In-SPHERE March 2024

In-SPHERE

In-SPHERE

IMPROVING

ACCESS TO CHILD AND FAMILY SERVICES FOR MIGRANT FAMILIES

PROFILE: PROFESSOR DAVID SIMMONS

EXERGAMING: A NEW WAY TO HEALTH?

The official research magazine of Maridulu Budyari Gumal, the Sydney Partnership for Health, Education, Research and Enterprise (SPHERE)

Our Partners

Each of our 15 Partners has a proven record of pioneering advancements across healthcare research, innovation and education.

It is this fusion of these different entities into one potent force that makes The Partnership unique - the whole is greater than the sum of the parts.

In-SPHERE, published three times a year, is the official research magazine of Maridulu Budyari Gumal, the Sydney Partnership for Health Education Research and Enterprise (SPHERE).

In-SPHERE showcases the work of our Clinical Themes and Platforms as well as our Partner organisations.

Executive Director: Professor Christopher White

Editorial Committee

Linda Music (Editor/Chief Writer)

Kristine Concepcion

Sophie Gates

Liz Henness

Smita Khandelwal

Stephanie Macmillan

Natalie Walsh

Front Cover Credit:

A word from our Executive Director

It has been 18 months since Maridulu Budyari Gumal, the Sydney Partnership for Health Education Research and Enterprise (SPHERE) redrafted its strategy, emphasising three key deliverables: enhancing workforce research capacity, advancing research capabilities, and accelerating health transformation through rapid applied research translation. The implementation plan, building on previous work, aims to bring innovation to life by bridging evidence and practice swiftly.

Our redesigned SPHERE website has resolved legacy issues, to allow real-time updates and fostering crossparty collaboration. This agile platform supports researchers with user-friendly tools, open-access resources, and streamlined data access. Investment in technology facilitates unique collaborations while stabilising operating costs.

SPHERE is perhaps itself a unique innovation that will continue to connect the communities we serve with our healthcare and industry providers and the academics for whom thinking creatively to solve wicked problems is their core business.

We continue to invest in our people with initiatives like mentoring programs and recognition for Translational Research Fellows’ achievements. Bernadette Brady, a SPHERE Translational Research Fellow was recognised by NSW Health as the Allied Health Professional of the Year. The Women’s Health Research Network supports mentoring and Tania Rimes has a profile outlining her SPHERE supported research experience.

Monitoring early mid-career research candidates’ success and offering grants for innovative projects align with NHMRC priorities and promote diversity in the research workforce. The first tranche of our 2024 Investigator Initiated Partnership Support grants is soon to close prior to the second tranche for Health Services priorities opening in Q3 and EMCR leadership in these opportunities continues to be emphasised.

Showcasing early transformative innovations like exergaming for falls prevention and improved pregnancy outcomes, SPHERE continues to advocate evidence-based medicine through Menopause and Diabetes submissions to government Inquiries, the latter led by David Simmons who is featured in this edition.

We have a mature impact assessment framework. The strategy serves as a benchmark for future progress and reporting to members, emphasising ongoing efforts toward healthcare

“SPHERE is perhaps itself a unique innovation that will continue to connect the communities we serve...”

Professor White appointed SPHERE Executive Director

After 19 months in Interim and Acting Executive Director positions, we are delighted to announce that Professor Chris White has now been appointed as SPHERE’s Executive Director.

Professor White stepped into an interim position at SPHERE in August 2022 as the organisation recalibrated its direction in response to an external review and emerging issues around sustainable funding and direction. The goal was to ensure that SPHERE maintained its status as an NHMRC accredited Research Translation Centre, fostering connections between researchers and clinicians to enhance the health outcomes of our communities.

“SPHERE always was a cracking good idea; a ready-made research social network looking for an enterprise solution to support it. Following the recommendations from our Barlow review and recalibrating the strategy, operations and sustainability, now is a great time to consolidate the changes we have made with the great team we have assembled,” explains Professor White.

“It’s a privilege to lead this team for the duration of this strategic cycle to wherever our technology enabled future resides.”

In addition to his role at SPHERE, Prof White holds positions as Conjoint Professor at UNSW and Clinical Professor at UTS. He also continues to practise as an endocrinologist at POWH Randwick.

We congratulate Chris on his formal appointment as SPHERE’s Executive Director.

