The key health challenge of our time is to address the changing health needs of children and young people in our population. Our current model of hospital‐centred paediatric care was developed to deliver acute inpatient and high intensity specialist services rather than high quality care for children and young people with long-term conditions.
Our health systems needs radical transformation if it is to meet the health needs of the future. Our research aims to understand the determinants of poor health in children and young people; co-develop integrated scalable intervention packages that can be delivered by existing practitioners; evaluate these packages at scale and integrate them into everyday practice.
As part of the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE) our focus is on translational research that will have a direct impact on the everyday lives of children, especially children and young people whose voices often go unheard, such as those from Aboriginal, refugee and culturally and linguistically diverse backgrounds and those living in socioeconomic disadvantage or out of home care.
As well as working with communities and partners across New South Wales and Australia, we also have ongoing projects to help kids in the UK, Fiji, Bangladesh, India, Pakistan, Sri Lanka and Uganda.
Current projects
Our work is based along three strands with child health equity a key theme: healthy beginnings, which addresses the social determinants of health such as housing, improving outcomes for preschool aged refugee children as well as integrated care strategies to improve the transfer home of chronically ill children from rural or remote NSW; priority populations by optimising the life chances for children young people and families that are doing it tough, and transforming health systems by enhancing integrated care and developing equity focussed care pathways.
Healthy Beginnings
Happy Healthy Ready- Developing an outreach model of care in early childhood developmental surveillance for children from Culturally and Linguistically Diverse (CALD) Backgrounds in South Eastern Sydney. The Happy Healthy Ready Projects in Botany and Rockdale tested two different models for working with early childhood/family support services to increase access to early intervention for children with developmental concerns. Both projects have shown that training early childhood/family support workers in child development and undertaking developmental surveillance in places where families feel comfortable and safe increases identification and early intervention for developmental concerns and delays. The team is also working with ELDOH to trial a developmental surveillance app in GP settings.
Best START-SW - The vision is to optimise the health, development and wellbeing of all children residing in SWS including the culturally diverse, refugee and Indigenous child and youth population. Team members from CCH are senior co-investigators and research leads for this unit, which brings together world-class clinicians, researchers and policymakers, working with families, children and youth to create a Centre of Excellence. The BestSTART-SWS aims to create a virtual cohort that will embed research activities into health services, creating a healthier and more connected community of children and families.
Watch me Grow app- Changing practice to improve Universal Child Health and Developmental Surveillance in the primary care setting (I think this needs moew detail - but I do not know much about it - you could email Tony for a brief background).
Healthy Wealthy Famillies- Healthier Wealthier Families will test the feasibility and benefits of linking Australia’s existing child and family nursing and financial counselling services, and to assess whether it can improve the quality, efficiency and coordination of responses to poverty and deprivation in families of children aged 0-to 5 years. This pilot trial is a national project running across NSW, Fairfield, South West Sydney, and Vic, City of Whittlesea, North Melbourne.
Priority Populations
Aboriginal Services & Research
- Aboriginal Parent Program (NNM)- Developing innovative models of care to support mothers from Aboriginal backgrounds through the Ngala Nanga Mai pARenT Group Program (NNM).
- Study of Environment on Aboriginal Resilience and Child Health (SEARCH) - Improving the health of urban Aboriginal children and adolescents in the SEARCH study: Study of Environment on Aboriginal Resilience and Child Health
- Healthy Housing Project- Develop an evidence based equity focused pathway in Aboriginal community La Perouse to identify and address housing issues.
Migrant and Refugee Services & Research
- First 200- This study will document health and wellbeing outcomes of the children and adolescents who have been detained in offshore detention on the remote island of Nauru.
Child Protection Services
- ‘Pathways of Care Longitudinal Study’ (POCLS)- Use the data from Community and Justice (FACS) in the first large scale prospective longitudinal study of children and young people in out-of-home care (OOHC) in Australia. Research on out-if-home care in Australia using data from Community and Justice (FACS) and the first large-scale prospective longitudinal study of child and young people in out-of-home care.
International Services
- Fiji training local paediatricians- Our team works collaboratively with staff from Colonial War Memorial Hospital, Labasa and Lautoka hospitals to establish a tiered child development system in Fiji. We have conducted training for local paediatricians to undertake developmental assessments and supported local clinics, building local capacity and collaboration across services. Approximately 20 children are seen each 6-monthly visit.
- International research – Indonesia - In November 2019, we began a clinical and research collaboration with the University of Gadjah Mada in Yogyakarta, Indonesia. This includes shared PhD and Masters students, and support developing systems that promote and support child development.
