Promoting equity for the health and wellbeing of rural people

Our researchers are co-partnering with communities to translate healthcare findings into practice.

Our research aims to improve the health outcomes for vulnerable groups in rural and regional communities.

Equitable access to oral health

Research team:


Rural people severely disadvantaged through mental illness have appalling oral health outcomes, and face major inequity due to where they live. This study addresses one of the most complex and neglected health problems: the oral health of people with mental illness living in rural Australia.

Researchers will explore oral health interventions for people living with mental disorders, and the context and mechanisms that have contributed to the success of these interventions, or the barriers and challenges. They will produce program theories on causal, contextual and mechanistic factors to facilitate outcomes and implement interventions to improve oral health outcomes.

This is the first study to use a realist approach to explore the causal factors that impact on the success or failure of oral health interventions for people with mental disorders. This unique approach creatively deconstructs oral health as a dental issue and reinterprets it as a multi-causal/multi-impact issue that must be addressed through broad system engagement and change. The research outcomes will result in extensive stakeholder action and rapid translation of knowledge to practice.

Read a publication from this study.

Research team:


Poor oral health among older people is a global problem that impacts on health and wellbeing. The economic cost to the health system is significant and a rapidly ageing population is intensifying the need for action.

This study explores oral health interventions for older people in residential aged care. It aims to identify the underlying contexts and mechanisms of change and how these interact to produce intended and unintended outcomes.

Participants include older people living in residential aged care facilities, the aged care workforce, carers and families. To ensure data richness, oral health outcome data will supplement the findings. Stakeholders will be engaged to examine consistencies across studies and an explanatory causal theory will be developed to guide policy and practice.

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Australia resettles around 18,000 refugees each year. Victoria has received about a third of these refugees, 50% of which are expected to settle in regional and rural areas by 2022.

Refugees are considered a vulnerable group, as they are at an increased risk of poor oral health compared to the general population, with limited access to public dental services in Victoria. This study explores access as it relates to the resettled refugee population in Victoria. A geographic information system-based spatial analysis, using secondary data gathered from multiple sources, will be employed. Findings will inform oral health policy and highlight critical areas for future research.

Research team:


Children with Intellectual and Developmental Disabilities (IDD) experience poorer oral health and significant unmet treatment needs when compared to children in the general population. Barriers include physical inaccessibility of the service, lack of awareness of the importance of oral health, costs incurred by carers, and difficulties in making appointments.

This study explores why children with IDD do not enjoy equity in access to dental services. Using an explanatory multi-method study design, the first quantitative phase involves estimation of attendance rates of children with IDD in the general dental services in the Loddon Mallee region. The second qualitative phase involves interviewing parents and service providers from the clinics that participated in phase one, to identify factors across these clinics that have influenced service use.

Research team:


People who use illicit drugs experience higher prevalence of oral health problems compared to those who do not. However, there is lack of evidence on the barriers and enablers to achieving optimal oral health in people who use illicit drugs. This qualitative study will examine these barriers and enablers from the perspective of the people who use drugs, service providers and key stakeholders.

Research team:


Poor oral health is a significant issue among people with serious mental illness. While the psychological, physical, social, and economic burden of oral diseases are well documented, poor oral health of people with serious mental illness is often ignored by policymakers, service providers, and researchers. The current state of evidence on interventions to improve the oral health of people with serious mental illness is unknown.

This systematic review addresses this gap. It will determine the effectiveness of interventions to improve oral health outcomes for people with serious mental illness.

Building healthy communities

Research team:


For many older people, loneliness is not simply a part of life, but a way of life. While there are many studies that examine what loneliness is and how people come to be lonely, far less is known about experiences of loneliness in the rural context.

Underpinned by constructivist and interpretive methodology, this project will use a phased case study approach to examine how people interpret their life experiences of loneliness and the meaning that is born from their interpretations. A mixed-methods approach will be used to explore individual experiences of loneliness in the rural context.

Through meaningful participation in the research process, individuals within rural communities who experience loneliness will have the opportunity to share their stories. It is hoped that this participation will lead to the development of community-driven strategies to address the issue in the rural context.

Research team:


Loneliness is an emerging and important public health concern associated with an increased risk of morbidity and mortality. While much research has focused on interventions to alleviate loneliness and social isolation in urban populations, there has been no systematic investigation of interventions targeting loneliness and social isolation in a rural context. This systematic review will summarise the current understanding on the effectiveness of interventions for reducing loneliness and social isolation amongst rural populations.

Research team:


This study explores the barriers and facilitators of using technology among older adults in the Echuca Moama region. It will explore how technology can be best designed and implemented to support rural seniors to be more physically active and socially connected. Findings will inform a larger study focused on supporting older people to age well.

Research team:

  • Dr Evelien Spelten (VVMCRHR)
  • Professor Carlene Wilson (La Trobe University/Olivia Newton-John Cancer Research Centre)
  • Professor Hui Gan (Austin Hospital/La Trobe University/Olivia Newton-John Cancer Research Centre)
  • Dr Kerryn Pike (La Trobe University)
  • Dr Eva Yuen (La Trobe University/Olivia Newton-John Cancer Research Centre)
  • Dr Saskia Duijts (Netherland Comprehensive Cancer Organisation (IKNL), The Netherlands)
  • Dr Jan Maarten van der Zwan (Netherland Comprehensive Cancer Organisation (IKNL), The Netherlands)
  • Ruth Hardman (La Trobe University/Sunraysia Community Health Services PhD candidate)
  • Bryan McDade (Rare Cancers Australia)

This study examines various aspects of psycho-oncology. Projects include a review on the use of telehealth in the delivery of supportive cancer care and a clinical trial to examine the effectiveness of a tailored supportive programme for patients and survivors with rare cancers.

