Research supported by Western Alliance

2018-2019

Identifying barriers, facilitators and strategies for implementing cardiac tele-rehabilitation to address access inequalities in Western Victoria

Investigators: Jonathan Rawstorne, Dr Susie Catledge, Dr Sheik Mohammed Shariful Islam, Ralph Maddison (Deakin University), Dr Matthew Wallen (Federation University), Luke Evans (Ballarat Health Service),  John Amarena (Barwon Health), Cathreena Gervis (South West Healthcare), Anne Morrison (South West Healthcare)

Mentors: Professor Fergal Grace (Federation University)

Affiliation/collaboration: Barwon Health, Ballarat Health Service, South West Healthcare, Deakin University, Federation University

For completion by: August 2020

Western Alliance funding: $78,312

Exercise-based cardiac rehabilitation (exCR) saves lives but participation in current programmes is very low in regional areas. This project team developed a technology solution that solves key accessibility issues to reach people in almost any location, but the programme is only available in research trials. The project will work with health providers and people with heart disease to understand how to translate the programme into everyday practice, so more people can experience the life-changing benefits of exCR.

Exercise-based cardiac rehabilitation (exCR) confers health and cost benefits but low utilisation of face-to-face programmes show the traditional model doesn’t meet the needs of many people. Access barriers play a key role and are especially prominent in regional/rural areas, where participation is lowest. The project team built a state-of-the art telerehabilitation intervention (REMOTE) that connects participants with remotely located exCR professionals to receive high-quality individualised exercise and behavioural support from almost anywhere. Early evidence shows REMOTE is as effective as face-to-face exCR, well accepted, and substantially cheaper. Successful, scalable, sustainable translation into practice could increase exCR utilisation in western Victoria but evidence guiding implementation of telerehabilitation is lacking. Determinants of implementation success are complex and context-specific. The project will use an evidence-based framework to evaluate implementation determinants in multiple stakeholder, geographic and temporal contexts across western Victoria. Key context-specific determinants will be identified via Framework Analysis of qualitative data and synthesised into a toolkit of pragmatic implementation strategies. The toolkit will be pilot tested in selected sites, refined, and disseminated to stakeholders to facilitate future implementation initiatives. Inclusion of early career and clinical investigators will support capacity development, & cross-institution/cross-sectoral collaboration.

The following questions are embedded in the study’s aims and objectives:

  1. Prospectively identify factors that are perceived to influence successful implementation of REMOTE in multiple stakeholder, geographic and temporal contexts
  2. Co-design a pragmatic toolkit with stakeholders to guide future REMOTE implementation initiatives
  3. Pilot test the effectiveness of context-specific REMOTE implementation strategies

 The study’s outputs will advance scientific knowledge by generating ≥2 national/international conference presentations and ≥2 open access publications in high-impact CVD/health technology journals (e.g. Heart [impact factor=6.06], JMIR [impact factor=5.18) to maximise exposure to researchers. Co-creation of translational strategies with exCR practitioners/providers will inform local best-practice policies and facilitate expansion of high-quality services to address unmet needs for western Victoria’s CVD population.


A novel ‘bundle of care’ approach to cellulitis management in Western Victorian hospitals

Investigators: Jaclyn Bishop (Ballarat Heath Service)Raquel Cowan (Barwon Health, Ballarat Heath Service, Deakin University), Dr Thomas Shulz (National Centre for Antimicrobial Stewardship), Mary Smith (DHHS Grampians region)

Mentors: Dr David Kong (Ballarat Heath Service), A/Professor Kirsty Buising (National Centre for Antimicrobial Stewardship), A/Professor Deborah Friedman (Barwon Health)

Affiliation/collaboration: Ballarat Health Service, Barwon Health, Colac Area Health, National Centre for Antimicrobial Stewardship, Victorian Infectious Diseases Service, Deakin University, DHHS Grampians region

For completion by: March 2020

Western Alliance funding: $96,219

This study aims to improve antibiotic prescribing for cellulitis by introducing a set of key actions (known as a bundle of care) that must be completed by hospital staff when treating each and every patient with cellulitis. Cellulitis is a skin infection that is normally treated with antibiotics. If the incorrect antibiotic is chosen or the incorrect dose is prescribed, the infection may not get better. Incorrect use of an antibiotic can lead to it becoming ineffective.

 Given the treatment of cellulitis is well established, there is an evidence practice gap that needs to be addressed. Support to translate the treatment guidelines for cellulitis into practice in RRH is urgently needed. This study will develop and implement a novel care bundle for the management of cellulitis. Bundles of care (‘bundles’) are a package of independent evidence-based activities that must be undertaken for every patient every time. The study will investigate whether a cellulitis bundle of care can improve antibiotic prescribing for cellulitis in hospitals in the western region of Victoria. Ballarat Health Services is the lead site for the study and up to two other hospitals in the region will be invited to participate. The study will involve bundle; i) development, ii) implementation and iii) evaluation. The primary outcome is the appropriateness of antibiotics prescribed on day 1, day 3 and day 5 of treatment.

