Health, Culture and Society

Music for Life: Exploring music, health and wellbeing (opens in a new window)

Music enlivens us in ways that other media cannot, contributing to our health and wellbeing.  Music can be used in many ways in our everyday life, in planned and unplanned ways.

Sauna Studies (opens in a new window)

Sauna Studies @ Western Sydney is a new multidisciplinary research group that has been created to promote the development of sauna research at both national and international levels. The ultimate aim of the research group is to foster health, wellbeing, and community building, with a focus on the people and communities of Western Sydney.

 

Current Research

Cervical cancer early detection, and willingness to engage in preventative measures and screening, in women from CALD backgrounds living in Western Sydney

  • Investigators: Ussher, JM, Perz, J., Hawkey, A., Olayide, O., McBride, K., Kwok, C
  • Funding: Medical Research Innovation Fund MRIF (Ainsworth) $55,000 Ainsworth fund, Family Planning $20,000 (in kind)

Recent migrant women from CALD backgrounds are less likely to take part in cervical cancer screening, and have higher rates of cancer, than Australian born women.  Women who receive information and advice about cervical screening and early detection of cancer, particularly if community delivered, are more likely to attend screening. Many women are reluctant to attend meetings where the focus is on cancer screening, due to stigma, or believing it is not relevant to them. The aim of this project is to develop and test an innovative multi-pronged strategy to address the lack of knowledge and health literacy around cervical screening within CALD populations, and address the recent changes to the screening program, through peer education, culturally tailored resource delivery, and engagement with local communities.

Evaluation of an evidence based cultural care model in providing effective family support service to CALD families with a focus on child protection

  • Investigators: Ussher, JM, Perz, J., Hawkey, A., Narchal, R. (2019)
  • Funding: CMRC and Wesley Institute, contract research $33,000

Brighter Futures, delivered by Wesley Mission, is an early intervention program that helps families with children aged 0 to 9 years who are at high risk of entering or escalating within the child protection system. Despite offering the program in geographical locations that have a high density of migrant and refugee populations, historically Wesley Mission received few referrals for clients from culturally and linguistically diverse (CALD) backgrounds. In partnership, Wesley Mission and CMRC developed a program called ‘Collective Impact’, whereby CMRC multicultural support workers provide language and cultural support to Wesley Mission caseworkers working with CALD families across varying language and cultural backgrounds. This project is  an independent evaluation of the efficacy and acceptability of the Collective Impact program from the perspectives of Wesley Mission caseworkers, CMRC multicultural workers and CALD family clients.

Implementation and Evaluation of an Aboriginal Transfer of Care (ATOC) Model

  • THRI Investigators: Ilse Blignault, Liz Norsa
  • Funded by: SWSLHD (Aboriginal Health) through the NSW Health Translational Research Grant Scheme

In 2016, South Western Sydney Local Health District (SWSLHD) introduced an innovative Aboriginal Transfer of Care (ATOC) model, extending traditional hospital discharge planning to provide holistic and culturally-responsive transfer of care of Aboriginal patients with chronic conditions. In 2018, it embarked on a mixed-methods evaluation of the model of care. Project partners were SWSLHD, the NSW Ministry of Health and THRI. The quantitative component evaluated the ATOC model through a before and after study design with control groups using linked administrative health data. The qualitative component involved interviews, group discussion and participant observation. The project has strengthened practice on the ground, with a toolkit developed to support ongoing implementation and to future scalability, and built research translation capacity within the SWSLHD Aboriginal Health Directorate. Findings have been disseminated at state and national conferences. Peer-reviewed articles are in preparation.

Indigenous public health education: What is your experience of learning about Aboriginal health and [how] does it change you?

  • Project Lead: Sally Fitzpatrick

This research seeks to discern change processes and impacts among postgraduate students attending Aboriginal health studies. Through conceptual and methodological innovation this multiple methods research will provide university educators with new insight into how students experience learning about Aboriginal health, and how this learning may influence their professional practice. Working within an action research framework, this research involves analysis of five years of survey data collected from postgraduate Master of Public students using a tool developed to capture change in domains of empowerment (the Growth and Empowerment Measure (Haswell et al. 2010). It will also involve analysis of students' asynchronous online discussions and post-course feedback and interviews. This research will contribute to the fields of medical and public health education and transformative learning research.

Out with Cancer (opens in a new window)

‘Out with Cancer’, funded by an Australian Research Council Linkage grant, is a three-year research project focused on understanding the cancer experiences of lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ+) communities and their caregivers.

