health - university of canberra

2020RESEARCH

HIGHLIGHTS

HEALTHRESEARCH INSTITUTE

The University of Canberra acknowledges the Ngunnawal people

as the Traditional Custodians of the land upon which the University’s main campus sits

and pays respect to all Elders past and present. As a University, we are proud that we live in the country with the world’s oldest continuous living cultures, and

we are playing our part to support Aboriginal and Torres Strait Islander peoples to keep these cultures alive and

vibrant. We also pay respect to and celebrate the emerging leaders who, through higher education,

will grow the knowledge and qualifications that will equip them for rewarding and

influential careers.

INTRODUCTION

2DIRECTOR’S MESSAGE

3OUR PEOPLE

4RESEARCH PROJECT

HIGHLIGHTS

10KEY PUBLICATIONS

2020

34RESEARCH PROJECTS

36

HEALTH RESEARCH INSTITUTE

Contents | 1

Contents

© Copyright University of Canberra

Acknowledgements:We would like to acknowledge the ongoing support provided to HRI by the Deputy Vice Chancellor of Research and Innovation (Professor Leigh sullivan) and the executive Dean of the Faculty of Health (Professor Michelle Lincoln). We would like to thank nathasha Munasinghe Kumarage for collating the information for this report. this report was designed by Josephine eynaud from Redtail Graphic Design.

UnIVeRsItY oF CAnBeRRA

2 | IntRoDUCtIon

The University of Canberra’s Health Research Institute, despite the challenges of 2020, has continued to leap from strength to strength in its quest to improve health outcomes for individuals and communities nationally and internationally. Congratulations to the staff, students, collaborators and partners of HRI for the impressive list of achievements in this report.

CoVID-19 has underscored the value of health research to our whole community, the need for on-going investment and the importance of educating and developing the next generation of researchers. While we have all been preoccupied with CoVID-19, HRI has continued to produce translational research in the area of chronic illnesses such as diabetes, obesity and cardiovascular disease. While the world stopped to deal with the pandemic these chronic diseases marched on relentlessly shortening life expectancies and impacting well-being and quality of life. In a post-CoVID world these health challenges will require renewed focussed efforts if we are to solve the complex circumstance that cause and maintain them. HRI’s role in research training and education will ensure a pipeline of well equipped researchers are ready to keep tackling these challenges.

our research is firmly anchored to the Civic Mission of the University of Canberra through engagement with the ACt Government and local industry and the conduct of large research trials in the ACt. At the same time our international partnerships

allow us to share our knowledge and expertise around the world and bring their expertise to the ACt. Much of this collaboration occurred online in 2020 and likely will in 2021. We thank everyone who has made changes and adaptations to research projects to ensure we have all stayed safe.

HRI will continue with its ambitious research agenda, but for now we are delighted to share with you this report that outlines our achievements in 2020.

Professor Michelle Lincoln executive Dean, Faculty of Health

INTRODUCTION From the Executive Dean, Faculty of Health


DIReCtoR’s MessAGe | 3

First and foremost, I would like to acknowledge and thank the Health Research Institute (HRI) staff and PhD students for their hard work, dedication, and commitment to making a real difference through their translational research. Twenty-twenty has been a particularly challenging year for all but, despite this, we have continued to attract substantive research funding, published in the highest ranked journals for our disciplines, and forged important partnerships with industry and local government. I am extremely proud of our staff and students and their collective achievements. Our success depends on our people, who come first, so it is fitting that we introduce our Report for 2020 by highlighting key achievements in our individual, national and international research roles.

As the university founded and dedicated to Australia’s capital, the University of Canberra (UC) has an enduring commitment to provide ideas, talent, and solutions to advance our capital city and its surrounding communities. Our Vice Chancellor has a vision for UC as a civic university, a place deeply grounded in its community and responsive to its needs. The HRI is committed to helping improve the health and wellbeing of our Region.

Rapid advances are affecting all of our lives, both positively and negatively. I would like to kick off this Annual Report by highlighting some examples of research team efforts that address these opportunities and challenges. Firstly, our Regional Wellbeing Survey team are collaborating with the Australian Capital Territory (ACT) Government on an initiative to develop metrics of wellbeing and its drivers across our region. Secondly, another large-scale project across residential aged care facilities in Canberra is trialling an innovative model of on-site pharmacy to help better manage medication and reduce medication-related harm in older people.

Building on strong local foundations, the HRI is emerging as a significant player in important national and international partnership research. For example, at a national level, UC has played a contributing role, along with 16 other University and over 70 Industry partners, in the formation of the $220M Digital Health Cooperative Research Centre, which will spearhead Australia’s research and innovation in the digital health field. In addition, UC is collaborating with the National Best Practice Unit for Tackling Indigenous Smoking, and Indigenous organisation partners, to reduce smoking prevalence among Aboriginal and Torres Strait Islander peoples across Australia.

Finally, I would like to flag a few of our international partnership successes. Working with the Dasman Diabetes Institute in Kuwait, we have established an important international partnership, where UC-expertise in spatial epidemiology is helping to develop a geographic information system to drive research, training and education as part of a national effort to tackle the extremely high prevalence of diabetes in Kuwait. Our continued partnership with the Public Health Foundation India has enabled us to jointly tackle public health challenges in India relating to health inequity, and child and maternal health.

The University of Canberra’s Health Research Institute is genuinely committed to making a positive impact on Canberra and beyond.

Professor Rachel Davey Director Health Research

DIRECTOR’S MESSAGEHealth Research Institute (HRI)

4 | oUR PeoPLe


OUR PEOPLE

The drivers of our success


oUR PeoPLe | 5

Professor Rachel Davey (Director) Rachel is the Foundation Director of the Health Research Institute and Chief Investigator with the $220 million Digital Health Co-operative Research Centre (DH CRC). She also leads the flagship DH CRC theme “Changing Health Trajectories”. Rachel’s research interests are broad and include; physical activity for health and wellbeing, ecological models that emphasize multiple levels of influence on health behaviours and the design, delivery, and evaluation of public health and health services interventions.

Maddison Beck (Research Assistant)Maddison has a Bachelor of Health Science from the University of Tasmania and a Masters in Public Health from the University of Canberra. Her research interests are in health promotion and programme interventions to improve health and wellbeing.

Marcus Blake (Senior Data Scientist) Marcus is the technical manager for the Australian Geospatial Health Lab with a background in geospatial data and systems design. His research interest focusses on geographical and statistical methods and their application to census, survey and administrative data.

Professor Margaret Cargo Margaret’s research expertise is in the assessment of context and implementation (i.e., intervention dose, fidelity, adaptation) in complex population health interventions and systematic reviews. She has worked in partnership with government, not-for-profit and the Aboriginal community controlled health sector to identify and prioritise needs at local, state and national levels. Program planning and evaluation projects have included: prevention of childhood obesity, type 2 diabetes, tobacco control, Aboriginal parental engagement, Aboriginal grief and loss, and built community environments related to heart health.

Dr Suzanne Carroll Suzanne’s research interests are in improving our understanding of the multiple interrelated influences, environmental and social, that drive or constrain health behaviour and outcomes. Understanding environmental and social influences is essential to inform targeted interventions to reduce population health disparities. Her research involves use of Geographic Information Systems to characterise environments and complex statistical approaches including multilevel modelling and structural equation models to assess relationships.

Dr Helena ClaytonHelena has a research background in applied natural resource economics and works across varied wellbeing-focused interdisciplinary research projects. Her current research includes the development and measurement of wellbeing indicators for agricultural industries, connections between wellbeing and recreational fishing, and understanding connections between governance and social acceptability of natural resource management practices.

Associate Professor Neil Coffee Neil research has spanned urban/economic and social geography, urban planning, population health, the built environment and physical activity and obesity, developing socio-economic GIS databases and the use and adaptation of government collected and maintained administrative data for social and health research.

Dr Philip CootePhil is a Research Officer responsible for data analytics and visualisation in the Geospatial Health Lab. He completed his MBBS from the University of Sydney in 1999 and MPH from James Cook University in 2018, before undergoing further training in data science. He is interested in distilling complex information into clear and actionable insights that will ultimately have significant impact on people’s health.

Dr Michael DaleWith a background in the sports and exercise sciences, Michael’s research interests include the role of access to physical activity resources in the prevalence of sarcopenia and sarcopenic obesity in the elderly, the effect of the built environment on cardiometabolic health, and trends in children’s physical fitness. Dr Dale has extensive experience in the application of physical and digital anthropometric methods in large-scale surveys and was part of the team responsible for the recent update of the Australian Defence Force’s anthropometric standards.

Professor Mark DanielMark is Professor of Epidemiology and Director of the Australian Geospatial Health Laboratory. Mark’s research emphasis is the intersection of spatial epidemiology and prevention research, particularly the prevention of non-communicable disease and understanding the biological pathways between social and physical environments and important population health outcomes and costs. Mark’s research aims to identify the drivers and multi-sectoral levers for policy- and practice-level innovations to reduce risk factors and slow rising rates of chronic disease including obesity, metabolic syndrome, diabetes and cardiovascular diseases, and cancers related to lifestyle.

UNIVERSITY OF CANBERRA

6 | oUR PeoPLe

Professor Diane Gibson Diane Gibson is currently Distinguished Professor of Health and Ageing at the University of Canberra, and previously the inaugural Dean of Health at the University where she also led the development of the University’s innovative Health Precinct. She is a former Senior Executive at the Australian Institute of Health and Welfare, where she established the Ageing and Aged Care Unit, and developed the widely read “Older Australia at a Glance” series and pioneered key aspects of the Institute’s data linkage work. She has held academic positions at ANU, Griffith and the University of Queensland.

