A Multi-component Intervention For Smoking Cessation Among Australian Male Prison Inmates
Funder
National Health and Medical Research Council
Funding Amount
$551,500.00
Summary
The prevalence of smoking amongst the Australian prison population is much higher than that in the general community. Despite a perception that prison inmates are unlikely to give up smoking while in prison, a recent survey has found that many inmates have attempted to quit or have reduced the amount they smoke. The same survey reported that almost a quarter of male inmates were planning to give up smoking within the next three months. Depression and anxiety are common among prison inmates. Rese ....The prevalence of smoking amongst the Australian prison population is much higher than that in the general community. Despite a perception that prison inmates are unlikely to give up smoking while in prison, a recent survey has found that many inmates have attempted to quit or have reduced the amount they smoke. The same survey reported that almost a quarter of male inmates were planning to give up smoking within the next three months. Depression and anxiety are common among prison inmates. Research has shown that people with depression or anxiety problems are less likely to quit, and more likely to relapse, than smokers without these symptoms. For this reason there has been interest in incorporating antidepressant medications into quit strategies. As a group with a high prevalence of depression and anxiety, prisoners may benefit from an intervention strategy that includes an antidepressant medication. Prisoners are often poorly educated, on a low income or benefits, or from a lower socioeconomic or an indigenous background. Members of this disadvantaged group have been shown to be less likely to use preventive health services, such as smoking cessation programs. This research proposal represents the first large scale randomised controlled trial of a multi-component intervention for tobacco dependence amongst a prisoner population in the world. This project will compare the effectiveness of adding an antidepressant medication to counselling, nicotine replacement therapy, a coping with change package and referral to a Quitline. The proposed research follows a small pilot study of the feasibility of a similar intervention. It brings together the expertise of several people across Australia with experience in tobacco dependence and prison research. The results will inform future smoking interventions for prison inmates and offers a real opportunity to impact upon the health and well-being of some of the most marginalised groups in Australian society.Read moreRead less
Evaluation Of Internet-based, Cognitive Behaviour Therapy For The Treatment Of Anxiety Disorders In Adolescents
Funder
National Health and Medical Research Council
Funding Amount
$570,750.00
Summary
Anxiety disorders affect around 5-10% of adolescents and are associated with a range of adverse consequences if left untreated. The majority of young people with anxiety disorders do not seek nor receive treatment. This may be due partly to the perceived stigma of attending a mental health clinic and logistic problems of attending therapy. A challenge is to identify ways in which treatment can be made more accessible to adolescents in need, particularly those in rural and remote areas. Contrary ....Anxiety disorders affect around 5-10% of adolescents and are associated with a range of adverse consequences if left untreated. The majority of young people with anxiety disorders do not seek nor receive treatment. This may be due partly to the perceived stigma of attending a mental health clinic and logistic problems of attending therapy. A challenge is to identify ways in which treatment can be made more accessible to adolescents in need, particularly those in rural and remote areas. Contrary to original beliefs, evidence shows that the internet can be used to deliver effective psychological therapies for a range of mental health problems, including anxiety disorders. So far this research has focused on adults, but adolescents may be in a particularly strong position to benefit from these forms of therapy, being experienced users of internet resources. This research investigates the effectiveness of internet-based cognitive-behaviour therapy (CBT) in the treatment for anxiety disorders in adolescents. Recently we have piloted CBT for anxious children that combines clinic and internet therapy, with half the therapy sessions in the clinic and half over the internet. Pilot data show that clinic + internet therapy produced significant reductions in anxiety and is almost as effective full clinic-based therapy. The proposed research builds on our pilot work by evaluating the effectiveness of a more extensive internet-based therapy in which all sessions are completed using the internet and with an older age group. The research also examines the factors that predict which young people will respond most positively to the intervention so that the treatment can be matched to those most likely to benefit from it in the future. The aim is to develop an effective internet-based treatment for adolescents with anxiety disorders that is easily accessed and suitable for use in rural and remote populations, requiring minimal face-to-face therapist contact.Read moreRead less
Pandemic Influenza Containment Strategies In Aboriginal Communities: What Is Acceptable And Feasible?
Funder
National Health and Medical Research Council
Funding Amount
$1,056,688.00
Summary
Influenza is a serious disease with a much greater impact in Indigenous communities. This project will work with Aboriginal communities in NSW, north Qld and WA on modifying the national pandemic influenza plan to develop control strategies that are acceptable to the culture and circumstances of those communities. A template and acceptable process will then be offered to other Indigenous communities, finally leading to negotiation to modify implementation of pandemic influenza plans.
