Workshop #1

Facilitators:
Sarah Dennis
Nicholas Glasgow
Liz McDonald
Julie McDonald
Lucio Naccarella
Gawaine Powell Davies

Linkage and exchange: researchers and policy makers working together to improve health

The aim of this workshop will be to discuss the challenges and opportunities for linkage and exchange between researchers and policy makers in Australia.

To achieve good health for all, it is important that health policy reflects the best available evidence. Linkage and exchange describes the process of knowledge exchange between researchers and policy makers. If research evidence is to be useful to policy makers and implementers of policy, it is important that it is timely, accessible and relevant. Increasingly, with the Research Quality Framework, researchers are being asked to provide evidence as to the impact of their research findings on policy and practice and therefore effective two-way communication between researchers and policy makers is ever more important. Australia has looked to the linkage and exchange model developed by the Canadian Health Services Research Foundation and this has been adopted and adapted by APHCRI and the Sax Institute.

This workshop will provide an opportunity for researchers, policy makers and implementers to reflect on the linkage and exchange model proposed by Jonathan Lomas and colleagues at the Canadian Health Service Research Foundation and how effective this has been and can be in the Australian Health System context. The presenters involved in this workshop have all experienced the linkage and exchange process through the Stream 4 program of work at APHCRI and have been awarded funding from Stream 7 to explore the application of linkage and exchange in other health research and policy contexts such as the UK, Canada and the Netherlands.

Delegates will be provided with links to key papers as pre-reading for the workshop.

Objectives

• To explore the key successes and challenges of the linkage and exchange in Australia.
• To identify the current challenges to dialogue between policy makers, implementers and researchers.
• To briefly explore some examples of linkage and exchange between policy researchers, policy makers and implementers in other countries highlighting key successes and contextual factors/challenges.
• To propose some solutions to facilitate linkage and exchange between policy makers, implementers and researchers in Australia.
• To write up the findings for an APHCRI report.

Workshop #2

Facilitator:
Carol Holden

Men's Health: A Missing Chapter in Australia's Health Narrative

The Men in Australia Telephone Survey (MATeS) provided the first Australian data demonstrating that one in three men over the age of 40 years is affected by a reproductive health disorder (such as prostate disease, erectile dysfunction) with increasing prevalence with age 1. Excluding prostate and testicular cancer, disorders of male reproductive system are generally not life-threatening but are recognized to have strong associations with chronic disease (diabetes, CVD and depression) and significant impact on relationships, quality of life and overall well-being. However, few men discuss reproductive health problems with their doctor even though younger men express high levels of concern about developing reproductive health problems in later years 2.

The emergence of men's issues as part of a ‘health for all' approach is relatively new in Australia . A limited men's health evidence base exists to inform health and social policy pertinent to the unique Australian context. This significantly limits the development and implementation of suitable interventions and preventative strategies that would optimise the physical, social and emotional wellbeing of Australian men of all ages, racial, ethnic, geographical and socio-economic backgrounds.

Andrology Australia (The Australian Centre of Excellence in Male Reproductive Health, http://www.andrologyaustralia.org) has developed a proposal to undertake a landmark nationwide men's health longitudinal study to track the life-course trajectories of a representative group of men (18+ years). The proposal describes the intention to develop a core database and infrastructure to support a longitudinal study that can be ultimately accessed by a number of research organisations and government agencies in different fields with an interest in men's health.

Delegates at the GP & PHC Research Conference represent a key stakeholder network to provide input into the Longitudinal Study on Australian Men's Health. This interactive workshop will i) discuss findings from MATeS to increase delegates knowledge of the prevalence and concerns of men's health issues relevant to management of these conditions in general practice, ii) determine from a GP & PHC research perspective those factors and events that impact on men's health and wellbeing across the lifespan and iii) provide opportunities for delegates to express an interest for future collaboration and input into the Longitudinal Study on Australian Men's Health.

1. Holden CA, McLachlan RI, Pitts M, Cumming R, Wittert G, Agius PA, Handelsman D, de Kretser DM. Men in Australia, Telephone Survey (MATeS) I (2005). A National Survey Of The Reproductive Health And Concerns Of Middle Aged and Older Australian Men. Lancet. 366: 218-224.

Workshop #3

Facilitators:
Jon Emery
Jane Gunn

How to improve evaluations of complex interventions in primary care

Many primary health care activities depend on complex interventions for which we need robust evidence of effectiveness. Evaluating complex interventions is difficult and time-consuming. Unless trials of complex interventions illuminate pro­cesses and mechanisms they often fail to provide useful information. If the result is negative, we are left wondering whether the intervention is inher­ently ineffective (either because the intervention was inadequately developed or because all similar interventions are ineffective), whether it was inad­equately applied or applied in an inappropriate context, or whether the trial used an inappropriate design, comparison groups or outcomes. If there is a positive effect, it can be hard to judge how the results of the trial might be applied to a different context (BMJ 2007; 334:455-459).

The workshop will be interactive and allow small groups to develop a hypothetical trial of a complex intervention, applying the principles listed above. Examples from previous trials of complex interventions will be presented to highlight the underlying principles. This workshop is relevant to all researchers who may want to develop and test an intervention to improve primary healthcare – more often than not, things will be more complex than you first imagined!