Transforming Health Systems
Strengthening Care for Children (SC4C) and Strengthening Care for Rural Children - SC4C offers an integrated model of care, in which paediatricians work directly with GPs in their practices to bring the best possible close-to-home care to children and their families. Evaluation from the UK showed the model resulted in a 39% reduction in new patient hospital appointments, a 19% reduction in speciality referrals, and a 22% reduction in ED attendances 12 months after implementation of a similar model. Pilot data from Victoria has shown a 5% decrease in OP referrals and most importantly a 16% increase in parental confidence in GP care and satisfaction in the care they received. Through an NHMRC grant, we have taken this model to 23 GP practices across Central and Eastern Sydney and North West Melbourne. The model will be expanded to rural areas with our successful Medical Research Future Fund (MRFF) Primary Health Care Research Grant: Strengthening Care for Rural Children (SC4RC), which aims to deliver and rigorously evaluate a primary health care strengthening program for rural children.
Sustaining Strengthening Care for Children (SUSTAIN) - Learning from the COVID-19 pandemic, SUSTAIN, successfully funded by the NSW Health TRGS scheme, aims to deliver a telehealth version of the SC4C model to 21 GP practices across both metropolitan and regional NSW The SUSTAIN model of care, lasting 12 months in each GP practice, consists of:
- Weekday phone and email support from paediatrician
- Modular paediatric training for GPs by enrolment in the Sydney Child Health Program (SCHP)
- 6hrs/month access to telehealth GP-paediatrician co-consultation sessions
- Monthly “lunch and learn” virtual case-based discussions led by paediatrician
ALPHA NSW- The goal is to create a health intelligence system responsive to the changing needs of the population and determine how front line workers could benefit from a data analytic platform to inform service development and delivery, and how that platform would be best designed and implemented to suit their needs.
Evaluation of the Proof of Concept Child Digital Health Record (CDHR)- The CDHR is an electronic version of the information captured in hardcopy ‘Baby Books’, such as the Blue Book in New South Wales (NSW), the Red Book in Queensland, and Green Book in Victoria. with the Murdoch Children’s Research Institute (MCRI), we have been independently evaluating the process of developing the CDHR, which will store a child’s milestones, health, growth, development and immunisations throughout childhood (ages 0-4 years).
Link with Sphere- Professor Lingam is Co-lead of the K2A clinical academic group of SPHERE with Professor Marshall and Wakefield. The Group brings together NSW’s leading clinicians and scientists in child health. Our aim is to reduce the “whole of life” impact of chronic illness on the child and the consequent burden on the health economy, while ensuring protection of the rights of the individual child to achieve their personal potential.
Growing Healthy Kids- Randomised controlled trial evaluating an obesity clinic
CYPCH - Children Young Peoples health partnership - The Children & Young People's Health Partnership (CYPHP) is working in London (Lambeth and Southwark). It is unique in the UK and across Europe in its cross-organisational, system-wide, transformative, and academically rigorous approach to improving child health services. Professor Lingam is the Co-PI and External Evaluation theme lead for this programme.
http://www.cyphp.org/about-cyphp/cyphp-team/29-evaluation-team
SuCCEED - Develop a comprehensive translational research database on how best to support children and families with health-driven feeding difficulties.
EPIC-CP- New projects planned for 2020 include a study examining the experience of Aboriginal and Torres Strait Islander Children with CP; an examination of the impact of social policy on the rates of post-neonatal CP and development of a social care navigator pathway for disadvantaged families and children and young people with CP (EPICCP); and collaboration on a NHMRC funded cohort study ‘Early Moves’ examining pathways to care with Telethon Kids. Laurel Mimmo, a SPHERE funded PhD student of Sue Woolfenden, is examining the experience of quality, safety and equity of children with intellectual disability and their families.
Care Close to Home- Using integrated care strategies to improve transfer to local care for children with complex medical conditions living in rural or remote NS
The research team
Professor Raghu Lingam, Lead Population Child Health
Raghu is a Professor of Paediatric Population Health at the University of New South Wales, Honorary Senior Researcher at the University of Newcastle, UK and a Consultant Community Paediatrician within the Sydney Children’s Hospital Network. He has set up and leads the Population and Child Health Services Research group at UNSW and co-leads of the Kids to Adults clinical academic group as part of Sydney Partnership for Health, Education, Research and Enterprise (SPHERE). Raghu is a senior clinical academic with clinical and research interests in children and young people’s health services research. His expertise is in the development and evaluation of health services interventions that are evaluated at scale; he has run randomised controlled trials in the UK, Australia, India, Pakistan, Uganda, and Mozambique. Over the last 5 years he has attracted over £9.5 million of UK research funding from the UK NIHR, World Bank, national charity and Government funding. In addition, he is a Co-applicant in a recently awarded joint NIHR/ NHMRC grant for a further £2.5 million. In Australia he has attracted over $4.5 million dollars of grant funding over the last 24 months.