Indigenous Community Action To Reduce Harms Associated With Heavy Cannabis Use In Cape York
Funder
National Health and Medical Research Council
Funding Amount
$814,163.00
Summary
Cape York Indigenous communities together with Queensland Police, are working to reduce cannabis availability. Community leaders report that cannabis use is widespread in their communities with associated problems such as violence, mental illness and economic hardship. This project will deliver tailored strategies to reduce the demand for cannabis whilst providing support and education about the effects of cannabis and reasons to avoid using it over a three year period.
The DRUID Study: Diabetes And Related Disorders In Urban Indigenous People In The Darwin Region.
Funder
National Health and Medical Research Council
Funding Amount
$1,116,052.00
Summary
Indigenous Australians suffer a high burden of ill health from diabetes and related conditions, but very little is known about the burden of diabetes and its complications among Indigenous people in urban areas, and how to reduce it. Unlike Indigenous people in rural and remote areas, Indigenous people in urban areas (the majority of Indigenous Australians) have rarely been the subjects of health research and have even more rarely been the drivers of such research. The DRUID Study (Diabetes and ....Indigenous Australians suffer a high burden of ill health from diabetes and related conditions, but very little is known about the burden of diabetes and its complications among Indigenous people in urban areas, and how to reduce it. Unlike Indigenous people in rural and remote areas, Indigenous people in urban areas (the majority of Indigenous Australians) have rarely been the subjects of health research and have even more rarely been the drivers of such research. The DRUID Study (Diabetes and Related Disorders in Urban Indigenous People in the Darwin Region) is a partnership between researchers and members of the Darwin Indigenous community to: examine the health of adults aged 15 years and over; refer people with disease to appropriate health care and related services; follow people over time to collect information on the state of their health and their use of health services; and test the effectiveness of a program to improve dietary quality, increase physical activity and reduce tobacco smoking among those at highest risk for diabetes. The results will be of significant value to policy-makers, health practitioners, researchers, and, most importantly, Indigenous people and organisations. The study will provide the first-ever data on the burden of diabetes and related conditions in an urban Indigenous population. This information can be directly compared with recently collected national data from the AusDiab study, and used to inform the development and implementation of strategies for reducing the impact of diabetes and related conditions. The study will provide an important vehicle for the training and development of Indigenous researchers, and the central involvement of Indigenous people in the study will promote improved local awareness and understanding of diabetes among Indigenous people and increase the capacity of Indigenous people and service providers to manage diabetes and related disorders.Read moreRead less
An Examination Of The Causes Of Mortality Following Imprisonment In New South Wales Using Data-linkage.
Funder
National Health and Medical Research Council
Funding Amount
$205,500.00
Summary
Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine ....Prisoner populations are characterised by poor health status including infectious diseases, injury, risk taking behaviours (eg. smoking and self-harm), mental illness, and substance abuse. Serosurveys of blood borne viruses such as hepatitis C and hepatitis B conducted in Australian and overseas prison settings have found that over one third of inmates have been exposed to these viruses with higher rates detected in injecting drug users and female inmates. Few attempts have been made to examine the causes of mortality among prisoners following release from detention. Most interest has focused on overdoses in the period immediately following release; the aim of this study will examine all causes of death among individuals exposed to the correctional environment and compare these to death rates for NSW. Correctional centres house a largely male (94% in NSW) population with backgrounds of disadvantage in all areas, including Indigenous Australians, people of lower socio-economic status, those with a mental illness, and the intellectually disabled. There are currently over 21,000 (June 2001) prisoners detained in Australian correctional centres with approximately 39% housed in NSW. Fifteen percent of the NSW prisoners are Indigenous but comprise only 2% of the general population. The aims of this project will be to: (1) Identify all causes of death among ex-prisoners in NSW for the period 1985 to 2001; (2). Compare death rates in the study group with those in the NSW community; (3) Correlate pre-release health information contained in medical records with specific causes of death; (4) Compare causes of mortality among various sub-groups eg. injecting drug users, the mentally ill, violent offenders, and the intellectually disabled; (5) Examine causes of mortality between Indigenous and non-Indigenous inmates; and (6) use this information to develop pre-release programmes aimed at reducing excess mortality among this group.Read moreRead less
Investigating The Association Between Incarceration While Pregnant And Maternal And Infant Outcomes
Funder
National Health and Medical Research Council
Funding Amount
$307,500.00
Summary
