CENTRE FOR PRIMARY HEALTH CARE AND EQUITY
 UNIVERSITY OF NEW SOUTH WALES
Melanie Marshall
PHCRED Program Coordinator
P: 02 9385 8401
E: m.marshall@unsw.edu.au
AND
GENERAL PRACTICE UNIT
UNIVERSITY OF NEW SOUTH WALES
Jane Taggart
Research Fellow
P: 02 9616 8520
E: jane.taggart@unsw.edu.au
The UNSW electronic Practice Based Research Network (ePBRN)
Routinely collected clinical data is used for audit, continuous quality improvement, health service planning, epidemiological studies, evaluation research and enhanced integrated care.
Linking data from different providers in primary and secondary care settings, gives additional information for research into integrated health services and for other academic and quality improvement purposes. Practice Based Research Networks (PBRN) have been used as vehicles to put this into operation and to increase research capacity.
The General Practice Unit at Fairfield, a member of the University of New South Wales (UNSW) Research Centre for Primary Health Care and Equity, and a unit of the Sydney South West Area Health Service, is currently undertaking a study to examine the issues, challenges and utility of establishing an electronic PBRN (ePBRN) in South West Sydney. These findings will provide direction as to the management of ePBRNs for academic and quality improvement purposes and guide future strategies to address technical, methodological, ethical, legal and social issues associated with the ePBRN.
The General Practice Unit will recruit up to 20 general practices participating in the existing UNSW RCBI PBRN (PHReNet-GP) and health services involved in integrated care.
Data exploring the characteristics of the practices/services, staff interest in research and issues and challenges faced, will be collected through brief questionnaires, interviews and observations. In addition, re-identifiable diabetes data will be extracted from clinical systems and linked. This study will explore the data quality, the use of and interpretation of data, methodology of analyses and the accuracy of the linkage.
NSW PRIMARY HEALTH CARE RESEARCH CAPACITY BUILDING PROGRAM
 UNIVERSITY OF NEW SOUTH WALES
Jacqueline Schroeder
State Coordinator
P: 02 9385 1502
E: jschroeder@unsw.edu.au
The New South Wales Primary Health Care (NSWPHC) Consortium conducted a short course on Research Methods and a Project Development Retreat on
6-9 April 2010.
The short course provided Researcher Development Program fellows and other early career primary health care researchers from the NSWPHC network with an introduction to qualitative and quantitative research methods, while the project development retreat provided an additional day to work up research proposals under the guidance of expert mentors. Numbers were slightly lower than previous years, with 13 participants attending the short
course and nine the Project Development Retreat.
Overall, participants reported the training events as relevant, a reflection of their needs/expectations and as a fulfilling learning experience. From verbal and formal evaluation reports, participants were happy with the introductory level of the course and the links to further reading. They also appreciated contact with experts and peers in the primary health care community. Certainly providing an opportunity for early career researchers to interface with the primary health care community has turned out to be a major secondary benefit of our training events.
For the fifth year since 2006 the research methods short course and project development retreat will be repeated in September for rural early career researchers associated with the NSW Health Institute of Rural Clinical Services and Teaching.
In the meantime, our next short course and project development retreat will be held 12-15 July 2010 and will focus on evaluation and aims to build evaluation capacity within the Divisions of General Practice. This short course was developed in 2007 in collaboration with General Practice NSW, the peak state-based body for the Divisions of General Practice in NSW and has been attracting growing interest from this key sector of the primary health care community.
For more information about the NSWPHC Consortium, our short courses and other events, please visit: <www.nswphc.unsw.edu.au>
 CONSUMER HEALTH RESEARCH GROUP
MONASH UNIVERSITY
Dr Samantha Thomas
Head and Senior Research Fellow
P: 03 8575 2221
E: samantha.thomas@med.monash.edu.au
The School of Primary Health Care at Monash University has recently established the Consumer Health Research Group (CHaRGe) to provide a unique consumer focus to academic research studies. CHaRGe specialises in working with consumer and community organisations, industry and government to develop and conduct research projects which respond to consumer and community need.
 CHaRGe is led by health sociologist Dr Samantha Thomas, who has extensive experience in consumer health research and community engagement strategies. She spent time at the World Health Organization in Geneva, and King's College in London, before joining Monash University.
One of the driving forces behind CHaRGe is evidence which suggests that studies that are grounded in consumer needs and priorities are likely to impact on the transferability of research outcomes within communities.
CHaRGe involves consumers in setting the research priority areas, the design and conduct of studies, and the interpretation and dissemination of research. Current research studies involve the experiences of individuals with musculoskeletal conditions, cancer survivorship, men's health and risk taking behaviour.
Many of the studies that CHaRGe conducts focus on vulnerable and highly stigmatised groups, and provide an opportunity for individuals to 'have their say' about their health and health care.