The following questions are embedded in the study’s aims and objectives:

  1. Develop a novel bundle of care that promotes the appropriate prescribing of antibiotics and optimal management of cellulitis;
  2. Implement the cellulitis bundle in regional hospitals in western Victoria; and
  3. Evaluate the impact of the cellulitis bundle on the appropriateness of antibiotic prescribing for patients with cellulitis.

The study’s findings will be used to develop a novel bundle of care that promotes the appropriate prescribing of antibiotics and optimal management of cellulitis.


Identifying research priorities to optimize allied health care – informed by consumers: a modified Delphi study

Investigators: A/Professor Anna Wong Shee (Ballarat Health Service/Deakin University), Dr Renee Clapham, Dr John Aitken (Ballarat Health Service), Dr Anna Ugalde, Dr Jaithri Ananthapavan, Kevin McNamara (Deakin University)

Mentors: A/Professor Vincent Versace (Deakin University)

Affiliation/collaboration: Ballarat Health Service, Western Victoria PHN, East Grampians Health Service, Wimmera Health Service, Ballarat Community Health, Rural Northwest Health, Stawell Regional Health, Deakin University

For completion by: August 2020

Western Alliance funding: $79,709

This project brings together consumers, who can identify areas for improvement based on their experiences, allied health professionals, who understand the public health system, and academics, with research expertise, to identify and prioritise research needs for allied health practice in the Grampians region. In health service research, it is vital that we address questions that are important to patients and that the research meets a health service need or gap in the evidence.

 In the funding of public health service research, it is essential that the research questions are important to patients and align with the interests, needs, and values of the community. Many methods for identifying research priorities involve consultations with a number of experts from a range of disciplines. These approaches can be resource intensive, costly, and logistically challenging and do not always take into account patient or community priorities. There is a need for clear research priorities in rural and regional areas to address the health inequities that exist due to geographical, socioeconomic and workforce issues.

[1] We will engage with consumers, allied health professionals and managers, and researchers to identify areas of allied health practice that are high priority for change. This study will be conducted in two phases: Phase 1. Survey and focus groups will be used to elicit information about consumers’ experiences of allied health care, their perceptions of service gaps and ways to optimize care; and the values/criteria to be used to prioritise research areas for the Grampians region; Phase 2. A modified Delphi survey method to identify priorities relating to allied health care practice and frame tractable research questions for the areas identified. This study will consult broadly and provide an effective way of engaging with stakeholders. It will produce ‘researchable’ topics that have a direct link to the needs of the community and the health services.

The following questions are embedded in the study’s aims and objectives:

The aim of the study is to identify actionable priorities for allied health research in the Grampians region that can be rapidly translated into practice.

The study objectives are:

  1. Gain an understanding of (i) consumers’ experiences of allied health care, their perceptions of service gaps, and ways to optimize care; and (ii) factors consumers consider important in resource allocation decisions for allied health research
  2. Establish a systematic, explicit and transparent process of setting allied health research priorities

Translation outcomes (26) include clinical implementation, community benefit and advancing knowledge. Engaging consumers, clinicians and researchers to identify allied health research priorities will help ensure the relevance of health research, facilitate the translation of research findings into practice (clinical implementation) and ultimately improve patient outcomes (community benefit). Project information and outcomes will be made available to the public via community forums and partner agencies’ websites/information sharing forums. Dissemination of outcomes to stakeholders will include reports, presentations, and three peer reviewed publications (advance knowledge).


What is the prevalence of malnutrition in a small rural health service? Evaluation of a malnutrition screening program in Colac, Victoria

Investigators: Laura Alston (Colac Area Health/Deakin University), Megan Green, Alison Bucherri (Colac Area Health)

Mentors: Dr Melanie Nichols (Deakin University), Karen Cameron (DHHS), Kay Widdicombe (Colac Area Health)

Affiliation/collaboration: Colac Area Health, DHHS, Ballarat Health Service, Deakin University

For completion by: February 2020

Western Alliance funding: $37,143

This project is an observational study combined with an evaluation of a malnutrition screening program. Malnutrition on the acute ward contributes a significant, yet preventable burden on the health system. The prevalence of malnutrition and the associated socio-demographic characteristics that contribute to malnutrition in a rural health service setting, along with evidence-based strategies to address the issue in the rural context is lacking.

