‘Your Fertility’ is an Australian government funded fertility and preconception health promotion program. To inform the program’s content and dissemination strategies we were funded to conduct four studies. We reviewed the literature on men’s fertility-related knowledge, attitudes and behaviours and analysed data from focus group discussions with men about their fertility awareness. We found that men want and expect to have children but have inadequate knowledge about the factors that affect male and female fertility.
We also conducted two surveys where we explored general practitioners’ and Maternal and Child Health Nurses’ attitudes and practices relating to preconception health promotion. Both groups felt ill-equipped to discuss preconception health with their patients and wanted more education and resources to improve their capacity to do this. The findings of these studies are used to develop information about fertility and preconception health for men and primary health care providers.
We partnered with Victorian Assisted Reproductive Treatment Authority (VARTA) and Andrology Australia for this project, which was funded by the Australian Government Department of Health.
Hammarberg K, Taylor L: Survey of Maternal, Child and Family Health Nurses’ attitudes and practice relating to preconception health promotion. Australian Journal of Primary Health 2019, 25(1):43-48, https://www.ncbi.nlm.nih.gov/pubmed/30711021
Hogg K, Rizio T, Manocha R, McLachlan R, Hammarberg K. Men’s pre-conception healthcare in Australian general practice: GPs’ knowledge, attitudes and behaviours. Australian Journal of Primary Health, 25(4):353-358, https://doi.org/10.1071/PY19069
Holt L, Hammarberg K, Holton S, Australian men’s fertility information seeking attitudes and behaviour: a qualitative investigation, Under review.
Many common adult non-communicable diseases (NCDs), particularly cardiovascular, metabolic and respiratory conditions, have their origins in early life, possibly before birth. The risk trajectories track through childhood until clinical disease manifests in adulthood. Conception by assisted reproductive technologies (ART) has been suggested as adding to the risk profile for a range of adult onset NCDs. However, adequately powered and detailed studies are lacking. As the number of ART-conceived children reaching adulthood is accumulating, any health problems associated with ART that manifest as the child grows older will result in the magnitude of these problems increasing dramatically in the near future.
The aim of this study was to compare the health outcomes for adults aged 22-35 years old who were conceived via ART compared with adults of the same age conceived without use of ART. This study addressed significant gaps in knowledge of outcomes beyond adolescence and showed that young adult reported outcomes were similar for both groups.
We partnered with the Murdoch Children’s Research Institute for this study, which was funded by the National Health and Medical Research Council (NHMRC).
Halliday J, Lewis S, Kennedy J, Burgner DP, Juonala M, Hammarberg K, Amor DJ, Doyle LW, Saffery R, Ranganathan S et al: Health of adults aged 22 to 35 years conceived by assisted reproductive technology. Fertil Steril 2019, 112(1):130-139.
Novakovic B, Lewis S, Halliday J, Kennedy J, Burgner DP, Czajko A, Kim B, Sexton-Oates A, Juonala M, Hammarberg K et al: Assisted reproductive technologies are associated with limited epigenetic variation at birth that largely resolves by adulthood. Nature Communications 2019, 10(1):3922.
Juonala M, Lewis S, McLachlan R, Hammarberg K, Kennedy J, Saffery R, McBain J, Welsh L, Cheung M, Doyle LW et al: American Heart Association ideal cardiovascular health score and subclinical atherosclerosis in 22-35-year-old adults conceived with and without assisted reproductive technologies. Hum Reprod 2020, 35(1):232-239.
Review and Evaluation of The Jean Hailes for Women’s Health Anxiety Portal and e-resources for women and anxiety
Fisher J, Kirkman M
Jean Hailes for Women’s Health (JH) invited Professor Jane Fisher, Dr Maggie Kirkman, and Sarah Ashton from Monash University to review JH’s Anxiety Portal to ensure that the information it contains is evidence-informed and up to date. The Portal and its linked sites and documents were assessed to establish the currency, sufficiency, and salience of the content. Available e-resources for anxiety treatment in Australia were reviewed to identify those suitable for recommendation to women using the portal. The project team assessed the JH Anxiety Portal as a valuable resource for women and potentially also for the wider community.
We acknowledge the ground-breaking work of JH in establishing this portal. We recognise that it was necessary to begin with a focus on JH’s traditional audience of predominantly well-educated women and to present the most popular treatment. We suggest that it is now time to update and diversify the content of the portal to be of value to the diverse women in our community.
A report was submitted to The Jean Hailes Foundation, the funder of the project.
