Jessica Botfield

Young people from culturally diverse backgrounds and their use of services for sexual and reproductive health needs: a structured scoping review

Publisher: CSIRO Publishing

Date: 2016

DOI: 10.1071/SH15090

Abstract: Sexual and reproductive health needs are global health, development and human rights priorities, essential to the wellbeing of in iduals, couples and families. Despite widespread recognition of this, young people, including those from culturally erse backgrounds in wealthy nations such as Australia, remain largely hidden to, and underserved by, sexual and reproductive healthcare services. A scoping review was undertaken to describe the range of research on sexual and reproductive health among culturally erse young people in Australia, in order to identify gaps in the literature. This comprised a systematic literature search and key informant consultations, followed by descriptive thematic analysis of the included literature. One hundred and twenty papers were deemed eligible for inclusion, and findings are presented as three separate analyses. The first provides an overview of four dimensions identified in the literature: (i) cultural ersity (ii) the resettlement experiences of migrant communities (iii) the sexual and reproductive health needs of these communities and (iv) the practices of health services in this field. The second explores what is known from the literature about culturally erse young people’s needs for, use of, and engagement with services for sexual and reproductive health, while the third identifies two knowledge gaps: (1) the perspectives of culturally erse young people regarding sexual and reproductive health and health care and (2) the engagement of culturally erse young people with sexual and reproductive health services. New directions for a research agenda on sexual and reproductive health care for culturally erse young people in Australia are proposed, based on the identified knowledge gaps.

Clinician views and experiences with reproductive coercion screening in a family planning service

Publisher: CSIRO Publishing

Date: 24-01-2023

DOI: 10.1071/SH22143

Abstract: Background Reproductive coercion refers to behaviour that interferes with a person’s reproductive autonomy, such as contraceptive sabotage, pregnancy coercion, controlling a pregnancy outcome or forced sterilisation. Routine screening for reproductive coercion, together with clinician education, was implemented at a family planning service in New South Wales, Australia, in December 2018. A study was undertaken to explore the views and experiences of clinicians in undertaking reproductive coercion screening at this service. Methods Clinicians were invited to complete an online survey and interview to discuss their understanding of reproductive coercion and their views and experiences of undertaking reproductive coercion screening. Descriptive and thematic content analysis was conducted. Results Clinicians deemed reproductive coercion screening to be relevant and important in family planning services. Key barriers to reproductive coercion screening and responding to disclosures included time constraints and limited appropriate referral pathways. Ongoing education and training with resources such as a decision-support tool on reproductive coercion screening and management, as well as effective multi-disciplinary collaboration, were identified as strategies to improve the screening program. Conclusions Findings from our study highlight that clinicians’ perceived reproductive coercion screening as a relevant and important component of sexual and reproductive healthcare. Ongoing reproductive coercion education, training and support would ensure the competency and confidence of clinicians undertaking screening. Identifying appropriate referral pathways with multi-disciplinary collaboration (involving clinicians, social workers, support workers and psychologists) would support clinicians in undertaking screening and responding to disclosures of reproductive coercion in Australian health care settings which provide family planning and sexual and reproductive health services.

Opportunities for strengthening sexual health education in schools: Findings from a student needs assessment in NSW

Publisher: Wiley

Date: 09-07-2021

DOI: 10.1002/HPJA.518

Abstract: Comprehensive sexuality education (CSE) is important for the sexual and reproductive health of young people. To better understand young people's views and experiences of sexual health education in NSW, a student needs assessment survey was conducted in 2017. This paper presents the findings from 1603 NSW students in Years 8‐12 following online recruitment. Descriptive analyses explored students’ views and experiences in relation to sources of sexual health information, education providers, school‐based topics covered and resources drawn on. Findings indicate that school, parents, friends and social media are students’ most common sources of information on sexual and reproductive health. Approximately one‐third of students reported wanting more information on topics related to relationships, reproductive health, consent and sexual decision‐making and sexual harassment, abuse and bullying, and two‐thirds of transgender and gender erse students wanted more information on gender identity. For the topics which students reported receiving the least information about at school, they were most likely to seek this out on social media and websites. Findings provide valuable insight for improving CSE in NSW. The influence of social media, parents and the internet should be taken into consideration when developing resources and programme content. Professional development for educators could contribute to improving the quality of CSE delivered. Accurate and up to date resources must be utilised to support student engagement and effective learning.

Experience of domestic violence routine screening in Family Planning NSW clinics

Publisher: CSIRO Publishing

Date: 2017

DOI: 10.1071/SH16143

Abstract: Background: This study reviewed implementation of the Domestic Violence Routine Screening (DVRS) program at Family Planning NSW and outcomes of screening to determine the feasibility of routine screening in a family planning setting and the suitability of this program in the context of women’s reproductive and sexual health. Methods: A retrospective review of medical records was undertaken of eligible women attending Family Planning NSW clinics between 1 January and 31 December 2015. Modified Poisson regression was used to estimate prevalence ratios and assess association between binary outcomes and client characteristics. Results: Of 13 440 eligible women, 5491 were screened (41%). Number of visits, clinic attended, age, employment status and disability were associated with completion of screening. In all, 220 women (4.0%) disclosed domestic violence. Factors associated with disclosure were clinic attended, age group, region of birth, employment status, education and disability. Women who disclosed domestic violence were more likely to have discussed issues related to sexually transmissible infections in their consultation. All women who disclosed were assessed for any safety concerns and offered a range of suitable referral options. Conclusion: Although routine screening may not be appropriate in all health settings, given associations between domestic violence and sexual and reproductive health, a DVRS program is considered appropriate in sexual and reproductive health clinics and appears to be feasible in a service such as Family Planning NSW. Consistent implementation of the program should continue at Family Planning NSW and be expanded to other family planning services in Australia to support identification and early intervention for women affected by domestic violence.