 The Colac Area Health (CAH) Dietetics department implemented a malnutrition screening program in 2017 after anecdotal feedback that patients at risk of malnutrition were not always being referred to dietetics. These patients were being discharged without adequate treatment and with a high risk of rehospitalisation. It is not known whether the implementation of the screening has resulted in increased malnutrition identification and treatment, when compared to before the intervention period. The prevalence of malnutrition in patients presenting to CAH is also unknown. This project team plans to undertake a retrospective data audit of online medical files to determine an estimate of the prevalence of malnutrition, investigate the sociodemographics characteristics of the rural patients that may contribute to malnutrition and evaluate the accuracy of our existing malnutrition screening program.

The project team hope to use this pilot observation and evaluation study to inform improvements in nutrition policy and design a larger malnutrition intervention program translatable to the western district of Victoria and also aim to add to the evidence for the use of mandatory malnutrition screening in small rural hospitals.

The following questions are embedded in the study’s aims and objectives:

  1. To determine the prevalence of malnutrition in patients admitted to the CAH acute ward over the age of 18 years.
  2. To describe demographic characteristics associated with malnutrition in our patients.
  3. To evaluate the malnutrition screening program implemented from 2017-2018 on the acute ward at CAH.

 The findings of this study will be used to guide the development of nutrition policy at CAH and these findings will be communicated across the organisation, including to acute and nursing, governance and leadership staff. The project team will present results of this study to other dietetics departments and acute hospital staff to generate awareness of the new knowledge across the region of western Victoria. The study, through assessing the level of malnutrition and quality of the screening program will also have funding implications for the health service and will contribute to improving clinical documentation and therefore adequate funding classifications for malnutrition. 


2017-2018

Let’s have a yarn about chronic disease: A collaborative, multidisciplinary, participatory action research approach to addressing Aboriginal health in south-western Victoria

Investigators: Hannah Beks, Candice McKenzie and Dr Joshua Hayward (Deakin University); Kerry Hudson, John Bell and Tamika Amos (Dhauwurd Wurrung Elderly and Community Health Service); Dr Constance Kourbelis (Flinders University)

Mentors: A/Prof Vincent Versace, A/Professor Barry Morphett, Professor Peter Harvey and Prof Steven Allender (Deakin University); Dr Michael Johnstone and Dr Doug Creighton (Institute for Intelligent Systems Research and Innovation)

Affiliation/collaboration: Deakin Rural Health, Dhauwurd Wurrung Elderly and Community Health Service, Acute Care and Cardiovascular Research, Flinders University, Institute for Intelligent Systems Research and Innovation

For completion by: July 2019

Western Alliance funding: $74,804

This project builds upon a partnership between Dhauwurd Wurrung Elderly and Community Health Service (DWECHS) and Deakin Rural Health (DRH) for the purpose of establishing community driven methods to increase the uptake of structured care planning and chronic condition management for Aboriginal people in south-western Victoria (Gunditjmara country). Building local research and clinical capacity are central objectives of this project.

The primary aim of the project is to apply a PAR framework to establish community driven methods to increase care planning and improve chronic condition management for Aboriginal people in south-western Victoria.

Secondary aims include increasing the uptake and improving adherence to structured care planning for chronic disease in Aboriginal populations in south-western Victoria, to improve the health status of Aboriginal people within Gunditjmara country.

The following questions are embedded in the study’s aims and objectives:

(1) Where is research focusing on chronic disease in Australian Aboriginal people being conducted and is this proportionate to the distribution of Aboriginal people across Australia?
(2) What is the state of chronic disease in Aboriginal people residing in Gunditjmara country and how does this compare to statewide and national data?
(3) What proportion of Aboriginal people residing in Gunditjmara country are on structured care plans?
(4) What are the barriers and enablers to effective chronic disease management in Aboriginal people residing in Gunditjmara country?

The study’s outputs will include clinical skills training for Aboriginal Health Workers in the region, publication in peer-reviewed journals and conference presentations.


Developing a best-practice, pre-operative exercise therapy ‘prehabilitation’ model for patients with prostate, colon and breast cancer, in the Grampians region of Victoria

Investigators: Prof Fergal Grace, Dr Matthew Wallen (Federation University Australia); A/Prof Anna Wong Shee, Dr Luke Evans and Dr Stephen Brown (Ballarat Health Services); Dr Jonathan Rawstorn (Deakin University)

Mentor: Prof Jack Harvey (Federation University)

Affiliations/collaboration: Faculty of Health, Federation University Australia; Ballarat Health Services; Institute of Physical Activity and Nutrition, Deakin University. Ballarat Integrated Cancer Centre, Grampians Integrated Cancer Centre, East Grampians Health Service, West Wimmera Health Service, Wimmera Health Care Group, Stawell Regional Health Services

For completion by: June 2019

Western Alliance funding: $98,244

The post-operative period brings significant loss of physical function in cancer patients undergoing surgery. Exercise rehabilitation programs aim to recover cardiorespiratory fitness (CRF) post-operatively. However, pre-operative exercise training (‘prehabilitation’) is a largely untested method to optimise pre-operative CRF gains.

