Population and Health Services Research

The Ingham Institute is a global leader and centre of excellence in population and health services research.

Population and health services research aims to understand the origins of health and disease to improve the wellbeing of all generations, including babies and children. These groups work directly with our diverse and growing community of South West Sydney to develop health services and treatment programs that serve the current and emerging health needs of our community.

Our flagship programs in population and health services research

Patient safety and women’s and children’s health are key areas of focus for the population and health services research stream.

Population health researchers from our Simpson Centre for Health Services Research are developing and evaluating new ways to improve critical care in hospital emergency departments.

Meanwhile, The Centre for Applied Nursing Research (CANR) is focused on enhancing nursing and midwifery practice throughout Australia.

At the heart of our population health research is Maternal Early Childhood Sustained Home Visiting (MECSH), a sustained nurse home-visiting program for families at risk of poorer maternal and child health and development outcomes. Now a global program operating in the UK, Korea and USA, it originated in South Western Sydney as an outreach program for vulnerable and at-risk mothers. The program helps mothers create better home environments and improves the cognitive development of babies and children.

What is BestSTART-SWS?

BestSTART-SWS is a program of research embedded within local clinical services that aims to intervene early to optimise child outcomes and to ensure that no child is left behind.

Our mission is to transform local research and clinical practice, address the key global health issue of non-communicable diseases and enable South West Sydney Local Health District to lead a program, delivering local action with a global impact.

Our focus is school readiness: intervening early to ensure that all children in South Western Sydney have the right building blocks to be physically, psychologically, socially and emotionally ready for school. By supporting vulnerable families during the early childhood period, we will ensure that every child has the best start to life.

There are four components to BestSTART-SWS:

  1. Connecting data to improve health: By connecting data from health, social care and education, we can identify pathways to poor outcomes in children so that we can focus resources where they are needed most.
  2. Embedding treatment into care: BestSTART-SWS will test the effectiveness of different interventions so children can receive early intervention integrated with other services.
  3. Building research capacity: BestSTART-SWS will build research capacity by supporting staff in developing new projects and scaling existing projects.
  4. Community engagement: BestSTART-SWS will integrate the voices of young people and families into current research, so their voices help transform the health system.

 

How does BestSTART work in practice?

We work with young people, families, professionals and with the health system. Young people are invited to participate via co-designing research. We also work with health professionals who would like to transform their ideas into translational research projects. We do this by helping them ‘navigate the system’ and providing them with the logistics they need to carry out great research. Finally, we work with the health system to grow research, implement new ideas and build capacity in the district.

We have collaborators from different universities and disciplines, with a range of expertise. Please contact us at: beststart@inghaminstitute.org.au

 

For more information on BestSTART, click here.

Group Leaders

Professor Valsamma Eapen, Professor Raghu Lingam & Professor Paul Chay

The Centre for Applied Nursing Research (CANR) is a joint collaboration between South Western Sydney Local Health District (SWSLHD) and Western Sydney University School of Nursing and Midwifery (WSU SONM).  CANR is accessible to all employees of SWSLHD and WSU and aims to promote research and professional development within the two communities.

CANR’s purpose is to undertake research and to facilitate and support collaboration between nurses, midwives and academics to undertake research into clinical, health promotion and health education role of nurses and midwives and provide a basis for evidence-based practice.

CANR conducts research in the following areas:

  • Acute and Critical Care
  • Chronic and Complex Care
  • Evidence Based Practice – JBI Systematic & Fellowship Training
  • Mental Health Nursing
  • Patient Safety & Quality
  • Research Education and Training
  • Vascular Access
  • Workforce

 

To learn more, click here, and follow the team on Twitter @weCANResearch.

Group Leader

Dr Steve Frost

Our mission

The Centre for Health Equity Training, Research and Evaluation (CHETRE)’s mission is to ‘co-create intelligence for better and fairer health’ in and beyond South Western Sydney. CHETRE provides leadership and expertise in training, research and evaluation for health equity, which is recognised locally and globally.

CHETRE is :

 

Our work

CHETRE’s work is structured in three streams:

  • The Decision Support stream assesses the impacts of environmental, social, economic and policy change (proposals) on health and health equity and frames its findings in policy-relevant briefings and communications. Grounded in its international reputation in health impact assessment (HIA), the team supports local partners, other CPHCE research hubs, state, national and global health development through training and assessment.
  • The Locational Disadvantage Stream engages with communities in South Western Sydney that experience health and other disadvantages due to complex social and economic challenges. The stream focuses on community development and partnership approaches that empower communities to build resilience and more equitable health.
  • The Indigenous Health stream builds on nearly twenty years of close connections with the Tharawal Aboriginal Corporation and the Aboriginal community in South Western Sydney. At the request of the community, and integrated in its Aboriginal-controlled governance structures, CHETRE has undertaken a unique longitudinal cohort study of the health of Aboriginal Babies since the early 2000s through the Gudaga program (‘Gudaga’ is Tharawal for ‘healthy baby’).

