JCU > Research Portfolio > Prof Sarah Larkins

About

Dr Sarah Larkins is an academic general practitioner and Professor of Health Systems Strengthening in the College of Medicine and Dentistry, James Cook University, and Director of Research Development, Division of Tropical Health and Medicine. Sarah has particular skills and experience in Aboriginal and Torres Strait Islander health research and health services and workforce research and is an internationally recognised expert in social accountability in health professional education. Sarah is also Co-Director of the Anton Breinl Research Centre for Health Systems Strengthening, a centre of the Australian Institute of Tropical Health and Medicine.

To date, Sarah has over 110 published peer-reviewed journal articles and several book chapters, with an h-index of 26, more than 2200 citations and well over $16m in grant funding. This includes four current NHMRC grants as a CI (2 as CI A), investigating participatory strategies to strengthen quality improvement in Indigenous primary health care centres and a DFAT grant on strengthening implementation research capacity for surveillance and response in the Pacific. She currently supervises 19 students at HDR level. Other recent funding is from the CRC-NA and the Commonwealth Department of Health.

Sarah's particular focus is on collaborating to improve equity in health care services for underserved populations, particularly rural, remote, Indigenous and tropical populations, and on training a health workforce with appropriate knowledge, attitudes and skills for this purpose. She is a past Director, Townsville Mackay Medicare Local and past member of the World Health Organisation Technical Working Group on Health Workforce Education Assessment Tools and the National Technical Advisory Group for Health Workforce Australia.

She currently serves as the Convenor, Clinical Leadership Group for the NHMRC-recognised Tropical Australian Academic Health Centre, and Co-Chair of the Primary and Chronic Care Panel and Guideline Leadership Group Member of the Living Evidence Guidelines for COVID-19.

Teaching

MD1020: Introduction to Integrated Medical Studies Part 2 of 2 (Level 1; TSV)
MD2011: Integrated Human System Pathophysiology Part 1 of 2 (Level 2; TSV)
MD4011: Integrated Pathology and Clinical Medicine Part 1 of 3 (Level 4; TSV)
MD4012: Integrated Pathology and Clinical Medicine Part 2 of 3 (Level 4; TSV)
MD4013: Integrated Pathology and Clinical Medicine Part 3 of 3 (Level 4; TSV)
MD5010: Integrated Clinical Practice Part 1 of 3 (Level 5; TSV)
MD5020: Integrated Clinical Practice Part 2 of 3 (Level 5; TSV)
MD5030: Integrated Clinical Practice Part 3 of 3 (Level 5; TSV)
MD6010: Advanced Clinical Medicine Part 1 of 3 (Level 6; TSV)
MD6020: Advanced Clinical Medicine Part 2 of 3 (Level 6; TSV)
MD6030: Advanced Clinical Medicine Part 3 of 3 (Level 6; TSV)
MD8001: Foundations of Rural and Remote Medicine (Level 8; TSV)

Interests

Research

Health systems strengthening
Rural health workforce
Socially accountable health professional education
Aboriginal and Torres Strait Islander Health
Primary health care
Maternal and child health

Teaching

Research methods
General Practice
Sociology of health care and social determinants of health

Experience

2007 to present - General Practitioner, Health and Wellbeing North Ward (Townsville)
2014 to 2019 - Associate Dean, Research, College of Medicine and Dentistry, James Cook University (Townsville)
2011 to 2015 - Associate Professor, James Cook University (Townsville)
2012 to 2014 - Director of Research and Postgraduate Education, School of Medicine and Dentistry, James Cook University (Townsville)
2010 to 2012 - School of Medicine and Dentistry Honours coordinator, James Cook University (Townsville)
2008 to 2010 - Senior Lecturer, James Cook University (Townsville)
1998 to 2007 - General Practitioner, Townsville Aboriginal and Islander Health Services (Townsville)