This study will review local practice and analyse current research before undertaking an experimental cancer prehabilitation study with patients in the Grampians region of Victoria.

The study aims to evaluate the current exercise physiology program for new cancer diagnoses in the Grampians region of Victoria (2012–16); execute a systematic review and meta-analysis of controlled studies to evaluate pre-operative exercise training on physical capacity and post-operative outcomes in cancer patients; and conduct a 6-month experimental pilot study of supervised prehabilitation in newly diagnosed prostate, colorectal and breast cancer patients in the Grampians region.

The study will aid clinical decision-making by identifying candidates who may benefit from prehabilitation. Outputs will include medical research articles published in peer-reviewed journals and international conference presentations. A regional stakeholder workshop in cancer care will be hosted in western Victoria and will include input from study participants.


Patient measure of safety in primary care: Pilot study of an intervention to improve safety in rural Victoria

Investigators: Andrea Hernan, Kate Kloot, Hannah Beks, Dr Marley Binder and Dr Vivienne Ramsbottom (Deakin University)

Mentor/s: A/Prof Vincent Versace and Dr Kevin McNamara (Deakin University)

Affiliations/collaboration: Deakin Rural Clinical School, Centre for Rural Emergency Medicine, primary care practices in western Victoria

For completion by: June 2019

Western Alliance funding: $87,348

This study aims to investigate whether patient safety in primary care can be improved through patient feedback. The research will explore possible problems, or factors, that support carrying out patient feedback and safety improvement in primary care.

The overall aim of this pilot study is to test the feasibility of the Primary Care Patient Measure of Safety (PC PMOS) as a tool to improve patient safety in the western region’s primary care. PC PMOS is an anonymous, 28-item survey covering nine domains of safety, including access to care, communication, the external policy environment, information flow, organisation and care planning, patient related factors, the physical environment, referral systems and task performance. The PC PMOS also captures safety incident reports.

The study’s findings will be used to develop a manual for patient involvement in patient safety for primary care. The manual will assist in scaling up the PC PMOS for national implementation.
Outputs from the study include dissemination of findings to general practices in the region, publication in peer-reviewed journals and presentations at conferences.


Validity of a body-worn alarm system for the effective management of enuresis in children: A study in western Victoria

Investigators: Dr Blake Peck (Federation University Australia); Bronwyn Peck, Dr Rosemarie Shea and Dr Mark Nethercote (Ballarat Health Services); Shirley Whitaker, Andrea Green, Kerrie Svedas and Stacey Dubberley (Grampians Regional Continence Service); Erica Pearce (Barwon Health); Sarah Schuhmann (Colac Area Health)

Mentor/s: Prof Peter Vuillermin (Deakin University); Prof Jack Harvey (Federation University)

Affiliation/collaboration: Federation University Australia, Ballarat Health Services, Grampians Regional Continence Service, Barwon Health, Colac Area Health, Deakin University

For completion by: March 2019

Western Alliance funding: $58,701

Bedwetting is a major concern for children in Australia. Currently, the most widely used system for managing this issue is the bell-pad alarm system. This alarm is expensive and children often have to wait for long periods before they can get access. However, there is an alternative device that is cheaper and therefore more readily accessible for children and families. This project will consider how well this alternative device compares to the bell-pad for treating bedwetting in children.

This study aims to evaluate the effectiveness of the body-worn alarm system, as an alternative to the current therapy (bell-pad device) for the treatment of enuresis across the region of western Victoria, and will include an economic evaluation to assess its cost-effectiveness for both families and the health services.

The study’s outputs will include publication in peak industry based academic journals, both national and international, and presentation at scientific conferences. If the new insights generated from this clinical trial pilot project are suitably robust in support of the new therapy, these findings will inform a national study seeking to demonstrate statistical non-inferiority between the two devices and translated into clinical guidelines for practice.


2016-2017

Determining best practice for the management of teenage pregnancy in rural and regional health services, $65,207

Investigators: Dr Natasha Frawley, Dr Anna Wong Shee, Carolyn Robertson, Anne Marie McKenzie and Julie Lodge, Ballarat Health Services; Dr Catherine Nagle and Dr Vincent Versace, Deakin University; Allison Schotton, Maryborough District Health Service; Kerry Sturmfels, East Grampians Health Service

For completion by: July 2018

Teenage pregnancy is associated with high rates of maternal and neonatal death, and medical complications. Australia has the sixth-highest rate of teenage pregnancy in the developed countries, with the highest rates occurring in non-urban areas.