CHaRGe is most well known for its understanding of individuals who are obese in Australia. The project Obesity! Have Your Say has provided valuable information about the lived experience of obesity, but also how responses to weight may better reflect these experiences and needs.
Dr Thomas says that one of the benefits of being located within a School of Primary Health Care is the connectedness that primary health researchers and professionals have to communities and individuals. It is this connectedness to understanding community needs that provides a great starting point for the six PhD students currently undertaking their doctoral studies with CHaRGe.
PHCRED PROGRAM
SPENCER GULF RURAL HEALTH SCHOOL (SGRHS)
Elena Rudnik
PHCRED Coordinator
P: 08 8645 8153
E: elena.rudnik@unisa.edu.au
Working toward a PhD, Elena Rudnik is exploring whether the relationship between health literacy and health behaviour is mediated by executive functions.
Blokes Brains and Behaviours is primary health care research looking at relationships between health behaviours, health literacy and executive functions of men aged 16-40 years.
Executive functions are a psychological construct which, among other things, enable a person to plan and implement goal oriented behaviour. The health behaviours being investigated include alcohol and illicit drug use, smoking, physical activity, health service access and diet.
 A convenience sample was recruited from two regional South Australian communities; Whyalla and the Barossa Valley. Participants were engaged through employers, service agencies incorporating work site visits, shopping mall information sessions and print media. One hundred and six men completed the two-hour assessment, which involved participating in health questionnaires, anthropometrics, health literacy and neuropsychological testing.
Functional health literacy was measured trialling an Australian version of the Newest Vital Signs (NVS), developed in accordance with Australian food label standards, along with the original American NVS, the sTOFHLA and a Japanese measure for critical and communicative literacy. Preliminary analysis of the data from the first 80 men has commenced and the sample, with a mean age of 29 years (sd 7.8) is described in the table below. This research will contribute to what is already known about health-related issues faced by working age men and why some men have trouble self-managing their health.
DISCIPLINE OF GENERAL PRACTICE
 UNIVERSITY OF QUEENSLAND
Geoff Mitchell
Professor of General Practice and Palliative Care
P: 07 3381 1363
E: g.mitchell@uq.edu.au
"Dying patients are a small but very important proportion of a general practitioner's professional life."
Professor Geoff Mitchell's Primary and Palliative Care research team has been investigating palliative care in general practice for the last ten years.
The team's research has followed several streams:
- Health services research, investigating the delivery of palliative care in general practice
- Enhancing the relationship between general practitioners and specialist palliative care teams
- The care of carers of very ill people
- The use of single patient trials in advancing the evidence base of palliative care treatments.
 Professor Mitchell's research team has provided important research findings around the practice of palliative care in Australia, and contributed important trial data to support the efficacy of general practice involvement in the area. The team is actively generating clinical evidence of the efficacy of some palliative care treatments, and has recently begun concentrating research effort on the care of carers of very ill people.
All involved have developed unique research methodologies which have impacts on a wide range of settings. These include:
- a recruitment technique that identifies patients through specialist services, then engages their GPs through these patients
- gathering data on GP clinical practice by aggregating a GP's recall of their care of the last palliative patient they treated
- single patient trial design as a means of gathering high-level evidence for treatments in groups of patients with small numbers, delivering treatment evidence on par with randomised controlled trials but with a fraction of the sample size
- unique means of measuring outcomes from clinical interventions in palliative care settings.
Professor Mitchell was previously awarded a PCHRED Senior Fellowship by the Department of Health and Ageing (DoHA) for his research and believes it gave him the scope to develop his work:
"The Senior Fellowship allowed me to define and progress this research agenda and I am thankful to DoHA for that opportunity. I have had to relinquish it this year due to a change in role within the University of Queensland Medical School, but the research agenda will continue to be active."
PHCRED TRI-STATE PROGRAM
 FLINDERS UNIVERSITY
Elena DiBez
Tri-State Administrator
P: 08 7221 8535
E: elena.dibez@flinders.edu.au
In 2010 the Tri-State Program will continue to deliver capacity building activities to the partner Universities: University of Adelaide, Flinders University, Spencer Gulf Rural Health School, Centre for Remote Health and the University Department of Rural Health Greater Green Triangle.
Key Events:
A PHCRED Policy Forum was held on 12 May in Adelaide with key speakers Professor Leonie Segal (National Preventative Health Task Force) and Sinead O'Brien (Deputy Director State Wide Services Strategy SA Health). The Forum focused on the state and federal contexts for primary health care research. There were also speakers from the South Australian Health and Medical Research Institute, PHC RIS and Health Consumers Alliance.
A Career Pathways Intensive Workshop was held on 28 May at Flinders University and assisted researchers to develop skills in writing for publication.
