Medical Research Future Fund webinar – From research plan to research proposal – 23 November 2023

 

Dr Masha Somi:

Welcome everyone to the November 2023 Medical Research Future Fund webinar. I’m Masha Somi. I’m the Chief Executive Officer of the Health and Medical Research Office and I’m really pleased today to be co-hosting with the wonderful Caroline Homer who’s the Deputy Chair of our Board, the Board that advises the Medical Research Future Fund providing advice to the Minister for Health and Aged Care.

Before we begin the webinar, I’d like to acknowledge the traditional owners of the lands we’re all joining from today. I’m joining from Ngunnawal and Ngambri country here in the Canberra region, however, acknowledge that there are many lands that we’re all joining from today as this is a video conference.

So today’s webinar is about how MRFF priorities are set and then can be enacted through MRFF funding opportunities and grant applications. The MRFF is a priority-led funder and our focus is on addressing the priorities of consumers and health workers through research. This webinar provides advice for researchers on how to engage with these priorities and it also focuses on the important role of consumers and those with lived experience, the role they can play in priority setting and also in how research addressing these priorities is designed and then implemented.

So this is the outline of today’s presentation. I’m joined by a really wonderful panel, as I mentioned, co-hosting with Professor Caroline Homer who’s the Deputy Chair of our Board. And she’ll talk about how Medical Research Future Fund priorities are set. We also have Professor Maree Teesson and Shannon Calvert who’ll talk about priority setting in two MRFF initiatives and activities, the Million Minds Mental Health Research Mission and the Childhood Mental Health Research Plan. Also joined by Associate Professor Jacqui Macdonald and Professor Michael Berk and together they and Shannon Calvert will talk about how research projects can be designed and implemented around these priorities. So I’ll ask each panel member to introduce themselves as they begin their presentations.

We’ll also take questions at the end of the presentation. You should be able to see a little bar called Slido where you can enter your questions and there’s also an opportunity to like any of the questions that you think are great. I’ll use the number of likes to help prioritise which questions to ask the panel at the end of the session.

So as I said today’s session is about how MRFF priorities are set and can be enacted through research. At the very top of this process are the Australian Medical Research and Innovation Strategy and Priorities and they’re set by our Board, the Australian Medical Research Advisory Board and they’re actually provided to Parliament. They’re actually legislative instruments that are tabled and provided to Parliament. The Minister for Health and Aged Care must consider the Priorities when he’s making investment decisions through the Medical Research Future Fund. So there are absolutely key and critical processes and documents supporting the implementation of the Medical Research Future Fund.

So AMRAB in doing this work, producing a Strategy and the Priorities, undertake a national consultation and the Strategy is provided every five years and the Priorities are updated every two years. Another really important priority document for the Medical Research Future Fund is our 10-year Investment Plan. So the current one is our second 10-year Investment Plan. And that is the document that articulates the Strategy and Priorities into a funding plan that’s then used by the Health and Medical Research Office to run funding opportunities through the Medical Research Future Fund. And the current plan provides $6.3 billion over ten years through 21 initiatives each of which maps to the Priorities that were set by our Board.

So I’ll now hand over to Professor Caroline Homer and she will talk about the current Australian Medical Research and Innovation Priorities.

Professor Caroline Homer:

Great. Thank you so much Masha and a very warm welcome to you all joining this afternoon. I’m joining from Wurundjeri land in Melbourne and it’s a real pleasure to be with you today. So these were the Priorities that were developed in late 2021 and they are for 2022 to 2024. So we’ll be embarking on a similar process that I’m just about to describe to you next year. We always think two years is a long time but it suddenly comes around.

So at the end of 2021, the office of the health and medical research group in the Department of Health developed a Discussion Paper with AMRAB, the Advisory Board that I’m Deputy Chair of. We looked at the Priorities from the previous two years. We also looked at the key health issues facing Australians and also the disease burden. Where are the key issues that are needing to be addressed. Of course this was halfway through COVID, of those first emergency couple of years, so we did most things online in terms of the consultation. But a Discussion Paper was released and then we undertook consultation over a month in October 2021 and many people were invited to submit their thoughts around the Discussion Paper and also their thoughts around what the Priorities should be. And of course that included universities, MRIs, professional colleges, the biotech sector, commercialisation sector and of course consumers and carer groups. And we had about 250 submissions which was just fantastic. It just shows how engaged people are around this important issue. We also had a public webinar that explained the process and we had a series of roundtables that were invited- roundtables addressing key areas.

So that resulted in a long list of priorities that the office then bunched them together and did some synthesis. AMRAB, the Advisory Board, looked at those. AMRAB also includes the CEO of NHMRC so there’s really nice synergies there between the Priorities for MRFF and the potential target areas for NHMRC going forward. And then we came up with this list that you’re seeing on the screen and the list was then presented to the Minister of Health and was signed off in early 2022. So this is the list we’re working with at the moment. As you can see, some of these topics are pretty broad. And so while they are trying to focus health and medical research on these areas, there’s also I think quite a lot of scope within them that we’ll talk about over the next hour anyway.