There is a lack of evidence for best-practice management of teenage pregnancy. This study will conduct a systematic review of the literature, scope best-practice models of care and seek to understand the experiences of teenagers giving birth in rural and regional areas.

The project’s outcome will be development of evidence-based guidelines for best-practice management of teenage pregnancy in rural and regional areas, and its outputs will include publication of research findings in academic journals and conference presentations.


Interprofessional Graduate Transition Program for nursing / paramedicine double degree graduates – work outcomes and participant experiences in western Victoria, $6,941

Investigators: Prof Penny Paliadelis, Federation University Australia; Denielle Beardmore and Kristee Winters, Ballarat Health Services

For completion by: November 2017

 The interprofessional graduate program (IPGP) for graduates with a double degree in paramedicine and nursing was the first program of its kinds to be conducted jointly by a public hospital and ambulance service in Victoria.

The workforce structures in health and, in particular of both of these professions, does not always facilitate a smooth transition for the early entry worker with a double degree to work across both professions at the same time. Ballarat Health Services, in partnership with Ambulance Victoria, created and implemented an innovative transition program to address these issues and provide graduates with a supportive framework. However, it is unclear whether this transition program has assisted the graduates in finding employment in their chosen professions within the region.

This study aims to evaluate the employment outcomes and participant experiences of the first cohorts of the IPGP program, based at Ballarat Health Services. To date, it has not been identified whether double degrees in health disciplines such as nursing and midwifery, or nursing and paramedicine serve the needs of regional and rural communities, and there is little evidence of the experiences of graduates in transitioning into the rural workforce in either profession.

A mixed-methods study using a graduate destination survey, followed by focus group discussions, will explore the successes, challenges and barriers of participants in the program, and will inform future program development. The findings may also assist health education providers and services to create a curriculum that prepares double-degree graduates for rural practice and, ultimately, benefits the health workforce in western Victoria.

The study’s outputs will include publication in an academic journal and conference presentations.


The western Victoria Practice Nurse study, $22,803

Investigators: Prof Gerard Gill, Prof Daryl Pedler and Dr Bernard Shui, Deakin University; Dr Blake Peck and Andrew Smith, Federation University Australia; Linda Govan, Australian Primary Healthcare Nurses Association; Dr Denise Ruth, General Practitioner, Geelong; Dr Jane Opie, Western Victoria Primary Health Network

 For completion by: March 2018

Studies reveal an older general practitioner (GP) population in western Victoria. The Western Victoria Primary Health Network (PHN) demonstrates a similar proportion of older Practice Nurses (PNs) approaching retirement. Recruiting and retaining PNs is a priority as nurses provide primary health care vital to improving health outcomes for people living in rural communities. There is limited research identifying the education needs of PNs specific to this region.

This study will engage with PNs, GPs and consumers to explore the role of PNs and their education needs, with the aim of improving nurse-led models of care in western Victoria. The study’s outputs will include development of a website, articles in local news outlets, presentations at scientific meetings and conferences, and publication in academic journals.


Developing a comprehensive hepatitis C treatment program for western Victoria, $85,000

Investigators: Dr Amanda Wade, Prof Eugene Athan, Dr Greg Weeks, Margaret Wardrop and Christine Roder, Barwon Health; Prof Margaret Hellard, Burnet Institute; Dr Mark Davies, Western Victoria Primary Health Network; Angus McCormack, Deakin Medical School

For completion by: February 2018

 More than 230,000 Australians are infected with hepatitis C virus (HCV). The majority remains untreated because therapy is toxic, often unsuccessful and accessible only through specialist doctors. Untreated HCV can lead to liver cancer and death.

New, direct-acting antiviral (DAA) treatment for HCV became available in March 2016. DAA treatment is highly effective and well tolerated. Australia is now in the position to eliminate HCV; the key is to increase access to treatment.

This study aims to increase access to treatment in western Victoria by developing a program that facilitates DAA prescribing in general practice and provides a clear referral network.

The study’s outputs will include publication in an academic journal and conference presentations.

To read more about this project, including the findings please click here.


A post-hospital discharge pharmacist medication management service for high-risk patients, using telehealth, $35,000

Investigators: Dr Diana Bortoletto, Dr Greg Weeks Dr Adrian Low, Michelle Wilson and Rachel Fyfe, Barwon Health; Dr Kevin McNamara and Dr Vincent Versace, Deakin University; Alice King, Barwon South West Telehealth Program

For completion by: December 2017

 Medication reviews conducted by hospital pharmacists after patients’ discharge from hospital have been shown to be beneficial to patients, especially for those at risk of medication-related problems. These reviews are generally conducted in the patients’ home or over the telephone.

