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Population and Health Services Research

The Ingham Institute is a global leader and centre of excellence in population and health services research.

Population and health services research aims to understand the origins of health and disease to improve the wellbeing of all generations, including babies and children. These groups work directly with our diverse and growing community of South West Sydney to develop health services and treatment programs that serve the current and emerging health needs of our community.

Our flagship programs in population and health services research

Patient safety and women’s and children’s health are key areas of focus for the population and health services research stream.

Population health researchers from our Simpson Centre for Health Services Research are developing and evaluating new ways to improve critical care in hospital emergency departments.

Meanwhile, The Centre for Applied Nursing Research (CANR) is focused on enhancing nursing and midwifery practice throughout Australia.

At the heart of our population health research is Maternal Early Childhood Sustained Home Visiting (MECSH), a sustained nurse home-visiting program for families at risk of poorer maternal and child health and development outcomes. Now a global program operating in the UK, Korea and USA, it originated in South Western Sydney as an outreach program for vulnerable and at-risk mothers. The program helps mothers create better home environments and improves the cognitive development of babies and children.

The Centre for Health Equity Training, Research and Evaluation (CHETRE)’s mission is to ‘co-create intelligence for better health’ in and beyond South Western Sydney. CHETRE aims to provide leadership and expertise in training, research and evaluation for health equity.

CHETRE was established in 1998 to meet research and development needs in health equity within South Western Sydney. CHETRE was a founding member centre of the Centre for Primary Health Care and Equity when it was formed in 2005.

CHETRE was established as a joint unit between Population Health in South Western Sydney Local Health District and UNSW Australia. CHETRE is part of the management structure of both organisations and it aligns its work with both organisations’ policy priorities and strategies.

Through collaboration with its partners CHETRE develops, supports and evaluates projects, programmes and policies to reduce inequities in health. CHETRE’s leadership and expertise are recognised locally and globally.

Our Streams

CHETRE’s work is structured in three streams:

  • The Decision Support stream assesses the impacts of environmental, social, economic and policy change (proposals) on health and health equity and frames its findings in policy-relevant briefings and communications. Grounded in its international reputation in health impact assessment (HIA), the team supports local partners, other CPHCE research hubs, state, national and global health development through training and assessment.
  • The Locational Disadvantage Stream engages with residents and groups in communities and neighbourhoods in our service area in South Western Sydney that experience health and other disadvantages due to complex social and economic challenges.  The stream focuses on community development and partnership approaches that empower communities and consumers in order to promote resilience and more equitable health.
  • The Indigenous Health stream builds on nearly twenty years of close connections with the Tharawal Aborignal Corporation and the Aboriginal community in South Western Sydney. At the request of the community, and integrated in its Aboriginal-controlled governance structures, CHETRE has undertaken a unique longitudinal cohort study of the health of Aboriginal Babies since the early 2000s through the Gudaga program (‘Gudaga’ is Tharawal for ‘healthy baby’). Work within this stream also extends into social determinants of Indigenous health, health promotion and Health in All Policies for Indigenous equity.

Our Partnerships

Partnerships are central to all our research and service development activities. Our core partnerships include state government agencies, local governments, community organisations and NGOs, and service providers within and outside the South Western Sydney Local Health District.

CHETRE supports and manages a number of key partnerhsips with colleagues from the public and social housing sector, urban planning, primary health care, justice, education and social development. These partnerships range in scale from regional, to state wide, national and international

Group Leader

Prof. Evelyne de Leeuw

The Centre for Applied Nursing Research (CANR) was established in 1991 as a joint venture between the School of Nursing and Midwifery, Western Sydney University (WSU) and the South Western Sydney Local Health District (SWSLHD). CANR is accessible to all employees of SWSLHD and WSU and aims to promote research and professional development within the two communities.

