
Dr Vanessa Clark
Post-doctoral Research Fellow
School of Nursing and Midwifery
- Email:vanessa.clark@newcastle.edu.au
- Phone:(02) 40420418
Career Summary
Biography
Vanessa Clark is a post-doctoral researcher in translational asthma research within the Centre for Research Excellence in Severe Asthma. Severe Asthma is a complex disease, which is heterogeneous in it's nature and impacted by several comorbidities and exacerbated by several risk factors. Her recent work focuses around the best approach for the management of severe asthma and how to implement it that approach. This includes a primary care perspective, tertiary care perspective and patient perspective.
In 2015 she was awarded a PhD at the University of Newcastle and has a background in psychology (Ba. Psychology, Hons I), and her overall research interests are chronic illness, health behaviours and mental health.
Research Expertise
Vanessa has experience in quantitative and qualitative research methods. She has experience with multi-centre randomised controlled trials, and research experience with several chronic diseases, including cancer and severe asthma, as well as severe mental disorders.
Qualifications
- Doctor of Philosophy, University of Newcastle
- Bachelor of Psychology (Honours), University of Newcastle
Keywords
- Health Interventions
- Mental Health
- Severe Asthma
Fields of Research
Code | Description | Percentage |
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110203 | Respiratory Diseases | 75 |
111714 | Mental Health | 25 |
Professional Experience
UON Appointment
Title | Organisation / Department |
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Post-doctoral Research Fellow | University of Newcastle School of Nursing and Midwifery Australia |
Publications
For publications that are currently unpublished or in-press, details are shown in italics.
Journal article (10 outputs)
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2018 |
Stain H, Halpin S, Baker A, Startup M, Carr V, Schall U, et al., 'The impact of rurality and substance use on young people at ultra-high risk for psychosis', Early Intervention in Psychiatry, 12 1173-1180 (2018) [C1]
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2018 |
Baker AL, Richmond R, Kay-Lambkin FJ, Filia SL, Castle D, Williams JM, et al., 'Randomised controlled trial of a healthy lifestyle intervention among smokers with psychotic disorders: Outcomes to 36 months', Australian and New Zealand Journal of Psychiatry, 52 239-252 (2018) [C1] © 2017, © The Royal Australian and New Zealand College of Psychiatrists 2017. Objective: People living with psychotic disorders (schizophrenia spectrum and bipolar disorders) have... [more] © 2017, © The Royal Australian and New Zealand College of Psychiatrists 2017. Objective: People living with psychotic disorders (schizophrenia spectrum and bipolar disorders) have high rates of cardiovascular disease risk behaviours, including smoking, physical inactivity and poor diet. We report cardiovascular disease risk, smoking cessation and other risk behaviour outcomes over 36 months following recruitment into a two-arm randomised controlled trial among smokers with psychotic disorders. Methods: Participants (N = 235) drawn from three sites were randomised to receive nicotine replacement therapy plus (1) a Healthy Lifestyles intervention delivered over approximately 9 months or (2) a largely telephone-delivered intervention (designed to control for nicotine replacement therapy provision, session frequency and other monitoring). The primary outcome variables were 10-year cardiovascular disease risk and smoking status, while the secondary outcomes included weekly physical activity, unhealthy eating, waist circumference, psychiatric symptomatology, depression and global functioning. Results: Significant reductions in cardiovascular disease risk and smoking were detected across the 36-month follow-up period in both intervention conditions, with no significant differences between conditions. One-quarter (25.5%) of participants reported reducing cigarettes per day by 50% or more at multiple post-treatment assessments; however, few (8.9%) managed to sustain this across the majority of time points. Changes in other health behaviours or lifestyle factors were modest; however, significant improvements in depression and global functioning were detected over time in both conditions. Participants experiencing worse ¿social discomfort¿ at baseline (e.g. anxiety, mania, poor self-esteem and social disability) had on average significantly worse global functioning, lower scores on the 12-Item Short Form Health Survey physical scale and significantly greater waist circumference. Conclusion: Although the telephone-delivered intervention was designed as a comparison condition, it achieved excellent retention and comparable outcomes. Telephone-delivered smoking cessation support may potentially help to reduce smoking rates among people with psychotic disorders. Discomfort in social situations may also be a useful target for future health interventions, addressing confidence and social skills, and promoting social networks that reduce inactivity.