This study aims to assess whether using videoconferencing to conduct the medication review is a suitable alternative. Using videoconferencing means that the service can be offered to people who live remotely, which is not the case for reviews in patients’ homes. Participants will be evaluating the pharmacy service as well as the technology. The pharmacist will record the changes made to medications and the potential effect this may have had on the participant if the changes had not been made.

The primary objectives of the study include the evaluation of the service across the region, patients’ acceptance and satisfaction with both the pharmacy service and the telehealth technology; the number of pharmacist interventions made and a risk-classification of harm averted, as well as re-admission rates to hospital. Secondary outcomes will include improvements in medication adherence behaviours and collaboration across health care facilities and the care continuum.

The study’s outputs will include publication in an academic journal and conference presentations.


The Rural Acute Hospital Data Register (RAHDaR), $34,987

Investigators: A/Prof Tim Baker and Kate Kloot, South West Healthcare and Centre for Rural Emergency Medicine, Deakin University

For completion by: January 2018

Very little data is collected and collated from Victoria’s 45 small rural hospital-based emergency care facilities, despite the fact that their patients share a common patient identification number across the hospitals. They simply report one figure – the total number of patients they see each year. Those figures show these facilities manage approximately 140,000 emergency presentations annually – 8 per cent of all emergency presentations in Victoria, including critically ill and injured patients.

Currently it is not possible to determine details of these presentations, such as patient demographics, triage category, details of arrival and departure, and diagnosis data. This reduces the ability to examine how rural emergency care is shared, the types of patient presentations and needs of the region or, with linkage to other health databases, to evaluate how a change in clinical or procedural practice in one organisation might benefit or harm another.

This project aims to develop a comprehensive and ongoing emergency care database in south-west Victoria by collating data where it is not collated, and linking currently unlinked data. Data will be collected from all rural hospitals in south-west Victoria. (This scalable project will consider extension of data collection to 14 hospitals in the Grampians sub-region, and potential further.)

The project’s outcomes provide for both clinical service delivery and research benefits. Small hospitals will gain a new source of information to guide service delivery, while researchers will benefit by gaining access to data. Rural communities requiring emergency care will benefit from both.

The project’s outputs will be development of a working emergency care database for the south-west sub-region’s hospitals and a ready source of data for research, publication in academic journals and conference presentations.

To read more about this project, including the findings please click here.


Whole of systems trial of prevention strategies for childhood obesity: WHO STOPS childhood obesity $50,000 NHMRC partnership grant

Investigators: Prof Steven Allender, Dr Lynne Millar, A/Prof Andrew Bell, Prof Marjorie Moodie, Prof Robert Carter and Prof Boyd Swinburn, Deakin University

Partnering institutions: Deakin University, Western District Health Service, Southern Grampians and Glenelg Primary Care Partnership, Department of Health and Human Services for the State of Victoria, Southern Grampians Shire Council, Glenelg Shire Council, Barwon Health, Portland District Health, Colac Area Health and Western Alliance

For completion by: 2020

It is hypothesised that a systems intervention for childhood obesity will be effective in its impact, efficient in its implementation, scalable in its delivery and sustainable in its longevity. This 5-year study, supported by the NHMRC, Western Alliance and other regional partners, is testing effectiveness using a range of individual anthropometry and behavioural measures and community measures of capacity, system and environment change. The study is assessing efficiency, affordability and economic impact in the economic component. The stepped-wedge design allows for the testing of scalability (increasing participating communities) and sustainability (dose response of time exposed within trial compared to external comparator).


What matters most study

Investigators: Prof David M Ashley, A/Prof Charlie Corke and Dr Violet Mukaro, Barwon Health; Dr Renee Otmar, Western Alliance

For completion by: December 2017

Funded by the Department of Health, this project will use a simple, easy-to-use questionnaire to demonstrate the efficacy of engaging cancer patients in documenting their treatment priorities and goals. Data from the study will provide strong evidence to support widespread introduction of the tool into clinical practice. By evaluating the perspectives of both patients and clinicians, the study will be able to assess resistance, and the nature of that resistance, that might impede the integration of the questionnaire into clinical practice.


