2022 research projects
- A place-based model for community led solutions to complex health and social issues
- A place-based pandemic response to the strengths and vulnerabilities of Aboriginal communities in south-eastern NSW
- Amplifying the voices of Aboriginal women through culture and networking in an age of COVID-19
- Chronic Kidney Disease Study
- Disability inclusion and capacity building for emergencies
- Evaluation of the Calvary Household Model of Care Pilot
- Evaluation of the LikeMind pilot (Phase 2)
- Evaluation of the Family and Carer Mental Health Program
- Greater inclusion of people with a disability in Australian workplaces: A social marketing challenge
- Healthy Hearts: development and evaluation of an outreach, family-centred model of cardiac rehabilitation for Aboriginal people NSW
- Increasing the capacity of a regional Local Health District to respond to methamphetamine-related harm: Developing an integrated model of care informed by linked data, and consumer and clinician views
- Investigating gender differences in a suicide prevention aftercare program: How can we improve outcomes for all?
- Medication-related hospital admissions in the last five years of life: observational study from regional Australia
- Modelling the role of non-admitted care and its relationship to hospitalisation to guide system improvement for people living with dementia
- Self-care of older Australians
- Supporting integrated mental health care for new mothers using evidence-based tools: validation of the Postnatal Risk Questionnaire-Revised
Australian Research Council Discovery Indigenous Grant
May 2019 – June 2022
This project involves the Aboriginal-led investigator team working in partnership with ACCOs across south-eastern NSW. Few of the innovative models that operate within ACCOs have been theoretically considered, documented or evaluated. This study addresses this knowledge gap and consequently optimises the long-term and sustainable impacts of ACCOs on Aboriginal health and wellbeing. We apply a decolonising lens to better understand how Aboriginal organisations successfully operate within, and enable, key networks across social and community contexts; and investigate how, why and under what circumstances, community-led programs are effective.
The main aim of the project is to develop an Aboriginal place-based model of service delivery, and to share and transfer learnings to other locations within Australia. Phase one of the project will describe the policy environment; phase two will use regional case studies to understand and contextualise Aboriginal community controlled approaches; phase three will co-design a strategy to support the ACCO model; and phase four will translate the learnings from south-eastern NSW to locations in Western Australia and Queensland.
What we did
During 2019 we conducted three literature reviews. A scoping review of the literature on ACCOs was undertaken to determine the number, nature and scope of existing peer-reviewed literature on ACCOs. In a separate review we identified literature around Aboriginal conceptions of place in relation to health and are conducting a narrative analysis of the results. Additionally we have reviewed how ‘place-based’ is understood and applied by government in their policies, planning and programs of activity.
Ethical approval was obtained from the Aboriginal Health and Medical Research Council of NSW to conduct phases one and two of the project. For phase one we have completed a series of semi-structured interviews with key policy stakeholders from regional, state and Commonwealth government.
Phase two of the project, ethnographic regional case studies, took place from 2020 to 2021. Due to the COVID-19 pandemic, this focused on two sites in the Illawarra region, with virtual data collection occurring across both sites. The broader regional ethnographic study recommenced in 2021 and planning for Phase 2 and 3, which will be the focus of activities in 2022.
NSW Health COVID-19 Research Grants
July 2020 – June 2022
Aboriginal Community Controlled Organisations (ACCOs) in NSW are currently at the frontline of the COVID-19 pandemic response, with their already stretched resources, delivering health and social services to vulnerable Aboriginal communities, including those in south-eastern NSW still traumatised by the catastrophic bushfires of summer 2019-20.
This project addresses a gap in knowledge of how urban and regional ACCOs are responding to the complex health and social challenges confronting local Aboriginal communities in the context of the COVID-19 pandemic. The project aims to document their rapid and agile response to the pandemic in continuing service provision, and explore challenges including effective communication with Aboriginal communities. This project builds on an existing ARC Indigenous Discovery project and, using a Community Based Participatory Research approach and existing networks and partnerships, aims to address the key research question – what should a place-based COVID-19 response for NSW Aboriginal communities look like?
