Current and completed research

Current Research:

Mapping sex differences in the journey of an individual with coronary heart disease through the healthcare system

This innovative project hopes to improve patient care journeys for Australian women living with coronary heart disease (CHD) thanks to the National Health and Medical Research Council (NHMRC) funding.  Evidence suggests that women have poorer health outcomes compared to men and that systematic sex biases exist in the assessment and management of CHD. We also know that there are differences in rural and regional areas.  

Distinguished Professor Rachel Huxley, Executive Dean of Deakin’s Faculty of Health, is leading the four-year project.

“Over 60,000 people are living with coronary heart disease, one third of whom are women who often have poorer health outcomes compared to men,” Deakin Distinguished Professor Huxley said.

“Evidence suggests the existence of systematic sex biases in the assessment and management of coronary heart disease. How these biases occur however, is unclear since information documenting patients’ journeys throughout health and medical systems is siloed.”

Importantly, linked primary care information has been previously unavailable in Australian research studies due to privacy and confidentiality issues associated with health records. Using Privacy Preserving Record Linkage (PPRL), the research team will leverage data across the health systems to identify key sex differences in the utilisation of health resources and treatment pathways. This project will deliver an improved understanding of when, how and where it is best to intervene to improve health outcomes among women living with CHD. 

Deakin’s Professors Steven Allender and Anna Peeters, Associate Professors John Amerena, Susan Brumby and Adrienne O’Neil, Dr Lan Gao and Miss Kieva Richards are working on this project. 

Collaborating partners on this project include the Australian Institute for Health and Welfare, Centre for Health Record Linkage, Centre for Victorian Data Linkage, Curtin University, LaTrobe University and NPS MedicineWise. 

For further information about this project contact:

Recent publications from this research:

A Whole of Community Systems Approach to Co-Designing and Implementing a Safe Spaces Model of Primary Healthcare for Sexuality Diverse Young People in Western Victoria

In a national survey it has been identified that sexuality diverse young people in Australia experience disproportionate rates of mental health challenges, intimate partner violence, and homelessness. Research has identified the significant barriers faced by sexuality diverse people in accessing healthcare and indicates a strong link with poorer health outcomes overall.

The project will combine systems thinking and health economics in an innovative whole-of-community systems approach to support health services and consumer advocates in building safe and equitable rural primary healthcare ‘from the ground up and the inside out’.

A key feature is establishing a scalable prototype for a whole-of-community systems approach to co-designing and implementing models of primary healthcare that meet the intersectional needs of sexuality diverse young people in rural communities that can be adapted in other communities, including raising awareness and delivering education and training for mainstream primary healthcare providers on the needs of LGBTIQA+ young people.

This project is funded by the Medical Research Future Fund (MRFF). 

For further information about this project contact:

MH4Ag: Co-designing a peer-supported approach to improve mental health in rural farming communities

Compared to the general Australian population, rural farming communities face higher risk of suicide. While farmers are generous at providing help to others, they are often reluctant to ask for help themselves. Living in rural areas, access to mental health support is limited and where support is available, providers may have poor understanding of the realities of life and work in the farming environment. This project aims to develop and test a framework — working with farming community members and rural stakeholders — for the delivery of peer-supported, evidenced-based psychological therapy to farming community members experiencing depression or psychological/situational distress.

To complement this, the project has also worked with farmers and community stakeholders to develop Steering Straight – a personal challenge  ’action plan’ template for members of the farming community. This practical approach has been designed to help improve farmers’ and farming community members’ ability to focus on what TO DO in a challenging situation, rather than what NOT TO DO. The Steering Straight plan can be accessed here.

The project is led by the National Centre for Farmer Health in partnership with Western District Health Service and with the involvement of researchers from Deakin University, University of South Australia, La Trobe University and University of Melbourne.

This project is funded by the Western Victoria Primary Health Network.

