Completed Projects
Read about our recently completed projects in global and women's health.
Projects led by Global and Women’s Health
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Access to sexual and reproductive health services in Australia during the COVID-19 pandemic: barriers and facilitators
Dr Shelly Makleff, Professor Jane Fisher, Professor Kirsten Black, Professor Angela Taft.
The COVID-19 pandemic hindered access to healthcare, with particular challenges for sexual and reproductive health services. The Global and Women’s Health team conducted a qualitative study to understand the intersecting barriers to abortion care during the COVID-19 pandemic in Australia. We interviewed 24 people about their experiences seeking abortion care between March 2020 and November 2022.
The findings have been used to inform recommendations to improve access to high quality abortion care in Australia through a submission to Australian Senate inquiry into universal access to reproductive healthcare (submission 9). The research has been leveraged to engage the public in the topic of abortion access through the team’s contribution to an educational resource and in print and radio media about the topic, as seen in Women’s Agenda, Monash Lens, and on ABC Radio National Life Matters.
Peer reviewed publications:
Makleff S, Belfrage M, Wickramasinghe S, Fisher J, Bateson D, Black KI. Typologies of interactions between abortion seekers and healthcare workers in Australia: a qualitative study exploring the impact of stigma on quality of care. BMC Pregnancy and Childbirth. 2023 Sep 7;23(1):646. doi: 10.1186/s12884-023-05902-0.
Vallury KD, Kelleher D, Mohd Soffi AS, Mogharbel C, Makleff S. Systemic delays to abortion access undermine the health and rights of abortion seekers across Australia. Australian and New Zealand Journal of Obstetrics and Gynaecology (ANZJOG). 2023 Aug;63(4):612-615. doi: 10.1111/ajo.13716.
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How are you? Living with COVID-19 restrictions in Australia
Fisher J, Kirkman M, Tran T, Hammarberg K, Sastry J, Nguyen, Rowe H, Popplestone S, Stocker R, Stubber C.
Global and Women’s Health has undertaken two anonymous online surveys to see how people in Australia are experiencing the COVID-19 pandemic and the restrictions that have been necessary to contain it.
The first survey was launched in April 2020, four days after significant restrictions to limit the spread of COVID-19 were mandated in Australia. It attracted almost 14,000 responses from people aged from 18 to 90 years, from all Australian states and territories and from rural and urban areas.
This was the largest survey undertaken during the nationwide lockdown in Australia and the first to quantify the mental health impact of the restrictions. The survey found a widespread increase in psychological symptoms, including anxiety, depression, irritability and thoughts of being better off dead. The paper reporting the findings has been accepted for publication in the Medical Journal of Australia.
A second survey was conducted in July and August 2020 and secured 9,000 responses. The survey replicated the questions posed in the first survey and added questions asking what governments can do to help recovery. The findings of the survey will be made available soon on the Global and Women’s Health website.
This research was made possible by a generous donation from Professor John McBain and Dr Penny Foster. Neither the researchers nor the donors have any conflict of interest in the research.
Jane Fisher is supported by the Finkel Family Foundation which supports her position as the Finkel Professor of Global Health. Thach Tran is supported by a Monash University Senior Bridging Postdoctoral Fellowship.
For more information: monash.edu/medicine/living-with-covid-19-restrictions-survey
Vale Dr Claire Stubber, Adjunct Research Fellow
15 August 1978 – 23 December 2020
It is with sadness that the Global and Women's Health Unit reports the death of researcher and advocate Dr Claire Stubber. Claire's life was shaped by her experience as an organ recipient, caused by significant congenital cardiac defects. Reflections on her own life drove her passion for research into improving outcomes and experiences for people receiving donated hearts and lungs. Claire was a remarkable woman and scholar. Read the full obituary here.