Workshop #4

Facilitators:
Carol Kefford
Sam Stott
Lena Sanci

Health for all young people: research, practice and policy implications

Research has shown that young people want a well-being and wholistic approach to health care, addressed through quality family relationships and a healthy community. They have identified barriers to accessing primary health care and defined a trusting relationship with a general practitioner as being important. Given the increasing health problems of sexually transmitted infections, obesity, smoking and mental and behavioural ill health in young people, many research questions remain to be answered such as: does the removal of these barriers make a difference and how can primary health care address the multi-faceted health needs of adolescents?

The Youth Health Research Interest Group (YHRIG) believes there is an urgent need to answer these questions. We ran breakfast sessions at the last two PHCRED national conferences to raise the importance of youth health research on the national agenda and our YHRIG workshop would build on this important theme. Ultimately workshop members will write the "Hobart Declaration" for Health for all young Australians to highlight the 30-year anniversary of Alma-Ata

Workshop aims to ascertain what is ideal primary health for young Australians.

To ask:-

• “Are we there yet?
• “What is being done? How is research bridging the gaps?
• “Is research being translated into policy and practice?
• “What still needs to be done?”
• “What can we do?”

We will engage local young people to assist with and be involved in every stage of the program.

• Education session on the ideal components to youth health and total well being in primary care. 30 minutes
• Break into small groups. Each group will work shop the above questions. 1 hour
• Morning Tea. 15 minutes
• Panel discussion – on current adolescent health issues, such as internet use. 30 minutes
• Plenary. Workshop members bring all ideas together and write the “Hobart Declaration”. 45 minutes

Arising from the conference: Declaration of Hobart [ PDF:64KB]

Workshop #5

Facilitators:
Frida Cheok
Saravana Kumar

From evidence to practice: a multi-faceted approach to implementing evidence - includes case study approach

There is a wide literature reporting major challenges in introducing evidence, including clinical guidelines, into routine practice. Many approaches have been tried and evidence suggests that it is possible to change behaviour, but this change generally requires comprehensive approaches at different levels, tailored to specific settings and target groups. Involving those who will be affected by change is also crucial in achieving ‘buy-in' and ultimate uptake, through the various phases from development to implementation.

This workshop will outline what is currently known from the literature about ways to get guideline recommendations taken up. Using the example of the TRACsa Whiplash Associated Disorders (WAD) guidelines, participants will learn how to develop a practical action plan to increase successful uptake of guidelines and improve sustainable best practice management of patients in primary care settings.

TRACsa: Trauma and Injury Recovery was established in December 2005 to improve health and social outcomes for people injured on the road and in the workplace. A key strategy is the uptake of evidence-based guideline recommendations in areas where there is a significant evidence-practice gap combined with high volume and/or cost. Soft tissue injuries have been identified as a priority for action, with neck and back pain representing 55% of Workcover claims in SA and over 60% of claims under the road accident compensation scheme. Further, data indicate that health and social outcomes for those in compensation systems tend to be poorer than those with the same injuries outside compensation settings.

TRACsa has conducted a systematic review of the evidence to determine best practice in the management of acute and chronic WAD and is developing multidisciplinary evidence-based guidelines and pathways of care, with the aim of achieving endorsement by the National Health and Medical Research Council (NHMRC). This will be followed by a review of the evidence for lower back pain.

The South Australian WAD guidelines will be finalised in early 2008, and a range of initiatives are planned for their implementation at the practitioner, consumer and system levels, including the awarding of an NHMRC National Institute of Clinical Studies Implementation Fellowship.

Workshop #6

Facilitators:
Jenine Godwin
Robyn Preston
Sarah Larkins

Indigenous Research Capacity Building

This workshop will explore how to build Indigenous Research Capacity through the process of Indigenous cultural learning. We believe this is best learnt, hands on, through sitting around having a ‘good yarn'. Participants will be encouraged to reflect on themselves as practitioners and apply learning within an Indigenous context.

The workshop will encompass Indigenous Research Capacity Building strategies through scenarios and/or role playing, including:

• The roles and hierarchy within the local community and organizations and how these interplay with service delivery
• Service delivery issues, including workforce development as well as interpretations on how can research contribute to service delivery
• Sourcing research funding
• Ethics in research, involving the community in ethical approval for research projects
• Research Methods (developing skills in research)
• Applying research findings to your practice (using research to assist in improving service delivery and health outcomes)

As well as workbook and reading activities, visual learning formats will be used through:

• DVD or short presentation by local elder of Aboriginal history to outline the importance of self-determination in community settings
• Practical activities i.e. participants will be asked to develop their own model of research process or service delivery relevant to them

A resource pack will also be provided to participants.

The skills & gaps identified through community consultation and addressed through the workshop are:

• need for further education and training
• recognition of formal current skills and knowledge
• need for Aboriginal and Torres Strait Islander Community and Health Service workers and services to be more proactive, self-reliant and self-sufficient through research capacity building

After the workshop participants/researchers should have knowledge in the five elements of capacity building:

• Knowledge building
• Leadership: the capacity to develop shared directions and influence what happens in the community
• Network building: the capacity to from partnerships and alliances
• Supporting information: the capacity to collect, access and utilize quality information
• Supporting information and analysis: the availability of data that is accessible for program development and objectives