Australia: the healthiest country by 2020
National Preventative Health Strategy – the roadmap for action

8.5 - National prevention research infrastructure

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'National surveillance and research will be key to developing and directing cohesive prevention strategy' (Quote from submission)

Policies and interventions in preventative health must be underpinned by strong, interdisciplinary research and evaluation capacity and strategy that supports innovation and incorporates both universal and targeted approaches. This includes:

• The capacity to conduct research into 'what works' to improve health and wellbeing
• To promote, synthesise and translate evidence-based findings into practical and effective interventions
• To evaluate the outcomes of interventions

Once again, investment in core infrastructure and collaborative partnerships will be important in attaining this vision for preventative health.

Within the areas of obesity, tobacco and alcohol, there is significant variation in the available infrastructure, capacity and status of research currently being conducted in Australia. Significant gaps in knowledge and evidence also exist which need to be addressed in order to inform policy and other initiatives in these areas, particularly in regard to children and adolescents, disadvantaged communities and the Indigenous population.

The Taskforce is supportive of a range of initiatives outlined below that would address this imbalance and drive national research agendas in obesity, tobacco and alcohol through investment in capacity building and strategic partnerships. Central to the success of these initiatives is the involvement of key research agencies and institutions (NHMRC, ARC, CSIRO, AIHW), various levels of government, other sectors (for example, universities, private NGOs and industry) and communities.

The NHMRC has established a Public Health Research Advisory Committee (PHRAC), chaired by Professor Don Nutbeam, whose report has recently been published. It will be important to follow through the recommendations of this review, especially in areas such as funding levels, improved funding mechanisms, a focus on intervention research, adequate support for researchers, appropriate structure, coordination and workforce development.
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A National Strategic Framework for preventative health research

A National Strategic Framework for preventative health research is a fundamental element of infrastructure. The development and implementation of national research strategies for obesity, tobacco and alcohol as part of this framework will identify and drive the research agenda in each of these areas, and build upon and consolidate the available evidence base.

The Taskforce has identified a number of key research and evaluation priorities within each of the national strategies:

• Obesity – evidence-based interventions in maternal and child health, Indigenous and other disadvantaged populations
• Tobacco – evidence-based interventions in Indigenous and other disadvantaged populations
• Alcohol – alcohol taxation modelling to encourage safe consumption in Indigenous and other disadvantaged populations, maternal and child health

A preventative health research fund

Both the Wills Review (1998) and the Grant Review (2004) recommended increases in priority and strategic research. This could be facilitated through the establishment of a preventative health research fund which would make a significant contribution to building the levels of available research evidence in obesity, tobacco and alcohol.
Investment that enables the further development of investigator-led, peer-reviewed research which utilises a common set of measures to compare outcomes is essential in further developing the evidence base.

National prevention research centres

If Australia is to build research collaboration and partnerships, critical mass is required and this is only likely to be achieved through multi-institutional cooperation. The Taskforce recommends:

• The development of a network of prevention research centres, coordinated and part funded by the NPA, similar to the US CDC Prevention Research Centers and appropriate to the Australian context. These would build on the work of the Public Health Education and Research Partnership (PHERP).
• The centres would partner with community interventions in the region they serve, with NGOs, and have a national specialty role (for example, in obesity, tobacco or alcohol).
• The centres would also have a workforce development role in educational terms (MPH or similar), in research terms (Masters by research, PhDs and post docs) and in intervention practice. The NPA would foster leadership, mentoring, and knowledge sharing.
• The NPA can host an annual symposium to share research and ideas.

National preventative health research registers

National research registers will be of great benefit to researchers, policy makers and other interested parties. They will enhance the transparency of the conduct and the reporting of research results, enhance access to evidence to facilitate the transfer of knowledge through synthesis and translation of evidence into practice, and be used for meta analyses, where possible and appropriate.

National research registers can also assist policy makers and researchers in identifying gaps in knowledge and minimise the potential for duplication of work.
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What this will do

It is proposed that this increased investment in research infrastructure would result in positive outcomes for preventative health research, especially in the areas of obesity, tobacco and alcohol. These include:

• Large-scale, long-term (10–20 years), nationally relevant intervention, translational and dissemination research to inform policy and other initiatives
• Increased capacity and focus on research into the social determinants of health and the effects of interventions on reducing inequities
• Capacity and a focus on Indigenous health research
• Long-term research and evaluation projects, such as major cohort studies
• Ensuring that postgraduate research occurs where interventions are taking place or policies are being developed, such as Departments of Health, Education, Planning, Transport, Treasuries, NGOs and local governments

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