ORCID Profile
0000-0002-8257-7772
Current Organisation
University of Sydney
Does something not look right? The information on this page has been harvested from data sources that may not be up to date. We continue to work with information providers to improve coverage and quality. To report an issue, use the Feedback Form.
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Criminology | Mechanical engineering | Classical physics | Physical sciences | Engineering | Human society | Paediatrics | Midwifery | Oncology and carcinogenesis | Environmental Science and Management | Aboriginal and Torres Strait Islander Environmental Knowledge | Environmental Management | Health sciences | Biomedical and clinical sciences | Aboriginal and Torres Strait Islander Health |
Aboriginal and Torres Strait Islander Health - Determinants of Health | Health Inequalities | Environmental Health
Publisher: MDPI AG
Date: 07-10-2021
Abstract: Smoking in pregnancy remains a public health challenge. Our team developed a comprehensive intervention using the Behaviour Change Wheel to support clinicians’ implementation of guidelines on supporting women to stop smoking in pregnancy. Integral to the intervention was a suite of evidence-based video and print materials. This paper describes the rationale and process for developing these materials. Comprehensive mixed methods research was undertaken to identify the key barriers and enablers for clinicians in implementing the guidelines. This research identified which behaviours required change, and which behaviour change techniques were best suited to effecting that change. Materials were developed based on this understanding, in a collaborative process with multiple stakeholders, and their feasibility and acceptability explored in a small trial. Materials developed included leadership, clinician and client resources. There are considerable advantages to systematically and collaboratively developing materials which are integral to a behaviour-change intervention even though it is resource intensive to do so.
Publisher: Walter de Gruyter GmbH
Date: 1993
Publisher: Springer Science and Business Media LLC
Date: 05-03-2020
Publisher: MDPI AG
Date: 24-05-2022
Abstract: Flood events can be dramatic and traumatic. People exposed to floods are liable to suffer from a variety of adverse mental health outcomes. The adverse effects of stressors during the recovery process (secondary stressors) can sometimes be just as severe as the initial trauma. Six months after extensive flooding in rural Australia, a survey of 2530 locals was conducted focusing on their flood experiences and mental health status. This mixed methods study analysed (a) quantitative data from 521 respondents (21% of total survey respondents) who had insurance coverage and whose household was inundated, 96 (18%) of whom reported an insurance dispute or denial and (b) qualitative data on insurance-related topics in the survey’s open comments sections. The mental health outcomes were all significantly associated with the degree of flood inundation. The association was strong for probable PTSD and ongoing distress (Adjusted Odds Ratios (AORs) with 95% confidence intervals 2.67 (1.8–4.0) and 2.30 (1.6–3.3), respectively). The associations were less strong but still significant for anxiety and depression (AORs 1.79 (1.2–2.7) and 1.84 (1.2–2.9)). The secondary stressor of insurance dispute had stronger associations with ongoing distress and depression than the initial flood exposure (AORs 2.43 (1.5–3.9) and 2.34 (1.4–3.9), respectively). Insurance was frequently mentioned in the open comment sections of the survey. Most comments (78% of comments from all survey respondents) were negative, with common adverse trends including dispute/denial, large premium increases after a claim, inconsistencies in companies’ responses and delayed assessments preventing timely remediation.