Professor Gibson has published widely in the fields of ageing and aged care. She is a former editor-in-chief of the Australasian Journal on Ageing, a Fellow of the Academy of Social Sciences Australia, and is currently Chair of the Ministerial Advisory Council on Ageing in the ACT.

Dr Jane KoernerJane has an academic background in health promotion and epidemiology. She worked in women’s domestic violence and youth homeless services. While undertaking a PhD, Jane lead and collaborated on studies evaluating community-based HIV prevention interventions and lectured in health promotion and international health. Jane’s research interests include; infection control, palliative care. She is currently project manager for the Pharmacists in Residential Aged Care RCT.

Vincent LearnihanVincent has worked internationally both in technical and consulting capacities applying Geographic Information Systems (GIS) to urban planning, transportation and public health data. His current research areas include the application of GIS to understanding spatial distribution of chronic disease, research into the associated clinical risk factors and health behaviours, and the social and built environment determinants.

Dr Itismita MohantyItismita is a Senior Research Fellow in Health Economics. She completed her PhD in Economics from the University of Sydney in 2009. She has strong interest in quantitative modelling of economic, social and health related issues preferably using applied data analysis, programming or computer modelling methods, econometric analysis and policy evaluation methods.

Dr Mel MylekMel’s area of research focusses on the social dimensions of natural resource management in Australia, specifically looking at how working with natural resources influences people’s health and wellbeing. She has most recently been exploring the health and wellbeing of people working in the forest industry across Australia and is currently examining the health and wellbeing issues in rural and regional Australia.

Associate Professor Theo NiyonsengaTheo has applied statistical methods to research focusing on, but not limited to, the areas of multivariate data analysis methods such as structural equations modelling, longitudinal and multi-level data analysis, spatial statistics with application to spatial epidemiology.

Dr Victor OguomaVictor has degrees/training in medical/public health parasitology/entomology, cardiometabolic disease epidemiology, and biostatistics. His research interests include: Cardiovascular disease risk factors classification, Indigenous health, infectious diseases, the design and analysis of randomised controlled epidemiological studies.

Dominic PeelDominic’s research has focused on wellbeing, resilience and liveability in regional Australia, in particular in regional farmers and their communities.

Dr Vicky SaundersVicky has a multidisciplinary background with qualifications in nursing and social work. Her research includes vulnerable populations with a specific focus on children and young people, Vicky completed her PhD (social work) at the Institute of Child Protection Studies, ACU in 2019. Her thesis examined children and young people’s experience of parental incarceration in the ACT.

Associate Professor Jacki SchirmerJacki leads the Regional Wellbeing Survey, an annual survey in Australia examining the views of rural and regional Australians about the liveability and resilience of their community, and their own wellbeing and resilience. In addition to leading the Regional Wellbeing Survey, Jacki’s personal research interests focus on understanding the social dimensions of natural resource management, particularly how people’s access to and use of natural resources affects their health and wellbeing.

Dr Ralf SchroersRalf is a GIS professional, with expertise in spatial analysis, data science and data system integration. Since 2013 he has been working in the sector of health geography. He had completed a German Diploma of Natural Resource Planning and later a Master Sc. degree in Geospatial Science at University of Queensland (UQ) in 2006. His experience in spatial science also covers the areas of natural resource and conservation planning, as well as geoscience. He lived and worked in regions such as West-Africa, Central Asia and Melanesia. He is now working within UC-HRI, on the DH CRC/HMS project “Spatial management of health risks”. This work comprises working with HMS medical claims data for a selected set of U.S. states, steering Big Data analyses, process automation and integration of geospatial information.

OUR PEOPLECONTINUED...


oUR PeoPLe | 7

ADMINISTRATION TEAM

Ms Nathasha Munasinghe KumarageNathasha is the administration officer for the Health Research Institute. Nathasha previously worked for SYNERGY Nursing and Midwifery Research Centre, a collaboration between the University of Canberra and ACT Health. Nathasha has an administrative background and has worked in finance, retail and tertiary education sectors. She has completed her professional studies with the Chartered Institute of Management Accountants (UK) and has more than five years of experience working in administration.

Sarah NikroSarah joined the Health Research team as a Research Administration Officer in December of 2019. Prior to this, Sarah was employed at the Canberra Institute of Technology (CIT) for a number of years. Sarah has a keen interest in the area of health improvement and learning, having previously worked in International Studies, Compliance and My Aged Care. Sarah managed from start to completion the first Recognition of Prior leaning study online for students in Western Australia and assisted in developing and continuous improvements of the Compliance and My Aged Care Learner Experience (MACLE) platform.

Dr Wubshet TesfayeDr Wubshet Tesfaye is a pharmacist, pharmaceutical scientist, and an early career researcher. Wubshet completed his PhD in 2019 from the University of Tasmania and was recruited as a post-doctoral researcher at the University of Canberra in early 2020. Prior to this, Wubshet worked as an academic scientist and lecturer in pharmacology and clinical pharmacy in Ethiopia and Australia. He also has considerable work experience in the community and hospital pharmacy settings in Australia, the US, and Africa.

Professor Gavin TurrellGavin’s primary research interests are in social epidemiology, with a focus on the social determinants of health and health inequalities. His research is population-based and much of it examines how the neighbourhood environment interacts with individual-level factors to influence health and related behaviours and risk factors. Gavin was recently a Chief Investigator on an NHMRC Centre of Research Excellence in Healthy, Liveable, and Equitable Communities, where he led a research program examining whether the built environment is causally related to health and well-being.

Associate Professor Penny UptonDr Penney Upton is an experienced research psychologist whose work focuses on the improvement of health and wellbeing across the lifespan. Her work has had significant influence on local and national policy and strategy in both Australia and the UK. As part of this work Penney is commitment to the development of best practice and is co-author of the evidence-based practice questionnaire (EBPQ) and the student evidence-based questionnaire (S-EBPQ) two psychometrically sound measures which continue to have an impact internationally in both clinical and educational settings.

Penney is the lead UC academic in the National Best Practice Unit for Tackling Indigenous Smoking which involves research translation and training to support best practice in population level tobacco control across Australia.

Administration team: nathasha Munasinghe Kumarage (right) and sarah nikro (left)

The University of Canberra is proud to be recognised as a leader in equity and social justice.


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PhD Students: L–R: Jahidur Khan, Kimberly Brown, sunil George, Vincent Learnihan, Rahanan sathiyakumar, sushmitha Kasthuri, Danish Ahmad and sindus nizamani.

OUR PEOPLECONTINUED...


oUR PeoPLe | 9

HIGHER DEGREE BY RESEARCH — PhD Students

Danish AhmadThesis title: Impact of an Integrated Microfinance and Health Literacy program on maternal health care awareness and practice — the case of rural India

Supervisory panel/advisors: Itismita Mohanty, theo niyonsenga, Rachel Davey, Dileep Mavalankar

Miranda BattenThesis title: evaluating the Implementation of an Aged Care Intervention

Supervisory panel: sam Kosari, Mark naunton, Margaret Cargo, Rachel Davey

Kimberly BrownThesis title: exploring associations between wellbeing and regenerative agriculture

Supervisory panel: Jacki schirmer, Penelope Upton

Sunil GeorgeThesis title: equitable access to health care in the era of Universal Health Coverage: A study of excluded communities in Kerala

Supervisory panel: Itismita Mohanty, Rachel Davey, Rakhal Gaitonde, Penelope Upton, theo niyonsenga

Ibrahim HaiderThesis title: the effectiveness of an integrated on-site pharmacist model on quality use of medicines in the residential aged care setting

Supervisory panel/advisors: sam Kosari, Mark naunton, Gregory Peterson, David Wright, Rachel Davey, Jackson thomas

Susan HartonoThesis title: Growing up in Australia: the effects of parental immigration status, country of origin, and acculturation on the dynamics of children’s body weight status

Supervisory panel: Yohannes Kinfu, tom Cochrane, theo niyonsenga

Sara HudsonThesis title: Valuing Indigenous social enterprises: Understanding and assessing the impact on Indigenous health and well-being

Supervisory panel: Margaret Cargo, Dennis Foley

Sushmitha KasthuriThesis title: Geographic variation in the association between the risks of mental ill-health and cardiometabolic health in young population in Australia

Supervisory panel: Itismita Mohanty, theo niyonsenga

Jahidur KhanThesis title: Geographic access, socio-demographic and built-environmental features predictive of breast screening service utilisation in Greater sydney

Supervisory panel: Mark Daniel, suzanne Carroll, neil Coffee

Vincent LearnihanThesis title: Residential instability and mental health outcomes: A case study of middle aged residents of Brisbane, Australia

Supervisory panel: Gavin turrell, Yohannes Kinfu

Xi LiThesis title: socioeconomic disparities in health outcomes among people with comorbidities undergoing surgical procedures in Queensland

Supervisory panel: Itismita Mohanty, theo niyonsenga, Anindita Das

Kacie PattersonThesis title: smartphone apps for sedentary behaviour change in cardiac rehabilitation and the effect on hospital admissions

Supervisory panel: nicole Freene, Rachel Davey, Richard Keegan

Rahanan SathiyakumarThesis title: the role of neighbourhood supermarkets in community food access during recent food system disruptions: A case study from Canberra, Australia

Supervisory panel: Rachel Davey, shawn somerset, Ro McFarlane

Thomas VaseyThesis title: Active, safe travel to school

Supervisory panel: Margaret Cargo, suzanne Carroll, Mark Daniel, Andrew Crichton (transport Canberra & City services)


10 | ReseARCH PRoJeCt HIGHLIGHts

As the University of Australia’s capital, UC has an enduring commitment to provide ideas, talent and solutions for the advancement of the capital and our surrounding communities.