2015-2016

Development of a Grampians small towns cancer strategy, $80,000

Investigators: Prof Richard Osborne, Roy Batterham, Dr Alison Beauchamp, Prof Trish Livingston, Dr Siew Lim and Carol Wildey, Deakin University; Glenn Reeves and Joanne Gell, Grampians Integrated Cancer Services; Andrew Howard, Grampians Pyrenees Primary Care Partnership

For completion by: June 2017

A recent needs assessment conducted across the Grampians region found that people in small towns face particular barriers to their participation in care across the cancer journey. This study will work with a range of stakeholders from services and community groups in small towns in the Grampians region to develop strategies to overcome these barriers. The study will lay the groundwork for the development of a framework to guide small town service development nationally.This project is a collaboration of researchers, clinicians and the local communities in participating towns. In addition, the project provides a focal point for new collaborations between researchers at Deakin University and clinician–researchers at Grampians Integrated Cancer Services.


Farm-related major trauma in Victoria and both the long-term and immediate impact on recovery (Pedler et al.), $40,000

Investigators: Prof Daryl Pedler, Meg Murray and Jessica Beattie, Deakin University; Prof Belinda Gabbe, Monash University, A/Prof Susan Brumby, National Centre for Farmer Health

For completion by: June 2017

Farms are known to be dangerous sites for both work and leisure activities, but few studies have explored in detail the effects of farm-related injury. This study will measure the social, mental and physical effects of farm-based major trauma. The aim is to provide a realistic insight into the barriers that prevent farmers from returning to a pre-injury lifestyle and to identify interventions that may assist in promoting a return to their pre-injury work role. This project is a collaboration of researchers and clinicians from Deakin University, Monash University and the National Centre for Farmer Health.


Does 20-minute rounding reduce the number of falls in aged care? $30,000

Investigators: Bronwyn Roberts, Katherine Armstrong and Tatum Pretorius, Western District Health Service; Hannah Beks and Dr Kara Holloway, Deakin University; Dr Alison Kennedy, National Centre for Farmer Health

For completion by: June 2017

Falls in aged care continue to be problematic and often result in injury. Hourly ‘staff rounding’ of aged-care residents at high risk of falls (to observe and intervene if necessary), has been shown to be effective in reducing the incidence falls and relate injury. This study aims to examine whether staff rounding on a 20-minute basis can further reduce falls and minimise falls-related injury. This project is a collaboration of nursing and allied health clinicians in aged care at 6 sites of Western District Health Service and Deakin University.


Antimicrobial stewardship in general practice: R3/S7 (Athan et al.), $30,000

Investigators: Prof Eugene Athan and Alicia Neels, Barwon Health

For completion by: December 2018

Antimicrobial resistance is a global crisis threatening the benefits of many contemporary medical advancements, including chemotherapy, transplantation and prosthetic joint replacement. Prudent use of antibiotic medicines will slow down or possibly halt emerging resistance. This study is the first of its kind to prospectively measure the effect of education and training on the prescribing behaviour of general practitioners (GPs) in Australia. There is evidence of inappropriate, excessive and prolonged antibiotic prescribing, which is increasing the risk of antibiotic resistance and adverse effects such as antibiotic-related diarrhoea.


Whole of systems trial of prevention strategies for childhood obesity: WHO STOPS childhood obesity, $50,000, NHMRC partnership grant

Investigators: Prof Steven Allender, Dr Lynne Millar, A/Prof Andrew Bell, Prof Marjorie Moodie, Prof Robert Carter and Prof Boyd Swinburn, Deakin University

Partnering institutions: Deakin University, Western District Health Service, Southern Grampians and Glenelg Primary Care Partnership, Department of Health and Human Services for the State of Victoria, Southern Grampians Shire Council, Glenelg Shire Council, Barwon Health, Portland District Health, Colac Area Health and Western Alliance

For completion by: 2020

It is hypothesised that a systems intervention for childhood obesity will be effective in its impact, efficient in its implementation, scalable in its delivery and sustainable in its longevity. This 5-year study, supported by the NHMRC, Western Alliance and other regional partners, is testing effectiveness using a range of individual anthropometry and behavioural measures andcommunity measures of capacity, system and environment change. The study is assessing efficiency, affordability and economic impact in the economic component. The stepped-wedge design allows for the testing of scalability (increasing participating communities) and sustainability (dose response of time exposed within trial compared to external comparator).


What matters most study

Investigators: Prof David M Ashley, A/Prof Charlie Corke and Dr Violet Mukaro, Barwon Health; Dr Renee Otmar, Western Alliance

For completion by: December 2017

Funded by the Department of Health, this project will use a simple, easy-to-use questionnaire to demonstrate the efficacy of engaging cancer patients in documenting their treatment priorities and goals. Data from the study will provide strong evidence to support widespread introduction of the tool into clinical practice. By evaluating the perspectives of both patients and clinicians, the study will be able to assess resistance, and the nature of that resistance, that might impede the integration of the questionnaire into clinical practice.


