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Strategic Research and Development
Demonstration Research Grants Scheme (DRGS)
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Title |
Tai Chi and Falls Prevention for Older People |
AHS |
Central Sydney Area Health Service (CSAHS) |
Principal Investigators |
Mr A Voukelatos (CSAHS) |
Responsible officers |
Dr C Rissel |
Funding Years |
2000/2001 to 2003/2004 |
Funding |
$249,000 |
Aim |
To investigate the effectiveness of a community based tai chi program for people over 65 in reducing the time to first fall, and in improving balance. |
Objectives |
By the end of the project there will be:
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Status |
Completed |
Summary of the project report Preventing falls in older people is a public health priority. Not only do falls incur a major cost to the health system but they adversely affect the quality of life of older people and increase the risk of premature death. The Central Sydney Tai Chi Trial was a randomised control trial investigating the effectiveness of an introductory tai chi program in reducing the risk of falling among community-dwelling people aged 60 years or over. Eligible participants were randomised into either a control group (n = 347) or an intervention group (n = 355) for 6 months. The intervention consisted of a one-hour tai chi class per week for 16 weeks. The
main outcome variable was falls recorded concurrently throughout the 6-month trial period. Results indicate that an introductory 16-week tai chi program reduces the risk of falling by 35 per cent in people aged 60 years and over living independently in the community. The 16-week program also improves aspects of balance, although the exact relationship between balance and falls is not clear. The trial showed that a relatively simple community-based program of an introductory tai chi consisting of a one-hour class per week reduces the risk of falling by 35 per cent in people aged 60 years and over living independently in the community |
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Download the Report |
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Title |
Evaluation of the NSW Rural Hearing Conservation Program |
AHS |
New England Area Health Services (NEAHS) |
Principal Investigators |
Ms K Challinor (NEAHS) |
Responsible officers |
Ms K Edwards |
Funding Years |
2000/2001 to 2002/2003 |
Funding |
$17,667 |
Aim |
The goal of this project is to evaluate the effectiveness of the New South Wales Rural Hearing Conservation Program. |
Objectives |
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Status |
Completed |
Summary of the project report The New South Wales Rural Hearing Conservation Program is a hearing screening and education program for farmers and farm workers, which is provided at agricultural field days. Farmers and farm workers avail themselves of this program while attending a field day. Once they enter the program they fill in a questionnaire about noise exposure, hearing ability, and other relevant information. After the questionnaire is completed, they then have their hearing screened by a hearing health professional. The results of the screening and questionnaire are then interpreted and the farmer or farm workers are provided with a set of recommendations about maintaining their hearing health. The program has been offered to farmers since the late 1980s and in its current form has provided in excess of 6,000 screenings. Due to rural people traditionally accessing fewer health services than their urban counterparts, the program was designed to be available during 'down time' and as such has enabled a number of farmers to have their hearing screened who would otherwise have missed out. The evaluation consisted of a mail survey sent to a random stratified sample of participants. There were 5,013 farmers from New South Wales who had their hearing screened as part of the program between 1 January 1995 and 31 December 2001. Of the 1,000 individuals sampled, 15 were duplicates and 97 were returned unopened. Of the remaining 888 farmers, 64 per cent returned the survey. Of the 565 farmers who responded, 67 per cent reported that they had started using or increased their use of hearing protection since their field day hearing screening. The use of PHP for non-cabined tractors found a net gain of 13 per cent, for chainsaws 21 per cent, for firearms 7 per cent, and for workshop 21 per cent. Forty-one per cent of survey respondents had instigated strategies to reduce noise exposure beyond the use of PHP alone. Twenty-five per cent of those recommended to seek further hearing consultation followed through with the advice provided. Participants expressed a high level of satisfaction with the program, with very few reporting that the program was not helpful. Ninety-eight per cent felt that the field day hearing screening should continue and 97 per cent would recommend the program to other farmers. It is clear from the results that the program has had a positive effect on farmers' hearing conservation behaviour. However, the results varied across commodity groups and noise exposures. The farmers who participated were highly satisfied with the program and recommended that it continue. Based on the results of this evaluation, the authors recommend that the New South Wales Rural Hearing Conservation Program be continued and, where possible, expanded. The program clearly showed that farmers' behaviour in relation to noise injury prevention improved as a result of being part of the program. |
