What People With Aphasia Want: Towards Person-centred Goal-setting In Aphasia Rehabilitation
Funder
National Health and Medical Research Council
Funding Amount
$427,702.00
Summary
Consumers of health services expect their concerns and priorities to form part of their health care. People with aphasia have difficulty communicating their needs and speech pathologists are challenged to plan therapy to meet aphasic clients' needs. Family members of people with aphasia also have unrecognised concerns. The first aim of this study is to determine the goals of people with aphasia and their families and to gain their perspective of whether these goals were addressed in speech thera ....Consumers of health services expect their concerns and priorities to form part of their health care. People with aphasia have difficulty communicating their needs and speech pathologists are challenged to plan therapy to meet aphasic clients' needs. Family members of people with aphasia also have unrecognised concerns. The first aim of this study is to determine the goals of people with aphasia and their families and to gain their perspective of whether these goals were addressed in speech therapy. The study will then seek the perspective of their treating speech pathologists about the goals of therapy and the challenges that speech pathologists face in practising person-centered goal setting. This study will not only provide a framework for aphasia services in Australia but also provide data that will inform professional educational programs about person-centered practice for speech pathologists and other health professionals. It will also contribute to current theories on collaborative goal setting in a rehabilitation context.Read moreRead less
Economic Evaluation Of The Costs And Benefits Of Options For Publicly Funded Dental Care Provision In Australia
Funder
National Health and Medical Research Council
Funding Amount
$219,135.00
Summary
Governments and administrators of public dental services (PDS) currently address resource allocation problems with little guidance from the public. This project will provide evidence of population priorities that can underpin planning for public dental care and provide direction for priorities in PDS A cost-benefit analysis of dental care, to guide future decisions, will be conducted by comparing the community's willingness to pay for dental services and the cost of providing those services.
Patient Preferences For Adjuvant Chemotherapy In Early Breast Cancer: What Makes It Worthwhile?
Funder
National Health and Medical Research Council
Funding Amount
$69,420.00
Summary
Adjuvant chemotherapy, used in addition to surgery and radiation, improves recurrence and survival rates in women with early breast cancer. These gains must be balanced against the side effects and inconvenience of chemotherapy including hair loss, nausea, tiredness and risk of infection. This study will determine the gains considered necessary to make modern adjuvant chemotherapy for early breast cancer worthwhile by asking women who have had such treatment. It will determine factors that might ....Adjuvant chemotherapy, used in addition to surgery and radiation, improves recurrence and survival rates in women with early breast cancer. These gains must be balanced against the side effects and inconvenience of chemotherapy including hair loss, nausea, tiredness and risk of infection. This study will determine the gains considered necessary to make modern adjuvant chemotherapy for early breast cancer worthwhile by asking women who have had such treatment. It will determine factors that might influence the gain considered necessary, such as the kind of treatment, the severity of the side effects experienced, social and other factors. Three hundred women who have had modern adjuvant chemotherapy in an ongoing international clinical trial will be recruited and interviewed. The interviews are standardised, scripted and administered by trained researchers to avoid influencing the subjects. Diagrams and props are used to make the questions clearer. Evaluation of these aids is an additional aspect of the project. This information will be invaluable for women and clinicians considering this potentially curative treatment over the next 15 years. The study will also provide new knowledge on how best to provide information about the benefits of treatment. This can then be applied to discussions about treatment in routine clinical practice. The methods are suitable for a wide range of questions in other diseases and settings. The project will be extended to develop the materials for other questions in breast cancer and other settings.Read moreRead less
Health Care Priorities: The Community's Preferences For Using Community Preferences
Funder
National Health and Medical Research Council
Funding Amount
$52,355.00
Summary
Determining how health care resources should be allocated - often termed rationing or priority setting - has traditionally been carried out by health care personnel, usually doctors but increasingly managers. More recently there has been a move to involve the general public in this process. Much of the research in this area has focussed on the methods used to elicit community preferences. While this is an important area of investigation, a prior issue of how community members feel about the use ....Determining how health care resources should be allocated - often termed rationing or priority setting - has traditionally been carried out by health care personnel, usually doctors but increasingly managers. More recently there has been a move to involve the general public in this process. Much of the research in this area has focussed on the methods used to elicit community preferences. While this is an important area of investigation, a prior issue of how community members feel about the use of their preferences in informing health care priorities needs to be investigated. Four specific questions will be addressed in this study: (i) do members of the general public feel that, as individuals, they have a legitimate role to play in informing priority decisions in health care? if so why? if not, why not? (ii) does the nature-level-setting of the decisions for which priorities are to be set affect whether individual members of the public would wish to participate in the priority setting process? (e.g. different health services, medical procedures-treatments, diseases) (iii) whose preferences should be used if not the community's? (iv) faced ex post with the preferences of the community and the preferences (possibly different) of health service decision makers (i.e. Oexperts'), does this knowledge affect preferences for having community preferences count? A number of health authorities are currently looking for ways of engaging local communities in health care decision making. This study will indicate the appropriate levels at which community preferences are to be elicited and the type of decisions and settings in which they are most relevant.Read moreRead less
Long Term Impact, Capacity Gains And Cost-effectiveness Of A Successful Community-wide Child Obesity Prevention Program
Funder
National Health and Medical Research Council
Funding Amount
$703,191.00
Summary
Be Active, Eat Well is the first community-wide obesity prevention project to successfully reduce the weight and waist gain of children. The 'intervention' was to 'boost' community capacity to enable the local organisations to create their own solutions to childhood obesity. This research will continue to assess the project 3 years after that 'boost' to determine the long-term sustainability, impact and cost-effectiveness of this approach to prevent childhood obesity.
