The following researchers were recently awarded Research Fellowships under the PHCRED Strategy. Here are their profiles. In the next issue we will be publishing summaries of the following 2007 PHCRED project grants.
PHCRED PROJECT GRANTS
In brief:
A/Prof Hylton Menz
La Trobe University
A randomised controlled trial of a tailored podiatry intervention to enhance mobility and prevent falls in older people.
Prof Elizabeth Waters
Deakin University
Environmental, socio-behavioural and biological predictors of early childhood caries: a rural birth cohort study.
Prof Lynne Daniels
Flinders University
Positive feeding practices and food preferences in very early childhood - a primary care obesity prevention program.
Dr Karen Campbell
Deakin University
A randomised controlled trial to promote healthy lifestyle behaviours from infancy with the aim of preventing childhood overweight.
Dr Anushka Patel
The University of Sydney
A randomised trial of a "polypill" to improve guidelines adherence for vascular disease prevention in primary health care.
JOHN FURLER
It is a privilege to be supported within the PHCRED strategy to pursue research over an extended period, but the privilege carries a responsibility to ensure the work produces useful outcomes in line with the goals of the strategy 1 . The strategy calls for research that is relevant and usable for end users and that is taken up in policy and practice and I hope that my work will do both.
My interest is in socioeconomic inequalities in health and my work will focus on chronic disease, specifically diabetes and depression, two high prevalence conditions commonly managed in general practice. Inequalities exist in the prevalence of these conditions and there are differences in the care people receive. Disadvantaged people with diabetes are less commonly referred or tested and in the case of depression they are less commonly referred and more likely to receive a medication.
Previous research suggests that interventions designed to improve overall quality of care (evidence based clinical guidelines, patient centred methods) in practice tend to be used in ways that reproduce wider social inequalities. Such unintended inequitable effects are important for patients, practitioners and people designing interventions and general practice programs for chronic disease.
My work is linked to two larger intervention studies, one in diabetes (the PEACH study 2) and another in depression (the re-order study 3) in general practice. I plan to use qualitative methods to evaluate aspects of these interventions, exploring how social and economic contextual factors, the interventions themselves and professional frameworks (such as notions of adhering to evidence based practice and practicing patient centred medicine) all interact, and whether unintended inequities can be seen in the experience of providing or receiving care.
I plan to synthesise the findings from these two studies and use them to explore, with key professional leaders and policy makers, how they could use this information in developing chronic disease programs that are most likely to reduce health inequalities across the socioeconomic spectrum as well as improve the quality of care more generally.
John Furler
University of Melbourne
E: jfurler@bigpond.net.au
- Australian Department of Health and Ageing. Primary Health Care Research, Evaluation and Development Strategy: Phase 2 (2006-9) strategic plan. Canberra: Australian Department of Health and Ageing; 2005.
- http://www.peach.unimelb.edu.au/
- http://www.reorder.unimelb.edu.au/
JON ADAMS
I will use the four-year Fellowship to further develop two research programs I have been conducting with national and international colleagues over recent years:
The investigation of the intersection and integration of complementary and alternative medicines (CAM) alongside primary care practice and provision
The popularity of CAM use (including acupuncture, chiropractic, reflexology, naturopathy, etc) has grown over recent years and the relationship and interface between CAM patients, services and practitioners and those of conventional primary care have become ever more significant in terms of both individual patient care and wider issues of public health.
The focus of this program is to draw upon my previous general practice-CAM research to examine the grass-roots context of integrated care management and also approaches to evidence amongst general practitioners, CAM therapists and patients. The research will complement clinical enquiry and aid the development of policy and practice guidelines in this area.
The examination of occupational violence within general practice
This program examines the core research gaps currently identified (from my previous NHMRC project findings) with reference to addressing the significant problem of occupational violence in Australian general practice.
I propose to use the Fellowship to pursue a national longitudinal study of this topic, the first to:
- provide national coverage on this issue
- undertake longitudinal data collection (prospective, current and retrospective)
- advance a broader research gaze upon the wider practice team (general practitioners, plus receptionists, allied health practitioners, etc).
Jon Adams
University of Queensland
E: j.adams@sph.uq.edu.au
MELINA GATTELLARI
Around 50,000 Australians experience a stroke every year and this number is expected to increase as the population ages. Cardiovascular risk prevention has been nominated as a National Health Priority. General practitioners (GPs) play an important role in managing and reducing stroke risk. Yet research rarely focuses on how to optimise the delivery of primary health care and GPs themselves are rarely engaged in research activities.