Publisher: Elsevier BV
Date: 07-2023
Publisher: BMJ
Date: 11-2015
Publisher: Walter de Gruyter GmbH
Date: 1992
Publisher: CSIRO Publishing
Date: 2013
DOI: 10.1071/AH12152
Abstract: Background. Research on frequent or avoidable hospital admission has not focussed on the perspectives of service providers or rural settings. The link between social isolation and admission is not well explored, although social isolation is known to have negative health effects. Objective. This paper reports further analysis from a study investigating service providers’ perspectives on factors influencing frequent hospital admission in older patients with chronic disease, and explores the perceived role of social isolation. Methods. Semi-structured interviews with 15 purposively s led community-based service providers in rural New South Wales, Australia were thematically analysed. Results. Social isolation was repeatedly identified as an important contributory factor in frequent and/or avoidable admission. Patients were described as socially isolated in three broad and interrelating ways: living alone, not socialising and being isolated from family. Social isolation was perceived to contribute to admission by limiting opportunities offered by social interaction, including opportunities for: improving mental health, pain tolerance and nutritional status facilitating access to services reinforcing healthful behaviours and providing a monitoring role. Conclusions. Social isolation is perceived to contribute to admission in ways that may be amenable to intervention. Further research is needed to understand patients’ perspectives on the role of social isolation in admission, in order to inform policy and programs aimed at reducing hospitalisation among older people with chronic disease. What is known about the topic? Social isolation has been shown to adversely affect physical health and mental health and wellbeing across a range of populations. However, less is known about the influence of social isolation on hospital admission among older people with chronic disease, and in particular in instances where admission might have been avoided. What does this paper add? This paper adds to our understanding of the ways in which social isolation might link to hospital admission among older people with chronic conditions. It does this by reporting the perspectives of community-based service providers with many years’ experience of working with this patient group. What are the implications for practitioners? Practitioners need to consider the wider determinants of hospital admission among older patients with chronic disease, including social structures and support. For policy makers the implications are to review support for such patients and explore the possible impact of reducing social isolation on hospital admission.
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/PY17191
Abstract: Developing and targeting interventions to reduce hospital admissions for ambulatory care sensitive (ACS) chronic conditions for older people is a key focus for improvement of the health system. To do this, an understanding of any modifiable factors that may contribute to such admissions is needed. To date, the literature on ACS admissions has rarely included the patient perspective. This qualitative study involved one-to-one telephone interviews with 24 patients aged ≥45 years who had had an unplanned admission for an ACS chronic condition to one of two participating regional hospitals between February and August 2015. Data were transcribed and analysed thematically. Most participants did not perceive their admission to be preventable, yet they described a series of interlinking factors, which may have contributed to their admission and which may offer potential points of leverage. Key interlinked themes interpreted were: ‘support deficits’, ‘non-adherence to treatment’ (including medication), ‘mental health’ and ‘lack of awareness or understanding of condition’. Improving system-, clinician- and patient-level factors within a framework of appropriately resourced and supported comprehensive primary health care that is accessible, affordable, holistic, practical and evidence-based may contribute to improving patients’ quality of life and to delaying or preventing hospital admission.
Publisher: MDPI AG
Date: 19-05-2023
Abstract: Global warming is bringing with it continued long-term changes in the climate system. Extreme weather-related events, which are already becoming a daily reality around the world, are predicted to be more intense and frequent in the future. The widespread occurrence of these events and climate change more broadly are being experienced collectively and at scale and do not affect populations evenly. These climate changes have profound impacts on mental health and wellbeing. Existing reactive responses include frequent implied and direct references to the concept of ‘recovery’. This is problematic in three ways: it conceives of extreme weather events as single, one-off occurrences implies their unexpected nature and contains an integral assumption of an end point where in iduals/communities are ‘recovered’. Models of mental health and wellbeing support (including funding) need to change, shifting away from ‘recovery’ towards a focus on adaptation. We argue that this presents a more constructive approach that may be used to collectively support communities.
Publisher: Public Library of Science (PLoS)
Date: 07-01-2021
DOI: 10.1371/JOURNAL.PONE.0244313
Abstract: Reducing potentially preventable hospitalisations (PPH) is a priority for health services. This paper describes the factors that clinicians perceived contributed to preventable admissions for angina, diabetes, congestive heart failure (CHF) and chronic obstructive pulmonary disease (COPD), and what they considered might have been done in the three months leading up to an admission to prevent it. The study was conducted in a rural and a metropolitan health district in NSW, Australia. Expert Panels reviewed detailed case reports to assess preventability. For those admissions identified as preventable, comments from clinicians indicating what they perceived could have made a difference and/or been done differently to prevent each of the preventable admissions were analysed qualitatively. 148 (46%) of 323 admissions were assessed as preventable. Across the two districts, the most commonly identified groups of contributing factors to preventable admissions were: ‘Systems issues: Community based services missing or inadequate or not referred to’ ‘Patient issues: Problems with adherence/self-management’ and ‘Clinician issues: GP care inadequate’. In some instances, important differences drove these groups of factors. For ex le, in the rural district ‘Systems issues: Community based services missing or inadequate or not referred to’ was largely driven by social and welfare support services missing/inadequate/not referred to, whereas in the metropolitan district it was largely driven by community nursing, allied health, care coordination or integrated care services missing/inadequate/not referred to. Analyses revealed the complexity of system, clinician and patient factors contributing to each admission. Admissions for COPD (rural) and CHF (metropolitan) admissions showed greatest complexity. These findings suggest preventability of in idual admissions is complex and context specific. There is no single, simple solution likely to reduce PPH. Rather, an approach addressing multiple factors is required. This need for comprehensiveness may explain why many programs seeking to reduce PPH have been unsuccessful.
