An innovative new study by George Institute researchers is looking to make the ‘healthiest’ use of the time Australian women spend at the hairdressers. Hairdressing is one of the most common paid services used by women across the country, so salons present an opportunity to reach a large proportion of the female population. The ‘Hairdressers for Health’ study will use this setting to give women a gentle ‘nudge’ along with their cut and blow dry and encourage them to visit their GP for relevant health checks.

“Women are often too busy looking after everyone else in the family to prioritise their own health, but getting their hair done is often one of the few things they will do for themselves. It’s important to try and better engage women on health issues, potentially in places beyond traditional health care settings. We want to see how effective promoting women’s health outside traditional health care settings can be, using hairdressing salons across New South Wales,” says project manager Kellie Nallaiah.

Women’s health: low priority?

Australian women have high rates of modifiable risk factors for chronic disease including 60 percent being overweight or obese, and 20 percent having high blood pressure that is not being properly managed. Unfortunately, there are many barriers preventing women from visiting their GP to discuss their health. These range from social, cultural, economic to various other factors.

Dr Jennifer Barraclough, Research Fellow at The George Institute and project co-lead, says much more needs to be done to help women prioritise their own health.

“It is well known that women tend to put themselves last on the list, often not prioritising their own needs and health. Changing culture in our society towards greater equality will help drive change in women’s health and education and more research involving women will assist this - both of which this study provides.”

Data shows that just over half of Australian women aged 50 years and above visit a hairdresser over a four-week period. By leveraging this trusted and non-confrontational environment to deliver a positive intervention, the project will assess whether non-traditional health influencers can deliver positive health outcomes for women.

How it works

The study will enrol 3,240 women, initially over a 12-month period, across greater Sydney and some regional areas of New South Wales. It is inspired by a 2018 project conducted in Los Angeles, United States, in which barbers encouraged meetings in barbershops between customers and specially-trained pharmacists. This community-led trial resulted in much larger reductions in blood pressure in those who met with the pharmacist than those who didn’t. The positive results from this trial has prompted researchers to expand this model to other countries and larger populations.

Replicating this model in Australia could help us learn how non-medical influencers could be employed to deliver health promotion messages among certain groups of people. The trial is in its final stages of development with recruitment starting before the end of 2021.

Women’s Health Week

September 6-12 marks Women’s Health Week in Australia, which is dedicated to encouraging women to prioritise their own health by making appointments for health checks and taking other steps to prevent illness. Kellie Nallaiah underlines the significance of this work against the backdrop of this calendar week.

“Women have a strong tendency to put themselves last. Women’s Health Week shines a light on women and what’s really important to them. We believe our study represents a novel and much needed non-traditional way of engaging with women that will lead to better health outcomes,” she says.

The George Institute and UNSW School of Women’s and Children’s Health have been jointly awarded a ‘UNSW Medicine & Health Cardiac, Vascular and Metabolic Medicine Big Ideas grant’ for a research project aimed at preventing type 2 diabetes among high-risk women. The ‘DIVINE’ project will involve research in New South Wales, Australia, to understand the incidence of subsequent type 2 diabetes among women who develop diabetes in pregnancy, known as gestational diabetes mellitus (GDM). GDM, previously considered a temporary condition, is now an established risk factor for long-term diabetes.

“This study aims to understand the current landscape in NSW regarding diabetes risk in the early years after GDM across diverse populations, and the acceptability of any planned medication intervention,” says project co-lead Amanda Henry, Associate Professor at the School of Women’s and Children’s Health UNSW and Honorary Sr Research Fellow at The George Institute.

Women whose blood sugar levels do not return to normal soon after giving birth are at particularly high risk of developing diabetes and consequent heart and blood vessel disease. Lifestyle interventions may help, but they are hard for busy mothers to adopt and sustain. Even with lifestyle interventions, many women still face substantial risk.

