ORCID Profile
0000-0002-6350-843X
Current Organisations
Max Planck Institute of Biophysics
,
La Trobe University Judith Lumley Centre
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Research Topics
In Research Link Australia (RLA), "Research Topics" refer to ANZSRC FOR and SEO codes. These topics are either sourced from ANZSRC FOR and SEO codes listed in researchers' related grants or generated by a large language model (LLM) based on their publications.
Top 5 Research Topics
ANZSRC Field of Research (FoR)
Primary Health Care | Nursing | Preventive Medicine | Mental Health | Public Health and Health Services | Epidemiology | Nursing Not Elsewhere Classified | Sociology | Applied Sociology, Program Evaluation and Social Impact Assessment | Health Promotion |
ANZSRC Socio-Economic Objective (SEO)
Women’s health | Mental Health | Prevention—biologicals (e.g. vaccines) | Women's Health | Child health | Injury Control | Evaluation of health outcomes | Health policy evaluation
Related Links
Publications
Psychological therapies for women who experience intimate partner violence
Publisher: Wiley
Date: 15-05-2018
Protocol for ACCESS: A qualitative study exploring barriers and facilitators to accessing the emergency contraceptive pill from community pharmacies in Australia
Publisher: BMJ
Date: 12-2015
Screening for domestic violence
Publisher: BMJ
Date: 14-12-2002
Understanding sustained domestic violence identification in maternal and child health nurse care: Process evaluation from a 2-year follow-up of the MOVE trial
Publisher: Wiley
Date: 12-11-2016
DOI: 10.1111/JAN.12851
Abstract: To investigate factors contributing to the sustained domestic violence screening and support practices of Maternal and Child Health nurses 2 years after a randomized controlled trial. Domestic violence screening by healthcare professionals has been implemented in many primary care settings. Barriers to screening exist and screening rates remain low. Evidence for longer term integration of nurse screening is minimal. Trial outcomes showed sustained safety planning behaviours by intervention group nurses. Process evaluation in 2-year follow-up of a cluster randomized controlled trial. Evaluation included a repeat online nurse survey and 14 interviews (July-September 2013). Survey analysis included comparison of proportionate group difference between arms and between trial baseline and 2 year follow-up surveys. Framework analysis was used to assess qualitative data. Normalization Process Theory informed evaluation design and interpretation of results. Survey response was 77% (n = 123/160). Sustainability of nurse identification of domestic violence appeared to be due to greater nurse discussion and domestic violence disclosure by women, facilitated by use of a maternal health and well-being checklist. Over time, intervention group nurses used the maternal checklist more at specific maternal health visits and found the checklist the most helpful resource assisting their domestic violence work. Nurses' spoke of a degree of 'normalization' to domestic violence screening that will need constant investment to maintain. Sustainable domestic violence screening and support outcomes can be achieved in an environment of comprehensive, nurse designed and theory driven implementation. Continuing training, discussion and monitoring of domestic violence work is needed to retain sustainable practices.
Unplanned pregnancy and emergency contraception in Australia: Unsolved dilemmas
Publisher: Elsevier BV
Date: 04-2014
p63 uses a switch-like mechanism to set the threshold for induction of apoptosis
Publisher: Springer Science and Business Media LLC
Date: 27-07-2020
Associations of Self-Reported Violence with Age at Menarche, First Intercourse, and First Birth Among a National Population Sample of Young Australian Women
Publisher: Elsevier BV
Date: 09-2007
DOI: 10.1016/J.WHI.2007.06.003
Abstract: This paper estimates the relation between women's experience of violence and the age of menarche, first sexual intercourse, and first birth. The data are from the Younger Cohort of the Australian Longitudinal Study on Women's Health, which includes 9,683 women, aged between 22 and 27 years in 2000, who responded to surveys in both 1996 and 2000. In 1996, 9% of women reported current or previous partner violence and a further 5% reported it in 2000. Similarly, 11% and 8% reported recent nonpartner violence. Fifteen percent of the women reported first intercourse at <16 years. Early first intercourse was strongly associated with partner violence whereas young age at menarche and teenage birth were only associated with partner violence reported when women were or =17 years. These data clearly demonstrate a nexus between early intercourse and reported violence and add to the evidence of risks associated with early sexual initiation. These findings substantiate the need to prevent or reduce rates of early sexual abuse, to protect very young women from sexual exposure and to assist and support young women in their sexual decision making. We need to identify young women who have already experienced abuse or violence and undertake therapeutic interventions to prevent further victimization.
