Research Areas

Allied Health Oncology Research

There are a number of projects active projects in this stream including:

The Allied Health Clinical Trials Unit – Oncology Project (ACT-ONC Project)

The primary aim of this project is to build capacity for allied health professionals to lead clinical trials in cancer supportive care and survivorship. This is a multi-stage 3-year project funded by a Clinical Trials Management Scheme Competitive Grant from Cancer Council Victoria and the Victorian Cancer Agency ($500,000), and a Funding Support Grant from Western Alliance ($20,000).

The education and training needs of allied health professionals to engage with and lead clinical trials are being explored as part of a Barwon Health/ Deakin PhD by the Project Lead.
Consumer perceptions of allied health clinical trials will also be investigated – recruitment is about to commence in a qualitative study examining consumer needs when engaging with allied health clinical trials as trial participants. Consumers are also as a part of the study design team.

For further information on the ACT-ONC Project please contact Project Lead Catherine Williams, Physiotherapist.

The Exercise Prehabilitation Trial (EXERT)

This is a feasibility trial investigating the use of a remote monitoring digital platform and wearable technology to improve the safety and accuracy of at-home exercise monitoring during prehabilitation (clinician-led exercise) prior to autologous stem cell transplant for individuals with Multiple Myeloma.

This collaborative project between the Institute of Physical Activity and Nutrition (IPAN-Deakin) and Barwon Health (Allied Health and Cancer Services) is about to commence recruitment.

For further information on this study please contact lead researcher Catherine Williams, Physiotherapist.

Surgery for breast cancer - Barriers and enablers to engagement with prehabilitation.

Breast cancer is the most common cancer in Australia. Unfortunately, breast surgery can commonly result in loss of shoulder and neck movement, increased pain and limited ability to participate in everyday life. Actively engaging in clinician-led exercise before surgery for breast cancer (prehabilitation) offers an opportunity to improve fitness, reduce long term issues with shoulder movement, arm strength and pain. Despite established benefits, the Barwon Health prehabilitation service was poorly utilised. This research aims to investigate why, with the goal of shaping a service that facilitates more people to access prehabilitation and potential improvements in patient outcomes relating to fitness, neck and upper limb pain and dysfunction.

For more information on this project, contact the lead researcher, April Chiu, Physiotherapist.

Advancing psycho-oncology care services

Psycho-oncology services are a key element in optimising outcomes for patients undergoing cancer treatment.

Evaluation has been undertaken to appraise an online group psychoeducation intervention for cancer patients that has been integrated into a stepped-care model. The success of this model has generated international interest with the Barwon team leading the way in implementation and evaluation. Further exploration of this model of care is being undertaken as a qualitative study in collaboration with Deakin University.

For more information on this project, contact the lead researcher Fiona Lynch, Psychologist.

 

Strengthening Health Services Response to Family Violence (SHRFV)

Family Violence impacts patients and workforce at Barwon Health. From 2018 to mid-2021, Barwon Health received funding to roll out the Strengthening Hospital Responses to Family Violence (SHRFV) initiative, and provide support to Colac Area Health, Hesse Rural Health and Great Ocean Road Health Service to implement this enhanced response to family violence. This initiative sits alongside the Victoria-wide Multi-Agency Risk Assessment and Management Framework (MARAM). Policies, procedures, practice guidance and tools supporting the response to family violence need to align with the MARAM framework and encompass ongoing legislative requirements of the Child and Family Violence Information Sharing Schemes.

Our current research aims provide an evidence-based understanding of the impact, outcomes, and processes that have evolved through the implementation of the SHRFV project and the expanding legislative requirements. Alongside assessing the impact of implementation, we will be exploring staff perceptions of training that supports engagement in addressing family violence and defining the requirements for a sustainable, effective and legislation-aligned model for the future.

This research aims to support Barwon Health to be instrumental in reducing family violence, family violence injuries, deaths from family violence and facilitate the effective provision of support.

This project is led by members of the social work team; Karen Todd & Jacinta Bourke can be contacted for further information.

 

HIPSTER: HIP fracture Supplemental Therapy to Enhance Recovery

Every year more than 22,000 Australians break their hip, with this number expected to grow to 60,000 by 2050.

Early movement and walking are key to enabling people to reduce their hospital and rehabilitation stays and return to day to day life, however, historically the amount of physical activity performed by patients who have had a hip fracture whilst in hospital is low.

Barwon Health is proud to be taking part in the “HIPSTER: HIP fracture Supplemental Therapy to Enhance Recovery” randomised controlled trial. This research is a multi-site Australian trial funded by NHMRC that investigates the effects of a more intensive early physiotherapy program on the recovery of patients with hip fractures.

