Anna is a registered nurse with extensive experience working in primary health care. Anna has worked for many years as a Clinical Nurse Specialist providing accessible and equitable health care to marginalised populations, including sex workers, at risk youth and injecting drug users. During this time Anna has been involved in several clinical trials related to Hepatitis C and she has published, and presented in this area. Anna joined the faculty as a casual academic in 2012 and as a full time staff member in 2013. Anna completed her Bachelor of Nursing at the University of Sydney and she gained a Master of Public Health from UNSW.
Marginalised populationsPeople who inject drugsAt risk young peopleSex workers
Dawson, AJ, Rossiter, C, Doab, A, Romero, B, Fitzpatrick, L & Fry, M 2019, 'The Emergency Department Response to Women Experiencing Intimate Partner Violence: Insights From Interviews With Clinicians in Australia', Academic Emergency Medicine.View/Download from: UTS OPUS or Publisher's site
© 2019 by the Society for Academic Emergency Medicine Background and Objectives: Emergency departments (EDs) are essential providers of compassionate, immediate treatment and referral for women experiencing intimate partner violence (IPV). IPV, largely perpetrated by men against women, exerts a substantial burden on the health systems and economies of all nations. There is little known about how staff in Australian EDs respond to the challenges such violence generates. We therefore examined the clinical team response to women experiencing IPV in two large Australian metropolitan hospital EDs. Methods: We undertook qualitative semistructured interviews and focus group discussions with 35 social workers, nurses, and doctors. Transcripts were recorded and transcribed verbatim. We analyzed the data thematically. We first undertook line-by-line coding and organized content into descriptive categories. Latent and manifest patterns were identified across the data and mapped to key themes in negotiation with all authors. Results: Respondents emphasized challenges identifying IPV resulting from professional uncertainty or discomfort and women's fear of the ramifications of disclosure. Emergency clinicians routinely referred women to social workers after medical treatment and described effective collaboration across professions. Social workers outlined difficulties coordinating care with health and community agencies. Staff highlighted challenges maintaining nonjudgmental attitudes and managing their own feelings—especially clinicians who had personally experienced violence. Conclusions: Emergency departments can provide caring environments for women experiencing IPV. Effective interprofessional teamwork across nursing, medical, and social work professionals may mitigate the need for formal screening tools. Supportive workforce environments can improve staff understanding, reduce stigma, enhance appropriate treatment, and counsel health professionals experiencing violence....
Power, TJ, Virdun, C, Gorman, E, Doab, A, Smith, R, Phillips, A & Gray, J 2018, 'Ensuring Indigenous cultural respect in Australian undergraduate nursing students', Higher Education Research and Development.View/Download from: UTS OPUS or Publisher's site
Similar to other Westernised countries, Australia's history of colonisation, racism and oppression has impacted upon Indigenous Peoples' health and wellbeing. It is also evident that institutional racism and ongoing colonisation are present in the Australian health system. Better preparation of health professionals to work in a culturally respectful way can contribute to addressing health disparities and prejudices. One approach to enabling the development of cultural respect, is through embedding an Indigenous Graduate Attribute (IGA) across curricula and ensuring the process is thoughtfully developed and assessed. This paper describes and discusses the process of developing an Assessment Criteria Template (ACT) to assess Indigenous cultural respect in an undergraduate nursing degree program. Critical to the project was meaningful engagement with Indigenous stakeholders and Indigenous leadership to inform the development and implementation process. Although the context will vary globally due to the diversity of Indigenous Peoples and each country's history of colonisation, by publishing this work, we intend to provide transparency into the process we undertook to embed and assess an IGA ACT in an undergraduate nursing curriculum. We hope this is helpful for other tertiary institutions internationally who are also engaging in this space.