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2018 |
McDonald VM, Hiles SA, Jones KA, Clark VL, Yorke J, 'Health-related quality of life burden in severe asthma', MEDICAL JOURNAL OF AUSTRALIA, 209 S28-S33 (2018) [C1]
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2017 |
Clark V, Conrad AM, Lewin TJ, Baker AL, Halpin SA, Sly KA, Todd J, 'Addiction Vulnerability: Exploring Relationships Among Cigarette Smoking, Substance Misuse, and Early Psychosis.', Journal of dual diagnosis, 1-11 (2017)
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2017 |
Clark V, Baker A, Lewin T, Richmond R, Kay-Lambkin F, Filia S, et al., 'Self-Reported Reasons for Smoking: Predicting Abstinence and Implications for Smoking Cessation Treatments Among Those With a Psychotic Disorder', Journal of Dual Diagnosis, 13 6-14 (2017) [C1] © 2017 Taylor & Francis Group, LLC. Objectives: People living with a psychotic illness have higher rates of cigarette smoking and face unique barriers to quitting compared t... [more] © 2017 Taylor & Francis Group, LLC. Objectives: People living with a psychotic illness have higher rates of cigarette smoking and face unique barriers to quitting compared to the general population. We examined whether self-reported reasons for smoking are useful predictors of successful quit attempts among people with psychosis. Methods: As part of a randomized controlled trial addressing smoking and cardiovascular disease risk behaviors among people with psychosis, self-reported reasons for smoking were assessed at baseline (n = 235), 15 weeks (n = 151), and 12 months (n = 139). Three factors from the Reasons for Smoking Questionnaire (Coping, Physiological, and Stimulation/Activation) were entered into a model to predict short- and long-term abstinence. The relationship between these factors and mental health symptoms were also assessed. Results: Participants scoring higher on the Stimulation/Activation factor (control of weight, enjoyment, concentration, and ¿peps me up¿) at baseline were just less than half as likely to be abstinent at 15 weeks. Female participants were five times more likely to abstinent at 15 weeks, and those with a higher global functioning at baseline were 5% more likely to be abstinent. There was a positive correlation between changes over time in the Stimulation/Activation factor from baseline to 12-month follow-up and the Brief Psychiatric Rating Scale total score at 12-month follow-up. This indicates that increasingly higher endorsement of the factor was associated with more psychological symptoms. There was also a negative correlation between the change over time in the Stimulation/Activation factor and global functioning at 12 months, indicating that increasingly higher endorsement of the factor led to lower global assessment of functioning. Conclusions: The Stimulation/Activation factor may be particularly important to assess and address among smokers with psychosis. It is recommended that further research use the Reasons for Smoking Questionnaire among smokers with psychosis as a clinical tool to identify specific quit barriers. Further research into why females have higher smoking cessation rates in the short term and relapse prevention interventions seem worthy of further investigation.
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2017 |
Clark VL, Gibson PG, Genn G, Hiles SA, Pavord ID, McDonald VM, 'Multidimensional assessment of severe asthma: A systematic review and meta-analysis', Respirology, 22 1262-1275 (2017) [C1] © 2017 Asian Pacific Society of Respirology The management of severe asthma is complex. Multidimensional assessment (MDA) of specific traits has been proposed as an effective stra... [more] © 2017 Asian Pacific Society of Respirology The management of severe asthma is complex. Multidimensional assessment (MDA) of specific traits has been proposed as an effective strategy to manage severe asthma, although it is supported by few prospective studies. We aimed to systematically review the literature published on MDA in severe asthma, to identify the traits included in MDA and to determine the effect of MDA on asthma-related outcomes. We identified 26 studies and classified these based on study type (cohort/cross-sectional studies; experimental/outcome studies; and severe asthma disease registries). Study type determined the comprehensiveness of the assessment. Assessed traits were classified into three domains (airways, co-morbidities and risk factors). The airway domain had the largest number of traits assessed (mean ± SD = 4.2 ± 1.7) compared with co-morbidities (3.6 ± 2.2) and risk factors (3.9 ± 2.1). Bronchodilator reversibility and airflow limitation were assessed in 92% of studies, whereas airway inflammation was only assessed in 50%. Commonly assessed co-morbidities were psychological dysfunction, sinusitis (both 73%) and gastro-oesophageal reflux disease (GORD; 69%). Atopic and smoking statuses were the most commonly assessed risk factors (85% and 86%, respectively). There were six outcome studies, of which five concluded that MDA is effective at improving asthma-related outcomes. Among these studies, significantly more traits were assessed than treated. MDA studies have assessed a variety of different traits and have shown evidence of improved outcomes. This promising model of care requires more research to inform which traits should be assessed, which traits should be treated and what effect MDA has on patient outcomes.