So I hope that gives you an idea of how we went about actually doing this. There is a process. It happens every two years and then there’s an opportunity when we do it again to reflect and reconsider. So I’ll hand over to Masha now. Thanks everybody.

Dr Masha Somi:

Thank you very much Caroline. So the Priorities that Caroline talked through apply to the whole of the MRFF and the next level of priorities are set at the initiative level. These are the 21 initiatives that I mentioned earlier when I was talking about the 10-year Investment Plan. So 8 of the 21 initiatives are research missions and these 8 research missions address areas of unmet need or areas of transformational potential such as genomics.

We’ve also had some investments in some of our other initiatives that are very into priority areas and one of these is childhood mental health and Maree and Shannon will be able to talk about both the Million Minds Mental Health Mission but also our childhood mental health research investment. So for both the missions and our priority investment areas we have independent expert advisory panels that are appointed by the Minister for Health to provide him with advice on the research investments that are required to generate meaningful change in care and outcomes. So I’ll hand over to Professor Maree Teesson. She was the Chair of the Million Minds Mental Health Research Mission Expert Advisory Panel that worked to establish an implementation plan.

Professor Maree Teesson:

Thank you so much Masha. It’s a delight to be here today and to talk to everyone about my role in being a chair of an expert advisory panel. So I’m Professor Maree Teesson and I was asked to chair the Million Minds Mission EAP and I am joining you from the wonderful lands of the Cammeraygal people.

I was also asked to be a member of the Childhood Mental Health Research Plan Expert Advisory Panel. So I wanted to just give a few words on how the process works with expert advisory panels and hopefully then when you read the research missions and implementation plans from those missions you’ll be able to see how they were developed. So like all expert advisory panels the Million Minds Panel included a range of stakeholders. So we had outstanding, world leading researchers. We had extraordinary clinicians. We had amazing people with lived experience and Shannon will speak more to this in the next little section. And we also had Aboriginal and Torres Strait Islander leaders on the Expert Advisory Panel for the Million Minds Mission.

So importantly it brought all those people together with diverse expertise and experience to really hothouse and debate the investment for the future in the area of mental health research as funded through the Million Minds Mission. We also considered priority populations, communities, First Nations, culturally and linguistically diverse and this also was reflected in the Research Plans and the Implementation Plans where the targeted objectives are also framed around priority populations.

So in addition in Million Minds Mission we also considered emerging issues and remembering that we were developing this in the time of major changes in trends and issues with COVID-19. So why is there a Million Minds Mission? Well the mission supports research to improve mental health by translating research outcomes into practice. And more than four million Australians, adult Australians, will experience a mental illness each year and rates of mental health problems amongst young Australians, children, are also extraordinarily high. So there’s significant disease burden in this area. So the really big aim of the Million Minds Mission is to address the impact of this on people’s lives and to reduce this burden.

The Research Mission supports research that addresses key national mental health priorities and we were very strongly linked to other research priority setting processes, particularly the National Mental Health Research Strategy, which is a very large undertaking by leaders in the mental health space, which summarised the research strategy for mental health. So there’s connections across and that was of course taken into account. And we’re really hoping to improve the lives of one million people who might not otherwise benefit from mental health research.

So I was also asked to just give a really – and I’m seeing in the chat that people are saying they can’t hear. So I’m going to plough on but I’m hoping that that’s being addressed.

I was asked to give an example of how the MRFF Expert Advisory Panel takes into account the incredible Priorities that Caroline outlined. And I just want to give one standout example and I’m hoping for those online I can bring your attention to this because I think it is a really key thing that comes out of the missions and it’s one standout example for me. And that was in strengthening capacity. So a key priority of the MRFF is strengthening health and medical researcher capacity and capability and that was along the bottom of the slide that Caroline just presented. So this also emerged as a key theme in the data that was extracted for the Expert Advisory Panel and the MRFF office provides each expert advisory panel with extensive data on the field that they are developing the roadmap for.

So mental health is a very quickly emerging area. I mean Australia punches above its weight being fourth or fifth internationally for publications and citations but we really need to build capacity. So EMCR-led research was hotly debated in the Expert Advisory Panel but also considered to be absolutely critical. So in the roadmap in the Implementation Plan, you’ll see the development of research workforce as being very important to that roadmap. And so in developing the grants and the plan we also took that into account. So the top ranked grant and the top ranked EMCR-led grant are funded in many of the calls in the Million Minds Research Mission. So this is an EMCR grant, the definition of which is Chief Investigator A is an EMCR and more than 50% of the Chief Investigator team is early or mid-career researcher.