The co-developed Aboriginal-led qualitative study leverages existing Indigenous chronic disease related research in south-eastern NSW to develop strategies, and produce evidence, to support a de-centralised place-based response to COVID-19; one that is culturally safe and responsive to local Aboriginal community needs, which will produce outcomes that are transferable to other settings.
What we did
Phase 1 of the study began in July 2020 and continued throughout 2021. In 2021, an application to amend the existing ethics protocol was approved by the Aboriginal Health and Medical Research Council, and an expanded steering committee was established for governance oversight of the project. Three component parts were conducted and finalised: a rapid review of literature; stakeholder consultation; and a review of communications and social media. This phase focused on contextualising Aboriginal responses to COVID-19 and was oriented to collecting and analysing information about the pandemic from social media communications and available literature. It also focused on consulting with ACCOs and their government stakeholders about the impacts of COVID-19 prevention measures on their services and the challenges they face in continued service provision. Consultation with regional stakeholders has continued throughout the year and an additional survey instrument to capture the impact of COVID-19 on staff wellbeing was developed and implemented. The results of Phase 1 were presented to key stakeholders in November 2021.
Preparation for Phase 2 of the study began in 2021. This phase aims to co-design a framework for the preparedness, delivery and recovery in relation to crisis. It draws on results from Phase 1 and will involve discussions with key regional stakeholders to identify barriers and enablers to renegotiating relationships with funding bodies.
UOW Community Engagement Grants Scheme
October 2021 – October 2022
In collaboration with the Illawarra Aboriginal Corporation (IAC), Ngarruwan Ngadju applied to the UOW Community Engagement Grant Scheme for a small grant to develop and evaluate a project that addressed the isolation of Aboriginal women occurring as a result of the COVID-19 pandemic. The project aimed to strengthen and support local Aboriginal women living in the Illawarra region during difficult times, to restore networks, and nurture the exchange of Aboriginal knowledge and traditional practices. The project was structured around a 10-week program of cultural activities including: traditional weaving with an Aboriginal elder, bush tucker and exploring Country, excursions to the Australian Institute of Aboriginal and Torres Strait Islander Studies, and short films. At the end of the project participants were expected to have: increased knowledge in their culture which equates to an increase in confidence; improved networking skills through meeting other Aboriginal women in the group; and access to respected Aboriginal Elders and Aboriginal facilitators and organisations.
What we did
Ngarruwan Ngadju collaborated with the IAC on the implementation and evaluation of the project. Drawing on a strengths-based approach we worked alongside the IAC to support them to demonstrate the outcomes of their work. Ngarruwan Ngadju researchers refined an evaluation plan and developed indicators and culturally appropriate data collection methods to measure its success both qualitatively and quantitatively.
This project supported the IAC to provide a cultural knowledge and skills program for 22 Aboriginal women from the local area. The program was developed and delivered flexibly over a six-month period. Ten of the planned 11 workshops were organised and delivered. A survey of participants found evidence of high levels of engagement and improved skills attainment. In qualitative group yarns and individual yarning interviews the women expressed a high level of satisfaction and an interest in participating in ongoing cultural programs. A community report was produced and disseminated during 2022 to program participants, the local Aboriginal community and through the Ngarruwan Ngadju website.
UOW Health Impacts Research Cluster – Small Research Grants Scheme
September 2021 – September 2022
In 2015, the Illawarra Shoalhaven Local Health District was identified as having the highest proportion of Chronic Kidney Disease (CKD) in its population effectively making it the number one kidney disease hot spot in Australia (Kidney Health Australia, 2015). This was based on biomedical results from the Australian Health Survey 2011-13, which found a CKD stage 1-5 prevalence of 19.5% among Illawarra Shoalhaven residents, as compared to an average of 10.0% for Australian residents.
The reasons for the apparently high prevalence of CKD among Illawarra Shoalhaven residents identified in the Kidney Health Australia report are unknown. One explanation relates to the relatively small numbers of study participants from the Illawarra Shoalhaven – the Kidney Australia report advised caution in use of the Illawarra Shoalhaven estimate, given that the relative standard error of the estimate was 25-50%. However these findings are concerning and warrant further investigation either to confirm or dispel. We therefore set up this study to investigate this issue.