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Download the Report |
Evaluation of the New South Wales Rural Hearing Conservation Program - PDF (2,105KB) |
Title |
Clean Air for All: Reducing Smoking in Mental Health Units |
AHS |
South Western Sydney Area Health Service |
Principal Investigators |
Dr S Knowlden (SWSAHS) |
Responsible officers |
Ms M Williams |
Funding Years |
2000/2001 to 2002/2003 |
Funding |
$38,449 |
Aim |
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Objectives |
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Status |
Completed |
Summary of the project report The Clean Air For All project aimed to establish procedures to assess and treat nicotine dependence in patients admitted to mental health units in the Sydney South West Area Health Service. The records of 2407 patients were assessed during the project period. Follow-up interviews with patients who used NRT and surveys of nursing staff and GPs were also conducted. Just over half (56%) of the patients were identified as current smokers and assessment of nicotine dependence was completed for 35 per cent of patients who smoked. Of those patients who smoked who were also assessed for nicotine dependence, 81 per cent had medium, high or very high dependence scores, which meant they were eligible to receive the NRT intervention. The offer of NRT was made to 77 per cent of patients who were eligible to receive the NRT intervention, and 27 per cent of these patients chose to use NRT. Patches were the most common type of NRT used by patients (92%). Findings from the project confirm that nicotine dependence is an important issue among patients of mental health units. The CAFA project demonstrated that NRT is acceptable to many staff and patients of mental health units and important for managing nicotine dependence in the context of a Smoke Free Workplace Policy. Patients also used NRT to assist them to attempt to quit smoking, even after discharge. |
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Download the Report |
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Title |
Health Promotion Secondary Prevention in Patients with Cardiovascular Disease |
AHS |
Hunter Area Health Service (HAHS) |
Principal Investigators |
Principal Investigators Dr J Wiggers (HAHS) |
Responsible officers |
Dr J Wiggers |
Funding Years |
2000/2001 to 2003/2004 |
Funding |
$204,779 |
Aim |
Using the Hunter Area Heart and Stroke Register as a mechanism for delivery of an out patient intervention, a patient intervention and a combined out patient and patient intervention to increase health promotion and secondary prevention in patients discharged from hospital with heart disease or stroke. |
Objectives |
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Outline of study: Synopsis (or extract) |
Those with existing cardio-vascular-disease (CVD) are at higher risk of a cardiac or cerebral event than the general population. In the Hunter Area, almost one third of patients discharged alive from hospital with acute myocardial infarction (AMI), ischemic heart disease (IHD), congestive cardiac failure (CCF) or stroke were readmitted or died within 12 months. There is good evidence of reduced mortality and morbidity, and sound economic reasons for delivering secondary prevention routinely to patients after discharge from hospital following AMI, lED, CCF and stroke. About half of the recent decline in heart disease mortality is attributed to changes in risk factor levels, and at least 50% of this due to secondary prevention. This suggests that management of patients with CVD has had a significant effect on mortality. Despite this, the delivery of health promotion and secondary prevention measures in patients with known coronary disease or stroke has been less than optimal, and has not adopted an integrated approach. One reason for this has been the difficulty in identification of and access to patients with known CVD, outside the OP arena. |
Status |
Completed |
Title |
The NASH Project: Promoting better nutrition using accreditation standards in youth housing services |
AHS |
Northern Sydney Area Health Service (NSAHS) |
Principal Investigators |
Mr R Forero (NSAHS) |
Responsible officers |
Mr P Whitecross |
Funding Years |
2000/2001 to 2003/2004 |
Funding |
$9,916 |
Aim |
To develop a good practice model for nutrition policy development for youth housing services, to ensure such services meet the nutrition related Accreditation Standards for SAAP and Substitute Care Services. |
Objectives |
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Outline of study: Synopsis (or extract) |