Reflections on maternal health care within the Victorian Maternal and Child Health Service
Publisher: CSIRO Publishing
Date: 2016
DOI: 10.1071/PY15096
Abstract: Women suffer significant morbidity following childbirth and there is a lack of focussed, primary maternal health care to support them. Victorian Maternal and Child Health (MCH) nurses are ideally suited to provide additional care for women when caring for the family with a new baby. With additional training and support, MCH nurses could better fill this health demand and practice gap. This discussion paper reviews what we know about maternal morbidity, current postnatal services for women and the maternal healthcare gap, and makes recommendations for enhancing MCH nursing practice to address this deficit.
Body Mapping to Explore Reproductive Ethno-Physiological Beliefs and Knowledge of Contraception in Timor-Leste
Publisher: SAGE Publications
Date: 31-12-2018
Abstract: Maternal mortality remains a significant public health challenge for Timor-Leste. Although access to quality family planning measures may greatly reduce such deaths, consideration of indigenous perceptions, and how they influence reproductive health decision-making and behavior, is crucial if health services are to provide initiatives that are accepted and helpful in improving reproductive health outcomes. We aimed to demonstrate that body mapping is an effective method to traverse language and culture to gain emic insights and indigenous worldviews. The authors' two qualitative research projects (2013 and 2015) used a decolonizing methodology in four districts of Timor-Leste, body mapping with 67 men and 40 women to illuminate ethno-physiology and indigenous beliefs about conception, reproduction, and contraception. Body mapping provided a beneficial conduit for identifying established indigenous reproductive perceptions, understandings, and vocabulary, plus fears surrounding contraception. This may inform health service provision and engagement, ultimately improving the reproductive health of community members.
Increasing the availability of long-acting reversible contraception and medical abortion in primary care: the Australian Contraception and Abortion Primary Care Practitioner Support Network (AusCAPPS) cohort study protocol
Publisher: BMJ
Date: 12-2022
DOI: 10.1136/BMJOPEN-2022-065583
Abstract: Although primary care practitioners are the main providers of long-acting reversible contraception (LARC) and early medical abortion (EMA) in Australia, few provide these services. A professional community of practice (CoP) has the potential to improve LARC and EMA provision through evidence-based guidance, expert support and peer-to-peer engagement. The primary objective is to establish, implement and evaluate an innovative, multidisciplinary online CoP (AusCAPPS Network) to increase LARC and EMA services in Australian primary care. Secondary objectives are to (1) increase the number of general practitioners (GPs) and pharmacists certified to provide or dispense EMA, respectively, (2) increase LARC and EMA prescription rates and, (3) improve primary care practitioners’ knowledge, attitudes and provision of LARC and EMA. A stakeholder knowledge exchange workshop (KEW) will be conducted to inform the AusCAPPS Network design. Once live, we aim to reach 3000 GPs, practice nurses and community pharmacists members. Changes in the number of GPs and pharmacists certified to provide or dispense EMA, respectively, and changes in the number of LARCs and EMAs prescribed will be gleaned through health service data. Changes in the knowledge attitudes and practices will be gleaned through an online survey with 500 in iduals from each professional group at baseline and 12 months after members have joined AusCAPPs and experiences of the AusCAPPS Network will be evaluated using interviews with the project team plus a convenience s le of 20 intervention participants from each professional group. The project is underpinned by the Reach, Effectiveness, Adoption, Implementation and Maintenance framework, and a realist framework will inform analysis. Ethical approval was received from the Monash University Human Research Ethics Committee (No. 28002). Dissemination will occur through KEWs, presentations, publications and domestic and international networks. ACTRN12622000655741.