So I’m sure this was a first mission to do this. It was really reflected in the panels and the thoughts and the discussion from the Expert Advisory Panel. And it was also reflected in documents like the National Mental Health Research Strategy which I also was involved with. So a major emphasis and one that I really would want people to think about if they’re looking at investing in this area, to think about that EMCR focus and how we could build the capacity for more EMCRs to lead grants. And I think Jacqui Macdonald is talking a little bit later in the webinar and she is one of the recipients of an EMCR. So that will be nice to hear from her. Thank you Masha.

Dr Masha Somi:

Thank you so much Maree. Thank you for a great overview. Look there’s just a couple of comments in Slido about some challenges with hearing. I guess for those who can’t hear they may not hear me saying, please have a look within Slido because there’s some hints about how to update your settings or your audio arrangements so that any issues will be resolved.

So we’ll now look at consumer involvement in priority setting and just sort of within the context that within the MRFF we’ve been making effort to increase and promote consumer involvement in all levels of research and this has included involving consumers and those with lived experience in priority setting including for the research missions and the priority investments I just mentioned. So I’ll now hand over to Shannon Calvert. So she was a member of the Million Minds Mental Health Mission Expert Advisory Panel and also on the panel supporting the Childhood Mental Health Research Investment. And she’ll talk about her experiences of consumer involvement in priority setting.

Before I do that I just wanted to share the Principles for consumer involvement in research that are used within the Medical Research Future Fund and these were developed by our Medical Research Future Fund Consumer Reference Panel and published earlier this year. And the Panel, the Consumer Reference Panel, provides advice to me and the broader MRFF team on strategies for improving our support for consumers in research design and implementation. The Principles that you can see on the screen set out that consumers wish to be involved in all types and stages of research. They want to be partners with researchers and they want to be involved safely and effectively. It’s also important to note that the Consumer Panel also has a really strong focus on diversity and equity and so that’s one of the Principles that came through that process.

So I’ll just hand over to Shannon now to talk about her experiences on these MRFF priority setting processes.

Shannon Calvert:

Thanks very much Masha and hello to everyone. My name’s Shannon Calvert and I’m joining you from Whadjuk Noongar Boodjar here in Perth, Western Australia. I also just wanted to acknowledge the MRFF in recognising the importance of evolving in research and its understanding of what lived experience engagement looks like more broadly. So to that also acknowledging and recognising my peers in the community. Yes, I sort of bring more of a consumer lens to the space but I know that there is such a rich, diverse community out there from carers and families to siblings and kin, and acknowledging that actually we all bring such a unique, rich, lived experience into the space and so I look forward to that evolving over time.

And so I’m so glad that you touched on the Principles of consumer involvement, Masha, because it’s really interesting to come into the space as someone that is not a researcher and is not an academic and almost have this expectation for myself even, almost like an imposter syndrome, to bring insight or sort of a perspective that’s actually not necessary or required. I think it’s really important to bring the lens of community and come in with curiosity and speak a different language so to speak. Because I think what we’re learning in the context of research is that it’s fundamental we establish ways in which we bring different expertise to complement the skills that we all have, so whether it is the types and unique types of research. But ultimately at the end of the day the focus is to enhance the quality of lives of Australians and to do that and to do that thoughtfully and to be considerate in that process it’s also then recognising that we do at times have a great deal to learn and there’s multiple factors that need to come into consideration.

So I guess when we look at the setting of the priorities it’s always challenging when we’re conscious of the multiple challenges that are faced by Australians experiencing mental health challenges. And none of us ever want to be in that position to pick or choose but at the same time there is a degree of accountability to recognise that there are voices that never get to come to the table, that never get to advocate on their behalf. And so I think it’s really important to actually say well we all have a role to acknowledge that there is those needs out there in the community and how can we best ensure that not only do we need further research in those spaces but also bring the people of the community alongside the process of research. To do research well at the end of the day it’s understanding what the community needs, wants, and they need to learn and understand what it is that they’re contributing towards. There’s nothing worse than ever going into a room and not understanding anything anyone is saying. But when we sort of collectively find a way to meet a middle ground, it enhances the conversation and the richness of the conversation even if at times we have to work through challenging and diverse perspectives.

And so when I sort of came onto the Expert Advisory Panel I was really conscious of expertise I didn’t bring but then I also needed to acknowledge that what I could bring was a lived experience lens in terms of accountability to ensure that it wasn’t about me or my experience but being conscious of what we were missing in that process, and returning back into my community and peers to hear and recognise where there were more broader challenges in our communities and where people weren’t being recognised.

