IJMSC Author Spotlight: Yvonne C. Learmonth and Claudia H. Marck

In July 2025, the International Journal of Multiple Sclerosis Care (IJMSC) published “Disaster Preparation for People With Multiple Sclerosis: A Scoping Review of Resources.” Two of the paper's authors recently sat down with IJMSC to talk about the paper.

Yvonne C. Learmonth, PhD, is an associate professor and physiotherapist in the School of Allied Health at Murdoch University and an affiliate senior researcher at the Perron Institute. She completed her PhD at the University of Glasgow and undertook postgraduate work at the University of Illinois at Urbana-Champaign.

Claudia H. Marck, PhD, is an associate professor and deputy head of the Disability and Health Unit in the Melbourne School of Population and Global Health at the University of Melbourne. She completed her PhD at Erasmus University Rotterdam.

International Journal of MS Care: Tell us the story of this paper—where did the idea come from?

Yvonne C. Learmonth, PhD (YCL): The story of the paper that we’re talking about today stems from the identified need to be more prepared ahead of crisis events, particularly for people living with multiple sclerosis (MS) or other chronic health conditions. We noted a few years ago, prior to COVID[-19 and] during the Australian bushfires, that there was a lack of accessibility to health care when these crisis events happened. When we delved a little bit deeper to identify what preparation resources were available ahead of the crisis events [that were] happening, we found a lack of information. This led us to undertake a scoping review to identify resources that were currently available via what we call gray literature. Gray literature is freely available resources that people may access for themselves online. We identified 59 different resources and started filtering down the content of those.

Claudia H. Marck, PhD (CHM): As Yvonne said, we had a major bushfire crisis in Australia, and then 6 months later, that was followed by the COVID pandemic. It made this work all the more urgent.

IJMSC: How did you form the team of researchers/authors?

YCL: Some of the authors, such as myself and Claudia, have been working together for about 8 years or so, and all of our work focuses on MS and health care and health behaviors related to MS. Because we saw that these might be impacted during times of crisis, we formed a team and expanded from there. We’ve got an expert on crisis and disaster resilience in Australia, Professor Lisa Gibbs, and an expert on [post-traumatic stress disorder] and trauma response, Associate Professor Petra Skeffington, and other team members are experts in clinical health and experts in research methods, such as scoping reviews.

CHM: And then we’ve also got a person living with MS on the team as well, which really informs everything that we do.

IJMSC: Can you say a little bit more about that? I know that’s a current focus of research, and [forming] teams of researchers that include people with MS is an important effort.

YCL: Including consumers, or people with a health condition, in all aspects of research is vital and important. It can pivot the research to answer a question [that is] relevant for someone with a health condition, and this is something that we, as a team, have tried to include in all of our research. They give a voice to ideas and experiences that we would not otherwise know. In this project in particular, we worked with someone living with MS, and we involved them throughout the project, asking them questions about whether or not they saw the project [as] relevant, and then we went back to them and got feedback and ideas once we’d identified some of the resources. Also, as part of this project, we went back to a larger stakeholder group, which involved people living with MS and health care providers, and we got their input on what would be ideal content and future resources, if we’re developing them, for people with MS to better prepare for a crisis.

"Including consumers, or people with a health condition, in all aspects of research is vital and important.... They give a voice to ideas and experiences that we would not otherwise know." ~YCL

IJMSC: Was anything about this research surprising?

CHM: This really aligns with what we were just talking about. I think one of the really surprising things was that almost all of the resources, 97% of the resources, didn’t actually report any consumer engagement or involvement of people with MS during their creation. For me, that was quite surprising, because I think the field has been moving in the direction of involving people with MS throughout all stages of research. I know a lot of the resources weren’t focused specifically on people with MS, but I think this goes for people with disabilities or chronic health conditions in general. I think most researchers are moving in that direction, aligning with people who the research is about, to make sure that your study [is] about their wants and needs, and that it is relevant and current….

One of the other surprising things was [that] we used data from the Australian MS Longitudinal Study, a large cohort study in Australia that’s been running for a couple of decades now, and we had about 1500 people with MS answering questions [about] whether they have any sort of crisis or disaster preparedness plan in place, whether for fires or floods or heat strokes or anything like that. It was quite surprising that in a country like Australia, where there are a lot of crises [and] it’s very common to have bushfires and floods, only 17% actually had a plan that met their needs. What further surprised me was that quite a large number of people indicated that they didn’t see a need for such a plan. About 30% said that they didn’t think that they needed a plan.

"...we had about 1500 people with MS answering questions [about] whether they have any sort of crisis or disaster preparedness plan in place.... About 30% said that they didn’t think that they needed a plan." ~CHM

IJMSC: How did you get involved in MS research?