Health Professionals’ and Women’s Information Needs (Endometriosis and Menopause Research)
Fisher J, Rowe H, Hammarberg K, Brown H, Langford K, Camilleri R, Dwyer S, Wilby L
Health education and promotion resources and clinical tools are important sources of information and support for consumers and health professionals. Jean Hailes for Women’s Health was contracted by the Victorian Government Department of Health and Human Services to develop a set of comprehensive evidence-based women’s reproductive health promotion resources. To inform these, this collaboration had two aims. First, to establish women’s and health professionals’ needs and preferences for endometriosis and menopause-related information, and translate this to inform the development of up-to-date, evidence-based resources. Second, to establish the quality of online information about menopause and endometriosis using the Health On the Net (HON) criteria.
The Jean Hailes Foundation was our partner and funder for this project.
Rowe H, Hammarberg K, Dwyer S, Camilleri R, Fisher J, Improving the quality of care for women with endometriosis: qualitative analysis of women’s and health professionals’ views. J Psychosom Obstet Gynaecol. 2019 Nov 6:1-7. doi: 10.1080/0167482X.2019.1678022, https://www.ncbi.nlm.nih.gov/pubmed/31691598
Camilleri R, Dwyer S, Rowe H, Fisher J, Hammarberg K, How comprehensive and reliable is online information about menopause? Under review.
Fertility information needs and preferences of women with polycystic ovary syndrome (PCOS)
Hammarberg K, Holton S
Some women who have polycystic ovary syndrome (PCOS) experience difficulties when they try to conceive. The aim of this study was to identify the fertility and childbearing concerns and information needs and preferences of women with PCOS. Women with PCOS took part in an online discussion group where they were asked about fertility and childbearing, the sort of information they would like about fertility and PCOS, and when they would like to receive it. They indicated that they were concerned about their fertility, including whether they could become pregnant, how to prepare for pregnancy and what they should do before trying to conceive given their PCOS. They also said that they found it difficult to get information about fertility and childbearing that was up-to-date, relevant and reliable. The Victorian Assisted Reproductive Treatment Authority (VARTA) use the research findings to develop information for women with PCOS.
VARTA was our research and funding partner for this project.
Secondary analysis of data from the 2017 Jean Hailes annual survey of women
Hammarberg K, Fisher J
The aim was to describe the mental and physical self-reported health of women in Australia aged 50 years and older, and determine factors associated with better physical and emotional health. We analysed data collected through a national, anonymous, online survey of women aged 18 years and above living in Australia. Of the 10,620 women who completed the survey, 4947 (46.6%) were aged 50 years or over. More than half reported being in “excellent” or “very good” overall health and almost all had low levels of anxiety. Regular exercise and workforce participation were associated with better physical and mental health. The findings can inform future targeted interventions to increase physical activity levels and retain older women in the workforce.
This project was funded by the University of Melbourne. Our project partners were the University of Melbourne and The Jean Hailes Foundation.
What to expect: preconception planning and pregnancy care information for women with cystic fibrosis
Holton S, Wilson J, Button B, Fisher J
The life expectancy of women with cystic fibrosis (CF) has increased, enabling many to reach reproductive age. However, little is known about the childbearing concerns and information needs of women with CF or their preferences for information about the effect of their condition and its treatment on childbearing. The aim of this study was to identify the childbearing concerns and related information needs and preferences of women with CF.
We partnered with Alfred Health for this project, which was funded by Monash University.
Holton S, Fisher J, Button B, Williams E, Wilson J. Childbearing concerns, information needs and preferences of women with cystic fibrosis: An online discussion group. Sexual & Reproductive Healthcare 2019;19:31-5.
Health capability in a rural Swazi community caring for children affected by AIDS
Brear M (PhD candidate), Fisher J, Hammarberg K (Supervisors)
This was an ethnographic account of qualitatively-driven mixed-methods participatory action research (PAR) for health capability. The research aims were to generate knowledge about: (1) the process and outcomes of PAR, including empowerment; and (2) health capability, its enablers and deprivations; in a community caring for children affected by HIV and AIDS.
The research was conducted over an 18-month period, in partnership with lay “co-researchers” from a rural Swazi community caring for children affected by HIV and AIDS. The findings demonstrate that, from the perspective of community members and co-researchers, empowerment, as a multidimensional theoretical construct should be conceived as: a process of human development towards; and/or an outcome representing the realisation of, health capability for all. Extensive participation in PAR can enhance scientific knowledge creation and contribute to the empowerment of co-researchers. However, it does not negate the need for improved access to material resources to create enabling environments and secure empowerment, that is, health capability for all, in communities caring for children affected by HIV and AIDS.
