The Population Child Health (PCH) Research Group is a multidisciplinary research team working across Australia and internationally from the University of New South Wales (UNSW) Randwick precinct and Sydney Children’s Hospitals Network (SCHN). We conduct translational health services and health systems research to optimise child health outcomes and address inequities.

Our goals

We improve quality of care, integrate services, promote equity and enhance access for the ultimate benefit of children and young people.

Our objectives are to:

  1. Work with children and young people to discover the factors affecting their health, wellbeing, and access to the care they need.
  2. Conduct translational research that focuses on sustainably tailoring health systems to the needs of children and young people.
  3. Develop, implement, and evaluate scalable interventions that can be delivered by existing practitioners to increase access to high quality paediatric care for all children.

Research strengths

Central to our work is Consumer and Community Engagement. Our multidisciplinary research brings together clinicians across paediatric disciplines within health services. Our researchers have expertise in epidemiology, statistics, implementation science, qualitative research methods and economics. We assess the impact, implementation, and cost effectiveness of novel models of care and health innovations delivered across the health system embedded within gold standard health systems randomised controlled trials, quasi-experimental studies, and longitudinal cohorts.

Our partners include Sydney Children’s Hospitals Network (SCHN), Local Health Districts (LHDs), NSW Health, Aboriginal Controlled Community Health Organisations (ACCHOs), Primary Health Networks (PHNs) and the national Child Unlimited Network. With our partners we embed child health, implementation science and health economics researchers into health service initiatives to inform policy and service delivery.

Our results

Academic excellence
383 peer-reviewed publications, $42 million funding successes
Innovation & engagement
Growth of our team and building research projects
Social impact
Broadened national and international research networks

2023-24

19 academic and professional staff
$9.8m successful grants
8 HDR students
20 projects
100+ links with external partners

2021-22

14 academic & professional staff
> $13.8 million successful grants
4 HDR students
> 20 projects
100+ links with external partners

2020

14 academic & professional staff
> $4.5 million successful grants
4 HDR students
> 15 projects
100+ links with external partners

2019

8 academic & professional staff
> $5 million successful grants
4 HDR students
> 10 projects
International collaborations

2018

6 academic & professional staff
> $1.3 million successful grants
4 HDR students
Established 3 streams

Our experts

 Raghu Lingam

Professor and Financial Markets Chair Population Child Health Research Group

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  Karen Zwi

Clinical Director of Priority Populations at SCHN

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  Nusrat Homaira

Senior Lecturer and NHMRC Fellow

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 Michael Hodgins

Senior Research Associate

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2023-11-Kris-Pierce-SoCM

Director, Consumer Engagement and Advocacy

2023-09-Nan-Hu

Research Fellow

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2024-03-Dr_Vilas_Sawrikar

Research Fellow    

2023-09-Jahid_Khan

Research Associate

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2023-09-Tammy-Morris-Myers
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2023-09-Jenny_Sohn

Conjoint Associate Lecturer

2024-05-Saeneen_Wallace

Project Coordinator    

Our extended team

Jackie Curtis, Shanti Raman, Valsamma Eapen, Paul Chay, Michelle Jersky, Natasha Larter, Louise Sealy, Vanessa Sarkozy, Ingrid Wolfe, James John, Alicia Montgomery.

Adjuncts

  Sue Woolfenden
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  Katarina Ostojic

Adjunct Research Associate

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Students

2023-10-Lahiru_Amarasena_PhD_SoCM

PhD Student

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2023-10-Ryan_Mackle_Phd_SoCM

PhD Student

2023-10-Dr_Corin_Miller_PhD_SoCM

PhD Student

2023-10-Jack_Murphy_PhD_SoCM

PhD Student

2023-11-Mahbub-Rashid-PhD-SoCM

PhD Student

Our affiliated partners

  • George Institute of Global Studies
  • Endocrinology, Garvan Institute and St Vincents Hospital
  • Renal Medicine, St Vincents Hospital and Prince of Wales Hospitals
  • Australian Institute of Health Innovation, Macquarie University
  • Infectious Diseases, St Vincent’s Hospital 
  • Faculty of Pharmacy, University of Sydney
  • Institute of Musculoskeletal Medicine, University of Sydney
  • Australian and New Zealand Musculoskeletal Studies Clinical Trials Network

Project overview

Our research addresses 3 key themes: Integrating Care; Priority Populations and the First 2000 Days.