Homeless young people, especially those experiencing adolescence, are likely to be at increased risk for inadequate nutrition. The nutritional needs in adolescence are great since the rate growth at this stage of life is second only to that in infancy. Poor nutrition is linked to the permanent impairment of growth and development, as well as life long health problems, including increased risk of non-communicable diseases. Improving food and nutrition practices in organisations that provide food to people is a major public health nutrition priority. A key strategy to bring about effective change is to have input into policy and regulations relating to nutrition at organisational, State and National levels. Standards for accreditation of youth housing services were published in 1998 by the Department of Community Services, some of which related to nutrition. However, these standards were not developed in consultation with dietitians or public health nutritionists and are believed to be difficult to interpret, implement and monitor for compliance in a workforce lacking nutritional expertise. This project sought to develop and validate tools to assist youth housing services to meet the nutrition related standards. Two reviews of the literature were conducted; one to find recognised models or guidelines for the tools and the other to explore the accreditation systems and nutrition standards for other settings such as childcare and licensed boarding houses. The project moved from developing new tools to assist services with implementing the existing standards, to developing new draft nutrition standards with reference to tools and resources already in existence. The new draft nutrition standards developed by this project were developed in consultation with experts and consumers. As the project progressed the direction changed to focus more on building the capacity of services to support quality nutrition practices being part of youth work culture. This was to be achieved through advocacy, education and debate rather than focussing solely on accreditation standards and tools. There was also an opportunity to develop best nutrition practice with a comparatively well-resourced service that was setting up a new residential program. |
Status |
Completed |
Summary of the project report |
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| Download the Report | The NASH Project: Promoting better nutrition using accreditation standards in youth housing services |
Title |
Making connections in the MAC |
AHS |
South Western Sydney Area Health Service (SWSAHS) |
Principal Investigators |
Ms W Peacock (SWSAHS) |
Responsible officers |
Ms R Hayek |
Funding Years |
2000/2001 to 2002/2003 |
Funding |
$10,000 |
Outline of study: Synopsis (or extract) |
This project aims to research, identify and develop an early intervention program targeted at 8 to 12 year olds in a disadvantaged community. The primary focus of this project will be to decrease absentee rates of the target group from schools on the Macquarie Fields Housing Estate by identifying strategies to establish reconnectedness with their school. The project will also identify strategies to address risk behaviours such as stealing, break and enter, drug & alcohol misuse and other related social issues which influence the current and future health of disadvantaged communities. Strategies for mainstream health service providers to work within a health promoting and community development framework will also be identified and piloted within the scope of this project. |
Aim |
To develop an early intervention program that will increase connectedness with school and address risk behaviours of 8 to 12 year olds in the Macquarie Fields Housing Estate. |
Objectives |
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Status |
Completed |
Summary of the project report Report under development |
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Title |
Safer Streetscapes for Older People |
AHS |
Macquarie Area Health Service (MAHS) |
Principal Investigators |
Ms Emma Craythorn (Health Improvement Manager, MAHS) |
Responsible officers |
Ms Emma Craythorn |
Funding Years |
2001/2002 to 2004/2005 |
Funding |
$40,000 |
Aim |
Conduct focus groups and in-depth interviews with older people (55 years and older) in the Wellington CCD with the highest proportion of older people to identify main pedestrian routes and older person's perception of environmental hazards on these routes. |
Objectives |
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Status |
Completed |
Summary of the project report The Safer Streetscapes for Older People Project assessed comments from older people about the streetscape environment and compared this to current Australian Standards to assess suitability of current standards to the identified needs of older people. Current standards do reflect a streetscape environment that is appropriate for older people; however, one of the challenges for all councils is upgrading existing streetscapes to meet new standards. This is a major issue for all councils, particularly those that have a shrinking ratepayer base due to population decline. Capital works of this nature are extremely expensive and as a result the streetscape environment is below current Australian Standards. This environment is likely to contribute to fall-related injury, or fear