Publisher: American Association for the Advancement of Science (AAAS)
Date: 11-08-2023
Abstract: Indigenous communities shoulder a disproportionate burden of ill health compounded by climate change. In Australia, the oldest surviving cultures have adapted their ecological knowledge over millennia and across climatic ages. However, European colonization has severely curtailed Indigenous peoples’ ability to adjust to climate change. An effective response to the climate crisis requires decolonizing processes to reform our relationship with the planet. From an Australian Indigenous perspective, precursors for a self-determined and healthier future are justice, culture, and relationships. We review existing studies on Indigenous-led contemporary climate and health initiatives to assess these precursors. There are ex les that highlight the need to attend to issues of restorative justice as the basis for respectful valuing of culture and genuine collaboration to address the climate crisis.
Publisher: BMJ
Date: 03-2016
Publisher: Springer Science and Business Media LLC
Date: 06-2015
Publisher: Informa UK Limited
Date: 1994
Publisher: MDPI AG
Date: 21-10-2020
Abstract: In 2017, marginalised groups were disproportionately impacted by extensive flooding in a rural community in Northern New South Wales, Australia, with greater risk of home inundation, displacement and poor mental health. While social capital has been linked with good health and wellbeing, there has been limited investigation into its potential benefits in post-disaster contexts, particularly for marginalised groups. Six months post-flood, a cross-sectional survey was conducted to quantify associations between flood impact, in idual social capital and psychological distress (including probable post-traumatic stress disorder). We adopted a community-academic partnership approach and purposive recruitment to increase participation from socio-economically marginalised groups (Aboriginal people and people in financial hardship). These groups reported lower levels of social capital (informal social connectedness, feelings of belonging, trust and optimism) compared to general community participants. Despite this, informal social connectedness and belonging were important factors for all participant groups, associated with reduced risk of psychological distress. In this flood-prone, rural community, there is a pressing need to build social capital collectively through co-designed strategies that simultaneously address the social, cultural and economic needs of marginalised groups. Multiple benefits will ensue for the whole community: reduced inequities strengthened resilience improved preparedness and lessened risk of long-term distress from disaster events.
Publisher: Springer Science and Business Media LLC
Date: 11-09-2019
DOI: 10.1186/S12889-019-7501-Y
Abstract: Climate change is associated with greater frequency, duration, intensity and unpredictability of certain weather-related events, including floods. Floods harm mental health. There is limited understanding of the mental health and well-being effects from river flooding, particularly over the longer term and in rural contexts. This paper describes the rationale, aims, objectives, study design and socio-demographic characteristics of the s le for a study measuring associations between flood experience and mental health and wellbeing of residents (particularly those most likely to be negatively impacted and hard to reach) in rural NSW Australia 6 months following a devastating flood in 2017. To our knowledge, the study is the first of its kind within Australia in a rural community and is an important initiative given the likelihood of an increasing frequency of severe flooding in Australia given climate change. A conceptual framework ( The Flood Impact Framework ) drawing on social ecological approaches was developed by the research team. It was based on the literature and feedback from the community. The Framework describes putative relationships between flood exposure and mental health and wellbeing outcomes. Within a community-academic partnership approach, a cross-sectional survey was then undertaken to quantify and further explore these relationships. The cross-sectional survey was conducted online (including on mobile phone) and on paper between September and November 2017 and recruited 2530 respondents. Of those, 2180 provided complete demographic data, among whom 69% were women, 91% were aged 25–74, 4% identified as Aboriginal and/or Torres Strait Islander, 9% were farmers and 33% were business owners. The study recruited a wide range of respondents and the partnership facilitated the community’s engagement with the design and implementation of the study. The study will provide a basis for a follow-up study, that will aim to improve the understanding of mental health and wellbeing effects over the longer term. It will provide an important and original contribution to understanding river flooding and mental health in rural Australia, a topic that will grow in importance in the context of human-induced climate change, and identify critical opportunities to strengthen services, emergency planning and resilience to future flooding.