Professor Chris White

Policy win SPHERE Nursing and Midwifery Implementation Science Academy

The SPHERE Nursing and Midwifery Implementation Science Academy in conjunction with the Australasian Nursing and Midwifery Clinical Trials Network has successfully lobbied the Australian Health Practitioner Regulation Agency to insert questions into the workforce survey (the National Health Workforce Dataset) undertaken by clinicians when they renew their annual registration. Supported by medical and allied health representatives on the Clinician Researcher Committee from the Royal Australasian College of Surgeons, these new questions will ask those seeking

nursing, midwifery, allied health and medical (re)registration for their highest academic qualification.

In addition to providing a robust baseline, these data will enable the health sector to determine if the number of health practitioners with research masters and PhDs increases over time as a result of varied state and national efforts to foster research, such as clinician researcher pathways. The group also requested a new additional title of ‘clinician researcher’ be added as a response option to describe people’s ‘principal role’.

New website for SPHERE

SPHERE’s new website is a user-friendly hub showcasing our expertise in key healthcare areas across our 10 Clinical Themes and five Platforms. The site’s resource section provides valuable insights and educational materials, constantly updated with news and events, making it a vital resource for researchers and healthcare professionals. www.thesphere.com.au

Musculoskeletal Health Clinical Theme lead wins prestigous award

Congratulations to Dr Bernadette Brady, co-lead of our Musculoskeletal Health Clinical Theme and one of our most successful SPHERE Fellows, who was awarded the Allied Health Professional of the Year at this year’s NSW Health Excellence in Allied Health Awards.

Bernadette joined 35 finalists at the Awards evening in February. Health Minister Ryan Park congratulated the finalists and winners in each of the seven categories.

“I want to thank all our hardworking allied health professionals for the significant contribution they make in delivering patient-centred care to the people of NSW every day,” Mr Park said.

“In particular, I would like to congratulate NSW’s Allied Health Professional of the Year, Dr Bernadette Brady, who was recognised for their significant contribution to musculoskeletal and pain physiotherapy, both as a clinician and researcher, with a special interest in Culturally and Linguistically Diverse (CALD) populations,” he said.

Making Moves

Empowering childhood cancer survivors through physical activity

By Linda Music

According to research and findings, including those from the Childhood Cancer Survivor Study (CCSS), it is estimated that between 60% to 70% of children who undergo cancer treatment will develop a chronic health condition by age 50. This alarming fact highlights the urgent need for tailored support for childhood cancer survivors.

Enter Making Moves, an exciting new research program designed to provide young cancer survivors with the tools and guidance they need to lead active and healthy lives, after cancer treatment.

The Need for Physical Activity Support

Childhood cancer survival rates have significantly improved in recent decades, thanks to advancements in cancer therapy. However, survivors often face long-term health challenges because of their treatment, including secondary cancers, cardiovascular disease, and physical limitations such as fatigue and reduced fitness. Engaging in regular physical activity can increase physical fitness, improve muscular strength, and reduce the risk for cardiovascular disease and obesity.

Despite the benefits of regular physical activity in improving survivors’ health and wellbeing, many do not meet recommended activity guidelines.

Dr Lauren Ha, a post-doctoral research fellow at UNSW School of Clinical Medicine and The Behavioural Sciences Unit, Sydney Children’s Hospital is supported by The Kids’ Cancer Project to lead a nationwide physical activity program of work. As an exercise physiologist, she recognised the lack of physical activity programs for young cancer survivors during her undergraduate studies. This realisation ignited her passion to support these

individuals in leading active and healthy lives after cancer.

The Program

Co-designed by Australian childhood cancer survivors, parents, healthcare professionals, exercise professionals, and researchers, Making Moves is a comprehensive program aimed at empowering young cancer survivors to embrace physical activity as an essential part of their health.

The program offers age-appropriate health education and personalised guidance on making healthy lifestyle changes. Through a series of digital modules and videos, participants learn about the importance of physical activity and how to incorporate it into their daily lives. The content is tailored to different age groups (8-12 years, 13-17 years and 18-21 years), ensuring that each participant receives relevant and engaging information.

Tailored Support

One of the key features of Making Moves is the personalised support provided to each participant.