RESEARCH PROJECT HIGHLIGHTS


ReseARCH PRoJeCt HIGHLIGHts | 11

ACT WELLBEING FRAMEWORKIn 2019, the ACT Government announced that it would develop a Wellbeing Framework for the Australian Capital Territory. During 2019 and 2020, the ACT Government conducted a range of consultation processes as part of developing a proposed set of indicators to be used to measure wellbeing in the ACT.

In doing so, this jurisdiction joined the growing number of countries and regions internationally who are seeking to measure progress by examining whether their citizens have a good quality of life, as well as measuring economic growth.

University of Canberra researchers Jacki Schirmer and Rob Tanton were pleased to contribute to the consultation process, discussing key learnings from the development of wellbeing frameworks around the world as part of multi-stakeholder workshops.

They also participated in a range of discussions and providing expert advice on the development and design of indicators. In March 2020, the ACT Government released the ACT Wellbeing Framework, and we are proud that University of Canberra researchers were able to contribute to its development.

This project has been funded by the ACT Government.



The framework was developed by the Government in consultation with Canberrans, community and industry organisations, as well as experts from the University of Canberra, the Australian National University, Deakin University and Murdoch University.

The 12-domain Wellbeing Framework is meant to feed into policy and budget planning processes from 2021–2022. Each domain is an area important to the life of a Canberran; there are also indicators for each domain, which help to track progress.

Incorporating a strong, nine-month community consultative process, the framework includes ratings of Canberrans across various dimensions including environment, health, housing, economy, identity and social connection. It measures what’s really important to people living in Canberra, drawing on feedback from over 3,000 locals.

The University’s Associate Professor Jacki Schirmer from the Health Research Institute (HRI) and Centre for Applied Water Science (CAWS) and Professor Robert Tanton from the Institute for Governance & Policy Analysis are two of the researchers who worked in consultation with the ACT government.

Personal Wellbeing

Access and connectivity

Economy SafetyHealth

Time Social connection

Education and life-long

learning

Identity and belonging

Environment and climate

Governance and institutions

Housing and home

Living standards

Twelve Domains of Wellbeing for the ACTsource: ACt Wellbeing Framework www.act.gov.au/wellbeing

The ACT will be the first jurisdiction in Australia to create its own wellbeing index.

https://www.act.gov.au/wellbeing


HeALtH ReseARCH InstItUte

Australia has an ageing population, many of whom living in residential aged care. Residents are at risk of medication related problems that can contribute to negative health outcomes and unplanned hospital visits.

the study aims to improve quality use of medicines and reduce adverse health events and emergency department and hospital visits. the randomised control trial will test the benefits of having on-site pharmacists employed in residential aged care facilities in the ACt. on site pharmacists will be employed in facilities in the intervention arm on a part time basis for 12 months, and the pharmacist will work with residents and families, facility staff, GPs and other health care staff.

to date 15 facilities in the ACt are involved in the study, which is being conducted by researchers at the Health Research Institute and Pharmacy Discipline at the University of Canberra. Funding is provided by the Capital Health network through the ACt’s Primary Heath Program. the study builds on a pilot study conducted in 2017 at Goodwin’s residential aged care facility in Canberra.

INTEGRATING PHARMACISTS IN RESIDENTIAL AGED CARE FACILITIES TO IMPROVE THE QUALITY USE OF MEDICINES

Research team: standing L–R: Ms Sarah Nikro (Administration officer), Mr Ibrahim Haider (PhD student), Ms Miranda Batten (PhD student) and Professor Mark naunton (Head of school of Health sciences)

sitting L–R: Dr Jane Koerner (Research Project Manager), Dr sam Kosari (Associate Professor of Pharmacy) and Professor Rachel Davey (Director of Health Research Institute)

The project is funded by the Capital Health Network through the ACT’s Primary Health Program.




A large body of research suggests that the early years of a child’s life have a significant impact on their lifetime health and wellbeing. It is well known that children from disadvantaged environments, particularly those exposed to a range of early childhood adversities, are at increased risk for poor health including developmental delay, mental health problems, school failure and increased adult mortality and morbidity. This in turn, imposes significant, and increasing burden on health and societal cost.

While many children in Australian are progressing well, an increasing number are falling well below national benchmarks. For example, in the Australian Capital Territory over the past decade there has been a significant increase in the proportion of children classified as ‘developmentally vulnerable’ and this disparity varies quite markedly geographically.

Our approach will evaluate an innovative, integrated preventive public health approach to reduce the proportion of children with developmental vulnerabilities.

We seek to change the developmental trajectory of vulnerable children during early childhood (0–5 years) in order to improve health, social integration and resilience for the next generation.

Collaboration across academic disciplines, policy makers, social services and health services will maximise children’s early development opportunities. Using data from the Australian Early Development Census and our expertise in ecological mapping and programme evaluation, we will specifically target neighbourhood areas with a high proportion of developmentally vulnerable children.

The project is funded for four years from the Medical Research Future Fund.

Research team: Rachel Davey, Margaret Cargo, Michelle Lincoln, Christine Phillips, Jane Herbert, Jacqui Mckechnie, tony oakley, Greg Mews, Vicky saunders, suezanne Packer Associate Investigator, Alan Philip, Amber shuhyta and Bill Caddy

REDUCING THE VULNERABILITY OF CANBERRA’S YOUNG CHILDREN



ENVIRONMENTAL AND SOCIAL DETERMINANTS OF HEALTH IN THE ACT The Health Research Institute was awarded funds for a four-year study that aims to keep people out of hospital. The project, titled Environmental and Social determinants of health in ACT: Program interventions aimed at reducing the burden of disease and avoidable hospital admissions.

Increasing rates of lifestyle-related chronic diseases such as cardiovascular disease, some cancers and type 2 diabetes remain a major public health concern and are among the predominant reasons for avoidable hospital admissions in the ACt.

the aim of this research is to create local neighbourhood environments which encourage and support healthier and better-connected communities.

“We will take a two-pronged approach; one to address aspects of broader social and environmental determinants of wellbeing in helping to develop healthier communities, and another; to develop and test implementation strategies for better co-ordination and self-management of chronic disease,” said Professor Davey.

“Geographical mapping, spatial modelling and predictive analytics will be used to identify high-priority, disadvantaged target areas for the planning of public health policy and practice interventions.”

By partnering with local health care providers, key stakeholders and undertaking co-design with the community for the delivery of the interventions, the project will facilitate uptake and translation of research into routine practice.

The project is funded by the Medical Research Future Fund.

Research team: Rachel Davey, Mark Daniel, neil Coffee, Margaret Cargo, suzanne Carroll, theo niyonsenga, Victor oguma, Vincent Leanihan, nicole Freene and sam Kosari

The project will test whether a local integrated system, that includes identification, referral and targeted service delivery, will improve child development outcomes in intervention suburbs where there are the highest levels of developmental childhood developmental vulnerability.

L-R: Margaret Cargo, Maddison Beck, Vicky Saunders and Rachel Davey.



SUPPORTING MENTAL HEALTH THROUGH BUILDING RESILIENCE DURING AND AFTER BUSHFIRES

LESSONS FROM THE 2019–20 BUSHFIRES IN SOUTHERN NSW AND THE ACT

This project, funded by Medical Research Future Fund, is expected to improve individual and collective bushfire preparedness and response through examining which types of individual, social and community-scale resilience resources available to fire affected individuals and communities, including preparedness and response actions during and post-bushfires, most strongly predict (a) positive coping during bushfire and (b) positive recovery in which there is growth in resilience resources (including individual and community adaptive capacity) that protect mental health and improve preparedness for future events.

Resilience resources means access to natural and build environment, cultural, social, economic, legal, and political resources at individual, household and community scale: resilience resources are recognised as critical to maintaining mental health during and after disasters, yet remain under-studied, with limited understanding of which are most important for mental health at different stages of disaster cycles (Paton & Buergelt 2019; Buergelt & Paton 2014).

Our mixed methods study will identify and assess the complexity and dynamics of the cumulative impacts of the unique 2019–20 bushfire event, reflecting emerging evidence of the importance of evaluating cumulative impacts when studying complex events (e.g. Loxton et al. 2013, Lowe et al. 2019, Liddell et al. 2020). In this context, this includes impacts of drought preceding the fires as well as cumulative impacts of the fires (e.g. Hanigan et al. 2018).

The project is funded by the Medical Research Future Fund.

Research team: Jacki schirmer, Petra Buergelt, Douglas Patton, theo niyonsenga, Dominic Peel, Mel Mylek, Rachel Davey and Claudia Benham



As the University of Australia’s capital, UC has an enduring commitment to provide ideas, talent and solutions for the advancement of the capital and our surrounding communities.

LOCALLY-ANCHORED

GLOBAL HUB



NATIONAL BEST PRACTICE UNIT TACKLING INDIGENOUS SMOKING

HRI continues to play a key role in the National Best Practice Unit Tackling Indigenous Smoking (NBPU TIS). Established in 2015, NBPU TIS is a consortium of three (HRI, HealthInfoNet, and Ninti One) which supports 40 community-based organisations across Australia that have received a Regional Tobacco Control Grant (RTCG) under Tackling Indigenous Smoking (TIS) Program.

Funded by the Federal Government Department of Health, the tIs program has proven to be one of the most effective packages provided under the Closing the Gap strategy. the program has been funded by the Department in various guises since 2010, however the biggest drop in smoking rates has been since the program was revised in 2015 following a review by HRI, and the introduction of new elements including the nBPU tIs: for example, in 2014–15 the proportion of Aboriginal and torres strait Islanders aged 15 years or over who smoked daily was 41.4% in 2014–151, which reduced to 37.4% in 2018–192.

