Population Health Research Strategy Population Health Division ACT Health

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1 Population Health Research Strategy Population Health Division ACT Health

2 1. Foreword The shift in policy direction towards prevention and early intervention, and the associated funding for preventive initiatives, has resulted in an increased need to focus on population health research to inform and evaluate policy and programs. Many of the challenges identified in the Population Health Division (PHD) strategic framework Towards a Healthier Australian Capital Territory require the translation of solid useable health research into policy and programs that lead to better health products and health-care services. There is a need for high quality priority driven research that can contribute directly to population health outcomes. There are many barriers in developing research capacity, not least are resources and staff capable of undertaking population health research. Building the capacity for population health research in the ACT will provide sound evidence for informed health care decisions and policy-making and provides an opportunity to address problems unique to the ACT As a small jurisdiction, the ACT is continually challenged to do more with limited resources. This is particularly relevant to health research and even more to population health research. The challenge is to focus research activities, harness existing resources, build capacity and support for population health research and ensure sustainability of activities. The Strategy will guide the research agenda for the Population Health Division and research partners. The building blocks of this strategy are dependent on each other. They include identifying priorities and need, strengthening capacity of the ACT to engage in research activities and ensuring that the outcomes from research are transferred into health policy and programs and finally monitoring and evaluating the success of the strategy in achieving population health outcomes. The Population Health Research Strategy has been developed in consultation with all branches within the Population Health Division of ACT Health as well as the Research Office within ACT Health. The development of this strategy also included consultation with our local academic institutions, the Australian National University and the University of Canberra, to identify possible future partnership opportunities. 2 Population Health Research Strategy

3 2. Introduction - Protecting our future The key objectives of population health activities are: protecting health, preventing diseases, illness and injury and promoting health and wellbeing of an entire population. Population health activity seeks to step beyond the individual-level focus of mainstream medicine and public health by addressing a broad range of factors that impact health on a population-level such as: environment, social structure, and resource distribution. One major step in achieving this goal is to reduce health inequities among population groups. An important theme in population health is the importance of social determinants of health and the relatively minor impact that medicine and healthcare have on improving health overall. Population health utilises a multi-strategy approach to improve health and wellbeing through: education, screening, immunisation and other interventions; promoting and supporting healthy lifestyles and behaviours; legislation, regulation and fiscal measures; strengthening skills, competencies, systems and infrastructures in communities; ensuring safe and healthy environments; and monitoring and surveillance. The ACT context The Australian Capital Territory (ACT) boasts a healthy population against most key indicators of health. Life expectancy is high in comparison to other jurisdictions and is expected to increase over the next ten years. Many of the social and economic factors that influence health continue to yield favourable results for the ACT compared to the rest of Australia. Over eighty per cent of ACT residents rate their health as excellent, very good or good. ACT residents have generally higher weekly earnings and education attainment levels than the national average, however this social and economic advantage often masks pockets of disadvantage. Homeless rates, a measure of extreme disadvantage, were estimated to be 4.2 per 1,000 ACT population, and Aboriginal and Torres Strait Islander people in the ACT continue to experience poorer health status across a range of health indicators. Although ACT residents overall rated better than most Australians for most health risk factors, approximately one-third of the overall disease burden can be attributed to these risk factors. Opportunities for improving the health of the ACT population are largely dependent on reducing the impact of known risk factors such as: smoking, alcohol and other drug abuse, poor nutrition and lack of physical activity ACT residents continue to have low levels of fruit and vegetable consumption and physical activity levels have declined in recent years. The proportion of the ACT population that is overweight or obese has increased over the last decade (consistent with national trends).there has been a sustained decline in the uptake of sun protection measures by adolescents in recent years. Chronic diseases will persist as the leading causes of disease burden, given the ageing of the population. The prevalence of diabetes mellitus continues to rise. Cancer projections suggest that the number of people diagnosed with cancer will increase by about 22% each year, largely because of growth and changes in the age structure of the population. Although ACT residents enjoy good quality water and air there are persistent issues associated with ever increasing notification rates of genital chlamydia infections, outbreaks of respiratory infections and the ongoing outbreaks of food-borne diseases. Health service utilisation in the ACT faces several challenges. The ever increasing and ageing ACT population will further exacerbate the issues associated with low level per capita of general practitioners in the ACT, the rate of aged care places remains lower than national rates and residents have long wait times for emergency department services and elective surgery. A broad range of stakeholders have an interest in and contribute to outcomes in public health. To achieve desired population health outcomes, population health approaches need to operate across different levels of the government, non government and community groups and include academic organisations. A partnership approach is essential to achieving population health outcomes. Strengthening population health research and translating this research to inform good policy and programs is critical in addressing the health challenges and achieving further health gains in the ACT. Population Health Research Strategy 3

4 Population health research is an important investment in the health and wellbeing of our community through: generation of information, knowledge and evidence on the health status of population groups within our community that leads to improved health outcomes and a reduction in health inequities; enabling of sound health care decisions, policy making and program development based on strong evidence and program evaluation; more effective use of resources; greater understanding of the determinants of health and their impact; timely response to emerging health and wellbeing trends; effectively addressing health issues and health inequities resulting in a healthier and more productive population and a reduction in healthcare costs in the long-term. This is the first population health research strategy developed for the ACT and aligns with the overall ACT Health research strategy and the Strategic Framework for the Population Health Division Population Health Research Strategy