Young migrants and sexual and reproductive healthcare

Publisher: Edward Elgar Publishing

Date: 30-12-2016

DOI: 10.4337/9781784714789.00036

Increased demand for abortion information and advice during the COVID‐19 pandemic

Publisher: Wiley

Date: 10-2023

DOI: 10.1111/AJO.13651

Effectiveness of a peer education gender and health project for men in Timor‐Leste

Publisher: Wiley

Date: 31-05-2021

DOI: 10.1002/HPJA.359

Abstract: In response to high rates of gender‐based violence and poor sexual and reproductive health indicators in Timor‐Leste, a ‘Men's Health Project’ was implemented in two rural communities in 2013. A peer education model was utilised to engage men in issues regarding health, relationships and well‐being. Community‐based baseline and endline surveys were undertaken to evaluate the project in the two communities. In 2013, 401 men and boys completed a baseline survey, and 400 completed an endline survey in 2016. Significant differences were found in a number of areas, with more men in the endline survey aware of the negative impacts of alcohol, safe pregnancy practices, family planning and sexually transmitted infections. Many men reported making the major decisions in their family in both surveys. The peer education approach engaged men in health awareness and contributed to increasing knowledge of sexual and reproductive health and other health issues. However, while education and positive attitudes are an important foundation for change, other enabling mechanisms including vital infrastructure, services and health personnel must be in place to facilitate change and increase access to information and healthcare. Findings highlight the importance of engaging both women and men in processes of challenging behaviours and structures that reinforce gender inequalities. Peer education appears to be an effective model for engaging community members in gender and health issues in Timor‐Leste. The Men's Health Project enabled men to participate in health awareness and issues regarding health, relationships and well‐being.

Cost-benefit analysis of enhancing the uptake of long-acting reversible contraception in Australia

Publisher: CSIRO Publishing

Date: 2020

DOI: 10.1071/AH18190

Abstract: Objective Long-acting reversible contraception (LARC) is the most effective form of reversible contraception, but its use in Australia is low compared with other countries. The aim of this study was to evaluate the economic effect of an increase in LARC uptake to international rates. Methods An economic model was designed to assess two scenarios, namely increasing the current rate of LARC uptake of 12.5% to the international benchmark of 14.8% among: (1) women currently using the oral contraceptive pill (OCP) and (2) women at risk of pregnancy and not using contraception. Model inputs included cost of contraceptive methods, discontinuation rates and abortion and miscarriage costs associated with unintended pregnancies. Results Women who switch from an OCP to LARC would save A$114–157 per year. Those not currently using any contraception who adopt LARC would incur costs of A$36–194 per year, but would reap savings from the reduction in unintended pregnancies. Over 5 years there would be a net saving of A$74.4 million for Scenario 1 and A$2.4 million for Scenario 2. Conclusion Greater use of LARC would result in a net gain in economic benefits to Australia. These benefits are largely driven by women switching from an OCP to LARC who have reduced costs, as well as women wishing to avoid pregnancy who choose to use LARC rather than no method. This evidence will support women making an informed contraceptive choice and policy makers in increasing the accessibility of LARC. What is known about the topic? LARC is the most effective form of reversible contraception, but uptake in Australia is relatively low. What does this paper add? There are economic benefits to society for women who switch from an OCP to LARC, as well as for women who switch from no contraception to LARC. What are the implications for practitioners? The findings of this study will support women in making an informed contraceptive choice and policy makers in increasing the accessibility of LARC.

Engaging Migrant and Refugee Young People with Sexual Health Care: Does Generation Matter More Than Culture?

Publisher: Springer Science and Business Media LLC

Date: 15-02-2018

DOI: 10.1007/S13178-018-0320-6

Working towards gender equality in rural Timor-Leste and Papua New Guinea: community health survey

Publisher: Pacific Society for Reproductive Health Charitable Trust

Date: 02-09-2019

DOI: 10.18313/PJRH.2019.914

Abstract: The centrality of gender equality for sustainable human development is well recognised and reflected in the Sustainable Development Goals (SDGs), however in many countries in the Pacific region gender inequality is widespread. Working with men and boys presents an important opportunity to address gender inequality. A ‘Men’s Health Project’ was implemented in rural districts in Timor-Leste and Papua New Guinea (PNG) in 2014-17, which aimed to promote gender equality and improve sexual and reproductive health and maternal and child health outcomes by actively engaging men. Community surveys were undertaken in each community before and after project implementation to enable a greater understanding of men’s knowledge and attitudes at these different time points. This paper reports findings from the more recent surveys with 400 men in Timor-Leste in 2016 and 243 men in PNG in 2017, in order to provide a ‘snapshot’ of the situation in these rural communities at this time. In both countries, the vast majority of men reported that the husband makes the major decisions in the household (80% in Timor-Leste and 84% in PNG). In Timor-Leste, 5% of respondents felt it was okay for a husband to beat his wife, with 13% reporting this in PNG. Findings suggest that meeting SDGs 3 and 5 will require ongoing and concerted efforts in Timor-Leste and PNG.