3 key themes: Integrating Care; Priority Populations and the First 2000 Days.

Our evidence-based projects aim to improve quality of care, integrate services, promote equity, and enhance access for the ultimate benefit of children and young people.  We work with children, young people, parents/carers and families by recruiting people with lived experience of chronic and complex diseases to act as research advisors.  All our projects include impact evaluation (outcomes: health service use; patient-reported outcomes such as quality of life; patient-reported experiences), economic analysis (including cost-effectiveness analysis), and implementation evaluation.  

Integrating Care

  • SC4C offers an integrated model of care, in which paediatricians work directly with GPs in their practices to bring the best possible close-to-home care to children and their families. Evaluation from the UK showed the model resulted in a 39% reduction in new patient hospital appointments, a 19% reduction in speciality referrals, and a 22% reduction in ED attendances 12 months after implementation of a similar model. Pilot data from Victoria has shown a 5% decrease in OP referrals and most importantly a 16% increase in parental confidence in GP care and satisfaction in the care they received. Through an NHMRC grant we have taken this model to 23 GP practices in Sydney and Melbourne, and the model will be expanded to rural areas with our successful Medical Research Future Fund (MRFF) Primary Health Care Research Grant: Strengthening Care for Rural Children (SC4RC), which aims to deliver and rigorously evaluate a primary health care strengthening program for rural children. 

  • SC4C is evaluating an integrated model of care, with paediatricians working directly with GPs in their practices to bring the best possible close-to-home care to children and their families. The GP-led intervention consists of paediatricians working in co-consultation with GPs, providing case based education and being available by phone and mail support. 

    In the United Kingdom, following a similar 12 month-long integrated GP-paediatrician intervention,   a 39% reduction in new patient hospital appointments, a 19% reduction in speciality referrals, and a 22% reduction in ED attendances 12 months was reported. Pilot data from this same model of care implemented in Victoria demonstrated a 5% decrease in OP referrals and most importantly a 16% increase in parental confidence in GP care and satisfaction in the care they received. The SC4C study is supported by an NHMRC partnership grant, with 21 participating GP practices across Central and Eastern Sydney PHN and North West Melbourne PHN regions.  

    Following on from the SC4C study, our group has been successfully awarded two further grants to expand this idea beyond metropolitan areas. 

    • The SUSTAIN Strengthening Care for Children project is funded through a NSW Health Translation Research Grant Scheme (TRGS) award to deliver a telehealth version of the SC4C model to GP practices across urban, regional, and rural and remote NSW.
    • Strengthening Care for Rural Children (SC4RC), supported by a Medical Research Future Fund (MRFF) Primary Health Care Research Grant, aims to deliver and rigorously evaluate this primary health care strengthening program for rural children. 
  • If families are asked about their social and emotional needs, they are up to 40 times more likely to have these needs met. EPIC-CP asks families what they need from services and then uses a co-designed social care navigation pathway to meet the needs of the children and young people with cerebral palsy and their families. Funded by the Cerebral Palsy Alliance Research Foundation and Sydney Children’s Hospitals Foundation the EPIC CP team, led by A.Prof Sue Woolfenden, will deliver and evaluate their EPIC-CP pathway in 2023. Sue is also leading the psychosocial pillar of the Luminesce Alliance Developing Brain Study proposal with SCHN, UNSW, and University of Sydney collaborators extending this concept to children with other neurological and developmental needs.  

  • RuralKidsGPS is an innovative, integrated model of care. Care coordinators will work closely with care teams and families to meet the needs of children with complex health conditions through shared care plans, technology-enabled healthcare, and capacity building for families and local healthcare providers. RuralKidsGPS builds on a successful model of care—KidsGPS—developed by SCHN. Evaluation of this model within urban Sydney showed a 40% reduction in Emergency Department (ED) presentations and a 42% reduction in day-only admissions over two years, saving the health system $2.5million/annum and families >50,000km of travel. RuralKidsGPS will extend and evaluate the model across four rural LHDs: Murrumbidgee, Southern, Western, and Northern New South Wales. If proven acceptable and cost effective, RuralKidsGPS could be delivered to the nearly 100,000 children across rural NSW who live with a chronic medical condition. RuralKidsGPS received NSW health Translational Research Grant Scheme (TRGS) funding starting in July 2021.