What we did
A retrospective longitudinal analysis will be conducted on the available HIRC CKD data, which will be obtained from the Illawarra Health Information Platform. The HIRC CKD data will include a longitudinal cohort database of all adult patients who attended the Illawarra Shoalhaven Local Health District between 1 January 2007 and 31 December 2017. ICD-10 codes and laboratory pathology will be used to determine a CKD diagnosis. This dataset will then be used to confirm the prevalence of CKD among Illawarra and Shoalhaven residents during the study period and will also be used for a number of medical student projects.
UOW Global Challenges Seed Funding
December 2020 – April 2022
People with disabilities are considered especially vulnerable to natural disasters and health emergencies, due to poor health, limited information, and dependence on formal support in home or institutional settings. Interdisciplinary approaches are needed to understand the lived experience of disability and to utilise these insights to inform social change.
This project is working with leading disability service providers in the Illawarra-Shoalhaven to understand how their experiences during the global COVID-19 pandemic and the local 2019/2020 bushfire emergencies can be placed at the heart of community preparedness and recovery, and improve disaster responses.
What we did
Co-researchers with disabilities are working as an integral part of an interdisciplinary team using qualitative methods to understand the experiences and perspectives of disability service providers to answer the following research questions:
- How have disability service providers supported people with disabilities during emergencies, and how effective was that support and what happens when it is not available?
- How can insights, experiences and expertise of people with disabilities inform recovery and planning for future local and global natural disasters and health emergencies?
- What is the experience of emerging co-researchers with disabilities of the research process?
Throughout the year, a structured program of development was implemented to advance the qualitative research skills of the two co-researchers. A series of semi-structured interviews (and one focus group) with senior staff from from major local disability service providers were conducted by the co-researchers and other project team members and analysis is in progress. Each co-researcher is also developing a digital story to reflect their experience as an emerging researcher and issues associated with the COVID-19 pandemic. In addition to academic publications, the major outputs of the project will be a media resource about the experiences of co-researchers with disabilities and a framework to support understanding of people with disabilities during emergencies in the future for use by government agencies and disability services.
Calvary Health Care
December 2020 – September 2022
Calvary Health Care is conducting a pilot of a new model of care (MoC) to be implemented for residential aged care. The aim of the pilot is to develop and implement a person-centred MoC that reflects current best practice for aged care and aligns with the recommendations from the Royal Commission into Aged Care Quality and Safety, released in March 2021. The multi-faceted MoC is being implemented using a phased approach, with a focus on particular ‘building blocks’ in each stage.
CHSD was engaged by Calvary Health Care to undertake an evaluation of the pilot which is being conducted at two aged care homes in the Hunter region of NSW. Findings from this evaluation will inform the ongoing development and future expansion of the MoC across all of Calvary’s residential aged care homes.
What we did
The study has been designed to capture data on processes, outputs and outcomes, as well as the involvement of residents, families and service providers at the different stages of the pilot. The evaluation framework considers the changes and outcomes at three levels: the consumers (resident and family experience), providers (aged care staff, related health staff), and the system (Calvary structures and processes, networks, relationships), as well as issues around capability building and generalisability across the organisation.
A mixed methods approach was developed, incorporating formative elements to inform the ongoing development and improvement of the program, and summative elements to assess the extent to which the pilot meets its objectives. Data collection activities include resident and staff surveys, interviews with families and senior Calvary staff, and observation of MoC related activities, including resident and staff meetings. Data will also be utilised from routinely collected datasets, such as National Quality Indicators and other resident outcome information, as well as human resources and financial data.
During 2021, planning and implementation of the MoC was significantly disrupted due to factors including the COVID-19 pandemic, resulting in significant delays to the pilot. Consequently, the timeframe of the evaluation was extended until September 2022.
The evaluation team has maintained regular communication with Calvary throughout this period, and some work was progressed on the collection of baseline data, including the preparation of two survey tools: a resident experience survey and a staff job satisfaction survey. A number of resident surveys were completed and planning is in place for the completion of both surveys prior to the commencement of the MoC implementation in early 2022.