 

Our partnerships

Partnerships are central to all our research and service development activities. Our core partnerships include state government agencies, local governments, community organisations and NGOs, and service providers within and beyond the South Western Sydney Local Health District. CHETRE supports and manages a number of key partnerships with colleagues from the public and social housing sector, urban planning, primary health care, justice, education and social development. These partnerships range in scale from regional, to state-wide, national and global.

To learn more about CHETRE, click here.

Group Leader

Professor Evelyne de Leeuw

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Poor oral health can have a negative impact on various systemic conditions such as cardiovascular disease, diabetes, stroke and adverse pregnancy outcomes. Unfortunately, the majority of the population are unaware of the impact of poor oral health on general health and seldom seek dental care. Oral health is also often neglected in general clinical practice and patient care in Australia.

To address this, it is now recommended that non-oral health professionals such as nurses, midwives, allied health professionals and doctors play a more active role in promoting oral health among their patients. To facilitate this, the School of Nursing and Midwifery at Western Sydney University and South Western Sydney Local Health District Oral Health Services formed the Centre for Oral Health Outcomes and Research Translation (COHORT); an innovative collaboration affiliated with and located within the Ingham Institute for Applied Medical Research. COHORT has also partnered with Nepean Blue Mountains Local Health District Oral Health Services to expand their research program across Greater Western Sydney.

The COHORT group is the first of its kind in Australia focusing on interprofessional oral health care and capacity building and training of non-oral health professionals and undergraduate students in providing oral health education, screening and referrals to their patients. The group also works with Local Health Districts to improve the delivery of oral health services and government bodies, professional organisations and industry partners to improve clinical practice through evidence-based oral health promotion resources and professional development training programs. COHORT has a strong track record in research impact and has influenced oral health policy and translated interprofessional oral health models of care into practice across Australia. COHORT is also a founding member of the Australian Network for Integration of Oral Health and has strong collaborations nationally and internationally including in UK, USA, Nepal, India, Jordan, Finland, Japan and East Timor.

COHORT has twelve research streams which include: Maternity, Paediatrics, Aboriginal Health, Cardiovascular Health, Stroke, Cancer, Diabetes, Aged & Palliative care, Disability, Obesity, Drug Health, and Mental Health. COHORT also has 9 PhD students working across these streams in the area of interprofessional oral health care.

To learn more about COHORT, click here, and follow Associate Professor George on Twitter @AjeshGeorge_ .

Group Leader

Associate Professor Ajesh George

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The Centre for Research, Evidence Management and Surveillance (REMS) was established in 2004 and its team of epidemiologists and biostatisticians conduct research, evaluation and surveillance in population health, promote an evidence-based approach to population health programs, and support graduate and postgraduate learning in population health and epidemiology.

Current research areas are in environmental health and air pollution epidemiology, social epidemiology, neighbourhoods and health, health services for diabetes and stroke, and in the use of spatial methods and linked data for epidemiological research.

REMS program of air pollution and climate research involves investigating the effects of outdoor air pollution on birth defects, effects of bushfires on mortality and hospital admission, the effects of heatwaves on hospital admissions and emergency department visits and estimating the health benefits from reducing outdoor air pollution.

Our health services research focuses on patterns of care and outcomes for subarachnoid haemorrhage and stroke, and investigating best practice primary care for older Australians with diabetes and investigating, with both these projects using record linkage.

Group Leader

Professor Bin Jalaludin

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The Department of Community Paediatrics is committed to their involvement in clinical work and associated research focusing on children with special needs and developmental problems, as well as vulnerable populations of children such as refugees, Aboriginal and children considered to be at a social disadvantage (e.g. children of parents with substance abuse, mental illness or disability and children in “out of home care”).

The Department has been active participants and leaders in the development of evidence-based state-wide, metropolitan, area and local initiatives aiming to improve the health outcomes of children, young people and their families.

In 2010, the Department of Community Paediatrics undertook a range of population needs assessments, systematic reviews and research and evaluation projects arising from the various clinical services they provide to the South West Sydney area.

Additionally, the Department is involved in a number of collaborative child health and development research projects with other agencies/departments such as CHETRE, General Practice and the Department of Community Services.