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Learning clubs to improve women’s health and infant’s health and development in Vietnam: a cluster randomised controlled trial of a low-cost, evidence-informed, structured psycho-educational program
Fisher J, Biggs B, Tran T, Luchters S, Tran TD, Hipgrave D, Tran H, Simpson J, Hanieh S, Nguyen T.
Optimal early childhood development is an international priority. Risks during pregnancy and early childhood have lasting effects because growth is rapid. We are testing whether a complex intervention addressing multiple modifiable risks: maternal nutrition, mental health, parenting capabilities, infant health and development and gender-based violence, is effective in reducing deficient cognitive development among children aged two in rural Vietnam.
The Learning Clubs intervention is an evidence-based program combining perinatal stage-specific information, learning activities and social support. It comprises 20 modules, in 19 accessible, facilitated groups for women at a community centre and one home visit. Content has been translated and culturally adapted for Vietnam and acceptability and feasibility established in pilot testing. This is, to our knowledge, the first trial to address eight risks to the early development of children in a multicomponent intervention in a resource-constrained setting.
Each of the program's 19 community-based facilitated group sessions provides mothers, fathers, and grandparents with access to learning activities, educational DVDs, and social support. The program's effectiveness is being investigated in a cluster randomised controlled trial in rural Vietnam.
We have partnered with the Research and Training Centre for Community Development (RTCCD)-Vietnam, University of Melbourne, Burnet Institute, and UNICEF for this project, which is funded by the National Health and Medical Research Council (NHMRC).
Protocol
Fisher J, Tran T, Luchters S, Tran TD, Hipgrave DB, Hanieh S, Tran H, Simpson J, Nguyen T, Le M, Biggs BA. Addressing multiple modifiable risks through structured community-based Learning Clubs to improve maternal and infant health and infant development in rural Vietnam: protocol for a parallel group cluster randomised controlled trial. BMJ Open. 2018 Jul 17;8(7):e023539. doi: 10.1136/bmjopen-2018-023539.
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Learning Clubs to improve women’s health & infant’s health and development in Vietnam: a cluster randomised controlled trial to inform transition to scale
Fisher J, Luchters S, Tran TD, Le M, Nguyen T, Tran T, Tran H, Biggs B, Hanieh S, Nguyen V.
Grand Challenges Canada was supported by the Canadian Government to fund Bold Idea with Big Impact. One of their initiatives, Saving Brains, supports promising programs to improve the development of young children in resource-constrained settings throughout the first 1000 days of a child's development.
The Learning Clubs program was selected by Grand Challenges Canada for support. They provided funds to match the National Health and Medical Research Council funding to evaluate the economic impacts of the program, and to undertake additional analyses to identify how Learning Clubs works and what is needed to take it to scale in Vietnam. Grand Challenges Canada has provided active support to assist us to take the program to scale upon completion of the trial.
Protocol
Fisher J, Nguyen T, Tran TD, Tran H, Tran T, Luchters S, Hipgrave D, Hanieh S, Biggs BA. Protocol for a process evaluation of a cluster randomized controlled trial of the Learning Club intervention for women's health, and infant's health and development in rural Vietnam. BMC Health Services Research. 2019 Jul 23;19(1):511. doi: 10.1186/s12913-019-4325-5.
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Experiences of heart and lung transplantation in Australia: creating a pre- and post-transplant resource
Kirkman M, Stubber C.
People who need a lung, heart, or heart and lung transplant not only have life-threatening conditions but are also aware that their only chance of survival depends on a fellow human’s death. These are highly emotionally-arousing circumstances. Access to accounts of the experiences of transplant recipients can reduce distress and improve the mental health and wellbeing of potential and recent recipients, but there is little opportunity in Australia to learn from those who are living with transplanted organs. The known benefits of learning from peers include feeling less alone, being better informed, knowing what to ask clinicians, and insight into managing such difficult procedures.
We are developing an online resource as an outcome of our video-recorded research with organ recipients. We plan that this resource will be of benefit to people contemplating organ transplantation, organ recipients, their families and friends, and professionals working with recipients and prospective recipients. This project is funded by the Grenet Foundation.
