Current Research Projects

Health adaptation in the Pacific

Researchers: Hilary Bambrick (Western Sydney University), Simon Hales (University of Otago). Funding: UNDP, Western Sydney University

Pacific Island countries are especially vulnerable to the impacts of climate change and variability because of isolation, poverty, limited land area, low lying topography and widespread reliance on subsistence farming and imported foods. The poorest countries especially have few resources to adequately manage climate risks. Endemic poverty and minimal access to capital limit capacity to respond and adapt to climate events and long term changes, while coping actions are necessarily reactive and targeted at immediate threats; longer term vulnerability may even be enhanced by unsustainable and ineffective practices. In coming years, for example the Pacific is expected to experience increasing climate extremes; periods of drought and heavy rainfall, cyclones and heat may become more frequent and more intense, oceans may become warmer and more acidic, and sea-level rise may affect artesian water supplies and cause flooding. This project investigates the ways in which climate change will affect health in the region, and examines potential adaptation strategies to minimise the adverse impacts.

Climate change and health vulnerability on Rabi Island, Fiji

Researchers: Hilary Bambrick (Western Sydney University), Stefano Moncada (University of Malta), Marie Briguglio (University of Malta). Funded by Western Sydney University, Maltese Ministries for Foreign Affairs and for Resources and Rural Affairs, and the University of Malta

Rabi Island is home to the Banaba Island people from Kiribati, who were brought to Rabi Island in the 1940s after their homeland was destroyed by phosphate mining. Pacific islands are especially vulnerable to climate change, with extreme events such as cyclones and vector-borne diseases such as dengue likely to increasingly impact upon health in the region. This project uses household survey and focus group data to identify specific areas of climate vulnerability in this largely subsistence community.

Health vulnerability and community adaptive capacity in the context of extreme urban poverty, Shashemene, Ethiopia

Researchers: Hilary Bambrick (Western Sydney University), Stefano Moncada (University of Malta), Marie Briguglio (University of Malta). Funded by Western Sydney University, Maltese Ministries for Foreign Affairs and for Resources and Rural Affairs, and the University of Malta

Community-based adaptation is an essential element in minimising the adverse consequences of climate change in the world's poorest communities. Communities that are geographically close to each other and share a number of characteristics such as size, levels of poverty, infrastructure and governance can differ on key features that affect their climate vulnerability. Working in partnership with two NGOs (Women and Children Development Organisation, Ethiopia and Kopin, Malta), this project explores the health and economic impacts of a community-based adaptation intervention of a biogas facility in informal urban communities. Preliminary results indicate that the greatest direct benefits have been among women, with reduced illness and more time for income generating activities.

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An examination of family homelessness: A study of families accessing Mission Australia Centre Kingswood

Researchers: Dr Elizabeth Conroy, Dr Chloe Parton, Doctoral candidate: Catherine Hastings. Funded by Mission Australia

The project will be conducted in two phases. Phase 1 is a qualitative study exploring family, homelessness and resilience and will be based on semi-structured interviews with clients and their support workers. Client cases will be purposively sampled to include a range of family types (e.g. grandparent-headed household, young single mother, parent without custody of children) and risk pathways (e.g. child protection, family breakdown, financial stress). A thematic analysis of narratives will be conducted in which meaning-making and experiences of resilience, family and key life events that have led the client participants to their current situation will be examined. Phase 2 will be a quantitative study that further explores risk and resilience factors identified during Phase 1. This second stage will involve a cross-sectional survey of clients.

Families with children account for approximately one third of people accessing homelessness services in Australia. In addition, they have been identified as the fastest growing group of people experiencing homelessness in Australia. At present there is very little evidence on what is effective for families experiencing housing issues. Mission Australia and the Centre for Health Research have partnered to undertake a study on family homelessness. The study aims to develop a better understanding of risk and resilience in the context of family homelessness among clients accessing the Mission Australia Centre Kingswood. The outcome of the study will be an assessment framework to assist staff in identifying and responding to families at risk of homelessness.

Evaluation of two initiatives within St Vincent's Hospital Homeless Health Service: COMET and Tierney House

Researcher: Dr Elizabeth Conroy. Funded by St Vincent's Hospital Darlinghurst

The COMET and Tierney House Evaluation is being led by Dr Elizabeth Conroy at the Centre for Health Research but also involves researchers from the Centre for Social Impact at the University of New South Wales (Dr Rebecca Reeve) and the University of Western Australia (Prof Paul Flatau). The evaluation focuses on two services provided by the Homeless Health Service at St Vincent's Hospital, Sydney.

The first service – Community Outreach Medical Emergency Team (COMET) – provides outreach assessment and treatment for sub-acute health problems to people sleeping rough on the street or attending one of the homeless drop-in centres in the inner-city. The second service – Tierney House – is a 12-bed facility located nearby St Vincent's Hospital. It provides non-acute health care such as post-surgical recovery and convalescence following a hospital stay or stabilisation on medication for diabetes, drug and alcohol or mental health problems.

