La Trobe University > Research > Violet Vines Marshman Centre for Rural Health Research > Research > Preventative and primary health care

Preventative and primary health care

CP@clinic. Photo courtesy of Sunraysia Community Health Services.

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

Our research focuses on improving equity and access for rural people. We develop and test cost effective, flexible models of service delivery that increase access and eliminate disparity.

Preventative and Primary Health Lead Contact: Dr Evelien Spelten

Research Projects

The SPARC (Supporting People with A Rare Cancer) initiative comprises two complementary projects:

SPARC-I is an industry-funded PhD project aimed at identifying and addressing the unmet informational needs of rare cancer patients. This project seeks to design, implement, and evaluate tailored interventions to improve information access for these patients.

SPARC-R, funded by Cancer Council Victoria, explores the distinctive supportive care needs of rare cancer patients living in rural, regional, and remote areas of Australia. The project examines peer support as a feasible and effective supportive care option for this group, with the goal of enhancing access to relevant resources for patients outside urban centres.

Research Team: Professor Evelien Spelten, Dr Laura Hemming, Professor Carlene Wilson (University of Melbourne), Dr Eva Yuen (Deakin University), Dr Saskia Duijts (Netherland Comprehensive Cancer Organisation (IKNL), The Netherlands), Dr Nienke Zomerdijk (University of Melbourne), Christine Cockburn (Rare Cancers Australia) and PhD student Tamsin Farrugia.

Learn more about this project

The CP@clinic programme, originally developed in Canada, is designed to improve health care in rural Victoria by offering regular health check-ups and support in local community centres. Run by trained paramedics, the programme focuses on prevention and early intervention to help manage conditions like diabetes and high blood pressure. This evaluation will assess how the programme affects individual health and overall healthcare usage, such as reducing emergency calls. By collecting and analysing data from participants, surveys, and interviews, the project will identify ways to make this service effective and sustainable, ultimately aiming to expand it to more rural areas across Australia.

Research Team: Professor Evelien Spelten, Dr Laura Hemming, Associate Professor Ruth Hardman, Professor Leigh Kinsman, Dr Louise Reynolds (Safer Care Victoria) and Professor Gina Agarwal (McMasters University).

Learn more about this project

Past Projects

Research team:

This study began as an evaluation of a community palliative care service, set up to support patients who wanted to die at home, and their carers. It resulted in the establishment of an integrated community palliative care service that was subsequently assessed and found to be sustainable, acceptable and affordable. There were, however, concerns about its adaptability, mainly due to rural workforce shortages.

As part of this project, a study with Indigenous Elders in the Mildura area and their experiences with the local palliative care service was also undertaken, focussing on ways to increase uptake.

Further research, in collaboration with Sunraysia Community Health Services, hopes to identify innovative ways to improve symptom management and access to pain medication, and a proof-of-concept study with community paramedicine to support palliative care services in residential aged care facilities.

This research was supported by the Murray Primary Health Network (first two evaluations) and the Loddon Mallee Regional Palliative Care Consortium (focus groups with Indigenous Elders).

Research team:

  • Dr Evelien Spelten
  • 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:

This multidisciplinary study is evaluating headspace services in Western Victoria for the Western Primary Health Network, from service and stakeholder perspectives.

Research team:

Is violence at work becoming the new normal? Incidences of violence against healthcare workers only seem to increase. A recent Cochrane Review confirmed that there is no evidence that any intervention works to reduce violence.

Focus has been on teaching healthcare workers how to de-escalate or encouraging them to report. This study shifts the focus to the perpetrator. Research is being undertaken in rural Australia, rural Canada and the Royal Melbourne Hospital to understand who is perpetrating the violence, and why.

This research is supported by La Trobe University’s Building Healthy Communities Research Focus Area, the La Trobe Overseas Study Program and the University of Newcastle.

Read an opinion piece on this study.

Breast cancer screening for women over 75 years

Development of a rural consumer panel to inform health research and teaching

The development of the GoHealth model: A decision-support tool for policy makers
Steve Begg (VVMCRHR) advisor to the project team consisting of Jo-An Atkinson (University of Sydney), Danielle Currie (Sax Institute) Jacqueline Davison (Sax Institute), Paul Crosland (Deakin University), Jaithri Ananthapavan (Deakin University), Haitham Taha (Sax Institute), Stuart Brentnall (Sax Institute)

Addressing Health Inequalities in the Murray PHN Catchment Area: ENT Hotspots

Evaluation of integrated area-based health systems for children & young people

LMARG Deadly Choices Aboriginal Health Data Analysis

Evaluation of Aldara Yenara’s indigenous youth mentoring program


Quantitative Data Feasibility Assessment and Analysis Services for the Evaluation of the Australian Government’s Investment in Aboriginal and Torres Strait Islander Primary Health Care (PHC) through the Indigenous Australians’ Health Programme (IAHP)

  • Christopher Doran, CQ University
  • Associate Professor Steve Begg
  • Robert Sanson-Fisher,
  • Anthony Shakeshaft (UNSW),
  • Chris Oldmeadow (Hunter Medical Research Institute),
  • Boyd Potts, CQ University
  • Erika Langham (Allen & Clarke)

Evaluation of the Nukal Murra Health Support Service

  • Christopher Doran, CQ University
  • Associate Professor Steve Begg
  • Roxanne Bainbridge, CQ University
  • Anthony Shakeshaft (UNSW),
  • Boyd Potts, CQ University
  • Erika Langham, CQ University

Higher degree research student projects

Research team:

  • John Baker (La Trobe University PhD candidate)
  • Steve Begg (La Trobe University)
  • Dr Mohd Masood (VVMCRHR)
  • Lukar Thornton (Deakin University)
  • Aziz Rehman (Federation University)

Density and proximity of tobacco retailers have important implications for smoking and tobacco use. There is a relationship between tobacco retailer density and/or proximity, and smoking behaviour among residents in lower-socioeconomic status communities, and among students who attend schools with a retailer located nearby.