Vale Dr Claire Stubber, Adjunct Research Fellow
15 August 1978 – 23 December 2020
It is with sadness that the Global and Women's Health Unit reports the death of researcher and advocate Dr Claire Stubber. Claire's life was shaped by her experience as an organ recipient, caused by significant congenital cardiac defects. Reflections on her own life drove her passion for research into improving outcomes and experiences for people receiving donated hearts and lungs. Claire was a remarkable woman and scholar. Read the full obituary here.
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Strengthening mental health capacity and service integration in primary postnatal care in Victoria
Rowe H, Fisher J, Weller C, Campbell D, Meggetto K, Robertson J.
Postnatal mental health problems among women are associated with morbidity, reduced social participation, impaired infant development and family functioning, and constitute an Australian public health priority. Universal primary care health services (Maternal and Child Health and General Practice) are at the forefront of promotion, prevention and early intervention for postnatal mental health. However, they are under-resourced for these roles, and the two sectors are organisationally segregated.
Health service reform to increase consistency of care and service integration, supporting a comprehensive stepped-care model of prevention, early intervention and treatment, is required.
What Were We Thinking (WWWT) is an evidence-informed, effective, acceptable, psycho-educational model of postnatal care that addresses known but neglected risks for mental health at this phase of life. It is non-stigmatising, and facilitates clinician professional development, parent skill-building, and identification of, and early intervention for, mental health problems. The Department of Health and Human Services Victoria has commissioned Rowe and Fisher to implement WWWT in the Latrobe Valley (2018-2020).
The Flagship will leverage this project to bring implementation science experts and consumers together with key government, primary care and community health partners to translate and scale up successful implementation of the reform. The Theoretical Domains Framework will guide investigation of stakeholder perspectives about required modifications and how to achieve and measure change in barriers and enablers for implementation. The Flagship outcome will be rigorously-evaluated, practical, implementation tools, specifically for consumers, clinicians, and health services. The tools will support WWWT scale-up across Victoria, and will be readily transferrable to implementation of other complex interventions and health settings.
This project is being led by Global and Women's Health's Dr Heather Rowe. The project is funded through the 2019 Monash Partners Medical Research Future Fund (MRFF) Rapid Applied Research Translation funding round.
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Actions louder than words: development of curriculum and course for health professionals and a mobile phone app for intrapartum women to actualize Respectful Maternal Care (RMC) in India
Fisher J, Sastry J.
In collaboration with JIPMER, a federally run medical college and hospital in Pondicherry in India, we work to prevent the disrespect and abuse of mothers during childbirth, which has been widely reported from several low- and middle-income countries (LMIC), including India. The World Health Organization has redefined the standards of respectful maternity care and has encouraged countries to adhere to them. Our intervention is to develop a core course to improve respectful maternity care through undergraduate training of health professionals, and as continuing medical education for qualified professionals in India (and other LMICs).
In this project, we are using mixed research methods to ascertain experiences of disrespectful care at JIPMER through surveys of women who have recently given birth, and interviews with birth companions, labour room staff including interns, nurses, doctors, and senior faculty members, to understand factors that drive disrespectful care. We will use these data to develop a curriculum about how to provide respectful care, and then we will pilot test and evaluate it.
This project is funded by the Government of India – Ministry of Human Resource Development. This project was awarded to Dr Jayagowri Sastry and Prof Jane Fisher through an international competition of 25 countries around the world.
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Cohort investigation of women admitted with their infants or toddlers to Masada Private Hospital Early Parenting Centre to identify indicators of immediate- and medium-term program impact
Fisher J, Tran T, Stanzel K, Popplestone S.