Click here for Raghu's UNSW profile page.
Associate Professor Susan Woolfenden, NHMRC Senior Research Fellow, Deputy Group Lead of Healthy Beginnings theme
Sue is a NHMRC funded Senior Research Fellow and a senior staff specialist in the Department of Community Child Health, Sydney Children’s Hospital Network. She leads research that investigates the impact of inequitable health and health care for children in the early years of childhood in Australia and globally, in particular those who are at risk of or have a neurodevelopmental disorder.
Click here for Sue's UNSW profile page.
Professor Karen Zwi, Head of Community Child Health, Sydney Children's Hospital, Lead of Priority Populations theme
Karen is head of the Department of Community Child Health, Clinical Director of Priority Populations across Sydney Children’s Hospitals Network and Refugee Clinical Lead. Her research interests include the service development for refugee health, Aboriginal health, child protection, mental health and adolescent services.
Click here for Karen's UNSW profile page.
Dr Nusrat Homaira, Paediatric Epidemiologist, Infectious Diseases
Nusrat is a Lecturer in Paediatric Epidemiology at UNSW with more than 10 years working experience in the field of epidemiological and population health research. Her research interests include transforming health services delivery for children with chronic illness such as asthma. She holds an honorary academic position at George Institute for Global Health where she continues to be involved in ongoing global health collaborative research.
Click here for Nusrat's UNSW profile page.
Associate Professor Shanti Raman, Co-Lead of Priority Populations theme
Shanti is a Head of Department and Consultant Paediatrician in South West Sydney. Her research and teaching interests include global maternal, newborn and child health, child rights and child maltreatment, health of migrants and refugees, poverty, indigenous child health, and quality and safety in health. Her PhD in international maternal and child health at the University of New South Wales was about socio-cultural factors influencing perinatal health in urban India.
Click here for Shanti's UNSW profile page.
Dr Nan Hu, Research Fellow
Nan is an epidemiologist and bio-statistician by training, and has more than 10 years of professional and academic experience in public health research. His PhD examined the impact of family psychosocial factors, parental psychiatric disorders, and child maltreatment experience in the risk of deliberate self-harm behaviours among adolescents, using administrative linked data. Following his PhD, he was heavily involved in multiple projects investigating behaviour and emotional problems among children with intellectual disability and/or Autism Spectrum Disorder. Nan has a great interest in child health, with particular interests in mental health and behavioural problems, social disadvantage and vulnerability, early intervention strategies and polices, and clinical integration and innovation.
Dr Antonio Medonza Diaz, Research Associate
Antonio Mendoza Diaz (Tony) is a postdoctoral researcher with BestSTART-SWS (Systems Transformation and Research Translation) and ELDoH (Early Life Determinants of Health) at UNSW and the Ingham Institute, with research focusing on paediatric mental health, particularly clinical psychology and public health research. Tony is a mixed-methods researcher, having experience in both database management, research design and quantitative modelling and analyses as well as in qualitative participatory methodologies. Tony has worked with health professionals across a number of different child health services, and is happy to be contacted by those interested in research.
Dr Michael Hodgins, Research Associate
Michael Hodgins is a research associate within the Population Child Health Research Group. He began his career as a primary school teacher before moving into a diverse research career exploring topics ranging from health service delivery, youth health, palliative care, and arts-based and innovative methodologies. He has worked as a research assistant at Western Sydney University and the Hospital for Sick Children on a number of research projects. Michael holds a Master of Qualitative Health Research degree and Doctorate of Philosophy exploring emotion and knowledge translation in community based palliative care.
Dr Jade Burley, Research Associate
Jade Burley is a research fellow at UNSW. She is passionate about improving the health and well-being of children, with a research interest in physical activity and sedentary behaviour, health inequality, early intervention strategies and policy change. Jade is passionate about research innovation, translation, and accessibility.