1 Lovett R, thurber K, Wright A, Maddox R, and Banks e. Deadly progress: Changes in Australian Aboriginal and torres strait Islander adult daily smoking, 2004–2015. Public Health Research & Practice, 2017; 27(5):e2751742. Available from: www.phrp.com.au/issues/december-2017-volume-27-issue-5/deadly-progress-changes-australian-aboriginal-torres-strait-islander-adult-daily-smoking-2004-2015

2 Australian Bureau of statistics. 4715.0 — national Aboriginal and torres strait Islander Health survey, 2018–19: smoking. ABs, 2019. Available from: www.abs.gov.au/AUSSTATS/[email protected]/Latestproducts/4715.0Main%20Features152018-19?opendocument&tabname=Summary&prodno=4715.0&issue=2018-19&num=&view

3 World Health organisation (WHo) 2020 available at www.who.int/news-room/q-a-detail/q-a-on-smoking-and-covid-194 Cosh, s., Hawkins, K., skaczkowski, G., Copley, D., & Bowden, J. (2015). tobacco use among urban Aboriginal Australian young people: a qualitative study

of reasons for smoking, barriers to cessation and motivators for smoking cessation. Australian Journal of Primary Health, 21(3), 334–341.5 Cambron, C., Haslam, A. K., Baucom, B. R., Lam, C., Vinci, C., Cinciripini, P., ... & Wetter, D. W. (2019). Momentary precipitants connecting stress and

smoking lapse during a quit attempt. Health Psychology.

nBPU tIs work has not slowed down during the 2020 pandemic. If anything, we have been busier than usual, albeit working differently. Aboriginal people and torres strait Islanders are one of the groups at most risk of serious infection from CoVID-19 due to the high rates of chronic disease within the population. Higher smoking rates are also a risk factor in these communities since smokers are likely to be more vulnerable to CoVID-19 infection3. the vulnerability of smokers relates to reduced lung capacity and increased lung disease associated with smoking, as well as its behavioural characteristics. For example, the act of smoking includes frequent hand to mouth action which increases the possibility of virus transmission. other common behaviours which increase the risk of transmission include sharing cigarettes, and collecting and smoking discarded butts. evidence also shows that smoking is a response to stress, particularly for Aboriginal and torres strait Islander people4. stressful situations (such as caused by CoVID-19 anxieties) may well increase tobacco use in smokers, meaning that previously successful quitters are more likely to lapse5.

https://healthinfonet.ecu.edu.au/

https://www.nintione.com.au/

http://www.phrp.com.au/issues/december-2017-volume-27-issue-5/deadly-progress-changes-australian-aboriginal-torres-strait-islander-adult-daily-smoking-2004-2015/

http://www.phrp.com.au/issues/december-2017-volume-27-issue-5/deadly-progress-changes-australian-aboriginal-torres-strait-islander-adult-daily-smoking-2004-2015/

https://www.abs.gov.au/AUSSTATS/[email protected]/Latestproducts/4715.0Main%20Features152018-19?opendocument&tabname=Summary&prodno=4715.0&issue=2018-19&num=&view



http://www.who.int/news-room/q-a-detail/q-a-on-smoking-and-covid-19



NATIONAL BEST PRACTICE UNIT

Key Facts About E-Cigarettes

What are e-cigarettes?

What are the risks of vaping? Evidence is emerging of a possible link between the use of e-cigarettes and severe lung disease and an increased risk of heart attack.

Studies have shown that vapers are exposed to heavy metals such as chromium, nickel and lead in greater quantities than in conventional cigarettes.

Cartridge containing liquid

Vaporizer (heating device)

What are the risks to passive bystanders? While vapour produced by e-cigarettes is probably less harmful to bystanders than cigarette smoke, it is not completely harm free.

Vaping and tobacco use?

30%

21%

Battery that powers the device

Can vaping help someone to quit? There is insufficient evidence to show e-cigarettes to be an effective method for smoking cessation.

A trial that showed that e-cigarettes are no better as a quit method than established approaches such as Nicotine Replacement Therapy, Champix® and cold turkey for quitting smoking.

of all Australian smokers have tried e-cigarettes.

of Aboriginal and Torres Strait Islander smokers have tried e-cigarettes and those who have were younger, living in non-remote areas and daily smokers.

We know that e-cigarettes are popular with youth and there is a strong link between vaping and smoking.

Nicotine in e-cigarettes can negatively affect adolescent brain development.

NBPU Stance · NBPU supports Australia’s precautionary

approach to the use of e-cigarettes. Use of e-cigarettes should not be encouraged but can be used as a point of discussion around the available best practice quit methods.

· Smokers or vapers attempting to quit should use evidence-based treatments including cold-turkey, NRT, other prescription medications such as Champix®, and quit smoking counselling.

tacklingsmoking.org.au

· Facebook first. Make it engaging.

· Twitter is used by professionals, politicians, activists and journalists. Make it about advocacy.

· Instagram allows users to use compelling pictures or short videos to share a catchy message. Make it personal.

· Snapchat is a fun way of connecting with younger social media users. Make it youthful.

Key Tips

Communicate Engage Share Support

Provide real-time peer to peer support and discussion around tobacco use.

of the Australian population are active users of Facebook.

70% Social media use is

higher among Aboriginal and Torres Strait Islander people than the general

Australian population.

Select employees to be administrators or moderators of your organisation’s social media accounts.

Make messages “stick”. A “sticky” health message is understandable, memorable, and effective in changing thought or behaviour.

Content should be simple. Written text should be free of jargon, acronyms, long sentences and complicated graphics.

Create posts that appeal to positive emotions.

Create videos. Keep the videos short and post directly on Facebook, without links.

Engage with your community. Ensure you reply to every comment on your page.

Recent studies have shown that focused social media messaging and carefully designed networks can increase quit attempts, as well support people who have quit to remain smoke-free.

Online conversations often remove the expert-client power relationship.

The use of

images can be

effective for

people who

prefer visual

information.

tacklingsmoking.org.au

NATIONAL BEST PRACTICE UNIT

Key Facts about Social Media

Providing appropriate, evidence-based culturally safe support and advice through trusted channels (RtCG teams) around tobacco use, smoking cessation and the importance of staying smoke-free has therefore been highly relevant and vital during 2020.

our aim has been both to keep people safe from CoVID-19 infection as well as to protect the current reduction in prevalence in smoking to which the program has already contributed. Much of our work has therefore focused on ensuring tIs teams have access to the emerging evidence and supporting them to find new ways of deploying their resources to maximum effect.

Usually, nBPU tIs would deliver much of this support through face-to-face workshops and training days. this year has been a little different, with all training provided via Zoom. We have also made more use of our TIS website, developing and uploading a range of new resources including factsheets and training presentations. In addition, HRI are leading the development of a set of online learning resources in two areas identified by tIs teams as important for continuing professional development: population health promotion and monitoring and evaluation. It is anticipated that these resources will be released by the end of 2020.

Providing tailored support and bespoke training in Population Health promotion during a global pandemic and the travel and physical distancing measures put in place to mitigates its effects, has therefore not been without its challenges. While CoVID-19 has affected the nBPU tIs’ capacity to engage face-to-face with stakeholders in this period, we are pleased to note that evidence has emerged during 2020 of our increasing national exposure and influence. For example: the national Aboriginal Community Controlled Health organisation (nACCHo) Aboriginal Health news Alerts for World no tobacco Day, provided the nBPU tIs evidence summary about the relationship between smoking and CoVID-19; whilst the new RACGP Smoking Cessation Guidelines included a link to the tIs website as a source of culturally appropriate tobacco control information for General Practitioners (GPs) and other health professionals who are working with Aboriginal and torres strait Islander communities.

The project is funded by the Commonwealth Department of Health and Ninti One. Associate Professor Penney Upton leads the UC workstream.

Research team: Penney Upton and Rachel Davey

Key Facts About E-Cigarettes and Key Facts about Social Media brochures.

https://tacklingsmoking.org.au/

https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/supporting-smoking-cessation

https://www.racgp.org.au/clinical-resources/clinical-guidelines/key-racgp-guidelines/view-all-racgp-guidelines/supporting-smoking-cessation



GEOSCIENCE AUSTRALIA — NATURAL HAZARD MODELLING Following are the two projects with Geosciences Australia and Bushfire and Natural Hazards CRC.

1. Developing the National Hazard Exposure Information Modelling Framework: Consistent and reliable information on natural hazard exposure is crucial for disaster risk mitigation and evidence-based decision-making. exposure is referred to as the elements that have been, or could be, subject to the impact of natural hazards within an area. the project was to develop Australian Natural Hazards Exposure Information Framework (AnHeIF) that links strongly with the national strategy for Disaster Resilience (CoAG, 2011).

2. The Cost Effective Mitigation Strategy Development for Building Related Earthquake Risk:Much of the Australian building stock has not been designed or constructed with consideration of earthquake hazard. Mitigation intervention is needed to reduce risk, but an evidence base is lacking to inform investment.

this project is to develop economic measures of the benefits of retrofit as an offset to the sometimes-large costs of upgrading structures for earthquake. It developed the economic framework for estimating the earthquake related economic costs of avoidable loss that can be adopted by a range of Australian decision makers including building owners, owners of both premises and the business within, local authorities and state and national governments. the avoided loss estimates can be scaled up from individual building level to business precinct level exposures and the interdependence of building performance within them.

the methodology for estimating business income loss, rental income loss, direct health care expenditure and the burden of disease due to injuries, are developed as part of this project. these translate the physical consequences of an earthquake scenario to economic measures that can be used as part of decision making.

