Research Activity

The Broken Hill Centre for Remote Health Research is involved in a number of research projects relevant to population health and the delivery of health services in rural and remote settings.

Silver, lead and zinc have been mined in Broken Hill for more than 100 years. In the early 1990’s lead was identified as a significant public health issue for young children living in the city, and a major government funded program was initiated to deal with the problem. Children’s blood lead levels have since decreased by more than half. However participation in blood lead screening has decreased in recent years, to about 50% in 2005, raising concern that children with high blood lead levels are not attending the clinic and so missing out on appropriate treatment and advice.

To begin to understand what factors contribute to clinic attendance, this project is comparing information from data routinely collected by the lead testing clinic with the 2001. The information will be used to develop strategies that aim to increase the number of young children who attend for annual blood lead testing.

The research is being led by Frances Boreland. Final results will be available from August 2006. For further information about the study contact Frances Boreland on +61 8 8080 1279.

During the last 20 years in Australia there has been a doubling in overweight and obesity rates in adults. Prevalence data show that the rates are higher in rural and remote Australia. The rates are of concern due to the links between obesity and chronic life threatening diseases such as Type II diabetes and coronary heart disease.

To assist with the design of healthy lifestyle interventions, a qualitative study, using in-depth interviews and focus group discussions, commenced in 2006, exploring the meaning of overweight and obesity for people living in remote Australia. Phase one of the study is being undertaken in Broken Hill and is exploring attitudes towards ‘healthy weight’, food and physical activity. We anticipate a variety of healthy lifestyle strategies and barriers to lifestyle change will be identified.

The research is being led by A/Professor Gaynor Heading. Preliminary results will be available from August 2006. For further information about the study contact Gaynor Heading on +61 8 8080 1282.

There is good evidence from well-designed international studies showing that early referral (while in the prediabetes stage) to diet and exercise interventions can delay and even prevent the onset of diabetes.

A study exploring diabetes prevention in General Practice started in 2006, based on a qualitative research design. It involves interviews with GPs, Area Health Service staff and focus groups with patients to explore the feasibility, barriers and facilitators of the implementation of early detection and prevention of diabetes in rural general practice and in rural communities.

The study is being undertaken in partnership with the Northern Rivers University Department of Rural Health (the other rural arm of the study) and in parallel with an urban arm, being undertaken in Sydney by researchers from the University of NSW.

A/Professor Gaynor Heading is leading the Broken Hill study arm. Ms Eve-Lyn Kennedy, as part of her research development placement, is involved in the research. For further information contact Gaynor Heading on +61 8 8080 1282 or Eve-Lyn Kennedy on +61 8 8080 1289.

Point of care testing is pathology testing performed by, or on behalf of, a medical practitioner at the time of consultation, allowing the results to be used to make immediate, informed decisions about patient care.

The aim of the Point of Care Testing (PoCT) Trial is to demonstrate that local pathology testing will improve and create more efficient care and be acceptable to both GPs and patients. It will also test whether these innovative models can be sustainable and safely implemented in general practice.

The trial started in mid 2005 with an initial six month preparation phase during which the trial was set up and recruitment commenced for participants from urban, rural and remote communities. Participants with existing diagnoses for diabetes, hyperlipidemia and anticoagulant therapy were eligible to apply. The first live phase of the trial was carried out between October 2005 and March 2006. In this phase, those in the intervention group had their pathology tests done by a pathology laboratory as normal, as well as PoCT in the practice. The Trial is currently in the second live phase, during which testing is being done by PoCT only for the intervention group. For both phases on the trial, the control group will have their pathology test done by a pathology laboratory as normal.

The trial is being implemented by a consortium which includes the Department of General Practice, the University of Adelaide, the Community Point-of-Care Services Unit, Flinders University Rural Clinical School, and iCARnet, Cardiology Department, Flinders Medical Centre.

The role of the Broken Hill Centre for Remote Health Research within the project is to provide assistance with recruitment of general practices in remote communities (i.e. communities with Rural, Remote and Metropolitan Area (RRMA) categories of 5 and/or 6 and/or 7) and act as a conduit between the practices and Trial Management team. For further information about the study contact Helen Cameron on +61 8 8080 1281.

Silver, lead and zinc have been mined in Broken Hill for over 100 years. In the early 1990s lead was identified as a significant public health issue for young children living in the city, and a major government funded program was initiated to deal with the problem. As part of the program evaluation, the effectiveness of home remediation for reducing children’s blood lead levels was explored using a randomized controlled trial. The results showed the benefits to be modest.

The study is currently being prepared for publication.

For further information contact Professor David Lyle on +61 8 8080 1236.

Alcohol misuse is dealt with initially by police and the hospital emergency department (ED). Simultaneous participation by both agencies over two one week periods, one in cooler and one in warmer seasons, are planned.

Using routinely collected data, short term economic costs of dealing with alcohol misuse can be calculated. For ED this is based on the NSW Health Costs of Care Standards and for the police on staff hourly rates and, where appropriate, costs for vehicle maintenance etc. To complete the picture basic demography of those affected by alcohol will be included.

The research is being led by Dr Margaret Lesjak with co-investigators Loi Zanette (Broken Hill Base Hospital ED), Dr David Garne (UDRH) and Sgt Greg McMahon (Broken Hill Police, Barrier LAC responsible for police data). For further information contact Margaret Lesjak on +61 8 8080 1287

While the effects of severe lead poisoning have been known for centuries, the effects of low-level lead exposure remain highly controversial. Recently concern has been raised that blood lead levels below the current National Health and Medical Research Council guidelines (10 µg/dL) may not be safe. The aim of this study is to examine the relationship between low level lead exposure (around 10 µg/dL and less) and childhood development problems.

The study is being undertaken jointly by the University of Adelaide, the Adelaide Women’s and Children’s Hospital, and the Broken Hill University Department of Rural Health, and will involve recruiting children from two communities long involved with the lead industry, Port Pirie and Broken Hill. Children’s blood lead level and IQ will be measured, along with other potential confounders such as parental IQ.

The research is being led in Broken Hill by Professor David Lyle. For further information about the study contact David Lyle on +61 8 8080 1236.