The evaluation aims to:

1. document the health needs and service outcomes of clients presenting to COMET and Tierney House;

2. measure the extent to which the two services are delivering effective health care to people who are homeless; and

3. comment on the impact of COMET and Tierney House in relation to the NSW homelessness strategy.

The study will use a range of methods including analysis of administrative data held by St Vincent's Hospital such as emergency department presentations, hospitalisations, and pathology results; a survey of homelessness services that partner with COMET to provide the outreach health clinics; and case studies of Tierney House patients to document referral and treatment pathways. A cost effectiveness analysis will also be undertaken to examine the health costs of those utilising the COMET and Tierney House services, the recurrent and capital costs of delivering these two services and the extent to which they are offset by any health savings costs.

Changes in subjective wellbeing and the experience and construction of motherhood amongst young Aboriginal mothers attending an early intervention program: a comparison of perspectives.

Researchers: Jane Ussher, Janette Perz. Funded by a Western Sydney University partnership grant

The aim of this research is to examine the construction and experience of motherhood from the perspective of young Aboriginal women attending an early intervention program for Aboriginal mothers and babies, and health professionals who work in the program. The reproductive health of Aboriginal women is a matter of concern for health providers and policy makers, due to poor outcomes relative to other Australian women, and is related to the mental health and wellbeing of mothers and their children. The outcomes will be a greater understanding of Aboriginal women's reproductive health, which will lead to the development of policy and early interventions, to be offered by the Industry Partners.

An examination of the process and efficacy of an early intervention program for Aboriginal preschool children, from the perspective of key stakeholders: teachers and program developers.

Researchers: Janette Perz, Jane Ussher, Kerry Robinson. Funded by Gunawirra

Gunawirra are a Redfern based not for profit organisation, offering preventative and early intervention specialised health programs for Aboriginal families and their young children. Drawing on a program of research conducted with traumatised preschool children, their teachers, and their parents, Gunawirra have developed an early intervention program The Five Big Ideas. This program is offered to pre-school children, with a focus on schools which have a significant proportion of Aboriginal children, and aims to address trauma in a practical holistic fashion, through prevention and education. This study will examine the process and efficacy of The Five Big Ideas program, using a combination of quantitative and qualitative methods; examine the perspectives of teachers and Gunawirra staff involved in the development and execution of the program; and document the pedagogical practices involved in the provision of the intervention program, through a case study approach.

A microsimulation model for the prediction of health and health care utilization under different policy scenarios.

Researchers: Shima Ghassem Pour, Federico Girosi and researchers from NSW Health and the National Health Performance Authority (NHPA). Funded by Capital Markets CRC ($120,000).

What are the costs of obesity and smoking? What if we could reduce the incidence of diabetes by 30%? What if we could eliminate hypertension? Which types of cancer should we target for prevention? How should the medical workforce look like 30 years from now? Policy makers commonly ask questions of this type, but they lack tools that can provide them with a view of how the future looks like under different policy scenarios. We will remedy this situation by developing a predictive model of the trajectories of the population in both the health and the health care utilization domains. The model will be able to simulate a variety of policy scenarios and predict, over the next 30 years, the health and functional status of the NSW population over age 45 as well as its health care utilization and expenditures. The scenarios include the status quo (that is business as usual, without policy changes), interventions aimed to reduce risk factors and the introduction of new treatment/technologies that can alter the course of disease or prevent it from occurring. For each scenario the model will be able to project outcomes such as prevalence and incidence of several chronic conditions, the disability status of the population, hospital/MBS/PBS costs and demand for services such as primary care, specialist visits and hospital beds.

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.

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.

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 studyOpens in a new window

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

Find out about the Cancer and Fertility Self-Help GuideOpens in a new window

Sex after 55 research study

Researchers: Professor Jane Ussher, Professor Janette Perz, Doctor Chloe Parton and Alexandra Hawkey.

Sexuality is a central aspect of quality of life, intimate relationships, and identity. Whilst there have been a number of research studies examining sexuality in young people and those of reproductive age, there has been little research on the experiences of sexuality and sexual wellbeing in women post the menopause transition and during later life. The aim of the proposed project is to examine the ways in which women experience sexuality in later life. Having greater understanding of women's lived experiences will allow for the development of appropriate health information and sexual service provision.

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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, $288,013, 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.

Find out more about the prostate cancer and gay and bisexual men study Opens in a new window

Find out more about the comparative study of prostate cancer and heterosexual and non-heterosexual menOpens in a new window

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 StudyOpens in a new window

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 StudyOpens in a new window

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.

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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. 

 In November 2014, the MISHA Evaluation won the Excellence in Social Impact Measurement award(Opens in a new window). The award was presented by the Social Impact Measurement Network of Australia (SIMNA) and recognises best practice in outcomes measurement in the social sector.

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