For further information about this project contact:

Injury risk and safety behaviours of children in rural Victoria | 2020-2023

Farms are complex environments as the distinction between the workplace and home is often blurred, resulting in children being exposed to various industry hazards. As injury is preventable, it is alarming that the rate of unintentional farm-related child fatalities and key agents causing them has remained constant overtime. Therefore, it is vital to understand the contexts in which children are participating and engaging with the farm. By exploring the safety measures, risk-taking behaviours and common activities of children on farms, this research will gain a fresh and novel insight into the culture and perceptions around children on farms. Understanding common hazardous exposures will assist in the development of targeted interventions to improve child farm safety.

For further information about this project contact:

Who, what, when, where, how and why: Rural Emergency Presentations in a changing climate | 2022-2023

As the climate is changing, the number of hot days increasing and heat is becoming more intense, it is important to gain an understanding around heat-related illnesses. Heat kills more Australians than any other natural disaster.

Limited research has been conducted on the effects of high heat days and heatwaves in Australia on individuals’ health, particularly in rural and agricultural communities. These communities are particularly vulnerable as they typically work long-hours outdoors. Heat related illness is preventable and so it is vital to gain a deeper understanding of its trends.

This project builds on the previous RAHDaR on Climate project and aims to examine trends in presentations to Emergency Departments and Urgent Care Centres in rural south-west Victoria during high heat days/episodes from 2017-2027.

For further information about this project contact:

Agriculture-dependent Community Resilience | 2021-2023

Resilience is broadly defined as the ability to respond to change and restore, maintain or improve community wellbeing ability. Personal and community resilience are influenced by many factors applicable to farmers and farming community networks including culture, social relationships and engagement. A range of tools and methods have been used to date to engage communities in resilience building. Just as important are the approaches that underpin these tools and methods, including place-based and co-designed approaches, and ways of working that build on established and trusted community networks. This project aims to:

(i)      Conduct a review of the evidence relating to resilience initiatives in agriculture dependent communities

(ii)     Draw on findings from this review to support communication, collaboration and shared learning between 11 resilience projects by establishing, coordinating and evaluating a Communities of Practice (CoP)

(iii)   Develop and apply/implement an evaluation framework to assess the process, impact and short-term outcomes of the agriculture-dependent community resilience activities.

For further information about this project contact:

Influencing and measuring the culture of safety on farms | 2021-2023 

Agriculture continues to have high rates of injuries and fatalities. Safety culture refers to the shared attitudes, values, and beliefs about safety in the workplace, and it is important to foster a positive safety culture on farms to promote safe work practices.

A range of programs, such as safety campaigns, hazard checklists, and safety training programs, have been designed to influence safety culture on farms. However, it is unclear how effective these interventions are and whether they provide value for investment. Therefore, it is important to establish ways to measure farm safety culture for farmers, policy makes and the Australian agricultural industry as a whole.

The National Centre for Farmer Health (NCFH) has worked to identify a range of factors that influence farm safety culture. We are now working collaboratively with a range of stakeholders to develop ways to measure farm safety culture. By measuring safety culture, it will be possible to identify areas for improvement and tailor interventions accordingly. This will ultimately help to promote safer work practices and reduce the high rates of injuries and fatalities in the agricultural industry.

For further information about this project contact:

Completed Research

Primary Producers Knowledge Network | 2020-2023

Victoria’s primary producers (including farmers and fishers) are a vulnerable workforce in industries undergoing significant transition, and experience a wide-range of workplace-related mental health challenges. Vulnerability stems from an ageing and reducing workforce, rapidly increasing technological demands, exposure to a global marketplace and increasing uncertainty – with links to psychological distress and suicide risk.

This project worked with farmers, fishers and industry partners to co-design, develop and evaluate the online Campfire platform, podcasts, blogs, and social media messaging and capacity building activities to foster sustainable change across primary industries. Content had a primary prevention focus and was tailored to reflect the needs of a range of industry sectors and cohorts. The project adopted a holistic primary prevention approach to address workplace-related factors impacting primary producers’ health, wellbeing and safety.

The Primary Producer Knowledge Network was a partnership with Western District Health Service, Deakin University, Griffith University, University of SA and Cath Cosgrove Consulting and was funded by WorkSafe’s WorkWell Mental Health Improvement Fund.

The development of Campfire podcasts on a range of practical topics is ongoing. Podcasts and blog posts can be accessed here.

