Aim 1 – Generating new knowledge to improved health outcomes
The Centre of Research Excellence is conducting research within three themes:
1) Mechanisms and processes that contribute to poor health outcomes;
2) Screening and assessment of early injury to promote early intervention
3) Management of injuries in the community with a focus on primary care and vocational rehabilitation.
The Centre of Research Excellence is the hub, integrating projects, ensuring the development of research trainees and enabling translation of research outcomes to clinical practice, to inform policy development and to educate and inform consumers. In addition, the Centre of Research Excellence are providing an important platform for two-way exchange of information between researchers, policy-makers, practitioners and consumers, acknowledging the importance of research grounded in practical knowledge.
The project targets an identified risk factor (stress symptoms) by using the current workforce in a more efficient way. We envisage that by training physiotherapists to deliver psychological based interventions in the early injury stage it will improve health outcomes and negate the need to include additional providers such as psychologists or counsellors. This avoids over-treatment in the crucial early post-injury stage and reserves the expertise of providers such as psychologists for those with actual psychopathology who will likely benefit most.
Aim 2 – Promote effective transfer of research outcomes into health policy and/or practice
A key rationale for the Centre of Research Excellence is effective research translation to health practice and policy. Mitton et al (2007) note that inexperience; mistrust and negative attitudes can impede the translation of research into practice and policy. Furthermore, competing interests, unsupportive cultures and incompatible timeframes have been identified as barriers to effective research translation. There is growing support for interactive partnership approaches involving “linkage and exchange” that promote genuine interaction between researchers, decision makers and other stakeholders such as clinicians and consumers. This two-way process ensures that research is meeting current and projected policy needs and policy makers can ensure that the findings are presented in ways that are able to be implemented into policy. Chief Investigator Collie has explored the barriers to the uptake of research specific to compensation policy settings and this information will provide a foundation on which effective translational policies can be developed. Chief Investigator Kendall has focused on implementation and normalisation theories about how new practices become accepted and embedded into clinical environments. These theories offer practical guidance about how to facilitate translation and are currently being tested in an ARC-funded project. We have experience in overcoming barriers to research translation via the CIs strong working relationships with the motor accident insurance commissions in Qld, NSW and Victoria and with primary care networks. These longstanding relationships are testament to the CIs capacity to effectively and genuinely engage with stakeholders. The CIs also have established links with key government and professional agencies such as Department of Health and Ageing and those representing general practitioners and allied health practitioners. We will use the translational strategies of the Centre of Research Excellence to bring all these relevant groups to one table. This will enhance dialogue between them and the Centre of Research Excellence researchers so problems that are common to the whole of Australia are addressed from many perspectives in a united way, rather than as isolated state bodies. This is being achieved by the involvement of these stakeholder groups as part of the Practice and Policy Advisory Groups.
We will extend and integrate these partnerships to achieve effective knowledge linkage and exchange through a number of mechanisms including embedding expert advisory groups into the governance structure of the Centre of Research Excellence. The Centre of Research Excellence are supported by two expert advisory groups: a Clinical Advisory Group and a Policy Advisory Group.
Aim 3 – Develop the health and medical research workforce
The Centre of Research Excellence will provide an internationally recognised research training program for early career researchers in medicine (primary care, pain medicine), allied health (physiotherapy, psychology), social science, vocational and community rehabilitation, health policy and economics to expand Australia’s research capacity in non-hospitalised road traffic crash injury. Currently, we have training programs at each site for research higher degree students and post-doctoral fellows. With Centre of Research Excellence funding, we will coalesce and expand these existing programs into a National Centre of Research Excellence Research Training Program. This national program will draw together early career researchers from all states into a road traffic crash injury research community, promoting interchange of staff and students, encouraging collaborative projects between sites, and supporting new researchers from all states who wish to gain specialised research training at specific Centre of Research Excellence sites. In this way, we can ensure that all students and postdoctoral fellows involved in the Centre of Research Excellence are exposed to well-rounded and best practice research training.
We will aim to attract and recruit the best students and postdocs to the Centre of Research Excellence and Centre of Research Excellence funding will be used to support these clinical research leaders of the future. We will identify potential research students and research fellows from the existing links Chief Investigators have into undergraduate and postgraduate teaching programs as well as through the education of graduates from a broad range of health professionals with which Chief Investigators are involved.
Aim 4 – Facilitate collaboration
Improving outcomes for survivors of road traffic crash clearly requires a multi-disciplinary approach to research and translation and significant collaboration between researchers and policy makers. The Centre of Research Excellence is designed to achieve this because our interdisciplinary Chief Investigator team consists of complementary expertise and an excellent record of collaborative achievement in the field of road traffic crash injuries. More importantly, the collaborative efforts of the team have successfully translated into policy and practice. The CIs also have strong and productive collaborations with national and international research leaders in their specific areas (see below) and strong links with major national and international organisations and discipline bodies that influence policy and practice. The Centre of Research Excellence will focus on strengthening and developing these important links and collaborations, but also facilitating cross-fertilization.
Several highly productive collaborations already exist between the various Chief Investigators. We aim to capitalize on these collaborations, but also bring them together to create a larger entity that encompasses all areas relevant to road traffic crash injury. This has never been done before but we believe it is essential in order to adequately address the complex and persistent problem of road traffic crash injury recovery. Chief Investigators Sterling, Kenardy, Connelly, & Kendall have demonstrated highly productive and effective collaborations and intellectual exchange (grants and publications) with respect to research of road traffic crash injury. Chief Investigators Cameron, Kenardy and Collie collaborate on projects to understand the influence of compensation on health outcomes. CIs Sterling, Refshauge, Cameron, Kenardy, Connelly and AI Rebbeck collaborate in the area of clinical assessment and pathway development and evaluation. CIs Sterling, Kenardy, Connelly and AI McLean have collaborated on the recent inaugural international summit of whiplash injury with Sterling, Galloway and AI Farrell collaborating on research using MRI and fMRI. Chief Investigators Collie and Mazza collaborate on projects examining the role of General Practitioners in return to work and recovery of people with compensable injury.
There is every reason that this fusing of already productive collaborations will be fruitful. Further to this, the team includes researchers from additional areas necessary to translate important findings into the prevention of chronic difficulties following road traffic crash injury. Overall, the team has expertise in all appropriate and necessary areas; economics; policy, social and system factors and consumer focussed issues. In summary, the goal of the Centre of Research Excellence is to leverage off these collaborations to maximise impact and exploit all possible opportunities to make real and significant inroads into health outcomes and services for individuals with road traffic crash injuries.
Aim 5 – Record of research and translation achievement
Our Chief Investigator team comprises international experts in the area of road traffic crash injury from leading Australian centres. We bring together a unique combination of expertise and an outstanding record of achievement in order to make real inroads into improving health outcomes and decreasing costs associated with non-hospitalised road traffic crash injury. In this section, we highlight some of our achievements in mechanisms underlying ongoing pain, disability and poor mental health following injury; assessment/screening and treatment, and the translation of our research findings into clinical practice and policy.