So I think the process of course in itself is very strategic to say the least but I think what I was really encourage over time coming in with a certain degree of vulnerability and almost wanting to sort of hold back and fear that I may not use a language that is not contemporary to the context of research, I realised actually then it was my accountability. If I’d put my hand up to say yes I would come on board that in fact I needed to bring that authenticity into the room so that we could establish really what is it that we need the community to understand. Because for the community to trust the process as well it’s important for them to acknowledge and see what is being done so that there is an extent of accountability because it is very challenging for people with mental health issues and concerns to trust the process when so many have been harmed along the way.

So these conversations emerged authentically in that process and there were times where I think it was about asking questions that I might have raised diverse perspectives that others didn’t understand. And so I do want to acknowledge the Consumer Advisory Panel because I think the process is also taking into account that how we do research well with people with lived experience and community has to be done thoughtfully and in a considerate way. And so to do that I think those Principles are fundamental and I would encourage everybody to please explore those. It’s not so much about saying yes I follow the Principles and I know what they are. It’s truly understanding what they mean and I would implore people to actually go out to lived experience advisory panels and groups out there to actually support your learning and understanding potentially as a researcher in terms of what those Principles mean from both sides.

So it’s been an encouraging learning and it’s definitely a sector and a space in the context of research we are emerging and evolving. I’m encouraged that we do actually have a lot more to learn so as we start to bring more diverse perspectives to the table it’s starting to enhance the way we consider those priority populations for example and actually how it is that we need to – and what we need to do to do research collectively and collaboratively as well. So it’s not just about the community participating in research but having an opportunity to do pro research as well.

So that was reflecting on my examples, my experience initially but it’s certainly been a powerful learning for me and I just wanted to thank the other Advisory Panel members that I have learned a great deal from but also their willingness to sort of be in the grey with me as well. Thanks Masha.

Dr Masha Somi:

Thank you Shannon. So, so far we’ve talked about priorities at the Medical Research Future Fund and the initiative levels and we’ll now move to how priorities are articulated at the grant opportunity level. And that’s the level of which funding is allocated to research through grants. So in our office we review the Priorities and the initiative level priorities when we’re developing grant opportunities. So section 1.3 of all of the guidelines set out what’s to be achieved through the funding and that’s set out in the objectives and the intended outcomes. We always encourage researchers to take a close look at the guidelines especially section 1.3 when considering whether and how to apply. And if there is a research plan or an implementation plan that the grant opportunity is enacting through the funding mechanism that’s always referenced and we encourage people to go back to those original documents, to read them more broadly and understand what the Expert Panel was trying to achieve through the funding mechanisms.

So I’ll now hand over to Associate Professor Jacqui Macdonald. She’ll talk through her process for addressing the Million Minds Mental Health Mission priorities for her MRFF funded project which was called ‘1 in 10 men: informing prevention of and treatment for the paternal mental health problems’.

Associate Professor Jacqui Macdonald:

Thank you Masha and thank you everybody for inviting me to be part of this today. I’m Jacqui Macdonald from Deakin’s School of Psychology and the Centre for Social and Early Emotional Development, but I’m also convenor of the Australian Fatherhood Research Consortium. I’m joining you today from Bunurong land in Melbourne.

And as was mentioned by Maree my application was 50% EMCR-led for which I am extremely grateful that the MRFF made this a possibility. The call that I addressed was specifically for incubator funding to conduct small scale developmental projects that would improve understanding of social determinants of mental health and then inform the prevention of and treatment for mental illness and psychological distress. And I had actually been keeping an eye on MRFF calls for the last couple of years and nothing stood out to me as precisely as this one as the right fit for the program of work that I do. I think the clear alignment with this particular call is very important for the team’s success.

So to put this in context my work centres on men’s and fathers’ mental health from preconception to the early parenting years when we know that one in 10 men will experience psychological distress hence the name of my project. And this occurs in the context of a system that was designed to provide reproductive and perinatal care for mothers and infants but not fathers, and the system is already stretched in supporting mothers. But the workers in perinatal healthcare know that when fathers have mental health problems their partners and their children are also at significantly higher risk but they’re just not resourced or equipped to respond to everyone in the family.

So against that context I’m going to quickly draw attention to three key expectations noted in the scheme guidelines and the Million Minds Roadmap and Implementation Plan that I needed to bring together into a cohesive plan. And these relate to knowledge generation, alignment of that knowledge to a critical issue and to partnerships.

So firstly the call was for an understanding of social determinants of mental health problems and this falls under aim one in the roadmap which is to build a better understanding of the contributing factors of mental illness. So this is very much a knowledge generation aim and that’s perfect for me because my work is primarily with longitudinal cohorts and these offer the best research design to understand the antecedence and determinants of mental health problems. And I work within a wonderful team which has demonstrated this advanced, analytic capacity in cross-cohort analyses and particularly in techniques that are useful for guiding public health advice.