The general practice interface is where primary and secondary prevention of stroke is most commonly enacted and where such activity is ideally situated. National medical authorities have identified three key areas of stroke risk management that require urgent attention.
These key areas are: 1) Uptake of appropriate anti-thrombotics for patients with atrial fibrillation (NICS 2003); 2) Community awareness of the need for expeditious admission of patients with stroke symptoms to emergency departments (National Stroke Foundation); and 3) Secondary prevention of stroke in patients with a history of stroke or transient ischaemic attack (National Stroke Foundation, NHMRC). General practice provides an ideal context to appropriately and comprehensively address these three key areas.
I have proposed a program of research to address these three key areas. It is integral that strategies designed to assist GPs caring for Australians at risk of stroke are developed and rigorously evaluated. The proposed Fellowship aims to redress evidence-practice gaps in the management of stroke risk and focus on the National Health Priority of cardiovascular disease.
Melina Gattellari
University of New South Wales
E: Melina.Gattellari@sswahs.nsw.gov.au
EMILY HANSEN
The PHCRED mid-level Fellowships allow recipients to work full time as researchers for four years. This was exactly what I was looking for after five years working in the PHCRED RCBI program where I had become increasingly involved in administrative and research training activities and thus had less and less time available do my own research. As a recipient of a fellowship I will now be able to focus entirely on research and postgraduate supervision.
I plan to consolidate my research interests, engage with researchers from different disciplinary backgrounds and to cement my research links with other sociologists and medical anthropologists. I also intend to spend some time working overseas, write and publish extensively about health and illness and to develop new projects using qualitative approaches (such as ethnography) that require longer amounts of time.
My research program for the fellowship is focused around two key areas - 1) investigating the most appropriate methods for achieving behavioral changes among primary care patients (with a focus on smoking cessation) and 2) investigating how we can achieve the most effective management of chronic illness in primary care. Both of these issues are highly relevant to current primary health care policy and practice.
The end result for me will be a stronger research track record and the further development of my skills and career. There will also be an increase in the amount of quality primary health care research being conducted and a higher profile for primary health care research. My hope is that these outcomes will in turn be of benefit to my students and colleagues and to Australian primary health care in general.
Emily Hansen
University of Tasmania
E: Emily.Hansen@utas.edu.au
PIM KUIPERS
To date my research has largely focused on rehabilitation and disability service delivery with a focus on community level services. I have also recently been doing research in the systematic review and synthesis of non-research (mixed-methods evaluation) data - for research purposes.
The target areas of my research fellowship are: (a) the allied health (and broader community health) PHC service provider workforce in rural and remote areas, and (b) community based rehabilitation (CBR) approaches as a means of enabling PHC providers a way of working more effectively with family members, community members and patient support networks.
Having taken up my mid-career fellowship at the Centre for Remote Health in Alice Springs, I'm acutely aware of the need to involve more people in rural and remote PHC research. I plan to contribute towards building research capacity here by involving local allied health and other practitioners in research where possible. I also plan to build collaborations with other researchers in clinical and policy areas, who may want to add rural and remote dimensions to their work.
Dr Pim Kuipers
Flinders University
E: pim.kuipers@flinders.edu.au
JUDY TAYLOR
After a busy time with lots of project management, research and evaluation consultancies in diverse areas with tight timeframes I regard the opportunity to concentrate on a research theme as a privilege.
My background is in community and health service and program development mostly in regional, rural, and remote areas with a long period in North Queensland. I came away from this experience with lots of questions about how and why some health and social care programs went swimmingly in some communities with lots of participants and good health outcomes and in others the same programs did not take off. Was it all a matter of personalities or were there factors operating at the community level?
This research aims to gain a understanding about whether these factors will lead to more effective primary prevention activities, health promotion, health planning, and service delivery. There are three areas of interest:
- understanding more about the community factors that affect community health development (including mental health) in communities of place, including Indigenous communities
- identifying ways to measure some of these factors, for example, levels of community participation, in order to improve community health development processes
- understanding more about the relationships between community participation in program and service development, uptake of programs, and aspects of community health status.
Judy Taylor
University of South Australia
E: Judy.Taylor@unisa.edu.au
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