in well-being for people with cancer and their partners. However, health professionals rarely address this important health problem, and little is known about the factors which predict difficulties or re-negotiation of sexuality post-cancer. This study will examine the experience and construction of intimacy and sexuality post-cancer, from the perspective of people with cancer, their partners, and health professionals, and elucidate pathways to difficulty or re-negotiation. Based on these findings, programs of targeted couple interventions will be developed, and evaluated in a randomised controlled trial. More details

 

The construction and experience of fertility in the context of cancer: patient, partner and health professionals

  • Researchers: Jane Ussher, Janette Perz, Emilee Gilbert (CI), Gerry Wain, Kendra Sundquist, Gill Batt, Kim Hobbs, Laura Kirsten, Catherine Mason, Pandora Patterson, Edith Weisberg (PI). Funded by an ARC Linkage Grant ($693,824). 
Changes to fertility can be experienced as the most difficult long term effect of cancer diagnosis and treatment. However, health professionals rarely address this important health issue, and there has been no examination of fertility concerns post-cancer across gender, across a broad range of cancer types, or from the perspective of partners. This study will examine the gendered construction and experience of fertility for men and women with cancer, their partners, and health-professionals. Psycho-social, emotional and identity concomitants of fertility concerns will be examined, as well as negotiation within relationships, and professional communication, leading to the development and evaluation of a psycho-educational intervention. 

Find out more about the Cancer and Fertility study

If you are a Health Care Practitioner, find out about the Cancer and Fertility study for HCP

 

Sexual Wellbeing and Quality of Life after Prostate Cancer for Gay and Bisexual Men and their Partners

  • Researchers: Jane Ussher, Janette Perz, Suzanne Chambers, David Latini, Ian Davis, Scott Williams, Alan Brotherton, Gary Dowsett. Funded by the Prostate Cancer Foundation of Australia, Movember New Concept Grant, in partnership with ANZUP Clinical Trials Group and ACON.

It is estimated that 600 - 1000 Australian gay men are diagnosed with prostate cancer each year. This study aims to examine the psychological burden of changes to sexual wellbeing, sexual identity and intimate relationships in gay and bisexual men with prostate cancer and their male partners. Sexuality and intimacy are important aspects of an individual's Quality of Life, with changes to sexual functioning, relationships, and sense of self reported to be among the most negative influences on the wellbeing of men with prostate cancer. However, the focus of previous research has been heterosexual men, with gay and bisexual men with prostate cancer being described as an "invisible diversity", or a "hidden population". This has led to a plea for research on the impact of potentially important differences in sexuality, identity, and intimate relationships on gay and bisexual men's experience of prostate cancer, which can be used to inform health education and health promotion, as well as lead to targeted psycho-social interventions. More details

 

Impact of Community Based Fisheries Management on child health in the Pacific: Evaluation of a climate adaptation program

  • Researchers: Hilary Bambrick, Damian Hoy, Quentin Hanich, Yvan Souar√®s, Neil Andrew. 
This project is a collaboration between UWS, University of Wollongong, the Secretariat of the Pacific Community and WorldFish. It is evaluating outcomes for child health and household food security associated with a climate change adaptation program. Community Based Fisheries Management (CBFM) is being piloted in Solomon Islands, Kiribati and Vanuatu to increase the resilience of coastal fisheries that are highly climate sensitive. The prevalence of child malnutrition and rates of child mortality are already high in these communities. This project, a community intervention trial of the CBFM, will assess health impacts, build local and regional capacity, and model potential health benefits and cost-effectiveness of CBFM as a regional climate adaptation strategy across the Pacific.

 

Young women's experiences of cigarette smoking: a qualitative examination of the intersection of gender, class, cultural and sexual identity

  • Researchers: Emilee Gilbert, Jane Ussher, Janette Perz. Funded by an ARC Discovery Grant ($171,663).

Cigarette smoking is the single largest preventable cause of disease and premature death in Australia, presenting serious health effects unique to women, with young women specifically at risk. While anti-smoking policies and practices have been instrumental in reducing the overall rate of smoking, they have been less effective at reducing rates of smoking among young women, in particular, young women from disadvantaged social classes, those who are socially marginalised, and those from Indigenous and Culturally and Linguistically Diverse (CALD) communities. This is of concern as smoking is associated with unique gender and age specific health risks for young women. This research study uses a multi-layered qualitative approach which includes semi-structured individual interviews and cultural probe activities to explore the intersections of gender, social class, cultural identity and sexual identity in relation to smoking. The study will give insight into the constructions, meanings and experiences of smoking for young women smokers and ex-smokers aged 18-30 years. It will examine how young women negotiate and position anti-smoking policies and practices in the context of their everyday lives, and explore the circumstances and conditions that contribute to smoking cessation for ex-smokers. The study will contribute to knowledge that will directly lead to the development of targeted anti-smoking interventions.