Fractured Identity in the Context of Intimate Partner Violence: Barriers to and Opportunities for Seeking Help in Health Settings
Publisher: SAGE Publications
Date: 02-09-2016
Abstract: Intimate partner violence has profound effects on women’s identities. However, detailed examination of how abuse affects identity is lacking. We interviewed 14 erse women (Australia), applying social identity theory to analyze their experiences of identity and help-seeking in health settings. The destabilizing effect of violence on social identities was strongly supported. Women concealed abuse to preserve a public identity. However, when the violence threatened the most integrated identities, women unveiled an abuse identity, receiving mixed responses from health providers. A healing context where a woman can display an abuse identity safely is crucial to enable her to rebuild an integrated self-concept.
Screening women for intimate partner violence in healthcare settings
Publisher: John Wiley & Sons, Ltd
Date: 30-04-2013
Screening women for intimate partner violence in health care settings
Publisher: John Wiley & Sons, Ltd
Date: 23-01-2008
Access, equity and costs of induced abortion services in Australia: a cross-sectional study
Publisher: Elsevier BV
Date: 06-2017
Abstract: To examine access and equity to induced abortion services in Australia, including factors associated with presenting beyond nine weeks gestation. Cross-sectional survey of 2,326 women aged 16+ years attending for an abortion at 14 Dr Marie clinics. Associations with later presentation assessed using multivariate logistic regression. Over a third of eligible women opted for a medical abortion. More than one in 10 (11.2%) stayed overnight. The median Medicare rebated upfront cost of a medical abortion was $560, compared to $470 for a surgical abortion at ≤9 weeks. Beyond 12 weeks, costs rose considerably. More than two-thirds (68.1%) received financial assistance from one or more sources. Women who travelled ≥4 hours (AdjOR: 3.0, 95%CI 1.2-7.3), had no prior knowledge of the medical option (AdjOR: 2.1, 95%CI 1.4-3.1), had difficulty paying (AdjOR: 1.5, 95%CI 1.2-1.9) and identified as Aboriginal and/or Torres Strait Islander (AdjOR: 2.1, 95%CI 1.2-3.4) were more likely to present ≥9 weeks. Abortion costs are substantial, increase at later gestations, and are a financial strain for many women. Poor knowledge, geographical and financial barriers restrict method choice. Implications for public health: Policy reform should focus on reducing costs and enhancing early access.
Screening and counselling in the primary care setting for women who have experienced intimate partner violence (WEAVE): A cluster randomised controlled trial
Publisher: Elsevier BV
Date: 07-2013
Two-year follow up of a cluster randomised controlled trial for women experiencing intimate partner violence: effect of screening and family doctor-delivered counselling on quality of life, mental and
Publisher: BMJ
Date: 12-2020
DOI: 10.1136/BMJOPEN-2019-034295
Abstract: This was a 2-year follow-up study of a primary care-based counselling intervention (weave) for women experiencing intimate partner violence (IPV). We aimed to assess whether differences in depression found at 12 months (lower depression for intervention than control participants) would be sustained at 24 months and differences in quality in life, general mental and physical health and IPV would emerge. Cluster randomised controlled trial. Researchers blinded to allocation. Unit of randomisation: family doctors. Fifty-two primary care clinics, Victoria, Australia. Baseline: 272 English-speaking, female patients (intervention n=137, doctors=35 control n=135, doctors=37), who screened positive for fear of partner in past 12 months. Twenty-four-month response rates: intervention 59% (81/137), control 63% (85/135). Intervention doctors received training to deliver brief, woman-centred counselling. Intervention patients were invited to receive this counselling (uptake rate: 49%). Control doctors received standard IPV information delivered usual care. Twenty-four months primary outcomes: WHO Quality of Life-Bref dimensions, Short-Form Health Survey (SF-12) mental health. Secondary outcomes: SF-12 physical health and caseness for depression and anxiety (Hospital Anxiety Depression Scale), post-traumatic stress disorder (Check List-Civilian), IPV (Composite Abuse Scale), physical symptoms (≥6 in last month). Data collected through postal survey. Mixed-effects regressions adjusted for location (rural/urban) and clustering. No differences detected between groups on quality of life (physical: 1.5, 95% CI −2.9 to 5.9 psychological: −0.2, 95% CI −4.8 to 4.4, social: −1.4, 95% CI −8.2 to 5.4 environmental: −0.8, 95% CI −4.0 to 2.5), mental health status (−1.6, 95% CI −5.3 to 2.1) or secondary outcomes. Both groups improved on primary outcomes, IPV, anxiety. Intervention was no more effective than usual care in improving 2-year quality of life, mental and physical health and IPV, despite differences in depression at 12 months. Future refinement and testing of type, duration and intensity of primary care IPV interventions is needed. ACTRN12608000032358.