Sex after 55 research study

  • Researchers: Professor Jane Ussher, Professor Janette Perz, Doctor Chloe Parton and Alexandra Hawkey

Sexuality is a central aspect of quality of life, intimate relationships, and identity. Whilst there have been a number of research studies examining sexuality in young people and those of reproductive age, there has been little research on the experiences of sexuality and sexual wellbeing in women post the menopause transition and during later life. The aim of the proposed project is to examine the ways in which women experience sexuality in later life. Having greater understanding of women's lived experiences will allow for the development of appropriate health information and sexual service provision.

Suicide prevention with Aboriginal and Torres Strait Islander people

  • THRI Investigator: Ilse Blignault
  • Funded by: Blacktown Mt Druitt Hospital Kickstarter Medical Research Grant

Aboriginal and Torres Strait Islander suicide rates are two times that of non-Indigenous people. This exploratory qualitative study, led by Blacktown Hospital Mental Health, will involve focus groups and interviews with different stakeholders (consumers and carers, clinicians and community leaders and elders) in an attempt to understand the elevated rates within the Blacktown LGA and to consider best practices to help reduce such rates. Project outcomes will be used to inform recommendations for initiatives to target suicide prevention among Aboriginal people in the area and guide further research.

System-level Integration to promote the mental health of Indigenous Children: A community-driven mixed methods approach

  • THRI Investigator: Ilse Blignault
  • Funded by: NHMRC Project Grant through CQUniversity

Mental ill-health exacts a particularly high toll in Aboriginal and Torres Strait Islander communities. In partnership with PHC, schools, mental health, child welfare and juvenile justice services in three communities, this projects aims to use continuous quality improvement (CQI) processes to: Co-design and implement interventions to improve systems-level integration; and Evaluate the intervention effects on Indigenous children’s service use, satisfaction and mental health, and the costs and benefits. The multi-disciplinary investigator team is led by Prof Janya McCalman and Prof Roxanne Bainbridge at CQUniversity.

 

Completed Research

Crossing the line: Lived experience of sexual violence among trans women of colour from culturally and linguistically diverse (CALD) backgrounds in Australia

  • Investigators: Professor Jane Ussher, Professor Janette Perz, Dr Alex Hawkey, Professor Pranee Liamputtong, Professor Virginia Schmeid, Dr Brahm Marjadi, Dr Tinahe Dune and Dr Eloise Brook
  • Funding: $261,820, Australian Commonwealth, state and territory governments under Australia’s National Research Organisation for Women’s Safety Limited (ANROWS) core grant 2017

Transgender (trans) women are at higher risk of sexual violence than cisgender women. Trans women of colour face discrimination and violence on the basis of the intersection of their gender and racial identities, and, for some, their sexual identities as queer women. However, there is an absence of Australian research investigating the experiences of sexual violence among trans women of colour. The aim of this project is to increase understanding of the lived experience of being a trans woman of colour living in Australia, in relation to gender transitioning and experiences of sexual violence. This project uses a sequential mixed methods design, and a feminist intersectional approach, including analysis of interviews, photovoice, a survey, and online posts, to address its aims.

Read final report (opens in a new window)

View exhibition of photovoice (opens in a new window)

Career Pathways for Aboriginal and Torres Strait Islander Health Professionals

  • THRI Investigators: Ilse Blignault, Jannine Bailey, Christine Carriage
  • Funded by: Lowitja Institute through UNSW Sydney

Expanding and strengthening the Aboriginal and Torres Strait Islander health professional workforce is recognised as crucial for improving the health and wellbeing of Aboriginal and Torres Strait Islander communities. The ‘Career Pathways Project’ aimed to provide insights and guidance to enhance the capacity of the health system to retain and support the development and careers of Aboriginal and Torres Strait Islander people in the health workforce. This national research project incorporated a concurrent mixed-methods design, gathering and bringing together qualitative and quantitative data from a range of primary and secondary sources. Five ‘pillars of action’ for successful career pathways were identified: Leadership and self-determination, Cultural safety, Valuing cultural strengths, Investment in the workforce and workplace, and Education and training.