  • The CYPHP is the largest paediatric health systems transformation program in the UK involving 120,000 children across two London boroughs. The trial is co-led by Prof. Lingam (UNSW) and Dr Ingrid Wolfe (Kings). Children receiving the CYPHP integrated model of care had a 13% lower non-elective admission rates compared to those receiving enhanced usual care. In addition, children in the CYPHP group had improved quality of life and improvements in clinical symptoms after the intervention. Importantly we found children registered with intervention practices were 50% more likely to be prescribed a spacer for their asthma compared with children registered in enhanced usual care practices. Children with severe asthma seen by the CHILDS service compared with those seen in primary care, were significantly more likely to have asthma action plans 76% versus 37%, and asthma control monitored 89% versus 53%. The program has been adopted across South Thames, presented in parliament, and informed the NHS plan for 2025.

  • Our work studying the myriad innovations created through COVID-19 was a unique opportunity to understand the healthcare system and select the best innovations e.g., telehealth for rural communities to upscale and mainstream in the future. We co-designed the Resilient Healthcare for Children framework that informed the NSW Covid-19 research response plan. Our work on Covid health services trends for respiratory illness was used by the US CDC and the UK winter planning initiatives; our work documenting the 55% increase in mental health presentations for children has led to increased NSW children’s community mental health funding.

  • Asthma is the most common cause of unscheduled hospital presentation in Australian children. Most of these hospital presentations can be prevented by comprehensive ongoing and planned care. However, our fragmented health system is failing to provide comprehensive asthma care which is further complicated by inequitable access to health care in vulnerable, marginalised populations like culturally and linguistically diverse (CALD) communities. Using “asthma” as an exemplar, CoMPAs is an Asthma Australia funded two arm randomised controlled trial and implementation evaluation, led by Dr Nusrat Homaira, that aims to evaluate the feasibility and efficacy of a comprehensive model of care to improve quality of life and reduce preventable paediatric hospital presentations within the largest CALD community of NSW. Facilitated by an embedded care-coordinator, the model of care connects all key stakeholders involved in a child’s asthma management and provides a personalised approach to asthma care. It builds upon our previous work at Sydney Children’s Hospital, Randwick in the Asthma Follow-Up Initiative, which utilised an integrated co-developed suite of interventions and resulted in a 60% reduction in number of asthmatic children presenting with acute asthma exacerbations to the emergency room. 

  • Asthma Care from Home is an NSW Health Translational Research Grant Scheme (TRGS) funded project, led by Dr Nusrat Homaira and Mrs Melinda Gray, focusing on 5-12 years olds discharged from hospital in Northern NSW LHD, Illawarra Shoalhaven LHD, Southern NSW LHD and Western NSW LHD following an asthma exacerbation. Based on our preliminary data, and leveraging our enhanced capacity for technology due to COVID-19, Asthma Care from Home aims to evaluate the impact, implementation and cost effectiveness of a comprehensive integrated technology enabled model of asthma care that a. supports families, communities and healthcare providers, b. is flexible and locally acceptable, and c. adopts innovations such as digital technologies so that asthma care can be provided ‘from home’ when necessary, thereby not only reducing the significant burden of potentially preventable asthma hospital presentations but also ensuring patients’ and families satisfaction with healthcare delivery. We hypothesize that our model of care will reduce asthma hospital presentations, improve asthma quality of life for children in rural NSW and be cost-effective.

  • The Growing Healthy Kids study delivers a comprehensive integrated weight management service to children in South West-Sydney where 98% of children in the service have severe psychological and social needs.

  • Alpha NSW aimed to create a health intelligence system that responds to the changing needs of the population. The project also aims to determine how frontline workers could benefit from a data analytic platform that informs service development and delivery. The final report has been submitted to the Ministry of Health.  

  • In partnership with the Murdoch Children’s Research Institute (MCRI), we led the project Evaluation of the Proof of Concept Child Digital Health Record (CDHR). The CDHR is an electronic version of the information captured in hardcopy baby books, such as the Blue Book in NSW. We have evaluated the process of developing a CDHR, which will store a child’s milestones, health, growth, development, and immunisations throughout early childhood (0-4 years). Our report considers the challenges encountered and the implications for product delivery with a view to informing future state and national rollouts.  

