Latrobe Health Innovation Zone

The Victorian Government established the Latrobe Health Innovation Zone (LHIZ) in 2016 to improve the health and wellbeing of residents in Latrobe City, with partners, local health providers and the community working together to drive innovation and change.

Latrobe Health Innovation Zone Early Detection and Screening Including Tobacco Initiative

Following the inquiry into the 2014 Hazelwood Mine fire, nine key areas related to early detection and screening including smoking cessation formed the scope of the Latrobe Health Innovation Zone Early Detection and Screening Including Tobacco Initiative.

In 2017, Gippsland PHN was commissioned by the Victorian Department of Health to support the implementation of activities under the Initiative.

Project activities were both community facing and health system facing. The initiative was implemented using the concept of community co-design to ensure a community voice, and under the guidance of a Project Control Group comprising local service providers, subject matter experts, and other relevant stakeholders.

The aim of the Initiative was to support people to prevent illness before it occurs, detect illness early and ensure that those who need treatment and support services can access them locally, across three themes:

Smoking cessation
Population based cancer screening (breast, bowel and cervical)
Risk assessment and opportunistic screening

To assess the overarching evaluation aims, five evaluation areas were assessed:

IMPACT – The project contributed to longer term impact level outcomes or project goals
EFFECTIVENESS – Short and medium-term project outcomes were achieved
EFFICIENCY – Project inputs were efficiently translated to produce project outputs
APPROPRIATENESS – Project design was appropriate for the target population and context
SUSTAINABILITY – Project results contributed to sustainable capacity with funding or policy support

There were four overarching evaluation questions, relating to co-design, system redesign, smoking and cancer/opportunistic screening and community attitudes.

The final evaluation report for the Initiative has been accepted by the Victorian Department of Health. Selected findings include:

Evaluation Question	Selected Findings
How has the co-design process enhanced development of program initiatives and program outcomes?	Activities in the Initiative engaged well with community to understand enablers and barriers regarding smoking cessation, cancer screening and opportunistic screening. Activities/projects that were co-designed with community had good participation rates. Co-design processes take time to receive community input, establish the project, recruit staff and participants and implement the project.
What system redesign changes have occurred, who has benefited and are they sustainable?	Across all three themes, projects were undertaken that engaged community, health professionals and system redesign. HealthPathways were developed to aid GP referrals for all three themes: cervical cancer and weight management, nutrition and physical activity were in high demand. A system redesign approach that linked health system and community facing activities was not applied.
Have smoking rates decreased, cancer screening rates increased (bowel, breast and cervical) and opportunistic screening rates increased?	The Initiative had little effect on reducing smoking rates in Latrobe by 2021. Limited confidence in the data for small geographies does not allow conclusions to be drawn about changes in smoking rates. The Initiative demonstrated positive effects on cancer screening rates in participating general practices arising from process changes, but improvements in population level screening rates were not observed. Smoking status and alcohol consumption state were well captured by GPs in Latrobe and Gippsland.
Have community attitudes towards lifestyle modifications to improve overall health and wellbeing improved? Has this resulted in behaviour change?	Social media was a wide-reaching medium especially when cross promoted by relevant stakeholders and therefore was an effective way to promote campaign messaging. Ongoing activities and prompts were required to create lasting behaviour change. Barriers to sustainability were a lack of demonstration of value for money and lack of sustainable funding models identified.

The full evaluation report can be accessed here.