The construction and experience of fertility in the context of cancer: patient, partner and health professionals

  • Researchers: Jane Ussher, Janette Perz, Emilee Gilbert, Gerry Wain, Kendra Sundquist, Gill Batt, Kim Hobbs, Laura Kirsten, Catherine Mason, Pandora Patterson, Edith Weisberg
  • Funded by an ARC Linkage Grant ($693,824)

Changes to fertility can be experienced as the most difficult long term effect of cancer diagnosis and treatment. However, health professionals rarely address this important health issue, and there has been no examination of fertility concerns post-cancer across gender, across a broad range of cancer types, or from the perspective of partners. This study will examine the gendered construction and experience of fertility for men and women with cancer, their partners, and health-professionals. Psycho-social, emotional and identity concomitants of fertility concerns will be examined, as well as negotiation within relationships, and professional communication, leading to the development and evaluation of a psycho-educational intervention.

Download the latest Cancer and Fertility Self-Help Guide (opens in a new window)

Publications:
Infertility‚Äźrelated distress following cancer for women and men: A mixed method study (opens in a new window)

Threat of biographical disruption: the gendered construction and experience of infertility following cancer for women and men (opens in a new window)

Sexual wellbeing and quality of life after prostate cancer for gay and bisexual men and their partners

  • Researchers: Jane Ussher, Janette Perz, Suzanne Chambers, David Latini, Ian Davis, Scott Williams, Alan Brotherton, Gary Dowsett
  • Funded by the Prostate Cancer Foundation of Australia, $288,013, in partnership with ANZUP Clinical Trials Group and ACON

It is estimated that 600 - 1000 Australian gay men are diagnosed with prostate cancer each year. This study aims to examine the psychological burden of changes to sexual wellbeing, sexual identity and intimate relationships in gay and bisexual men with prostate cancer and their male partners. Sexuality and intimacy are important aspects of an individual's Quality of Life, with changes to sexual functioning, relationships, and sense of self reported to be among the most negative influences on the wellbeing of men with prostate cancer. However, the focus of previous research has been heterosexual men, with gay and bisexual men with prostate cancer being described as an "invisible diversity", or a "hidden population". This has led to a plea for research on the impact of potentially important differences in sexuality, identity, and intimate relationships on gay and bisexual men's experience of prostate cancer, which can be used to inform health education and health promotion, as well as lead to targeted psycho-social interventions.

Publications:
Health-Related Quality of Life, Psychological Distress, and Sexual Changes Following Prostate Cancer: A Comparison of Gay and Bisexual Men With Heterosexual Men (opens in a new window)

Threat of Sexual Disqualification: The Consequences of Erectile Dysfunction and Other Sexual Changes for Gay and Bisexual Men With Prostate Cancer (opens in a new window)

Sexual and Reproductive health of Migrant and Refugee Women: An international comparison

  • Researchers: Janette Perz, Jane Ussher, Renu Narchal in partnership with Family Planning NSW: Jane Estoesta, Jane Wicks; Community Migrant Resource Centre: Melissa Monteiro; and Simon Fraser University, Vancouver: Marina Morrow
  • Funded by an ARC Linkage Grant ($271,144 and $129,000 from partner organisations)

Sexual health is a key component of women's quality of life, with utilisation of sexual health services associated with positive mental health. However, these services are underutilised by migrant and refugee communities, resulting in negative sexual health outcomes. This project will investigate the experiences and constructions of sexual health for women from a range of recent migrant and refugee communities living in Australia and Canada, in order to understand unmet needs, and inform targeted service provision. This research project uses a multi-layered qualitative approach, which includes focus groups and semi-structured interviews with community interviewers. Data will be analysed through thematic analysis, in-depth group comparisons and case studies. Guidelines for programs of sexual health education and promotion will then be developed, and subjected to a formative evaluation, from the perspective of key stakeholders.

Research report and recommendations PDF, 520.45 KB (opens in a new window)

Publication: Negotiating Discourses of Shame, Secrecy, and Silence: Migrant and Refugee Women’s Experiences of Sexual Embodiment (opens in a new window)

Career Pathways for Aboriginal and Torres Strait Islander Health Professionals

  • THRI Investigators: Ilse Blignault, Jannine Bailey, Christine Carriage
  • Funded by: Lowitja Institute through UNSW Sydney

Expanding and strengthening the Aboriginal and Torres Strait Islander health professional workforce is recognised as crucial for improving the health and wellbeing of Aboriginal and Torres Strait Islander communities. The ‘Career Pathways Project’ aimed to provide insights and guidance to enhance the capacity of the health system to retain and support the development and careers of Aboriginal and Torres Strait Islander people in the health workforce. This national research project incorporated a concurrent mixed-methods design, gathering and bringing together qualitative and quantitative data from a range of primary and secondary sources. Five ‘pillars of action’ for successful career pathways were identified: Leadership and self-determination, Cultural safety, Valuing cultural strengths, Investment in the workforce and workplace, and Education and training.