For further information about this project contact:

Agriculture Chemical Use Mapping | 2021-2022

This project was undertaken in collaboration with Deakin University’s Centre for Regional and Rural Futures (CeRRF) to develop an understanding of chemicals being used on farms in Victoria and the immediate and long-term health and disease risks associated with these chemicals. A database of chemicals used within Agriculture was drafted and mapped against land use in Victoria. Farmers and farm workers were then invited to contribute to a survey to better understand how agrichemicals were being used. This work has provided an evidence review of these used chemicals for known immediate and long term health risks to humans associated with the chemicals in use in Victoria to inform strategies for exposure and injury prevention.

For further information about this project contact:

Agriculture Safer Plant and Equipment | 2021-2022

Commencing in 2021 with the National Centre for Farmer Health, contributed to a rapid investigation of existing and emerging engineering solutions for tractor and side-by-side vehicles. The purpose of this study is to support Worksafe Victoria and their associated stakeholders with increased knowledge of options to make agricultural plant safer in the pursuit of reducing fatalities caused by rollovers or run overs on farms.

The findings are based on a desktop literature review. This project was undertaken in collaboration with Deakin University’s Institute for Intelligent Systems Research and Innovation to develop an understanding of transferability of safety technologies from other industries to agriculture.

This study takes a three-stage approach to the engineering solution assessment:

1. Minimum safety requirements and solutions for manufacturers of PMP
2. Engineering review of existing and emerging solutions for fatality incident prevention
3. Legislation and regulations review

The findings of this body of work will increase awareness and understanding of the problem and the potential solutions to help inform next steps. This work has provided insight into the effectiveness of solutions and direction to support decision-making.

For further information about this project contact:

Resuming Employment after Stroke: Enhancement through Tele-coordination (RESET) | 2021-2022

Young adult stroke survivors may be at the peak of their career, with family and financial commitments, and decades until reaching retirement. Consequently, returning to work (RTW) after stroke is a key rehabilitation milestone. In Australia, post-stroke RTW support may be offered via rehabilitation services, however many people miss out. Rural areas, in particular, have limited access to specialised health services. This is particularly true of those living in rural areas with increased travel time to, and reduced availability of, local services.

This project was undertaken in collaboration with Deakin University IMPACT to test a new telehealth support service. The RESET program linked stroke survivors from regional and rural areas with a RESET Coordinator, who helped them to negotiate services and organisations in the return to work journey, and provided support to help them stay at work once returned.

This is part of a larger, ongoing program of research.

For further information about this project contact:

Quad Bike Spraying and Injury Surveillance (QuadSIS) | 2021

Quadbikes are extensively used in Australia within the agriculture and forestry industries. It is estimated that quadbikes are responsible for an average of 16 fatalities per year and six accident and emergency presentations per day. Whilst quadbikes are also used for recreation such as sport, hunting and tourism, the major use in Australia is farming. Tasks involving the use of quadbikes that are considered ‘high risk’ include transportation, weed control/spraying and mustering. The risks associated with the use of spray tanks mounted on the rear rack and the shifting of tank fluid are high.

QuadSIS investigates the extent to which farmers and farm workers aged between 18-75 years are using quadbikes whilst during agrichemical spray application and identify the extent and frequency of incidents and injuries associated with this task. This work will help to inform education and direct work practices when using quad bikes for spray application.

The objectives of this study include: (i) To investigate the experiences of private agrichemical applicators using quad bikes for spraying, and (ii) To determine the mechanisms for injury and any contributing factors associated with occupational deaths whilst spraying with a quad bike. iii) determine the types of agrichemicals used during quadbike spraying.

This work has found that the use of quad bikes to spray continues to be widespread on Victorian farms, despite the inherent and known risk to farmer’s health and safety. The findings of this pilot project continue to assist in both the review of education material, and farmer engagement to improve safety advice at an individual farm and industry level.

For further information about this project contact:

Mental health at the COVID-19 frontline: An assessment of distress, anxiety and coping from staff and attendees at screening clinic’s | 2020-2021

Across Western Victoria, the COVID-19 response included drive-through screening and respiratory assessment clinics (RAC).  People seeking COVID-19 screening were met with healthcare workers fully donned in gowns, gloves and masks which may threaten people already experiencing distress, as well as hamper communication to the general population.

