MOSAIC: A GP Cluster Randomised Trial To Reduce Partner Violence Among Pregnant Women And Women With Pre-school Children
Funder
National Health and Medical Research Council
Funding Amount
$432,250.00
Summary
Intimate partner abuse or domestic violence is common and damaging for women in the early childbearing years. It has a negative effect on the mental and physical health of women and their children. Because of poor health, victimised women and children are frequent attenders to family doctors (GPs), but doctors face many barriers in making an effective response. One of these barriers is the critical absence of evidence for what would help women attending GPs in dealing with partner abuse. This is ....Intimate partner abuse or domestic violence is common and damaging for women in the early childbearing years. It has a negative effect on the mental and physical health of women and their children. Because of poor health, victimised women and children are frequent attenders to family doctors (GPs), but doctors face many barriers in making an effective response. One of these barriers is the critical absence of evidence for what would help women attending GPs in dealing with partner abuse. This is vital to inform both GP training and clinical practice. There is sound evidence that home visiting or support by peers improves the health of disadvantaged mothers and children. Similarly, advocacy improves the health and wellbeing of abused women. The MOSAIC community intervention trial combines these two elements: home visiting-peer support and domestic violence advocacy and this strategy will be evaluated in a randomised trial. The trial aims to reduce partner abuse and depression among women pregnant or with children under 5 attending GPs. It also aims to strengthen mother-child bonds. Trained and supported GPs from 40 participating practices will identify 700 abused or at risk women over a 40 week period. Women in the intervention arm of the trial, identified as abused or at risk by their GPs will be offered the support of trained para-professional 'mentor mothers' for up to a year, while the comparison arm will be offered standard GP care. Recent funding allows a pilot study of mentor mother recruitment and training to be undertaken in 2003. The study will strengthen GP support for this difficult issue and build a 'critical mass' of GPs interested in partner abuse management in the 5 participating divisions. The MOSAIC study will assess the value to GPs and women of an enhanced support system for victims' care and provide much needed evidence of an intervention embedded in general practice to reduce partner abuse of pregnant women and women with young children.Read moreRead less
A Family-centred Intervention To Reduce Challenging Behaviours In Children With Acquired Brain Injury
Funder
National Health and Medical Research Council
Funding Amount
$87,926.00
Summary
Children with acquired brain injury (ABI) are at risk of behavioural and social difficulties. Parental distress compromises parenting abilities, with adverse effects for the child with ABI. This project investigates the applicability of a family-centred program for parents to manage the difficult behaviour of their children. It is expected that parents of children with ABI will benefit from the parenting skills taught in the program, and prevent difficult behaviour occurring in the future.
A Cluster Randomised Controlled Trial Of Nurse And General Practitioner Partnership For Care Of COPD
Funder
National Health and Medical Research Council
Funding Amount
$449,377.00
Summary
Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease that can progress to severe disability and use of hospital services. It is an important cause of both death and disability in Australia. Specifically it is the third leading cause of disease burden after heart disease and stroke. Smoking is the most important cause of the disease and there is strong evidence that smoking cessation will largely prevent progression of COPD. National evidence based guidelines for management of COPD w ....Chronic Obstructive Pulmonary Disease (COPD) is a chronic disease that can progress to severe disability and use of hospital services. It is an important cause of both death and disability in Australia. Specifically it is the third leading cause of disease burden after heart disease and stroke. Smoking is the most important cause of the disease and there is strong evidence that smoking cessation will largely prevent progression of COPD. National evidence based guidelines for management of COPD were published in 2003 but these need to be implemented in the community. General practice is well placed to have a key role in early intervention and evidence based management of COPD. There is evidence that specialised nurses working in collaboration with GPs can improve the care the chronic illnesses including COPD. Care Plans with input from health professionals from a range of disciplines have been recommended for COPD but there are barriers to implementing these in general practice. This project brings together nurse assistance and care planning in a model of care designed to deliver best practice management of COPD in the community. The aim of this research is to evaluate the impact of anurse and GP partnership for care of COPD. We will examine the effect on quality of care and health outcomes at 6 and 12 months follow up. Our hypothesis is that the use of a nurse to work as a team with the patient and GP to develop and implement a care plan based on clinical practice guidelines will improve the quality of care received and have a beneficial effect on the patients' respiratory and overall health. This research will be of major significance for improving COPD care in the community and will have far reaching implications for both policy and practice. It will also define a new role for nurses and GPs working in partnership.Read moreRead less
Can Preventive Care Activities In General Practice Be Sustained When Financial Incentives And External Audit Plus Feedback Are Removed? A Randomised Controlled Trial
Funder
National Health and Medical Research Council
Funding Amount
$1,201,443.00
Summary
There is increasing debate about the effectiveness of incentive payments and audit plus feedback on the clinical behaviour of general practitioners (GPs). Governments both in Australia and the UK are raising the threshold targets for payment eligibility making it more difficult for GPs to get payments. We will conduct a trial that will investigate the impact of removing financial incentives and/or external audit plus feedback on the preventive care activities of GPs.