5 3. A Population Health Research Strategy 3.1. Scope This Strategy provides a framework for Population Health Division to generate and integrate population health research. The Strategy builds on Towards a Healthier Australian Capital Territory - A Strategic Framework for the Population Health Division Population health programs are not confined to Population Health Division and a key element of this strategy are the partnerships and collaborations across government and non-government organisations and academic institutions. The strategic plan is designed for implementation by Population Health across the whole of the ACT but excludes specifically clinical research. For the purpose of this Strategy, population health research is defined as: the investigation and analysis of factors that influence the health status of groups or whole populations, as well as the testing and evaluation of policies and interventions to improve population health outcomes (National Health and Medical Research Council) Aims and objectives The aim of the Strategy is to promote the generation and use of high quality, relevant research to inform and improve the development of policy and delivery of programs to improve the health, reduce morbidity and increase the life expectancy of the ACT population. The Strategy will document our key priorities, our practice and our opportunities to build capacity as well as outline how we will translate research findings into usable evidence to inform policy and practice. The key objectives of the Strategy are to: generate population health research activity and knowledge in the ACT; develop systems to translate research evidence into population health programs and policies; and develop capacity to undertake population health research within the Population Health Division. Implementation and monitoring of this strategy resides with the Population Health Division under the stewardship of the Chief Health Officer. Population Health Research Strategy 5

6 4. Key objectives and strategic priorities 4.1. Generation of population health research activity and knowledge The Population Health Division (PHD) under the stewardship of the Chief Health Officer is responsible for providing leadership and direction for population health research in ACT Health. The focus of the Strategy will be on the generation of knowledge through high quality research activity that is available to inform population health policy and practice with a focus on alignment with priority research areas. Strategic priorities for the Population Health Division include: Establishing a Population Health Division Research Committee (PHDRC) that will develop criteria for identifying population health research priorities for the PHD. o PHDRC will develop processes to work with key stakeholders including: research organisations in the ACT such as the University of Canberra, the Australian National University and the Australian Catholic University, government agencies and nongovernment organisations and community groups to identify priority research activities. o Research priorities will be regularly reviewed and updated to allow PHD flexibility to respond to changing priorities. Population health research priorities will be endorsed by the Population Health Executive Team and tabled at the ACT Health Research Strategy Committee. Engaging in research within PHD and externally through collaborative research projects that foster links and partnerships between government, non-government and research organisations. Promoting research opportunities through the establishment of a PHD research website that identifies funding opportunities, priority research areas and processes. This will clearly identify PHD s research priorities to allow research organisations and funded organisations (including grant recipients) to align research programs. Current research priorities incorporate existing research activities and priorities identified by the Population Health Research Strategic Advisory Group that are based on: health needs of the ACT population as identified in the Chief Health Officer s report and other ACT publications; priorities of the ACT Government; existing strengths in the research community; availability of resources; and emerging opportunities presented by federal funding mechanisms Translating knowledge into policy and practice Evidence-based decisions require access to quality evidence and knowledge. Transferring knowledge generated from research into useable information for policy necessitates access to information that is useable, relevant and reliable to policy-makers and program deliverers. Effective knowledge transfer requires effective partnerships. In the ACT partners include research bodies, other government agencies, non-government organisations, federal and other jurisdiction agencies and funding bodies. Strategic priorities for the Population Health Division include: Establishing and maintaining effective partnerships and communication between various stakeholders in the ACT, including research bodies, other government agencies, nongovernment organisations, federal and other jurisdiction agencies and funding bodies; Developing a knowledge transfer framework to ensure successful transfer of knowledge and exchange of information between the various stakeholders; Encouragement and support for policy-driven research where possible through promotion of grants processes, funding opportunities and sharing of resources; Developing a process for systematically capturing and reviewing published literature that can inform policy and program development and establishing mechanisms for transferring information to relevant programs e.g. Evidence Check (Sax Institute website: 6 Population Health Research Strategy

