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Sax Institute

Monthly e-newsletter. October 2018


New issue of our flagship journal

How can research best impact health policy? The latest issue of our journal Public Health Research & Practice (PHRP) features a series of articles that explore how to improve health systems through innovation in research. An article by Professor Trish Greenhalgh of the University of Oxford looks at why health technology projects so often founder. Too much complexity can doom them to failure, she argues: project managers should remove complexity where possible and manage it better where it is not. Another paper, co-authored by the Sax Institute’s Gai Moore, offers pointers on how to ensure health policies are backed by research evidence. The authors say efforts to improve the use of research should involve better access to research summaries and greater involvement of policy makers in research.


PHRP’s article on the prevalence and dangers of mixing alcohol with energy drinks has elicited plenty of media attention: the Sydney Morning Herald has done a long, thoughtful piece on the research, which was also extensively covered by the Daily Telegraph and other News Corp papers.


Read the latest issue of our online, open-access journal by clicking below.


Workshop: Critical appraisal of research to support policy and program professionals

Next month we’re continuing our training program with a new workshop for policy makers and program managers/implementers. The aim is to help busy policy and program professionals understand how to critically appraise research when designing their policies and programs. The workshop will have a strong practical focus on the tools needed to judge the quality of research and its relevance to “real world” policy and program design. Participants will walk away with a greater understanding of the different types of evidence; information on where to access research evidence; and experience in using tools to critically appraise research for its quality and relevance.


The two workshop presenters are Associate Professor Mary Haines, Senior Adviser at the Sax Institute and an Adjunct Associate Professor at the University of Sydney School of Public Health; and Dr Carmen Huckel Schneider, Adviser at the Sax Institute and Senior Lecturer and Director, Master of Health Policy at the University of Sydney School of Public Health. Between them, Mary and Carmen have over 30 years’ experience in health policy and translational initiatives.


The “Critical appraisal of research to support policy and program professionals” workshop will be held in Sydney at 12.30pm on Friday, 9th November. Places for this event are limited to 30 participants only, so book early.

45 and Up study

Latest research from 45 and Up

The Sax Institute’s healthy ageing 45 and Up Study is a massive driver of research in Australia, engendering well over 200 published papers since its inception. Several more have been published in the past month alone, including one that has garnered international media attention.


A paper published in a journal of the American Heart Association used the 45 and Up cohort to look at whether anxiety and depression were linked to higher rates of stroke and heart attack in the middle-aged and elderly. The researchers, from the University of Queensland and Edinburgh University, found that women suffering high levels of psychological distress were 44% more likely to suffer a stroke, while men were with high levels of distress were at a 30% increased risk of heart attack, compared with those with low levels of distress. The research was picked up by Reuters, the Daily Mail, Science Daily and many other publications.


Another study, published in BMJ Open, looked at level of education and the risk of stroke in the 45 and Up cohort. This study found a link between the two, which attenuated over time but persisted into old age. And researchers from the University of Wollongong looked at the prevalence of Alzheimer’s disease in rural areas. Previous work had suggested higher prevalence in these areas, but data from the 45 and Up study showed that it was in fact lower in outer regional and remote areas than in urban centres.


Other research papers published this month using 45 and Up data found large ethnic disparities in diabetes outcomes (featured in the 6minutes GP newsletter); an association between even low-level air pollution and asthma-related hospitalisation; substantial cancer care costs in the Australian health system; and widespread initiation of testosterone replacement therapy outside national guidelines.

evidence check

Spotlight on Sax Evidence Checks

What diet best prevents heart disease? How do we steer young people away from drug and alcohol abuse? What’s the best way to promote breastfeeding? These are some of the many policy-related questions that have been answered in one of the Sax Institute’s Evidence Check reviews, using the most reliable evidence and research. Evidence Check is a service for agencies who need a rapid review of existing evidence to help answer their specific health policy questions. Tapping into a network of experienced researchers and knowledge brokers, Evidence Check offers a concise summary of the most up-to-date evidence presented in a policy-friendly format. Sometimes these reviews remain confidential, but the majority are published in the Sax’s open-access Evidence Check Library. Here are three of the latest to be published:

Dietary patterns and cardiovascular outcomes
Systematic reviews of the role of diet in preventing cardiovascular disease show the DASH diet to be the most beneficial in addressing risk factors among the healthy. For secondary prevention, the Portfolio diet was deemed to be the best option, although this depended on the nature of the pre-existing condition. For both primary and secondary prevention, adhering to DASH improved blood pressure, blood lipids and body weight.