Funded by Geoscience Australia. Dr Itismita Mohanty leads the UC stream of work.

Research team: Dr Itismita Mohanty and Prof Rachel Davey



COMMISSIONING STRONGER EVALUATIONS OF INDIGENOUS HEALTH AND WELLBEING PROGRAMSBillions of dollars are spent annually on Indigenous programs, services and initiatives yet, despite the need, there is limited evidence on what programs are effective for improving Indigenous health outcomes. The Productivity Commission has called for ‘more and better’ evaluations of Indigenous programs and commissioning processes that engage Indigenous communities, organisations and leaders.

The commissioning of evaluations plays a significant role in the way program evaluations are carried out. It is through the commissioning process that the budget is set, the evaluators are identified, the aims and objectives of the evaluation are set, and many other aspects of the evaluation are determined.

This National Health and Medical Research Council funded project (GNT1165913) responds to a call from Indigenous leaders for opportunities to influence decision-making processes within the health system and across sectors for the commissioning of health programs to reflect their needs, priorities and views on program design, delivery and evaluation.

This project aims to identify how government (federal, state/ territory) and non-government (not-for-profit, corporate, foundation, philanthropic) commissioning practices can better support Indigenous engagement and leadership in the evaluation of health and wellbeing programs in Australia.

To achieve this aim, this project will address the following objectives:• To characterise the spectrum of commissioning practices of

government and non-government organisations in contracting evaluations for health and wellbeing programs particularly the role of Indigenous engagement and leadership during, and resulting from, the commissioning process.

• To identify the issues, challenges and opportunities for Indigenous engagement and leadership across the spectrum of commissioning practices from the perspectives of: (a) commissioners/policy makers;(b) service providers; and(c) the Indigenous community.

• To translate the findings into resources to support Indigenous engagement and leadership in the commissioning of program evaluations.

The project is supported by an advisory group, chaired by Professor Tom Calma AO.

Research team: Associate Professor Margaret Cargo (University of Canberra), Professor Dennis Foley (University of Canberra), Ms. summer Finlay (University of Canberra), Professor Bronwyn Fredericks (University of Queensland), Professor Jenni Judd (Central Queensland University), Professor James smith (Menzies school of Health Research) and Associate Professor Yvette Roe (Charles Darwin University)

https://researchprofiles.canberra.edu.au/en/persons/margaret-cargo

https://researchprofiles.canberra.edu.au/en/persons/margaret-cargo

https://researchprofiles.canberra.edu.au/en/persons/dennis-foley

https://researchprofiles.canberra.edu.au/en/persons/summer-finlay

https://uq.edu.au/about/pvc-ie

https://uq.edu.au/about/pvc-ie

https://spectre.cqu.edu.au/profiles/view/9237

https://www.menzies.edu.au/page/Our_People/Researchers/James_Smith/

https://researchers.cdu.edu.au/en/persons/yvette-roe



REGIONAL WELLBEING SURVEYWorldwide, many nations and organisations are starting to measure social progress using measures that go beyond economic growth. This is because it is increasingly understood that economic growth alone doesn’t guarantee a good quality of life. We need to understand how liveable, safe and friendly communities are, if they have good access to key services and infrastructure, and if they are welcoming and inclusive. However, there’s not much information to help us understand quality of life in Australia — particularly for rural and remote regions. The Regional Wellbeing Survey was established to start addressing this gap.

Launched in 2013, the Regional Wellbeing Survey (RWS) is an annual survey that measures subjective wellbeing of people and communities and their ability to cope with challenging times. The goal of the RWS is to improve understanding of the wellbeing, resilience and liveability of communities across Australia, and to help organisations across Australia have access to the data they need to help them support and grow quality of life across the country.

The RWS has grown to include over 13,000 participants each year from remote, rural and urban areas across Australia.

A wide range of reports are produced from the Regional Wellbeing Survey data, as well as data tables showing the latest survey data for regions right across Australia, and for specific groups such as farmers. These can be found at www.regionalwellbeing.org.au.

The RWS is funded by a consortium of funding organisations, which changes year to year. Since 2013, the University of Canberra has funded key core costs of the survey. Each year, a number of organisations fund the RWS to examine specific additional topics, or to increase the sample of specific groups or communities. In addition to the direct funders of RWS, a large number of organisations across Australia support the Regional Wellbeing Survey by increasing awareness of the survey and sharing findings.

Research Team: (L-R) Helena Clayton, Kimberly Brown, Rahanan sathiyakumar, Dominic Peel, Jacki schirmer and Mel Mylek

http://www.regionalwellbeing.org.au


Past and current funders of the RWS include:• Australian Capital territory Government• Australian Competition and Consumer Commission• Australian Government Department of Agriculture,

Water and the environment• Australian national University• Clarence City Council• Cotton Research and Development Corporation• Dairy Australia• Fisheries Research and Development Corporation• Forest and Wood Products Australia• Meat and Livestock Australia• Monash University• Murray Darling Basin Authority• Murray Darling Basin Futures Collaborative Research

network• Murray Local Land services• national Health and Medical Research Council —

Medical Research Future Fund

• new south Wales Government Department of Planning, Industry & environment

• new south Wales Government Department of Primary Industries

• noosa shire Council• nRM Regions Australia• Panel for the Independent Assessment of social and

economic Conditions in the Murray-Darling Basin• Riverina Local Land services• softwoods Working Group• tasmanian Department of Infrastructure, energy and

Resources• Victorian Government Department of Jobs, Precincts

and Regions (collaborating with the national Centre for Farmer Health)

The Regional Wellbeing Survey is one of the largest annual surveys examining wellbeing and quality of life in Australia’s rural and regional areas. First conducted in 2013, it examines how the wellbeing of people in rural and regional communities is influenced by the many social, economic and environmental changes occurring in these communities.




Our mission is to improve the quality of healthcare for all, through evidence. We believe research and innovation in digital health offers Australia significant economic and business development opportunities, as well as great promise for the better health of our community.

DIGITAL HEALTH

COOPERATIVE RESEARCH

CENTRE



The University of Canberra is one of 17 University Partners in the DH CRC along with over 70 industry partners. We are developing a unique, multidisciplinary, collaborative taskforce of research, clinical, industry, government and educational organisations to focus research and development on combining individual and collective expertise with data, information and telecommunication technologies.

The Health Research Institute currently runs two projects in the DH CRC; 1. Spatial management of health risk: applying geospatial technology for risk visualisation, hotspot identification, and

analysis of geographic variation. 2. Individual-level predictive models for management of postoperative pain.

AUSTRALIAN GEOSPATIAL HEALTH LABResearch team ‘mapping the way’ to a healthier future Ground-breaking work at the University of Canberra (UC) is combining geospatial data for individuals with health data to help drive healthier lifestyles, prevent chronic disease and reduce future demand on hospitals.

The Australian Geospatial Health Lab is a unique partnership between UC (one of Digital Health CRC’s university participants) and GIS global industry leader, Esri.

The Lab provides portal-to-portal collaboration that is secure at defence industry standards, enabling organisations that hold sensitive population data to work with the UC-Esri research team to analyse the relationships between place and health.

Through this approach, the team is exploring the causes of ill health — and how to reduce disease consequences — in the context of environmental determinants of health that vary spatially and geographically.

In another first, the Lab is also enabling the more accurate comparison of ‘apples with apples’ when expressing the spatial indicators that can impact people’s health — between suburbs, census units, regions and states of Australia, and even between countries.

“Through the Lab, we can identify the social, natural and built environment factors that contribute to an individual’s healthfulness, and their propensity to live a healthful lifestyle or to engage in behaviour that is riskier for their health” says Professor of Epidemiology from UC’s Health Research Institute, Mark Daniel.

“We can evaluate the features of their spatial environment that shape how they develop risk factors (like poor diet, physical inactivity, alcohol use and smoking), in conjunction with clinical measures and biomarkers, their disease outcomes, and disease consequences (like complications or hospitalisation).”

“Through this, we can better assess an individual’s risk of contracting — and how to better manage — conditions like obesity, metabolic syndrome, diabetes, cardiovascular diseases and cancers, based on their location.”

“We can then identify high-priority targets and decision-making tools to help deliver more targeted clinical and public health interventions, as well as support broader efforts for planning healthful environments.”

“Ultimately, this will help prevent the rise of chronic disease and the cost to the health system of treating it.”



‘Layering the cake’ of an individual’s environmentProfessor Daniel says the Lab can aggregate a wide range of environmental, spatial and health data in building a picture of an individual’s way of life and how that contributes to their health — or ill health.

“We can tie together many different datasets to understand environmental influences for radii around where you live, where you work, how you get there, and the activity you undertake over the course of a day” he says.

“We can then express these influences at different spatial settings, not just for census administrative units.”

“We integrate many different datasets covering satellite images, public open space, vegetation, road networks, transportation grids, property values, census information, local businesses, crime and safety, access to healthcare, and healthcare costs — the list goes on.”

“All of these datasets can be layered. So if you can imagine a layered cake and you put a pen down through the middle of it that is, in the simplest sense, the ‘x,y’ co-ordinates of where you live — and the layers are different datasets each describing different dimensions of your surrounding social, built and physical environments that ultimately shape your lifestyle and healthfulness.”

“This type of research has been pursued in the scientific literature for about 20 years, but it has been bogged down because there has been no basis for standardised, comparative cross-jurisdictional work, and there have been major blocks in linking sensitive health outcome datasets with the spatial environment datasets that we are utilising.”

“We’ve overcome those limitations with the Australian Geospatial Health Lab.”

Developing more healthful environmentsThrough the Lab’s work, the research team is also seeking to influence the development of policies that support healthful environments.