7 Ongoing support for appropriate and systematic evaluation and review of existing projects and programs to ensure appropriateness and effectiveness of programs and evaluations; Dissemination of research findings through publication of research activities in peer reviewed publications and presentations and other relevant forums; and Promoting an organisational culture that supports the use of research evidence in policy and practice Strengthening population health research capacity The success of this Strategy requires a supportive research environment that can provide human, physical and financial resources that researchers and policy makers may need to commission, undertake and utilise research. The proportion of the PHD budget allocated to population health research has remained relatively steady at about one per cent of overall PHD budget, despite the demand for research to inform good policy and practice. The poor performance of Population Health in national funding competitions represents a missed opportunity for the ACT. Building workforce capacity can be achieved through direct means such as the provision of training, mentoring, fellowship or scholarship programs, or indirectly through skills transfer such as involvement in collaborative projects (e.g. with academic partners), territory wide projects or professional networks. Strategic priorities for the Population Health Division include: Forming research partnerships and research teams between researchers and organisations with a common interest; Encouraging collaboration with external organisations to apply for NHMRC Partnership Grants, ARC Linkage Grants and other grants will improve the competitiveness for both internal and external researchers in the ACT; Providing opportunities and encouragement to staff to engage in research activities through provision of grants and scholarships for staff in PHD and developing skills in applying for external grants and scholarships; Provision of training and development of staff in research methodologies and writing for journal publication; Raising the profile of population health research both within the ACT and nationally. This requires reporting on research activity through presentations, reports, publications and the internet. This profiling should include research achievements and recognition of partnerships and funding sources. Advertising the tangible outcomes of research activities is a key element to building public support and retaining and attracting quality research staff; Developing a culture of research through the generation of health research projects and activity; and Generating and improving access to quality information for surveillance, research and analysis, including standards for ethical and governance arrangements around access to data to ensure privacy and confidentiality of public information. Population Health Research Strategy 7

8 5. Implementation and evaluation of the strategy This strategy is intended to serve as a blue-print for strengthening population health research capacity over a five-year period. Implementation and evaluation of the implementation strategy and action plan will occur for both short and longer term actions. Performance measures and an evaluation plan will be developed against key action areas by the Population Health Evaluation Committee. 8 Population Health Research Strategy

9 6. Action plan GENERATION OF POPULATION HEALTH RESEARCH ACTIVITY AND KNOWLEDGE Strategy Action Lead area Establish an ongoing Population Health Division Research Committee (PHDRC). Audit of population health research activities in the ACT. Establishing population health research priorities. Develop population health research website page. Develop Terms of Reference and Membership. Formalise governance structure for population health research activities. Complete a map and gap of research activities in the ACT including collaborative research projects. Develop criteria for identifying population health research priority areas. Establish process for consultation with key stakeholders and research partners. Engage web manager to design web presence that includes: information on research priorities, funding opportunities, and processes for engaging in research activities. Executive Office PHDRC and web manager TRANSLATING KNOWLEDGE INTO POLICY AND PRACTICE Promote an organisational culture that supports the use of research evidence in policy and practice. Establishing and maintaining effective partnerships to facilitate knowledge transfer. Translating knowledge into practice-a framework. Ongoing presentation and seminar program to relevant stakeholders. Participate in relevant conferences. Establish processes to improve communication between research partners. Develop knowledge transfer framework to facilitate synthesis of and access to research evidence. PHET Collaborative project between, EPID and ANU Establish systematic literature reviews and watching briefs on priority research areas. Ensure appropriate and systematic evaluations and reviews are undertaken on funded projects to ensure appropriateness and effectiveness of programs and evaluations. Improve dissemination of research findings. Review existing mechanisms for reviewing literature. Develop priority list for systematic literature reviews and watching briefs. Develop process for capturing information and transferring knowledge to relevant stakeholders. PHD Evaluation Committee to document and review evaluation processes and implementation of evaluations undertaken on behalf of the Population Health Division. Disseminate research findings through peer review publications, health series reports, fact sheets and presentations of research findings. PHD Evaluation Committee PHD Population Health Research Strategy 9

10 STRENGTHENING POPULATION HEALTH RESEARCH CAPACITY Form research partnerships and research teams. Improve the number and quality of applications for research grants and applications for external funding sources. Provide research opportunities for staff in PHD. Build research capacity in the Division. Raising research profile of PHD Generating and improving access to quality information for health research use. Develop strategy to engage, communicate and facilitate collaboration with research partners. Collaborate with research partners to develop project proposals and grant applications. Develop and deliver a program of scholarships and funding to support staff to actively engage in research activities. Develop and deliver training programs and seminars that contribute to building research capacity in the Division. Improve the number and quality of publications and presentations across the Division. Develop research activity in the Division. Continue to generate quality information for surveillance, research and analysis. Improve availability of reliable information by improving governance and processes for accessing population health datasets. Development of data linkage capacity across ACT and active participation in Population Health Research Network. PHDRC, PHDRC, PHDRC, PHDRC, PHDRC EPID IMPLEMENTATION AND EVALUATION OF THE STRATEGY Develop evaluation framework for Population Health Research Strategy Develop performance measures and evaluation framework for the Strategy. PHD Evaluation committee Note: PHDRC: Population Health Division Research Committee EPID: Epidemiology Section ANU: Australian National University HPG: Health Promotion Grants program HP: Health Promotion PHET: Population Health Executive Team : Research Evaluation and Public Health Nutrition Section. 10 Population Health Research Strategy

11 7. References Strategic Plan: Research in ACT Health, draft discussion paper, Research Office, ACT Health. Towards a Healthier Australian Capital Territory: A Strategic Framework for the Population Health Division , Population Health Division, ACT Health. The UK Department of Health Best Research for Best Health - A new national health research strategy ce/browsable/dh_ Saskatchewan healthy people. A healthy Province. Promoting the generation and effective use of population health research in NSW. A Strategy for NSW Health _use_of_population_health_research_in_nsw.pdf Population Health Research Strategy 11

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