CENTRE FOR PRIMARY HEALTH CARE AND EQUITY
 UNIVERSITY OF NEW SOUTH WALES
Mark Harris
Executive Director and Professor of General Practice
P: 02 9385 8384
E: m.f.harris@unsw.edu.au
Mark Harris was awarded a Senior Professorial Research Fellowship by the Department of Health and Ageing 2007-2010 which allowed him to focus his research in the prevention and management of chronic illness, with a particular focus on diabetes and cardiovascular disease and to health equity.
Two large multisite trials of ‘within’ practice teamwork and ‘between’ general practice and allied health providers in the management of patients with chronic disease have been recently completed. These demonstrated the importance of multi-disciplinary teamwork and its impact on quality of care for patients with chronic disease, the influence of practice size, team roles and organisational readiness to change, and the difficulty creating effective teams across organisational boundaries.
Mark has completed a before and after trial of behavioural risk factor management in the 45 year old health check and currently leads two large cluster randomised controlled trials of cardiovascular absolute risk assessment and vascular disease prevention in general practice. The latter two studies are due for completion later in 2010 and will be the first of their kind in Australia. They have already provided key insights into the implementation of preventive care in general practice including, the limitations of opportunistic prevention, the challenges in linking general practice with providers and group programs outside the practice. This work and editing of the last three editions of the Royal Australian College of General Practitioners Guidelines for Preventive Care in General Practice has led to a four year National Health and Medical Research Council Partnership project on the Implementation of Guidelines for the Prevention of Chronic Disease in General Practice which commenced in 2010.
This, and other work, has resulted in 67 journal publications and contributions to three books since 2007 and has contributed to national health reform policy and the implementation of preventive guidelines.
PHCRED Tri-State Program
 Flinders University
Elena DiBez
Tri-State Coordinator
P: 08 7221 8535
E: elena.dibez@flinders.edu.au
Southern setting for the Tri-State Conference 16-17 September in Warrnambool, Victoria
The Greater Green Triangle will host this year’s Tri-State Conference. Primary health care researchers from SA, NT and the Greater Green Triangle region will meet in Warrnambool to present their current research projects. Key speakers are Dr Mark Morgan (GP) and Dr Ruth Sladek from Flinders University.
A pre-conference workshop on grant writing will be held on 15 September at the Conference venue – the Lady Bay Resort, Warrnambool. To register for the workshop contact Liz Jackway at the Greater Green Triangle University Department of Rural Health: liz.jackway@greaterhealth.org
It is not too late to register to attend. The registration deadline is 27 August. For more information please contact raelene.burnley@flinders.edu.au or go to the Tri-State website www.phcredtristate.org.au
Professor Leonie Segal guest speaker at Tri-State Policy Forum
National Preventative Health Task Force member, Professor Leonie Segal was a key speaker at the Tri-State Policy Forum in May 2010. In her address she spoke about the ‘myths surrounding prevention’ and identified research gaps related to primary health care research. In determining whether investment in primary and community care reduces costs Professor Segal reported that evidence related to investment in primary care and chronic disease management is mixed.
A full copy of her presentation is available at www.phcredtristate.org.au/presentations/PreventativeHealthPriorities.pdf
The Forum also included a panel session with Sinéad O'Brien, Deputy Executive Director, Statewide Service Strategy, SA Health, Professor Nigel Stocks, Head of the Discipline of General Practice at the University of Adelaide, Professor Richard Reed, Head of the Discipline of General Practice at Flinders University, Professor Leonie Segal and John Binda Reid, Centre for Remote Health. Panel members discussed current trends in primary health care research.
Policy forums are a valuable opportunity for policy makers, health professionals and researchers to meet and discuss issues and the Tri-State program will continue to focus on establishing links between research and practice.
BROKEN HILL UNIVERSITY DEPARTMENT OF RURAL HEALTH
UNIVERSITY OF SYDNEY
Frances Boreland
Research Fellow
P: 08 8080 1279
E: fboreland@gwahs.health.nsw.gov.au
Broken Hill University Department of Rural Health is pleased to welcome three new Researcher Development Fellows, all of whom are employed by NSW Health in the Greater Western Area Health Service.
Diena Grant-Thomson is a Speech Pathologist and Manager of Allied Health Services at the Broken Hill Hospital. She will work closely with Associate Professor David Perkins to evaluate an innovative student-led service which aims to help meet otherwise unmet local needs for allied health services, while providing final year students with valuable practical experience.
Linda Wilson is a Carer Support Liaison Officer and aims to explore the support needs of older male carers in the local area, with a view to adapting current services to better meet their needs. Her project will be supervised by Ms Frances Boreland.
Kathy Seward is Manager TB/Surveillance Officer and aims to review existing surveillance of mosquito borne diseases in western NSW and assess its adequacy during major flood conditions that are currently being experienced in that area. She will be supervised by Professor David Lyle.