Research Disciplines

Socio-Economic Objectives

Honours

Awards

2013 - Office of Learning and Teaching National Program Award. JCU MBBS Program in the category "Widening Participation"
2012 - Finalist, Ron Harden Innovation in Medical Education International Award – Presented for THEnet on development and piloting of the common evaluation framework
2011 - Co-author of Australian Family Physician best research paper for 2011. Cheffins T, Spillman M, Larkins S Heal C (2011) “Recommending vaccination: General practice intervention with new parents” Australian Family Physician 40 (6) 437-439
2003 - Royal Australian College of General Practitioners National Registrar Research Prize
2003 - MBBS (Dean's Honour List)
1989 - Bachelor of Medical Science Prize, University of Melbourne, BMedSci
2009 to 2011 - 2009 Brisbane Initiative – 8 emerging Primary Health Care Research Leaders selected from around the world for 3 year program of mentoring and support with residential periods in Oxford, UK.
2003 to 2007 - National Health and Medical Research Council Public Health Postgraduate PhD Scholarship

Fellowships

2012 - Graduate, Australian Institute of Company Directors course
2004 - FARGP
2004 - Fellow, Royal Australian College of General Practitioners

Memberships

2013 - Queensland Representative , Australian Association of Academic Primary Care Executive
2012 - Health Workforce Australia, National Technical Advisory Group
2003 to 2005 - National Research Advisory Board, Australian Primary Health Care Research Institute

Other

2013 - "Strength of Mind: 125 years of women in medicine". Invited to be one of 60 women graduates of University of Melbourne Medical School over the last 125 years featured in exhibition and book.
2011 - Board Member, Townsville Mackay Medicare Local
2008 - PhD
2000 - MPH&TM

Publications

These are the most recent publications associated with this author. To see a detailed profile of all publications stored at JCU, visit ResearchOnline@JCU. Hover over Altmetrics badges to see social impact.

Journal Articles

Edelman A, Brown A, Pain T, Larkins S and Harvey G (2020) Evaluating research investment and impact at a regional Australian Hospital and Health Service: a programme theory and conceptual framework. Health Research Policy and Systems, 18 (30), DOI:10.1186/s12961-020-0542-y.
Harrington R, Redman-MacLaren M, Harvey N, Puia M, Carlisle K and Larkins S (2020) Barriers and enablers to using contraceptives for family planning at Atoifi Hospital, East Kwaio, Solomon Islands. Pacific Journal of Reproductive Health, 1 (10), pp. 586-597, DOI:10.18313/pjrh.2020.003.
Ireland S, Larkins S, Ray R and Woodward L (2020) Negativity about the outcomes of extreme prematurity a persistent problem - a survey of health care professionals across the North Queensland region. Maternal health, neonatology and perinatology, 6, Article: 2, DOI:10.1186/s40748-020-00116-0.
Johnston K, Preston R, Strivens E, Qaloewai S and Larkins S (2020) Understandings of dementia in low and middle income countries and amongst indigenous peoples: a systematic review and qualitative meta-synthesis. Aging & Mental Health, 24 (8), pp. 1183-1195, DOI:10.1080/13607863.2019.1606891.
Larkins S, Carlisle K, Harrington H, MacLaren D, Lovo E, Harrington R, Alves L, Rafai E, Delai M and Whittaker M (2020) From the frontline: strengthening surveillance and response capacities of the rural workforce in the Asia-Pacific region. How can grass-roots implementation research help? Frontiers in Public Health, 8, Article: 507, DOI:10.3389/fpubh.2020.00507.
Callander E, Bates N, Lindsay D, Larkins S, Preston R, Topp S, Cunningham J and Garvey G (2019) The patient co‐payment and opportunity costs of accessing healthcare for Indigenous Australians with cancer: a whole of population data linkage study. Asia-Pacific Journal of Clinical Oncology, 15 (6), pp. 309-315, DOI:10.1111/ajco.13180.
Callander E, Bates N, Lindsay D, Larkins S, Topp S, Cunningham J, Sabesan S and Garvey G (2019) Long-term out of pocket expenditure of people with cancer: comparing health service cost and use for indigenous and non-indigenous people with cancer in Australia. International Journal for Equity in Health, 18, Article: 32, DOI:10.1186/s12939-019-0931-4.
Felton-Busch C and Larkins S (2019) Remote dwelling Aboriginal Australian women and birthing: a critical review of literature. Women and Birth, 32 (1), pp. 5-15, DOI:10.1016/j.wombi.2018.05.003.
Ireland S, Ray R, Larkins S and Woodward L (2019) Perspectives of time: a qualitative study of the experiences of parents of critically ill newborns in the neonatal nursery in North Queensland interviewed several years after the admission. BMJ Open, 9 (5), Article: e026344, DOI:10.1136/bmjopen-2018-026344.
Ireland S, Larkins S, Ray R, Woodward L and Devine K (2019) Adequacy of antenatal steroids, rather than place of birth, determines survival to discharge in extreme prematurity in North Queensland. Journal of Paediatrics and Child Health, 55 (2), pp. 205-212, DOI:10.1111/jpc.14184.
Larkins S, Carlisle K, Turner N, Taylor J, Copley K, Cooney S, Wright R, Matthews V, Thompson S and Bailie R (2019) 'At the grass roots level it's about sitting down and talking': exploring quality improvement through case studies with high-improving Aboriginal and Torres Strait Islander primary healthcare services. BMJ Open, 9 (5), Article: e027568, DOI:10.1136/bmjopen-2018-027568.

