ProfessorAlexandra Martiniuk

Project Opportunities

Title: Digital health technologies (including Telehealth) for rural children in Australia

Summary of opportunity:

Improving access to care for children living in rural Australia

Purpose:
To increase access to early assessment, intervention and sustainable paediatric and allied health services in rural Australia by increasing community-level partnerships, integration of existing health services and digital health technologies like Telehealth/Telecare.

Opportunity synopsis:

Objectives

1. To facilitate integration and partnerships at the community level to create a shared funding platform for telecare
2. Determine the incidence, root-causes, outcomes and potential prevention strategies for adverse events during the use of telecare and to strengthen the use of routine data collection to continuously learn from any such incidents
3. To better understand the needs of young people and their parents, with respect to telecare, in order to improve the design and delivery of services to best meet their needs
4. To understand the costs, and cost savings and to who, of providing services via telecare in rural NSW
5. To better understand how digital health technologies (mobile apps, video Telehealth etc) can support multi-disciplinary pediatric teams to provide care for rural children
6. To better understand the role of the coordinating staff team for Telehealth effectiveness and efficiency
7. To create and evaluate digital health tools (online modules, gamification etc) to support mental health early intervention, assessment and treatment for children
8. The role of the NDIS and digital health technologies for children with disability (functional needs) in rural Australia
9. To better understand the role, education and supports required for telehealth staff and clinicians for rural pediatric health services

Methods:
Methods being used in this program of research include: epidemiology (quantitative research including cluster randomised trials, case control studies, cohort studies and thus analytic techniques such as mixed effects modelling, multivariate models), qualitative methods (including realist methods, observation, focus groups and interviews), policy, cost and economic analyses, and knowledge translation. There may be the opportunity to learn about intellectual property protection (patenting, trade marks) and spin-out companies.

Implementation partner:  Royal Far West (RFW) Children's Health Service.
In 2013 RFW received the Premier's Award for Excellence in Public Service Delivery. Working with RFW enables continuous engagement with delivery arms of the health system increasing the relevance of the questions asked but also increasing opportunities for knowledge translation.

RFW connects care across service sectors and over time, as well as directly providing paediatric and allied health care, in person and via telecare, to rural children in Australia. One quarter of these children are Aboriginal. RFW works with Medicare locals, NSW Health, NSW Kids and Families, the Dept of Education, communities, and non-government groups to identify children who need extra support, to intervene early to prevent poor health. RFW supports children with fetal alcohol syndrome, autism spectrum disorders, attention deficit, and mental health conditions amongst others.

Partners involved: CSIRO and others

Significance
The questions that policy makers tend to ask include: what should be done in practice; how will it work; what will the effects be; how much will it cost; will there be adverse consequences?; and on whom will they fall? Very little evidence provides answers to such questions (Tilley and Laycock 2000) - this is true in the digital health space for rural children.

This body of work is aligned with the NSW Kids and Families Strategic Plan to 2024, including targeting children at risk, strengthening early intervention services, improving developmental outcomes, delivering best-practice care close to home, integrating care and doing so using evidence, eHealth and partnerships.

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Project Opportunities

Title: Building health systems research capacity in the Solomon Islands

Summary of opportunity:

The Australian government has supported the social sector in the Solomon Islands for over a decade including substantial efforts to provide equitable, effective and financially feasible health care for the people of the Solomon Islands. One way to ensure this is through health system research to answer key questions with follow-on improvements to programs, clinical and management practices, and health policies based on evidence.
The University of Sydney, the Solomon Islands Ministry of Health and the National Referral Hospital in Honiara are collaborating on a suite of qualitative and quantitative research projects. Overall the aim of the projects are to both produce research/policy outputs as well as support capacity development in the Solomon Islands for health systems and policy research. Projects aim to lead to evidence-based health systems improvements and to date have been in the following areas: health aid coordination (sector-wide approaches), injury/trauma, critical care, referral practices and telemedicine.

Opportunity synopsis:

This is a great opportunity for a keen student who would like to engage in research in Sydney and/or the Solomon Islands. Students may suggest a particular area of their own interest within health systems, clinical and chronic care or join one of the on-going research projects. Projects involve collaborating with colleagues in the Solomon Islands, Australia and globally who are doing similar research.

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Project Opportunities

Title: The Marurra-U Partnership Study: Evaluation of wrap-around services for children with FASD in the Fitzroy Valley, WA

Summary of opportunity:

Reigniting community resilience using a strengths-based, solution-focused approach to support children and families with FASD.   This project will involve implementing and evaluating a model of wrap-around care developed in the Fitzroy Valley that incorporates trauma-informed, culturally appropriate care delivered in person in communities as well as using telehealth. This model of care is built upon a strong global evidence-base about wrap-around service models for children with complex mental and behavioural conditions as well as our team’s evidence and experience built over the past decade together including in the Lililwan (APP1024474) and PPP (APP1068620) projects.

Opportunity synopsis:

This project is led by an established collaboration between Marninwarntikura Women's Resource Centre (Marninwarntikura), Royal Far West (RFW) and the University of Sydney - called the Marurra-U Partnership. This collaboration extends the work of the Marulu Unit in Fitzroy Crossing which focuses on diagnosis and support of children with FASD and their families and communities. 
Our research shows that one in five children in the Fitzroy Valley have fetal alcohol spectrum disorder (FASD)1,2.Children with FASD have increased risk of adverse adult outcomes including contact with justice and incarceration. In the Banksia Hill study in WA, 36% of detained youth had FASD and the majority of these youth were Indigenous3. Early diagnosis and treatment improves life outcomes. Although our Lililwan prevalence study showed 20% of children in the Fitzroy Valley have FASD and are challenged by complex and chronic disability; current services are un-coordinated and unsustained lacking paediatric and multi-disciplinary expertise, and diagnosis and treatment is delayed. There is no comprehensive service model for children with FASD in Australia. There are also knowledge gaps regarding service models for remote Aboriginal communities struggling with FASD regarding acceptability, what works for who under what circumstances, outcomes from such services as well as cost effectiveness.  
This project meets priority needs named in the FASD National Plan, has been requested by the community, emerges from a set of strong and long-standing partnerships and RFW's extensive expertise in delivering allied health services to rural and Aboriginal children, families and schools, in-person and over telehealth. Our team includes policy makers, program managers from local community organisations, service providers and researchers. 
The research focuses on: implementing effective models of health care service delivery that build linkages with multiple sectors including early childhood and education; assessing the comparative value of various health interventions and return on investment; identifying what types of interventions are most appropriate to scale up and why - including how this can best be achieved. 
The research questions to be answered are:
1. How is the evidence-based wrap-around service delivered for children with FASD?
2. What is the impact of the wrap-around service on health and well-being?
3. Is the wrap-around service cost-effective for children with FASD?