Professor Jane Fisher and Dr Karin Stanzel were invited to join a panel discussing a current research project at Masada's Early Parenting Centre. Watch the webinar on YouTube.In Australia about 15% of women experience a depressive, anxiety or adjustment disorder in the year after giving birth and, about one per thousand, the severe mental disorder of postpartum psychosis. The postnatal mental health of women is a major determinant of their capacity to provide sensitive responsive care for their infants or toddlers and thereby optimise infant mental health and early childhood development. It is an Australian priority to provide clinically and cost-effective treatments for women with mental health problems and their infants and toddlers.
Ramsay Health Care is the main private sector provider of mother-baby psychiatric and residential early parenting services in Australia. Ramsay Health Care’s Masada Private Hospital Early Parenting Centre is the largest and most well-established private sector residential early parenting service in Australia. It has a systematic admission protocol and women admitted to the service complete self-report measures prior to admission, on day of discharge and six weeks post-discharge.
The overall goal of the research is to generate evidence about the characteristics of women and their infants or toddlers admitted to Masada Private Hospital Early Parenting Centre and indicators of short and medium impact to inform benchmarking of current clinical services and provide a comparison for new and enhanced services.
This project will provide the basis for maintaining continuous quality improvement in early parenting and mother-baby psychiatric services. It will generate the most detailed evidence to date about the characteristics of women admitted with their infants or toddlers to one early parenting centre and the most sensitive indicators of program impact. Together these will inform the development of assessment protocols that can be implemented at scale in all early parenting and mother-baby psychiatric services and enable quality improvement through benchmarking and program consistency.
This project is funded by the Ramsay Hospital Research Foundation.
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Latrobe Valley early parenting – What Were We Thinking
Fisher J, Rowe H.
What Were We Thinking (WWWT) is a carefully researched, evidence-based set of materials and activities designed to promote confidence and reduce distress in parents with a first baby.
WWWT is a two-session program, designed to be offered at local health centres, appropriately constructed as safe environments for parents and infants. It is intended to be conducted four to six weeks postpartum, at a time that is convenient to parents, and facilitated by an experienced maternal and child health or early childhood nurse.
This project involved the provision of course materials, face-to-face training, implementation and post-training support for 30 maternal and child health (MCH) nurses in the Latrobe Valley and the delivery of WWWT to parents attending all first-time parenting groups (FTPG) in the Latrobe Valley.
We partnered with the Victorian Government Department of Education and Training, City of Latrobe, Shire of Baw Baw, and the Shire of Wellington for this project, which was funded by Department of Education and Training.
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Clinician-level Quality Indicator Reports: A qualitative research project to understand views of clinicians receiving and not receiving these reports
Kirkman M, Evans S, Heathcote P, Fisher J, Millar J, Mark S, Currow D, Frydenberg M, Khadra M.
The Prostate Cancer Outcome Registry-Australia and New Zealand (PCOR-ANZ) was established to monitor the quality of care provided by contributing hospitals and clinicians to patients with prostate cancer. Quality indicators were developed through a consensus process as tools to measure quality of care and, since 2012, the Prostate Cancer Outcome Registry-Victoria (PCOR-Vic) has provided Quality Indicator Reports six-monthly to clinicians and hospitals. These reports provide to contributing sites and clinicians a summary of the patterns of care of patients they are managing and specifies their individual performance relative to others. The PCOR-Vic and the PCOR-ANZ Steering Committees have sought guidance on how best to manage those who fall outside the ‘normal’ range of quality indicators (defined as two standard deviations below the mean). Given the many reasons why a hospital or clinician might register outside the normal range, management needs to be sensitive and responsible. The aim of this research is to understand how urologists respond to reports of the quality of care and how potential ‘outlier’ activity could be best be communicated. Urologists in Australia and New Zealand will be consulted to ascertain their views and advice.
Report
Kirkman M, Fisher J. Clinician-level Quality Indicator Reports: A qualitative research project to understand the views of clinicians receiving and not receiving these reports. Final report. December 2021.
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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.
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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.