“This will be through better urban design, more efficient public transportation which gets people out and moving, gets people out of their cars, and creates better access to public open spaces, healthful food source options, and accessible health and medical care” Professor Daniel says.

Professor of Epidemiology from UC’s Health Research Institute, Mark Daniel.

“As an example, we have been doing some work in Adelaide and with colleagues in Melbourne around those cities’ concepts of a 20-minute neighbourhood — which is all about ‘living locally’ and giving people the ability to meet most of their everyday needs, including access to primary if not acute medical care, within a 20-minute walk, cycle or local public transport trip from their home.”

Your idea of healthy may not be that healthyProfessor Daniel says your idea of healthy is ultimately socially shaped by where you live.

“A large part of that is due to your local community’s norms” he says.

“Our work has shown that norms vary geographically and spatially across different locations — so if you live in an area where the prevalence of overweight and obesity is high, this has a direct bearing on your lifestyle behaviour and your cardio-metabolic risk, above and beyond built environment features and what you do as an individual.”

“In other words, if the norms in your local community are largely unhealthful, your risks are going to be higher relative to other communities — even if you are living more healthily than others in your community.”

“A very simple example is our work showing that living in an area with a greater density of fast food outlets is associated with greater cardio-metabolic risk and mortality relative to areas with lesser densities of fast-food outlets, even accounting for all kinds of individual behavioural factors.”

“Compared with a peer in another area, you might be inclined to eat more fast food because the norms of your community support that. So you might live more healthily than your immediate neighbour, but less healthily than a peer in an area with less fast food outlets.”

“Much of the work to-date has been on census-type data relating to ill health. We are going beyond a purely social census-based perspective to look at what is happening (or not happening) on the ground, and in the built environment, that is associated with the evolution of ill health over time.”

“Through the Australian Geospatial Health Lab, we can model you as an individual to show how the geospatial and socio-demographic environments in which you live and work shape your health-related behaviour, physiological risk factors, disease and healthcare costs.”

“This will have a significant role in the clinical management of disease, shaping social and health policy, and designing programs that support healthful living and help avoid chronic disease.”

“It’s a bit like smoking was back in the ‘40s, when the tobacco companies said there’s no evidence that smoking leads to cancer. We’re seeking to provide the hard, scientific evidence around the need for healthier lifestyles as shaped by healthful environments. These factors might seem inherently obvious, but without the evidence it’s hard to argue for them in a policy sense, and to generate support for prevention — even secondary and tertiary prevention — over acute care, hospital-based intervention.”

The research team has been able to negotiate the inclusion of a set of questions in the next National Health Survey to be conducted by the Australian Bureau of Statistics, enabling them to potentially tie in data from the Medicare Benefits Scheme and Pharmaceutical Benefits Scheme to understand how people’s environment is shaping their health over time.



Breast screening — at the shopping centre or hospital?The research team has been working with the NSW Cancer Institute on a fascinating project that considers the impact that access to, and the location of, breast cancer screening clinics has on the uptake of breast screening in locations across the state. The aim of this work is to optimise the placement of fixed and mobile screening clinics.

“We haven’t just been assessing distance from screening clinics, but also things like traffic flow and speed in getting there — and even the setting in which the clinics are located” Professor Daniel says.

“While this is a work in progress, an early finding is suggesting that a screening clinic is more likely to be utilised if it is co-located with shops, than if it is co-located at a hospital where it’s difficult to park.”

“We have also been taking into account the demographics of specific areas, to determine whether the social composition and norms of particular communities are having an impact on screening uptake.”

Other projects with Primary Health Networks and an NHMRC-funded 10-year biomedical population cohort in South Australia has seen the team assessing how healthy lifestyles and chronic disease risk are impacted not just by socio-demographics but also by spatial factors like traffic flows, access to fast food, and public open space (or a lack of it).

The team has just completed a full outcomes evaluation of the state-wide $45 million Obesity Prevention and Lifestyle (OPAL) initiative in South Australia to prevent obesity in children, and will be issuing a final report on this by the end of June — in which the role of environmental factors features prominently.

Additionally, through a project funded by the NHMRC and Australian Research Council, the team is working with over 100 remote Indigenous communities in the Northern Territory to look at the impact of built environment infrastructures on outcomes like cardiovascular mortality and infectious disease.

“We’ve been able to show things that might seem eminently obvious, but there hasn’t been good data on it before — for example, that overcrowding at a household level and poor community infrastructures are associated with greater rates of common infectious and chronic diseases” Professor Daniel says.

“No-one’s ever done a study of this scale in Australia before. There have been smaller studies that have only involved about 10 communities, but through our much larger study we’ve got lots of different health data outcomes. The idea is to provide an evidence base for progressive social policy in support of more healthful infrastructure in these communities.”

An opportunity for collaborationThe Australian Geospatial Health Lab will be officially launched in October, and the UC-Esri partnership will be seeking formal collaboration arrangements with additional partners, including non-government organisations and governments.

“It really is a win-win situation, because we get access to health outcomes data and our partners get the benefits of outcomes analyses enriched with spatial data — this helps them to do what they do better” Professor Daniel says.

“Health research is getting increasingly sophisticated and our work is a great example of novel ways to apply digital health and geomatics technology.”

Reproduced with permission from the DH CRC.

INDIVIDUAL-LEVEL PREDICTIVE MODELS FOR MANAGEMENT OF POSTOPERATIVE PAIN

Opioids are a first-line treatment of postoperative pain, and as a result, this perioperative opioid Opioids are a first-line treatment of pain following surgery, but this may be a gateway to opioid misuse and addiction. Over the past decade, opioid misuse and abuse has become a major epidemic crisis in the USA.

Most surgical patients receive opioids regardless of co-morbidities, prior opioid-related problems, or possible drug-drug interactions.

In addition, the success of treatment using opioids is likely to be a complex function of a variety of individual and societal level factors, which are currently not well understood.

this project will use linked claims data — sourced from a de-identified Medicaid (UsA) dataset made available by HMs in conjunction with the Digital Health CRC — to gain a deep understanding of patterns of opioid use and prescription, and develop new insights into what constitutes successful treatment.

It will accomplish this utilising novel machine learning methods to extract interpretable patterns and associations in opioid prescribing and use.

this project is highly relevant to a range of stakeholders, both in Australia and overseas.

While the findings and the delivered machine learning tools will be specific to the Medicaid (UsA) population, the methodology will be easily portable to the Australian setting.

Research team: tina Hernandez-Boussard (stanford University) and Rachel Davey



Kernel density surface of expected counts of fast-food restaurants in Kuwait (200m cell size).

KUWAIT PARTNERSHIP TO MAP DIABETES FOOTPRINTThe Dasman Diabetes Institute Geohealth Lab (DDI-GeoH) is a partnership between the Dasman Diabetes Institute (DDI) in Kuwait and the University of Canberra (UC) to support population research in Kuwait applying spatial epidemiology to understand and prevent chronic disease.

DDI-GeoH enables the elucidation of built, social, natural and physical environmental factors to be targeted by policy and practice-level innovations to reduce risk factors and treatment costs arising from diabetes, obesity, metabolic syndrome, cardiovascular diseases and cancers. such work involves geospatial modelling with inferential, multi-level analyses assessing environmental features together with individual risk factors (diet, physical activity, smoking, clinical measures, biomarkers and disease outcomes) as these vary over time and change in response to policy, and public health and practice-based intervention. Predictive modelling informs the depiction of high-priority target areas and provides stakeholders indispensable decision-making tools for the planning of public health policy and practice interventions.

the goals of DDI-GeoH are:• Provide a resource with appropriate flexibility in support of

both public and private sector initiatives applying geospatial analysis of health and health care relevant data;

• exemplify a foremost collaborative effort to facilitate the geospatial analysis of public health data for prevention research involving internal and external partner agencies;

• support and co-ordinate existing expertise in trans-disciplinary geospatial analysis, health policy, health planning, environmental health analysis, and spatial epidemiology; and

• Facilitate the development of new approaches and methodologies to sustain effective public health and health and medical care interventions.

PUBLIC HEALTH: MAPPING THE BIGGER PICTUREsHAPInG HeALtHIeR CoMMUnItIes tHRoUGH GeosPAtIAL MAPPInG AnD AnALYsIsSTORY: SUZANNE LAZAROO PHOTOGRAPHY: LIGHTBULB STUDIO AND SOURCED

In the realm of public health, the Australian Geospatial Health Lab (AGeoH-L) has the capacity to reveal the bigger picture — and the power to shape population health trajectories.

Research team: neil Coffee, Mark Daniel, saad Alsharrah, Faisal Al-Refaei, Ralf-D schroers and Victor oguoma

https://www.canberra.edu.au/research/institutes/health-research-institute/australian-geospatial-health-lab

https://www.canberra.edu.au/research/institutes/health-research-institute/australian-geospatial-health-lab



the premise may sound simple, but where we live is composed of a complex, intricate interplay of factors.

Combining medical geography — via a powerful geographic information system (GIs), which captures and analyses spatial and geographic data — with a public health perspective, the AGeoH-L can highlight the patterns at work in different areas and populations.

A partnership between the University of Canberra and worldwide geospatial industry leader esRI, the lab was launched in 2019. It analyses datasets simultaneously at area and individual levels to show the impacts of spatial variations which drive inequities in health outcomes.

“this is particularly clear when you look at Aboriginal communities,” says AGeoH-L Director Mark Daniel, Professor of epidemiology at the University’s Health Research Institute (HRI).

“Between 2010 and 2018, we worked with over 100 Aboriginal communities in the northern territory. our work showed that those worse off in terms of infrastructure and services, also have worse health outcomes for both chronic and infectious diseases.”