But secondly in the guidelines it was stated that the project needed to assess the potential and feasibility of novel strategies to address critical or intractable health issues. So here the focus is on a critical health issue and on strategy more than knowledge generation. So for my project this critical health issue was our failure to engage and support fathers with mental health concerns and a lack of evidence based programs or infrastructure to facilitate change. And we needed to demonstrate in our application the link between our knowledge generation and a strategy that would address the critical health issues.

And then third there’s a full page in the guidelines encouraging strategic partnerships with health policy and healthcare delivery organisations. So bringing these points together even though the call was for knowledge generation it was also necessary in our mind to demonstrate that this knowledge would become foundational in solving the critical health issue and that this solution would be generated with key strategic partners. And in my case that was with Movember and Healthy Male with whom I was already able to demonstrate emerging collaborations.

So together our team are now creating a fatherhood living knowledge bank of evidence reviews, a fatherhood life course research alliance of longitudinal cohorts, and living guidelines for paternal preconception mental healthcare. That means they’re updated regularly. I detailed in the application how these are foundational in building an evidence-based system of care for fathers from the ground up that will complement the parallel evolved system of care for mothers, but also my team of EMCRs and our wonderful mentors, three of which already have NHMRC investigator grants, were each skilled in various components of the methodologies as well. And as well as that the living components of the knowledge bank and the guidelines that we’re developing are augmented by new technologies and software supports that will expedite the dissemination of evidence for translation. And I draw attention to those points in particular because they match criteria and principles within the guidelines and the roadmaps.

In the application one strategy that we used was under the descriptions of each project component we listed evidence of the capabilities and feasibility examples of prior works by our CIs, work that was formative on the path to our particular project that we were putting forward here. And that was us showing that this didn’t just spring up out of thin air. And this was also a way to demonstrate the methodological skills and the leadership activities of the different members of the team.

So very quickly I’ll also point out that we endeavoured to show that the application ticked off many of the principles of the Million Minds Mental Health mission that you’ll see outlined in the roadmap document. And that is we have an interdisciplinary and international team, our project is translational in nature, it responds to emerging trends and to show this we detailed international and Australian emerging policy in reproductive care and gender equality that showed where the project aligned with new directions. The project incorporates data sharing and harmonisation into its design and uses existing data and established frameworks. And that’s actually a stated funding principle in the roadmap document.

And as well as partners the application detailed how our team would engage with consumer and expert reference groups to codevelop our guidelines with people with lived experiences of both receiving and providing care.

So I don’t have much time so I’ll just finish with a final tip that I consider might be useful and that’s that we tended to use the language of the guidelines and the principles in the application and we did this so that the reviewers would be left in no doubt that we were giving these full consideration.

Finally, I’d just like to thank and acknowledge my CI team and I hope that these reflections are helpful and good luck to everybody with your future applications.

Thanks Masha.

Dr Masha Somi:

Thank you very much Jacqui. Okay. So this slide covers the key considerations when applying to the Medical Research Future Fund and you’ll see on the slide a focus on the objective and intended outcomes that are set out in section 1.3 of the guidelines that I mentioned earlier. And these all link to the MRFF Priorities and also the initiative priorities. We also have an evaluation strategy and framework which links to the broader MRFF Strategy and the impact that the Strategy sets the MRFF to achieve. And we focus on this in the application and assessment process as we want to make sure that every MRFF funded grant is contributing towards the broader MRFF Priorities.

So I’ll now hand over to Professor Michael Berk and he’ll provide some reflections on how to develop a grant application that can meet the Priorities set for the MRFF and the initiative that you’re applying to. His MRFF funded project is called ‘Mental Health Australia General Clinical Trial Network’ or MAGNET.

Professor Michael Berk:

Thank you very much Masha. So I’m Michael Berk. I’m the Director of the Impact Institute at Deakin University which is a transdisciplinary research institute. So I’ll be talking about how we wrote MAGNET to meet MRFF priorities. So we looked at the MRFF priorities and the number one MRFF priority which is consumer research resonated beautifully with what we were trying to achieve because inadequate treatments is a major consumer priority. There’s much literature out there that better and safer treatments is a priority. But we also looked at other MRFF priorities like translation and commercialisation, preventative healthcare as far as trials can inform this. We very strongly focused on health and medical research capability and capacity generation. And lastly we focused on mental health as a priority population but also investing in sub-populations such as First Nations, LGBTQ+ as particular foci.

The way that we invested our resources to meet these was also key in as much as we have platform resources to assist trialists with things like assessments but also we created platform resources to provide consumer driven input as well as First Nations input into the design and implementation of studies. We were also mindful of MRFF strategic priorities and we are fortunate that the development of new therapeutics with potential transformative inputs was one of those as well as the development of a skilled and sustainable medical research workforce with expertise in translation and commercialisation. So that was certainly very helpful to us.