“In addition to the educational modules, participants work one-onone with exercise physiologists to set goals and develop individualised plans to increase physical activity. These sessions focus on motivational interviewing and behaviour change techniques to empower participants to take ownership of their health and well-being,” explains Lauren.

“The program also emphasises family or community involvement, recognising that the support of loved ones plays a crucial role in the success of young cancer survivors. Videos at the end of each module encourage family members or friends to join in activities and provide support along the way.”

Expanding Access and Impact

Initial pilot testing of the Making Moves program has shown promising results, with participants reporting high levels of satisfaction and feasibility. Building on this success, the program is now being expanded to reach a wider range of participants, including

those up to 21 years old and those six months post-treatment.

By offering support online, Making Moves ensures that young cancer survivors can access resources and guidance no matter where they live. This flexibility is particularly important for individuals who may face barriers to accessing traditional in-person programs.

Making Moves represents a significant step forward in supporting the health and well-being of childhood cancer survivors. By providing tailored physical activity support and education, the program empowers young survivors to lead active and fulfilling lives after cancer. With continued research and innovation, programs like Making Moves have the potential to make a lasting impact on the lives of survivors and their families.

“We have an opportunity to make a real difference to the lives of young cancer survivors. By empowering them to embrace physical activity and healthy living, we can hopefully see improvements in their physical fitness and quality of life especially as they transition to adulthood,” said Lauren.

Lauren Ha

Inaugural mentoring program: a success

Six early to mid-career researchers embarked on a journey of professional growth with SPHERE’s Women’s Health Research Network mentoring initiative.

SPHERE’s Women’s Health Research Network (WHRN) launched its inaugural Mentoring Program at the end of last year with the goal of advancing women’s health research and fostering the growth of the next generation of researchers. The program, a collaborative effort between WHRN and Franklin Women, provided the opportunity for six early-mid career researchers to each receive three mentoring sessions tailored to their specific goals.

As a program only just in its infancy, the WHRN committee was keen to learn about the experiences of the program’s participants and the results did not disappoint. Feedback was exceptionally positive, as evidenced by the 100% satisfaction rate reported by participants in a post-program survey, all of whom expressed being ‘extremely satisfied’ with their experience.

Two participants, Tamara Macdonald and Rachel Grove, illustrate the substantial positive impact of this program, each gaining significant benefits and clarity through their mentoring sessions.

Tamara – solidifying her research trajectory

Tamara Macdonald, a seasoned nurse with 17 years of experience, currently works in a leadership role as a Clinical Nurse Educator for Child and Family Health in Narellan. Amidst emerging challenges for nurses and heightened responsibilities, particularly in navigating issues concerning increased high-risk and vulnerable families, Tamara recognised an opportunity to conduct research with the aim of enhancing staff wellbeing. Having been awarded a research internship with SPHERE’s Early Life Determinants of Health (ELDoH) Clinical Theme, Tamara has needed to traverse unfamiliar territory as an early career researcher.

Through the mentoring program, Tamara received personalised coaching sessions focusing on her research goals. These sessions equipped her with essential skills, from networking with senior executives to time management and boundary setting.

“I learnt more about myself in the three sessions of coaching than I have in the past 17 years of nursing,” Tamara remarked.

The program’s tailored approach not only bolstered Tamara’s confidence but also solidified her plans, with a clear path towards completing her research internship and pursuing a PhD in the future.

WOMEN’S HEALTH RESEARCH NETWORK

Tamara Macdonald

SPHERE’s Women’s Health Research Network

In 2021, the Australian Health Research Alliance (AHRA) formed a national Women’s Health Research Translation and Impact Network (WHRTIN) comprising representation from each of Australia’s NHMRC-accredited Research Translation Centres.

The SPHERE Women’s Health Research Network (WHRN) has been established to support the vision and mission of the AHRA WHRTIN:

The AHRA WHRTIN seeks to empower and improve equity, health and quality of life for all Australian women integrating prevention, healthcare, research and translation for community benefit. The WHRTIN also aims to advance and support the careers of women in research.

SPHERE’s WHRN is working on delivering on WHRTIN objectives, strengthen collaboration, and assist women’s career development opportunities in women’s health research.

“The program showed me how I can use my strengths and interests to make jobs work for me.”