Evaluation of the acceptability and clinical utility of the Arabic Mindfulness Intervention

  • Chief Investigator: Ilse Blignault
  • Funded by: South Eastern Sydney Local Health District

In 2015, SESLHD Multicultural Health Service and Mental Health Service embarked on an evaluation of the acceptability and clinical utility of a Mindfulness CD tailored for Arabic-speakers. Phase 1 of the research, in which Arabic-speaking community members were engaged individually to participate in the five week self-management intervention, has been completed. Results demonstrated both clinical utility and cultural acceptability, with significant changes in Depression, Anxiety and Stress Scale post intervention and at follow up. Phase 2 of this project will explore the acceptability and clinical utility of the Arabic Mindfulness CD when Arabic-speaking women are engaged in a community group setting.

Evaluation of collective healing programs

  • Chief Investigator: Ilse Blignault

Project Partner: Aboriginal and Torres Strait Islander Healing Foundation

Evaluation has a key role to play in helping Aboriginal and Torres Strait Islander communities to strengthen their own healing practices, as well as encouraging broader support for collective healing models. In order to fulfil this role evaluation must be undertaken in a way that reflects an Aboriginal and Torres Strait Islander worldview; is accountable to Aboriginal and Torres Strait Islander communities; and acknowledges and respects Aboriginal and Torres Strait Islander histories, cultures, and knowledge systems. This project involves a review of Indigenous healing project reports and interviews with experienced evaluators.

Evaluation of two initiatives within St Vincent's Hospital Homeless Health Service: COMET and Tierney House

  • Researchers: Dr Elizabeth Conroy and Ms Lauren Kadwell, Dr Rebecca Reeve (Centre for Social Impact UNSW), Prof Paul Flatau (Centre for Social Impact UWA)
  • Funded by St Vincent's Hospital Darlinghurst

This evaluation aims to: i) document the health needs and outcomes of service users accessing COMET and Tierney House; and ii) measure the extent to which the two services are delivering effective health care to individuals experiencing homelessness. COMET provides outreach assessment and treatment for sub-acute health problems while Tierney House provides residential support for homeless adults requiring non-acute health care (such as post-surgical recovery and convalescence following a hospital stay or stabilisation on medication for chronic health problems). The study will use a range of methods including analysis of hospital separations and emergency department presentations pre- and post-service delivery to examine changes in presenting health needs and service utilisation; a survey of key stakeholders to identify ; and case studies of service users to document referral and treatment pathways. A cost effectiveness analysis will also be undertaken to examine the health costs of those utilising the COMET and Tierney House services, the recurrent and capital costs of delivering these two services and the extent to which they are offset by any health savings costs.

The first output from this project is a Research Bulletin that summarises some of the key findings from the project.

Research Bulletin PDF, 483.55 KB (opens in a new window)

Emotional responses to food and neurobiological response in children and adults (Emotions and Food)

  • Researchers: Phillipa Hay, Sloane Madden, Simon Clarke, Michael Kohn, Perminder Sachdev, Stephen Touyz, Mark Williams, Brooke Adam, Vaughan Macefield, Luke Henderson, Beatriz Martin Monzon

Central to an eating disorder are sufferer's thoughts, behaviors and feelings around food, and the impact of the former on weight and body image. Cognitive and behavioral aspects of eating disorders have been widely recognized as important to the identification, theoretical understanding and development of treatments. Exploration of functional brain imaging and emotive responses is still in its infancy in the area of eating disorders. Hence this study aims to examine participants' emotional and neurobiological responses to images of food via questionnaires and functional magnetic resonance imaging (fMRI). The study will include a sample of adults, adolescents and children with eating disorders.

An examination of family homelessness: A study of families accessing Mission Australia Centre Kingswood (MAC-K)

  • Researchers: Dr Elizabeth Conroy , Dr Chloe Parton , Dr Lauren Shone
  • Funded by Mission Australia

This mixed methods study will explore the risk and protective factors for family homelessness. It aims to answer the question of why some families become homeless while other families do not, given similar experiences of disadvantage. The primary outcome of the project will be an assessment framework to assist staff in identifying and responding to families at risk of homelessness.