Reported in:
Rowe HJ, Hammarberg K, Dwyer S, Camilleri R, Fisher JR. Improving clinical care for women with endometriosis: qualitative analysis of women's and health professionals' views. Journal of Psychosomatic Obstetric & Gynecology. 2021 Sep;42(3):174-180. doi: 10.1080/0167482X.2019.1678022.
Camilleri R, Dwyer S, Rowe H, Fisher J, Hammarberg K. How comprehensive and reliable is online information about menopause? Under review.
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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.
Reported in:
Holton S, Hammarberg K, Johnson L. Fertility concerns and related information needs and preferences of women with PCOS. Human Reproduction Open. 2018 Nov 8;2018(4):hoy019. doi: 10.1093/hropen/hoy019.
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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.
Reported in:
Hammarberg K, Holton S, Michelmore J, Fisher J, Hickey M. Thriving in older age: A national survey of women in Australia. Maturitas. 2019 Apr;122:60-65. doi: 10.1016/j.maturitas.2019.01.011.
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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.
Reported in:
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 Mar;19:31-35. doi: 10.1016/j.srhc.2018.11.004.
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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.
Reported in:
Brear MR, Hammarberg K, Fisher J. Community participation in health research: an ethnography from rural Swaziland. Health Promotion International. 2020 Feb 1;35(1):e59-e69. doi: 10.1093/heapro/day121.
Brear MR, Shabangu PN, 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. 2019 Jan;20:e15. doi: 10.1017/S1463423618000774.
Brear MR, Shabangu PN, Fisher JR, Hammarberg K, Keleher HM, 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. 2018 Oct;28(12):1897-1909. doi: 10.1177/1049732318768236.
Brear M, Hammarberg K, Fisher J. Community participation in research from resource-constrained countries: a scoping review. Health Promotion International. 2018 Aug 1;33(4):723-733. doi: 10.1093/heapro/dax010.
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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.
Reported in:
Hammarberg K, Mills C, Holton 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.
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Further evaluation of the MyTime program
Fisher J, Hammarberg K.
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).
Reported in:
Wynter K, Hammarberg K, Sartore GM, Cann W, Fisher J. Brief online surveys to monitor and evaluate facilitated peer support groups for caregivers of children with special needs. Evaluation and Program Planning. 2015 Apr;49:70-5. doi: 10.1016/j.evalprogplan.2014.12.019.
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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.
Reported in:
Pritchard N, Kirkman M, Hammarberg K, McBain J, Agresta F, Bayly C, Hickey M, Peate M, Fisher J. Characteristics and circumstances of women in Australia who cryopreserved their oocytes for non-medical indications. Journal of Reproductive and Infant Psychology. 2017 Apr;35(2):108-118. doi: 10.1080/02646838.2016.1275533.
Hammarberg K, Kirkman M, Stern C, McLachlan RI, Clarke G, Agresta F, Gook D, Rombauts L, Vollenhoven B, Fisher JRW. Survey of Reproductive Experiences and Outcomes of Cancer Survivors Who Stored Reproductive Material Before Treatment. Human Reproduction. 2017 Dec 1;32(12):2423-2430. doi: 10.1093/humrep/dex314.
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.
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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.
Reported in:
Tran TD, Kaligis F, Wiguna T, Willenberg L, Nguyen HTM, Luchters S, Azzopardi P, Fisher J. 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. 2019 Mar 1;246:189-194. doi: 10.1016/j.jad.2018.12.042.
Fisher J, Kaligis F, Tran T, Wiguna T. How we can help detect depression in our teens. The Conversation. 2018 Sep 10.
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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.
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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. -
Knowledge, attitudes and social norms about healthy lifestyle behaviours among disadvantaged communities in Victoria: Findings of the Adult and Child Preventive Health Surveys
Wynter K, Tran TD, Fisher J, Nguyen H, Gualano R, and DHHS staff.
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.
