Cabrini Research Annual Report 2020-21
Dr Tomas Rozbroj POSTDOCTRAL RESEARCH FELLOW, MONASH-CABRINI DEPARTMENT OF CLINICAL EPIDEMIOLOGY
Dr Tomas Rozbroj is a postdoctoral research fellow in the Monash-Cabrini Department of Clinical Epidemiology. He specialises in researching how people understand, accept and use healthcare information. In his role at Cabrini, he applies this speciality to identifying strategies for improving patient and public understanding about low value care and how to avoid it. Tomas utilises social science, social psychology and public health research perspectives, and has worked on a variety of topics. His earlier research focused on improving mental health services for same-sex attracted people and exploring resilience and psychological flourishing among people living with HIV. Since 2015, his research focused on examining attitudes to vaccination in Australia, which was also the topic of his doctoral thesis. His findings about the ways that vaccine refusal beliefs are linked to identities, self-perceptions, experiences and defined against societal attitudes, remain significant in understanding vaccine hesitancy in Australia today. Tomas has published widely, with several articles ranking in the first percentile of impact scores. He has contributed media commentaries to outlets including The Conversation, ABC Australia and Radio National, Triple R radio and in News Corporation newspapers. His work has helped influence health policy in Australia and abroad. In 2018, he spent six months in Prague as a visiting academic at Charles University.
Current work Tomas and his colleagues, led by Professor Rachelle Buchbinder AO and Associate Professor Denise O’Connor, examine strategies to reduce low value care and overdiagnosis. Their work responds to the increasingly recognised problem of ‘too much medicine’. Examples of too much medicine include unnecessary medical imaging, ineffective or harmful treatments and the inappropriate labelling of medical abnormalities. The research group is part of the National Wiser Healthcare collaboration, and makes significant contributions to international research to reduce low value care. 40
One key component of reducing low value care and overdiagnosis is patient-centred strategies to raise awareness and promote informed health decision-making. This can be a tricky task as ideas about excessive testing and overdiagnosis tend to be counter-intuitive and difficult to translate into action. Sometimes, low value care practices are desired by patients, propagated by healthcare professionals and ingrained through decades of public health messaging, media narratives and commonly-held assumptions. To date, public messaging about low value care has had modest success. This is the challenge that Tomas and his colleagues are working to overcome. Tomas’ research examines how lay people understand and use messages about low value care. He led a global systematic literature review and meta-synthesis of qualitative research about lay understandings of overdiagnosis and overtesting. This work produced novel theories about how to talk about low value care with the public. Now, with support from a Cabrini Foundation Research grant, Tomas is commencing research to empirically evaluate these novel theories in-depth among a sample of the Australian public. His multi-stage research will examine the resonance of different messages about low value care, including how different messages fit with the public’s broader beliefs, assumptions, values, emotions and social expectations. The project will also examine the public’s preferences and perceived capacities for using information about low value care in their medical decision-making. Tomas will use the insights gained from the research to design, test and implement a new generation of public messages to reduce low value care, that are more resonant with the public’s beliefs, motivations, values and capacities. The research by Tomas and his colleagues is driven by a desire to help patients make informed healthcare decisions, but it will also benefit providers, like Cabrini, that are committed to delivering high-value care. The work touches on many key challenges in contemporary public health, including the need for strategies to support informed patient medical decision-making and health literacy, and the need to develop salient healthcare communications for the post-modern information landscape.