CANR purpose is to undertake research, and to facilitate and support collaborations between nurses and nurse academics that will generate research relevant to the clinical, health promotion and health education role of nurses, and provides a basis for evidence based practice within this context, CANR conducts research in:

  • Comprehensive Care
  • Patient Safety and Quality
  • Chronic and Complex Care
  • Cross Cultural Health & Health Literacy
  • Education
  • Workforce and Service Development
  • JBI – Systematic & Fellowship Training

Group Leader

Martin Christensen

Poor oral health can have a negative impact on various systematic conditions such as cardiovascular disease, diabetes, stroke and adverse pregnancy outcomes. Unfortunately the majority of the population are unaware of the impact of poor oral health on systemic health and seldom seek dental care. Oral health is also often neglected in general clinical practice and patient care in Australia.

To address this it is now recommended that non-oral health professionals such as nurses/midwives, allied health professionals and doctors play a more active role in promoting oral health among their patients. To facilitate this, South Western Sydney Local Health District Oral Health Service and the School of Nursing and Midwifery at Western Sydney University have formed the Centre for Oral Health Outcomes and Research Translation (COHORT) ; an innovative collaboration affiliated with and located within the Ingham Institute for Applied Medical Research. COHORT has also partnered with Nepean Blue Mountains Local Health District Oral Health Services to expand the research program across Greater Western Sydney.

The COHORT group is the first of its kind in Australia and focuses on interdisciplinary oral health care and capacity building and training non-oral health professionals and undergraduate students in providing oral health education, screening and referrals to their patients. The group also works with Local Health Districts to improve the delivery of oral health services and government bodies/industry partners to change and improve clinical practice and develop evidence-based oral health promotion resources.

COHORT has eight research streams over which we aim to implement interdisciplinary oral health programs: Maternity, Paediatrics, Aboriginal Health, Cardiovascular Health/Stroke, Cancer, Diabetes, Aged/Palliative care, and Disability. COHORT also has five PhD students who are currently working in these streams to incorporate oral health guidelines into practice.

Group Leader

Associate Professor Ajesh George

The Centre for Research, Evidence Management and Surveillance (REMS) was established in 2004 and its team of epidemiologists and biostatisticians conduct research, evaluation and surveillance in population health, promote an evidence-based approach to population health programs, and support graduate and postgraduate learning in population health and epidemiology.

Current research areas are in environmental health and air pollution epidemiology, social epidemiology, neighbourhoods and health, health services for diabetes and stroke, and in the use of spatial methods and linked data for epidemiological research.

REMS program of air pollution and climate research involves investigating the effects of outdoor air pollution on birth defects, effects of bushfires on mortality and hospital admission, the effects of heatwaves on hospital admissions and emergency department visits and estimating the health benefits from reducing outdoor air pollution.

Our health services research focuses on patterns of care and outcomes for subarachnoid haemorrhage and stroke, and investigating best practice primary care for older Australians with diabetes and investigating, with both these projects using record linkage.

Group Leader

Professor Bin Jalaludin

The Department of Community Paediatrics is committed to their involvement in clinical work and associated research focusing on children with special needs and developmental problems, as well as vulnerable populations of children such as refugees, Aboriginal and children considered to be at a social disadvantage (e.g. children of parents with substance abuse, mental illness or disability and children in “out of home care”).

The Department has been active participants and leaders in the development of evidence-based state-wide, metropolitan, area and local initiatives aiming to improve the health outcomes of children, young people and their families.

In 2010, the Department of Community Paediatrics undertook a range of population needs assessments, systematic reviews and research and evaluation projects arising from the various clinical services they provide to the South West Sydney area.

Additionally, the Department is involved in a number of collaborative child health and development research projects with other agencies/departments such as CHETRE, General Practice and the Department of Community Services.

Group Leader

A/Professor John Eastwood ED

The Emergency Medicine Research Unit (EMRU) currently represents the research capacity of the Emergency Department at Liverpool Hospital.