of fall-related injury, in older people. Using qualitative methods, including semi-structured interviews and focus groups, researchers asked members of the target group to describe their experiences using the streetscape in the study area. The researchers also identified common pedestrian routes used by older people. The information provided by the target group through face-to-face interviews was enriched by information from focus groups with other older people living in Wellington who resided outside the study area. Throughout the project, researchers employed New South Wales Health's Capacity Building Indicators in an effort to determine both the strength of coalition with other sectors represented on the Advisory Committee and the sustainability of the project beyond the project time frame. The major findings included identification of:
The information gathered was prioritised and compiled into a report by researchers in collaboration with the staff of Wellington Shire Council. The report contained a list of 7 recommendations for action, which was presented to councillors and staff at a council meeting. All recommendations had the potential to be addressed by the council over the financial years between 2002 and 2008 (the council's strategic planning cycle). The recommendations were included in the Wellington Shire Council's 2003-2008 Strategic Corporate Management Plan. Other actions were also initiated as a result of the research. Standards Australia advised that a ramp, identified by older people as being too steep, met the Australian Planning Standards when it was built but these standards have since been superseded. Problems of roaming dogs, people riding skateboards and bikes, and an unsafe pedestrian crossing, were also brought to the attention of the council. Signs were erected warning motorists of the presence of the pedestrian crossing, and signs highlighting bans on bike riding on the footpaths were erected in the main street. Speed limits in the area were introduced as part of a statewide initiative. At the completion of the Safer Streetscapes Project in May 2004 an audit was conducted of the study area by researchers and council staff to determine which of the 7 recommendations adopted by the council had been acted upon. It was found that 3 of the 7 recommendations had been acted on at the time the audit was conducted. The capacity building indicators used to assess the strength of the coalitions formed for the project indicated that the project partners had worked well together for a common purpose. There were some concerns among the project partners about the likely sustainability of the intervention given that many of the recommendations would require significant expenditure by the council. The qualitative methods used in this project obtained valuable information from older people that could be articulated to community policy and decision makers by researchers as a means of advocating for changes to the streetscape. This process can be replicated with other community groups who have views about their local streetscape but who traditionally do not have a voice to express those views. |
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Download the Report |
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Title |
The evaluation of mental health first aid in a rural area |
AHS |
Southern Area Health Service (SAHS) |
Principal Investigators |
Dr Richard O'Kearney (SAHS) |
Responsible officers |
Dr Richard O'Kearney |
Funding Years |
2001/2002 to 2004/2005 |
Funding |
$156,880 |
Aim |
The randomised controlled trial of the Mental Health First Aid Program will test the following hypotheses:
The sustainability component of the project will test the following hypotheses:
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Objectives |
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Outline of study: Synopsis (or extract) |
There is high prevalence of mental health problems in Australia. The most common mental disorders are depression, anxiety and alcohol misuse. Few Australians have good knowledge regarding mental health problems and many mental problems are frequently not diagnosed in primary care settings. It is possible that greater mental health literacy will help a person better manage a potential or developing mental health problem in him or herself. Similarly, a person with greater mental health literacy should be in a better position to help family members and friends who develop a mental health problem. Greater awareness in the general community about mental illness will also help people recognise their problems and help them feel comfortable discussing these issues with their doctor. Thus any programme to increase the mental health literacy level of members of the general public can be seen as facilitating both mental health promotion and mental illness prevention. The study will involve training instructors from southern NSW to deliver Mental Health First Aid courses in the region and then delivering Mental Health First Aid courses. Potential participants will be randomly assigned to either participate immediately in a course or to be placed on a wait-list control group.