Inclusion of intrauterine device insertion to registered nurses’ scope of clinical practice

Publisher: Elsevier BV

Date: 02-2019

DOI: 10.1016/J.COLEGN.2017.12.002

Telehealth sexual and reproductive health care during the COVID-19 pandemic

Publisher: Wiley

Date: 09-08-2021

DOI: 10.5694/MJA2.51219

More confident, less formal: stylistic changes in academic psychology writing from 1970 to 2016

Publisher: Springer Science and Business Media LLC

Date: 26-09-2021

DOI: 10.1007/S11192-021-04166-9

National Cervical Screening Program renewal in Australia: survey of clinician views and attitudes

Publisher: CSIRO Publishing

Date: 2020

DOI: 10.1071/PY20032

Abstract: From 1 December 2017, the National Cervical Screening Program was renewed in Australia, with updated national cervical screening guidelines released. This study was performed to determine clinicians’ familiarity with the updated guidelines and explore their views and attitudes towards the renewed program. Clinicians providing cervical screening in New South Wales, Australia, were invited to complete an online survey in 2018. Of the 241 clinicians who responded, 91.5% supported the change to 5-yearly human papillomavirus screening from the age of 25 years. However, nearly 13% indicated they did not know where to access the renewed guidelines and 37% had never or rarely accessed them. Open-ended responses highlighted clinicians’ concerns about missed cancers and missed opportunities for health checks. Those raising these concerns accessed the guidelines less frequently. The findings highlight important areas for additional education and support for clinicians in translating guidelines into practice to ensure successful delivery of the renewed program.

Maternal and Child Health in South Sudan

Publisher: SAGE Publications

Date: 04-2015

DOI: 10.1177/2158244015581190

Abstract: The Republic of South Sudan continues to face considerable challenges in meeting maternal, newborn and child health (MNCH) care needs and improving health outcomes. Ongoing instability and population displacement undermine scope for development, and damaged infrastructure, low coverage of health services, and limited government capacity and a human resource base have resulted in a fragmented health system. Despite considerable attention, effort and support, the issues and challenges facing South Sudan remain deep and sustained, and urban–rural disparities are considerable. There is a need to maintain investments in MNCH care and to support developing systems, institutions, and programs. This review of the literature offers a commentary and appraisal of the current MNCH situation in South Sudan. It explores the barriers and challenges of promoting MNCH gains, and identifies priorities that will contribute to addressing the Millennium Development Goals and the emerging health priorities for the post-2015 development agenda.

Intrauterine contraceptive device training and outcomes for healthcare providers in developed countries: A systematic review

Publisher: Public Library of Science (PLoS)

Date: 15-07-2019

DOI: 10.1371/JOURNAL.PONE.0219746

Beyond Compliance Checking: A Situated Approach to Visual Research Ethics

Publisher: Springer Science and Business Media LLC

Date: 19-03-2018

DOI: 10.1007/S11673-018-9850-0

Abstract: Visual research methods like photography and digital storytelling are increasingly used in health and social sciences research as participatory approaches that benefit participants, researchers, and audiences. Visual methods involve a number of additional ethical considerations such as using identifiable content and ownership of creative outputs. As such, ethics committees should use different assessment frameworks to consider research protocols with visual methods. Here, we outline the limitations of ethics committees in assessing projects with a visual focus and highlight the sparse knowledge on how researchers respond when they encounter ethical challenges in the practice of visual research. We propose a situated approach in relation to visual methodologies that encompasses a negotiated, flexible approach, given that ethical issues usually emerge in relation to the specific contexts of in idual research projects. Drawing on available literature and two case studies, we identify and reflect on nuanced ethical implications in visual research, like tensions between aesthetics and research validity. The case studies highlight strategies developed in-situ to address the challenges two researchers encountered when using visual research methods, illustrating that some practice implications are not necessarily addressed using established ethical clearance procedures. A situated approach can ensure that visual research remains ethical, engaging, and rigorous.

Views and experiences of the female condom in Australia: An exploratory cross-sectional survey of cisgender women

Publisher: Public Library of Science (PLoS)

Date: 19-02-2021

DOI: 10.1371/JOURNAL.PONE.0246664

Abstract: The female condom is the only female-initiated form of protection against unintended pregnancy and sexually transmissible infections (STIs). However, use of this method in Australia is low. To better understand women’s views and experiences of the female condom, we conducted an interventional cross-sectional study. Cisgender women ≥16 years, heterosexually active and living in New South Wales were recruited through social media advertisements and email invitations to clients of a family planning service. Eligible participants were provided with three female condoms and invited to complete a follow-up survey. Survey responses for women who attempted to use at least one female condom were summarised using counts and proportions. We recruited 556 women few (30/556) had used the female condom before the study. There were 284 women who used, or attempted to use, a female condom during the study and completed the follow-up survey. Fifty-one percent (104/205) reported experiencing some difficulty in insertion, although only 46% (130/284) had seen an instructional demonstration. Approximately half (105/204) of women rated the sensation and comfort of the female condom as the same or better than the male condom, and 66% (137/204) reported that it provided the same or better lubrication. Approximately half of women said they would consider using the female condom again for STI prevention (51% (133/260)) or contraception (40% (103/260)), or would recommend to others (43% (112/260)). Findings highlight the need for increased health promotion and education regarding use of the female condom. To increase access it will be important to address method cost and availability in Australia. Future research should explore other perspectives of this method, including among the LGBTIQ+ community.