Projects on which Global and Women’s Health was a partner
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Centre of Research Excellence in childhood adversity and associated depression and anxiety
Hiscock H, Jorm A, Goldfeld S, Fisher J, Eastwood J, Reupert A, Sanci L, Yap M, Dalziel K, Eapen V.
Through this Centre of Research Excellence, we aim to prevent depression, anxiety problems and suicidality by reducing the occurrence of adverse childhood experiences. With our multi-disciplinary, multi-site team, we will develop practitioner and policy makers documents showing which experiences are associated with depression, anxiety problems and suicidality and how best to manage them. We will then use this evidence to develop and test new ways of helping families facing these experiences.
This project is being led by the Centre for Community Child Health at the Royal Children's Hospital Melbourne, and project partners include: Monash University, the University of Melbourne, South Western Sydney Local Health District, and the University of New South Wales. The project is funded by the National Health and Medical Research Council (NHMRC).
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Safe Families multi-component qualitative research study – Solomon Islands
Trembath A, Greenwood K, Fulu E, Fisher J, Lees S, Dicker K, Puiahi D, Honda T, Tran T.
The Solomon Islands has one of the highest rates of family violence in the world. Safe Families is the first long-term, intensive, locally-developed community mobilisation-based violence prevention program to be implemented in Solomon Islands.
We aimed to evaluate the implementation of the Safe Families intervention, and to understand the processes of change to harmful social norms that drive family and sexual violence in two provinces in the Solomon Islands.
We sought to better understand and describe the context-specific responses of individuals, communities and agencies to the Safe Families model for violence prevention in the Solomon Islands, in order to inform optimisation and scale-up of the intervention. Additionally, we aimed to advance our understanding of how to conduct research on violence against women that is ethical, safe and rigorous in the context of small, geographically-disparate island communities where violence is relatively normalised.
Led by Oxfam Australia, other partners included Monash University and the Equality Institute. The project is funded by the World Bank’s Sexual Violence Research Initiative.
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Defining the impact of universal iron interventions in young children: a randomised controlled trial in rural Bangladesh
Biggs B, Dibley M, Pasricha S, Arifeen S, Spelman T, Hamadani J, Grantham-Mcgregor S, Fisher J.
The World Health Organization (WHO) recommends universal distribution of anaemia control iron supplements or iron-containing multiple micronutrient powders (MMPs), with the goal of restoring developmental potential, health and wellbeing. However, it is increasingly uncertain whether universal iron interventions are a safe, beneficial and cost-effective public-health strategy in children in low-income (especially malaria endemic) settings. There is an urgent need to quantify the magnitude of benefit in functional outcomes from these interventions.
Although nearly half of the world's young children are anaemic, evidence regarding the best approaches to correct this problem is limited. New data even suggests that the conventional approaches (iron supplements, multiple micronutrient powders) may be harmful. We performed the definitive trial to confirm the existence and magnitude of any benefit (and harm) from these interventions in young Bangladeshi children. This trial informed global policy on anaemia control.
This University of Melbourne was the lead in this project, and partnered with Monash University, University of Sydney, International Center for Diarrhoeal Disease Research, Bangladesh, Burnet Institute, and the University College London (UCL). This project was funded by the National Health and Medical Research Council (NHMRC).
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Your Fertility: Supporting Reproductive Choices
Johnson L, Hassard J, de Silva R, Hammarberg K.
Your Fertility: Supporting Reproductive Choices is an evidence-based national fertility health promotion and infertility prevention program which addresses primary and secondary prevention of infertility. The program promotes awareness of the factors that affect fertility and reproductive outcomes and the benefits of positive health behaviours for reproductive health.
Your Fertility is funded by the Commonwealth Government and delivered by the Fertility Coalitions, a collaboration between the Victorian Assisted reproductive Treatment Authority (VARTA), Robinson Research Institute, Healthy male, Jean Hailes for Women’s Health and Monash University.