Effective strategies to promote breastfeeding
Only 1 in 10 Australian babies are breastfed according to national guidelines. There are, however, a range of proven interventions to improve breastfeeding initiation, exclusivity and duration. The key is the Baby Friendly Health Initiative Ten Steps approach, although other policies to protect, support and promote breastfeeding are also necessary.

Alcohol and drugs prevention in vulnerable teens
This rapid review identified a number of promising approaches for prevention and early intervention for substance use in this population. These included mentoring, personality-targeted programs, family-based programs, community-based programs and SBIRT (screening, brief intervention, referral to treatment). But the authors found no strong evidence for one solution over another.

To visit the website click Read More below.


PHRP Awards

This year sees the launch of the Public Health Research & Practice Excellence Awards, to celebrate and acknowledge the most impactful articles published in the Sax Institute’s peer-reviewed journal Public Health Research & Practice (PHRP). The journal will be presenting an award for best paper, and another for the best “in practice” paper, where the focus will be on the potential impact and practical usefulness of the research on health policy and practice. Both papers will also be assessed on rigour of methodology, quality of analysis and effectiveness in writing, structure and presentation.

The winners of the inaugural awards will be announced on Wednesday 7 November and will feature in the next issue of Evidence Matters. Stay tuned for interviews with the winners on their work and the impact it has had on the health landscape.

looking back

The Australian Prevention Partnership Centre: the first five years

The Australian Prevention Partnership Centre, which is administered by the Sax Institute, began in June 2013. The Prevention Centre model is based on the idea that research is more likely to influence policy and practice if it is coproduced by researchers and policy makers working together. In this context, the Prevention Centre was set up to explore the systems, strategies and structures needed to inform decisions around preventing lifestyle-related chronic disease.

A new paper in the latest issue of the Sax Institute’s journal Public Health Research & Practice looks at the achievements and challenges of the first five years of the Centre. Its ambitious program has transformed it into a key driver of prevention research, offering a new way of bringing together the prevention community in Australia. All of the research the Prevention Centre has undertaken has involved partnerships between researchers, policy makers and practitioners, guided by government and industry funding partners.

One example of the partnership model is a project in which the Prevention Centre benchmarked policies to address unhealthy diets and obesity, working with government officials in each of Australia’s jurisdictions and with over 100 nongovernment experts from 53 organisations.

The Prevention Centre has worked to build capacity in prevention research, establishing more than 20 early to mid-career research positions and awarded five scholarships. It has also demonstrated the value of collaboration, developing models with policy makers to look at the impacts of programs aimed at alcohol harms, childhood overweight, tobacco control, chronic obstructive pulmonary disease and gestational diabetes.

There have, of course, been challenges along the way. Building trust between researchers, policy makers and practitioners has not always been easy and has taken longer than expected. Coproduction requires participants to develop new skills for working together, and not all are willing to do so. For policy makers, used to top-down commissioning, it has required new levels of trust, while for researchers, a major concern has been lower publication rates with the coproduction model.

Overall, though, the Prevention Centre approach has provided the time, resources and flexibility to produce large-scale, policy-relevant research in ways that would not have been possible without the coproduction model.


Associate Professor Sonia Wutzke to be remembered through Institute’s Research Action Awards

The annual Research Action Awards were established by the Sax Institute in 2015 to recognise research that has had a significant impact on health policy, programs or service delivery. The Awards are open to researchers who work for one of the Institute’s 52 Ordinary Member organisations.

This year, the Sax Institute is dedicating one of the three Research Action Awards to the memory of Associate Professor Sonia Wutzke, who was Deputy Director of The Australian Prevention Partnership Centre and Head of the Institute’s Analysis and Evaluation Division before her untimely death in December 2017.

Professor Wutzke strongly believed in the power of research to drive positive change, which is one of the central missions of the Sax Institute. Sax CEO Professor Sally Redman said the decision to dedicate the Award to Professor Wutzke was a fitting tribute to her commitment to mobilising research evidence in dynamic and creative ways to help solve complex health system problems.

Winners of this year's Research Action Awards will be announced at an event in Sydney on 28 November 2018.