Gawaine Powell Davies, Research Centre for Primary Health Care and Equity, UNSW
Primary health care research often has a long gestation, with considerable development required before flagship research can
begin. This became clear as we recently reviewed our research effort in preparation for a three yearly review by the University.
Here are three examples from our current work.
The MESCH (Miller Early Childhood Sustained Nurse Home Visiting) program arose in 2002 from a community development project.
The need to match three child and family nurses to the needs of up to four hundred families led to a review of literature and
existing programs, and development of a new intervention to suit Australian conditions. Competencies had to be developed for
the nurses, training and supervision set up and the system refined before it was ready to support the first Australian RCT of
sustained home visiting. One month after birth, mothers receiving the program knew significantly more about preventing Sudden
Infant Death and reported better health and greater ability to care for themselves and their babies than controls. At 24 months
they had a better home environment and experience of being a mother. Children of mothers who were psychosocially distressed in
pregnancy had improved mental development. These findings have helped change policy and practice at local, state and national
levels
Our research into the practice capacity required for high quality chronic disease care also began in 2002 with extensive
consultation with Divisions and practices, leading to a cross sectional study of 96 practices that showed the importance of
practice organisation and clinical linkages with other providers. This led to two studies of the impact of interventions to
improve teamwork, one within the practice and one with other services. These are now being finalised, and publications are
starting to emerge.
The Health Impact Assessment program is now five years old. Here the emphasis has been on developing the methods, training
and supporting those doing HIAs, and developing international networks, particularly in Thailand and the UK. More than
200 people have been trained and 35 HIAs were undertaken. We are now planning research on the reach and impact of HIA,
in association with a PhD study.
For further details of this and other research at the Centre visit <www.cphce.unsw.edu.au>
or contact Gawaine Powell Davies on
P: 02 9385 1506
E: g.powell-davies@unsw.edu.au
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