2014-2015

SEA Change: Preventing childhood obesity within the Great South Coast, beginning with Portland (Allender et al.), $100,000

Led by Professor Steven Allender, colleagues and collaborators in western Victoria, this project took a systems approach to reducing obesity. Communities of the Great South Coast of Victoria partnered with obesity experts at Deakin University to deliver sustained change in the weight status of children. They sought to change the ways in which families, communities and organisations do things, so that healthy weight is the norm rather than the exception. Obesity is a national priority as well as a local one: in parts of the Great South Coast, up to 48 per cent of children have been measured as overweight or obese.

Through its funding of this project, Western Alliance provided support for:

  • children to live, learn and play in communities that encourage healthy eating and active lifestyles
  • collection of data and information to inform local, state and national policy and practice on obesity prevention
  • development of an innovative, scientific approach to childhood obesity prevention
  • workforce capacity building in research.

Integrating alcohol and drug prevention and treatment services in western Victoria: A community wide approach to reducing harm (Toumbourou et al.), $80,000

Led by Professor John Toumbourou, colleagues and collaborators, this project took a systems-wide approach to reducing harms associated with alcohol and other drug use. Communities across the western region of Victoria partnered with experts at Deakin University in a range of interventions designed to reduce harmful alcohol and drug use. The project continued successful interventions that have reduced alcohol supply to adolescents and reduced adolescent alcohol consumption.

The project’s aims:

  1. To develop a monitoring system that will provide accurate annual estimates for the City of Warrnambool and the Shires of Moyne, Glenelg, Southern Grampians, Horsham City and Corangamite of trends in: youth rates of alcohol and drug use; youth alcohol and drug supply sources; community norms unfavourable to youth alcohol and drug use; rates of sales of alcohol to underage youth; perceived community support for effective prevention and screening and early intervention services; implementation of screening, early intervention and treatment services; rates of client participation in AOD services; and rates of adult alcohol and drug-related harms
  2. To conduct annually repeated surveys (and later an intervention) with primary care and AOD staff to monitor changes in: perceived community support for effective prevention and screening and early intervention services; and implementation of screening, early intervention and treatment service. Harmful alcohol and drug use is a national priority as well as a local one: compared to Victoria, the western region has higher rates of alcohol-related problems, including assaults, hospitalisations and family incidents. These are related to higher densities of liquor licenses that result in competitive pressures to illegally supply alcohol to minors and intoxicated patrons.The high rate of alcohol problems is also related to an earlier age of introduction to alcohol use relative to metropolitan areas. In recent years the region has been taking effective steps to reduce these problems.

Through its funding of this project, Western Alliance provided support for the development of:

  • community support for health care staff advising patients on how to cut back on harmful alcohol and drug use
  • collection of data and information to inform local, state and national policy and practice on prevention of harms associated with alcohol and other drugs
  • development of an innovative scientific study of approaches to increasing health care advice to patients about alcohol and drug use
  • workforce capacity building in research.

Ageing, chronic disease and injury (ACDI) in western Victoria: Opportunities to improve health delivery (Pasco et al.), $100,000

Led by Professor Julie Pasco, colleagues and collaborators across the region, this project aimed to establish the extent and influence of ageing on disease and injury in western Victoria. The project collected new data and drew on existing information collected by various agencies to provide a detailed snapshot of the health and safety of people living in the region and its relationship to age.

This information is required to identify gaps and plan changes to services and infrastructure to better serve the community. The global burden of chronic disease is growing and is expected to escalate because of the expanding and ageing population. In western Victoria, the burden of chronic disease and its consequent effect on physical disability, psychological distress, dementia and mortality is set to grow in accordance with this trend. The region also has pockets of older populations that are more remote and isolated, particularly those living on farms.

Through its funding of this project, Western Alliance provided support for:

  • description and better understanding of the burden of chronic disease and injury in the western region
  • planning of future interventions as well as their evaluation
  • collection of data and information to inform local, state and national policy and practice
  • development of an innovative, scientific approach to data collection on chronic disease and injury in western Victoria
  • workforce capacity building in research.

Improving the primary prevention of heart disease in rural and regional populations: A Practice Nurse-led absolute risk assessment clinic: HeartsFirst Study

Led by Dr John Rolley, this pilot project developed and tested a Practice Nurse-led clinic to assess the cardiovascular risk of otherwise healthy patients attending a general practitioner (GP) practice located in the Great South Coast Medicare Local region. Practices identified for this project are located within high-risk areas for cardiovascular disease. The project duration was 8 months, commencing in mid-2014.


For more information on these projects, log into HealthTrax

  • About the author: Western Alliance

If you would like to write an article for our Talking Points newsletter or In Brief blog, email Cassandra Hamilton (cassandrahamilton@westernalliance.org.au) or call 03 4215 2900.