Dr Yalemzewod Gelaw (Yalem), Research Associate
Yalem is a Research Associate in Epidemiology and Biostatistics at the UNSW Faculty of Medicine Discipline of Paediatrics. He has a strong public health and epidemiology background with considerable research experience, evidenced by an impressive publication record for such an early career stage. Graduated from Debub University with a Bachelor degree in Environmental Health in 2006 and received a MPH, specialising in epidemiology and biostatistics in 2013 from the University of Gondar in Ethiopia. Yalem has had ten years’ experience working in the Ministry of Health in Ethiopia as a senior environmental health officer, as well as holding an academic position at the University of Gondar.
Nora Samir, Research Assistant
Nora is currently the coordinator of a refugee health research study and is also working on setting up and running children and young people’s research advisory groups at Sydney Children’s Hospital, Randwick and in a local school. Her research interests include improving access to health care services in refugee and migrant populations, particularly through community-based interventions.
Christine Balane, Research Officer
Christine manages the research projects of the population child health group at UNSW including a diverse range of research and communications activities such as systematic reviews, participant recruitment and manuscript writing, blog posts and establishing an online presence. She has experience in various research settings including health systems for low and middle income countries and nutrition research. She has developed a keen interest in communicating research using digital platforms and has gained experience in managing academic research outputs and strategies to maximise research impact.
Key publications
Significant reductions in tertiary hospital encounters and less travel for families after implementation of Paediatric Care Coordination in Australia, Breen C; Altman L; Ging J; Deverell; Woolfenden S; Zurynski Y, 2018, BMC Health Services Research, 18:771-781
Use of health services by preschool-aged children who are developmentally vulnerable and socioeconomically disadvantaged: Testing the inverse care law. Woolfenden S, Galea C, Badland H, Smithers Sheedy H, Williams K, Kavanagh AM, Reddihough, D., Goldfeld, S., Lingam, R., Badawi, N., O'Connor, M.. Journal of Epidemiology and Community Health. 2020.
Strengthening health systems to support children with neurodevelopmental disabilities in Fiji—A commentary. Woolfenden S, Milner K, Tora K, Naulumatua K, Mataika R, Smith F, Lingam, R., Kado, J., Tuibeqa, I. International Journal of Environmental Research and Public Health. 2020;17(3).
Asylum seeking children and adolescents in Australian immigration detention on Nauru: A longitudinal cohort study. Zwi K, Sealy L, Samir N, Hu N, Rostami R, Agrawal R, Cherian, S., Coleman, J., Francis, J., Gunasekera, H., Isaacs, D., Larcombe, P., Levitt, D., Mares, S., Mutch, R., Newman, L., Raman, S., Young, H., Norwood, C., Lingam, R. BMJ Paediatrics Open. 2020;4(1).
The Acceptability and Effectiveness of Web-Based Developmental Surveillance Programs: Rapid Review (Preprint). Baker J, Kohlhoff J, Onobrakpor SI, Woolfenden S, Smith R, Knebel C, Eapen, V. JMIR Mhealth Uhealth 2020;8(4):e16085
"Improving Access to Early Childhood Developmental Surveillance for Children from Culturally and Linguistically Diverse (CALD) Background". Edwards K, Rimes T, Smith R, Fernandez R, Stephenson L, Son J, Sarkozy, V., Perkins, D., Eapen, V.,Woolfenden, S. Int J Integr Care. 2020;20(2):3.
Developmental risk among Aboriginal children living in urban areas in Australia: the Study of Environment on Aboriginal Resilience and Child Health (SEARCH). Chando, S; Craig, J; Burgess, L; Sherriff, S; Purcell, A; Gunasekera, H; Banks, S; Smith, N; Banks, E;Woolfenden, S. BMC Pediatrics 20(1) 2020
The Bumps and BaBies Longitudinal Study (BaBBLeS): a multi-site cohort study of first-time mothers to evaluate the effectiveness of the Baby Buddy app. Deave T, Ginja S, Goodenough T, Bailey E, Piwek L, Coad J, Day C, Nightingale S, Kendall S, Lingam R. Mhealth. 2019 Sep 25;5:42. doi: 10.21037/mhealth.2019.08.05
The Children and Young People's Health Partnership Evelina London Model of Care: process evaluation protocol. Satherley RM, Green J, Sevdalis N, Newham JJ, Elsherbiny M, Forman J, Wolfe I, Lingam R; CYPHP team. BMJ Open. 2019 Sep 3;9(8):e027302. doi: 10.1136/bmjopen-2018-027302.
Discharge against medical advice in culturally and linguistically diverse Australian children. Guo XY, Woolfenden S, McDonald G, Saavedra A, Lingam R. Arch Dis Child. 2019 Jun 22. pii: archdischild-2019-317063. doi: 10.1136/archdischild-2019-317063.