Rachel Grove –discovering strengths to forge a new path

Rachel Grove, currently a Chancellor’s Research Fellow at UTS, embarked on the mentorship journey to navigate the transition from early to mid-career researcher. With her Fellowship nearing an end, Rachel used the opportunity provided by the mentoring program to develop her future career plans.

With her mentor, Rachel delved into her values and strengths, gaining a fresh perspective on career alignment. The mentoring experience provided her with invaluable clarity, not only in defining her career aspirations but also in discerning what paths to avoid.

“The program showed me how I can use my strengths and interests to make jobs work for me,” Rachel reflected.

“It has given me direction because not only has it made me look at what I want to do but also has made me realise exactly what I don’t want.”

Tamara and Rachel’s experiences highlight the program’s effectiveness

in providing tailored guidance and support, ultimately empowering participants to navigate their professional journeys with confidence and clarity.

“It’s a program that should be offered to all early-mid career researchers,” said Tamara.

Keep an eye out on SPHERE’s website for future opportunities for early-mid career researchers.

Rachel Grove

Exergaming A new approach to health and wellness

At the intersection of technology and health, exergaming stands out as a promising way to promote physical activity while providing an engaging and entertaining experience. Two research studies have shed light on its potential to transform health outcomes, particularly in falls prevention for older adults and promoting physical activity during pregnancy.

Falls Prevention Study

Led by

Dr

Daina Sturnieks,

Senior Research Scientist at NeuRA and Senior Lecturer at UNSW Medicine & Health, a five-year randomised controlled trial investigated whether exergaming could prevent falls in older individuals. With falls being a significant concern among the elderly, finding engaging ways to improve balance and reduce fall risk is crucial.

The study recruited 769 people aged 65 -95 years, living independently in the community. They were divided into three groups: two intervention arms, one involving balance challenge exercises and the other involving brain training exercises, and a control group. The primary outcome measured was the rate of falls over 12 months, while secondary outcomes focused on understanding the training effects on physical and cognitive functions.

“We designed this trial because we know you can prevent falls in people living in the community quite well with exercise, in particular with balance challenging exercises but the problem is the low adherence rate to many exercise programs,” explains Dr Sturnieks.

“So, we designed step training exergames as a fun exercise program that challenges balance and cognition and potentially prevents falls.”

Taking cues from the 1998 video arcade sensation Dance Dance Revolution, Daina’s research team devised smart±step, an innovative system comprising eight interactive games that can be played either in a seated position using a touchpad or by engaging with target panels on a mat.

“We aimed to make exercise enjoyable by gamifying the experience, which also allowed us to incorporate cognitive challenges aimed at training the cognitive functions associated with fall risk,” Dr Sturnieks added.

“Previous studies have demonstrated that cognitive training interventions can enhance physical functions like gait and mobility. However, no one had investigated whether cognitive training alone could prevent falls, which led to the inclusion of the second intervention arm.”

The results were promising, showing a significant reduction (26%) in the rate of falls in the exergame training group. Despite the brain training group not showing significant benefits on the primary outcome, subgroup analyses revealed promising results, particularly among individuals with a history of falls.

Statistics highlight the urgency of such interventions. In people aged 65 years, one in three will fall each year, while for those over 80, it increases to one in two falls annually. This demographic is particularly vulnerable, with a higher risk of injury, fractures, and even death resulting from falls.

“Falls are the leading cause of injury-related hospitalisations in older people and the leading cause of injury-related death in older people. We spend far more money in hospitals

each year on falls than on motor vehicle injuries,” explains Dr Sturnieks.

“The fact that we have an ageing population means the issue of falls is getting worse.”

Dr Sturnieks has conducted other studies on using exergaming in diverse populations, including those with medical conditions such as MS and Parkinson’s disease. She is currently looking at how exergaming can be used to help people who have developed peripheral neuropathy after chemotherapy.

Implementing the system

The future implementation of the smart±step system for falls prevention holds great promise. Although the system is not yet available for commercial purchase, there is significant interest, with over 1000 individuals eager to acquire it. Additionally, one aged care provider has already installed the system in 25 facilities nationwide, indicating a growing recognition of the potential of interactive gaming technology in promoting health and wellness.