So I’ll tell you a little bit about MAGNET. So we really have the vision of being a leading clinical trial network to generate high quality mental health trials that meet consumer and community needs. Prior to MAGNET there were no mental health clinical trial networks at all in mental health which is a massive shortfall given mental health is the largest burden of disability in the community.

So our mission was really to unify and improve adult mental health clinical trial research and translation and we wanted to create a reusable, sustainable and shared infrastructure to strengthen the capacity, the quality and the effectiveness of mental health clinical trials. It was critical for us at the get-go to ensure that it was seen by the community as a resource that was created for their use and their benefit. So we focused and prioritised transformative mental health research to address major mental health needs and unanswered questions, the kind of studies that can only be done through large scale trials requiring a collaborative network. And we learnt a lot from other successful networks like the ANZICS and the ANZMUSC networks.

We had values in terms of how we planned this including the prioritisation of collaboration, aiming for quality with integrity, inclusivity of our various community partners, transparency in terms of our processes and outputs, reciprocity with respect to mutual benefit for all and an active process of community engagement and communication. So that’s what we tried to do. And if you’ll forgive me, I will highlight four idiosyncratic beliefs I have about how to draft a clinical trial that helps us in guiding our clinical trials.

I’m a great believer in what Tolstoy wrote in Anna Karenina’s Guide to Clinical Trials. Tolstoy wrote that all successful grants are alike and every unsuccessful grant is unsuccessful in its own way. There’s really one way to get a good grant and you can fail in any of a myriad of ways and the result is the same. I think that the area which is the most important in putting together a grant application is creativity. You can spend an awful lot of time choosing the right outcome measure but if the fundamental premise on which your grant application is based is insufficiently impactful you’re not going to have traction. So we worked very hard at kicking the tyres of the actual fundamental idea underpinning the grant because that is where you’re going to live or die.

Another analogy which I find useful is the analogy of surfing. In order to catch a wave you’ve got to get the timing right. We can all think of an idea where the idea is really just too early for the field to be ready for it and unquestionably if you catch the wave too late you’re just going to be dumped into the mud. So you have to time your idea with where the field is ready and where the process and program is ready for your idea. Can’t catch it too early and you can’t catch it too late.

Another very idiosyncratic idea is something we borrow from the NIH system which is the value and importance of an NIH specific aims page. So the NIH mandates that your page one of the grant should be written in a very formulaic way. You’ve got to have an opening with a hook, stating what your knowledge is, what the gaps are, what’s the critical need. You’ve got to talk to the who, why and what of your grant, what’s your goal, what’s your rationale, what’s your objective. You need to define your aims very clearly, your aims and hypotheses and your payoff. What reinforces the need for an NIH style specific aim page as your page one is when you send your grant round to your colleagues to review you’re going to get huge amounts of edits to your first paragraph, quite a lot of edits to page one in general, and nobody is ever going to edit page eight of your grant. And that’s how reviewers read them. If your page one is not great you’re dead in the water. The cliché I use is you get all your brownie points on your first page by having the idea right and from pages 2 to 8 you can only lose points because your pilot data is not right, your stats aren’t right, your health economics isn’t right etcetera. So the critical page is page one.

The other thing that we were very focused on in terms of our MAGNET grant is looking at sustainability which is a major challenge for us in running a clinical trial network. It’s one thing to get a network started but we’ve needed to face the challenge of how we maintain sustainability when the grant itself winds down.

But I think I’ve used my time so thank you very much for the opportunity to talk to you about this issue.

Dr Masha Somi:

Thank you Michael. So consumer involvement in proposed projects is a key part of the MRFF assessment process and this slide shows how consumer involvement is embedded in the three weighted assessment criteria. And it also shows that we have additional assessment components for any research that involves the priority populations that are laid out in the slide. So I’ll now pass back to Shannon to talk about the role of consumers in research projects.

Shannon Calvert:

Thanks Masha. And I think this is a topic I’m incredibly passionate about because I think we’re all learning in the process. So I don’t think any of us come with a way of knowing that we can do it perfectly but it’s really important that we collectively determine ways in which we work with each other and potentially bring people with lived experience and those from the community as part of the research and not just participating in the research.

And look I acknowledge that there is so much to learn in this process. We hear the co-design and co-production word a great deal. But I think ultimately at the end of the day if you maintain transparency and authenticity with those that you are hoping to collaborate with I think ultimately at the end of the day there is a trust that can be built there to determine the process rather than you feeling this pressure on yourself potentially as a researcher to figure it out on your own. And so I think there’s a lot to be said about learning and upskilling around how we can do this collectively moving forward and by do this I mean work in collaborative ways.