Rupert Sangster, Physiotherapist, Principal Investigator at Barwon Health can be contacted for more information.

 

Healthcare gaps and barriers to service utilisation within Geelong refugee communities; a co-designed research and service improvement project

The North Primary Care team regularly provide services to refugee and asylum seeker communities and recently, were able to add bicultural workers to the allied health team. There are now 3 bicultural workers supporting some of the most prevalent refugee communities who access care at Corio Community Health Centre.

The primary aim of this team-based research project was to explore the gaps and barriers to health service utilisation for Geelong refugee communities. The research team comprised three bicultural workers, Eh Blu Moo Htay Thoo, Aisha Sallam, Maryam Esghaei; psychologist Joseph Daffy; social workers Erin Parker and Simone Haines and Tracey Young (nurse and primary care coordinator).

Qualitative data was collected from four focus groups from the Karen and Afghan communities. Bicultural workers and refugee health nurses, as well as the wider north area team, assisted with the recruitment of participants.

The data collected indicated several challenges for refugee communities, particularly in relation to use of interpreters. Participants highlighted challenging personal experiences of trying to access a range of health services, including pharmacy, GP’s, optometry and specialist appointments.

Participants overwhelmingly expressed a desire to improve health literacy and requested in person information sessions on health-related topics to do this. Group sessions were requested, with participants stating they welcomed the opportunity to learn from one another. Participants also expressed gratitude to the research team and the health service for having an interest in refugee experiences.

The team are now working on developing new ideas, processes and quality improvement initiatives to act on the learnings from the focus groups. A bicultural worker drop-in clinic is now in place offering group education sessions, which has resulted in increased engagement with health professionals. The team continue to explore further strategies to address the challenges identified.

If you would like a copy of the research report or further information, please contact Erin Parker (Social Worker).

 

Evaluating outcomes of public involvement in health service design

There is an increasing emphasis on involving the public in designing (or redesigning) health services. At Barwon Health, this is referred to as consumer engagement. The National Safety and Quality Health Services Standards have ‘Partnering with Consumers’ as the second of eight standards (Australian Commission on Safety and Quality in Health Care, 2021). This standard details how health services must include consumers in the “planning, design, delivery, measurement and evaluation of systems and services”.

While there are multiple potential benefits of public involvement, many authors have concluded the benefits are lacking in strong evidence. Studies have been primarily focused on outcomes for participants, rather than outcomes for health services, or how these have been evaluated. It is not known how outcomes are, or should, be evaluated.

The purpose of this programme of research is to explore:

• what outcomes from public involvement in health service design occur,
• if and how they have been evaluated,
• the barriers and enablers to evaluation, and
• how evaluation might be improved

This research has benefits for consumers, future practise and policy, and research. Previous research findings indicate that members of the public want to know their contributions to health service design have made a difference. Without improved evaluation, these differences are unknown. It is expected a planning guide/resource will improve the likelihood, ease and quality of evaluations being conducted by key stakeholders at Barwon Health. Improved evaluation will increase knowledge about the outcomes and processes of public involvement in health service design. Evaluation also has an important role in learning for improvement. Improved evaluation and dissemination of these findings will translate into a growing body of research evidence in this area, which benefits Barwon Health and other public health services.

This research is being conducted as part of a PhD at La Trobe University.

Contact physiotherapist Nicola Lloyd for further information.

Lloyd, N., Hyett, N., & Kenny, A. (2023). Barriers and enablers to evaluating outcomes from public involvement in health service design: An interpretive description. Qualitative Health Research, 1-12. https://doi.org/10.1177/10497323231191048

Lloyd, N., Kenny, A., & Hyett, N. (2021). Evaluating health service outcomes of public involvement in health service design in high-income countries: a systematic review. BMC Health Services Research, 21(1), 364-364. https://doi.org/10.1186/s12913-021-06319-1

 

Improving the provision of prescribed food, fluid and mealtime supervision requirements in inpatient and aged care settings

A food allergy refers to the reaction of the immune system to a substance (allergen) in the environment which is usually harmless (such as food). An allergic reaction occurs when a person develops symptoms following exposure to an allergen. Dysphagia refers to difficulties in swallowing. People with food allergies and/or dysphagia have specific meal requirements (e.g. no peanuts, texture-modified food, thickened fluids) and may require ‘specified higher-level care’ which involves a specific set of strategies to ensure safety when eating and drinking. These supports may include supervision, assistance with eating/drinking, verbal prompting and regulating the rate of eating/drinking and/or size of mouthfuls. Inappropriate management of food allergies and dysphagia can have life-threatening consequences including choking, aspiration and severe allergic reactions.