Publisher: MDPI AG
Date: 03-07-2023
Abstract: Climate change is exposing populations to increasing temperatures and extreme weather events in many parts of Australia. To prepare for climate challenges, there is a growing need for Local Health Districts (LHDs) to identify potential health impacts in their region and strengthen the capacity of the health system to respond accordingly. This rapid review summarised existing evidence and research gaps on the impact of climate change on health and health services in Northern New South Wales (NSW)—a ‘hotspot’ for climate disaster declarations. We systematically searched online databases and selected 11 peer-reviewed studies published between 2012–2022 for the Northern NSW region. The most explored health outcome was mental health in the aftermath of floods and droughts, followed by increased healthcare utilisation due to respiratory, cardiovascular and mortality outcomes associated with bushfire smoke or heat waves. Future research directions were recommended to understand: the compounding impacts of extreme events on health and the health system, local data needs that can better inform models that predict future health risks and healthcare utilisation for the region, and the needs of vulnerable populations that require a whole-of-system response during the different phases of disasters. In conclusion, the review provided climate change and health research directions the LHD may undertake to inform future adaptation and mitigation policies and strategies relevant to their region.
Publisher: Oxford University Press (OUP)
Date: 29-03-2011
DOI: 10.1093/NTR/NTR030
Abstract: The aims of this study were to explore home smoking behaviors and the motivators and barriers to smoke-free homes among a group of disadvantaged caregivers for young children and to identify the positive levers that health care professionals can utilize when supporting smoking behavior change. In-depth qualitative interviews were conducted between July and September 2009, with 22 disadvantaged smoking caregivers, accessing Children's Centre Services in Nottingham, UK. Interviews were audiorecorded and transcribed verbatim. Data were coded and analyzed thematically to identify emergent main and subthemes. Caregivers had some general understanding of the dangers of secondhand smoke (SHS), but their knowledge appeared incomplete and confused. All interviewees described rules around smoking in the home however, these tended to be transient and fluid and unlikely to be effective. Caregivers were often living in difficult and complex circumstances and experienced significant barriers to creating a smoke-free home. The motivators for change were more strongly linked to house decor and smell than children's health, suggesting that visible evidence of the harm done by SHS to children might help promote smoke-free homes. Findings suggest that further tailored information on the effect of SHS is required, but to instigate caregiver behavior change, providing demonstrable evidence of the impact that their smoking is having on their children's health is more likely to be effective.
Publisher: Wiley
Date: 27-08-2016
DOI: 10.1111/AJR.12233
Abstract: Integration of mental health services is a prominent Australian mental health policy goal however, there is little detail in the literature of how integrated mental health services are established or function. This study aimed to describe a nurse practitioner-led primary healthcare rural mental health service and evidence of how the service was integrated with other services and the community. This pragmatic exploratory study used case study methodology and analysed documents, quantitative data and qualitative data from in idual and group semi-structured interviews and a 'stakeholder meeting'. The study was part of a formal evaluation of this nurse practitioner service. Rural New South Wales. Twenty-one service providers and stakeholders. Introduction of a nurse practitioner led mental health service. Not applicable. Purposely s led participants were interviewed. Documentary evidence included briefing notes, minutes and progress reports and provided important background information. Non-identifiable aggregated client data were analysed. Thematic analysis of the qualitative data produced a description of how and why the service was established, a description of the service and its impact and three analytic themes providing evidence of integration. Challenges to integrating this service are also discussed. The service was highly regarded. It addressed the drug and alcohol and mental health needs of a vulnerable rural community. The inception and implementation of the service were community driven, led by a number of agencies supported by a steering committee and underpinned by a Partnership Agreement. The service demonstrated key features of integration alongside experiencing challenges in optimising integration with acute mental health services.
