Health, Culture and Society

AOD Research Network (opens in a new window)

The AOD Research Network comprises Western researchers with a range of disciplinary backgrounds including psychology, social work, criminology and public health. The network aims to foster high quality research on critical substance use issues facing communities within South Western and Western Sydney.

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

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)

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.

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.

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)

A randomised controlled trial of a new integrated approach to management of eating and weight disorders, namely a Healthy APproach to weIght management and Food in Eating Disorders (HAPIFED) compared to cognitive behaviour therapy – enhanced (CBT-E)

  • Researchers: Phillipa Hay, Jessica Swinbourne, Amanda Salis, Stephen Touyz, Haider Mannan, Ian Caterson

At least a third of people with eating disorders bulimia nervosa or binge eating disorder will be overweight. However, therapies for such disorders do not address weight management well. Similarly, treatments for obesity do not address the eating disorder symptoms, and whilst there may be short-term reductions in binge eating with weight loss therapy this is not sustained over time. We have developed an approach that integrates standard cognitive behaviour therapy (CBT) for eating disorders with behavioural weight loss management adapted for this group i.e. HAPIFED. This study is the first controlled trial of HAPIFED versus CBT.

Longer-term follow-up of women with disordered eating (WHEL)

  • Researchers: Phillipa Hay, Shameran Slewa-Younan, Jonathan Mond, Deborah Mitchison

Much can be learned from longitudinal studies and there is an imperative to better understand the relationships between peoples' lived experiences and their health. This project has been following a group of women over a decade asking questions around life and lifestyle, eating and activity, and health related quality of life as well as embedded projects from doctoral and other students.

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.

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.

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 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)

Mental health literacy in a resettled refugee community in New South Wales: Paving the way for mental health promotion in vulnerable communities

  • Researchers: Dr Shameran Slewa-Younan, Dr Jonathan Mond,  Dr Mitchell Smith, Ms Diana Milosevic, Professor Anthony Francis Jorm
  • Funding: University of Western Sydney & South Western Sydney Local Health District

Resettled refugees are a particularly vulnerable group.  They have very high levels of mental health problems, in particular, trauma-related disorders, but very low uptake of mental health care.  Evidence suggests that poor "mental health literacy", namely, poor knowledge and understanding of the nature and treatment of mental health problems is a major factor in low or inappropriate treatment seeking among individuals with mental health problems.  Hence, efforts are needed to identify specific aspects of mental health literacy likely to be problematic in different demographic subgroups and to use this information to develop health promotion programs.

View final project report PDF, 939 KB (opens in a new window)

Mental Health First Aid for Post-Traumatic Stress Disorder and Depression: The Development of First Aid Guidelines for Frontline Community Workers Assisting Resettled Refugees

  • Researchers: Ms Maria Gabriela Uribe Guajardo, Dr Shameran Slewa-Younan, Professor Anthony Francis Jorm
  • Funding: PhD study and Cross Cultural Public Health Research Award

This study aims to develop culturally appropriate evidence-based actions to assist individuals from a refugee background.  By building on the highly successful standard MHFA training, these guidelines will inform tailored education on how to help an Iraqi refugee presenting with common mental health problems such as depression and posttraumatic stress disorder among others. Future directions will include the delivery and evaluation of this tailored educational program, currently being undertaken.

View guidelines PDF, 1008.19 KB (opens in a new window)

Mental Health Literacy of Resettled Afghan Refugee Communities in Australia: An Exploration of How Resettled Refugees Understand Trauma Related Mental Health Disorders and Treatment Practices.

  • Researchers: Ms Anisa Yaser , Shameran Slewa-Younan , Caroline A Smith , Rebecca E. Olson, Jonathan Mond

Resettled refugees are a particularly vulnerable group given the high prevalence of exposure to traumatic events and the known links between such exposure and mental health impairment.  It is particularly concerning that despite the very high levels of mental health problems, in particular, trauma-related disorders, there is very low uptake of mental health care.  Evidence suggests that poor "mental health literacy", namely, poor knowledge and understanding of the nature and treatment of mental health problems is a major factor in low or inappropriate treatment seeking among individuals with mental health problems.  Currently, one of the largest groups of refugees being resettled in Australia are those who originate from Afghanistan. This study seeks to examine the "mental healthy literacy" of resettled Afghan refugees in Adelaide, South Australia using a mixed methods design. It is proposed that information collected in this thesis will be used to develop culturally appropriate and responsive health promotion programs.

Assessing Mental Health Literacy in undergraduate health professional students at entry level in the UAE

  • Researchers: Dr Rachel Rossiter, Dr Nabeel Al Yateem, Dr Shameran Slewa-Younan
  • Funding: Al Jalila Foundation

Health literacy has been shown to influence recognition of and appropriate treatment-seeking behaviors. As health professionals play a vital role in developing the health literacy of community members and supporting early intervention programs, it is vital that they themselves have a high level of health literacy. Mental health literacy has received much less attention than literacy regarding physical health issues. Low levels of mental health literacy have been identified in many countries and this has been identified as an area requiring focused attention. In contrast, increased level of stress and at times distress have been reported in students undertaking tertiary studies. Providing interventions to enhance student resilience has been described as key to universities meeting their role in supporting student well being. This project will measure psychological distress and to describe mental health literacy amongst students at entry level to undergraduate studies as health professionals in the UAE. Findings will be used to inform future initiatives to support student well being and to inform development of courses and curricula that will improve mental health literacy. The overall aim is to prepare competent health professionals who are able to identify, screen and handle different mental health problems within the UAE.