Group Leader

Associate Professor John Eastwood ED

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The General Practice Unit is a long-standing academic family medicine clinic located in the Fairfield Hospital. Here, we integrate the medical education, research, health services development, and liaison with clinical care delivery. In 2016, the Clinic co-located with the Prairiewood Community Health Centre, on the Fairfield Hospital campus, and the Research Office moved into the Ingham Institute of Applied Medical Research building, in Liverpool.

We provide expert family medicine care to the local community and staff of Fairfield Hospital.  This includes a broad range of primary care services including shared and “stepped up” care with local GPs for patients living with complex care needs, and occupational health services (e.g., fluid exposure injuries).

The Unit trains both clinical and academic GP registrars under the national Australian General Practice Training program. We have a strong focus on health education and promotion, and evidence-based medicine in the program.  This has resulted in our registrars leading a health education program for students with special needs at Fairfield High School, numerous evidence-based health articles in the medical and lay press, and publication of registrar research projects relevant to the local community.

As part of the UNSW Sydney family (SWS Clinical School, School of Public Health and Community Medicine, and the Centre of Primary Health Care and Equity) we are deeply involved in all three phases of the UNSW Medicine program (teaching, assessment, curriculum design, medical education research), and the Unit is an UNSW research facility.

We work closely with the SWS Primary Health Network (SWSPHN) and Local Health District (LHD). We develop, implement, and evaluate innovative and culturally appropriate models of care at the primary-secondary care interface.

Our research and evaluation activities, with funding from agencies including the NHMRC and ARC, are focused on (i) quality primary care, and (ii) health informatics.

The Unit has an emphasis on cultural respect in all its activities. This has special salience in South Western Sydney, with its ethnically and culturally diverse population. This area and its communities has the highest proportion of Aboriginal people in the Sydney basin. We developed a cultural respect program and toolkit, Ways of Thinking and Ways of Doing (WoTWoD), and are evaluating it with a cluster randomised trial, funded by the NHMRC (2014-2017).

The Unit is especially interested in the systematic integration of care between the primary and acute health sectors. For instance, with funding from the Cancer Institute of NSW, we undertook an action research program to improve communication between SWSLHD Cancer Services and local general practice. This quality improvement work is now being extended to other clinical services.

With funding and support from UNSW Medicine and SWSLHD, the Unit established its major health informatics infrastructure – the electronic Practice Based Research Network (ePBRN). This project enables translational health services research, especially for the local area. Routinely collected data in the electronic health information systems of GP clinics, the Fairfield Hospital diabetes service, and admissions, are pseudonymised, extracted and linked in the ePBRN data repository in an ongoing basis. For instance, the ePBRN ‘big data’ approach helped develop predictive models for admission of patients with diabetes in the Fairfield neighbourhood, with funding from the HCF Research Foundation.

We are extensively involved in health, education, and research development, and provide professional service, expertise and leadership to numerous SWSPHN, SWSLHD, and UNSW Sydney committees.  We further provide service to a range of other organisations including: NPS, RACGP, GP Synergy Ltd, Nepean Blue Mountains PHN, NSW Agency for Clinical Innovation, Mental Health Commission of NSW, NHMRC, and others.

Over 2014-6, we have published 44 peer-reviewed papers. As supporters of the concept of knowledge exchange, we have a further 27 publications in the medical and lay press promoting evidence-based health care during this period, along with numerous other media engagements including newspaper and radio.

Group Leader

Professor Siaw-Teng Liaw

The Simpson Centre for Health Services Research (SCHSR) is part of the SWS Clinical School and is affiliated with the Ingham Institute for Applied Medical Research. The SCHSR has been in the forefront of the development, implementation and research into the Medical Emergency Team/Rapid Response System (MET/RRS) and is one of the most productive and cited original research groups internationally in this area.  Its RRS research not only covers general patients but also surgical, female and patients attending emergency departments (ED); as well into developing a machine learning based tele-RRS for both in-hospital and community patients during a pandemic.

The Centre is collaborating with national and international organisations in conducting translational health services and policy in diverse areas such as the establishment of a public health emergency responding system in developing countries, patient reported measures in integrated care, routine collection of patient-centred outcome measures in an oncological setting and public reporting of health system performance

Another important area of the Centre’s work includes improving outcomes for people presenting to EDs. The Centre is interested in the design and analysis of epidemiological studies and clinical strategies aimed at improving mental health services; health services research and health outcomes in the ED and its association with chronic disease prevalence and health behaviours. The Centre has gained an international reputation for their work exploring factors associated with mortality and poor health outcomes in Australian EDs and has recently completed a study on the impact of National Emergency Access Target in Australia which has been recognised as one of the most important studies in emergency medicine research with several media articles published in the last 12 months.

