Ageing Creatively in Rural Areas (ACRA)

The Community-engaged Research in Education, Advocacy, & System Transformation for Equity (CREATE) Project’s aim is to support researchers to work with communities, making change within a framework of social accountability. The project is led by the Northern Ontario School of Medicine, Canada with a number of other global sites including our AWRA work at CQUniversity.

The CREATE Project - Exploring the transformative potential of socially accountable research networks, locally and globally:

How can those who undertake research, across various disciplines and settings, become more connected and accountable to those they are obligated to serve? 

How can we pursue the goal of health equity through the formation of research practices and networks where social accountability is a core value?

For further information, visit the  the CREATE Project website.

Storumans Kommun in northern Sweden is a challenging environment in which to provide elder care. More than 15% of the population is aged 70 years or older. Over 40% live in small villages that can be very distant from health and care services. Overall health for older people is improving, but health needs are increasingly complex. This includes increased cases of dementia and other mental illnesses, chronic illness and multiple co-morbidities that mean a demand for care services even when people are able to mostly live independently. The Kommun provides both in-home care and public housing, but always finds it difficult to recruit and retain care workers. Current models of care are very expensive, and there is a need to find new models. 

For more information contact [email protected]

In her PhD research, AWRA researcher Dr Wendy Newton (link to profile) found that there were few guidelines for including animals in Australian Residential Aged Care Facilities (RACFs), which, with the changes in the New Aged Care Bill 2024, could be problematic for RACFs that are now obligated to provide residents who want animal contact with access to pets or other animals. Some of her research also suggested there could be differences between how metropolitan and regional/rural areas include animals (an area she would like to explore further). Ultimately, she found that there is a need to explore ways to include animals in RACFs that are sustainable by being safe and fun for people and animals. In addition to her thesis, she produced five co-authored papers with her supervisors, Professors Jenni Judd and Tania Signal.  Dr Newton hopes to undertake further research exploring the human-animal bond and its relationship to health and wellness. 

An Ageing population means that health services are dealing with an increasing number of older adults, placing challenges on health care systems. ​ 

Research demonstrates many students who are in the health sciences carry negative views toward older adults, affecting their choice to work with older adults. ​ 

Dr Annie Holt’s (link to profile)  study evaluated whether course curriculum via an experiential learning activity that exposed Pre-Medicine students to older adults in retirement villages, improves attitudes to working with older adults upon graduation. 

Methods

A survey using four validated tools: Australian Ageing Semantic Differential (AASD); Relating to Older People (ROPE); Reactions to Ageing Questionnaire (RAQ); Geriatrics Attitudes Scale (GAS) was implemented. 

Thematic analysis to evaluate students’ reflective essays post-placement was conducted. 

Results

There were significant positive shifts in attitudes toward older adults and Ageing (AASD/GAS), along with improvements in students’ self perceptions of Ageing supported by qualitative analysis. 

Quotes

“She has [resident] greatly influenced my own view on Ageing and continues to break many stigmas and stereotypes often associated with older adults” (P02).​ 

“Reflecting on my own ELJ, it has become apparent to me how harmful and wrong stereotyping, prejudice [towards older adults] and discrimination is” (P09). 

Discussion

Results support the need for educational interventions like the RV-ELJ model for reducing ageism and encouraging a mind-set shift toward working with older adults 

It is important to expose students to settings where older adults live independently to build rapport and breakdown prejudices and stereotypes. This is likely to encourage interest in working with older adults. 

Reference

Holt, A., Mortley, E., & Haydock, C. (2025). The retirement village experiential learning journey (RV-ELJ): An Australian “case study” in university course curriculum to reduce ageism and promote working with older adults. Gerontology & Geriatrics Education, 46(1), 45–61. 

From: 14/02/2020 to 29/10/2021 
Grant: Scholarly project (Internal L&T Grant) 
Funding Schemes: CQU internal Scholarship of Learning and Teaching Grants 2019 

Lead by Dr Annie Holt, with Dr Robyn Preston, this project provided evidence that students require the opportunity to experience working with older adults in placements and given mentorship opportunities to work specifically with older adults. Further research is needed around scholarship of teaching and learning to address attitude- and stereotype-based positive change. 