Books

Noble K, Dennis T and Larkins S (2019) Agriculture and Resilience in Australia's North: a lived experience. Springer, Singapore

More: ResearchOnline@JCU stores 124+ research outputs authored by Prof Sarah Larkins from 1990 onwards.

Current Funding

Current and recent Research Funding to JCU is shown by funding source and project.

National Health & Medical Research Council - Boosting Dementia Research Grant

Reducing Dementia Risk in Aboriginal and Torres Strait Islander Communities

Indicative Funding: $1,515,145 over 5 years
Summary: The aim of the project is to address these issues through the development of a range of interventions to specifically target the high rates of dementia in Indigenous communities. This project will use a Participatory Action Research approach to enable communities to identify and prioritise dementia risk reduction strategies/potential risk and protective factors. Using a Continuous Quality Improvement Framework, primary health care centries will address modifiable dementia risk factors to change practice and systems through the development of culturally appropriate interventions. The outcome will be a culturally appropriate framework that incorporates evidence-based best-practice guidelines for delivering community specific interventions for risk reduction and prevention of dementia.
Investigators: Edward Strivens, Sarah G Russell, Rachel Quigley, Sarah Larkins, Robyn McDermott, Venessa Curnow, Kate Smith, Prabha Lakhan and Veronica Matthews in collaboration with Alan Cass, Yvonne Hornby-Turner, Desley Harvey, Leon Flicker, Dina LoGiudice, Frankie Clive, Gavin Miller, Dallas McKeown and Gail Garvey (College of Medicine & Dentistry, Australian Institute of Tropical Health & Medicine, Queensland Health, The University of Western Australia, The University of Sydney, Menzies School of Health Research, The University of Queensland, The University of Melbourne and North Queensland Primary Health Network)
Keywords: Indgenous Health; Healthy Ageing; Dementia; Chronic Disease

National Health & Medical Research Council - Targeted Call for Research into Healthy Ageing of Aboriginal and Torres Strait Islander Peoples