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2016 |
Sankaranarayanan A, Clark V, Baker A, Palazzi K, Lewin TJ, Richmond R, et al., 'Reducing smoking reduces suicidality among individuals with psychosis: Complementary outcomes from a Healthy Lifestyles intervention study', Psychiatry Research, 243 407-412 (2016) [C1] © 2016 Elsevier Ireland Ltd. This study sought to explore the impact of smoking reduction on suicidality (suicide ideation and behaviour) among people with a psychotic disorder (n... [more] © 2016 Elsevier Ireland Ltd. This study sought to explore the impact of smoking reduction on suicidality (suicide ideation and behaviour) among people with a psychotic disorder (n=235) who participated in a randomized trial of a healthy lifestyle intervention trial. Suicidality, measured by item -4 of the Brief Psychiatric Rating Scale (BPRS) was the main variable of interest. Measures were collected by research assistants blind to treatment allocation at baseline, at 15 weeks (mid-intervention) and 12 months after baseline. Mediation analysis, adjusted for confounders, was used to determine the relationship between smoking reduction and suicidality and to explore whether this was mediated through depression. At 12 months, smoking reduction was found to be significantly associated with suicidality change; an association was also seen between smoking reduction and depression and depression and suicidality. After adjusting for depression, the association between smoking reduction and suicidality was attenuated but remained statistically significant; the proportion of the total effect that was mediated through depression was 30%. There was no significant association between suicidality and treatment group (vs. controls) over time. Our study suggests that smoking interventions may have benefits over and above those for improved physical health, by reducing suicidal ideation in people with psychosis.
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2016 |
Andrews M, Baker AL, Halpin SA, Lewin TJ, Richmond R, Kay-Lambkin FJ, et al., 'Early therapeutic alliance, treatment retention, and 12-month outcomes in a healthy lifestyles intervention for people with psychotic disorders', Journal of Nervous and Mental Disease, 204 894-902 (2016) [C1] © 2016 Wolters Kluwer Health, Inc. Engaging and retaining individuals with psychotic disorders in psychosocial treatments is difficult. Early therapeutic alliance, treatment reten... [more] © 2016 Wolters Kluwer Health, Inc. Engaging and retaining individuals with psychotic disorders in psychosocial treatments is difficult. Early therapeutic alliance, treatment retention, and 12-month outcomes were examined in a subsample of smokers with a psychotic disorder (N = 178) participating in a healthy lifestyles study comparing a telephone versus face-to-face delivered intervention. Therapeutic alliance was assessed using the Agnew Relationship Measure; primary outcomes were treatment retention and changes in symptoms and health behaviors. Contrary to expectations, early alliance did not predict treatment retention. However, elements of both client- and therapist-rated alliance predicted some clinical outcomes (e.g., higher confidence in the therapeutic alliance at session 1 predicted improvements in 12-month depression). Some modest interactions between early alliance and intervention condition were also identified (e.g., clients initially with lower self-perceived initiative, or higher therapist-perceived bonding benefited preferentially from the telephone-delivered intervention), highlighting the need to further examine the interplay between therapeutic alliance and treatment modality.