This research study ‘Mental health at the COVID-19 frontline’ assessed psychological distress, anxiety and coping strategies from two regional screening sites:

1. A drive-through screening clinic based at Western District Health Service, Hamilton and 
2. A Respiratory Assessment Clinic with prior phone screening at South West Healthcare. 

Attendees and healthcare workers at both sites were requested to complete a structured, validated and anonymous online questionnaire to assess distress, anxiety and coping strategies. The experience of frontline healthcare workers was further explored through focus group discussions.

This project was led by Western District Health Service and funded through Western Alliance and supported by partners Southwest Healthcare, Federation University, Deakin University.

For further information about this project contact:

Filtering the Facts – Kidney function in rural communities

This research project investigates Chronic Kidney Disease (CKD) in rural communities in Victoria. A number of ‘CKD hot spots’ have been identified, including the Grampians region where the prevalence is significantly higher (13.5%) compared to Victoria as a whole (10%). Global reports have identified a growing trend in CKD with non-traditional risk factors (CKDu) in male farm workers aged 30-50 years from agricultural communities. As kidney disease is typically silent, this research aims to determine the prevalence of kidney disease in rural south west Victoria and identify the presence of traditional and novel risk factors. Individuals’ with at least one traditional risk factor for CKD were identified and invited to participate in kidney clinics, consisting of; a lifestyle questionnaire, health assessment and a blood and urine sample for analysis. Individual participants were educated about kidney disease and made aware of their risk factors for CKD to enhance their health literacy. In 2020 a Deakin honours student Claire McKay is also looking at this.

For further information about this project contact:

RAHDaR on Climate: Emergency presentations across rural South-West Victoria

As the climate is changing, the number of hot days increasing and heat is becoming more intense, it is important to gain an understanding around heat-related illnesses. Heat kills more Australians than any other natural disaster.

Limited research has been conducted on the effects of high heat days and heatwaves in Australia on individuals’ health, particularly in rural and agricultural communities. These communities are particularly vulnerable as they typically work long-hours outdoors. Heat related illness is preventable and so it is vital to gain a deeper understanding of its trends.

This research will use the Rural Acute Hospital Data Register (RAHDaR) to determine and understand the prevalence and characteristics of heat-related illness in rural south-west Victoria between February 2017 and January 2020. The outcomes of this research project will assist in developing a profile of heat-related illness in the rural and agricultural populations and understand the associated risk factors. Results will inform the development of initiatives to prevent and manage heat-related illness.

For further information about this project contact:

From Inside the Farm Gate: Rural women’s stories of thriving and surviving | 2018-2019

‘From Inside the Farm Gate’ provides an opportunity for women from rural farming communities to voice their experiences of tough times and for others to learn from these stories. The project was  conducted in two phases:

• Phase 1: Victorian farming women from rural communities experiencing tough times participating in a digital storytelling workshop to share personal stories of managing personal challenges—including socio-economic hardship and challenges to physical, social and emotional wellbeing.
• Phase 2: The digital stories from Phase 1 were publically exhibited to a range of audiences (including rural women’s events, via social media and on the farmer health website)—giving voice to Victorian women, promoting communication and encouraging mutual reflection, empathy and understanding.

For further information about this project contact:

Financing Fortitude: evaluating scholarship in strengthening Victorian rural woman and agriculture | 2017-2019

This research project investigates a group of Victorian women who attended the 2^nd International Conference on Women in Agriculture in Washington DC, 1998. Following the rural women’s movement of the 1980s and 1990s, the Conference was designed to recognise the contribution of women, globally, to agriculture, education programs in rural areas and commitment to furthering the status of rural women. Acknowledging a selection of Victorian women for their ongoing contributions to agriculture and rural women’s issues, the Department of Natural Resources and Environment awarded 20 travel bursaries and organised a pre-Conference Agricultural Tour through agricultural California. Limited follow-up evaluation has explored whether the intended objectives and outcomes of the Conference and travel bursaries were realised. This research measures Conference attendees’ association between different elements of the experience and their career choices in the last two decades. Findings will improve understanding of the opportunity for growth and progress when investing in Victorian agricultural women.

