Health Services

Baby Business - a guide for parents

The Baby Business intervention project provided parents with information about normal infant sleep and cry patterns and strategies to manage these behaviours. Managing sleep and crying with a new baby can be challenging. 'Baby Business - a guide for parents' is a short booklet to help parents to manage their baby’s sleeping and crying in the first few months of life. It’s based on the Baby Business trial and provides accessible and practical information for parents. The booklet is available for just $6 per copy (less for bulk orders), plus postage and handling. 

• Baby Business - The Royal Children's Hospital

Centre of Research Excellence in Childhood Adversity and Mental Health

The Centre of Research Excellence in Childhood Adversity and Mental Health is funded by the National Health and Medical Research Council (NHMRC) and Beyond Blue. Our vision is to create a sustainable service approach, co-designed with end-users, to improve children’s mental health by early detection and response to family adversity. We have reviewed the evidence around which interventions are most effective for reducing the impacts of adversity on children and co-designed an integrated care Hub to better detect and respond to childhood adversity in the early years. We will test and evaluate our approach Hubs in Wyndham Vale, and Marrickville, NSW.

• Centre of Research Excellence in Childhood Adversity and Mental Health

Changing patterns in health services use and effects of care forgone: a report on impacts of Covid-19 pandemic restrictions on Victorians’ healthcare

The Covid-19 pandemic has seen a “transformative shock” to our healthcare system. We have seen fewer patients presenting to primary care, optometrists, dentists, hospital emergency departments and hospital admissions. Much care has been provided by telehealth and new mothers have been discharged home earlier. This project analyses statewide hospital data sets (ED, admitted and outpatient) across 2018, 2019, and 2020 to determine changes in the number and proportion of patients attending ED and being admitted to hospital for infants younger than 3 months; vaccine preventable diseases; ambulatory care sensitive conditions; mental health; pregnancy and postpartum conditions; eye conditions; and aged care. 

EuroQoL grant: testing EQ-5D-Y for use in children aged 2-5 years

Few Health-related Quality of Life (HRQoL) measures are available for the estimation of child quality-adjusted life-years (QALYs) with a nearly clear absence of measures for children under 5 years. The EQ-5D-Y is recommended for children 4-7 years using parent proxy, but there has been relatively little research into its use for children under 4 years. This research project establishes if the EQ-5D-Y can be used for children 2-4 years and to co-design a suitable adaptation for testing with parents/carers. A further aim is to validate the adapted EQ-5D-Y with proxy completers alongside CHU9D and PedsQL.

Medicinal cannabis for developmental disorders

There is intense interest from parents and paediatricians in medicinal cannabis as a treatment for developmental disorders. At present there is insufficient evidence to guide prescribing practice. This nationally leading program of research is investigating the safety and efficacy of different forms of medicinal cannabis to treat symptoms of developmental disorders in children and adolescents. We are currently conducting two trials, one in patients with intellectual disability (funded by a Medical Research Future Fund grant) and one in Tourette syndrome (funded by philanthropy and industry). 

CARE study: Children’s Asthma REadmission Study

Asthma is the most common chronic childhood illness and one of the most frequent reasons for hospital admission. To prevent admissions, we need to understand the factors in a child’s care journey associated with readmissions. This project follows a cohort of 770 children from The RCH, Northern and Geelong Hospitals who were admitted for asthma treatment. Using medical record analysis, GP surveys, family interviews and linked hospital and medication administrative data, this project aims to identify modifiable hospital, GP, family and environmental factors associated with asthma readmissions.

Strengthening Care for Children (SC4C)

This project is a stepped-wedge randomised control trial conducted within 22 GP practices across Victoria and NSW. SC4C is testing a new model of integrated GP-Paediatrician care for children. The integrated models involve regular GP-paediatrician co-consultations; monthly case study discussions led by the Paediatrician; and specialist paediatric phone and email support for participating GPs. SC4C aims to reduce paediatric referrals to hospital emergency departments and outpatient clinics, increase GP confidence and knowledge in paediatric care, reduce low value paediatric care in primary health settings, and increase family confidence in GP care. SC4C is funded through an NHMRC Partnership Grant.

QUOKKA Project- Quality Of Life in Kids: Key evidence to strengthen decisions in Australia

Decisions about health care rely on evidence that treatments work and are value for money. This is typically assessed by the improvements in Quality adjusted life years (QALYs).  Methods conventionally used to measure and value adults’ health related quality of life (HRQoL) do not work well in valuing paediatric HRQoL. There has been a low uptake of these tools in the evidence used to inform healthcare decisions. Our research will deliver (i) a database of paediatric HRQoL data across different questionnaires and diseases (ii) improved methods for self-and proxy-report of child HRQOL and (iii) new methods for valuing child health states.

Towards equitable access for child mental healthcare: a co-designed digital health intervention

Behavioural and emotional problems (BEPs) in children are common and can lead to lifelong adverse sequelae. For these problems, 40% of families seeking help will see a paediatrician but face out-of-pocket costs over $80 per visit and long waitlists of six-12 months. The overall aim of this PhD is to co-design and trial a consumer-facing digital health intervention to help families who have a referral to see a paediatrician, by shortening the waiting time to access mental health support services suited to their family and the child’s needs.

Resilience in childhood adversity, a mixed method assessment of system barriers

Description: (100 words maximum): Access to timely, affordable health care is a major determinant of health. There are several barriers to health care including a fragmented healthcare system, poor health literacy, lack of services or long waiting times, costs, and stigma. Families who are experiencing more adversity are less likely to engage with preventative health care for children. This PhD will identify what are the main barriers to the identification of children living with adversity and the barriers to referrals for interventions for children and families living with adversity. An intervention to address the main system barriers will be undertaken within the Child and Family Hub. 

A health/education collaboration to improve outcomes for children with emotional and behavioural difficulties

Emotional and behavioural problems are common in children and can adversely impact development and wellbeing. They are an early indicator of mental illness therefore early intervention is essential. Many Australian children miss out on mental health care. Schools are well placed to identify and help these children, but they need support to implement timely, evidence-based approaches. This PhD will first co-design a structured collaborative model targeting more accurate and earlier identification of children with emotional and behavioural difficulties in primary school. It will then pilot the model in metropolitan and rural primary schools to assess the feasibility and acceptability of the intervention.

COnnecting Mental-health PAediatric Specialists and community (COMPASS)

Led by Prof. Harriet Hiscock, the Health Services Research Unit (RCH) in partnership with the North Western Melbourne Primary Health Network (NWMPHN) and The Royal Children’s Hospital Mental Health team, piloted an integrated system approach to strengthen paediatric mental health care and reduce the burden on specialist services and hospitals.

The COMPASS pilot evaluation comprises three components within the NWMPHN catchment area:

1. Online community of practice (CoP) supported by a child psychiatrist
2. Child Psychiatry secondary consultation and liaison service
3. Senior MH clinician support to community-based Hub MH clinicians (HeadtoHelp).