Promoting cervical screening among women experiencing homelessness and socio-economic disadvantage in Sydney

Publisher: Wiley

Date: 15-02-2020

DOI: 10.1002/HPJA.322

Abstract: Australia's national cervical screening program has reduced rates of cervical cancer morbidity and mortality. However, these benefits have not been experienced by all women. A Cervical Cancer Screening Project was implemented with lay health educators to address inequitable screening access by women experiencing socio-economic disadvantage. Resources and a training program were developed and piloted with the specialist homelessness services workforce in Sydney, NSW. Data was collected to inform their development and evaluation through interviews, focus groups, self-administered surveys and analysis of NSW Pap Test Register data. Women reported low familiarity with the term 'cervical screening'. They identified a good patient-doctor relationship, and seeing a female practitioner, as screening enablers. While the majority reported having cervical screening before, NSW Pap Test Register data showed only 74% had screened previously and of those, 69% were overdue. Homelessness service workers expressed interest in talking with clients about cervical screening, and reported increased knowledge and confidence following training. The homelessness sector is an appropriate venue to access women who are disadvantaged and under-screened. However, increasing workforce capacity to discuss screening does not lead to increased screening for women accessing these services. Further efforts are required. SO WHAT?: Access to cervical screening by women experiencing disadvantage remains a challenge. Sustained multi-faceted health promotion efforts are required to increase access. These should be informed by additional research exploring barriers and enablers for this group of women.

Feasibility, acceptability and sustainability of postpartum contraceptive implant provision by midwives in NSW public hospitals

Publisher: Elsevier BV

Date: 09-2022

DOI: 10.1016/J.WOMBI.2021.11.002

Abstract: Repeat pregnancy in the first year after a birth is common. Many of these conceptions are unintended and may be prevented by providing access to contraception in the immediate postpartum period. Midwives in the hospital setting could potentially play a greater role in improving postnatal contraception information and provision. We sought to implement and examine the success of a program training hospital-based midwives in immediate postpartum implant insertion. This mixed methods study in two hospitals in New South Wales sought to explore the feasibility, acceptability and sustainability of a program that provided competency-based implant insertion training for midwives. The study documented training completion, implant insertion numbers and experience, and conducted end of study interviews with midwives and stakeholders. Twenty-seven midwives undertook training and inserted 265 implants during the study period. Interviews with 13 midwives and 11 stakeholders concluded the program to be feasible and acceptable with midwives reporting high satisfaction from their involvement. All interviewees felt that midwives were well placed to insert implants, and reported that challenges around workload and opportunities for practice were generally manageable. It was recognised that sustainability of the program would require supportive policy and regular insertion opportunities. Midwives successfully upskilled in implant insertions and there was widespread support for the program with expectations it would be sustained. Provision of contraceptive information and implant insertion by midwives in the immediate postpartum period is likely to increase contraceptive choice and access for women and contribute to reducing rapid repeat pregnancies.

Sexuality education for primary school students with disability in Fiji

Publisher: SAGE Publications

Date: 23-04-2021

DOI: 10.1177/00178969211011227

Abstract: People with disability have the same sexual and reproductive health needs and rights as people without disability, yet experience considerable barriers in accessing information and services. The Reproductive and Family Health Association of Fiji, Family Planning Australia, and disability stakeholders implemented a comprehensive sexuality education (CSE) disability inclusion project to increase access for students with disability to age-appropriate sexuality education. A train the trainer model was utilised, whereby staff and disability stakeholders undertook competency-based training on delivering sexuality education to teachers and people with disability, then trained and supported teachers working in special disability schools to provide sexuality education to students. An evaluation explored the acceptability and effectiveness of the project, utilising baseline and endline surveys and interviews. From 2016 to 2018, the CSE disability project reached teachers and students in nine special disability schools in Fiji. At project completion, teachers reported increased confidence overall in teaching about sexuality and relationships, and students demonstrated increased knowledge regarding puberty and body changes. Interview findings suggested the project contributed to overcoming silence and stigma for people with disability and promoting safety for young people. Age- and developmentally appropriate sexuality education for people with disability is essential for equipping them with necessary knowledge and skills. The CSE disability project utilised a collaborative, capacity building approach to co-design and implement sexuality education in special disability schools in Fiji. With commitment from stakeholders, this could be sustained and expanded to support students with disability in achieving optimal sexual and reproductive health.

Hidden Carers? a Scoping Review of the Needs Of Carers of People with HIV in the Contemporary Treatment Era

Publisher: Bristol University Press

Date: 11-2018

DOI: 10.1332/239788218X15411705099442

Abstract: The role of carers in supporting people with HIV is largely hidden in Western countries in the contemporary era of antiretroviral treatments. Little is known about their needs. A scoping review was undertaken to describe the research available on the needs of this group and identify gaps in existing knowledge. Findings reveal that carers of people with HIV have similar needs to other carers but are currently mostly invisible to support services. The article suggests that the discourse of independence underpinning the new HIV treatment era may be difficult for carers to ‘disrupt’ by naming what they do as ‘care’.

Men and masculinities in qualitative research on vasectomy: perpetuation or progress?