Quotes:

For one question students were asked to describe the type of people they would like to look after them when they are older. Their responses gave insight into the type of health professional they wanted to be and who might be a good role model:  

Kindness. Respect. Humour, sense of humour. They’re big ones for me. (P02) 

 I think someone who will take my word for what I say and not just write me off as being some … I’ll probably be a crazy old lady when [I’m older]. (P05)  

Probably someone who will take my word for what I say, if I say I’m uncomfortable … you know, actually, genuinely listen to how I feel and respect me as a human being, regardless of how I am in my capacity to do whatever. (P06) 

Reference:

Holt, A. -M., Preston, R., & Guggisberg, M. (2023). “Everyone’s got a story”: Nursing and allied health students’ attitudes (interest, desire and intent) to work with older adults on graduation. Focus on Health Professional Education, 24(3), 31-46.

Dr Robyn Preston is a social scientist specialising in qualitative and mixed methods research. Her research portfolio covers critical areas for prioritised communities, including access to health and community and regional/rural/remote populations, as well as Rural Home-based Aged Care. Robyn possesses extensive experience in complex collaborative projects, often involving partnerships with service, peak bodies, and industry, promoting embedded capacity building and working virtually across different cultures and countries. She demonstrates exceptional leadership in the development and management of strategic research teams and in cultivating productive collaborations and partnerships that drive research impact.

View Dr. Preston's profile. 

Geraldine is an early/mid-career researcher focused on health services and outcomes for priority populations particularly in rural settings. Core member of the ACRA team since 2023, working with consumers, health services and organisations to support meaningful community-led research. Established track record of multi-jurisdictional health services research, including projects examining health outcomes and service access in rural and remote Australia, where community voices and health services have informed its demonstrated policy impact.

In this project she will contribute to research governance, data collection/analysis, support consumer researcher capacity building (particularly focused on housing) and knowledge translation aimed at informing local practice and policy for ageing well in rural communities.

Geraldine will work closely with community partners and industry stakeholders to ensure the research delivers practical benefits for participating communities.

View Dr Geraldine's profile.

Dr Wendy Newton has been a registered nurse for nearly 40 years and she is a certified behavioural dog trainer. Her PhD combined both those skills and was completed in 2024, with a thesis titled Animals in Australian Residential Aged Care Facilities: Provision, Policy, and Practice. Working with the ACRA team while completing her PhD provided her with additional research skills and insight into working in rural areas. Wendy is keen to continue working with the ACRA team and the communities in the Central Highlands. She also hopes to undertake further research exploring the human-animal bond and its relationship to health and wellness. Wendy also enjoys supporting higher degree by research students as they navigate their degrees.

View Dr Wendy Newton's Profile

Lauren is an experienced multidisciplinary mixed-methods researcher, with a PhD in developmental and health psychology. She contributes specialist knowledge of health behaviours, mental health and wellbeing of people in early and later years of life. Her research career has centred on applying strengths-based approaches to wellbeing, resilience, and quality-of-life. Lauren’s recent work has focussed on wellbeing in the later stages of life, using longitudinal evaluation methods to inform implementation of death-literacy and end-of-life care efforts in compassionate communities. She will provide intellectual and practical input into the project’s overall research design and project implementation, including data collection and analysis, report writing and publications.

View Dr. Miller-Lewis Profile

Linda is a mid-career researcher with an established Chief Investigator capability. She has over $2M in competitive external funding ($1.76M HERDC) and a sustained record leading multidisciplinary, community-embedded research with health/wellbeing impact in regional and First Nations communities. Her signature methodology is participatory action research (PAR) with applied arts which positions hard-to-reach populations as co-researchers and health communicators, producing peer-reviewed outputs alongside community-owned artefacts. She holds two Queensland State Health Awards and two CQU VC Awards for Outstanding Research. 

View Dr Lorenza’s Profile 

Prior to becoming an academic at the age of 45, Olav was a farmer and rural-based businessperson, with a significant role as head of iNGO that builds and runs rural/remote Bangladeshi schools. His work in rural and remote access issues is driven by that experience, as well as a range of projects in Australia and Bangladesh. His initial research job examined innovation in HR in SMEs, which gave rise to a stream of interest in small business mindset and entrepreneurship, and another ARC-funded project looking at workplace health in mining, primarily in Queensland. Trained primarily as a social psychologist but working almost exclusively in a business school environment, his experience in social/entrepreneurship includes running multidisciplinary teaching and research teams, eg led the multi-disciplinary multi-university graduate research program for End Food Waste CRC, and appointed Entrepreneurship Champion to the RUN group of universities.

Drawing from his specialist knowledge of the Central Highlands region and social enterprise, Olav will provide intellectual and practical input into the overall research design and project implementation, including evidence-led advice on embedding social entrepreneurship to improve sustainability.