To see if participants’ gains are maintained, there will be an 18-month follow-up interview for participants in the intervention group. |
Status |
Completed |
| Summary of the project report A cluster randomised controlled trial and qualitative evaluation was conducted which determined that Mental Health First Aid was effective in improving mental health literacy, attitudes and behaviour towards people with mental health problems. |
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| Download the Report | The evaluation of mental health first aid in a rural area |
Title |
Implementation of the Guide for the treatment of nicotine dependent inpatients |
AHS |
Hunter Area Health Service (HAHS) |
Principal Investigators |
Dr John Wiggers (HAHS) |
Responsible officers |
Dr John Wiggers |
Funding Years |
2001/2002 to 2004/2005 |
Funding |
$249,970 |
Aim |
The goal of the project is to identify whether an intervention designed to enhance uptake of smoking care guidelines is able to increase the degree to which inpatient care complies with a guide for the Treatment of Nicotine Dependent Inpatients of NSW Health Facilities (The Guide). |
Objectives |
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Outline of study: Synopsis (or extract) |
Smoking continues to be a major cause of morbidity and mortality. In 1999, NSW Health introduced the Smoke-free Workplace Policy, which aimed to reduce the harm associated with tobacco use among staff, patients and others. In recognition of the difficulties this creates for nicotine dependent patients within the hospital system, NSW Health is developing a Guide for the Treatment of Nicotine Dependent Inpatients of NSW Health Facilities (The Guide). Development and distribution of The Guide represents a useful first step in changing the care of inpatients who are smokers or recent quitters. However, in the absence of active dissemination strategies, changes in clinical practice are difficult to achieve. While changes in organisation-wide practice, such as those required for inpatient care as proposed in The Guide, might be achievable, they are likely to require active support in order to achieve high levels of uptake. The project will compare uptake of the guidelines at two intervention hospital sites as compared to two 'usual care' control hospital sites. The uptake intervention will be based on strategies with demonstrated effectiveness for the dissemination of health-related guidelines within the framework of relevant models. The two control hospitals will continue existing care in terms of uptake of The Guide. The control sites will demonstrate the likely degree of change in the absence of funded dissemination strategies. Evaluation of the intervention will involve conducting qualitative interviews with relevant managerial staff, Computer Assisted Telephone Interviews (CATI) with consenting patients, auditing of patient notes for all consenting smokers, and medical records checks. |
Status |
Completed |
Summary of the project report Report under development |
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Title |
Increasing walking to and from school: the Central Sydney Walk-to-School RCT |
AHS |
Sydney South West Area Health Service (SSWAHS) |
Principal Investigators |
Dr LM Wen (SSWAHS) |
Funding Years |
2004/2005 to 2007/2008 |
Funding |
$288,923 |
Aim |
To determine the efficacy of a coordinated and comprehensive Walk-to-School program as a strategy to increase the proportion of children (Years 3 and 4) who walk to and from school and those who engaged in more walking during their leisure in Central Sydney. |
Objectives |
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Status |
In progress |
| Title | Reduction in falls injuries, especially hip fracture, within aged care facilities in the Hunter |
AHS |
Hunter New England Area Health Service (HNEAHS) |
Principal Investigators |
A/Professor J Ward (HNEAHS) |
Funding Years |
2005/2006 to 2007/2008 |
Funding |
$284,786 |
Aim and objectives |
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Status |
In progress |
Title |
Does the use of pedometers increase physical activity in Illawarra residents who are referred to outpatient cardiac rehabilitation? |
AHS |
South Eastern Sydney Illawarra Area Health Service (SESIAHS) |
Principal Investigators |
Dr S Furber (SESIAHS) |
Funding years |
2004/2005 to 2006/2007 |
Funding |
$180,507 |
Aim and objectives |
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Status |
In progress |