The research areas being pursued by the EMRU includes research into:

– Clinical epidemiology
– Multicultural emergency medicine
– Geriatric emergency medicine
– Critical illness diagnosis and treatment
– Non-invasive monitoring
– Data visualisation and pattern recognition
– Complex adaptive systems as applied to ED and hospital function
– Clinical structures and interactions

The EMRU  have also established the Multicultural Emergency Medicine Collaboration between a number of collaborators, with an intent to closely analyse the epidemiology, degree of illness, health literacy and health outcomes of all culturally and linguistically diverse (CALD) patients attending emergency departments in the SWSLHD.

We believe we should use the culturally diverse demographics of the district to formally study CALD patients’ expectations, experiences and health outcomes, with a view to maximising patient outcomes from emergency care, and collaborating with the PHN and community bodies to deliver potentially preventative emergency health education to the community.

The EMRU and the Simpson Centre for Health Services Research are currently carrying out collaborative research with the Goals of Care study in end-of-life choices in elderly emergency department patients.


Group Leader

A/Professor Paul Middelton

The General Practice Unit is a long-standing academic family medicine clinic located in the Fairfield Hospital. Here, we integrate the medical education, research, health services development, and liaison with clinical care delivery. In 2016, the Clinic co-located with the Prairiewood Community Health Centre, on the Fairfield Hospital campus, and the Research Office moved into the Ingham Institute of Applied Medical Research building, in Liverpool.

We provide expert family medicine care to the local community and staff of Fairfield Hospital.  This includes a broad range of primary care services including shared and “stepped up” care with local GPs for patients living with complex care needs, and occupational health services (e.g., fluid exposure injuries).

The Unit trains both clinical and academic GP registrars under the national Australian General Practice Training program. We have a strong focus on health education and promotion, and evidence-based medicine in the program.  This has resulted in our registrars leading a health education program for students with special needs at Fairfield High School, numerous evidence-based health articles in the medical and lay press, and publication of registrar research projects relevant to the local community.

As part of the UNSW Sydney family (SWS Clinical School, School of Public Health and Community Medicine, and the Centre of Primary Health Care and Equity) we are deeply involved in all three phases of the UNSW Medicine program (teaching, assessment, curriculum design, medical education research), and the Unit is an UNSW research facility.

We work closely with the SWS Primary Health Network (SWSPHN) and Local Health District (LHD). We develop, implement, and evaluate innovative and culturally appropriate models of care at the primary-secondary care interface.

Our research and evaluation activities, with funding from agencies including the NHMRC and ARC, are focused on (i) quality primary care, and (ii) health informatics.

The Unit has an emphasis on cultural respect in all its activities. This has special salience in South Western Sydney, with its ethnically and culturally diverse population. This area and its communities has the highest proportion of Aboriginal people in the Sydney basin. We developed a cultural respect program and toolkit, Ways of Thinking and Ways of Doing (WoTWoD), and are evaluating it with a cluster randomised trial, funded by the NHMRC (2014-2017).

The Unit is especially interested in the systematic integration of care between the primary and acute health sectors. For instance, with funding from the Cancer Institute of NSW, we undertook an action research program to improve communication between SWSLHD Cancer Services and local general practice. This quality improvement work is now being extended to other clinical services.

With funding and support from UNSW Medicine and SWSLHD, the Unit established its major health informatics infrastructure – the electronic Practice Based Research Network (ePBRN). This project enables translational health services research, especially for the local area. Routinely collected data in the electronic health information systems of GP clinics, the Fairfield Hospital diabetes service, and admissions, are pseudonymised, extracted and linked in the ePBRN data repository in an ongoing basis. For instance, the ePBRN ‘big data’ approach helped develop predictive models for admission of patients with diabetes in the Fairfield neighbourhood, with funding from the HCF Research Foundation.

We are extensively involved in health, education, and research development, and provide professional service, expertise and leadership to numerous SWSPHN, SWSLHD, and UNSW Sydney committees.  We further provide service to a range of other organisations including: NPS, RACGP, GP Synergy Ltd, Nepean Blue Mountains PHN, NSW Agency for Clinical Innovation, Mental Health Commission of NSW, NHMRC, and others.