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2016 |
Stain HJ, Bucci S, Baker AL, Carr V, Emsley R, Halpin S, et al., 'A randomised controlled trial of cognitive behaviour therapy versus non-directive reflective listening for young people at ultra high risk of developing psychosis: The detection and evaluation of psychological therapy (DEPTh) trial', Schizophrenia Research, 176 212-219 (2016) [C1] © 2016 Elsevier B.V. Background Intervention trials for young people at ultra high risk (UHR) for psychosis have shown cognitive behaviour therapy (CBT) to have promising effects ... [more] © 2016 Elsevier B.V. Background Intervention trials for young people at ultra high risk (UHR) for psychosis have shown cognitive behaviour therapy (CBT) to have promising effects on treating psychotic symptoms but have not focused on functional outcomes. We hypothesized that compared to an active control, CBT would: (i) reduce the likelihood of, and/or delay, transition to psychosis; (ii) reduce symptom severity while improving social functioning and quality of life, whether or not transition occurred. Method This was a single-blind randomised controlled trial for young people at UHR for psychosis comparing CBT to an active control condition, Non Directive Reflective Listening (NDRL), both in addition to standard care, with a 6 month treatment phase and 12 months of follow-up. Statistical analysis is based on intention-to-treat and used random effect models to estimate treatment effects common to all time-points. Results Fifty-seven young people (mean age = 16.5 years) were randomised to CBT (n = 30) or NDRL (n = 27). Rate of transition to psychosis was 5%; the 3 transitions occurred in the CBT condition (baseline, 2 months, 5 months respectively). The NDRL condition resulted in a significantly greater reduction in distress associated with psychotic symptoms compared to CBT (treatment effect = 36.71, standard error = 16.84, p = 0.029). There were no significant treatment effects on frequency and intensity of psychotic symptoms, global, social or role functioning. Conclusion Our sample was higher functioning, younger and experiencing lower levels of psychotic like experiences than other trials. The significantly better treatment effect of NDRL on distress associated with psychotic symptoms supports the recommendations for a stepped-care model of service delivery. This treatment approach would accommodate the younger UHR population and facilitate timely intervention. Trial registration: ANZCTR 12606000101583
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2015 |
Baker AL, Richmond R, Kay-Lambkin FJ, Filia SL, Castle D, Williams JM, et al., 'Randomized controlled trial of a healthy lifestyle intervention among smokers with psychotic disorders', Nicotine and Tobacco Research, 17 946-954 (2015) [C1] © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. Introduction: People with severe mental... [more] © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. Introduction: People with severe mental disorders typically experience a range of health problems; consequently, interventions addressing multiple health behaviors may provide an efficient way to tackle this major public health issue. This two-arm randomized controlled trial among people with psychotic disorders examined the efficacy of nicotine replacement therapy (NRT) plus either a faceto- face or predominantly telephone delivered intervention for smoking cessation and cardiovascular disease (CVD) risk reduction. Methods: Following baseline assessment and completion of a common, individually delivered 90-minute face-to-face intervention, participants (n = 235) were randomized to receive NRT plus: (1) a "Healthy Lifestyles" intervention for smoking cessation and CVD risk behaviors or (2) a predominantly telephone-based intervention (designed to control for NRT provision, session frequency, and other monitoring activities). Research assistants blind to treatment allocation performed assessments at 15 weeks (mid-intervention) and 12 months after baseline. Results: There were no significant differences between intervention conditions in CVD risk or smoking outcomes at 15 weeks or 12 months, with improvements in both conditions (eg, 12 months: 6.4% confirmed point prevalence abstinence rate; 17% experiencing a 50% or greater smoking reduction; mean reduction of 8.6 cigarettes per day; mean improvement in functioning of 9.8 points). Conclusions: The health disparity experienced by people with psychotic disorders is high. Faceto- face Healthy Lifestyle interventions appear to be feasible and somewhat effective. However, given the accessibility of telephone delivered interventions, potentially combined with lower cost, further studies are needed to evaluate telephone delivered smoking cessation and lifestyle interventions for people with psychotic disorders.
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Show 7 more journal articles |
Review (1 outputs)
Year | Citation | Altmetrics | Link |
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2010 | Clark VL, 'CBT for Beginners', Drug and Alcohol Review (2010) [C3] |
Conference (4 outputs)
Year | Citation | Altmetrics | Link | ||||
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2014 |
Stain H, Bucci S, Halperin S, Emsley R, Shall U, Lewin T, et al., 'DEPTh: randomized controlled trial of cognitive behavioral therapy for young people at ultra high risk for psychosis', EARLY INTERVENTION IN PSYCHIATRY (2014)
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2012 |
Baker AL, Richmond R, Kay-Lambkin FJ, Filia S, Castle D, Williams J, et al., 'Smoking and healthy lifestyles intervention among people with psychotic disorders: Preliminary results from a randomised controlled trial', Drug and Alcohol Review: Abstracts of the Australasian Professional Society on Alcohol and other Drugs Conference 2012, Melbourne, Vic (2012) [E3]
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2012 |
Baker AL, Richmond R, Kay-Lambkin F, Filia S, Castle D, Williams J, et al., 'A smoking intervention among people with psychotic disorders: Preliminary results from a randomized controlled trial', Asia-Pacific Journal of Clinical Oncology, Brisbane, Qld (2012) [E3]
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2010 |
Filia S, Baker AL, Richmond R, Kay-Lambkin FJ, Castle D, Williams J, et al., 'Randomised controlled trial of a healthy lifestyles intervention to reduce cardiovascular disease (CVD) risk among smokers with psychosis: Interim results', Australian & New Zealand Journal of Psychiatry, Sydney, Australia (2010) [E3]
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Show 1 more conference |
Grants and Funding
Summary
Number of grants | 8 |
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Total funding | $323,801 |
Click on a grant title below to expand the full details for that specific grant.