NSW Ministry of Health
June 2020 – February 2022
CHSD was commissioned by the then Mental Health, Drug and Alcohol Branch of the NSW Ministry of Health in 2015 to conduct an independent evaluation of the LikeMind pilot. The LikeMind initiative’s service model can be characterised as a NGO-led and managed service-hub approach to the integrated provision of care and support, which is readily accessible in a community setting, for adults aged between 25 and 65 years old who experience moderate to severe mental illness.
The Phase 1 evaluation, conducted over three years and completed in February 2019, found it had largely achieved its primary objectives and identified key challenges and opportunities for the initiative moving forward. At that time, LikeMind services had funding arrangements in place until 30 June 2019. The Ministry subsequently approved additional funding to these four services for the period 1 July 2019 to 30 June 2022. In line with the decision to extend the delivery of LikeMind services, the Ministry also engaged CHSD to extend the LikeMind evaluation.
What we did
The methodology built on the previous evaluation and incorporated the same evaluation framework and a broadly similar approach to stakeholder engagement, data collection and data analysis activities. An interim report was delivered early in 2021 which outlined the major developments that occurred within the LikeMind pilot since the completion of the Phase 1 evaluation. Throughout 2021 lead agencies continued to collect the LikeMind Minimum Dataset and members of the evaluation team carried out interviews with key stakeholders and developed a satisfaction survey for LikeMind consumers. A final report was submitted in early 2022.
NSW Ministry of Health
July 2020 – January 2022
The Family and Carer Mental Health Program is a state-wide program funded by the NSW Ministry of Health. It aims to improve the wellbeing of those who care for and support people with mental health issues, as well as promote and facilitate family inclusive mental health services. The importance of involving families and carers in order to achieve strong outcomes for mental health consumers is well supported in the research. This program acknowledges that crucial role through the provision of services that identify and address the complex needs of carers.
The program is delivered through a partnership between specialist community managed organisations and the Local Health Districts and Justice Health and Forensic Mental Health Network. A range of services are provided, such as education and training, individual support and advocacy, group activities, and support and education initiatives for mental health services.
CHSD was engaged by the NSW Ministry of Health in mid-2020 to evaluate the program. This is the first formal evaluation that has been undertaken on the program since it was established in 2005.
What we did
The evaluation comprised both process and outcome evaluation components. The aim was to better understand the achievements of the program, assess the extent to which the model of care is effective, efficient and appropriate, and identify opportunities to enhance the program’s outcomes. The development of a program logic model was also a key project outcome.
In the context of undertaking an initial evaluation of a long-running program, an exploratory mixed methods research design was used, conducted over two phases. Phase One commenced in 2020, and included a range of data collection activities along with the development of a draft program logic and the documenting of background and context of the program. The quantitative data comprised administrative datasets reported by the community managed organisations, for the period July 2018 to September 2020 as well as historical data from 2008 to 2018. Qualitative data was collected through 15 semi-structured interviews with a range of key informants. An interim report incorporating the findings of Phase One was provided to the NSW Ministry of Health in February 2021. This report was subsequently published on the Ministry’s website.
The second phase of the evaluation built on the findings of Phase One. Major data sources included: a carer experience survey which was completed by around 200 carers currently registered with the program; semi-structured follow-up interviews with a sample of 15 carer survey respondents; and a further 15 interviews with key informants. The administrative data was also further analysed, with the addition of a dataset reported by the Local Health Districts and Justice Health and Forensic Mental Health Network for an 18 month period to December 2020.
The findings from a synthesis of all evaluation data sources, along with a set of recommendations to further develop and refine the program, were provided to NSW Ministry of Health in a final report in October 2021. The final version of the report and a summary report were submitted to the Ministry in early 2022.
Project team: Rob Gordon, Pam Grootemaat, Carol Loggie, Mijanur Rahman, Peri O’Shea
Australian Research Council Linkage Projects Scheme
Duration: 2018 - 2022
Workforce participation of people with a disability remains low. This project aims to develop a model of successful employment for people with a disability, identify sources of employer diversity that explain willingness to hire, and develop social marketing messages that improve employer attitudes and achieve greater inclusion in Australian workplaces.