  • More than one million young Australians experience mental illness each year, and half of all young people experience at least one period of mental ill-health before the age of 25 Given the global burden of disease of youth mental disorders, there remains a need to examine how to improve care for this population. Integrated care has been posited as a potential solution, but there is limited evidence on how best to design, staff, and evaluate different models of integrated care for youth mental health. Through our systematic review of the literature on integrated youth mental healthcare we developed a framework that can form a basis for the development of well-articulated models of youth integrated mental health pathways, assisting services identify what operational changes are needed to best implement and sustain integrated care in their own context. Planned future work involving this framework includes using it to map the integration of primary, secondary, tertiary, public, and private youth mental health services within the Australian health system.

  • More than 2 million Australians will require transition from child to adult services over the next 20 years. Our pilot RCT evidence showed that structured transition interventions can increase adherence to care and use of adult health services. However, there are no national guidelines or standardised models of care for transition across Australia. Parents and young people have told us, through our ongoing consultation, that they need more structured help through the transition process. We aim to conduct an individual randomised controlled trial, across three states, to evaluate the effectiveness and cost-effectiveness of a structured paediatric-adult transition intervention (Transition Compass) for young people with chronic health conditions. Transition compass consists of in person transition coordination (up to 1-year pre-transfer to adult services and 1 year post transfer), behaviour change self-management training and long-term use of Perx, a digital care platform for condition self-management and behaviour change. 

First 2000 Days

  • FDCC is a holistic, first 2000 days model of care for migrant and refugee populations. Our team has been successful in securing TRGS funding to evaluate the impact of an integrated Child and Family Health (CFH) hub on attendance at CFH services, completion of developmental checks, support for child growth and development, breastfeeding and maternal wellbeing, and meeting family psychosocial needs. FDCC is TRGS funding and started in July 2021.

  • Our Healthier Wealthier Families project tested the feasibility and benefits of linking families to financial counselling services. We are assessing whether this initiative improves responses to poverty and deprivation in families of children aged 0-5 years. 

  • NHMRC funded SEARCH has been Australia’s largest long-term study of the health and wellbeing of urban Aboriginal Children. SEARCH is a partnership between researchers from numerous institutions, the Aboriginal Health and Medical Research Council (AH&MRC), and four Aboriginal Community Controlled Health Services (ACCHSs). Our preliminary results showed increased prevalence of hearing problems, risk of developmental disability, and language delay among urban Aboriginal Children as compared with non-Aboriginal children. Collaboration with the community and ACCHSs in SEARCH has been instrumental in our MRFF funding success (just under $900,000) for the Aboriginal Community Controlled Ear Health Support Systems (ACCESS) project. We are now working with the chief executives of 3 ACCHSs to develop a child health navigator program in their services to support children with or at risk of poor ear health and/or hearing impairment. 

Priority Populations

  • This Aboriginal participatory Arts in Health parent group is a multi-award-winning program delivered at the La Perouse Aboriginal Community Health Centre. Parents, children, and providers connect through artmaking, supporting children’s physical, social, cultural, and emotional wellbeing. Our evaluations have shown that NNM participants have improved use of health services, improved mental health, new aspirations for further education and employment, enhanced resilience, and a keenness to give back to their community. We have successfully been funded by Rotary to expand NNM to Western Sydney.

  • This project aims to improve communication pathways between housing, health, and social services working with Aboriginal families in South East Sydney. The Healthy Housing project is a strong collaboration between our team, The George Institute (TGI), SPHERE, Ngarruwan Ngadju First Peoples Health and Wellbeing Research Centre, Australian Health Services Research Institute (AHSRI), University of Wollongong, NGOs, community and primary health clinicians, and government organisations. We have completed a systematic review and qualitative interviews with multiple stakeholders and are in the process of developing clear guidelines and pathways for health and other professionals so they can more effectively support the housing needs of Aboriginal families. We will begin trialling the pathway in 2021. This project was funded by the Royal Australasian College of Physicians Fellowship program.

  • The aim of this study is to understand the life course development of children who enter out-of-home care and the factors that influence their development. We found that carer mental health was a strong predictor of child related mental health. These findings have been fed back to NSW health and social care. 