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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 K, Collins V, Holden C, Young K, McLachlan R. Men's knowledge, attitudes and behaviours relating to fertility. Human Reproduction Update. 2017 Jul 1;23(4):458-480. doi: 10.1093/humupd/dmx005.
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 Mar;25(1):43-48. doi: 10.1071/PY18078.
Hogg K, Rizio T, Manocha R, McLachlan RI, Hammarberg K. Men's preconception health care in Australian general practice: GPs' knowledge, attitudes and behaviours. Australian Journal of Primary Health. 2019 Oct;25(4):353-358. doi: 10.1071/PY19069.
Pearson L, Holton S, McLachlan R, Hammarberg K. Australian men's fertility information seeking attitudes and behaviour: A qualitative investigation. Sexual & Reproductive Healthcare. 2021 Sep;29:100621. doi: 10.1016/j.srhc.2021.100621.
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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, Welsh L, Cheung M, McBain J, Hearps SJC, McLachlan R. Health of adults aged 22 to 35 years conceived by assisted reproductive technology. Fertility and Sterility. 2019 Jul;112(1):130-139. doi: 10.1016/j.fertnstert.2019.03.001.
Novakovic B, Lewis S, Halliday J, Kennedy J, Burgner DP, Czajko A, Kim B, Sexton-Oates A, Juonala M, Hammarberg K, Amor DJ, Doyle LW, Ranganathan S, Welsh L, Cheung M, McBain J, McLachlan R, Saffery R. Assisted reproductive technologies are associated with limited epigenetic variation at birth that largely resolves by adulthood. Nature Communications. 2019 Sep 2;10(1):3922. doi: 10.1038/s41467-019-11929-9.
Juonala M, Lewis S, McLachlan R, Hammarberg K, Kennedy J, Saffery R, McBain J, Welsh L, Cheung M, Doyle LW, Amor DJ, Burgner DP, Halliday J. American Heart Association ideal cardiovascular health score and subclinical atherosclerosis in 22-35-year-old adults conceived with and without assisted reproductive technologies. Human Reproduction. 2020 Jan 1;35(1):232-239. doi: 10.1093/humrep/dez240.
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Preventing postnatal depression in new mothers using telephone peer support: a randomised controlled trial
Forster D, McLachlan HL, Dennis CL, Nicholson J, Shafiei T, Shiell A, Nguyen C, Nguyen T, Adams C, Grimes H, Fisher J, Petschel P.
Unfortunately, depression in women who have recently had a baby is a very common occurrence. More than 53,000 new mothers in Australia are affected by depression each year. The condition can lead to serious adverse consequences for a mother’s health and the health of her infant and family. Effective strategies to prevent and reduce maternal depression are therefore needed. We are testing whether support by telephone from other mothers (peer volunteers) helps in women at increased risk of depression at four weeks postpartum.
Monash University is supporting this project, which is being led by the Judith Lumley Centre at LaTrobe University, and the Royal Women’s Hospital. The project is funded by the National Health and Medical Research Council (NHMRC).
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Provision of a perinatal depression online support tool
Milgrom J, Smith T, Fisher J, Rowe H, Michelmore J, Kavanagh D.
MindMum is an App designed to assist expectant and new mothers by providing effective strategies to improve mood, strengthen relationships and help women to feel supported and confident in becoming a mum.
We aim to obtain qualitative information about users’ experience of the MindMum app, including factors that would lead them to download and continue to use this and similar apps for a sufficient amount of time to allow treatment benefits to occur. We aim to ascertain quantitative ratings of the MindMum application on the user version of the Mobile Application Rating Scale (MARS), and on the Components Perceived Usefulness Questionnaire.
This project is being led by the Parent-Infant Research Institute, and project partners include: Monash University, Queensland University of Technology, Perinatal Anxiety & Depression Australia (PANDA), and The Jean Hailes Foundation. This project is funded by the Australian Government Department of Health.