20173 grants / $25,300
Targeting anxiety and depression in severe asthma: A pilot randomised control trial$20,000
Funding body: Centre for Research Excellence in Severe Asthma
Funding body | Centre for Research Excellence in Severe Asthma |
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Project Team | Vanessa Clark, Vanessa McDonald, Peter Gibson, Amanda Baker, Kerry Inder, Laura Cordova-Rivera |
Scheme | Centre of research excellence in severe asthma seed grant |
Role | Lead |
Funding Start | 2017 |
Funding Finish | 2018 |
GNo | |
Type Of Funding | External |
Category | EXTE |
UON | N |
International Conference Travel Grant$3,300
Funding body: Centre for Research Excellence in Severe Asthma
Funding body | Centre for Research Excellence in Severe Asthma |
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Scheme | Centre for Research Excellence in Severe Asthma: Travel Grant |
Role | Lead |
Funding Start | 2017 |
Funding Finish | 2017 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
FHEAM Research Conference Travel Grant $2,000
Funding body: Faculty of Health and Medicine Research Conference Travel Grant
Funding body | Faculty of Health and Medicine Research Conference Travel Grant |
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Scheme | Faculty of Health and Medicine Research Conference Travel Grant |
Role | Lead |
Funding Start | 2017 |
Funding Finish | 2017 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
20165 grants / $298,501
Translational Research Fellowship- Centre for Research Excellence in Severe Asthma$198,000
Funding body: Centre for Research Excellence in Severe Asthma
Funding body | Centre for Research Excellence in Severe Asthma |
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Scheme | NHMRC- Centre for Research Excellence in Severe Asthma |
Role | Lead |
Funding Start | 2016 |
Funding Finish | 2019 |
GNo | |
Type Of Funding | External |
Category | EXTE |
UON | N |
Research Advantage: Early Career Researcher Research Higher Degree Scholarship$78,864
Funding body: Research Advantage UON
Funding body | Research Advantage UON |
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Scheme | HDR Scholarship |
Role | Lead |
Funding Start | 2016 |
Funding Finish | 2019 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
Assessment of alcohol use in people who are undergoing outpatient treatment for cancer$17,637
Funding body: Hunter Cancer Research Alliance
Funding body | Hunter Cancer Research Alliance |
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Scheme | Implementation Science Flagship Program for Pilot Project Funding |
Role | Lead |
Funding Start | 2016 |
Funding Finish | 2018 |
GNo | |
Type Of Funding | External |
Category | EXTE |
UON | N |
Statistical Support Grant $2,000
Funding body: HCRA Hunter Cancer Research Alliance
Funding body | HCRA Hunter Cancer Research Alliance |
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Scheme | Statistical Support |
Role | Investigator |
Funding Start | 2016 |
Funding Finish | 2016 |
GNo | |
Type Of Funding | Not Known |
Category | UNKN |
UON | N |
Centre for Brain and Mental Health Research- Statistical Support$2,000
Funding body: Priority Research Centre for Brain and Mental Health Research
Funding body | Priority Research Centre for Brain and Mental Health Research |
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Scheme | Priority Research Centre |
Role | Lead |
Funding Start | 2016 |
Funding Finish | 2016 |
GNo | |
Type Of Funding | Internal |
Category | INTE |
UON | N |
Research Supervision
Number of supervisions
Current Supervision
Commenced | Level of Study | Research Title | Program | Supervisor Type |
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2018 | PhD | Anxiety and Depression in Severe Asthma | PhD (Nursing), Faculty of Health and Medicine, The University of Newcastle | Co-Supervisor |
2017 | PhD | Determining Models of Care in Severe Asthma | PhD (Nursing), Faculty of Health and Medicine, The University of Newcastle | Principal Supervisor |
Dr Vanessa Clark
Position
Post-doctoral Research Fellow
Centre for Research Excellence in Severe Asthma
School of Nursing and Midwifery
Faculty of Health and Medicine
Contact Details
vanessa.clark@newcastle.edu.au | |
Phone | (02) 40420418 |
Fax | (02) 40420046 |
Office
Building | Level 2, West Wing, HRMI Building |
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Location | Kookaburra Circuit New Lambton Heights , |