Inclusion Health

CALD Health

Understanding the End of Life Needs of CALD and Aboriginal Communities in Western Sydney Local Health District

  • Investigators: Professor Debbie Horsfall, Professor Rosemary Leonard, Dr Joy Paton
  • Funding: $300 000 over 2 years. Funded by Western Sydney LHD

The research is a joint project between Western Sydney Local Health District (WSLHD) and Western Sydney University’s (WSU) Caring at End of Life Research Team. It is a project in two stages. In stage one we will be using multiple methods, including the Death Literacy Index (previously developed by this research team), focus groups, in-depth interviews and photo-voice to develop our understandings of culturally and linguistically diverse (CALD) and Aboriginal people’s experiences of death, dying and caring and their needs, if any, for support and services. Elders of the relevant communities will work with us as co-developers of the research design. Informed by the findings of stage one stage two is the co-design of culturally appropriate, and safe, models of palliative care and support for Aboriginal and CALD communities. We are cognisant of the fact that Indigenous and CALD groups have been endlessly studied, with much of the research to date, either deliberately or inadvertently, adopting colonial assumptions, thus reinforcing power imbalances between the researchers and the researched (West et al., 2012). Some communities have described this approach as ‘structural violence’ (Atkinson, 2002). To help address this, the methodology is strongly informed by principles to assist in developing ethical practices for culturally safe research within Aboriginal and CALD communities. Participants in the research will have the opportunity to be part of the co-design work including the writing of the research report and the generation of recommendations. A book of photographs and narratives co-generated through the in-depth interviews will also be published alongside the more traditional research report. Individuals from each community will also have the opportunity to be co-researches as desired.

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Indigenous Health

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.


LGBTQ Health

Queering Disability:  Sexual Health of LGBTQ

  • Investigators: Janette Perz, Rosalie Power, Catherine Londos, Jane Ussher, Alex Hawkey, Iva Strnadov√°, Amie O'Shea, Charbel Zada, Claire Quilliam, Ricki Spencer
  • Funded by: WHRTN

This research will use co-production methods to partner with consumers to examine the sexual health experiences and needs of LGBTQ women and gender diverse people with disability.


Completed Research

Out with Cancer

  • Investigators: Jane Ussher, Janette Perz, Martha Hickey, Suzanne  Chambers, Gary Dowsett, Kerry Robinson, Ian Davis, Antoinette Anazodo, Fiona McDonald
  • Funded by: ARC Linkage grant

‘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.

Find out more (opens in a new window)

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.

The gambling bug project: Problem gambling in Indigenous communities during COVID-19

  • Researchers: Paul Saunders, Professor Aunty Kerrie Doyle

The Indigenous Health team at Western Sydney University have secured an Australian Partnership for Preparedness Research on Infectious diseaSe Emergencies (APPRISE) First Nations-led research on COVID-19 grant to develop and evaluate a community-driven public health intervention based on the narratives of those with problem gambling behaviours within Indigenous communities during the COVID-19 pandemic. The project is planned to operate in one regional and one urban setting within New South Wales providing an insight into the impacts of COVID-19 on problem gambling for Indigenous communities in a range of geographical environments. The research will employ an indigenist approach, considering the complex socio-cultural factors contributing to the over-representation of Indigenous people in problem gambling statistics. The project, led by Dr Paul Saunders and Professor Aunty Kerrie Doyle from the university’s School of Medicine and Translational Health Research Institute, will look to develop a public health strategy to increase awareness around problem gambling and its dissociation with Indigenous culture. Dr Saunders was delighted with the grant outcome stating that “a focus on a strengths-based approach that is community-driven and locally-relevant to the two project communities will ensure community-control and sustainability of the developed strategies which, if successful, may also be translated to address other socially-mediated, and locally-relevant public health issues which have often been exacerbated by the COVID-19 pandemic”. The project is due to commence in early 2021.

A Place to Call Home: making meaning of home/lessness for people seeking asylum in Australia

  • Investigators: Dr Elizabeth Conroy (WSU THRI), Anjali Roberts and Mr Nishadh Rego (Jesuit Refugee Services Australia)
  • Summer Research Intern: Angelica Ukak

There is limited data on the number of people seeking asylum who are experiencing housing instability and homelessness in Australia although the demand for support from organisations working with this population suggest this need is quite large. This study aims to document experiences of housing and home-making for people at different stages in their claim for protection. This study has adopted the conceptual framework of Burn and Fabos (2015) in distinguishing between three kinds of homes – HOME that refers to the broader political and historical context in which home is understood and experienced; Home that refers to a person’s memory, longing and imagination of an idealised home; and home that refers to day-to-day practices and meanings individuals give to the places they inhabit. Data from narrative interviews and a brief cross-sectional survey will inform roundtable discussions with stakeholders to develop a set of recommendations for policy and practice across the housing and refugee sectors.

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.

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.

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)

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)

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.

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 the Excellence 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