Dr Daina Sturnieks

Improving physical activity in pregnant women by exergaming

In another study focusing on the feasibility of exergaming during pregnancy, UTS PhD candidate, Gemechu Kumera, explored its potential to promote physical activity among expectant mothers. With only three in 10 pregnant women in Australia meeting physical activity guidelines, finding ways to encourage exercise during pregnancy is crucial for women’s health. One such potential innovative approach may be exergames, emerging technologies designed to encourage physical activity in an engaging and entertaining manner, requiring physical activity as part of gameplay. With this in mind, the study aimed to evaluate the feasibility, potential efficacy and acceptability of home-based exergaming programs tailored for pregnant women.

The exergaming program was designed by a team with multidisciplinary expertise, in accordance with physical activity

guidelines for pregnant women. The suitability and safety of exergame exercises for pregnant women was evaluated using an expert’s heuristic evaluation. Based on this initial exploratory work, the team developed exergame programs tailored specifically for pregnant women. A pre-post testing design was employed to investigate the feasibility and potential efficacy of the exergame programs. Thirteen women followed the exercise program from 16 weeks gestation to birth. A qualitative study was adopted to explore women’s views and experiences of exergaming during pregnancy at the end of the intervention (near birth).

“The study findings demonstrated that the exergaming program has the potential to increase physical activity levels in pregnant women safely,” said Gemechu.

Results also indicated that exergaming was enjoyable, motivating,

“The exergaming program has the potential to increase physical activity levels in pregnant women safely”

and convenient for pregnant women, especially those with other children at home or facing inclement weather conditions. Qualitative feedback highlighted its potential to overcome barriers to exercise during pregnancy, making it a valuable tool for promoting maternal and foetal well-being.

As researchers continue to explore exergaming’s potential in diverse populations, the future of health and wellness looks increasingly intertwined with interactive gaming technology. With ongoing efforts to make exergaming more accessible, it holds promise for transforming how we approach physical activity and preventive healthcare.

Gemechu was supervised by the colead of SPHERE’s Maternal & Women’s Health Clinical Theme, A/Prof Deborah Fox, together with Prof Rob Duffield, Dr Jaime Garcia and Ms Justine Salisbury.

Gemechu Kumera

Credit: Liderina

Improving healthcare access for vulnerable children

The First 2000 Days Care Connect Project (FDCC)

By Linda Music

Early childhood (0-5 years) is a critical period for interventions to shape the long-term health and wellbeing of children. During this period, establishing a continuum of care, which includes regular growth and development checks plays a significant role in fostering optimal child health outcomes. However, for migrant and refugee populations, accessing and engaging with health services can be challenging.

Recognising this, the First 2000 Days Care Connect (FDCC) project emerged as a response, aiming to address these issues and improve the health trajectories of children from migrant and refugee populations. Funded by the NSW Health Translational Research Grants

Scheme, FDCC has leveraged research to pioneer a holistic model of care, focusing on transition from maternity service to community child and family health (CFH) services, engaging families in child growth and development checks with a CFHN Nurse and service navigation support to both health and social care services.

The problem

The statistics paint a concerning picture: one-quarter of NSW preschool-aged children from nonEnglish speaking families are at risk of delayed development. This risk stems from various factors, including undiagnosed maternal postnatal depression, premature cessation of breastfeeding, and unaddressed

psychosocial needs. Consequently, these children are doubly vulnerable to academic underachievement, compromised health, and escalated healthcare costs compared to their peers.

However, by 12 months of age, only a third of these children have their growth and development checks completed, meaning that developmental issues are often not picked up until they start school. Ensuring these families become engaged with CFH Nursing Services where concerns can be identified and early intervention offered, provides a significant way to prevent this from happening. However, as Tania Rimes, Chief Investigator of the FDCC project explains, accessing

and engaging with CFH services can be challenging due to various barriers including cultural disparities, language barriers, and limited health literacy.

The Solution: First 2000 Days Care Connect (FDCC) Intervention Model

The FDCC hub model, supported by care navigation, aims to bridge the gap between migrant and refugee families and essential healthcare services The model is an innovative approach which involves co-locating CFH services within or close to NonGovernment Organisations (NGOs) such as playgroups and childcare centres, and providing access to psychosocial support services, general practitioners, paediatricians, domestic

violence support, and more.

“Essentially, the project brings CFH services to where the families are rather than making them come to the service,” explains Tania.