What we did
This project consists of two sub-studies:
- Developing a theoretical model of successful employment for people with a disability: This study will conduct interviews with people with a disability and their employers to identify the factors that contribute to sustained employment of people with a disability, with a view to developing a theoretical model of success. It will then test the validity of this theoretical model through a quantitative survey of people with a disability.
- Using social marketing to improve employer attitudes toward hiring people with a disability: This study will identify differences in employer attitudes toward hiring people with a disability. It will involve interviewing and conducting a quantitative survey with employers. Segmentation analysis will be performed on the quantitative data to identify groups of employers that have common attitudes toward hiring people with a disability. Advertising messages will be developed (with undergraduate UOW students) and tested through an online survey with employers to assess the advertisements’ effectiveness in improving employer attitudes toward hiring people with a disability.
The outcome of this study will be more people with a disability and their carers gaining meaningful employment, with benefits including improved physical and mental health, social connections and economic security. It will benefit employers by creating more diverse workplaces and a broader talent pool, resulting in greater innovation and productivity.
PhD candidates Mr Paul Ikutegbe and Ms Rola Mahasneh commenced work on the project in 2019 and 2020 respectively. Both Paul and Rola continued to make excellent progress throughout 2021.
Project team: A/Prof Melanie Randle, A/Prof Rob Gordon, Prof Kathy Eagar, Prof Sara Dolnicar, Mr Simon Watts.
NSW Ministry of Health Translational Research Grant Scheme
May 2019 – June 2022
Aboriginal Australians are twice as likely to have a heart attack as other Australians and more than 10 times as likely to die from coronary heart disease. Cardiovascular disease also strikes Indigenous Australians much earlier, with more than 20% of 35 to 44 year olds already afflicted. There is a particularly high incidence around the Shoalhaven region of NSW.
This feasibility study developed and evaluated a family-centred outreach model for cardiac rehabilitation in the Aboriginal community. The study aimed to increase participation in evidence-based cardiac rehabilitation and culturally inclusive care, and identify and manage family members at risk of a cardiovascular event. Aboriginal Health Workers from the Aboriginal Chronic Disease Program at ISLHD delivered the program to consenting participants who had suffered a cardiac event, together with members of their family, in a community setting.
What we did
Working in partnership with ISLHD, Ngarruwan Ngadju provided research leadership and project support, including undertaking qualitative data collection, analysis and report writing. Assistance was also provided in the preparation of intervention materials and the administration of questionnaires.
Several activities were successfully completed in the early stages of the project, including establishment of governance committees, staff training and production of a project manual, cardiac client recruitment and baseline data collection. Qualitative data collected to date indicate strong support for the model, which was considered culturally appropriate; positive feedback was obtained around opportunities for improved skills (e.g. education and exercise, relationship building, engagement). Areas for improvement were also identified.
The study was suspended in 2020 due to natural disasters and the COVID-19 pandemic, and continued to be disrupted throughout 2021. The study recommenceed (and was completed) in 2022.
National Centre for Clinical Research on Emerging Drugs
June 2021 – December 2022
Regular and dependent methamphetamine use has increased three-fold in Australia since 2009; there are now an estimated 268,000 regular users of whom 160,000 are dependent users. Increases in the availability of the more potent crystalline forms of methamphetamine have been associated with increases in methamphetamine-related harm. Nationally, methamphetamine dependence is estimated to cost Australia around $5 billion per year.
The need for research into long-term utilisation patterns among frequent attenders has been identified, in particular understanding predictors of ongoing use to distinguish meaningful subgroups for intervention. Using data linkage to develop a retrospective cohort, this study undertook a systematic assessment of health service use and outcomes of residents presenting at acute care settings with methamphetamine-related problems in a region of Australia outside of a major city (covering rural, regional and metropolitan areas).
What we did
We used data from the Illawarra Health Information Platform and an innovative triage text-search algorithm provided by the NSW Ministry of Health to identify a cohort of 845 people who presented to emergency departments with methamphetamine use. We identified sub-groups of patients with short-term and ongoing presentations, and examined referrals and contact with Alcohol and Other Drug services. We modelled likelihood of receiving follow-up outpatient drug or alcohol treatment.
