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Project Summaries

Family planning activity: Your Fertility

Hammarberg K, Johnson L, Fisher J, McLachlan R

‘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.

Reported in:

Hammarberg, Collins V, Holden C, Young K, McLachlan R: Men's knowledge, attitudes and behaviours relating to fertility. Hum Reprod Update 2017, 23(4):458-480, https://www.ncbi.nlm.nih.gov/pubmed/28333354

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.

Health Implications for Young Adults Conceived Following ART

Health Implications for Young Adults Conceived Following Assisted Reproductive Technologies

Halliday J, Lewis S, Kennedy J, Burgner D, McLachlan R, Ranganathan S, Hammarberg K, Saffery R, Amor D, Cheung C, Doyle L, Juonala M, Donath S, McBain J

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).

Reported in:

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

Health Professionals’ and Women’s Information Needs

Fertility information needs and preferences of women with PCOS

Secondary analysis of data from the 2017 Jean Hailes annual survey of women

Preconception planning and pregnancy care information for women with CF

Health capability: a rural Swazi community caring for children affected by AIDS

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