The FDCC model was built upon the achievements of the “Happy Healthy Ready” pilot model implemented in Rockdale. This pilot demonstrated notable success, with 63% of families attending the Rockdale Hub re-engaging with CFH services during the period from 2014 to 2018, involving a total of 160 families.

From 2021-2023, the FDCC model was trialled across South Eastern Sydney Local Health District (SESLHD) and South Western Sydney Local Health District (SWSLHD). To participate in this

trial, expectant mothers needed to be beyond 20 weeks’ gestation, aged 16 or older at enrolment, and either newly arrived migrants or self-identified refugees from non-English speaking backgrounds within the past decade. Participants also needed to reside in the geographical catchment and attend antenatal clinics in specific hospitals such as St George, Liverpool, or Fairfield Hospitals.

The first six months –(Rockdale)

The impact evaluation of the FDCC project looked at the influence of the Hub model on attendance and completion rates of child health and development checks (primary outcome). Data about attendance was collected at 1-4 weeks, 6-8 weeks, six months and 12 months.

Although the finalisation of the 12-month electronic medical records (eMR) and survey data is not expected until June 2024, preliminary data collected up to the six-month mark indicates a notable disparity in attendance rates between families accessing services within the hub area and those outside (control group).

Within the first 1-4 weeks, the intervention group displayed full attendance (100%), while the control group followed closely at 94.34%. By the 6-8 week mark, the intervention group maintained a high attendance rate of 86.54%, whereas the control group exhibited a lower attendance rate of 68.3%. At the six-month milestone, the intervention group maintained a robust attendance rate of 86%, demonstrating sustained engagement with CFH Nurse

checks, whereas the control group’s attendance dropped to 50%.

“These findings demonstrate the tangible impact of the FDCC project in increasing attendance for growth and developmental checks and the length of time families engage with the Rockdale Hub,” said Tania.

Miller – small gains can lead to improve service delivery

At the Miller site, the distinctions between the control group and the intervention group remain noteworthy. At the six-month mark only 7.84% of families in the control group showed up for the child and family health check, compared to a significantly higher attendance rate

Tania Rimes: Driving change in child and family health

Tania Rimes, a psychologist turned Strategic Program Coordinator with the South Eastern Sydney Local Health District has dedicated over a decade to improving child and family health.

Her journey began in 2001 with Families NSW, where she played a pivotal role in early intervention programs targeting vulnerable families with children aged 0-5, collaborating closely with various service providers in the NGO sector.

As the landscape evolved, so did Tania’s role, transitioning into a more strategic position over time. With the advent of the Ministry of Health’s First 2000 Days Framework in 2019, Tania recognised a familiar thread from her earlier work—a renewed emphasis on early interventions to yield better out-

comes for children. Her involvement as a co-investigator in a translational research grant for a First 2000 Days - Care Connect (FDCC) project is testament to her commitment to driving impactful change at a systemic level.

For Tania, the most fulfilling aspect of her work lies in the opportunity to innovate and collaborate across sectors. Her outward-facing role allows her to forge new connections and partnerships, enriching the scope of interventions and amplifying their reach.

“One of the best parts of my job is witnessing tangible improvements in the lives of families and children due to the 2000 First Days - Care Connect,” said Tania. Drawing from her own experiences as a mother of two boys, Tania brings a unique perspective

of 33.33% in the intervention group. This suggests that the intervention is indeed making strides in boosting attendance rates. Acknowledging the differences in health seeking behaviour, socio-economic backgrounds and educational levels of families in this area, is key to enhancing services for families in South West Sydney.

Through their integrated care model, the FDCC project has proven to improve access to vital healthcare services and fosters healthier futures for children by catering to the unique needs of migrant and refugee families. The project’s ongoing evolution looks to ensure that children from these families receive the necessary support to thrive during their crucial early years.

to her work. Navigating the complexities of the healthcare system firsthand has instilled in her a deep empathy for vulnerable families facing similar challenges.

“Having faced my own challenges as a parent navigating the health system, gives me an understanding of how complicated services can be to access. This is why FDCC program has been so successful, because we bring the services to where the families are.”

Why have you chosen to spend most of your career working in diabetes research?