A framework for healthy ageing in the Torres Strait

Indicative Funding: $1,100,540 over 5 years
Summary: The aim of this project is to develop a culturally appropriate framework of healthy ageing for Torres Strait Comjmunities to enable older persons to remain living well at hme and on Country for as long as possible. Participatory Action Research (PAR) within a Continuous Quality Improvement (CQI) framework will be the overarching lmethodology for this project. The scope of the framework will be guided by the World Health organisation Framework of Healthy Ageing encompassing both intrinsic capacity and environmental characteristics that influence health outcomes.
Investigators: Edward Strivens, Sarah G Russell, Leon Flicker, Dina LoGiudice, Kate Smith, Rachel Quigley, Robyn McDermott, Sean Taylor, Venessa Curnow and Sarah Larkins in collaboration with Betty Sagigi, Desley Harvey, Dympna Leonard, Elizabeth Beattie, Gavin Miller, Jennifer Mann, Nancy Pachana and Yvonne Hornby-Turner (College of Medicine & Dentistry, The University of Western Australia, Melbourne Health, Australian Institute of Tropical Health & Medicine, College of Public Health, Medical & Vet Sciences, Cairns & Hinterland Health Service District, Queensland Health, Queensland University of Technology and The University of Queensland)
Keywords: Indigenous Health; Chronic Disease; healthy ageing; Dementia

National Health & Medical Research Council - Project Grant

Women's Action for Mums and Bubs (WOMB): A pragmatic trial of participatory women's groups to improve Indigenous maternal and child health

Indicative Funding: $1,786,415 over 5 years
Summary: There is strong evidence elsewhere that involving community women in decision-making about strategies to improve the health of mothers and babies is a cheap and effective way of improving health. The WOMB study tests whether community women's groups improve the quality of maternal and child health care and outcomes in Aboriginal and Torres Strait Islander communities, the cost-effectiveness and mechanism of action.
Investigators: Sarah Larkins, Judy Taylor, Yvonne Cadet-James, Ross Baille, Jane Farmer, N Passey, Catrina Felton-Busch, V Matthews, Emily Callander and Rebecca Evans in collaboration with Priscilla Page, J Kelly, Adrian Esterman, Merrick Zwarenstein, Robyn Preston, Karen Carlisle, Lynore Geia, Elaine Williams and N Turner (College of Medicine & Dentistry, Indigenous Education & Research Centre, The University of Sydney, Swinburne University of Technology, Mt Isa Centre for Rural & Remote Health, Australian Institute of Tropical Health & Medicine, University of Adelaide, The University of Western Ontario, College of Healthcare Sciences, NT Department of Health & Community Services and Menzies School of Health Research)
Keywords: Aboriginal Health; Torres Strait Islander health; Maternal & Child Health; Primary Health Care; Quality Improvement; Participatory women's groups; Community Participation

National Health & Medical Research Council - Partnership Projects

Implementation of quality improvement in Indigenous primary health care: Leveraging Effective Ambulatory Practices (LEAP)

Indicative Funding: $1,144,570 over 4 years, in partnership with North Queensland Primary Health Network ($315,000 over 3 yrs); Northern Territory Department of Health, Top End Health ($20,000 over 3 yrs); Northern Territory Primary Health Network (NTPHN) ($38,700 over 3 yrs) and Western Queensland Primary Health Network (WQPHN) ($210,000 over 3 yrs)
Summary: Despite increased policy attention and funding, not all primary healthcare (PHC) services for Indigenous Australians show the desired improvements in quality of care. Practices which provide PHC services are complex systems and emerging evidence indicates many things affect quality improvement. There remains a knowledge gap regarding what is required for Indigenous PHCs to succeed in improving the quality of their services and, subsequently, health outcomes for their patients. This project will capitalise on emerging research and existing strong partnerships to provide a solid evidence base for interventions to improve quality of priority health services in Indigenous PHC settings.
Investigators: Sarah Larkins, Ross Baille, Catrina Felton-Busch, Paul Burgess, Emma McBryde, Kerry Copley, Rebecca Evans, V Matthews and Karen Carlisle in collaboration with Judy Taylor, Karla Canuto, Donald Whaleboat, S Thompson, Christine Connors and Roderick Wright (College of Medicine & Dentistry, The University of Sydney, Mt Isa Centre for Rural & Remote Health, Department of Health (NT), Australian Institute of Tropical Health & Medicine, Aboriginal Medical Service, Apunipima Cape York Health Council, The University of Western Australia and Queensland Aboriginal and Islander Health Council)
Keywords: Learning community; Aboriginal and Torres Strait Islander; Primary Health Care; Quality Improvement