In August a Grant Writing Workshops for ARC and NHMRC will be offered. The presenter is Emeritus Professor Tim Miles.
The 2010 Tri-State Conference will be held in Warrnambool on 16-17 September. The theme is Research to Practice - How to Make it Happen. The Conference provides the opportunity for PHCRED researchers to present their research in short presentation sessions or as a poster. A collegiate and supportive environment is encouraged where peers can network and learn about the current research themes.
For more information about these events and to keep informed about Tri-State activities see the website at <www.phcredtristate.org.au> and register with the SARNet email network at <www.flinders.edu.au/medicine/sites/general-practice/phcred/sarnet.cfm>
MENZIES RESEARCH INSTITUTE
 UNIVERSITY OF TASMANIA
Sally Thurley
Acting Statewide Coordinator
P: 03 6226 4767
E: sally.thurley@utas.edu.au
PHCRED Tasmania concluded 2009 with another very successful Symposium. It was held at the Wrest Point Convention Centre in Sandy Bay, and we had 18 presentations from mostly early career researchers who have been involved with our PHCRED program in some capacity. Associate Professor Ellen McIntyre from PHC RIS was our honoured guest speaker this year and the theme was Getting It Out There, where the focus was on disseminating research findings and results. If you wish to read some of the abstracts, they can be found at <www.phcred.utas.edu.au/symposiums.htm>
Alison Archer was awarded our best 'first-time' presenter prize with her presentation on Deliberate Self-Harm in Rural and Urban Adolescents.
2009 RDP, Dr Faline Howes, was awarded the Allan Chancellor Award for best first-time presenter at GP09, the Royal Australian College of General Practitioners conference, in Perth in October 2009. She presented results of her qualitative study of barriers to diagnosing and managing hypertension in Australian general practice.
2009 RDP Ms Leigh Tesch presented her research findings at The Art of Good Health and Wellbeing International Arts and Health conference in Port Macquarie in November 2009. Her presentation was titled Arts and Health - what do we know about evaluation, which looked at the use of evaluation in community arts projects which had a primary health care focus.
PHCRED Director Professor Mark Nelson was awarded the AAAGP Bridges-Webb Medal at the GP & PHC Conference in Melbourne in July 2009.
We held 16 workshop/seminars relating to various aspects of PHCRED capacity building, with 299 attendees.
In 2009 we introduced a PHCRED sponsored award for 3rd Year Medical Students in their primary health care rotation who undertake mini-research projects in groups. Their findings are presented to other students and researchers. and the winning groups are awarded book gift vouchers - useful for any student!
MENZIES RESEARCH INSTITUTE
UNIVERSITY OF TASMANIA
Emily Hansen
Research Fellow in Primary Health Care
P: 03 6226 4769
E: emily.hansen@utas.edu.au
I have a continuing research interest in trying to better understand the process of ongoing smoking or smoking cessation. During my fellowship I have conducted research about smoking that explored the meanings of smoking, the ritual aspects of smoking, how smoking cessation can be partially understood as a rite of passage and how lay people construct explanatory narratives about smoking and their illnesses. While I started conducting research about smoking because it is an area that interests me as a sociologist, it has also proven to be an area where my research can directly contribute to policy and practice. It is also an area where dialogue with policy makers and practitioners about their evidence needs has helped me to refine and develop new research projects.
For example, Tasmania has very high rates of smoking during pregnancy and there is a lack of local research available for policy makers and for practitioners who implement smoking cessation programs for pregnant women.
In collaboration with the State Department of Health and Human Services Population Health Unit and a smoking cessation researcher based in the School of Pharmacy at the University of Tasmania, I have designed a new mixed method research project to investigate Tasmanian women's understandings, views and experiences of smoking and smoking cessation while pregnant. The study has received part funding from the Population Health Unit and will begin in mid 2010. The research will contribute to my larger project as a PHCRED Fellow of Prevention through behaviour change. Research findings will also be of considerable immediate value to practitioners and others who work with pregnant smokers and will help guide the future direction of purpose designed smoking cessation programs for pregnant women in Tasmania.
DEPARTMENT OF GENERAL PRACTICE
 UNIVERSITY OF MELBOURNE
Assoc Prof Meredith Temple-Smith
PHCRED Coordinator
Phone: 03 8344 3371
Email: m.temple-smith@unimelb.edu.au
"Postgraduate students of the third age can make a good contribution to primary care research"
The recent PHC RIS RESEARCH ROUNDup about Australia's primary care research workforce has attracted much interest.
 Our newest PhD candidate, Susan Webster, brings to this workforce over 35 years of experience in disability, equal opportunity, justice and primary health care. Her understanding of the policy, workforce and health care challenges faced by GPs drew her to consider how to use her experience and continue her learning through primary care research.