I started in hypertension research when a student. As a junior doctor working clinically, I was exposed to the beginning of the diabetes epidemic and the concurrent major treatment and access challenges, and decided to focus on the epidemiology of diabetes to answer many of the unanswered questions of the day. The communities I worked with said (and I paraphrase) that if I am to describe their diabetes epidemic, I should be involved in developing strategies to address the needs that were uncovered. I have been combining descriptive and intervention work ever since.

Is the prevalence of diabetes in Australia improving or is there a long way to go?

The prevalence of diabetes in some communities might have plateaued, but the age at onset with increasing numbers of children and young people with diabetes, is a growing problem. This of course leads to growing

Advancing diabetes research Professor David Simmons

numbers of women with type 2 diabetes in pregnancy (both diagnosed and undiagnosed) in our clinics, with a growing number of affected babies. Disparities are evident so particular communities are much more heavily affected than others (based on e.g ethnicity, socio-economic status).

How has your ongoing research helped to improve the diabetes outcomes for the groups you have studied?

We have contributed in a number of ways including better ways by which GP and diabetes specialist services working together improve the care of people with type 2 diabetes, reducing their risk of diabetes complications like kidney failure, blindness and amputations. We have also generated the evidence that Māori and Pacific people with type 2 diabetes in New Zealand should have access to the new drugs to reduce their risk of kidney and heart disease. Research among young adults with type 1 and type 2 diabetes has helped inform the development of wider multidisciplinary services to reduce the risk of diabetes ketoacidosis and unplanned

pregnancies with glucose levels that can lead to birth defects in the babies. Our most recent trial, TOBOGM (treatment of Booking Gestational Diabetes Mellitus) has shown that we should be detecting and treating GDM much earlier in a sizable proportion of pregnancies. The work to develop guidelines using this new evidence is already underway around the world, and TOBOGM has already informed both American and Scottish guidelines with an Australian conference to discuss this coming up soon.

What research projects are you currently working on?

We have a range of research projects currently underway. The largest SPHERE project is PPDP, the Pasifika Preventing Diabetes Program, under an NHMRC Partnership grant with local health districts, Primary Health Networks and others, all in partnership with the Pasifika community. This is looking at how we can prevent type 2 diabetes and its complications with a “through the church” culturally tailored lifestyle and peer support program. We also have the APHLID-M randomised controlled

trial funded by the federally funded TTRA-MTP across South Western Sydney and South Eastern Sydney hospitals, Sydney Children’s Hospital Westmead and Goulburn Valley base Hospital in Shepparton. This is testing whether a specially designed phone app can improve mental health and diabetes self-management in young adults with diabetes and a range of mental health issues. Our latest project is working with the Age and Ageing Clinical Theme on adapting and trialling an education platform, the Western Diabetes Education Program, for use among elderly people with diabetes. The aim is to give more confidence, knowledge and skills to those in the aged care sector around the day-today care of those with diabetes. We have another educational project with the Aboriginal Health and Wellbeing Clinical Theme for those with type 2 diabetes taking SGLT2 inhibitors.

As the Director of the Diabetes, Obesity and Metabolism Translation Unit (DOMTRU), have you seen an improvement in the translation of research into practice?

Yes, there have been enormous strides in the treatment of both type 1 and type 2 diabetes over the last 10 years and many of these discoveries and technological advances are being put into practice, for example, glucose sensors are now funded by the Federal government for those with type 1 diabetes, and the new SGLT2 inhibitors and GLP1 Receptor Agonists are increasingly being used for those with type 2 diabetes. However, there is still further to go, for example, we’ve shown that we can put type 2 diabetes into remission using an adapted approach for Australian general practice but this needs a policy framework to introduce it. Similarly, insulin pumps that can talk to sensors in something called hybrid closed loop systems which can improve

blood glucose and reduce frightening hypoglycaemia (low glucose) episodes, are not yet subsidised in Australia. We currently have an MRFF funded trial of one of these systems for use in type 1 diabetes in pregnancy with partners in Canada.

As Director of SPHERE’s Diabetes Obesity and Metabolic Disease Clinical Theme (DOM) how important is SPHERE to diabetes research?