For further information about this project contact:

In-field Personalised Cholinesterase Assessment Project (In-field PCAP)

A 12 month study funded by the Shepherd Foundation  grant to conduct much needed research to form the basis of a database of cholinesterase activity (an enzyme inhibited by organophosphate pesticides) from farmers exposed to agricultural pesticides in their workplace.  Organophosphates have been associated with chronic neurological diseases such as Parkinson’s in sheep farmers in particular. The critical window for exposure to toxicants may occur years before the onset of neurological symptoms. This research also aims to assess and improve the integration of cholinesterase monitoring into routine agricultural health clinics and in the field, whilst providing farming people with a link between their individual cholinesterase activity and their household and agrichemical use.

Partners: Birchip Cropping Group, Flinders University, Shepherd Foundation.

For further information about this project contact:

The Ripple Effect (STRIDE Project)

The Ripple Effect is an online intervention designed to investigate what works to reduce the self-stigma (negative attitudes you have towards yourself) and perceived-stigma (negative attitudes you believe others have about you) among males from the farming community, aged 30-64 years, who have been bereaved by suicide, attempted suicide, cared for someone who attempted suicide, have had thoughts of suicide, or been touched by suicide in some other way. The intervention provided:

1. Opportunity for anonymously sharing experiences in a peer-supported environment.
2. Opportunity to increase knowledge and literacy about the lived experience of suicide (challenging suicide myths and framing experience in a contextual way, facilitating help-seeking where required).
3. Encouragement for a positive cycle by which the disruption of the negative feedback of self-stigma and perceived-stigma will also reduce stigma in others.

Partners: The Ripple Effect is funded by beyondblue with donations from the Movember Foundation. National Centre for Farmer Health (NCFH), Deakin University, Victorian Farmers’ Federation, AgChatOZ, Sandpit, Western District Health Service and Mental Illness Fellowship North Queensland.

For further information about this project contact:

Fitter Farmers

Fitter Farmers is a research study funded through Deakin University which aims to paint a detailed picture of the amount and type of physical activity our agricultural and regional communities are involved in day-to-day, which will help us to develop better health promotion and disease prevention programs for our agricultural communities. Exercise is increasingly recognised as being protective against chronic disease, and beneficial to mental health. However, little is known about physical activity levels of farmers, or how they compare to other workforces.  This means that the development of effective physical activity programs or recommendations to improve farmer health and prevent disease is challenging.  The Fitter Farmers study will compare physical activity levels in farm-based agriculture, regional healthcare and urban workers. Identification of activity patterns in these workforce groups will provide a strong foundation for development of physical activity and exercise-based programs to enrich life-style, prevent disease, and improve mental health outcomes for Australian farmers.

Shhh hearing in a farming environment | 2012-2016

Two out of three farmers are affected by hearing loss. Farmers as a group are particularly at risk as their workplace is also their home. They are also exposed to many different and unique sources of noise on farms. This project tests the hypothesis that participating in early intervention hearing services focussed towards farming families will contribute to (a) significant reduction in the impact of hearing loss on farmers and (b) educate and empower farmers on their capacity to reduce their noise exposure.

Partners: Deakin University, Australian National University National Centre for Epidemiology and Population Health,  National Centre for Farmer Health, National Acoustic Laboratories

This project was funded by the National Health and Medicine Research Council (NHRMRC) Project Grant GNT 1033151. Research partners include the National Centre for Farmer Health, Deakin University, University of Canberra and the National Acoustic Laboratories.

For further information about this project contact:

Cholinesterase Research Outreach Project (CROP) – Measuring organophosphate exposure in western Victorian farmers | 2013

A 6 month Deakin University research grant to conduct a much needed study that will form the basis of a database of cholinesterase activity (an enzyme inhibited by organophosphate pesticides) from farmers exposed to agricultural pesticides in their workplace.  Organophosphates have been associated with chronic neurological diseases such as Parkinson’s in sheep farmers in particular. The critical window for exposure to toxicants may occur years before the onset of neurological symptoms. This study also aims to assess and improve the integration of cholinesterase monitoring into routine agricultural health clinics, whilst providing farming and non-farming people with a link between their cholinesterase activity and their household and agrichemical use.