The number of women incarcerated within Australian prisons has doubled over the last ten years. Prisons contain large numbers of women from Indigenous backgrounds, women with a mental illness, women with violent partners and women with substance abuse problems. As such they constitute one of the most disadvantaged groups within Australian society and their children are unlikely to experience a healthy start to life. At any one time around 5-10% of women inside Australian prisons are pregnant. Th ....The number of women incarcerated within Australian prisons has doubled over the last ten years. Prisons contain large numbers of women from Indigenous backgrounds, women with a mental illness, women with violent partners and women with substance abuse problems. As such they constitute one of the most disadvantaged groups within Australian society and their children are unlikely to experience a healthy start to life. At any one time around 5-10% of women inside Australian prisons are pregnant. There has been no Australian research into the effect incarceration has upon pregnant women or their babies. Some believe that women who are incarcerated during their pregnancy may have better outcomes as they are outside their normal milieu with restricted access to alcohol and illicit drugs and separated from abusive partners. Others argue that the stress of incarceration and separation from family and friends could result in poorer pregnancy outcomes. This study will investigate whether being imprisoned while pregnant results in better or worse pregnancy and birth outcomes for Australian women and their babies.Read moreRead less
INVESTIGATING MORTALITY AMONG EX-PRISONERS IN QUEENSLAND: A DATA LINKAGE STUDY
Funder
National Health and Medical Research Council
Funding Amount
$716,801.00
Summary
NOTE: At the time of submitting the NOI for this project we had not yet received feedback from a submission to a parallel NHMRC funding round concerned with social disadvantage. We have since received very positive reviews for the trial foreshadowed in our NOI, and consistent with the recommendations of one reviewer, we have modified our application to complement the proposed trial by conducting a record linkage study. The content area and ethical issues associated with the proposed project rema ....NOTE: At the time of submitting the NOI for this project we had not yet received feedback from a submission to a parallel NHMRC funding round concerned with social disadvantage. We have since received very positive reviews for the trial foreshadowed in our NOI, and consistent with the recommendations of one reviewer, we have modified our application to complement the proposed trial by conducting a record linkage study. The content area and ethical issues associated with the proposed project remain largely unchanged. Studies in Australia and elsewhere have identified a heightened risk of death among ex-prisoners, with drug overdose, suicide and 'accidents' three major causes. Many deaths occur soon after release. Although the high incidence of 'overdose' among ex-prisoners is often attributed to reduced tolerance,most fatal drug overdoses are due to the combined effects of multiple drugs. A detailed understanding of deaths among ex-prisoners is a prerequisite for evidence-based preventive strategies. The proposed study will: (a) Link the identities of prisoners released from custody in QLD between 1994 and 2006, with the National Death Index (NDI). The linked database will permit exploration of the incidence, timing, causes and risk factors for death among ex-prisoners. (b) Compare correctional records of deceased ex-prisoners and a random sample of ex-prisoners known to be alive, focussing on suspected risk factors including criminal history, behaviour in custody, health status, psychosocial adjustment, socio-economic status, and history and treatment for drug use. This will allow more detailed analysis of risk factors for death post-release. (c) Conduct in-depth analysis of causes of death among ex-prisoners, using the National Coroners Information System (NCIS). Information regarding cause and context of death will be coded by a research assistant and analysed to identify group differences (e.g., between ATSI and non-ATSI ex-prisoners).Read moreRead less
A Multisite Randomised Controlled Trial Of The Adolescent Cannabis Check-up
Funder
National Health and Medical Research Council
Funding Amount
$211,250.00
Summary
Recent Australian surveys cannabis use is more common than tobacco use among 14-19 year old (24.6% vs. 20.2%). More than 200,000 14-19 year olds have used cannabis in the last month and 7.1% report daily use. The population prevalence of cannabis dependence increases throughout adolescence, with a rate of 30% among those who use cannabis more than five times per year. Although experimentation is a normal part of adolescent development, regular cannabis use by young people exposes them to the neg ....Recent Australian surveys cannabis use is more common than tobacco use among 14-19 year old (24.6% vs. 20.2%). More than 200,000 14-19 year olds have used cannabis in the last month and 7.1% report daily use. The population prevalence of cannabis dependence increases throughout adolescence, with a rate of 30% among those who use cannabis more than five times per year. Although experimentation is a normal part of adolescent development, regular cannabis use by young people exposes them to the negative effects of cannabis at a time of rapid development and transitions in life roles. There have been no studies reported of interventions suitable for adolescents with cannabis problems who are not seeking treatment but are causing great concern for their families, schools and communities. The Adolescent Cannabis Check-up (ACCU) fills this serious gap by providing adolescents with an opportunity to objectively assess their cannabis use and develop strategies for change in a non-judgemental environment. The ACCU is a 2 session intervention: assessment and a follow-up session of personalised feed-back and brief skills-based therapy. Recruitment may be either direct or via a concerned family member. This novel approach provides parents with telephone coaching, and supporting booklets, on techniques to encourage their young person to participate. A feasibility study of 80 families has found more than 50% were able to do so. That study of 55 adolescents found a significant reduction in levels of cannabis use and an abstinence rate of 24.2% 3 months following participation in the ACCU. This project wll involve a multi-site RCT to compare the impact of the ACCU with a delayed treatment control group, on levels of cannabis use, dependence, and cannabis-related problems. This project would fill a gap in treatment service models and involve families in an initiative to assist young people to develop motivation and skills to abstain from problematic cannabis use.Read moreRead less