Publisher: Wiley
Date: 06-07-2016
DOI: 10.1111/AJR.12310
Publisher: Elsevier BV
Date: 05-2013
Publisher: Springer Science and Business Media LLC
Date: 30-10-2012
Publisher: MDPI AG
Date: 24-07-2023
Abstract: Rigorous and effective evaluations inform policy and service delivery and create evidence of program impacts and outcomes for the communities they are designed to support. Genuine engagement of communities is a key feature of effective evaluation, building trust and enhancing relevancy for communities and providing meaningful outcomes and culturally relevant findings. This applies to Indigenous peoples’ leadership and perspectives when undertaking evaluations on programs that involve Indigenous communities. This systematic scoping review sought to explore the characteristics of culturally informed evaluations and the extent of their application in Australia, including the use of specific evaluation tools and types of community engagement. Academic and grey literature were searched between 2003 and 2023, with 57 studies meeting the inclusion criteria. Over time, there was an increase in the number of culturally informed evaluations undertaken, predominantly in the health and wellbeing sector. Around a quarter used a tool specifically developed for Indigenous evaluations. Half of the publications included Indigenous authorship however, most studies lacked detail on how evaluations engaged with communities. This review highlights the need for further development of evaluation tools and standardised reporting to allow for shared learnings and improvement in culturally safe evaluation practices for Aboriginal and Torres Strait Islander communities.
Publisher: Elsevier BV
Date: 08-2017
DOI: 10.1016/J.WOMBI.2016.11.010
Abstract: The past two decades have seen progressive decline in the number of rural birthing services across Australia. Despite health system pressures on small birthing units to close there have been ex les of resistance and survival. This descriptive study explored the evolution of a rural birthing service in a small town to offer insight into the process of transition which may be helpful to other small healthcare services in rural Australia. Quantitative data derived from birth registers on number and types of birth from 1993-2011 were analysed. Interviews were conducted between January and August 2012 with nine participants (GP obstetricians, midwives, a health service manager and a consumer representative). This rural maternity service developed gradually from a GP obstetrician-led service to a collaborative care team approach with midwifery leadership. This development was in response to a changing rural medical workforce, midwifery capacity and the needs and wants of women in the local community. Four major themes were developed from interview data: (1) development of the service (2) drivers of change (3) outcomes and (4) collaborative care and inter-professional practice. The success of this transition was reported to rest on strategic planning and implementation and respectful inter-professional practice and alignment of birth philosophy across the team. This team created a unified, progressive community-focused birthing service. The development of collaborative care models that embrace and build on established inter-professional relationships can maximise existing rural workforce potential and create a sustainable rural service into the future.
Publisher: Elsevier BV
Date: 06-2012
DOI: 10.1016/J.MIDW.2011.12.011
Abstract: This paper is an empirically informed opinion piece revisiting an argument published in Midwifery 10 years ago, that the increasing professionalisation of breast feeding was not supporting women in Australia in sustaining breast feeding. We present the last 10 years of primary research on the topic, explore major policy initiatives and the establishment and growth of lactation consultants in Australia to see if this has made a difference to sustained rates of breast feeding. We present an analysis of the only consistently collected national statistics on breast feeding and compare this with national and state level government data collections from the last decade. We have found that the considerable effort invested in trying to improve duration of breast feeding amongst women in Australia appears to have failed to improve sustained breast-feeding rates. We argue that this situation might be related to losing sight of the embodied nature of breast feeding and the relationships that must exist between the mother and baby, the knowledge and skills women quickly develop, and a loss of woman to woman support. We conclude that midwives have a major role in avoiding us reproducing similar, unintended, negative consequences to those resulting from increasing obstetrician managed normal birth. These include midwifery scrutiny and involvement in policy development and institutional practices and the design of services.