DEPARTMENT OF GENERAL PRACTICE
 MONASH UNIVERSITY
Anna Chapman
VicPHCRED Statewide Coordinator
P: 03 8575 2246
E: anna.chapman@med.monash.edu.au
In May 2010, The University of Melbourne School of Rural Health (SRH) in Shepparton welcomed Victorian PHCRED fellows to attend workshops on qualitative and quantitative research theories and techniques.
PHCRED Fellows from Monash University Department of General Practice (DGP), The University of Melbourne DGP and The University of Melbourne SRH were involved in the day long excursion. This excursion enabled Victorian PHCRED fellows to come together as a group and it proved to be a great networking and research capacity building experience for everyone involved. It also gave the fellows from metropolitan Melbourne an opportunity to visit a regional university campus and meet its staff.
The excursion featured Associate Professor Julie Pallant, Director of Research and Graduate Studies at The University of Melbourne SRH, who gave the fellows a comprehensive introduction to quantitative research methods and theories. In addition to this, Dr Victoria Palmer, an applied ethicist from The University of Melbourne DGP conducted an interactive session on qualitative research. The experience was beneficial for all fellows, who will continue to build positive relationships from this and also support each other and their research.
The next Victorian PHCRED excursion will be hosted by the Monash University Department of Rural & Indigenous Health in Moe and will cover the issues and implications for rural and indigenous health research.
DEPARTMENT OF GENERAL PRACTICE
 MONASH UNIVERSITY
Associate Professor Danielle Mazza
Acting Head of Department
P: 03 8575 2290
E: Danielle.mazza@monash.edu
Increasing emphasis is being given to the need for implementation research and knowledge translation in primary health care with recognition that the development and implementation of quality improvement interventions require a rigorous methodological approach.
 Associate Professor Danielle Mazza is leading a program of work being undertaken in the Deptartment of General Practice at Monash University involving PHCRED Fellows. These projects focus on implementing evidence-based preventive care in general practice, current projects include:
- PREPARE: Patients perceptions of prevention in primary care, a qualitative study of patient’s understanding of and approach to prevention focusing on age, gender and socioeconomic status
- IMPROVE: A project aimed at improving HPV vaccination in the general practice setting
- implementing guidelines to routinely prevent chronic disease in general practice - an NHMRC partnerships grant involving several universities of which Monash is one
- implementing the Health Kids Check – this project is being undertaken by Dr Karyn Alexander a former PHCRED Fellow
- improving the implementation of preconception care.
This work builds upon Danielle’s previous experience related to guideline implementation, prevention and women’s health which includes involvement in the development of several evidence-based guidelines for common paediatric conditions, and the revision of the most recent edition of the Royal Australian College of General Practitioners’ Redbook of preventive care guidelines.
In 2007, Danielle was awarded a National Institute of Clinical Studies - Health Contribution Fund Foundation Fellowship. These awards are acknowledged for training a cohort of professionals within Australia who can provide leadership in health and medical research translation and implementation. While the focus of the fellowship was on the implementation of preconception care guidelines in general practice, the lessons learnt were relevant to the implementation of preventive care guidelines more broadly and relate to the need for a multilevel and theory-based approach to guideline implementation.
DISCIPLINE OF GENERAL PRACTICE
 UNIVERSITY OF SYDNEY
Dr Raechelle Rubinstein
PHCRED Coordinator
P: 02 9556 7200
E: raechelle.rubinstein@sydney.edu.au
This report presents two of our key research capacity building activities this year: our RDP Fellowships and the Youth Health Research Interest Group (YHRIG).
We are pleased to report that we have awarded three 2010 RDP Fellowships. Ms Alex McLaren, who is Area Services Coordinator, General Practice Support at WentWest (a Division of General Practice), is undertaking an evaluation project entitled Evaluation of the Practice Health Atlas. The Atlas is a decision support tool which queries clinical software data. The project will evaluate the practical application of the Atlas and its ability to influence data quality management, team based care, proactive practice population health care management and aggregated health outcomes in a general practice setting.
Dr Sylvia King (Guenther) is a General Practitioner who has taken a break from clinical practice to undertake postgraduate studies in medical education. Her research project concerns ‘GP tutors and effective clinical placements’. Its primary aim is to investigate issues that urban GPs identify as influencing the provision of an effective learning environment when teaching medical students during their clinical placements.
Ms Jasmine Sarinis Tobacco Control Project Officer at the Aboriginal Health & Medical Research Council of NSW. Her research topic is The use of pharmacotherapies in smoking cessation programs for Aboriginal people: the perspectives of staff working in Aboriginal Controlled Community Health Services. The project aims to understand how the perspectives of staff impact on the provision of smoking cessation support to clients.
YHRIG presented a Breakfast Session at the Primary Health Care Research Conference in Darwin on the topic Improving healthcare for young people through primary healthcare research and health reform. More than 60 people attended, and two young people from Darwin delivered a unique perspective on the challenges they have faced when accessing health care services.
DISCIPLINE OF GENERAL PRACTICE
 UNIVERSITY OF NEWCASTLE
Susan Goode
Research Manager
P: 02 4968 6737
E: susan.goode@newcastle.edu.au
A focus of the PHCRED program at Newcastle has been supporting practice-based research via our Network of Research General Practices (NRGP). Since its inception in 2006, the NRGP has expanded its membership to include 17 general practice surgeries incorporating over 100 GPs. There have been nine projects conducted through the NRGP, with many of the project ideas arising from our annual NRGP Forum.