Among those who had contact with Alcohol and Other Drug services (n=331), 39.3% attended the Stimulant Treatment Program, 30.5% attended counselling, 29.0% withdrawal management services, and 15.7% the Opioid Treatment Program. High levels of Mental Health and Alcohol and Other Drug service use indicate potential for improved patient and health systems outcomes regarding comorbidity. Understanding points of contact is the first step in developing person-centred, complexity capable and integrated care in the region.
Suicide Prevention Australia – Innovation Research Grant
July 2020– June 2022
Robust research on the effectiveness of suicide prevention aftercare programs in Australia is lacking. Gender differences are noted in most aspects of suicidality (e.g. rates of suicide attempts, deaths), including intervention outcomes, however there is little available in the literature to inform the design of gender-specific interventions that might maximise the outcomes of programs for all.
The Next Steps program is a four-week community-based follow-up service offered after a suicide-related visit to an ED, with an option for extension to 12 weeks. It is co-led by clinicians and peer-workers. Participants attend an initial one-hour appointment with a mental health clinician and peer-worker, then receive follow-up by the peer-worker.
This study investigates the experiences of males and females in the suicide prevention aftercare program, evaluating their outcomes after one year, and exploring potential contributing factors. The mixed methods study includes analysis of outcome data using six linked datasets, and qualitative interviews. The findings of this research will provide evidence-based guidelines for suicide prevention aftercare programs.
What we did
The study is led by A/Professor Vida Bliokas (School of Psychology), Dr Luise Lago (CHRISP), Dr Alex Hain (Illawarra Shoalhaven Suicide Prevention Collaborative/National Mental Health Commission), Prof Brin Grenyer (School of Psychology), Dr Rebecca Sng (Grand Pacific Health) and Tim Heffernan (Coordinare). A controlled non-randomised two group (intervention [n=167] vs treatment-as-usual control [n=2,839]) design has been used for the primary outcome (likelihood of self-harm/suicide related re-presentation to an ED). The recruitment of participants has been completed and the 12-month follow-up period for re-presentations is approaching. Selection and validation of study controls is underway. A subset of participants attending the intervention have been selected for individual qualitative interviews.
A systematic review is being prepared investigating outcomes following suicide prevention aftercare interventions, and specifically, exploring gender differences in intervention outcomes.
Rural Health Multidisciplinary Training (RHMT) Program
September 2021 – September 2022
It is well recognised that rural Australians have higher rates of chronic health conditions, potentially avoidable hospitalisation rates and mortality than their metropolitan peers. This study aims to ascertain whether medication misadventure contributes to the morbidity burden in rural Australians. Multiple chronic medical conditions (multi-morbidity) are a risk factor for polypharmacy and, in turn, medication related harm.
Given the higher rates of chronic conditions in rural Australians, we hypothesise that they will be at increased risk of medication misadventure related hospitalisations compared with metropolitan Australians. The data from this study will be used to help ascertain the need for, and design of, interventions specifically tailored towards reducing medication-related harm, including at risk groups e.g. those with dementia or cardiac failure.
What we did
The project employs a retrospective cohort study design. The CHRISP palliative care dataset is being used for analysis. Key analyses include rates of hospital admissions for medication misadventure in the last five years of life for Illawarra Shoalhaven residents deceased between approximately 2017 until 2019 and aged 65 years or older at the time of death. Study variables include age, sex, rurality, socioeconomic disadvantage, comorbidities and residential aged care facility status.
Dementia Collaborative Research Centre
July 2021 – December 2022
People with dementia often experience prolonged illness and disability after diagnosis. This includes higher risk of physical comorbidities, cognitive decline and neuropsychiatric symptoms. Physical conditions or symptoms such as epilepsy, falls, delirium, oral disease, malnutrition, frailty, incontinence, sleeps disorders and visual impairment are more frequent in people with dementia, however care is often focused on managing cognitive and behavioural symptoms.
People with dementia may experience increased hospital admissions, longer stays and poorer prognosis due to neglect of comorbidities that may have been avoidable. Hospitalisation of people with dementia is associated with increased morbidity and mortality as well as high healthcare costs. Avoiding unnecessary hospital stays is therefore a key goal for both people with dementia and the health system. There is currently a lack of evidence on the role of non-admitted health services in meeting the needs of people with dementia, and the impact on hospitalisations. This evidence is crucial to inform planning for the health system to support people living with dementia to live well.