Department of Health - Contract Research

National Research Project on Remote Radiology Assessment Service Delivery

Indicative Funding: $378,906 over 3 years
Summary: This project will investigate outcomes of the BreastScreen Australia remote radiology assessment trial at sites through9out Australia. Engaging a remote radiologist may assist with overcoming many challenges associated with providing health services in a regional, rural or remote location. This project seeks to ensure that the alternative model of service delivery is appropriate for consumers, evidence-based and safe. Specifically, this project will assess how the new remote radiology model affects: - Patient safety - Patient acceptability - Staff acceptability of new model of service provision - The safe, efficient organisation of BreastScreen services
Investigators: Sarah Larkins, Rebecca Evans, Robyn Preston, Emily Callander, Sabe Sabesan, Leila Murison, Karen Johnston and Nicole Bates (College of Medicine & Dentistry, Australian Institute of Tropical Health & Medicine and Townsville Hospital and Health Service)
Keywords: rural health services; breast cancer screening; Telehealth; Radiology; Health Workforce

Department of Foreign Affairs and Trade (DFAT) - Tropical Disease Research Regional Collaboration Initiative

Tropical partnerships to strengthen health systems responses to infectious diseases threats

Indicative Funding: $2,000,000 over 2 years
Summary: The Asia Pacific Region is facing frequent threats from emerging and existing infectious diseases. The capacity to mount a timely effective response is compromised in poorly functioning health systems seen in parts of the region. The resulting vulnerability affects the whole region, including Australia. Strengthening capacity to prepare and respond to these threats is thus a shared responsibility. This proposal aims to tackle the problem through collaboration with institutions, researchers and policy makers across the region, building on long held partnerships.
Investigators: Emma McBryde, Sarah Larkins, Archie Clements, Barend (Ben) Marais, Peter Siba, Maxine Whittaker, Tom Burkot, David MacLaren, George Milne and Richard Speare (Australian Institute of Tropical Health & Medicine, College of Medicine & Dentistry, Australian National University, The University of Sydney, Institute of Medical Research (PNG), College of Public Health, Medical & Vet Sciences and The University of Western Australia)
Keywords: Health system strengthening; Infectious Diseases; Epidemiology; Disease Surveillance

Western Queensland Primary Care Collaborative Limited - Contract Research

Diabetes Collaborative Evaluation Project

Indicative Funding: $28,860
Summary: The diabetes collaborative is a Continuous quality Improvement (CQI) approach to change that aims to improve health outcomes for patients diagnosed with Diabetes. It involves the introduction of a team-based, sustainable approach to learning whilst providing a sound understanding and application of quality improvement methodology and skills. This project aims to evaluate the implementation and outcomes of the WQPHN diabetes collaborative. Expected outcomes of the equation will be a greater understanding of the process of implementation and any changes within participant health services as a result of the collaborative. Evaluation of the program in the rural and remote context of WQPHN will inform on feasibility and effectiveness of this approach.
Investigators: Sarah Larkins, Karen Carlisle, Sabina Knight, Rebecca Evans, Robyn Preston and Karen Johnston (College of Medicine & Dentistry, Australian Institute of Tropical Health & Medicine and Mt Isa Centre for Rural & Remote Health)
Keywords: Quality Improvement Approach; Primary Health Care; Diabetes

Cancer Council NSW - Strategic Research Partnership Grant

Identifying the Out of Pocket costs of cancer care and the impact on healthcare access and patient outcomes - STREP Ca-CindaA