Massive spatial variations can be seen even across the Australian Capital territory (ACt), he adds. AGeoH-L Director Professor Mark Daniel.

“For example, there is a statistically significant disparity in hospital admissions for cardiac events in the ACt, which is clearly correlated to built environmental factors — access to parks, food sources and both primary and tertiary healthcare, to name a few,” Mark says. the better the environmental factors, the lower the number of cardiac event-related admissions.

HRI Director Professor Rachel Davey says that while Canberra has a very high socioeconomic status — because of the averaging of factors across the region — pockets of deprivation exist.

“these areas with a low socioeconomic status and poor health outcomes are almost ‘hidden’, and one of AGeoH-L’s latest projects is exploring this health inequity across Canberra,” she says.

Researchers at the AGeoH-L can drill down to pick apart tapestries of spatio-temporal data and analyse individual threads or weave them into multi-layered 3D visualisations.

Datasets can include satellite imagery, road networks and transportation grids, property values, crime and safety statistics and healthcare costs, among others.

“our spatial epidemiology combines traditional, census-based social and demographic data with objective measures of environmental context, like accessibility to food and health care,” Mark says.

“We advocate for primary intervention — preventing the development of risk in the first place — and secondary prevention — early detection and intervention on emerging risks, at targeted area levels.”

the AGeoH-L is growing a formidable evidence base that shows — in an objective, defensible, scientific sense — how people do not have full control over the things that shape their health.

“Health outcomes are not just about individual responsibility,” Mark says.

“Governments, medical authorities and health organisations must account for the environments in which people live and look at these spatial and environmental factors that shape lifestyles, health risks and outcomes.”

He adds that the work at AGeoH-L is not about excusing individuals’ poor decisions.

“It’s about acknowledging that bad decisions are often a consequence of accumulated exposure to an adverse environment,” Mark says.

The bottom line: Where we live shapes our health outcomes.



“It’s easy to point fingers at someone doing the wrong thing, without accounting for all the things in their lives — their environmental exposures — that have led them to that point. People need to be enabled to make the right health choices.”

Ultimately, basing town planning on a bedrock of such evidence will create a healthier populace, reduce the burden of chronic disease and alleviate some of the rapidly rising demand on the health system — most of which focusses on expensive acute care treatment of the kinds of preventable diseases that AGeoH-L seeks to prevent.

By enabling better policy and more efficient targeting of resources and services, the lab is a formidable driver of equity, its work illustrating why, where, and how the health playing field should be levelled.

“If we want to reduce health inequity, we need to accept the groups and areas suffering such inequity need resources, opportunities or benefits that need not extend to all population segments,” Mark says.

“our limits co-exist with the environments that shape them, and different environments simply need different levels of attention, funding and intervention.”

A Genesis in Frustration“two decades ago, advances in statistics and computing power made it possible to look at area-level influences related to population health outcomes,” Mark says.

“I was doing this work in the United states using census tracks, administrative area boundaries for which social demographic data was available, then analysing those data against individual and aggregated health outcomes.”

But this only revealed part of the story.

“For instance: we could say that people living in areas with lower collective educational levels or lower income levels have worse health outcomes — but what about the impact of local environmental factors?” Mark says.

He realised he needed to work with medical geographers — like Associate Professor neil Coffee, whom he would later work with at the University of south Australia in Adelaide, before they, and four other researchers, moved to UC to start up the AGeoH-L.

“Population health has always emphasised environmental impact, but what we typically do is deal with individual-level behaviour,” Mark says. “We allow that behaviours are shaped by environments, but often don’t actually express the environment except in terms of soil, water, contaminants, etc.”

Lifestyle is the intersection of environment and behaviour, Mark says. Because the environment, lifestyle and behaviour are reciprocal in relation to each other, each directly and indirectly (acting through the other) shapes clinical risk factor and disease.

therefore, if initiatives are introduced to improve environments, healthful lifestyles and behaviour are correspondingly improved, clinical health risks are lessened and health outcomes, improved.

Before moving to Australia, Mark had assembled an interdisciplinary team — medical geographers, epidemiologists, and computer programmers — at the Université de Montréal in 2002. they created the Megaphone GIs, which integrated

extensive numbers of spatial databases by which they could represent and analyse different dimensions of social and built environmental factors.

today, the Megaphone GIs prototype has been integrated into the Montreal Health Department; a second-generation version lives on as the national Australian epidemiological GIs (AeGIs), developed by the AGeoH-L in partnership with esRI Australia.

the new platform incorporates advances in geospatial database construction, analytic applications, and visualisations.

“our physical geospatial laboratory at UC has large, wall-mounted touch screens with streamlined automations that allow researchers to interact with the virtual environment, to visually express and analyse the data,” says AGeoH-L Manager Marcus Blake, formerly of the Australian Bureau of statistics.

“the virtual servers process tens of millions of records in mere minutes — and our data holdings are in the terrabytes. It’s incredibly exciting work.”

World First: Standardised Data Indicatorsone of the AGeoH-L’s most unique features is its standardised classification system for spatial indicators, a world first.

“this innovative system — which Mark developed — allows researchers to compare cross-jurisdictional studies and datasets, for instance with the work we’re doing here and partnering with the Kuwaiti Geospatial Health Hub and Diabetes Registry Initiative,” says Rachel.

this makes the research uniquely portable and flexible internationally, while enabling greater collaboration with government and research groups.

“the standardisation really helps to tell a coherent story through the research,” says Assistant Professor of Public Health suzanne Carroll. “And greater collaboration, in turn, helps with further fine-tuning of the standardisation itself.”

“Basically, we take a broad construct — like the physical environment — break it down into various components, and then further sub-divide them. these are then categorised and assigned to indicators, with measures provided to each indicator,” says Mark.



“It’s a sophisticated way to characterise the complexity of environments in a scientific coding schema that allows us to develop measures to represent these different aspects of environment.”

the AGeoH-L is currently working with the University of Wollongong to use advanced machine learning technologies to build a more comprehensive GIs which can express the multitude dimensions of an environment, and then coherently organise those dimensions.

“this will reduce the burden to manually code each measure to an indicator, and each indicator to an indicator group, with the system learning to do that itself over time,” Mark says.

Privacy and ConfidentialityWorking within defence industry level standards, the AGeoH-L has strict protocols around data protection.

“one of the main aims of the lab has been to create a safe space in which confidential data can be used, so we have multiple protection layers in place — including end-to-end encryption,” says Marcus.

the AGeoH-L uses private cloud and web-based technologies, which allow the secure sharing of information with government and health-based organisations.

“new software developments are all about data being held in the cloud, leveraging on the scalability of cloud processing, and being able to share info across the world,” Marcus says.

“Also, we work with datasets rather than individuals’ data. In addition, the ethical constraints applied are considerable — for example, with our multi-state project in the United states analysing spatial factors shaping Medicaid recipients’ costs and claims, we work within the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule, the national standards that protect individuals’ medical records.”

Research Rigour: Temporality and Biological Plausibilitythe AGeoH-L team is also one of the few globally to consistently target two key issues across all its research — temporality (observing the effects of time) and biological plausibility.

According to the team’s approach, temporality indicates that the exposure to environmental factors needs to precede the outcome in

One of the AGeoH-L’s most unique features is its standardised classification system for spatial indicators, a world first.

AGeoH-L Manager Marcus Blake, Professor Rachel Davey and Associate Professor Neil Coffee.

time, to link particular spatial exposures to the evolution of patterns of health and disease developing in space over time.

the AGeoH-L team evaluates observed place-based associations with health outcomes in terms of biological plausibility, measuring biological outcomes rather than just behaviour, establishing cause-and effect relationships that extend beyond simple correlations.

“We want to show that environments shape clinical changes like blood pressure, glucose and lipid levels, etc., that account for ‘hard’ outcomes like cardiac events, or death,” Mark says. “When you use observational epidemiological methods, it’s important to consider criteria for causality, including biological outcomes and the temporality of effects in order to implicate causal effects.”

“this circumvents the biases inherent in self-reporting in a huge amount of population and public health research, because people often tell you what they think you want to hear.”

An overarching emphasis on causal criteria and causal frameworks also helps to avoid biases inherent with poor study designs, measurement development and analytic procedures.

The Way Forward With the lab firmly ensconced in the research realm, Mark hopes to now grow it in terms of meaningful integration and engagement with policymakers.

the AGeoH-L is looking to strengthen its relationships with entities like the Australian Bureau of statistics (ABs). It has already collaborated with the ABs on a project to improve spatial data linkages, and researchers have included questions to add more built environment and health behaviour components into the 2020–2021 national Health survey.

“We hope to work with health portfolios which can introduce structured, novel health interventions and with different levels of government, especially sectors that relate to population health outcomes, like transport, zoning and food supply etc.,” Mark says.

“Dealing with environmental and spatial factors will reduce the health deficit — it will be more cost-effective than constantly treating the outcome of diseases that could have been prevented.

“[treatment of complex chronic disease] is overwhelming the hospital system. Most of these things can be prevented before they are even detected, or detected early and dealt with before progressing to require expensive acute care intervention.”

Aetiological research aside, the team can also effectively contribute in intervention planning, intervention and evaluation.

“We have health evaluation and intervention experts like Rachel and Professor Margaret Cargo on the team, which positions us to work on interventions,” says Mark.

the AGeoH-L holds immense potential for growth and change.

Powered by cutting-edge digital health and geomatics technology, underscored by scientifically rigorous approaches and driven by a progressive, insightful team dedicated to life-changing research, the AGeoH-L is poised to be a digital health cartographer with the power to shape a more healthful future.