What we did
The project commenced in July 2021, led by Dr Luise Lago (CHRISP), A/Prof Lyn Phillipson (School of Health and Society), Prof Lee-Fay Low (University of Sydney) and Clinical Professor Jan Potter (ISLHD). Suzanne Artiss, Stephen Moules and Dr Conrad Kobel have all joined the research team. We have recruited a broad range of expertise for our regional advisory group, including people with dementia, carers, people working in aged care and people from government agencies and universities. We have received ethics approval and data linkage is underway. The study will use admitted patients, emergency departments, non-admitted patients, community mental health, costs and mortality data to model the impact of use of non-admitted care on hospitalisation.
UOW Global Challenges Seed Funding
December 2020 – April 2022
Halcomb E, Thompson C, Morris D, James S, Dilworth T, Haynes K and Batterham M (2022) Impacts of the 2019/20 bushfires and COVID-19 pandemic on the physical and mental health of older Australians: a cross-sectional survey, Family Practice, cmac138, https://doi.org/10.1093/fampra/cmac138.
Chronic health conditions, loneliness and social isolation are predictors of functional decline and premature death in older persons. In addition, little is known about how older persons maintain self-care and connection with primary care during periods of natural disaster and pandemic. This mixed-method scoping study investigated the experience of older people residing in bushfire affected areas of South-East NSW. It explored their challenges in self-managing their health during a disaster (2019/2020 bushfire season) and throughout the COVID-19 pandemic.
Initially it was planned to include General Practice Nurses (GPNs) working in general practices in bushfire affected zones, however, the impact of the COVID-19 pandemic has been significant for primary care so this was not possible.
What we did
This study has brought together an interdisciplinary team of health professionals and researchers from across UOW to answer the following research questions:
- What are the experiences of older people in self-managing their health during a disaster and the COVID-19 pandemic?
- What factors impact the isolation and self-care of older persons who may be living with chronic health conditions, during a disaster and the COVID-19 pandemic?
- How did older people apply adaptive experiences relating to their health and self-care from the bushfires to the COVID-19 pandemic?
During the year, a series of semi-structured interviews were conducted with 19 people aged 65 years and over living in south-eastern NSW to learn about older people’s experiences of self-care during times of disaster and explore the factors that helped or hindered their ability to live with chronic health conditions throughout these difficult times. A survey of this population was also developed and administered in late 2021. Analysis is underway and a final report will be prepared in 2022. Findings from this study will inform policy about disaster preparation and ways to best support the self-care of older people during a disaster.
UOW RevITAlise Research Grant
July 2021 – June 2022
Australian clinical practice guidelines for pregnancy care (Department of Health 2018) and perinatal mental health (COPE 2017) recommend that all women be offered depression screening and psychosocial assessment as a routine component of maternity care. There are validated tools to support this universal prevention and early intervention approach during pregnancy. However to date, no postnatal tool, developed specifically for the Australian health care context, has met the rigorous evidence-based criteria required to be recommended in best practice clinical guidelines or new Medicare Benefits Schedule (MBS) requirements for obstetric care.
What we did
The aim of this project is to evaluate the Postnatal Risk Questionnaire-Revised. It will capitalise on data collected from nearly 800 postnatal women as part of the PIPA Project (Reilly et al 2017) – a large-scale comparative effectiveness trial led by our research team and undertaken at the Royal Hospital for Women, Sydney. If, as expected, this validation of the PNRQ-R shows it has strong psychometric properties, it will allow health care professionals without specialist mental health training to routinely use a single tool to identify new mothers at increased risk of poor mental health outcomes, or needing further mental health assessment, so that timely and appropriate referral and management and options can be offered.
This project is being conducted in partnership with Professor Marie-Paule Austin (UNSW, Royal Women’s Hospital Melbourne) and NSW Health South Eastern Sydney Local Health District, and is supported through a UOW RevITAlise Research Grant Scheme, as part of the Federal Government’s 2021 Research Support Program.