Publisher: AMPCo
Date: 09-2013
DOI: 10.5694/MJA13.10129
Publisher: Springer Science and Business Media LLC
Date: 12-10-2011
Publisher: BMJ
Date: 07-2013
Publisher: Elsevier BV
Date: 03-2018
DOI: 10.1016/J.MIDW.2017.12.016
Abstract: this study aimed to explore the enablers and barriers to implementation of the Australian smoking cessation in pregnancy guidelines. These guidelines direct clinicians to follow the 5As of cessation: Ask, Advise, Assess, Assist and Arrange follow-up. semi-structured interviews based on the Theoretical Domains Framework (TDF) elicited clinicians' views and experiences of implementing the guidelines. antenatal care in the NSW public health system. 27 maternity service managers, obstetricians and midwives. participants confirmed that implementation of the smoking cessation guidelines was sub-optimal. This was particularly the case with Assist and Arrange follow up at the initial visit, and with following any of the 5As at subsequent visits. Key barriers included systems which did not support implementation or monitoring, lack of knowledge, skills and training, perceived time restrictions, 'difficult conversations' and perceiving smoking as a social activity. Enablers included clinicians' knowledge of the harms of smoking in pregnancy, clinicians' skills in communicating with pregnant women, positive emotions, professional role and identity, the potential of training and of ch ions to influence practice, and systems that regulated behaviour. these findings will contribute to the development of a multifaceted intervention to support clinicians in implementing the guidelines. Building on existing strengths, antenatal care providers may be supported in implementing the guidelines by working with systems which remind and support implementation, the clear reframing of smoking as an addiction, knowledge and skills development and by realizing the potential of leadership to maximise the impact of reinforcement and social influence.
Publisher: SAGE Publications
Date: 04-10-2023
Publisher: Elsevier BV
Date: 11-2017
DOI: 10.1016/J.HEALTHPOL.2017.09.012
Abstract: In Australia, many small birthing units have closed in recent years, correlating with adverse outcomes including a rise in the number of babies born before arrival to hospital. Concurrently, a raft of national policy and planning documents promote continued provision of rural and remote maternity services, articulating a strategic intent for services to provide responsive, woman-centred care as close as possible to a woman's home. The aims of this paper are to contribute to an explanation of why this strategic intent is not realised, and to investigate the utility of an evidence based planning tool (the Toolkit) to assist with planning services to realise this intent. Interviews, focus groups and a group information session were conducted involving 141 participants in four Australian jurisdictions. Field notes and reports were thematically analysed. We identified barriers that helped explain the gap between strategic intent and services on the ground. These were absence of informed leadership lack of knowledge of contemporary models of care and inadequate clinical governance poor workforce planning and use of resources fallacious perceptions of risk and a dearth of community consultation. In this context, the implementation of policy is problematic without tools or guidance. Barriers to operationalising strategic intent in planning maternity services may be alleviated by using evidence based planning tools such as the Toolkit.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
Start Date: 2017
End Date: 2018
Funder: Cancer Institute NSW
View Funded ActivityStart Date: 2012
End Date: 2016
Funder: National Health and Medical Research Council
View Funded ActivityStart Date: 2014
End Date: 2014
Funder: Wellcome Trust
View Funded ActivityStart Date: 2014
End Date: 2014
Funder: University of Sydney
View Funded ActivityStart Date: 08-2022
End Date: 08-2026
Amount: $1,389,000.00
Summary: Healing Country: integrating knowledge systems to meet climate challenges. Aboriginal and Torres Strait Islander communities are currently experiencing severe environmental challenges related to a changing climate. Led by Aboriginal communities, this project aims to integrate traditional knowledges and environmental and health data to create community story-data maps. These interactive, online maps will be a unique and powerful blend of information, providing a rich evidence base, decision-suppo .... Healing Country: integrating knowledge systems to meet climate challenges. Aboriginal and Torres Strait Islander communities are currently experiencing severe environmental challenges related to a changing climate. Led by Aboriginal communities, this project aims to integrate traditional knowledges and environmental and health data to create community story-data maps. These interactive, online maps will be a unique and powerful blend of information, providing a rich evidence base, decision-support and communication tool to inform the co-design of local climate change mitigation, adaptation and resilience plans. The project aims to give agency to Aboriginal communities in leading a systems change process to reduce environmental risks and strengthen health and wellbeing. Read more Read less
Funder: Australian Research Council
View Funded Activity