I guess the role of consumers and research is really paramount and we’re learning this, but the role of lived experience more broadly as well. We acknowledge that there’s not enough research being done for carers and families or even for siblings. But if you look at the priority populations, the Aboriginal and/or Torres Strait Islander people, older people experiencing disease of ageing and people with rare or currently untreatable diseases and conditions and those in remote and rural communities, if you think even in that sort of cohort the uniqueness and diversity within that cohort is so critical to take into consideration because one voice will never be the same as every voice and I think it’s really important to acknowledge that there will be diverse needs.

And to that I think it’s about ensuring that the perspectives, experience and the needs of individuals directly affected by these priority areas are integral to that actual research process. So there’s multiple ways in which you can engage with lived experience and as I was touching on the consideration of co-design and co-production, although that is ultimately the most positive way in terms of sharing that perspective. You can also do really good consultation. It’s just knowing that you can versus what you can’t do in scope. But I guess the consultation is that fundamental form of involvement. It will entail seeking input from those in the community to actually understand their perspectives on how they understand research priorities and methodologies. We look at the concept of translation and ultimately can we say to people on the street this is what we’re doing and this is why it’s important because if they can’t understand then I think we need to take a step back and find that middle ground to make sure that there’s a shared understanding of the importance of this research and the research that you’re conducting.

It's always tricky to listen actively and value the lived experience of those who navigate complexities within the healthcare system but a whole lot of you feel confident that people will be very willing and open to learning with you and supporting that process. And so it’s not just about lived experience learning from researchers but I think it’s fundamental for researchers to learn from those with lived experience in community.

I guess the more sort of deeper step is collaboration which obviously is that level of involvement where we now have people from the community and with the lived experience that is specific to the type of research that you’re doing who are walking alongside you to do that research and it starts to get to more the co-research opportunity. This is a partnership now and this is where it’s more inclusive, it’s holistic and it ensures that the outcomes resonate with the realities actually faced by those that you are focusing your research on.

We do talk about consumer-controlled research which I guess represents a powerful paradigm shift. I think now we actually start to bring people from the community to take leading roles. And these are opportunities. It’s not the expectation that people wear both hats and I think it’s providing opportunity that we don’t initiate people wear multiple hats but we provide and capacity build people in the community to actually come and start to co-lead that research process as well. Bearing in mind that there is a lot to learn from both sides but it’s about people participating in your study design and the implementation. And this approach I think empowers people from the community as well to shape the research agenda with you and will very much allow for the opportunity to enhance that the work that you do is more person-centred as opposed to being patient or clinically centred or medically centred.

I guess in the context of the MRFF Priorities aligning lived experience involvement with these research opportunities contributes to that effectiveness and relevance of the study. So that is absolutely important, and knowing and understanding what lived experience engagement looks like on multiple levels. There will be some that will bring expertise on implementation of advisory groups and working groups but I think it’s important to ensure that the research directly addresses the needs of those priority populations because ultimately if you don’t do that the outcomes I would argue would be more [*less] applicable and impactful.

So I guess the closing of that is the involvement of people from the community and those with lived experience in research projects is not and cannot be a checkbox process. It is just a fundamental necessity and it’s about us all being accountable and recognising the inherent values of people with diverse perspectives from lived experience and those that actually are living with the challenges especially those in the priority areas and we are learning more from our young people, from our children how mental health challenges and complex needs are advancing. So it’s not people that are complex. It’s their circumstances and the world that we live in and the dynamics that we have to face. And so as we sort of move forward I think without acknowledging that our world will be incredibly diverse and continue to be we always need to be sort of on the top of our game to consider the needs of the people that we are focusing on with doing our research.

So I guess collectively I think we all have the same priority. We all hope to enhance true progress in the research process. But then ultimately I think to do that it would be about integrating the voices. But it’s not only just the voice. The insights of those that we aim to serve and support and to improve their quality of life. And so I think if you use the opportunity to step back and explore what genuine engagement will look like for you undoubtedly the outcomes will be far richer and certainly enhance the lives of many Australians as well. Thank you.

Dr Masha Somi:

Great. Thank you so much Shannon for the update or for the commentary. I just want to quickly throw to Caroline just to offer her a quick opportunity just to give a bit of a summary or an overview of what we’ve heard from the panellists and any of your thoughts.

Professor Caroline Homer:

Thank you so much Masha and thank you to the fantastic panellists. And I can see lots of questions coming in as well. I mean I think you’ve heard some specific information about the Priorities and the missions or the expert advisory panels, Maree certainly talked through this and Shannon as well, and I think that’s really helpful to understand where these things come from. But I guess you also heard some very nice general advice about grant writing particularly from Jacqui and Michael I think. And Jacqui really talked about the importance of looking at the objectives, the outcomes, the eligibility sections and really reading those documents. I know we’re all in a hurry when we’re writing a grant. We haven’t got time to read all the documents. We just want to write the grant. But I encourage you to spend a couple of hours on the MRFF and the NHMRC websites just looking at the documents, looking at what you’re doing, who you‘re writing for, before you hit that keyboard I think.