Currently, due to a lack of research, clinical guidelines do not recommend routine use of preventive medicines to thwart the onset of diabetes. This proposed project will study the feasibility of drug-related interventions after childbirth and provide preliminary data to conduct a definitive trial of preventive medicines in Australia and other countries.

 “Women of reproductive age, in particular women who are or have recently been pregnant or breastfeeding, are hugely under-represented in clinical trials. This means that we simply do not have sufficient information to help prevent chronic disease such as diabetes after pregnancy complications like GDM. There is also both a deficit in our understanding of what preventive therapies and medicine might be acceptable to young women to prevent chronic disease, and in recruitment of diverse populations to prevention trials,” explains A/Prof Henry.

An unequal burden

Women of certain ethnicities are more prone to gestational diabetes and developing type 2 diabetes following childbirth. Asian women are twice as likely to develop GDM compared to Caucasians, and Aboriginal and Torres Strait Islander women are four times more likely to develop type 2 diabetes from GDM than non-Indigenous women.

Therefore, this trial will study women discharged from three New South Wales hospitals serving socio-demographically diverse populations, namely, St George Hospital, Liverpool Hospital and the Royal Hospital for Women. The cohort will include women diagnosed with GDM during their pregnancy in the past three years. Participants will be invited to complete an online questionnaire, and if long term diabetes has not set in, to undergo a blood test to check glucose levels. Interviews will be conducted to understand their perspectives on GDM and willingness to take preventive medications. The views of healthcare providers will also be collected for a well-balanced understanding of potential preventive strategies.

Study co-lead Anushka Patel, Vice-Principal Director and Chief Scientist at The George Institute says, “This research will be of relevance not only to Australian women, but populations globally because of the rapidly increasing prevalence of GDM worldwide. We have recently completed and are currently analysing results from the largest trial ever conducted looking at lifestyle interventions to prevent diabetes in women with GDM. This trial was conducted in India, Sri Lanka and Bangladesh, and confirms that most women progress towards diabetes in the early months after childbirth, emphasizing the need for early intervention.”

The study leads will be supported by a multi-disciplinary team of researchers from The George Institute and University of New South Wales, cutting across cardiology, obstetrics and endocrinology.

Improving outcomes for women

The overall aim of the project is to improve the metabolic and cardiovascular health of women.

As a stand-alone study, the results will be important to assess the risks of gestational diabetes developing into type 2 diabetes. Women with type 2 diabetes are more likely to develop vascular complications and experience poorer outcomes than men. By focusing on a sex-specific risk factor like GDM, this study will address such disparities from a prevention perspective. Finally, data collected from this study will lay the foundation for a larger intervention trial of preventive drug therapy.

The George Institute for Global health India in collaboration with UNICEF co-designed  "A workshop with frontline healthcare workers: Innovations for psychosocial support to health workers” at one of the primary health centres in the Uddhanam region on 25th August 2021.

A total of 26 health care workers (medical officers, staff nurses, ASHAs & ANMs) participated in this workshop.  A comprehensive assessment was done for the participants, using SHARECARE application developed by the National Institute of Mental Health and Neurosciences (NIMHANS).  Using this validated and standard tool, the stress levels, psychological distress, and insomnia severity index was mapped for the participants. 

This workshop was a part of The George Institute and UNICEF Innovation challenge designed to identify “disruptive solutions for psycho-social support to health workers”, The aim  of this challenge is to leverage India’s vibrant start up ecosystem to source potential solutions to support healthcare workers that can be accelerated and scaled within health care delivery systems in India and other Low and Middle Income Countries (LMIC’s).

Applications were open for the innovation challenge till 22nd August 2021. Extremely promising applications were received for the challenge out of which 12 were shortlisted. The finalists made pitches before an eminent jury Urvashi Prasad, Dr Vivek Virendra Singh, Dr Vijay Anand Ismavel and Shabari Bhattacharyya on 1st September 2021.

The award-winning innovations under the challenge will be announced soon.