View Prof Muurlink’s Profile

Kim brings demonstrated leadership in community development across the Central Highlands region, underpinned by a strong commitment to community wellbeing, social resilience, regional sustainability and entrepreneurialism. As a long-term resident of the Sapphire Gemfields and Community Development Officer for Capella, she offers deep local knowledge, trusted community relationships, and extensive experience translating community priorities into measurable outcomes.

Over the past 10 years, Kim has led, co-designed, implemented, and evaluated a broad range of community development initiatives across the Central Highlands, working with diverse populations and settings. Her work has focused on strengthening social cohesion, enhancing community resilience, and supporting local communities to address emerging challenges associated with regional change, drought, and fluctuating economic conditions.

A key strength of Kim’s contribution is her ability to bridge strategic priorities with grassroots action. Through her involvement in Community Reference Groups (CRGs), she has facilitated consultation processes, increased community participation, and supported the development and implementation of locally driven action plans. Her work has consistently ensured that community voices inform decision-making and that initiatives remain responsive to local needs. Her community leadership is further demonstrated through numerous governance and volunteer roles.

Ashlyn is an experienced mixed methods researcher with a nursing background who has secured over $6 million in collaborative grant funding working with large research teams. She brings over three years’ sustained, on-the-ground consumer engagement experience as part of the Aging Creatively in Rural Areas (ACRA) team. She fosters genuine, trust-based relationships with rural and remote consumers, a capability built through direct, continuous community engagement. Ashlyn thus brings place-based cultural knowledge and a sustained working relationship with the members and partners of this team. She contributes the methodological expertise including practical community engagement and project delivery expertise that complements the team’s scientific skillset. Ashlyn has driven development of established, ongoing networks with local health services, community groups and informal older-adult networks, providing existing infrastructure to recruit, retain and support consumer co-researchers appropriately and safely. 

Dr Anne-Marie Holt is a public health scientist with a strong interest in gerontology, healthy ageing and workforce preparedness for the ageing population. Her current focus is on workforce issues and encouraging university graduates to value opportunities to work with older people across all health domains in their future career path.

View Dr Anne-Marie's profile. 

Dean is a human geographer with an interest in who lives in, who works in, and who visits small rural areas. He is the project leader for the Storuman Cares initiative in Sweden that is looking at innovative ways to improve aged care services in the sparsely populated north of the country. 

View Prof. Dean's profile. 

Carson, D. B., Brunet Johansson, A., & Carson, D. A. (2024). Who Gives? Non-Commercial Distribution Networks in Domestic Food Production in the Inland North of Sweden. Sustainability, 16(6), 2300. https://doi.org/10.3390/su16062300 

Carson, D. B., Carson, D. A., Lundmark, L., & Hurtig, A. K. (2022b). Resource deserts, village hierarchies and de-growth in sparsely populated areas: the case of Southern Lapland, Sweden. Fennia, 200(2), 210-227. https://doi.org/10.11143/fennia.120788 

Carson, D. B., Johansson, A. B., Schaumberg, M., & Hurtig, A. K. (2024). Addressing the workforce crisis in (rural) social care: A scoping review. The International Journal of Health Planning and Management. https://doi.org/10.1002/hpm.3774 

Carson, D. B., Messmer, R., & Leuf Fjällberg, E. (2024). Creating’good’hospital to home transfers in the rural north of Sweden: informal workarounds and opportunities for improvement. Home Health Care Services Quarterly, 43(1), 18-38. https://doi.org/10.3389/phrs.2022.1604921 

Carson, D., Preston, R., & Hurtig, A. K. (2022). Innovation in rural health services requires local actors and local action. Public Health Reviews, 43. https://doi.org/10.3389/phrs.2022.1604921 

Petrie, S., Carson, D., Hurtig, A. K., Simpson, H., Young, M., Hodge, H., & Gladman, J. (2021). What a pandemic has taught us about the potential for innovation in rural health: Commencing an ethnography in Canada, the United States, Sweden, and Australia. Frontiers in Public Health, 9. https://doi.org/10.3389/fpubh.2021.768624 

Petrie, S., Peters, P., & Carson, D. (2019). Antifragile by design: using antifragility as a guiding principle in future rural eHealth implementation & evaluation. Health Science Inquiry, 10(1). https://doi.org/10.29173/hsi21 

Vaughan, G., Carson, D. B., Preston, R., Mude, W., & Holt, A. M. (2022). A “toolkit” for rural aged care? Global insights from a scoping review. Frontiers in Political Science, 4. https://doi.org/10.3389/fpos.2022.885636