YCL: Two different pathways, I think. My background is as a physiotherapist. I did my training in Glasgow, Scotland, and my road into MS research [resulted from] that and my keen interest in neurological rehabilitation. Then I was lucky enough to be awarded a scholarship from the National Health Service in Scotland to complete my PhD, and that focused on community physical activity programs for people with MS. And I’ve continued working in that area, following up with a postdoctorate at the University of Illinois, and then moving to Australia to continue focusing on MS research, much of which has been funded by the National MS Society in the USA and by MS Australia.

CHM: My pathway was not as deliberate as Yvonne’s, but I’ve had a big interest in public health, preventative health, for a long time. I was lucky to work with someone who managed to get a big grant to look at these things in MS research, and I got involved and moved to the University of Melbourne 10 years ago. I’m very lucky to work with a really great team called the Disability and Health Unit. The focus is on social determinants of health and preventative health for people with disabilities and people with chronic health conditions more generally. I’m really passionate about looking at these factors within the MS population. And I’m lucky, like Yvonne, to have been awarded some funding from MS Australia and other funders to look at that.

IJMSC: We touched on how you came to focus on disaster preparedness. Do you have anything to add?

CHM: It’s becoming more urgent because crises are increasing in frequency with global heating. We’re seeing more heat waves and other events like bushfires. Especially in Australia, it seems to be one after another, and they have compounding impacts, especially for people who are more vulnerable, like people with disabilities and chronic health conditions.

IJMSC: What are some of the things clinicians could do ahead of disasters to help or better support their patients with MS?

YCL: It needs to be a multidisciplinary effort across the health care team. We need to be aware, as Claudia has mentioned, that there are increasing disasters happening in most countries, if not all countries, around the world. Clinicians need to be aware of the vulnerabilities of their patients and why it is particularly important for people with mobility problems, cognitive problems, [and] fatigue and mental health issues [that are] potentially related to the symptoms of MS to have access to support and to prepare ahead of time…and not just reacting when the event is seen on television. It would be useful for clinicians to raise their own awareness and ask their patients questions about whether or not they have access to support, and if they have considered what they need to organize if there [were] a crisis event. In this paper, we identified a good resource from the Australian Red Cross called the RediPlan. It is a step-by-step manual that takes people through how to better prepare themselves a long time ahead of potential crises and disasters. Part of our work in our paper was identifying key areas and questions that might need to be asked. For example, being prepared with medications and maintaining access to them [for the] long term. If you use any mobility devices or you have any service animals, what are you going to do to maintain access to them? It really is all about planning and thinking about these things. Sometimes we don’t want to think about crisis events happening. It can raise anxiety. It can raise worry. But when we’ve asked people to work through some of these documents as part of our wider project, they actually told us that it made them feel more settled and better prepared afterward, even though, initially, it could be a worrying thing to work through. In the end, they were very thankful that they had taken the time to do it.

"In this paper, we identified a good resource from the Australian Red Cross called the RediPlan. It is a step-by-step manual that takes people through how to better prepare themselves a long time ahead of potential crises and disasters." ~YCL

IJMSC: Is the RediPlan something that could be used by people in other countries? Is it translatable or adaptable to other situations?

CHM: I think so. We created some documents around the ReadiPlan that are especially relevant for people with health conditions or disabilities, which we’ve called the MS Crisis Toolkit. This is a free resource on the MS Australia website….A lot of people have told us they find it really helpful to get support from others, whether it’s family or friends or health care providers, when they complete this. We evaluated this crisis toolkit with 14 people with moderate to severe MS who live in crisis-prone areas, so in areas in Australia where they might be at higher risk of being impacted by floods or fires. When their MS nurses offered assistance to complete the toolkit, some people did take them up on that, but other people completed it just with the help of friends and family. And people told us that after they completed the toolkit, they actually felt more confident in being prepared for disasters. They felt better prepared, and they felt more resilient. And that was really important for us to know—that it actually improved these outcomes.

IJMSC: You've talked a bit about how this paper is part of a larger project. What does the whole project look like and what are the next steps?