Dawson, A, Nicholls, R, Bateson, D, Doab, A, Estoesta, J, Brassil, A & Sullivan, E 2017, 'Medical termination of pregnancy in general practice in Australia: a descriptive-interpretive qualitative study', Reproductive Health, vol. 14, no. 39, pp. 1-13.View/Download from: UTS OPUS or Publisher's site
Alavi, M, Spelman, T, Matthews, GV, Haber, PS, Day, C, van Beek, I, Walsh, N, Yeung, B, Bruneau, J, Petoumenos, K, Dolan, K, Kaldor, JM, Dore, GJ, Hellard, M, Grebely, J, Marks, P, Amin, J, Doab, A, Carroll, T, Teutsch, S, Li, H, Oon, A, Cameron, B, Lloyd, A, White, P, Rawlinson, W, Jacqueline Flynn, Goy, K, Nguyen, O, von Bibra, S, Ffrench, R, McCaughan, G, Madden, A, Farrell, G, Crofts, N, Sievert, W, Baker, D, Jacka, B, Pan, Y, Shaw, D, Sasadeusz, J, Crawford, D, Phung, N, George, J, Bloch, M, Hughes, B, Mollison, L, Roberts, S & Desmond, P 2015, 'Injecting risk behaviours following treatment for hepatitis C virus infection among people who inject drugs: The Australian Trial in Acute Hepatitis C', International Journal of Drug Policy, vol. 26, no. 10, pp. 976-983.View/Download from: Publisher's site
© 2015 Elsevier B.V. Background: A barrier to hepatitis C virus (HCV) treatment among people who inject drugs (PWID) has been a concern that interferon-based HCV treatment may increase injecting risk behaviours. This study evaluated recent (past month) injecting risk behaviours during follow-up among PWID that did and did not receive HCV treatment. Methods: The Australian Trial in Acute Hepatitis C (ATAHC) was a prospective study of natural history and treatment of recent HCV infection. Analyses were performed using generalized estimating equations. Results: Among 124 participants with a history of injecting drug use (median age 32 years), 69% were male, and 68% were treated for HCV infection. HCV treatment was not associated with an increase in recent injecting drug use (adjusted odds ratio (aOR) 1.06, 95% CI 0.93, 1.21) or recent used needle and syringe borrowing during follow-up (aOR 0.99, 95% CI 0.89, 1.08). HCV treatment was associated with a decrease in recent ancillary injecting equipment sharing during follow-up (aOR 0.85, 95% CI 0.74, 0.99). Further, among treated participants who remained in follow-up (n= 24), ancillary injecting equipment sharing significantly decreased from 54% at enrolment to 17% during follow-up (P= 0.012). Conclusions: HCV treatment was not associated with drug use or used needle and syringe borrowing during follow-up, but was associated with decreased ancillary injecting equipment sharing during follow-up. Programs to enhance HCV assessment and treatment among PWID should be expanded, given that HCV treatment does not lead to increases in injecting risk behaviours and has previously been demonstrated to be safe and effective among PWID.
Doab, A, Fowler, C & Dawson, A 2015, 'Factors that influence mother–child reunification for mothers with a history of substance use: A systematic review of the evidence to inform policy and practice in Australia', International Journal of Drug Policy, vol. 26, no. 9, pp. 820-831.View/Download from: UTS OPUS or Publisher's site
Treloar, C, Rance, J, Haber, P, Bath, N, Day, C, Dore, G, Grebely, J, Honey, C, Krahn, M, Lodge, M, Loveday, S, Micallef, M, Thein, HH, Alavi, M, Marks, P, Jones, I, Siriragavan, S, Tamaddoni, M, Abbott, P, Balcomb, A, van Beek, I, Dunlop, A, Phung, N, Weltman, M, Doab, A, Hazelwood, S, Lam, T, Petersen, J, Sevehon, A, Taylor, A, D'Aquino, F, Evangelista, L, Pollard, E & Wrightson, J 2014, 'How to build trustworthy hepatitis C services in an opioid treatment clinic? A qualitative study of clients and health workers in a co-located setting', International Journal of Drug Policy, vol. 25, no. 5, pp. 865-870.View/Download from: Publisher's site
© 2014 Elsevier B.V. Background: Given the increasing burden of hepatitis C (HCV) related liver disease, innovative health care models are required to extend the reach of HCV care and treatment. Opioid substitution treatment (OST) clinics are places of high HCV prevalence. The OST clinic is a complex environment, quite distinct to other health care settings, with punitive regulations and practices, and a client population likely to be mistrustful of systems of authority. Nonetheless, trust is widely documented as essential to effective therapeutic encounters. This paper examines what is required to develop a trustworthy service in a place, the OST clinic, described by some critics as a site of "social control". Methods: In-depth interviews were conducted with 57 clients and 19 staff from four NSW pilot clinics participating in the Australian ETHOS study. Results: Interview data were examined using Hall's framework of trust, involving five principle domains: fidelity, competence, honest, confidentiality and global trust. 'Honesty' was found to be key to participants' establishing trust in the co-located service and its staff. However, the clinic site was also found to be a place of rationed trust, in which the themes of OST as "ruling peoples' lives" and the fear of repercussions resulting from perceived transgressions against clinic rules, threatened to over-ride or undermine the development of trust in HCV services. Client participants described trusting health workers "to a point". They expressed concerns about the fidelity of co-located HCV and OST services and described fears of "institutionalised lies" and breaches of confidentiality. Anxieties around the latter revealed a sense of "us and them" held by some clients, one in which health workers were perceived to "stick together" by putting their own interests before those of the clients. Discussion: Although the co-location of HCV and opioid treatments makes intuitive policy sense, HCV health workers in the ...
