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. 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 prescriptions records 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 policy changes.  


APHID - Are 'potentially preventable hospitalisations' a valid measure of the quality and affordability of primary and community care in Australia?

  • Researchers: Louisa Jorm, Michael Falster, Sanja Lujic. Funded by NHMRC Partnership Project Grant ($387,140 and $360,000 from partner organisations).

This project will investigate the validity of 'potentially preventable hospitalisations' (PPH) as a measure of the quality and affordability of primary and community care in Australia. It will explore relationships between use of primary care services, hospital admissions for PPH diagnoses, and health outcomes and quantify the contributions of person-, geographic- and service-level factors to variations in PPH. The project will make recommendations regarding the ongoing use of PPH measures to track the impacts of health reform in Australia. Find out more about APHID.

 

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

 

A population-based record linkage study of the impact of chlamydia infection on reproductive health in women

  • Researchers: Bette Liu, Louisa Jorm, David Preen, Jane Hocking, Basil Donovan, Christine Roberts, James Ward, Donna Mak. Funded by NHMRC Project Grant ($392,260 [via UNSW]). 
This project will provide reliable, population-based estimates of the impact of genital Chlamydia infection on reproductive health outcomes including fertility, pelvic inflammatory disease, and adverse obstetric outcomes such as ectopic pregnancy, miscarriage, and preterm delivery in Australian women. The results from this investigation will be vital to inform future evaluations of the effectiveness of Chlamydia screening.   

 

Investigating best practice primary care for older Australians with diabetes using data linkage

  • Researchers: Elizabeth Comino, Mark Harris, Louisa Jorm, Marion Haas, Bin Jalaludin, Jeff Flack, Kris Rogers. Funded by NHMRC Project Grant ($504,750). 
This project commenced in 2010 and is investigating best practice primary care for older Australians with diabetes using the 45 and Up Study and record linkage to MBS and PBS claims. Achievements to date include: successful extraction and linkage of datasets required for the project, analysis of baseline and supplementary surveys, and drafting of draft papers for submission addressing validation of self-reported diabetes and use of medications, and factors associated with annual cycle of care and team care for people with diabetes.

 

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 in 2011 include: three peer-reviewed journal articles, ethics approval from the AH&MRC to commence analyses of data relating to Aboriginal participants, analyses underway on BMI and health service costs, and a policy forum was held in November 2011, the results of which will inform for the next phase of analyses.

 

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 health service use and outcomes relating to otitis media in Indigenous and non-Indigenous children (TI: Kathleen Falster); and the health impacts of childhood pertussis infection (TI: Lisa McCallum). 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. A former UWS OSPREY TI, Bette Liu, continues to collaborate with the Group and was awarded an NHMRC project grant in 2011. The OPSREY program has produced 28 publications to date.

 

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, and potentially preventable hospitalisations. 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.

In 2011, findings from IHOPE were presented at the Coalition for Research to Improve Aboriginal Health Conference (Sydney), the Annual Australasian Epidemiological Association Conference (Perth), the Health Services and Policy Research Conference (Adelaide) and the World Congress of Epidemiology (Edinburgh). In 2012, findings were presented at the International Data Linkage Conference (Perth) and the Population Health Congress (Adelaide). The first publication on outcomes after AMI admission for Aboriginal and non-Aboriginal people in NSW was accepted for publication in early 2012. Two more papers are currently under review: one on disentangling the influence of area of residence on the rates of serious motor vehicle accidents for Aboriginal and non-Aboriginal people; and one on revascularisation rates after admission for AMI. 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.

 

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. Ethics approval has been obtained for this research, and analyses regarding the validity of smoking diagnoses in routinely collected hospital data are 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 Practictioner, find out about the Cancer and Fertility study for HCP

 

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 Souarès, 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.
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