Improving Metabolic Fitness In Aboriginal And Torres Straight Islander Women: A Pragmatic Controlled Trial Of Waist Loss
Funder
National Health and Medical Research Council
Funding Amount
$556,193.00
Summary
Torres Strait Islanders have the highest prevalence of diabetes in Australia and weight gain in young women can increase further the risk of diabetes for themselves and their babies. Waist loss can reduce the risk of diabetes and heart disease. A pilot study in the Torres Strait in 2007, has demonstrated that this is achievable and acceptable in young Indigenous women. This proposal aims to conduct a larger trial, to look at effectiveness and sustainability of waist loss in young women.
Planned Vaginal Birth Or Planned Elective Repeat Caesarean For Women At Term With A Single Previous Caesarean Section
Funder
National Health and Medical Research Council
Funding Amount
$741,750.00
Summary
In Australia over 1 in 5 women give birth by caesarean section. The largest contribution to the total number of caesareans is from women having a repeat caesarean; who have previously had a caesarean. Two care policies are standard for women who have had a previous caesarean; either a planned trial of vaginal birth or a planned elective repeat caesarean. This prospective cohort study will compare the risks and benefits of these two forms of care. The results will help provide better evidence fro ....In Australia over 1 in 5 women give birth by caesarean section. The largest contribution to the total number of caesareans is from women having a repeat caesarean; who have previously had a caesarean. Two care policies are standard for women who have had a previous caesarean; either a planned trial of vaginal birth or a planned elective repeat caesarean. This prospective cohort study will compare the risks and benefits of these two forms of care. The results will help provide better evidence from which to develop health advice that will guide clinical practice, for the optimal care of women who have had a previous caesarean and their infants.Read moreRead less
Empirical Ethics: Quantification Of Social Preferences For Economic Evaluation In The Health Sector
Funder
National Health and Medical Research Council
Funding Amount
$329,450.00
Summary
Recent studies indicate that there are significant differences between the social 'preferences'-priorities of the population and the priorities implied by health policy and embodied in health economic evaluations of the health sector. For example, members of the public give higher priority to the severely ill even when little can be done for them. The studies suggest that the public would also take into account, inter alia, a number of other factors, including prognosis, health potential and the ....Recent studies indicate that there are significant differences between the social 'preferences'-priorities of the population and the priorities implied by health policy and embodied in health economic evaluations of the health sector. For example, members of the public give higher priority to the severely ill even when little can be done for them. The studies suggest that the public would also take into account, inter alia, a number of other factors, including prognosis, health potential and the social context of the problem. They would not treat program costs in the way economic theory and practice recommends. These issues have been dramatised in the WHO's Evaluation of Health Systems (World Health Report 2000). This assigns a weight of only 0.25 to health improvement and 0.75 to issues of fairness. The proposed study will carry out three tasks. The first is to measure the importance of Australian health-related social preferences which should, potentially, be included in economic evaluation studies. Key values - parameters - including the rate of time preference and the social willingness to pay for an additional year of life will be measured precisely for immediate use. Secondly, the importance of other issues including illness severity, adaptation and prognosis will be tested to determine how these factors should be included in the economic evaluation of health programs. Finally, some general issues related to public versus private funding, egalitarianism and choice will be investigated. Results from interviews and surveys will be integrated in the Assessment of Quality of Life (AQoL) instrument and its user manual.Read moreRead less