Phase 1 is a qualitative study involving semi-structured interviews with MAC-K service users and their support workers. Service users will be purposively sampled to include a range of family types (e.g. grandparent-headed household, young single mother, parent without custody of children) and risk pathways (e.g. child protection, family breakdown, financial stress). A thematic analysis of narratives will be conducted in which meaning-making and experiences of resilience, family and key life events that have led the client participants to their current situation will be examined. Phase 2 is a quantitative study that further explores risk and resilience factors identified during Phase 1. This second stage will involve a cross-sectional survey of homeless and non-homeless families in Western Sydney. The survey will measure associations between resilience and risk and protective factors such as family conflict and cohesion, social support, and social problem solving.

Evaluation of the relative efficacy and mechanisms of a couple based intervention for Premenstrual Syndrome through a randomised control trial using mixed methods

  • Researchers: Jane Ussher, Janette Perz (CI), & Edith Weisberg (PI)
  • Funded by an ARC Discovery Grant ($430,000)

Of 9,689 Australian women recently surveyed nationally, 33% reported moderate or severe premenstrual symptoms (PMS). Whilst relationships have been identified as a significant factor in the experience of premenstrual distress, to date, there has been no systematic description or evaluation of couple-based PMS interventions. This research study will do this, comparing couple-based support to both one-to-one and self-help support, helping health-care providers understand the experience and treatment of PMS in the context of family relationships, thereby reducing PMS, and the physical and psychological distress associated with it. This will lead to improved psychological wellbeing and quality of life for women and their families, a priority area for the ARC.

Download the Self-Help Guide PDF, 289.82 KB (opens in a new window)

Multiple perspectives on sexuality and intimacy post-cancer, leading to the development and evaluation of supportive interventions

  • Researchers: Jane Ussher, Janette Perz, Emilee Gilbert (CI) Gerry Wain, Kendra Sundquist, Gill Batt, Kim Hobbs, Laura Kirsten (PI)
  • Funded by an ARC Linkage Grant ($585,308)

Sexuality and intimacy are key aspects of quality of life detrimentally affected by cancer, resulting in significant reductions in well-being for people with cancer and their partners. However, health professionals rarely address this important health problem, and little is known about the factors which predict difficulties or re-negotiation of sexuality post-cancer. This study will examine the experience and construction of intimacy and sexuality post-cancer, from the perspective of people with cancer, their partners, and health professionals, and elucidate pathways to difficulty or re-negotiation. Based on these findings, programs of targeted couple interventions will be developed, and evaluated in a randomised controlled trial.

Download the latest Sexuality, Intimacy and Cancer Self-Help Guide (opens in a new window)

Michael's Intensive Supported Housing Accord (MISHA) Evaluation (2011-2014)

  • Researchers: Paul Flatau, Lucy Burns, Elizabeth Conroy, Bridget Spicer, Tony Eardley
  • Funded by Mission Australia through a philanthropic donation ($230,568)

The MISHA Project was a collaborative research venture with Mission Australia that commenced in late 2010. It aimed to evaluate Michael's Intensive Supportive Housing Accord (MISHA), a 'housing-first'-type model that provided housing and case management for 75 chronically-homeless men in the Parramatta area. The evaluation involved: 1) Two year longitudinal client survey examining outcomes with respect to housing, economic and social participation, and physical and mental health; 2) In-depth interviews with clients and caseworkers to explore the critical success factors and barriers for the project; and 3) Cost analysis that modelled the savings associated with providing the MISHA service compared to the costs that would have been incurred by the government if the sample had remained homeless. The baseline and 12-month findings have been published and the 24 month findings are available in the From Homelessness to Sustained Housing: MISHA Research Report 2010-2013 PDF, 2405.97 KB (Opens in a new window). It is hoped that the findings from this research will inform housing and homelessness policy and improve the design of similar programs in the future.
In November 2014, the MISHA Evaluation won theExcellence in Social Impact Measurement award (opens in a new window). The award was presented by the Social Impact Measurement Network of Australia (SIMNA) and recognises best practice in outcomes measurement in the social sector.

An evaluation of the Inner City Drift Project (2012-2013)

  • Researchers: Elizabeth Conroy

System and Services Integration in the mental health, drug and alcohol and homelessness sectors (2009-2011)

  • Researchers: Elizabeth Conroy