Crossroads

Project Details

Longitudinal study of health, disease and access to care in rural Victoria: the Crossroads follow up study.

The Crossroads II study 2016-2018 is a population health study that repeats the original Crossroads I study undertaken in 2001-2003. Crossroads is one of the most detailed health studies undertaken in rural Australia providing vital health data to local services for service planning and improvement in the region and to attract funding to help meet local needs.

3,600 households were randomly selected and visited by trained research assistants. Of these, 1,900 households (overall response rate 59%) agreed to participate in the study with a total of 2,680 adults completing a detailed health questionnaire asking about health conditions, service use, concerns about health and demographic questions. Following, 743 of those adults surveyed attended a 2-hour health screening clinic that included assessment of dental health, lung function, mental health, liver health, hearing, body mass index, cardiovascular health and cognitive function.

This study compares rates of self-reported, undiagnosed and under-managed chronic disease between the baseline (2001-2003) and the current (2016-2018) study periods. The study also compares the self-reported waiting times and other barriers to accessing primary care, community services, dentistry, allied health, mental health, and specialist care. The data will be used for service planning and improvement in the region.

Researchers

Chief Investigators:

Associate Investigators:

  • Professor Rodrigo Marino, Melbourne Dental School, University of Melbourne
  • Professor Bill Adam, Department of Rural Health, University of Melbourne
  • Associate Professor William Kemp, Alfred Health
  • Ms Leigh Rhode, Gateway Health
  • Associate Professor Ravi Bhat, Department of Rural Health, University of Melbourne

Collaborators

Goulburn Valley Health

Primary Care Connect

Benalla Health

Cobram District Health

Seymour Health

The Alfred

Goulburn Valley Primary Care Partnership

Shepparton Access

Moira Shire

Greater Shepparton City Council

Partners

Funding

This research was funded by the National Health and Medical Research Council (NHMRC) and the local health and community partners listed above. The research acknowledges the Australian Government Department of Health's Rural Health Multidisciplinary Training Program.

Research Outcomes

Crossroads II 2016-2018 reports are available below (following publication). The Community Reports for Crossroads I 2001-2003 are also linked below.

Crossroads II  - Summary reports

Crossroads II - Full Reports

Crossroads I Reports

Research Publications

2023 - 2025

Vaz, K., Kemp, W., Majeed, A. et al. MAFLD but not MASLD increases risk of all-cause mortality in regional Australia, with components of metabolic syndrome exacerbating factors: 20 year longitudinal, cohort study. Hepatol Int 19, 384–394 (2025). https://doi.org/10.1007/s12072-024-10748-5

Vaz, K., Kemp, W., Majeed, A., Lubel, J., Magliano, D. J., Glenister, K. M., Bourke, L., Simmons, D., & Roberts, S. K. (2025). Validation of serum non-invasive tests of liver fibrosis as prognostic markers of clinical outcomes in people with fatty liver disease in Australia. Journal of gastroenterology and hepatology, 40(1), 241–249. https://doi.org/10.1111/jgh.16774

Glenister L, Bourke L, Simmons D. (2025, October). A detailed investigation into rural health in northern Victoria: Crossroads-II study overview. Rural and Remote health Scientific Symposium 2025, Alice Springs, Australia.

Bourke L, McNeil R, Thompson S, Debenham J, Freire K, Harvey P, Brown L (2025). Policy driven community development in rural and remote Australia: Analysis of University Departments of Rural Health using the Community Capitals framework. Journal of Rural Studies, 117, 103658. https://doi.org/10.1016/j.jrurstud.2025.103658

Vaz, K., Kemp, W., Majeed, A., Lubel, J., Magliano, D. J., Glenister, K. M., Bourke, L., Simmons, D., & Roberts, S. K. (2024). NAFLD and MAFLD independently increase the risk of major adverse cardiovascular events (MACE): a 20-year longitudinal follow-up study from regional Australia. Hepatology international, 18(4), 1135–1143. https://doi.org/10.1007/s12072-024-10706-1

Mariño, R.; Glenister, K.; Bourke, L.; Simmons, D. Prevalence of Medical Conditions and Medication Usage: Implications for Oral Health among Older Adults in Rural Victoria. Appl. Sci. 2024, 14, 7270.