I thought Michael’s comment about timing was really good and that’s really relevant for the priorities. It may not be your time. The priorities may not fit your studies at the moment and you may be better off spending this next year or so or two years doing all the other sort of work to get in the best place for when the right grant comes along. And I also really like the advice about making it easy for the reviewers and thinking about your reviewers. And the reviewers now include consumers or lived experience advocates. So, yes, you have to write technical language but make it easy for the reviewers. Write that first page. I love that Michael. The first one page to get people engaged. And then think about your readers. Frankly we’re usually reading them late at night or after a long day and sometimes with a glass of wine. So make it easy for your reviewers. Make it that they just are so engrossed that they can’t stop reading.

And get lots of peer review from your friends, from your colleagues, from people out of your field as well I think. Don’t wait for your feedback at a grant review panel. Get that before you go into the grants. So thanks everybody. Masha I know we’re running out of time but over to you to just take some of the questions.

Dr Masha Somi:

Thank you so much Caroline. And this one I might throw to you Michael. So it’s the most popular question so far.

Q:         Can you give some examples or maybe one example given the time or some ideas around what meaningful consumer involvement might look like for basic science?

So if I can throw to you on that one.

Professor Michael Berk:

That is such an important question and it’s one that we really have grappled with. Because we understand in our network if you’re doing a study on trauma, that resonates, that makes sense. If you’re studying calcium-calmodulin kinase II, you’re going to have trouble. So you need to engage consumers at the level of which the fundamental mission of the project resonates with consumer needs. So calcium-calmodulin kinase II may not resonate easily but if you can create a resonance with why this regulatory protein might lie at the heart of a disorder that you’re trying to solve that is a major burden or disability you need to sell that and you need to communicate that.

And then we often find that we get very useful input for consumers even though the idea itself might be rather arcane because there are many points of intersection and many points of resonance where consumers need to provide input into this or how this is going to impact consumers or how they might think that the project might be framed. And so we’ve got incredibly useful input even in relatively arcane fields. But it’s a really complex issue. We need to get this right. We need to get input where the priorities are most tightly resonant and we don’t want to compromise pre-clinical research because the resonance isn’t obvious. That’s a tightrope we have to walk and it’s one that we really struggle with.

Dr Masha Somi:

Thank you. Thank you Michael. So I might just quickly take the next question because it’s a little bit more of a program one.

Q:         Is there a reason why we receive no feedback at all on non-successful grants? Hard to know how to improve with no feedback.

Just to let everyone know that we have been able to implement a process with Business Grants Hub for the grants that they assess or they support assessment of for the MRFF. And feedback is provided to all applicants, successful and unsuccessful. We have been working with NHMRC for a while now asking for implementation of a feedback model and that’s something that they’re looking at for us. So I recognise this is a really important issue and that keeps being raised with us but just want to let people know that it’s on our radar and we are working actively with NHMRC to introduce a feedback system.

I might ask you this one Maree.

Q:         If a grant call doesn’t specify that the CIA must be an EMCR, can EMCRs be successful in applying as a CIA in more general calls if they can demonstrate strong support from a team with co-CIs with more well established track records?

And I’ll just pipe in and say it does happen. It happens quite a bit in the MRFF that our successful grantees are early to mid-career researchers. But I’ll hand over to you Maree to respond in a more fulsome way.

Professor Maree Teesson:

Thanks Masha. And yes absolutely. We did see that. We wanted to supercharge that actually. That’s why in the Million Minds Mission it was the case that the top funded grant and the top funded ECR grant would be successful – sorry the top-rated ECR grant would be successful. We also knew that both of those, the top-rated grant, could be led by an ECR. So it might be that in any call the two grants that get funded are both funded by ECRs. I would just harp back to what Michael and also what Jacqui said. It’s the idea and it’s the creativity that should count. And if you’ve then got a backup of your team then in the general funding round then those things ticked you have a really good chance of being successful. But I know it does happen Masha but it is a tough field. It’s a tough space and it is really hard when you’re EMCR and your ten years out from your PhD. That’s why we wanted to make sure some rounds were specifically targeted to EMCR-led research.

Dr Masha Somi:

Great. Thank you so much Maree. And we’re right on three o’clock everyone so I’ll just take a moment to wrap up. I’d really like to thank my co-host Caroline Homer and also the wonderful panel for all of the great insights that they were able to share with us. And thank you to everyone for attending and asking some really great questions as well. The webinar will be made available including the slide deck. That was a question. It will be made available on the Health website shortly. Thank you all again and look forward to seeing you at the next webinar.

 

Professor Caroline Homer:

Thanks everyone. Take care.

Professor Maree Teesson:

Thank you.