YCL: This paper is part of a larger project entitled Crisis Resilience in MS. This paper started back in 2020. It was inspired by flooding that had happened in western Australia. Because of this major flooding event, some individuals with MS had gone over a year without access to physiotherapy, and at the time of analyzing some of this data, the bushfires were happening on the other side of the country…. These events impacted not only access to health care, but [also] health behavior, such as people’s ability to maintain physical activity. Because of bushfire smoke, they weren’t able to get outside, they weren’t able to get access to their health care providers, and they potentially weren’t able to get access to friends and family as easily as they would have otherwise. Back then, we started a project looking into the impact of these events and what, potentially, we could do as health care researchers to address it. As we know, not long after the bushfires in Australia, the COVID-19 pandemic emerged and had a worldwide impact that led to an inability to access health care providers. Individuals were told to isolate at home. Even though we might not see that as a typical crisis event, if you are someone [who] needs a lot of support and you have to stay indoors and can’t get access to it, that can really have an impact and limit what you’re able to do with your life. One of our first publications looked at the impact of the COVID-19 pandemic and bushfires, and we identified that physical activity was significantly reduced. This is important because physical activity is the number 1 lifestyle choice and lifestyle medication, as it were, that individuals with MS can use to manage their symptoms and manage their disease progression. The crisis also led to reductions in diet quality as well, which can have an effect because we know that individuals with MS should be following a healthy diet to maintain their symptom management and symptom control. From those, we then looked at access to health care, and we were lucky enough to link up with researchers at the University of Tasmania who host the Australian MS Longitudinal Study. Through that [partnership], we’ve been able to look at the impact over a number of years, including the pandemic [period], of access to health care and things like telehealth, and whether or not that’s an optimal change in health care delivery. Over the 4 or 5 years of this project, we’ve really taken a close look at the impact of crises for people living in Australia with MS, and I think the next step is linked with that crisis toolkit that is available online and seeing whether or not health care providers might be able to better support individuals so they complete this, or whether or not other support services can be available to better prepare people with health conditions ahead of crisis. The hope is that they’re better prepared and not likely to reduce positive health outcomes in the future.

CHM: We’ve looked at the short-term impact of how people felt after completing the crisis toolkit, but I think the long-term evaluation will be really important.

IJMSC: Do you have a list or a website that gathers the papers you've published?

YCL: The nice thing about the crisis toolkit website that MS Australia worked with us to develop is that all of our papers are hosted there. MS Australia is very good at supporting the research that all MS Australian researchers do, and [they] frequently update their information and really turn heavy research into something accessible for individuals who might be short on time or not able to fully understand complex scientific concepts.

IJMSC: One of the pillars of IJMSC and the Consortium of Multiple Sclerosis Centers is multidisciplinary care. What role do you see for your research in MS care? How does research influence or improve patient care?

CHM: Very broadly speaking, I think research, obviously, helps to uncover the biological or genetic mechanisms of MS, leading to better diagnostic tools [and] treatments, which are then usually tested in clinical trials and studies that contribute to new therapies. That’s not the type of research that Yvonne and I are doing. Our research focuses on care practices and interventions such as rehabilitation intervention, and Yvonne’s doing a lot of really important research in the physical activity and exercise space; [she is] also looking at lifestyle modification. My research focuses quite a bit on social determinants of health, looking at that holistic picture of the patient. What I’m hoping to achieve with my research is evidence-based guidelines for health care providers, for people with MS, and for carers that will help improve outcomes, whether that’s mental health outcomes, physical health outcomes, or whether they just have a better experience with their care team. As I said before, for me, it’s really important to continue to work with people with MS in all stages of my research to make sure that it really aligns with patient needs and preferences, and the same with health care professionals. We want to make our research relevant and applicable and translatable. Yvonne and I…work with people with MS, with carers, with advocates, and with health care professionals in all stages of our research, which also makes it really fun.

"...it’s really important to continue to work with people with MS in all stages of my research to make sure that it really aligns with patient needs and preferences, and the same with health care professionals. We want to make our research relevant and applicable and translatable." ~CHM

YCL: The importance of the multidisciplinary team and really engaging with researchers is vital. They definitely can help us bridge the gap between evidence and practice. What we also know is that individuals with MS want to hear evidence from their health care practitioner, who they’re most likely to go to for trusted information. Claudia has already mentioned some of the guideline preparation work that we’ve done and many other researchers have done in this space around the world. But linking with clinicians, researchers, and their patients…is important because it can bridge that junction between evidence and delivery into care. We often work with neurologists, with nurses, with allied health care providers, [such as] physiotherapists, occupational therapists, psychologists, and even social workers…in our work, and we value their opinions and their views because we, as researchers, don’t always have access to the experiences that they do. They really enrich our work and improve outcomes and care for people with MS.

CHM: And as we also have mentioned before, MS Australia plays a really important part because they have a big [role] in terms of policymaking and advocacy efforts, so we really hope that our research informs their efforts. Obviously, the final aim is to improve care for people with MS.

Be sure to keep an eye out as we continue to spotlight other IJMSC authors this fall!