Children and Young People's Health Partnership (CYPHP) Evelina London model of care: protocol for an opportunistic cluster randomised controlled trial (cRCT) to assess child health outcomes, healthcare quality and health service use. Newham JJ, Forman J, Heys M, Cousens S, Lemer C, Elsherbiny M, Satherley RM, Lingam R, Wolfe I. BMJ Open. 2019 Sep 3;9(8):e027301. doi: 10.1136/bmjopen-2018-027301.
‘You've come to children that are in care and given us the opportunity to get our voices heard': The journey of looked after children and researchers in developing a Patient and Public Involvement group. Alderson H, Brown R, Smart D, Lingam R*, Dovey-Pearce G.* Joint senior. Health Expect. 2019 May 21. doi: 10.1111/hex.12904.
Assessing the quality of care for paediatric depression and anxiety in Australia: A population-based sample survey. Ellis LA, Wiles LK, Selig R, Churruca K, Lingam R, Long JC, Molloy CJ, Arnolda G, Ting HP, Hibbert P, Dowton SB, Braithwaite J. Aust N Z J Psychiatry. 2019 Oct;53(10):1013-1025. doi: 10.1177/0004867419866512. Epub 2019 Aug 8.
"There are carers, and then there are carers who actually care"; Conceptualizations of care among looked after children and care leavers, social workers and carers. Brown R, Alderson H, Kaner E, McGovern R, Lingam R. Child Abuse Negl. 2019 Jun;92:219-229. doi: 10.1016/j.chiabu.2019.03.018. Epub 2019 Apr 19.
The key therapeutic factors needed to deliver behavioural change interventions to decrease risky substance use (drug and alcohol) for looked after children and care leavers: a qualitative exploration with young people, carers and front line workers. Alderson H, Brown R, Copello A, Kaner E, Tober G, Lingam R*, McGovern R*. (*Joint senior). BMC Med Res Methodol. 2019 Feb 21;19(1):38. doi: 10.1186/s12874-019-0674-3.
Reducing Loss to Follow-Up of Culturally and Linguistically Diverse Children in a Developmental Screening Clinic. Lim J, Sarkozy V, Perkins D, Van Muster K, Woolfenden S. Journal of Paediatrics and Child Health (letter to the editor).2019
The Rights of Children for Optimal Development and Nurturing Care. Uchitel J, Alden E, Bhutta ZA, Goldhagen, J, Narayan, AP, Raman, S, Spencer, N, Wertlieb, D, Wettach, J, Woolfenden, S, Mikati, MA. Pediatrics. November 2019.
Partnerships for safe care: A meta-narrative of the experience for the parent of a child with Intellectual Disability in hospital. Mimmo, L., Woolfenden S., Travaglia J. & Harrison, R. Health Expectations. 2019
The quality of care for Australian children with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders. Churruca, K., Ellis, L. A., Long, J. C., Pomare, C., Wiles, L. K., Arnolda, G., Ting, H. P., Woolfenden, S., Sarkozy, V., de Wet, C., Hibbert, P., & Braithwaite, J. 2019
Risk factors for non-participation in a universal developmental surveillance program in a population in Australia. Chandra Ayer , Valsamma Eapen , Bronwyn Overs , Joseph Descallar , Bin Jalaludin , John Eastwood , Cheryl Dissanayake , Katrina Williams , Elisabeth Murphy , Sue Woolfenden. Australian Health Review 2019
Driving precision policy responses to child health and developmental inequities. Goldfeld, S., S. Gray, F. Azpitarte, D. Cloney, F. Mensah, G. Redmond, K. Williams, S. Woolfenden, M. O'Connor. Health Equity 2019.
Discharge against medical advice in culturally and linguistically diverse Australian children. Archives of disease in childhood. XY Guo, S Woolfenden, G McDonald, A Saavedra, R Lingam. 2019
Demographic and clinical characteristics of hospitalised unintentional poisoning in Aboriginal and non-Aboriginal preschool children in New South Wales, Australia: a population data linkage study. Lee C, Hanly M, Larter N, Zwi K, Woolfenden S, Jorm L. BMJ Open. 2019
The impact of social disadvantage on indicators of cerebral palsy (CP) severity - an examination of the Australian CP Register. Woolfenden S, Galea C, Smithers-Sheedy H, Blair E, McIntyre S, Reid S, DeLacy M, Badawi N, ACPR Group,CP QUEST. Developmental Medicine and Child Neurology, 2019