Glenister, K., Gray, S., Bourke, L., & Simmons, D. (2024). Management of chronic pain in a rural Australian setting: Findings from the Crossroads-II mixed-methods study. Australian journal of general practice, 53(1-2), 62–69. https://doi.org/10.31128/AJGP/01-23-6695

Glenister K, Bolitho, L, Bourke, L & Simmons, D. Prevalence of atrial fibrillation in a regional Victoria setting, findings from the crossroads studies (2001–2003 and 2016–2018). Aust J Rural Health. 2023; 31: 80– 89. doi:10.1111/ajr.12914

Dashputre, A., Agho, K.E., Piya, M.K. et al. Prevalence and factors associated with mental health problems of psychological distress and depression among rural Victorians – analysis of cross-sectional data (Crossroads II). BMC Psychiatry 23, 450 (2023). https://doi.org/10.1186/s12888-023-04931-5

2020 - 2022

Kemp, W., Clayton-Chubb, D., Majeed, A., Glenister, K. M., Magliano, D. J., Lubel, J., Bourke, L., Simmons, D., and Roberts, S. K. (2022) Impact of renaming NAFLD to MAFLD in an Australian regional cohort: Results from a prospective population-based study. Journal of Gastroenterology and Hepatology, 37: 395– 403. https://doi.org/10.1111/jgh.15723.

Marino, R; Glenister, K; Bourke, L; Morgan, Ml; Atala-Acevedo, C; Simmons, D. (2021) Patterns of use of oral healthcare services in rural adults: The Crossroads II Dental sub-study. AUSTRALIAN DENTAL JOURNAL (accepted) 2021.

Roberts, S. K., Majeed, A., Glenister, K., Magliano, D., Lubel, J. S., Bourke, L., . . . Kemp, W. W. (2021). Prevalence of non-alcoholic fatty liver disease in regional Victoria: a prospective population-based study. MEDICAL JOURNAL OF AUSTRALIA, 6 pages. doi:10.5694/mja2.51096

Glenister, K. M., Guymer, J., Bourke, L., & Simmons, D. (2021). Characteristics of patients who access zero, one or multiple general practices and reasons for their choices: a study in regional Australia. BMC FAMILY PRACTICE, 22(1), 11 pages. doi:10.1186/s12875-020-01341-4

Glenister, K., Kemp, W., Tomic, D., Simmons, D., & Roberts, S. (2020). Prevalence of Hepatitis C and treatment uptake in regional Victoria. AUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, 44(6), 514-516. doi:10.1111/1753-6405.13040

Simmons, D., Glenister, K., Magliano, D. J., & Bourke, L. (2020). Changes in prevalence of diabetes over 15 years in a rural Australian population: The Crossroads Studies. DIABETES RES CLIN PRACT, 170, 108492. doi:10.1016/j.diabres.2020.108492

Glenister, K., Bourke, L., Terry, D., Simmons, D. (2019) Chronic Ill Health in a Regional Victoria setting: a 13 year comparison. AUSTRALIAN JOURNAL OF RURAL HEALTH, 00 1-8. (Crossroads-1)

Glenister KM, Simmons D. (2019) Hearing loss and access to audiology services in rural Victoria: Findings from the Crossroads Study. NOISE AND HEALTH. (2019), 21(102): 217-222. (Crossroads-1)

Glenister KM, Bourke L, Bolitho L, Wright S, Roberts S, Kemp W, Rhode L, Bhat R, Tremper S, Magliano DJ, Morgan M, Marino R, Adam W, Simmons D. Longitudinal study of health, disease and access to care in rural Victoria: the Crossroads-II study: methods. BMC PUBLIC HEALTH,18:670.

Research Group

Rural Health Services Research

Key Contact

For further information about this research, please contact the research group leader.

Department / Centre

Rural Health

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