Alavi, M, Grebely, J, Matthews, GV, Petoumenos, K, Yeung, B, Day, C, Lloyd, AR, Van Beek, I, Kaldor, JM, Hellard, M, Dore, GJ, Haber, PS, Marks, P, Acraman, B, Amin, J, Doab, A, Carroll, T, Ffrench, R, Flynn, J, Goy, K, Nguyen, O, von Bibra, S, White, P, Li, H, Oon, A, Cameron, B, Rawlinson, W, Dolan, K, Jacka, B, Pan, Y, Haber, P, McCaughan, G, Madden, A, Farrell, G, Crofts, N, Sievert, W, Baker, D, Desmond, P, Shaw, D, Sasadeusz, J, Crawford, D, Phung, N, George, J, Bloch, M, Hughes, B, Mollison, L & Roberts, S 2012, 'Effect of pegylated interferon-α-2a treatment on mental health during recent hepatitis C virus infection', Journal of Gastroenterology and Hepatology (Australia), vol. 27, no. 5, pp. 957-965.View/Download from: Publisher's site
Background and Aim: Pegylated interferon (PEG-IFN) treatment for hepatitis C virus (HCV) infection has neuropsychiatric side effects. Data on the effect of HCV treatment on mental health among injecting drug users (IDUs) are limited. We assessed mental health during treatment of recently acquired HCV, within a predominantly IDU population. Methods: Participants with HCV received PEG-IFN-α-2a (180μg/week) for 24weeks; HCV/HIV received PEG-IFN with ribavirin. Depression was assessed using the Mini-International Neuropsychiatric Interview (MINI). Logistic regression was used to identify factors associated with depression at enrolment and during treatment. Also, the effect of depression prior to and during treatment on sustained virological response (SVR) was assessed. Results: Of 163 participants, 111 received treatment (HCV, n=74; HCV/HIV, n=37), with 76% ever reporting IDU. At enrolment, 16% had depression (n=25). In adjusted analysis, depression at enrolment occurred less often in participants full-/part-time employed (adjusted odds ratio [AOR] 0.23; 95% confidence interval [CI]: 0.06, 0.82, P=0.023) and more often in recent IDUs (AOR 3.04; 95% CI: 1.19, 7.72, P=0.019). During treatment, 35% (n=31) developed new-onset depression. In adjusted analysis, poorer social functioning (higher score) was associated with new-onset depression (score≤9 vs score≥17; OR 5.69; 95% CI: 1.61, 20.14, P=0.007). SVR was similar among participants with and without depression at enrolment (60% vs 61%, P=0.951) and in those with and without new-onset depression (74% vs 63%, P=0.293). Conclusions: Although depression at enrolment and during treatment was common among participants with recent HCV, neither influenced SVR. Participants with poor social functioning may be most at risk of developing depression during HCV therapy. © 2011 Journal of Gastroenterology and Hepatology Foundation and Blackwell Publishing Asia Pty Ltd.