Brear M, Hammarberg K, Fisher J, Community participation in health research: an ethnography from rural Swaziland, Health Promotion International, 2019, https://doi.org/10.1093/heapro/day121
Brear M, Shabangu P, Hammarberg K, Fisher J, Keleher H, Community-based care of children affected by AIDS in Swaziland: a gender-aware analysis, Primary Health Care Research & Development, doi:10.1017/S1463423618000774
Brear M, Shabangu P, Fisher J, Hammarberg K, Keleher H, Livingstone C. Health capability deprivations in a rural Swazi community: understanding complexity with theoretically informed, qualitatively driven, mixed-method design, participatory action research, Qualitative Health Research, DOI: 10.1177/1049732318768236
Brear M, Hammarberg K, Fisher J, 2017, Community participation in research from resource-constrained countries: A scoping review, Health Promotion International, https://doi.org/10.1093/heapro/dax010
Fatherhood aspirations, expectations and outcomes: an interdisciplinary investigation
Hammarberg K, Mills C, Holton S
The aim of this project was to develop and pilot test a survey investigating the associations between structural (policy governed) and individual factors and contemporary men’s fatherhood desires, expectations and outcomes, and establish comprehensive theoretical explanations of fertility decision-making which include men’s perspectives and experiences.
This project was funded by Faculty of Arts and Faculty of Medicine, Nursing and Health Sciences Interdisciplinary Research Funding Scheme Monash University,
Hammarberg K, Mills C, Hoton S, Development and pilot testing of a survey to explore men’s fatherhood aspirations and reproductive decision-making, Journal of Reproductive and Infant Psychology. Under review.
The aim of this project was to investigate the feasibility of using brief, online surveys for monitoring and evaluating peer support groups for caregivers of children with disabilities. Responses revealed both positive and negative aspects of group participation. In general, expectations of benefits and support were met or exceeded. The surveys were found to be meaningful and acceptable and therefore to have face validity. Brief online surveys appear to be a feasible, sensitive method of monitoring and evaluating peer support group programs for caregivers of children with disabilities. This project was funded by the Parenting Research Centre (PRC).
Wynter K, Hammarberg K , Sartori G, Cann W, Fisher J, 2015, Brief online surveys to monitor and evaluate facilitated peer support groups for caregivers of children with special needs, Evaluation and Program Planning, 49, 70-75.
Understanding women’s experiences of egg freezing to inform health care
Fisher J, Hammarberg K, Kirkman M, McBain J, Agresta F, Hickey M, Bayly C
The aims of this study were to describe experiences of oocyte cryopreservation for non-medical reasons among a cohort of women in Australia in order to inform healthcare. The specific objectives were first, to understand the social circumstances in which women in Australia freeze their eggs and second, their expectations about and outcomes of subsequent use of their stored oocytes. The third objective was to understand women’s experiences of healthcare specific to this procedure, and, drawing from these, their recommendations for patient-centred clinical care for oocyte cryopreservation for non-medical indications. This project was funded by Melbourne IVF Research Sponsorship.
Pritchard N, Kirkman M, Hammarberg K, McBain J, Agresta F, Bayly C, Hickey M, Peate M, Fisher J, 2017, Characteristics and circumstances of women in Australia who cryopreserved their oocytes for non-medical indication, Journal of Reproductive and Infant Psychology, 2017, 35:2, 108-118, DOI: 10.1080/02646838.2016.1275533.
Hammarberg K, Kirkman M, Stern K, McLachlan R, Clarke G, Agresta F, Gook D, Rombauts L, Vollenhoven B, Fisher J, Survey of reproductive experiences and outcomes of cancer survivors who stored reproductive material before treatment, Human Reproduction, 32(12):2423-2430.
Fisher J, Hammarberg K, Kirkman K, Hickey M, Peate M, Agresta F, McBain J, New evidence to inform Patient-centred care for non-medical oocyte cryopreservation: Women’s experiences and recommendations, Journal of Psychosomatic Obstetrics & Gynecology. Under review.