Walk the talk: A study of an online population-based intervention to improve the mental health of young people who are unemployed

  • Researchers: Vanessa Rose, Janette Perz
  • Funding: Australian Rotary Health Grant

This study aims to investigate the effectiveness of an online self-directed vocationally-oriented cognitive behavioural program ('Walk the Talk') in improving the mental health of young people who are unemployed. The online program features dramatised video of cognitive self-talk, coping with unemployment, job-searching, attending interviews and maintaining employment once in the workforce; online quizzes comprising multiple choice items to self-test understanding of content material; and downloadable diary sheets, activities, website links and tips. Participants will be aged between 17-25 years and currently looking for full-time employment. Results will assist with interpreting intervention integrity and will be used to make any required modifications to the program before a planned large population scale intervention trial.

You are invited to participate. Find out more (opens in a new window)

Empowering Consumers through Timely Context Based Information

  • Researchers: Maneesh Mathai, Athula Ginige, Uma Srinivasan, Federico Girosi

Timely information and education can enhance the ability of consumers to make informed choices about their health, lifestyle and modify disease risk factors. Due to its unstructured and varied format, and lack of targeted delivery methods, available information and knowledge does not often reach consumers, when they need it most. The aim of this project is to explore ways to provide personalised, context-specific, relevant information for consumers to better manage chronic diseases.  We will initially develop a mobile based system for managing diabetes; especially type II which is preventable in many cases. The learnings will then be generalised to cover other chronic diseases.

To provide context based information to consumers we need to find their information needs and the associated context for each of the needs. This we need to find from literature, diabetes educators and if possible from some patients.  Also we will obtain insights by analysing claim data to understand various episodes relating to diabetes patients, demography, co-morbidity issues and corresponding patient pathways. Based on above findings and literature a context model will be developed. Some of the parameter values in the context model such as type of diabetes, age, gender, current medications etc. can be pre-entered to create a user profile. Other parameters such as location, time, amount of exercise the user has done and the types of food being consumed in the last few days need to be captured through sensors in mobile phones.Based on specific values of various context model parameters at a given instance the relevant information can be filtered from an existing pool of knowledge to provide to the user as actionable information.Based on the above research findings a prototype mobile based app will be developed to provide necessary actionable information in context to diabetes patients.

The WATCH trial: Randomised controlled trial of antimicrobial treatment versus watchful waiting for acute otitis media without perforation in low-risk Aboriginal children

  • Researchers:  Jennifer Reath,  Penny Abbott, Hasantha Gunasekera, Amanda Leach, Deborah Askew, R Walsh, Kelvin Kong, Federico Girosi, Chelsea Bond, Peter Morris, San Lujic, Wendy Hu,  David Peiris, Geoffrey Spurling, Timothy Usherwood, Nadeem Siddiqui, Markeeta Douglas, Tallulah Lett & Cheryl Woodall, Keitha Rabbitt

Funding: NHMRC Project Grant

Professor Jennifer Reath, Dr Penelope Abbott and Professor Wendy Hu of the School of Medicine, and Associate Professor Federico Girosi of the Centre for Health Research, with research partners including five Aboriginal Community Controlled Primary Health Care Services and Inala Aboriginal & Torres Strait Islander Primary Health Care Service are investigating ways to manage ear infections in urban Aboriginal children.The National Health and Medical Research Council funded project will compare a "watchful waiting approach" used for non-Aboriginal children with the immediate use of antibiotics recommended for Aboriginal children living in remote areas. 'Acute otitis media [middle ear infection] is a major cause of ill health in children and a common reason for antibiotic prescriptions,' Professor Reath says. 'Ear health is an important Aboriginal health issue. Aboriginal children have higher rates of middle ear infections than other children, and complications of ear disease include hearing impairment which can affect education and quality of life. Also antibiotic resistance is growing in Aboriginal communities.'National guidelines recommend observation and waiting to see if antibiotics are needed. This "watchful waiting approach" is now recommended for urban Aboriginal children at low risk of complications. Professor Reath and her team will study the relative effectiveness of the watchful waiting approach while also gauging its cost-effectiveness and assessing its acceptability among parents, carers and health care providers. Avoidable hearing loss and chronic infection must be prevented and this study will inform the treatment of ear infections in Aboriginal children.

Find out more (opens in a new window)

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.

Caring, ageing and wellbeing in Aboriginal families

  • Project Lead: Rachelle Arkles

Experience and meaning of dementia among family members caring for an older Aboriginal person with memory, thinking or cognitive decline

Philosophical and methodological approaches to studies of lived experience Dialogue between Indigenous and Western research approaches

Visibility and invisibility in a study of family caregivers of Aboriginal older people with dementia

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.

Completed Research

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