Our research has identified challenges in the provision of appropriate food and drinks for patients/residents in healthcare settings. Some challenges are attributable to the enormity & complexity of the food/fluid operation and the inherent risks. However, we have identified a breakdown in the communication and documentation of dietary information to be an attributable factor, amenable to intervention strategies. Our current project aims to implement and evaluate tailored interventions that improve the provision of appropriate food, drink and supervision requirements for patients in inpatient settings and to optimise safety and high quality care. The project will benefit over 1051 patients across 21 sites in Victoria’s largest regional health service.

This project has been supported by a $5000 STaRR Western Alliance Grant.

Contact speech pathologists Cara Hill or Rhianon Beggs for further information. for further information.

 

Pain Management Unit (PMU)

Identifying patterns of access, use, and discharge from care in the Pain Management Unit

The Barwon Health Pain Management Unit (PMU) is a multidisciplinary service that provides assessment and management of people presenting with persistent pain. Within the PMU, the involvement of different discipline(s) is subject to the individual’s presentation. People with persistent pain may be seen by a single discipline or multiple disciplines, with multidisciplinary care delivered concurrently or asynchronously. The current wait time to access care in the PMU is frequently reported to be problematic and a source of frustration for clients, their referrers, and staff working in the PMU.

A review of routinely collected clinic data aims to establish current wait times to access care in the PMU, as well as service level factors that may be impacting on this wait time, such the amount, duration, and type of care each person receives in the PMU. This data review and analysis will inform the direction of service improvement strategies and the direction of research undertaken by the multidisciplinary PMU team driving initiatives for timely, equitable access to care and innovations in service provision.

For more information contact PMU physiotherapists Erika Kotowicz or Jessica Hill.

Examining the feasibility and acceptability of iRest as an adjunct to treatment for chronic pain within an Australian Pain Management Unit

Integrative Restoration (iRest) is a modern, trauma-sensitive adaptation of Yoga Nidra which follows a replicable 10-step protocol. Starting in 2021, a six week ‘iRest for Pain’ program was offered, via telehealth, to suitable clients as an adjunct to standard care for pain treatment and management. This program was offered by a Clinical Psychologist within PMU, who is also trained as a Level 2 iRest Yoga Nidra teacher. In collaboration with Deakin University School of Psychology, a qualitative feasibility and acceptability trial began in 2022. Two intakes of iRest for Pain participants were interviewed about their experience of the program. Preliminary results indicate the iRest for Pain program is highly feasible and acceptable as a practical pain management skill set for participants in the program.

iRest for Pain programs are an economic way of teaching foundational self-management of pain skills including; awareness of sensations, emotions and thoughts, self-regulation, relaxation and mindfulness, which commonly increases both subjective wellbeing and pain self-efficacy. The benefit of offering this intervention as a program rather than within an individual treatment plan is threefold. First, psychological management of pain can be offered in a more timely manner, as group programs improve waitlist throughput. Secondly, more patients can access more comprehensive psychological management of pain than what could be offered in individual care alone. Finally, this program provided the additional benefit of social activation, in a cohort who are at high risk of severe social isolation.

Future quantitative studies for this program are planned.

For more information contact Meg Odgers, Psychologist.

 

Implementing routine mental health screening for community-dwelling adults by allied health professionals

Community-based allied health professionals, such as occupational therapists (OTs), frequently work with adults experiencing one or more of the high prevalence mental illnesses: anxiety, depression, and distress. This collaborative health service-led qualitative study aimed to explore OT’s perspectives and consider the context of implementing routine screening for adult clients. This qualitative study will now underpin service development to facilitate community-based allied health professionals to feel confident in applying screening tools, supported by the establishment of clear referral pathways and integration with mental health services.

For more information contact occupational therapists Kate Ingwersen or Brooke Bufton.

King, O., Ingwersen, K., Bufton, B., Hitch, D., Dupre, B., Harding, M., Mayhew, C., & van de Ven, S. (2022). ‘Are we opening a can of worms?’: Community-based occupational therapists' experiences working with clients with unexpected mental health issues. Health & Social Care in the Community, 00, 1–10. https://doi.org/10.1111/

 

Drug and Alcohol Services

Barriers and facilitators for Medication Assisted Treatment for Opioid Dependence patients to engage with take home naloxone: an explorative study

Investigators: Isabella Natale (DAS), Craig Harvey (DAS), Pene Wood (La Trobe University), Karen Anderson (La Trobe University)

Deaths from accidental drug overdoses in Australia have increased consistently over the past 15 years despite the existence of a highly effective antidote, naloxone. Naloxone has been available via GP prescription on the PBS since 2012 and for people to purchase over the counter in pharmacies since 2017.