Grebely, J, Petoumenos, K, Hellard, M, Matthews, GV, Suppiah, V, Applegate, T, Yeung, B, Marks, P, Rawlinson, W, Lloyd, AR, Booth, D, Kaldor, JM, George, J, Dore, GJ, Marks, P, Haber, P, Ffrench, R, White, P, Day, C, van Beek, I, McCaughan, G, Madden, A, Dolan, K, Farrell, G, Crofts, N, Sievert, W, Baker, D, Acraman, B, Amin, J, Doab, A, Carroll, T, Nguyen, O, von Bibra, S, Teutsch, S, Li, H, Oon, A, Cameron, B, Jacka, B, Pan, Y, Flynn, J, Goy, K, Shaw, D, Sasadeusz, J, Crawford, D, Phung, N, Bloch, M, Hughes, B, Mollison, L, Roberts, S & Desmond, P 2010, 'Potential role for interleukin-28B genotype in treatment decision-making in recent hepatitis C virus infection', Hepatology, vol. 52, no. 4, pp. 1216-1224.View/Download from: Publisher's site
© 2010 by the American Association for the Study of Liver Diseases. Polymorphisms in the IL28B (interleukin-28B) gene region are important in predicting outcome following therapy for chronic hepatitis C virus (HCV) infection. We evaluated the role of IL28B in spontaneous and treatment-induced clearance following recent HCV infection. The Australian Trial in Acute Hepatitis C (ATAHC) was a study of the natural history and treatment of recent HCV, as defined by positive anti-HCV antibody, preceded by either acute clinical HCV infection within the prior 12 months or seroconversion within the prior 24 months. Factors associated with spontaneous and treatment-induced HCV clearance, including variations in IL28B, were assessed. Among 163 participants, 132 were untreated (n = 52) or had persistent infection (infection duration ≥26 weeks) at treatment initiation (n = 80). Spontaneous clearance was observed in 23% (30 of 132 participants). In Cox proportional hazards analysis (without IL28B), HCV seroconversion illness with jaundice was the only factor predicting spontaneous clearance (adjusted hazards ratio = 2.86; 95% confidence interval = 1.24, 6.59; P = 0.014). Among participants with IL28B genotyping (n = 102 of 163 overall and 79 of 132 for the spontaneous clearance population), rs8099917 TT homozygosity (versus GT/GG) was the only factor independently predicting time to spontaneous clearance (adjusted hazard ratio = 3.78; 95% confidence interval = 1.04, 13.76; P = 0.044). Participants with seroconversion illness with jaundice were more frequently rs8099917 TT homozygotes than other (GG/GT) genotypes (32% versus 5%, P = 0.047). Among participants adherent to treatment and who had IL28B genotyping (n = 54), sustained virologicresponse was similar among TT homozygotes (18 of 29 participants, 62%) and those with GG/GT genotype (16 of 25, 64%, P = 0.884). Conclusion: During recent HCV infection, genetic variations in IL28B region were associated with spontaneous but not...
Doab, AE, Topp, L, Day, C, Dore, G & Maher, L 2009, 'Clinical trial literacy among injecting drug users' in Sydney', Contemporary Clinical Trials, vol. 30, no. 5, pp. 431-435.View/Download from: UTS OPUS or Publisher's site
This pilot study examined knowledge, understanding and perceived acceptability of key methodological concepts in clinical trials among injecting drug users (IDUs) in Sydney, Australia. Participants were clinical trial-experienced (n=17) and trial-naïve (n=99) IDUs recruited from community needle and syringe programs, and through institutions involved in clinical trials with IDU participants.
White, B, Day, C, Thein, HH, Doab, AE, Bates, A, Holden, J, Van Beek, I & Maher, L 2008, 'Acceptability of hepatitis C virus testing methods among injecting drug users'', Drug and Alcohol Review, vol. 27, no. 6, pp. 666-670.View/Download from: UTS OPUS or Publisher's site
The acceptability of testing methods and procedures has implications for uptake of blood-borne virus screening in sentinel samples of injecting drug users (IDUs) likely to participate in surveillance. The aim of the current study was to determine the acceptability of three methods of hepatitis C virus (HCV) testing among injecting drug users (IDUs): oral fluid, capillary blood and venous blood sampling.