Publisher: Informa UK Limited

Date: 13-07-2020

DOI: 10.1080/14461242.2020.1789486

Abstract: Although vasectomy is a safe and highly effective method of contraception, uptake is variable globally, with scope for increased engagement in high income nations. Very little qualitative research has been published in recent years to explore men's perspectives on vasectomy, which represents a key opportunity to better understand and strengthen men's contribution to reproductive and contraception equality. This paper takes a scoping review approach to identify key findings from the small but important body of qualitative literature. Recent masculinities research argues that, despite some expansion in ways of being masculine, an underpinning ethos of

Women’s needs for lifestyle risk reduction engagement during the interconception period: a scoping review

Publisher: BMJ

Date: 27-02-2023

DOI: 10.1136/BMJSRH-2022-201699

Abstract: Unhealthy lifestyle is responsible for many chronic conditions, and antenatal engagement with women about lifestyle behaviours can be too late to prevent some adverse pregnancy outcomes and subsequent childhood risks. To reduce the risk of future adverse outcomes, the interconception period is an opportunity to implement positive health changes. The aim of this scoping review was to explore women’s needs for lifestyle risk reduction engagement during the interconception period. The JBI methodology guided our scoping review. Six databases were searched for peer-reviewed, English-language research papers published between 2010 and 2021 on topics including perceptions, attitudes, lifestyle, postpartum, preconception and interconception. Title-abstract and full text screening was independently undertaken by two authors. Included papers’ reference lists were searched to find additional papers. The main concepts were then identified using a descriptive and tabular approach. A total of 1734 papers were screened and 33 met our inclusion criteria. Most included papers (82%, n=27) reported on nutrition and/or physical activity. Papers identified interconception through postpartum and/or preconception. Women’s self-management needs for lifestyle risk reduction engagement during interconception included: informational needs, managing competing priorities, physical and mental health, self-perception and motivation, access to services and professional support, and family and peer networks. There is a range of challenges for women to engage in lifestyle risk reduction during interconception. To enable women’s preferences for how lifestyle risk reduction activities can be enacted, issues including childcare, ongoing and tailored health professional support, domestic support, cost and health literacy need to be addressed.

Policy context and narrative leading to the commissioning of the Australian Indigenous Burden of Disease study

Publisher: Springer Science and Business Media LLC

Date: 15-03-2015

DOI: 10.1186/S12961-015-0004-0

Unintended pregnancy among Aboriginal and Torres Strait Islander women: where are the data?

Publisher: Wiley

Date: 07-06-2022

DOI: 10.5694/MJA2.51605

Navigating trans visibilities, trauma and trust in a new cervical screening clinic

Publisher: Informa UK Limited

Date: 10-09-2022

DOI: 10.1080/13691058.2021.1952307

Abstract: Trans and gender erse people are globally recognised as being under-served in clinical services, with significant implications for their health. During a national reorientation of the Australian cervical screening programme - from Papanicolaou smears to human papillomavirus screening - we conducted interviews with 12 key informants in cancer policy, sexual and reproductive health and trans health advocacy to understand how trans people's needs and experiences were being accounted for and addressed in health policy and practice. Themes captured the complexities of increasing visibility for trans people, including men and non-binary people with a cervix. These complexities reflect the extensive system and cultural change required in asking policymakers and practitioners to think differently about who is at risk of a disease typically associated with cisgender women. Informants drew on the language of trauma to explain the resistance many trans people feel when engaging with clinical services, particularly relating to sexual and reproductive health. In doing so, they argued for increasing resources and processes to elicit trans people's willingness to put their trust in such services. Thinking critically about the relationship between the politics of trans visibilities, trauma and trust can support effective and inclusive approaches to transgender health.

Outcomes of routine screening for reproductive coercion in a family planning service

Publisher: CSIRO Publishing

Date: 05-10-2021

DOI: 10.1071/SH21079

Abstract: Background Reproductive coercion (RC) occurs when a person’s autonomous decision-making regarding reproductive health is compromised by another. RC screening, that is, the use of routine, non-invasive screening questions asked of service users/clients, is one strategy that can be used to assess for RC. Routine screening for RC was implemented within Family Planning NSW clinical consultations in December 2018. A cross-sectional study was undertaken to review the outcomes of screening to better understand the situation of RC among women accessing family planning services. Methods A retrospective review of clinical consultation data of eligible women attending Family Planning NSW clinics in 2019 was undertaken. Descriptive analysis was conducted and modified Poisson regression was used to estimate prevalence ratios and assess associations between binary outcomes and client characteristics. Results Of 7943 women eligible for RC screening, 5497 were screened (69%) and 127 women (2.3%) disclosed RC. RC was more likely to be disclosed among clients who were unemployed, had a disability or had more than one visit within 1 year. Conclusions Sexual and reproductive health clinicians, in particular, are well placed to conduct RC screening. However, they must have adequate training and access to resources to implement screening and respond to women who disclose RC.

Drawing them in: professional perspectives on the complexities of engaging ‘culturally diverse’ young people with sexual and reproductive health promotion and care in Sydney, Australia

Publisher: Informa UK Limited

Date: 26-09-2016

DOI: 10.1080/13691058.2016.1233354

Abstract: Young people from minority ethnic, migrant and refugee backgrounds are widely recognised as being under-served by mainstream sexual and reproductive healthcare in developed economy nations. This paper documents the views of professionals in Australia on the complexities of, and best practice approaches to, engaging members of this group with sexual and reproductive health promotion and care. Semi-structured interviews were conducted with 23 purposively selected key informants (health service providers, policymakers, academics and community advocates). Interviews were transcribed verbatim and coded in NVivo10 using interpretive thematic analysis. Principles of 'cultural competence' were employed to structure the interpretation of findings. Five key themes reveal pivotal aspects of how professionals work in, and make sense of, this complex field. These may be summarised as: (1) appreciating the complexities of cultural ersity (2) recognising structural barriers and disincentives to engagement (3) normalising sexual health (4) balancing 'youth-friendly' and 'culturally-competent' priorities and (5) going beyond simple translation. As migration to Australia continues to ersify the population, an integrated, national approach to the design and delivery of sexual and reproductive health promotion and care would be of value, along with training and support for those involved. Implications may have resonance for other countries similarly engaged in facilitating the successful settlement of migrants and refugees.