This study investigates the licencing of tobacco retailers in rural Victoria. It will also examine the relationship between the proximity of tobacco retailers in rural Victoria with smoking behaviour.

Research team:

The prevalence of mental ill health is high for Australian young people and the onset of depression, anxiety and first episode psychosis (FEP) commonly occurs when the individual is at school. The prevalence of mental ill health is highest for rural young people and barriers to treatment exist. Current evidence suggests that 40% of young people experiencing depression or anxiety disorders, and that over 50% experiencing FEP do not finish secondary school.

This study used survey methodology to examine the experiences of Victorian rural and regional secondary school principals, deputy principals, teachers and school counsellors working with students who experience mental illness in their school. It investigated whether mental illness had a negative impact on secondary school completion and if schools had access to effective early intervention mental health services for their students.

This study found that rural high schools experience high rates of student mental illness in their school, barriers to getting help for their students and high rates of students who die by suicide. It identified the need to implement mental health services within Victorian rural secondary schools. Researchers found that teachers can identify students at risk but accessing mental health services is an issue. Education and mental health services must work together to ensure young people receive services in a timely and accessible manner.

Research team:

This study explores the impact of rurality and socioeconomic status on people’s ability to self-manage common chronic health conditions, especially where there is multimorbidity. The project includes a systematic review examining the impact of socioeconomic status on participation, engagement and outcomes from self-management interventions, and qualitative interviews with patients and health providers working in regional community health settings.

Using Shippee’s Cumulative Complexity Model, the experiences and understanding of workload and capacity in chronic disease management from both the patient and provider viewpoint are also being investigated. Future research will include analysis of a patient survey assessing workload and capacity, leading to the development of an alternative model of care for chronic disease self-management in disadvantaged multimorbid populations.

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:

Ear, nose and throat (ENT) care in rural Australia is suboptimal. The ‘Perils of Place’ report by the Grattan Institute identified four ENT hotspots in rural Victoria, two of which are located in the Murray Primary Health Network (PHN) region.

This study aims to optimise ENT care in rural Australia by investigating current issues around diagnosis and care of ENT conditions in the Murray PHN region. The research team will develop and implement tailored ENT care training for primary healthcare professionals in the region, and educational material for a community health campaign. They will also evaluate the impact on ENT care delivery in the region as a result of these interventions.

New approaches to health promotion in the Wimmera

  • Michele Conlin (PhD Candidate),
  • Supervision team: Evelien Spelten and Sean MacDermott

Adolescent Rural Males's Health: In the Context of Emergent Masculinities

  • Sandra Connor (PhD Candidate)
  • Supervision team: Evelien Spelten, Margit Edvardsson, Christopher Fisher

From Badja to Cobargo: Elderly and Community Strength in the Aftermath of the New Year’s Day Fires 2020

  • Fiona Cochrane (Prof Doc Candidate)
  • Supervision team: Yvonne Wells and Samantha Clune

Sexual Violence in the Loddon-Campaspe Region: The Case for Analytical Frameworks in Support of Primary Prevention Models.

  • Emily Corbett (PhD Candidate)
  • Supervision team: Christopher Fisher, Paulina Billett, Leesa Hooker, Jacqueline Theobald

How do medications fit into the lifestyles of Indigenous people?

  • Melissa Deacon-Crooch (PhD Candidate)
  • Supervision team: Joseph Tucci, Stephen Begg, Isabelle Skinner, Timothy Skinner

Youth, technology and incivility

  • Brigette Glossop (PhD Candidate)
  • Supervision team: Wendy Mee, Paulina Billett, Evelien Spelten

Early Warning Systems for Patients in Hospital Emergency Departments

  • Gigi Guan (MAppSc Candidate);
  • Supervisor: George Mnatzaganian

Who Cares for the Carer? The Caregiver’s Perspective: Supporting Regional Victorian Caregivers during End-of-Life Care Pre and Post Loss

  • Michelle Hood (PhD Candidate),
  • Supervision team: Virginia Dickson-Swift and Robert Townsend

Community Paramedicine: Is prevention better than cure in improving the health of rural and remote South Australian?

  • Angela Martin (PhD Candidate),
  • Supervision team: Evelien Spelten, Sean MacDermott, Peter O'Meara


Examining Responsibility Allocation within the Social Care System for Older people in Rural Uganda: An Ecological Systems Approach

  • Diana Nabbumba (PhD Candidate),
  • Supervision team: Rachel Winterton; Suzanne Hodgkin; Jacqueline Theobald

Examining the Impact of the COVID-19 Pandemic on the Health and Well-Being of Rural and Regional Healthcare Workers

  • George Petrou (PhD Candidate),
  • Supervision team: Mark McEvoy; Stephen Begg; Angela Crombie


Examining the Impact of the COVID-19 Pandemic on the Health and Well-Being of Rural and Regional Healthcare Workers

  • Fiona Randall (PhD Candidate),
  • Supervision team: Mark McEvoy; Angela Crombie; Timothy Skinner


Early career physiotherapy transition in the rural context. How can this process be best supported?

  • Rachel McAleer (PhD Candidate),
  • Supervision team: Amanda Kenny, Lisa Hanson, Jo Spong