SPHERE has been enormously important in our work. The collaboration with those from other SPHERE partners, other Themes and the overall framework, has provided different perspectives and skills and a springboard for different research activities. We otherwise would not have gotten together without SPHERE. SPHERE has also supported our work in integrated diabetes care through a SPHERE symposium at our annual Tech and Talk conference. And of course, SPHERE has contributed partner funding in a range of research projects. SPHERE has been an enabler in propelling our research along, translation across the SPHERE catchment, linked clinicians into the research & vice versa. It has been a great avenue for ECRs and early clinicians to kick start their research. I’ve found it a great way to give back as a mentor & build capacity for the next generation of research leaders.

What is the best part of your job?

Hard to say! Watching and being part of the achievements of others whether its grants, PhDs, papers, recruitment into studies or completing grants and papers successfully.

Describe your typical week

I don’t have a typical week! It is anchored in a diabetes in pregnancy

clinic one day and a young adult or pre-pregnancy diabetes clinic on another day. In between is a lot of research, management, policy, clinical and education work!

Greatest professional achievement

I am proud of setting up the University of Melbourne Department of Rural Health and Rural Clinical School in Shepparton, the Diabetes Foundation Aotearoa in South Auckland and completing a number of big research projects that have influenced the care, and hopefully outcomes, of people with or at risk of diabetes.

Notable achievements

• Over 400 refereed publications.

• Has won national and international awards for his work Including:

- The Norbert Freinkel Award

2020 from the American Diabetes Association

- The Pederson 2022 Award by the (European) Diabetes in Pregnancy Study Group for his work in Diabetes in pregnancy and the Australian Diabetes Society (ADS)

- Jeff Flack Award 2022 for outstanding contribution to diabetes data collection in Australia.

• President of the Australasian Diabetes in Pregnancy Society (ADIPS) and was a member of the World Health Organisation technical working group on the criteria for hyperglycaemia in pregnancy.

• Previously the chair of Diabetes UK Health Professional Education Steering Group. He is a visiting academic to the University of Orebro Sweden and is a Professorial Fellow at the University of Melbourne.

“Our findings reveal significant gaps in service access for diabetes management within key communities in Australia.”

SPHERE advocates for better health outcomes

Credit: Fizkes

SPHERE submits paper into menopause inquiry

In response to the Senate Inquiry into issues relating to menopause and perimenopause, SPHERE listened to, and provided a submission from, the perspective of the primary stakeholders: women who are affected.

SPHERE consulted consumers, and expert representatives from our 15 partners and identified significant gaps in policy, education, service provision and research translation for the practical management of menopause and perimenopause symptoms within Australia.

To enable women to gain greater control over decisions and actions affecting their health, to ensure that

they have access to equitable and individualised care, and to future-proof our economy and society, SPHERE recommends:

• a population health approach to perimenopause and menopause management;

• a Shared Care Model of service delivery for perimenopause and menopause, including integrated care hubs for menopause;

• a structured and committed approach to increasing education and awareness in perimenopause and menopause for healthcare professionals, workplaces, communities, and individuals; and

• gender equity in evidence-based, translational research.

SPHERE responds to government inquiry into Diabetes

In collaboration with our community of consumers, clinicians, health service managers, researchers and industry contacts, we submitted crucial insights to the House of Representatives Standing Committee on Health, Aged Care, and Sport for their Inquiry into Diabetes.

Our findings reveal significant gaps in service access for diabetes management within key communities in Australia:

• Indigenous health

• Contraception, pre-pregnancy and young adults

• Communities in rural areas

• CALD communities (Pasifika)

• Overweight and obesity

• Severe mental health conditions

• Gastrointestinal cancers

• Chronic respiratory disease

The submission provided proposals to address the problems faced by these diverse populations.

Read the submission

Who’s who in SPHERE?

Biana Badolato, Administration Officer

Kristine Concepcion, Research Support Officer, Age and Ageing, Diabetes, Obesity & Metabolic Diseases, Aboriginal Health and Wellbeing, Kids to Adults, Musculoskeletal health

Sophie Gates, Research Support Officer, Maternal & Women’s Health, Palliative Care, Healthy Populations and Environments Platform, Industry and Innovation Platform, Early Life Determinants of Health

Natalie Walsh, Research Support Officer, Clinical Trials and Data Platform, Implementation Science Platform, Knowledge Translation Platform,

Professor Chris White Executive Director

Liz Henness Operations Manager

Smita Khandelwal Business Outcomes Coordinator

Linda Music Communications Officer & Editor In-SPHERE,