For further information about this project contact:

Farming fit? Depression and obesity in farm men and women

A two year research grant to study mental health status and obesity in farm men and women. This is a Western District Health Service and Deakin Medical School collaborative study, funded by a beyondblue research grant. This project is due for completion in June 2011.

Sustainable Farm Families™ Future Directions | 2009-2011

This project provided ongoing evidence-based information to support and inform future health, wellbeing and safety directions for Australia’s agricultural industries. The project focused on extending our understanding of the initial SFF program, implemented in the broad acre, cotton and sugar industries (2003-2006), in a longitudinal study. This project is in partnership with La Trobe University, Centre for Sustainable Regional Communities, Farm 500 Bendigo and funded by the Collaborative Partnership for Farming and Fishing Health and Safety managed by Rural Industries Research and Development Corporation. An independent external evaluation was undertaken by Roberts Evaluation of the Future Directions program and can be found below. The final report was submitted with RIRDC at the end of April 2011.

Sustainable Farm Families™: Future Directions (March 2013)

The health and wellbeing of all Australians is pivotal for economic and social success of the nation. Current data reveals that the health status of people living in rural and remote populations is poorer than their metropolitan counterparts. However there is a lack of understanding of the specific health statistics of rural farming populations. The Sustainable Farm Families (SFF) Future Directions program aims to fill this gap by providing ongoing evidence-based information and support to Australia’s agricultural industries, to gain insight into the health, wellbeing and safety of Australia’s rural farming populations.

Sustainable Farm Families Program

Victorian Auditor General’s Report September 2010 2010-11:7In 2010 the Victorian Auditor General undertook an audit of the Sustainable Farm Families™ program as funded through the Victorian Department of Primary Industries drought recovery program. (2007) The audit examined whether the SFF program has been effective in improving the health and wellbeing of farming families in Victoria. It reviewed:

• The program’s rationale and planning;
• Its implementation; and
• Evidence of its effectiveness.

Conclusions from the report were that participants report that they have learned from the program and have changed their behaviour as a result. This is borne out by clinical indicators that show their health is improving. Together these indicate the SFF program is effective in improving participants’ health.

Sustainable Dairy Farm Families™ – Future Directions | 2010-2012

This project will provide ongoing evidence-based information to support and inform future health, wellbeing and safety directions for Victoria’s dairy industries. The project focuses on extending our understanding of the initial SFF dairy program, implemented in 11 dairy communities across Victoria during 2005 – 2007. We will be revisiting the same communities and undertaking a longitudinal health, wellbeing and safety study during 2011.   Importantly we will also be providing health assessment, information and education and referral.

This project was in partnership with La Trobe University, Centre for Sustainable Regional Communities, Bendigo, United Dairy farmers Victoria and funded by the Gardiner Foundation and Colac Community Enterprise. 

• Alcohol and farming communities
  Development, implementation and evaluation of a program to reduce alcohol and related problems among farm men and women, by increasing the skills and knowledge of rural health professionals who work with farm men and women. This project is a partnership between Western District Health Service and Deakin University, School of Psychology and funded by an Australian Research Council Linkage Grant. 
• Evaluation of an alcohol intervention training program for nurses in rural Australia 
  Brumby, Susan, Kennedy, Alison J., Mellor, David, McCabe, Marita P., Ricciardelli, Lina A, Head, Alexandra and Mercer-Grant, Cate (2011) The Alcohol Intervention Training Program (AITP): A response to alcohol misuse in the farming community, BMC Public Health, vol. 11, no. 242
• Chest pain and farmers
  A project looking at farmers understanding of what to do when they have a pain in the chest. Survey research is been carried out among farm men and women. This is a collaborative project between the National Centre for Farmer Health and the Centre for Rural Emergency Medicine.
  Farmers with acute chest pain are uncertain how and when to seek help: A pilot study