Susan began the Researcher Development Program in 2007, studying a topic relevant to her work at General Practice Victoria.Earlier this year she was awarded a Master of Primary Health Care at The University of Melbourne for her thesis which examined GP health assessments of children and young people in out-of-home care.
"The PHCRED program was a return to study after a very long pause; I had last studied as an undergraduate in the 1970s. It was great to be back in an academic environment. I was hooked!"
Susan decided to continue after her retirement from the salaried workforce, and was recently awarded an Australian Postgraduate Award to commence a PhD study examining how child protection and primary health care systems interact in Australia in response to new standards about health care for children and young people in child protection.
Recently retired professionals are an excellent group to cultivate as potential members of the primary care research workforce, as they bring a wealth of experience to the academic environment. Not only that, but as Susan says "I don't think I would be very good at delivering meals-on-wheels or other hands-on volunteering options some people are attracted to in retirement. Academic research offers personal interest, fulfilment and a way to make a valuable contribution to some of the big issues in the community."
GENERAL PRACTICE AND PRIMARY CARE RESEARCH UNIT
 UNIVERSITY OF NOTRE DAME
Prof Tom Brett and Assoc Prof Diane Arnold-Reed
Director and Research Program Coordinator PHCRED
Phone: 08 9433 0571
Email: tbrett@nd.edu.au
Notre Dame Researchers focus on multimorbidity
Over the past 12 months, The University of Notre Dame Fremantle General Practice and Primary Health Care Research Unit has been examining the burden of chronic disease on medical practices resulting from a progressively ageing population.Whilst it is recognised that chronic diseases tend to come in multiples, existing best practice guidelines are usually formulated from evidence based on single disease entities.
The management of single diseases in isolation when they co-occur tends to limit the ability of primary care physicians and the broader health system to offer more comprehensive and cost effective care to patients. A more holistic approach to patient management is generally recognised as having the potential to offer better outcomes for these patients.
 GP researchers Dr Hilary Fine (East Fremantle Medical Centre) and Dr Geoffrey Bovell (Mosman Park Medical Group) together with Practice Nurse Claire Jenkins (Mosman Park) used their RDP Placements to undertake an overview of the prevalence of multimorbidity across the entire age spectrum over a six month period in two Perth metropolitan general practice settings. The extracted data was documented to show patterns of chronic disease combinations in their practice populations using the Cumulative Illness Rating Scale as described by Hudon et al (J Clin Epidem 2007; 60: 212-15). Second year Notre Dame medical student, Michael Toolis, was the recipient of a research bursary for his help with data entry for the study.
Findings from the study will help to provide evidence to document the widespread prevalence of multimorbidity amongst the older population in the community. This evidence may also point to the development of alternative models of chronic disease management, and assist with future health care planning for the increasing numbers of people who continue to be managed by general practitioners and other primary health care staff in their own communities.
FACULTY OF HEALTH SCIENCES & MEDICINE
 BOND UNIVERSITY
Dr Elly Scheermeyer
PHCRED Coordinator
P: 07 5595 4411
E: escheerm@bond.edu.au
PHCRED at Bond University, directed by
Professor Mieke van Driel in 2009, engaged three new GPs in research projects and continued collaboration with two nurses/fellows. The program was coordinated by Assistant Prof Elly Scheermeyer, who took on supervision of three Fellows and the additional work of Assistant Prof Neil Smart who moved to a full time teaching position.
The PHCRED team at Bond University has a strong interest in evidence-based practice research. They are supported by world experts in the field, Prof Chris Del Mar and Prof Paul Glasziou, currently director of the Oxford Centre for Evidence-Based Medicine and returning to Australia to work at Bond in 2010. We promote evidence-based practice through undergraduate teaching, professional workshops and coaching of students and health professionals in writing Cochrane Reviews.
Early in 2009 we held two interactive workshops: Introduction to Evidence-based Practice and How to start up and run a Journal Club. The workshops were attended by local GPs, hospital specialists and allied health care professionals, and past and present PHCRED fellows. This provided a nice mix of participants, and inspiring discussions. The hands-on activities concentrated on learning how to ask questions, search the literature and critically appraise research papers.
By encouraging and supporting students, clinicians and other health staff in writing Cochrane Reviews, we introduce many novice researchers into an important research skill and essential step in evidence-based practice, a systematic literature review. Prof van Driel guides and supervises the process of writing a Cochrane Review and established a Cochrane Author Support Group. Three workshops and two library searching sessions were held for the author groups to assist them in registering a title and writing a protocol. All author groups receive individual assistance and over 20 groups have initiated a review or taken up an 'orphaned review'. Their efforts may be rewarded with a Cochrane Award of Appreciation. In 2009 two full reviews were submitted and five protocols were published.
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