The female condom: What do Australian women say?

Publisher: Wiley

Date: 21-02-2022

DOI: 10.1002/HPJA.459

Abstract: The female condom is a barrier method for the prevention of sexually transmissible infections and unintended pregnancy. Uptake of this method remains low in Australia, although little research has been undertaken to explore this. An interventional cross‐sectional study was undertaken in 2019 to explore the views and experiences of women in New South Wales. After trying the female condom, they were invited to complete an online survey and/or structured interview. Training in the use of the female condom was not provided. This paper reports on qualitative findings from open‐ended survey responses and interviews. In total, 284 participants completed the survey and 20 participated in an interview. Most were aware of the female condom prior to participating in the study, but few had used it previously. Four broad themes were identified from the data: (i) accessibility of the female condom, including cost and availability, (ii) supporting choice in different circumstances, (iii) aspects of empowerment and control and (iv) use of gendered language. The female condom may be an acceptable option for many women in Australia. To support the choice of method and promote uptake, it will be important to increase the accessibility of the female condom by raising awareness and addressing the issues of cost and availability. Further exploration of issues regarding inclusive language and messaging in health promotion c aigns and marketing is warranted to ensure that this product is accessible for all people who may wish to use it, regardless of gender or sexuality. Similar research could be undertaken with men artners and members of the LGBTQ+ community to explore their perspectives of the female condom. To support contraceptive choice and promote the uptake of the female condom for those who desire this method, it will be important to address the issues of cost and availability. Accessibility will also be enhanced through the consideration of inclusive language and messaging in health promotion c aigns and marketing of the female condom.

The Strong Family Program: an innovative model to engage Aboriginal and Torres Strait Islander youth and Elders with reproductive and sexual health community education

Publisher: Wiley

Date: 18-08-2016

DOI: 10.1071/HE16015

Beyond deficit: ‘strengths-based approaches’ in Indigenous health research

Publisher: Wiley

Date: 19-06-2021

DOI: 10.1111/1467-9566.13311

Abstract: Health research concerning Indigenous peoples has been strongly characterised by deficit discourse—a ‘mode of thinking’ that is overly focused on risk behaviours and problems. Strengths‐based approaches offer a different perspective by promoting a set of values that recognise the capacities and capabilities of Indigenous peoples. In this article, we seek to understand the conceptual basis of strengths‐based approaches as currently presented in health research. We propose that three main approaches exist: ‘resilience’ approaches concerned with the personal skills of in iduals ‘social–ecological’ approaches, which focus on the in idual, community and structural aspects of a person's environment and ‘sociocultural’ approaches, which view ‘strengths’ as social relations, collective identities and practices. We suggest that neither ‘resilience’ nor ‘social–ecological’ approaches sufficiently problematise deficit discourse because they remain largely informed by Western concepts of in idualised rationality and, as a result, rest on logics that support notions of absence and deficit. In contrast, sociocultural approaches tend to view ‘strengths’ not as qualities possessed by in iduals, but as the structure and character of social relations, collective practices and identities. As such, they are better able to capture Indigenous ways of knowing and being and provide a stronger basis on which to build meaningful interventions.

Routledge International Handbook of Women’s Sexual and Reproductive Health

Publisher: Routledge

Date: 23-09-2019

DOI: 10.4324/9781351035620

Evaluation of Comprehensive Sexuality Education and Support Workshops for Parents and Carers of Children and Young People with Intellectual Disability and/or Autism Spectrum Disorders

Publisher: Springer Science and Business Media LLC

Date: 04-2023

DOI: 10.1007/S11195-023-09786-Y

Using digital storytelling to promote the sexual health and well-being of migrant and refugee young people: A scoping review

Publisher: SAGE Publications

Date: 13-12-2017

DOI: 10.1177/0017896917745568

Abstract: Digital storytelling and other methods of self-expression and autobiography have become an increasingly important tool for those working with young people, including those from migrant, refugee or other ‘culturally erse’ backgrounds. A structured scoping review was undertaken to better understand the potential value and challenges of using digital stories to promote the health and well-being of these erse groups of young people and to identify key knowledge gaps. The review process comprised a systematic search of the literature and strategic consultations with professionals working with young people in the area of sexual and reproductive health promotion and care. A descriptive-analytic method was used to collate and synthesise the literature and apply narrative and thematic analyses. In total, 28 papers were deemed eligible for inclusion. Findings are presented as two analyses: what is known from the literature and key knowledge gaps. Identified themes included the use of digital stories as social activism and as research intervention, recognition of digital stories as complex terrain and recommendations for good practice. Three key gaps of particular relevance to our research aims were identified. These were (1) the lack of digital stories on sexual health and relationships by ‘culturally erse’ young people in Australia, (2) the need for discussion of the ethical considerations of using digital storytelling and related methods in sexual health fields and (3) the value of exploring opportunities to employ digital methods as self-representation and autobiography to generate new knowledge and build organisational capacity. As confirmed in discussions with professionals working in the youth, migrant and sexual health sectors, the literature highlighted the many potential applications of digital storytelling to promoting the sexual health and well-being of young people from erse backgrounds. Additional research is required to understand the particular ethical and contextual issues shaping, and at times constraining, this engagement in specific cultural contexts.