Increasing The Use Of Long-acting Reversible Contraception: The Australian Contraceptive ChOice PRoject (ACCORd)
Funder
National Health and Medical Research Council
Funding Amount
$726,144.00
Summary
Of all reversible contraceptive methods, long-acting reversible contraceptives (LARCs), such as intrauterine devices and hormone implants, are by far the most highly effective at preventing pregnancy. However, the prescription and use of LARCs amongst Australian women who are at risk of pregnancy is very low. To increase the uptake of LARCs, our study will trial a complex intervention that involves providing counselling to women and developing rapid referral pathways to LARC insertion.
Integrating Lifestyle Risk Factor Management Into Community Health Service Provision: Multiple Case Studies
Funder
National Health and Medical Research Council
Funding Amount
$56,676.00
Summary
This study aims to improve our understanding of how nurses and allied health professionals working in the community can address lifestyle issues with patients as part of routine practice. Lifestyle issues include smoking, poor nutrition, excessive alcohol intake and lack of exercise. This has the potential to improve the help available from community health services for individuals wishing to change their lifestyle to prevent future health problems or to better manage existing health conditions.
A Perntership Intervention Trial To Redress TreatmentDelay And Improve Outcomes In Rural Cancer Patients
Funder
National Health and Medical Research Council
Funding Amount
$1,258,784.00
Summary
Improving the poor outcomes in Australian cancer patients living in rural and remote areas is a national priority, but there is as yet insufficient evidence on how the problem is best tackled. In this project, partner organisations that deliver cancer services in non-metropolitan WA will team with experienced researchers to develop a ‘best prospects’ package of interventions targeting the community, medical and other health practitioners and patients with cancer; and to evaluate the effectivenes ....Improving the poor outcomes in Australian cancer patients living in rural and remote areas is a national priority, but there is as yet insufficient evidence on how the problem is best tackled. In this project, partner organisations that deliver cancer services in non-metropolitan WA will team with experienced researchers to develop a ‘best prospects’ package of interventions targeting the community, medical and other health practitioners and patients with cancer; and to evaluate the effectiveness of the package using a scientifically valid randomised controlled trial.Read moreRead less
Improving Asthma Control: General Practice Strategies To Optimise Medication Adherence
Funder
National Health and Medical Research Council
Funding Amount
$460,820.00
Summary
Asthma is a major health problem for Australia. Many patients have frequent symptoms and need urgent health care because they do not use a preventer inhaler regularly. This may be intentional e.g. fear of side-effects, and-or unintentional e.g. forgetting. This real-life study will test two simple strategies for GPs to improve their patients' use of preventer medications, to improve asthma control. Innovative technology will allow GPs to tailor the approach to each patient during a normal visit.
Women's Evaluation Of Abuse And Violence Care Randomised Controlled Trial- Long Term Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$284,391.00
Summary
Domestic violence has major health consequences and is a common hidden problem for women attending general practice. The project evaluates if a general practice intervention involving screening women for partner abuse, health provider education and brief counselling for women decreases partner abuse experienced and improves women's mental, physical health, parenting skills & quality of life long term (2 & 3 years after intervention). Further, to understand long term whether it is cost effective.