Together with many national and international bodies the Centre has been looking at the way ageing, death and dying are currently managed as well as developing, implementing and evaluating innovative ways of improving care of the elderly frail to result in the development and implementation of a state-wide standardised system where patient’s own choices govern the care they receive. Professor Hillman is Co-Chair of the Frailty Taskforce of the Agency for Clinical Innovation.

Group Leader

Professor Ken Hillman

The South Western Emergency Research Institute (SWERI) is the academic centre of the Liverpool Hospital and SWSLHD Emergency Departments and, as such, leads the drive for a scientific and research based approach to emergency care.

SWERI works with clinicians, patients and managers to design and promote better emergency clinical care for patients attending Liverpool Hospital, the South Western Sydney Local Health District, NSW and by extension, all patients across Australia.

SWERI’s research agenda focuses on collaboration between clinical and scientific groups, and multiple domains of investigation.

It includes activity in large-scale data linkage, clinical epidemiology, multicultural emergency medicine, geriatric emergency medicine, critical illness and injury diagnosis and treatment, non-invasive monitoring, data visualisation and pattern recognition, complex adaptive systems as applied to ED and hospital function, clinical structures and interactions, medical decision-making and clinical cognition.

Group Leader

Associate Professor Paul Middelton

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The Translational Research and Social Innovation (TReSI) group, is part of the School of Nursing and Midwifery at Western Sydney University.

TReSI’s mission is to conduct translational research that develops and supports implementation of social and system innovations that ensure that evidence-based interventions reach the people who need them, and are implemented with quality.

TReSI is based at the Ingham Institute, and conducts research on understanding the processes for community-based delivery to whole populations at scale.

TReSI’s work has a particular focus on developing research methods and frameworks for translational research. These methods have wide application and are being explored for issues ranging from cancer treatments to health policy implementation.

At the core of TReSI’s work is the Maternal Early Childhood Sustained Home Visiting (MECSH) program. Pronounced like the word ‘mesh’, MECSH is a high-quality, evidence-based, nurse-led intervention for families needing extra support. MECSH has proven effective in supporting Aboriginal and Torres Strait Islander families as well as culturally and linguistically diverse families in Australia. MECSH programs are currently operating globally, including the UK, the Channel Islands, South Korea and the USA.

TReSI also works with the Volunteer Family Connect (VFC) program. This community-based strategy, linking vulnerable and isolated families with volunteers in their local community, runs across seven sites in four Australian states.

Currently in development are strategies to support children and young people living in the out-of-home care system, and their families (both biological and foster).

Each of these programs are designed to work with families to create a more developmentally nurturing environment for the children. MECSH and VFC have proven effective in linking clients to appropriate services, increasing parenting confidence, encouraging positive parent-child relationships and fostering a sense of belonging and resilience.

Group Leader

Distinguished Professor Lynn Kemp

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The overarching objective of WHITU is to create an internationally recognised women’s health centre that maximises holistic women’s health and well-being.

WHITU was established to build clinical trial capacity, research training opportunities and to improve health outcomes through implementation of evidence and innovation in women’s health care.

Its aim is to maximise equity, equality, health and empowerment for all women by practices guided by evidence, as well as women’s lived experiences in a culturally respectful way  by providing transformative care a multidimensional, individualised model of care that is translatable and relevant to all communities.

WHITU has built strong infrastructure to support research. There are active clinical and research collaborations with the Respiratory, Sleep, Environmental and Occupational Health, Cardiovascular, Early life Determinants as well as the Maternal, Newborn and Women’s Clinical Academic Group (CAG). The academic unit has also facilitated collaborations between the District and University of New South Wales, University of Technology Sydney and Western Sydney University. These collaborations with clinically relevant questions.

Newly formed in 2018, the unit has undertaken eight investigator-led trials as well as three external trials. Current research aims to facilitate earlier risk-stritified access to antenatal clinics to allow for the prevention of several complications in pregnancy. This will be done in a multicultural and patient-centred way using the latest smart-phone technology. Other work is investigating the optimal time for women to deliver their babies, and their journey through the health care system, especially for those women who have high risk pregnancies. The unit is developing a biobank of longitudinally assayed maternal, fetal and paternal samples.

WHITU has facilitated internal audits of current activity to optimise models of care for women with recurrent miscarriage, vaginal birth after caesarean, as well as usage of new angiogenic markers in management of preeclampsia.

WHITU is facilitating a patient and community participation committee to inform practice and research.

To date over $100,000 in funds have been generated in the form of grants and trials work.

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