To explore a snapshot of past, present and present-future projects from the AGeoH-L team, visit www.canberra.edu.au/uncover

http://www.canberra.edu.au/uncover



Joint PhD students from HRI and the Public Health Foundation of India: Sunil George (left) and Danish Ahmad (right).

PUBLIC HEALTH FOUNDATION INDIA PARTNERSHIPPHFI unites some of the world’s most renowned public health specialists, teachers, trainers, researchers and practitioners and have five major centres in India. The University of Canberra has a longstanding partnership with researchers in PHFI and joint PhD students.

CASE STUDY ALTHOUGH FREE, HERE’S WHY TRIBALS IN KERALA’S ATTAPADI DO NOT BENEFIT FROM HEALTHCAREPermission to reproduce this article approved by Preetha K Joseph In 2013, over 50 infants died in Attapadi —a protected area in the Palakkad district of Kerala. this incident, and more deaths in the subsequent years, put the spotlight on the health of the tribal population that lives here. several underlying health issues, including malnutrition and infant mortality, were identified to be rampant. Both the central and state governments responded with a financial package to provide healthcare and related facilities to these communities free of cost.

seven years later, a new study has found that free healthcare hasn’t solved the problem of poor access to healthcare and high levels of infant mortality. the study, published in the International Journal for equity in Health, was carried out by researchers from the Health Research Institute, University of Canberra, Australia.

Indigenous communities, across the world, fare poorly on several health indicators like life expectancy, infant mortality and nutrition. Poor access to healthcare worsens this situation. the United nations (Un) has identified Universal Health Coverage (UHC) as one of the sustainable Development Goals to address inequality in accessing healthcare. Free universal health coverage ensures that financial constraints do not stand in the way of access to healthcare. However, the researchers of the current study found that the present approach to UHC alone may not yield the desired results. Many factors, including indigenous culture and beliefs, play a vital role in these communities.

Attapadi has 192 villages, inhabited by members of the Muduga, Kurumba and Irula tribal communities. For the study, the researchers interviewed more than 50 people over several months during 2018–19. these included community members, healthcare workers and experts on UHC and tribal health. they also spent hours conducting observations at both the different villages and healthcare facilities across Attapadi.

through these interactions, the study aimed to find out if the current healthcare facilities had integrated into people’s daily life and solved the problem of poor healthcare in Attapadi. In most indigenous communities, traditional knowledge of health and culture is at crossroads with modern healthcare, alienating them from local health systems.

the study found that the tribal community’s approach to health like their counterparts elsewhere, was strongly linked to the environment, their cultural beliefs, and their traditional foods. However, many of these practices were disregarded by the modern healthcare system. For example, the use of medicinal plants is a vital part of their culture.

We seek to expand and diversify our international student body as well as providing international opportunities for our students.



However, in the guise of providing ‘good quality’ treatment, healthcare officials often dismissed these traditional medicines and replaced them with modern medicines. they were also generally uninformed about the indigenous cultural practices and beliefs, leaving these people feeling stigmatised and alienated. thus, although free, the present approach to providing healthcare wasn’t successfully integrated with the community and was not meeting their needs.

Forced compliance with specific healthcare programs was another issue. Under the antenatal care program implemented in Attapadi, pregnant women had to visit the tribal speciality hospital at Kottathara village every month for check-ups. this proved to be a challenge as these visits entailed travelling long distances on hilly terrains for several hours. the indigenous community members also expressed apprehension towards going to big town hospitals as navigating the vast, unfamiliar hospital buildings and interacting with unknown doctors was daunting.

the study also revealed some underlying causes for impoverished health conditions of the tribals. Much of their land was lost to settlers from outside. As a result, the nutritious food cultivated by these communities dwindled, resulting in malnutrition, and impacting livelihoods. However, when these issues were brought up by these people, healthcare providers often dismissed them as causes of concern.

the above issues have resulted in a lack of trust in doctors and the healthcare system for the local communities. Although they are aware of free healthcare schemes, they hesitate to access them due to marginalisation and lack of integration with their culture.

“Local communities need to be involved in planning and delivering healthcare services to remedy this situation,” says Mr sunil George, the lead author of the study. “Village chiefs and their councils

must have a more expanded and meaningful role in planning and

delivering them”, he adds.

the researchers also suggest sensitising healthcare workers to the indigenous

beliefs and culture and providing most services locally, rather than in hospitals

far away.

India is home to a tribal population of over 104 million, and this study highlights why the current

implementation of UHC needs to change. Integrating traditional practices, the natural environment, and broader

underlying health concerns specific to different communities must be taken into account.

“If interventions to promote UHC are to reach marginalised groups, they must be culturally safe, locally relevant and planned with the active involvement of the community.

source: Why does the indigenous community in Attapadi, Kerala continue to experience poor access to healthcare?


34 | KeY PUBLICAtIons 2020

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10. Erku, D. A., Belachew, S. A., Abrha, S., Sinnollareddy, M., Steadman, K. J., Thomas, J. & Tesfaye, W., When fear and misinformation go viral: Pharmacists’ role in deterring medication misinformation during the ‘infodemic’ surrounding COVID-19. 1 May 2020, In : Research in Social and Administrative Pharmacy. p. 1–10 10 p.

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KEY PUBLICATIONS 2020

https://www.scopus.com/authid/detail.uri?origin=AuthorProfile&authorId=56179771900&zone=



https://doi.org/10.1111/ajag.12823

https://www.publish.csiro.au/ah/AH20040


KeY PUBLICAtIons 2020 | 35

24. Heraganahally, S. S., Kruavit, A., Oguoma, V. M., Gokula, C., Mehra, S., Judge, D. & Sajkov, D., Sleep apnoea among Australian Aboriginal and Non- Aboriginal patients in the Northern Territory of Australia — a comparative study. Mar 2020, Sleep. 43, 3, p. 1–11 11 p.

25. Hooper, P., Foster, S., Bull, F., (...), Learnihan V., Sugiyama, T., Giles-Corti, B. Living liveable? RESIDE’s evaluation of the “Liveable Neighborhoods” planning policy on the health supportive behaviors and wellbeing of residents in Perth, Western Australia. 2020 SSM — Population Health 10,100538

26. Hooper P, Foster S, Edwards N, Turrell G, Burton N, Giles-Corti B, Brown W. POSitive HABITATS for physical activity: Examining use of public open spaces and its contribution to physical activity levels in mid- to older-aged adults. Health and Place 2020 63: 102308.

27. Kou Kou, Cameron J, Aitken JF, Youl P, Turrell G, Chambers S, Dunn J, Pyke C, Baade PD. Factors associated with being diagnosed with high severity of breast cancer: a population-based study in Queensland, Australia. Breast Cancer Research and Treatment (accepted August 29th 2020).

28. Lamb, K.E., Thornton, L.E., King, T.L., (...), Coffee, N.T., Daniel, M. Methods for accounting for neighbourhood self-selection in physical activity and dietary behaviour research: A systematic review. 2020 International Journal of Behavioral Nutrition and Physical Activity.

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36 | ReseARCH PRoJeCts

RESEARCH PROJECTS Funded Research Projects

9. National Hazard Exposure Modelling Framework. Funded by Geoscience Australia.

10. National Best Practice Unit for Tackling Indigenous Smoking.Funded by the Commonwealth Department of Health & Ninti One.

11. Social analysis of South Australia’s Marine Scalefish Fishery.Funded by the South Australian Research and Development Institute.

12. ACCC inquiry into water markets in the Murray-Darling Basin.Funded by the Australian Competition and Consumer Commission.

13. ACT Wellbeing and COVID-19 Research and Analysis.Funded ACT Chief Minister, Treasury and Economic Development Directorate.

14. Regional Wellbeing Survey — investment in understanding views about environmental watering in NSW. Funded by the Department of Planning, Industry and Environment.

15. Lake Eyre Basin: 2020 RWS data collection and reporting. Funded by the Department of Agriculture, Water and the Environment.

16. Measuring farmer resilience to drought. Funded by the Department of Agriculture and Water Resources.

17. Cotton industry social and wellbeing sustainability indicators. Funded by the Cotton Research and Development Corporation.

18. National Social and Economic Survey of Recreational Fishers.Funded by the Fisheries Research Development Corporation.

19. Validation of a novel skin antibiotic for treatment of impetigo.Funded by ANU Connect Ventures.

20. Bayesian networks for contextually appropriate urban solutions to reduce cardiometabolic risk. Funded by the NHMRC.

1. Supporting mental health through building resilience during and after bushfires: lessons from the 2019-20 bushfires in southern NSW and the ACT. Funded by the Medical Research Future Fund.

2. Environmental and social determinants of health in the Australian Capital Territory: program interventions aimed at reducing the burden of disease and avoidable hospital admissions. Funded by the Medical Research Future Fund.

3. A good start in life for young children: reducing vulnerability and health inequity. Funded by the Medical Research Future Fund.

4. Indigenous engagement and leadership in the evaluation of Indigenous health and wellbeing programs: Taking steps to improve government and non-government commissioning practices. Funded by the NHMRC.

5. Integrating Pharmacists in Residential Aged Care Facilities to improve the quality use of medicines. Funded by the Capital Health Network through the ACT’s Primary Health Program.

6. Dasman Diabetes Institute Geohealth Lab and Enablement Project. Funded by the Dasman Diabetes Institute.

7. Spatial management of health risk: Applying geospatial technology for risk visualisation, hotspot identification, and analysis of geographic variation. Funded by the Digital Health Cooperative Research Centre.

8. Individual-level predictive models for management of postoperative pain. Funded by the Digital Health Cooperative Research Centre.


ReseARCH PRoJeCts | 37

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