Research

Toddler Research
The toddler years can be an exciting but challenging time for many families, and toddler development and interventions have been a strong research focus for Karitane. In 2022-23, this included three major projects:

follow-up assessments with the 90 families who participated in My Toddler and Me, a randomised controlled trial testing outcomes of Parent-Child Interaction Therapy – Toddlers (PCIT-T) and Circle of Security – Parenting
a pilot research trial examining outcomes of PCIT-T delivered via telehealth, as a preventative intervention for families with young toddlers (12-18 months) and psychosocial risks
pilot trials of PCIT-T group programs at the Karitane Residential Units, and in the community at the Wolli Creek Hub.

Results from these studies were presented at the International Attachment Conference in Lisbon, Portugal (hybrid conference) in July 2022, the Child and Adolescent Mental Health Conference at the Gold Coast in March 2023, and the Australian Rural and Remote Health Symposium in Adelaide in November 2022.

Karitane Family Study
We completed the Karitane Families Study at the Carramar Residential Unit this year. Study results were used to inform the development of a new suite of parent-report outcomes tools that will be implemented at the Karitane Residential Unit in 2023. This includes the Karitane Family Outcomes Tool (KFOT). The study also tested outcomes of the in-person and virtual residential unit programs, with results showing significant gains for families who accessed both programs. Results from this study were presented at the Maternal Child and Family Health Nurses Association conference in Canberra in September 2022.

ForWhen Evaluation
Throughout 2022-23, the UNSW-Karitane research team continued working on the evaluation of the ForWhen program: the Australian-funded perinatal and infant mental health navigation program delivered by Karitane, AAPCH, Parenting Research Centre and UNSW. This evaluation will play an important role in assessing ForWhen’s clinical and implementation outcomes and economic return on investment, as well as informing ongoing service development and delivery. The evaluation protocol was published in BMJ Open in June 2023, and preliminary findings were presented at the International Marce Society conference in London in Sept 2022, the Maternal Child and Family Health Nurses Association conference in Canberra in September 2022, and the International Congress on Evidence-based Parenting Support (I-CEPS) conference in June 2023.

Other Karitane-Led Research Projects
• Emotional connection and contagion – an evaluation of an arts-based and biofeedback professional development program for child and family health nurses and midwives at the Karitane Residential Unit
• PCIT-T as prevention pilot study – a pilot study testing outcomes of PCIT-T delivered as a preventative intervention for toddlers with psychosocial risks
• Keeping the Infant in Mind – a longitudinal study investigating links among parental sensitivity and mentalisation, child temperament factors and callousunemotional traits in early childhood
• The neurobiology of disruptive behaviour disorder subtypes in early childhood and parenting sensitivity – an Australian Research Council funded study investigating the role of the oxytocin receptor gene in the development and treatment of disruptive behaviours in toddlers.

Research Partnerships

We have continued to be a partner on major research initiatives throughout 2022-23, including:

Early Life Determinants of Health clinical academic group within the Sydney Partnership for Health Education
BestSTART-SW (System Transformation and Research Translation) – South Western Sydney Academic Unit for Child Health Research.
We are also an active partner on transnational research grants, including:
NSW Health COVID-19 research grant
NSW Health Translational Research Grant Scheme grant
National Health and Medical Research Council
Partnership Project (2019-23)
Australian Research Council funded partnership project entitled ‘Integrated Kids Hubs – Ensuring Equity of Access for Children’, in partnership with UNSW, Mission Australia First Steps Count Inc., Mission Australia and Australian Research Alliance of Children and Youth.

We’ve partnered with health, community and universitybased organisations throughout 2022-23 to conduct specific translational research projects.

Associate Professor Jane Kohlhoff (group leader)
Ms Nicole Traynor (Research Assistant)
Ms Sophia Harris (Research Officer)
Ms Vivian Chau (PhD student)
Ms Praveena Rajaswaran (PhD student)
Angelique Roth (PhD student)
Amir Nadeem, Jack Vorgias and Sophie Welch
(undergraduate UNSW research students)
The team also collaborated with clinical teams at Karitane, and with researchers and clinicians from across Australia and internationally. The team has experienced significant successes this past year.

Kohlhoff, J., Harris, S., Lawson, K., and Eapen, V. (2023). ForWhen Australian perinatal and infant mental health navigation programme: evaluation protocol. BMJ Open 2023. DOI: http://dx.doi.org/10.1136/bmjopen-2022-070067

Winata, T., M. Smead, S. Cibralic, S. Wang, S. Woolfenden, J. Kohlhoff, J. Preddy, and V. Eapen. Watch Me Grow-Electronic (WMG-E) surveillance approach to identify and address child development, parental mental health and psychosocial needs. Australian and New Zealand Journal of Psychiatry (2022): 250-250.

Cibralic, S., Kohlhoff, J., Wallace, N., McMahon, C., & Eapen, V. (2023). Emotional regulation and language in young
children with and without autism traits. Journal of Early Intervention, 10538151231176188.

Kohlhoff, J., Karlov, L., Dadds, M., Barnett, B., Silove, D., Mendoza Diaz, A., & Eapen, V. (2023). Preschool behavioral
problems: Links with maternal oxytocin and caregiving sensitivity in the postnatal period, and concurrent maternal
psychopathology and attachment state-of-mind. Child Psychiatry & Human Development, 1-11.

Qiu, X., Wu, Y., Sun, Y., Levis, B., Tian, J., Boruff, J. T., ... & Thombs, B. D. (2023). Individual participant data metaanalysis
to compare EPDS accuracy to detect major depression with and without the self-harm item. Scientific reports, 13(1), 4026.

Cibralic, S., Diaz, A., Kohlhoff, J., Karlov, L., Styliankis, A., Schmied, V., Barnett, B., Eapen, V. (2023). The impact of
midwifery continuity of care on maternal mental health: A narrative systematic review, Midwifery, 116:103546. doi:
10.1016/j.midw.2022.103546.

Eapen, V., Winata, T., Gilbert, M., Nair, R., Khan, F., Lucien, A., Islan, R., Masi, A., Lam-Cassetari, C., Diaz MA., Dissanayake, C., Karlov, L., Decallar, J., Eastwood, J., Hassan, I., Jalaludin, B., Kohlhoff, J., Liaw, ST., Lingam, R., Ong, N., Tam, CWM., Woolfenden, S., Barbaro, J. Parental experience of an early developmental surveillance program for autism within Australian general practice: A qualitative study. BMJ Open

Lieneman, C., Kohlhoff, J., Cibralic, S., Wallace, N., Hawkins, N., Morgan, S., McNeil, C. Observational Measurement of
Attachment in Toddlers with Disruptive Behavior Using the Strange Situation Procedure and Attachment Q-Set. Journal of Child and Family Studies

Kohlhoff, J., Lieneman, C., Cibralic, S., Traynor, N., & McNeil, C. B. (2022). Attachment-based parenting interventions and evidence of changes in toddler attachment patterns: An overview. Clinical Child and Family Psychology Review, 25(4), 737-753.