AbstractsMedical & Health Science

Public health research is most valuable when it is academically rigorous and achieves public health consequence. Research that meets both these criteria is critical to ensure future public health challenges are met and opportunities realized. This thesis presents five studies that achieve a public health impact by applying academic thinking to real-world situations. In each study I identify gaps in public health knowledge, and use research to improve practice. In the first study I investigate risk factors for dental caries in rural or remote communities with a high proportion of Aboriginal people, particularly focusing on water fluoridation. Concession card status, child’s age and tooth brushing frequency are highly significant predictors of caries, and Aboriginal status is also important. Critically, water fluoridation is less strongly associated with caries, suggesting that fluoridation is only part of the solution to improving oral health in these disadvantaged areas. The next group of three studies focus on increasing population-based physical activity. The first of this group qualitatively explores the motivators, enablers, and barriers to cycling among older people. The next analyses census data to examine temporal trends in active travel to work and associations between socio-economic status and active travel at a local level. The final study in this group is an evaluation of the pilot Liverpool Hospital Travelpass Initiative to assess the impact of offering an interest free loan to staff to purchase public transport tickets. Findings from these studies have been used to improve existing programs, advocate for cycling and public transport and add new insight to the body of knowledge on active travel. For the final study, I monitor an outbreak of Enterovirus 71 using an enhanced surveillance system, and demonstrate that routinely collected emergency department data can provide a useful indication of Enterovirus 71 activity in the community. These projects contribute to public health practice in New South Wales by using applied research to address a knowledge gap. I examine the public health impact of each project through the theme of applied research and reflect on the reasons why some projects have been more successful than others in changing practice.