  • The last 200 children study is a national cohort study examining the health and well-being impacts of prolonged (up to 4-5 years) offshore immigration detention on refugee children. Indefinite mandatory immigration detention of those seeking asylum in Australia by boat is a key Australian Government policy, and this policy’s downstream impacts on refugee children and families. The consequences of such extreme prolonged detention have also not been explored in the international peer reviewed literature. The children’s treating clinicians from 10 participating sites across Australia are providing data on sociodemographic factors and health and well-being outcomes factors for up to 5 years after the children’s release from immigration detention. Preliminary findings from the baseline study have been presented at the Royal Australasian College of Physicians (RACP) national Congress in May 2021 and the International Society for the Prevention of Child Abuse and Neglect (ISPCAN) international Congress in June 2021. 

  • The Providing Enhanced Access to Child Health Services (PEACH) project is aimed at improving the health access and health outcomes of children and young people from priority populations at Sydney Children’s Hospitals Network.  Through experience-based co-design and quality improvement methodology, the PEACH project has made IT system enhancements to current electronic medical record systems, promoted earlier and enhanced access including prioritisation and the implementation of solution ideas co-designed between priority population patients and SCHN staff. Evaluation of the project, funded by the Luminesce Alliance, will continue until 2026, measuring impact and cost analysis of the project as well as sustainability and scale up of the intervention to other health services. The project is focused on five priority populations: Aboriginal and and/or Torres Strait Islander, Culturally and Linguistically Diverse, living in Out of Home Care, living with a disability and those from refugee backgrounds.  

International Research and Advocacy

Our team collaborates with researchers and clinicians globally to support international child health research and advocacy. Professor Karen Zwi led the development of a published Global Position Statement on the impact of COVID-19 on vulnerable children and youth. We are also working with universities and health services in Fiji and Indonesia to develop evidence-based interventions to support children with neurodevelopmental disorders. We work closely with colleagues in King’s College London and have run programs in India, Pakistan, Uganda, and Mozambique. The Spring Program has informed enhancements of the Lady Health Worker Program in Pakistan and the Asha Worker Program in India. It has been adopted in the participating states and presented at the WHO. The Inscale program has led to development of telehealth (mobile phone) enhancements of the IMCI program in Uganda and Mozambique. It has informed further development of Community services during the Covid Pandemic. 

Health Systems Research Leadership

  • The Sydney Partnership for Health, Education, Research and Enterprise aims to change the future of healthcare by combining research, innovation, education, and knowledge translation to drive better outcomes for communities. With a total of more than $5 billion annual revenue, this partnership combines 14 leading organizations in the Sydney region, including SCHN and UNSW, along with LHDs, hospitals, universities, and medical research institutes. SPHERE’s clinical academic groups bring together experts across disciplines to find answers to complex health challenges.

  • Lingam set up and co-leads Child Unlimited. Child Unlimited connects more than 200 world leading researchers and clinicians with children who live with chronic illnesses. Researchers and clinicians in the Alliance are based at children’s hospitals, research institutes, and community organisations across Australia. Child Unlimited’s mission is to enable children with chronic illness to live their best lives now and into the future. The Alliance builds on the current work of child health research organisations by leading new and collaborative research that focuses on ensuring children affected by chronic illness successfully navigate the journey to adulthood, supported by their family and community.

  • The Early Life Determinants of Health clinical academic group aims to improve policy and practice to ensure every child has the best start to life. ELDoH focuses on boosting access to health and wellbeing supports for children from vulnerable communities, such as those from culturally and linguistically diverse (CALD) and/or refugee backgrounds. The ELDoH clinical academic group includes >180 members including professors, senior clinicians, chief executives, and policymakers from SPHERE partner organisations. 

  • The Luminesce Alliance is a joint venture between the Children’s Cancer Institute, Children’s Medical Research Institute, SCHN, UNSW, and University of Sydney—established with the support of the NSW Government—that brings together experts in paediatric research and translation. The Alliance aims to invest in excellent research so all children can live healthy and productive lives. Luminesce Alliance programs include research on cancer, rare diseases, and paediatric mental health. 

  • BestSTART-SWS brings together world-class clinicians, researchers, and policymakers, who work with families and children to create a centre of excellence in child-health translational research. It aims to revolutionise health systems and integrate the voices of young people and their families into research efforts. The BestStart-SW is to optimise the health, development, and wellbeing of children and wellbeing of children and young people in South West Sydney, with a focus on CALD, refugee, and indigenous populations.