The first project run through our NRGP during 2007-08 was a study of occupational violence in general practice. Results were published in the British Journal of General Practice in 2009 and presented at several 2009 conferences including the GP&PHC Research Conference and the Society for Academic Primary Care (UK) conference.
Other projects have involved work by Dr Simon Holliday, one of our member GPs, who led a cross-sectional study of patients’ experiences of general practice waiting rooms. Analysis of the responses of 1138 patients from 15 practices is proceeding.
Another member GP, Dr Ben Ewald, conducted a pilot study of a randomised controlled trial involving an exercise intervention in several NRGP member practices in 2008. This project subsequently received National Health and Medical Research Council Project Grant funding in 2010 and is being conducted through a number of general practices in the Hunter region of NSW.
During 2009, our GP Academic, Dr Parker Magin, established a collaboration around a community stroke study between researchers in Newcastle, Australia and Oxford, UK. Parker, Associate Professor Chris Levi and Associate Professor Mark Parsons (Newcastle stroke physicians) and Dr Dan Lasserson (University of Oxford) were awarded a research grant from the John Hunter Hospital Charitable Trust to pilot the methodology for the general practice element of a larger community stroke study. The pilot project, to run in 2010, will be conducted in three member practices from the NRGP. We anticipate outputs from this pilot by the end of the year.
UNIVERSITY DEPARTMENT OF RURAL HEALTH, NORTHERN NSW
UNIVERSITY OF NEWCASTLE
Judy Coates
Senior Physiotherapist
P: 02 6767 8278
E: judy.coates@hnehealth.nsw.gov.au
 Falls among elderly Aboriginal people: a qualitative study exploring risks, experiences & outcomes
Judy Coates, a 2010 Researcher Development Program Fellow, is investigating the perceptions of falls risk, and the associated experiences and outcomes of falls, in the elderly Aboriginal community of the Tamworth area.
Due to the nature of the project it was necessary to seek approval from Ethics Committees of Hunter New England Area Health Service, University of Newcastle and Aboriginal Health and Medical Research Council of New South Wales. While the ethics application process was protracted, often convoluted, tedious and frustrating, the process did clarify why the research should be done, the most appropriate method for doing so and who the stakeholders and beneficiaries of the project were.
To ensure the local Aboriginal community considered the project worthwhile, consultation with Elder groups and Aboriginal health and research workers began prior to the project commencing. Consultation has continued and has provided valuable assistance to the project development and progress. In addition, on-going involvement and social interaction of the researcher with the local Aboriginal community has contributed to the development of mutual respect and gaining of trust and support.
The greatest challenge to the project has been recruiting participants for the interviews. Ultimately this has been strongly linked to the consultative and interactive style of the researcher with local Aboriginal Elders. The development of strong non-research related relationships proved to be the key to developing trust, mutual respect, understanding and sharing. These new relationships have greatly assisted in recruitment of participants.
The advice and support from Aboriginal researchers has been invaluable in bridging the cultural gap and breaking down the barriers to meaningful communication and understanding.
To date, three semi-structured in-depth interviews have been recorded and transcribed and data analysis has commenced. A further three to five interviews will be undertaken within the next two months.
GENERAL PRACTICE
 UNIVERSITY OF WESTERN AUSTRALIA
Lyn Brun
Statewide PHCRED Coordinator
P: 08 9956 0200
E: lyn.brun@cucrh.uwa.edu.au
Focusing in on rural and remote
The Combined Universities Centre for Rural Health (CUCRH) in Western Australia (WA) has awarded four Researcher Development Program (RDP) fellowships to a number of early to mid-career researchers to undertake research projects in 2010.
CUCRH provides funding for research which has a focus in rural and remote communities.
Holly Buykx, a Research Officer, has accepted an RDP to undertake a survey of community knowledge, attitudes and practice towards vector borne diseases.
 Isabel Ross, a Health Promotion Officer, Ronald Simpson and Richard Noddy will evaluate the Fix my Ride project. This project is innovative and encourages Aboriginal youth to become interested in cycling and become more physically active.
Lyn Brun, Statewide PHCRED WA Coordinator, will investigate the networks that researchers of rural and remote projects and decision makers are involved in and how these impact on research translation.
A joint funded fellowship with the WA Country Health Service was awarded to Ana Mairata. Ana’s project will investigate the predictors of therapy outcomes of children with developmental delay in rural and remote areas.
Gemma Walker from South East Premium Wheatgrowers Association, along with Jacki Ward from CUCRH, will investigate whether pyrethrum, which is used on farms, is transmitted back to the farm family home. An education package for farmers will be compiled to remind them of the safety principles of farm chemical management.
Past RDP recipient, Jo Jackson-King has just published a book titled Raising the Best Possible Child: How to parent happy and successful kids from birth to seven. This book is the result of the support and research skills she gained from her fellowship.
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