Provision of naloxone through Take Home Naloxone (THN) programs is becoming increasingly available in Australia yet there is much improvement to be made in terms of overdose occurrence.

Patients in receipt of Medication Assisted Treatment for Opioid Dependence (MATOD) (methadone and buprenorphine) contribute to preventable overdose deaths, and whilst the medication alone has not usually caused the death, it has often played a part.

Barwon Health Drugs & Alcohol Service aims to reduce overdose risk for MATOD patients by providing overdose education as part of the initial assessment and offering naloxone. However many patients decline. Barriers to the uptake of naloxone in Australia includes:

• Cost
• Access
• Inadequate patient education around overdose risk and naloxone use

Barwon Health Drugs and Alcohol service secured DHHS funding for naloxone, meaning patients can access it free of charge. Barriers to access have been overcome by offering naloxone to patients on the spot without any major delay by experienced drug and alcohol staff. Yet, MATOD patients still decline THN.

This study was undertaken to  explore patient barriers to MATOD patients engaging with THN.  The findings will inform program development internally to design a more responsive, appropriate service and may be utilized by other THN programs in Australia. The findings may also inform targeted training and education of clinicians working in drug and alcohol services at Barwon Health and beyond.

Natale, Isabella, Craig Harvey, Pene Wood, and Karen Anderson. 2023. “It Can Save Your Life, that’s All I know. Barriers and Facilitators for Engagement in Take-Home Naloxone for People Receiving Opioid Substitution Treatment in Regional Australia: An Explorative Study”. Qualitative Research in Medicine and Healthcare 7 (2). https://doi.org/10.4081/qrmh.2023.10868.

Benzodiazepines and harm reduction

A systematic review is currently been undertaken in collaboration between DAS and IMPACT (Deakin). This review will underpin the development of a research programme to address this area of need.

 

Clinical Education & Training

Interprofessional communication workshops during undergraduate workplace learning in a regional health service

Opportunities for undergraduate students to partake in interprofessional education (IPE) during workplace learning can confer many benefits; including increased knowledge of other professionals’ roles, improved collaborative practice and the development of an interprofessional identity.

Enduring challenges inherent in IPE in the university and workplace setting have limited its widespread implementation. With these challenges in mind, a unique IPE workshop was developed and delivered by interprofessional student coordinators to undergraduate students.

For more information contact Emma Edwards or Nikki Lyons of the Allied Health Clinical Education team.

Informal interprofessional interactions in public health

Established benefits of interprofessional interactions include improved collaboration and teamwork, enhanced communication, quality of care and patient safety, more consistent adherence to evidence-informed clinical practice and improved research translation. This research highlights the importance of addressing physical and socio-cultural influences on interprofessional collaboration to benefit patient care.

King O & Shaw N (2021): ‘ … breaks down silos’: allied health clinicians’ perceptions of informal interprofessional interactions in the healthcare workplace, Health Sociology Review, DOI: 10.1080/14461242.2021.1886865

Investigators: Olivia King & Nicole Shaw, Allied Health Clinical Education

 

{EarGenie}

Barwon Health Audiology is a key regional collaborator with the Bionics Institute, in an exciting trial researching new hearing technology, aiming to improve speech development.

Babies born with hearing impairment will benefit from a $500,000 grant from the Victorian Government’s Victorian Medical Research Acceleration Fund (VMRAF), which will accelerate development of a new hearing test for babies.

EarGenie is a revolutionary technology from the Bionics Institute that uses near-infrared light to measure the brain’s response to sound in infants, allowing audiologists to confidently select the best treatment for the first time. The EarGenie technology comprises a soft band containing near-infrared light sources and light detectors, which is wrapped around the baby’s head while asleep.

When a sound is played, specialised software records the brain’s response through changes in the reflected light, which can help audiologists to select an appropriate hearing aid or know when to refer the baby for a cochlear implant.

The research team is seeking infants under the age of 24 months to participate in the clinical trials so the technology can be developed for use in clinics as quickly as possible. Geelong newborns will be part of a trial at Barwon Health where the audiology team will be using a prototype EarGenie device to collect data and provide clinician feedback on the system design.

Recruitment will commence at Barwon in 2024.

For more information on participation, go to: Participate in Infant Hearing Research or contact Rachael Hyder, Manager Audiology, Barwon Health and site Principle Investigator for further information.