Translation, cultural verification and formal validation of the Centre for Epidemiologic Studies Depression Scale – Revised (CESD-R) for young people in Indonesia
Fisher J, Tran TD, Le M, Azzopardi P, Kaligis F, Wiguna T
The primary goal of this project was to improve the mental health of young people in Indonesia. In order to identify people needing mental health and social care, and to establish population burden, each country requires local language, culturally appropriate and psychometrically robust screening measures that are acceptable to members of the community, health professionals and policy-makers. This project contributed two translated, culturally verified, pilot-tested and formally validated psychometric instruments (the Centre for Epidemiological Studies Depression Scale – Revised and the Kessler psychological distress scale) for the identification of common mental disorders among young people in Indonesia. This project was funded by The Australia-Indonesia Centre. Our partner organisations for this project were: The Australian-Indonesia Centre, Burnet Institute, Universitas Indonesia.
Tran, T. D., Kaligis, F., Wiguna, T., Willenberg, L., Nguyen, H. T. M., Luchters, S., ... & Fisher, J. (2019). Screening for depressive and anxiety disorders among adolescents in Indonesia: Formal validation of the centre for epidemiologic studies depression scale–revised and the Kessler psychological distress scale. Journal of affective disorders, 246, 189-194, https://www.sciencedirect.com/science/article/abs/pii/S016503271831752X
Bilateral Primary Care Professional Exchange to Build Health Promotion Capacity
Honda T, Fisher J, Rowe H
This project, supported by the Australia-Japan Foundation in the Department of Foreign Affairs and Trade, aimed to exchange health professional education for postpartum mental health promotion between Australia and Japan. Japanese governments and health professionals recognise the urgent need to address the high prevalence of postnatal depression. Monash University has developed and tested What Were We Thinking (WWWT), an innovative gender-informed psychoeducational program for parents of first babies, which has been proven to reduce postnatal mental health problems among women.
Monash has a long collaboration with academics and midwives from Juntendo University School of Nursing. We have been working together to adapt WWWT for use in Japan. This project consisted of a 3-day visit of the Japanese professionals to Melbourne for learning Australia's experience, a 2-day workshop to enhance knowledge and practice of WWWT and to disseminate it in Japan, and a one-day symposium to discuss how best to establish the program's cultural authenticity and utility for Japan. This became the basis for future scientific testing of WWWT’s effectiveness and potential for scalability in Japan.
Service Capacity Review – Contraception, Pregnancy Support and Termination of Pregnancy Services in Victoria
Rowe H, Kirkman M, Fisher J, Holton S
This project was commissioned by the Victorian Government Department of Health and Human Services. The aim was to describe the delivery of contraception, pregnancy support and abortion services in Victoria to answer key evaluation questions. Data from multiple sources, including a literature review, Victorian private and public hospital service delivery reports, and interviews with key informants, were integrated in order to describe features of best practice, and current availability, accessibility, affordability and acceptability of services in Victoria. Gaps, duplication, barriers to best practice, and opportunities for improvement were identified. The findings included recommendations for necessary changes to improve equitable access to affordable, effective, and safe contraception, pregnancy support and abortion services in Victoria and were contained in a confidential report to the Victorian Government. This project was funded by Family Planning Victoria. Our partner organisations for this project were: Family Planning Victoria, Women’s Health Victoria, Royal Women’s Hospital.
This project was to analyse, interpret and describe in several formats, data collected in the Victorian Department of Health Preventive Health Survey - Child (PHS - Child). The data for this survey was collected in 2012 by structured computer assisted telephone interviews with 2500 parents of Victorian children aged 5-17 years. They were recruited from 23 Local Government Areas (LGAs), including twelve Healthy Together Communities (HTC) and eleven matched comparator areas. The PHS-Child is a key source of data on which assessment of the impact data for the Healthy Together Victoria (HTV) strategy is to be based. The PHS-Child survey instrument comprises structured survey-specific items assessing health and lifestyle factors including nutrition (fruit and vegetable intake), physical activity, and anthropometric indices. Social circumstances were also collected such as age, gender, language and parents’ demographic characteristics.
Firstly, we conducted data cleaning to provide a clean database ready for the analysis phase. Secondly, we performed descriptive analyses to describe child nutrition status using childrens’ Body Mass Index (BMI) scores and the converted z scores according to the three international reference populations: the International Obesity Taskforce (IOTF), Center for Disease Control (CDC), and World Health Organisation (WHO). Thirdly, we undertook comparative analyses of children’s BMI classifications by the IOTF, CDC, and WHO methods. Three reports were submitted to the Victorian Department of Health and Human Services, who was the funder and our partner organisation for the project.