Day, C, Thein, HH, Doab, AE, White, B, Dore, GJ, Bates, A, Holden, J & Maher, L 2008, 'Experience of hepatitis C testing among injecting drug users in Sydney, Australia.', AIDS Care-psychological And Socio-medical Aspects Of AIDS/HIV, vol. 20, no. 1, pp. 116-123.View/Download from: UTS OPUS or Publisher's site
Testing injecting drug users (IDUs) for HIV and hepatitis C virus (HCV) provides a useful opportunity for health promotion, risk-reduction assessment and counselling, and increases opportunities for treatment assessment, yet little is known about IDUs experience of testing.
Doab, A, Dawson, A & Nicholls, R 2016, 'Access to abortion in Australia: insights from health care professionals', International Federation of Abortion and Contraception Associates, Lisbon, Portugal.View/Download from: UTS OPUS
Doab, A, Fowler, C & Dawson, A 2014, 'Factors that influence mother-child reunification for mothers with a history of substance use:A systematic review of the evidence to inform policy and practice in Australia.', Australasian Professional Society on Alcohol and Drugs, Adelaide.
Issues: Child abuse and neglect are of national concern in Australia and increasing reports to authorities are placing statutory child protection services under pressure Given the current increases in the number of Australian children in out of home care (OOHC) care, and that a large proportion of children in OOHC are have a parent with a substance use disorder (SUD), it is worthwhile examining the literature to provide evidence to inform the development of preventative and remedial interventions.
Approach: Using a narrative synthesis design, this review explores programs and maternal characteristics that either facilitate or act as a barrier to mother-child reunification in mothers with SUD
Key Findings: Outcomes regarding treatment modality and reunification were mixed. Factors such as presence of a mental health disorder and using opiates and were among several barriers to reunification.
Implications: This has implications for health care planning and delivery for women who use opiates and a have a mental health issue.
Conclusion: Women with SUDs who have a child in out of home care have multiple unmet needs. More comprehensive and integrated care services as well as greater access to primary health care must be considered if we are to improve outcomes and address issues for these women, as well as their children and potential future generations.
Implications for Practice or Policy: Practice and policies that better support mothers with a SUD including reduction of stigma, removal of barriers for treatment access, and increased treatment retention are required. Furthermore, treatment for mental health issues must be better integrated into SUD treatment settings.
Doab, AE 2012, 'Workshop: injecting perfection versus harm minimisation', Sydney.
Doab, AE 2011, 'The Kirketon Road Liver Clinic: the role of the NSP sector in increasing access to hepatitis C testing, monitoring and treatment among at risk populations', NSP workers conference, Sydney.
Doab, AE 2011, 'Reducing the risk: KRC outreach to marginalised young people in inner city Sydney', Youth Health, Sydney.
Doab, AE 2008, 'Injecting drug users perceptions, knowledge and willingness to participate in clinical tiral related to hepatitis C prevention and treatment', International conference on the reduction of drug related harm, Barcelona.
Doab, A, Treloar, C & Dore, GJ 2005, 'Knowledge and attitudes about treatment for hepatitis C virus infection and barriers to treatment among current injection drug users in Australia', Clinical Infectious Diseases.View/Download from: Publisher's site
Despite recent improvements in outcomes of treatment for infection with hepatitis C virus (HCV), very few current injection drug users (IDUs) have access to treatment programs. We examined the natural history of and treatment knowledge about HCV infection and barriers and willingness to seek treatment for HCV infection. A convenience sample of current IDUs (n = 100) with self-reported HCV-positive status drawn from a primary health facility and methadone clinic in inner Sydney completed an interviewer-administered questionnaire. Participants had a reasonable knowledge of the natural history of HCV infection but poorer knowledge of treatment for HCV infection. Most believed that being a current IDU was an exclusion criterion for treatment. Despite this, 70%-80% of IDUs reported that they would consider treatment under current scenarios in Australia: requirement for liver biopsy, subcutaneous injections, common adverse effects, and 40% efficacy. Study participants at the methadone clinic had higher levels of consideration of treatment. These findings support the development of specific education programs regarding treatment for HCV infection for current IDUs. © 2005 by the Infectious Diseases Society of America. All rights reserved.