Talking to migrant and refugee young people about sexual health in general practice

Publisher: The Royal Australian College of General Practitioners

Date: 08-2018

DOI: 10.31128/AJGP-02-18-4508

Contraception provision in the postpartum period: Knowledge, views and practices of midwives

Publisher: Elsevier BV

Date: 02-2021

DOI: 10.1016/J.WOMBI.2020.07.013

Targeting cancer prevention and screening interventions to LGBTQ communities: A scoping review

Publisher: Hindawi Limited

Date: 14-12-2021

DOI: 10.1111/HSC.13257

Renewal of the National Cervical Screening Program: health professionals’ knowledge about screening of specific populations in NSW, Australia

Publisher: The Sax Institute

Date: 2022

DOI: 10.17061/PHRP31122104

Abstract: The National Cervical Screening Program was renewed in Australia from 1 December 2017, with the introduction of 5-yearly human papilloma virus (HPV) screening from age 25, and the release of updated national screening guidelines. This study aimed to determine health professional knowledge of the renewed screening program following implementation. We invited health professionals providing cervical screening in New South Wales (NSW), Australia, to complete an online survey in late 2018, to better understand their knowledge of the renewed screening guidelines, in particular regarding screening of specific populations, and to ascertain whether they had undertaken any educational activities relevant to the renewal. A total of 241 responses were included in the data analysis. Health professionals demonstrated good knowledge of some aspects of the renewed program, including 64-85% correctly identifying limited indications for testing people younger than 25 years, 87% correctly identifying the need for completion of the Test of Cure protocol following treatment of high-grade lesions, and 71-80% correctly identifying management of symptomatic women. However several key knowledge gaps were identified including management of immune-deficient women (only 37% of respondents were aware of the need for 3-yearly screening), screening after total hysterectomy (56% were aware of guidance) and approximately 66% of health professionals correctly identifying indications for self-collected screening. One in ten health professionals had not undertaken any education specific to the renewal of the program. We found significant associations between knowledge levels and practitioner characteristics, including practitioners' frequency of access to the guidelines, specific educational activities undertaken and geographic location. Health professionals demonstrated strong knowledge of key aspects of the renewed National Cervical Screening program. However, our findings highlight some important gaps that may impact successful delivery of the program in Australia, and some significant associations between practitioner characteristics and knowledge levels, which will be important for education providers to note. Targeted educational interventions informed by these findings could support health professionals to better translate guidelines into practice and ensure successful delivery of this important public health program, particularly in regard to management of immune-deficient women, screening after hysterectomy and indications for self-collected screening.

Cervical screening in Solomon Islands: challenges and opportunities for a national screening programme

Publisher: Informa UK Limited

Date: 11-05-2021

DOI: 10.1080/09614524.2021.1907541

Effectiveness of preconception interventions in primary care: a systematic review

Publisher: Royal College of General Practitioners

Date: 07-10-2022

DOI: 10.3399/BJGP.2022.0040

Abstract: Primary care-based preconception care (PCC) has the potential to improve pregnancy outcomes, but the effectiveness is unclear. To evaluate the effectiveness of primary care-based PCC delivered to reproductive-aged females and/or males to improve health knowledge, reduce preconception risk factors, and improve pregnancy outcomes. A systematic review of primary care-based PCC. Ovid MEDLINE, Cochrane CENTRAL, Embase, Web of Science, Scopus, and CINAHL were searched for randomised controlled trials (RCTs) published between July 1999 and May 2021. Two reviewers independently evaluated article eligibility and quality. Twenty-eight articles reporting on 22 RCTs were included. All but one focused on females. Interventions included brief education (single session) ( n = 8), intensive education (multiple sessions) ( n = 9), supplementary medication ( n = 7), and dietary modification ( n = 4). Brief education improved health knowledge in females ( n = 3) and males ( n = 1), reduced alcohol/tobacco consumption ( n = 2), and increased folate intake ( n = 3). Intensive education reduced spontaneous pregnancy loss ( n = 1), alcohol-exposed pregnancies ( n = 2), and increased physical activity ( n = 2). Supplementary medication increased folate intake ( n = 4) and dietary modification reduced pre-ecl sia ( n = 1) and increased birth weight ( n = 1). Only nine articles reported on pregnancy outcomes, with a range of interventions used of these, four reported improvements in pregnancy outcomes. Most RCTs were of low quality ( n = 12). Primary care-based PCC including brief and intensive education, supplementary medication, and dietary modification are effective in improving health knowledge and reducing preconception risk factors in females, although there is limited evidence for males. Further research is required to determine whether primary care-based PCC can improve pregnancy outcomes.

Ethical Considerations of Using Walking Interviews to Engage Migrant and Refugee Young People in Health Service Research

Publisher: SAGE Publications Ltd

Date: 2019

DOI: 10.4135/9781526473073

Understanding women’s views of and preferences for accessing postpartum contraception: a qualitative evidence synthesis