Indicative Funding: $121,160 (administered by Menzies School of Health Research)
Summary: AIM 1: Quantify the out-of-pocket healthcare expenditure of individuals who are diagnosed with cancer and compare it with their clinical outcomes. This will be done by building Australia?s first model of the out-of-pocket healthcare expenditure of cancer patients using administrative data. AIM 2: Identify the impact of out-of-pocket costs on decisions about health care utilisation. This qualitative research component will be undertaken, which aims to explore and explain how out-of-pocket costs (both anticipated and unanticipated) affect the health seeking decisions and behaviours of cancer patients and their families.
Investigators: Sabe Sabesan, Emily Callander, Sarah Larkins and Stephanie Topp (College of Medicine & Dentistry, Australian Institute of Tropical Health & Medicine, College of Public Health and Medical & Vet Sciences)
Keywords: Health Economics; Patient costs; Cancer; Indigenous; Rural Health; Access

Supervision

Advisory Accreditation: I can be on your Advisory Panel as a Primary or Secondary Advisor.

These Higher Degree Research projects are either current or by students who have completed their studies within the past 5 years at JCU. Linked titles show theses available within ResearchOnline@JCU.

Current

The role of Academic Health Science Centres in driving translational research to improve the health of underserved populations worldwide (PhD , Secondary Advisor/AM)
What is the economic and social impacts of Monash University, School of Rural Health - Bairnsdale, on the East Gippsland Community - Victoria (PhD , Secondary Advisor/AM)
Transition from Girlhood to Womanhood: Experiences of Adolescent Females in Papua New Guinea. (PhD , Advisor Mentor)
An exploration of the academic and early career professional practice for James Cook University medical students who have experienced academic difficulty (PhD , Advisor Mentor)
Implementation and evaluation of referral pathways for people with Ling Cancer in Townsville Health Service District (PhD , Advisor Mentor)
International Approaches to Rural Medical Generalism (PhD , Advisor Mentor)
Health System Capacity to Provide Male Circumcision for HIV Prevention in Papua New Guinea. (PhD , Advisor Mentor)
Developing Local Models to Strengthen and Improve Capacity in Health Research in Melanesia (PhD , Secondary Advisor/AM)
Enhancing Current International Human Research Ethics Guidelines by Including Indigenous Principles of Human Research Ethics. The Cases of the Pacific Island Nations of Fiji and Tonga. (PhD , Secondary Advisor/AM)
Family planning service provision in Solomon Islands: A Case Study Approach (PhD , Secondary Advisor/AM)
What InfluencesThe Provision Of Care To Periviable Babies In North Queensland And What Are The Consequences Of The Provision Of This Care. (PhD , Secondary Advisor)
An investigation of the Impacts of excess alcohol Consumption on chronic Disease management in a Regional setting (PhD , Secondary Advisor)
Birthing on Mornington Island: Culture, Identity and our Aspirations for the Future. (PhD , Primary Advisor/AM/Adv)
Is There a Role for L-Arginine Supplementation in the Treatment of Diabetic Foot Ulcers in a North Queensland Community Diabetics Clinic? (PhD , Primary Advisor/AM/Adv)
Development and Implementation of a Breast Cancer Care Pathway in Townsville Region - A Study Looking into Feasibility, Governance, Patient Centred Outcomes and Economics (PhD , Primary Advisor/AM/Adv)
Experiences of dementia in Fiji: perspectives of people with dementia, caregivers, community and service providers (PhD , Primary Advisor/AM/Adv)
Healthy Ageing in the Torres Strait: Developing and Implementing a Framework for Best-Practice Aged Care within Primary Health Care Centres (PhD , Advisor Mentor)

Completed

How do contextual issues influence socially accountable medical schools? (2015, PhD , Secondary Advisor)
Shifting the lens: Indigenous research into mainstream Australian culture (2017, PhD , Primary Advisor)
Exploring the development of clinical reasoning skills among doctors-in-training (2019, PhD , Secondary Advisor)
Medical interns' learning in the 21st century (2019, PhD , Secondary Advisor/AM)
Ageing in Place in Rural Australia (2020, PhD , Secondary Advisor)
Access to care and benefits for cancer patients in rural and remote locations using telemedicine (2015, PhD , Primary Advisor)

Collaboration

The map shows research collaborations by institution from the past 7 years.
Note: Map points are indicative of the countries or states that institutions are associated with.