This research hopes to make a significant impact on the health and wellbeing of this under-serviced, disadvantaged and substantial group of rare cancer patients and survivors.

This research is supported by a La Trobe University Research Focus Area grant.

Research team:


Without the basic needs of shelter and stability, it is very difficult for pregnant homeless women to prepare for motherhood practically, physically and emotionally. Homelessness creates negative consequences for the mother and baby.

This study, featuring interviews and focus groups with service providers and women who have experienced pregnancy and homelessness, found that pregnancy did not necessarily afford the women greater access to housing support or secure accommodation. While the women described positive relationships with staff from homeless, housing and health services, there was also evidence that homeless women face multiple systemic and social barriers, which exacerbated their exclusion from supported housing and homelessness services alongside other forms of social support and healthcare.

This research was supported by the Melbourne Lord Mayor’s Charitable Foundation and Launch Housing.

Read the report on the study and service responses to pregnancy and homelessness.

Research team:


This project will develop an occupational therapy recovery-oriented intervention for people with mental illness. It is based on findings from a participatory photovoice research, principles of recovery-oriented practice, a review of existing interventions and occupational therapy foundational knowledge.

Research team:


In collaboration with the University of Melbourne and ACT Government, this study will evaluate the processes and outcomes of a Recovery College in Canberra. Using a mixed-methods design, documentation analysis, an online survey, semi-structured interviews and focus groups, researchers will collect data from students, staff, educators, carers and other practitioners at ACT Recovery College as well as ACT mental health practitioners and stakeholders.

This research is supported by the ACT Government.

Research team:


Social inclusion is a core component of service development and delivery, within current human and health sectors, from policy to practice. Services, whether they be education, health, community or social, must ensure inclusivity. Despite its strong presence at the international and national policy level, social inclusion remains a challenge for individuals to achieve, practitioners to facilitate, organisations to measure and policy to define.

This study explores the concept of social inclusion and exclusion across policy to increase understanding of the connection or disconnect between policy, practice and person. Occupational therapy, with its understanding of the complex interplay between people, environment and participation is well placed to understand, support and promote social inclusion agendas at both the individual and population level.

Researcher:

  • Dr David Azul (VVMCRHR, The George Washington University, USA, Karolinska Institute, Sweden, Lund University, Sweden)

This study examines the relationships between communication, diversity in socio-cultural positioning and wellbeing in the fields of speech pathology and mental health practice. It explores how speech pathologists and mental health practitioners can work together to enhance wellbeing in people from diverse socio-cultural backgrounds in a manner that attends and does justice to the complexity of individual and supra-individual forces that affect wellbeing, and that are not necessarily under individual control.

Research team:

  • Dr David Azul (VVMCRHR)
  • Associate Professor Adrienne Hancock (The George Washington University, USA)
  • Dr Ulrika Nygren (Karolinska Institute, Sweden)

The VCSQPFAB is a self-evaluation questionnaire for gender diverse people presumed female at birth (GD peoplePFAB) based on an innovative transdisciplinary theoretical approach that is currently being piloted in the USA, Sweden and Germany. The research team are planning to expand this questionnaire and assessment approach for use by all people who are seeking support for their voice and communication function, the communication of their sense of socio-cultural belonging and their communication-related wellbeing.

Research team:


This project will co-design online education resources that can be used by parents, teachers and allied health professionals to improve inclusion of children with disability in mainstream primary schools. Researchers will develop and evaluate a tool to measure learning about the social model of disability and evaluate it through a randomised control trial.

Research team:


Foetal Alcohol Spectrum Disorder (FASD) is life-long condition caused by pre-natal exposure to alcohol. People with FASD have a range cognitive, physical and behavioural challenges which impact their day to day functioning. This under-recognised health concern impacts health and wellbeing in regional Victoria, where services and support for FASD may be absent. Drawing together health, social service and education professionals, consumers, and researchers from the La Trobe Rural Health School at La Trobe University, this project seeks to understand community awareness of FASD and to identify priorities and actions for future service provision across regional Victoria.

Participants in this research have contributed to focus group discussions, responding to the National FASD Strategic Plan (2018-2028), which set out a range of priorities and pathways for FASD prevention, diagnosis, support and management at the national level. They discussed how the objectives of the plan translate to the Victorian regional context and what the top priorities were for them. The outcomes of these discussions will provide a basis for fostering better understanding of the needs, challenges and steps required to enable better FASD service provision in regional Victoria.

Research team:


This study examines the impact of public involvement in health service design to understand barriers and enablers. Researchers have completed a systematic review determining what health service outcomes have been reported as a result of public involvement in health service design, and how they have been evaluated. Qualitative interviews with researchers who have published studies involving the public in health service design will now be undertaken.