Over 2014-6, we have published 44 peer-reviewed papers. As supporters of the concept of knowledge exchange, we have a further 27 publications in the medical and lay press promoting evidence-based health care during this period, along with numerous other media engagements including newspaper and radio.

Group Leader

Professor Siaw-Teng Liaw

The Simpson Centre was one of the first health service research institutions to be established in Australia and was established from a grant from the NSW government as a result of work in developing and evaluating a new system for processing elective surgery. The system involved a Perioperative Department for admitting all patients on the day of surgery and has now been adopted in most Australian acute hospitals as well as in many overseas countries.

The Unit is made up of epidemiologists, statisticians and social scientists who work closely with health economists and informatics experts.  A unique feature of the Simpson Centre is the close involvement of clinicians. The Unit closely works with social scientists and epidemiologists to simultaneously shape and evaluate change.

The work of the Centre has been enhanced by becoming part of the Australian Institute for Health Innovation at the UNSW Australia. Together with the Centre for Clinical Governance Research in Health and the Centre for Health Informatics, the Simpson Centre is broadening its research horizons, collaborating in a unique way to examine health services from different perspectives and dimensions.

Group Leader

Professor Ken Hillman

South West BestSTART (Systems Transformation And Research Translation) aims to revolutionise the health system by integrating the voices of young people and their families into current research efforts, making sure the research in South West Sydney (SWS) is locally relevant and internationally important. Leading to better health outcomes for young people and their families. We will achieve this by:

– Establishing a network with children and families in SWS, so their voices help transform the health system

– Supporting and informing ongoing initiatives in research design and data management

– Building research capacity by supporting staff in developing new projects and scaling existing projects

To organise our efforts, BestSTART splits its focus into three research areas:

– Healthy Beginnings: This area is focused on early interventions, as well as the monitoring and assessment of the health of young children during their first years of life, a key priority area for NSW Health.

– Health Systems: The evaluation of new integrated models of care, making sure that families can access the right level of care (GPs, specialists) when they need it.

– Population Child Health: Focuses on two key areas for the district, child obesity and child health equity. Obesity was chosen as a priority area as 1 in every 3 children in SWS is overweight or obese. Equity is critical to make sure that everyone, even those struggling to make ends meet, can have a fair go at a healthy life.


How does BestSTART work in practice?

We work with young people, with doctors and professionals, and with the health system. Young people are invited to participate via consulting groups that co-design research in the district. We also work with professionals in the health system who would like to transform their ideas & questions into scalable research projects. We do this by helping them “navigate the system” and providing them with the logistics they need to carry out great research. Finally, we work with the health system to grow research, helping implement new ideas and building capacity in the district.

We have collaborators from different universities, disciplines, and with different forms of expertise (some are children & young people). To get in touch please contact: beststart@inghaminstitute.org.au

Group Leader

Prof. Raghu Lingam

Translational Research and Social Innovation (TReSI)

The Translational Research and Social Innovation (TReSI) group, is part of the School of Nursing and Midwifery at Western Sydney University.

TReSI’s mission is to conduct translational research that develops and supports implementation of social and system innovations that ensure that evidence-based interventions reach the people who need them, and are implemented with quality.

TReSI is based at the Ingham Institute, and conducts research on understanding the processes for community-based delivery to whole populations at scale. Currently TReSI’s work is focussed on early childhood services, and developing research methods and frameworks for translational research. These methods have wide application and are being explored for issues ranging from cancer treatments to health policy implementation.

At the core of TReSI’s work is the Maternal Early Childhood Sustained Home Visiting (MECSH) program. Pronounced like the word ‘mesh’, MECSH is a high-quality, evidence-based, nurse-led intervention for families needing extra support. There are currently MECSH programs operating in Australia, the UK, the Channel Islands, South Korea and the USA. The MECSH program supports families to create a more developmentally nurturing environment for their children.

 Group Leader

Professor Lynn Kemp



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