I am a health services researcher, impact assessor and evaluator with more than twenty years of experience. My doctoral research was on the use of equity-focused health impact assessment in health service planning. Before joining UNSW I also worked as a consultant and in government.
My research activities have focused on primary health care, health service planning, integrated care, self-management, health equity, health promotion and health impact assessment. Some examples of my research and its impact are listed below.
Shisha No Thanks
I led a group of researchers looking at attitudes and beliefs about waterpipe (shisha) use in Arabic-speaking communities. This research led to a Cancer Institute NSW-funded project on raising awareness of the harms of waterpipe use (2018-2020). This resulted in community partners and four Health Districts developing the “Shisha No Thanks” project. I led the evaluation of the project, which found a significantly higher proportion of Arabic-speaking young people reporting that they were aware of the harms of shisha smoking (pre: 45%, post: 68%, p=0.003). This research helped secure an extension of funding to focus on health care worker capacity and service responses (2020-2021). This research has also supported the collaboration with the NSW Ministry of Health and Cancer Institute NSW to embed shisha smoking into broader tobacco control policies and practices. The project won the 2020 South Eastern Sydney Local Health District Healthcare Award in the Keeping People Healthy category and the 2020 Business Campaign of the Year award in the NSW Premier's Multicultural Communications Awards.
Typology of health impact assessment
Health impact assessment’s (HIA) use has been called for by agencies including WHO and the World Bank. Early in the development of the field of HIA, there was debate about the extent to which methods for appraising health risks, quantification models, lived experience, and citizen science should inform assessments. There was also debate about the role government should play in commissioning and undertaking HIAs. In response to this colleagues at UNSW and I developed a typology that sets out different forms of HIA, based on an empirical study of the forms of HIA conducted internationally. The typology enabled a more informed debate about the position and role of HIA in government, and more clearly differentiates the roles of commissioning agencies, assessors, and approval agencies. The typology been cited more than 145 times and has been cited or reproduced in the national policy and health impact assessment guidance developed in the Republic of Korea, Thailand, and Bhutan. I've delivered plenary addresses on the typology at conferences in Dunedin, Seoul, Quebec City, Kobe, and Paris.
Influencing policy on the use of translation apps in NSW
Colleagues at UNSW, five NSW Local Health Districts and I undertook a survey on the use of translation and apps and websites. The survey of more than 1,500 staff found that a third had used a translation app or website in a clinical encounter, and of those, it was clinicians who initiated use in 66% of cases. These findings informed an update of the NSW Health Policy Directive on Interpreters in December 2017 to clarify that the use of machine translation is not allowed.
Conceptual framework for the impact and effectiveness of health impact assessment
Colleagues at UNSW and I developed and piloted a framework for evaluating whether HIAs have an impact on decision-making and implementation, which was the first of its kind. This conceptual framework was further refined through my PhD research and informed the development of a successful ARC Discovery Project. This project tested and refined the conceptual framework, and was one of the largest studies internationally to investigate the difference that HIAs make to decision-making and implementation. The framework has been used in evaluations in New Zealand and informed a Robert Wood Johnson Foundation-funded review of HIA in the U.S.A. in 2013. I was an invited participant at a Pew Charitable Trusts HIA evaluation workshop in Washington DC in 2016.