Publisher: BMJ

Date: 12-01-2023

DOI: 10.1136/BMJSRH-2022-201718

Abstract: Nearly half of women experience unintended pregnancies. These are associated with increased risk of poor maternal physical and psychosocial health outcomes. Many pregnancies in the first year postpartum are unintended, further increasing risks of poor outcomes and complications. We undertook a qualitative evidence synthesis to evaluate qualitative research on women’s views and preferences for accessing postpartum contraception, and identify evidence gaps and opportunities for postpartum contraception provision. Five databases were searched to identify relevant qualitative studies. Included studies focused on views of, and preferences for, accessing postpartum contraception for women of reproductive age in high-income countries. Of 1854 studies identified, 28 full texts were assessed and 19 studies included. These were critically appraised using Confidence in the Evidence from Reviews of Qualitative research (GRADE-CERQual) and analysed using thematic synthesis. Included studies indicated the majority of women desire postpartum contraception, but face a range of financial, health system and personal barriers. Women felt unclear about the ideal interpregnancy interval (IPI) and the rationale for this. Women preferred contraceptive counselling at varying times both antenatally and postnatally, and commonly preferred to receive contraception in the immediate postpartum period before hospital discharge. Women commonly saw their obstetrician or general practitioner for contraceptive counselling, but welcomed midwifery involvement. Most women were interested in postpartum contraception and pregnancy spacing, but felt unclear about the optimal IPI, highlighting the need for further education and support around this issue. Contraceptive counselling was viewed as valuable antenatally and postnatally, and by varying maternal health providers, as was the provision of immediate postpartum contraception.

Learning about sex and relationships among migrant and refugee young people in Sydney, Australia: ‘I never got the talk about the birds and the bees’

Publisher: Informa UK Limited

Date: 30-04-2018

DOI: 10.1080/14681811.2018.1464905

Who is responsible for postpartum contraception advice and provision? The perspective of hospital‐based maternity clinicians in New South Wales, Australia

Publisher: Wiley

Date: 03-11-2023

DOI: 10.1111/AJO.13627

Abstract: Access to postpartum contraception is critical for the health of the mother and subsequent pregnancies. However, the differential roles and responsibilities of maternity care providers in contraception discussions and provision are often unclear. Our study, part of a larger study on midwifery provision of contraceptive implants, presents the perspectives of hospital‐based maternity clinicians. Participants suggested that contraception discussions and provision are a shared responsibility of maternity care providers but identified inconsistencies and issues with current approaches. Access to contraception could be improved through more routine discussions antenatally and postnatally and greater collaboration between maternity care providers in hospital, community and primary care settings.

Improving rural and regional access to long-acting reversible contraception and medical abortion through nurse-led models of care, task-sharing and telehealth (ORIENT): a protocol for a stepped-wedge pragmatic cluster-randomised controlled trial in Australian general practice

Publisher: BMJ

Date: 03-2023

DOI: 10.1136/BMJOPEN-2022-065137

Abstract: Women living in rural and regional Australia often experience difficulties in accessing long-acting reversible contraception (LARC) and medical abortion services. Nurse-led models of care can improve access to these services but have not been evaluated in Australian general practice. The primary aim of the ORIENT trial (ImprOving Rural and regIonal accEss to long acting reversible contraceptioN and medical abortion through nurse-led models of care, Tasksharing and telehealth) is to assess the effectiveness of a nurse-led model of care in general practice at increasing uptake of LARC and improving access to medical abortion in rural and regional areas. ORIENT is a stepped-wedge pragmatic cluster-randomised controlled trial. We will enrol 32 general practices (clusters) in rural or regional Australia, that have at least two general practitioners, one practice nurse and one practice manager. The nurse-led model of care (the intervention) will be codesigned with key women’s health stakeholders. Clusters will be randomised to implement the model sequentially, with the comparator being usual care. Clusters will receive implementation support through clinical upskilling, educational outreach and engagement in an online community of practice. The primary outcome is the change in the rate of LARC prescribing comparing control and intervention phases secondary outcomes include change in the rate of medical abortion prescribing and provision of related telehealth services. A within-trial economic analysis will determine the relative costs and benefits of the model on the prescribing rates of LARC and medical abortion compared with usual care. A realist evaluation will provide contextual information regarding model implementation informing considerations for scale-up. Supporting nurses to work to their full scope of practice has the potential to increase LARC and medical abortion access in rural and regional Australia. Ethics approval was obtained from the Monash University Human Research Ethics Committee (Project ID: 29476). Findings will be disseminated via multiple avenues including a knowledge exchange workshop, policy briefs, conference presentations and peer-reviewed publications. This trial is registered with the Australian New Zealand Clinical Trials Registry (ACTRN12622000086763).

Young migrant and refugee people’s views on unintended pregnancy and abortion in Sydney

Publisher: Informa UK Limited

Date: 03-05-2020

DOI: 10.1080/14461242.2020.1764857

Acceptability of the copper intrauterine device as a form of emergency contraception in New South Wales, Australia

Publisher: Informa UK Limited

Date: 19-02-2020

DOI: 10.1080/13625187.2020.1726888

Increasing the accessibility of long-acting reversible contraceptives through nurse-led insertions: A cost-benefit analysis

Publisher: Elsevier BV

Date: 02-2020

DOI: 10.1016/J.COLEGN.2019.05.001

Training nurses in contraceptive implant procedures: implications for practice in Australia

Publisher: Elsevier BV

Date: 02-2021

DOI: 10.1016/J.COLEGN.2020.04.005

UNSW Sydney

Location: Australia

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Monash University

Location: Australia

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University Of Technology Sydney

Location: Australia

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University Of New South Wales

Location: Australia

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Family Planning New South Wales

Location: Australia

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Linkage Projects - Grant ID: LP170100190

Start Date: 11-2018

End Date: 10-2022

Amount: $211,408.00

Funder: Australian Research Council

Linkage Projects - Grant ID: LP160101687

Start Date: 01-2018

End Date: 04-2022

Amount: $139,930.00

Funder: Australian Research Council