Find out more about the Young Women and Cigarette Smoking Study

 

Sexual and Reproductive health of Migrant and Refugee Women: An international comparison 

  • Researchers: Janette Perz, Jane Ussher, Renu Narchal (CIs) in partnership with Family Planning NSW: Jane Estoesta, Jane Wicks; Community Migrant Resource Centre: Melissa Monteiro; and Simon Fraser University, Vancouver: Marina Morrow (PIs). Funded by an ARC Linkage Grant ($271,144 and $129,000 from partner organisations).

Sexual health is a key component of women's quality of life, with utilisation of sexual health services associated with positive mental health. However, these services are underutilised by migrant and refugee communities, resulting in negative sexual health outcomes. This project will investigate the experiences and constructions of sexual health for women from a range of recent migrant and refugee communities living in Australia and Canada, in order to understand unmet needs, and inform targeted service provision. This research project uses a multi-layered qualitative approach, which includes focus groups and semi-structured interviews with community interviewers. Data will be analysed through thematic analysis, in-depth group comparisons and case studies. Guidelines for programs of sexual health education and promotion will then be developed, and subjected to a formative evaluation, from the perspective of key stakeholders.

Find out more about the Sexual and Reproductive Health of Migrant and Refugee Women Study.

 

Mapping the outcomes of calls to 'healthdirect Australia'

  • Researchers: Louisa Jorm, Maureen Robinson, Carlo Leonessa, David Washington, Mary Byrne, Anthony Lawler, Danielle Tran, Amy Gibson, Alys Havard. Funded by healthdirect Australia ($321,176)

Healthdirect Australia provides a telephone-based health care triage and advice service known as healthdirect Australia. This projects uses linked operational call data with routinely collected data (including emergency department data, hospital admissions and mortality data) and the 45 and Up Study baseline questionnaire. The project will examine a) to what extent is healthdirect Australia advice being followed, b) patient outcomes following calls to healthdirect Australia, c) the characteristics of patients who are less likely to follow advice and/or have unfavourable outcomes and d) explore how features of healthdirect Australia service provision relate to a) and c) above.

 

Walk the Talk: Phase II study of an online population-based intervention to improve the mental health of young people who are unemployed.

  • Researchers: Vanessa Rose, Janette Perz. Funded by an Australian Rotary Health Grant ($128,796)

This phase II randomised controlled trial aims to investigate the efficacy of an online self-directed vocationally-oriented cognitive behavioural program ('Walk the Talk') in improving the mental health of young people who are unemployed. The online program features dramatised video of cognitive self-talk, coping with unemployment, job-searching, attending interviews and maintaining employment once in the workforce; online quizzes comprising multiple choice items to self-test understanding of content material; and downloadable diary sheets, activities, website links and tips. Participants will be aged between 17-25 years and currently looking for full-time employment. Results will assist with interpreting intervention integrity and will be used to make any required modifications to the program before a planned phase III large population scale intervention trial.

 

The MISHA Project

  • Researchers: Paul Flatau, Lucy Burns, Elizabeth Conroy, Bridget Spicer, Tony Eardley. Funded by Mission Australia through a philanthropic donation ($230,568)

The MISHA Project was a collaborative research venture with Mission Australia that commenced in late 2010. It aimed to evaluate Michael's Intensive Supportive Housing Accord (MISHA), a 'housing-first'-type model that provided housing and case management for 75 chronically-homeless men in the Parramatta area.  The evaluation involved: 1) Two year longitudinal client survey examining outcomes with respect to housing, economic and social participation, and physical and mental health; 2) In-depth interviews with clients and caseworkers to explore the critical success factors and barriers for the project; and 3) Cost analysis that modelled the savings associated with providing the MISHA service compared to the costs that would have been incurred by the government if the sample had remained homeless. The baseline and 12-month findings have been published and the 24 month findings are available in the From Homelessness to Sustained Housing: MISHA Research Report 2010-2013 (PDF, 2405.97 KB) (opens in a new window). It is hoped that the findings from this research will inform housing and homelessness policy and improve the design of similar programs in the future. The Mission Australia website has further details.


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