Social determinants and maternal exposure to intimate partner violence of obstetric patients with severe maternal morbidity in the intensive care unit: A systematic review protocol
Publisher: BMJ
Date: 11-2016
Cost-effectiveness of health care interventions to address intimate partner violence: What do we know and what else should we look for?
Publisher: SAGE Publications
Date: 22-02-2011
Abstract: Intimate partner violence (IPV) creates a substantial burden of disease and significant costs to families, communities, and governments. Building the evidence for effective interventions to reduce violence and its sequelae requires increased use of economic evaluation to inform policy through the analysis of costs and potential savings of interventions. The authors review existing economic evaluations and present case studies of current research from the United Kingdom and Australia to illustrate the strengths and limitations of two approaches to generating economic evidence: economic evaluation alongside randomized controlled trials and economic modeling. Economic evaluation should always be considered in the design of IPV intervention research.
Screening women for intimate partner violence in healthcare settings: abridged Cochrane systematic review and meta-analysis
Publisher: BMJ
Date: 12-05-2014
DOI: 10.1136/BMJ.G2913
Childhood Sexual Abuse and Its Association With Adult Physical and Mental Health: Results From a National Cohort of Young Australian Women
Publisher: SAGE Publications
Date: 18-11-2015
Abstract: Childhood sexual abuse (CSA) occurs across the world, with a prevalence of 20% internationally. Our aim was to investigate the associations between CSA, CSA plus adult violence experiences, and selected self-reported physical and mental health in a community s le of women. Data from 7,700 women aged 28-33 years from the 1973-1978 cohort who completed Survey 4 of the Australian Longitudinal Study on Women’s Health (ALSWH) were analyzed. Questions about prior abuse experience such as child sexual abuse, IPV, adult physical and sexual assaults, andphysical and mental health. Women who experienced CSA were 1.4 times more likely to experience bodily pain (adjusted odds ratio [AOR] = 1.37, confidence interval [CI] = [1.19, 1.58]), 1.3 times more likely to have poorer general health (AOR = 1.33, CI = [1.15, 1.54]), and 1.4 times more likely to be depressed in the past 3 years (AOR = 1.44, CI = [1.22, 1.71]) compared with those without abuse.. Women who experienced both CSA and adult violence were 2.4 to 3.1 times more likely to experience poor general (AOR = 2.35, CI = [1.76, 3.14]) and mental health (AOR = 2.69, CI = [1.98, 3.64]), and suffer from depression (AOR = 2.84, CI = [2.13, 3.78]) and anxiety (AOR = 3.10, CI = [2.12, 4.53]) compared with women with no abuse. This study demonstrates the importance of CSA in pain and poorer long-term mental and physical health.. It emphasizes how prior CSA may lify pain and poorer long-term mental and physical health among women who are again exposed to violence in adulthood.
Children, Parental Alcohol Consumption, and Intimate Partner Violence: A Multicountry Analysis by Perpetration Versus Victimization and Sex
Publisher: SAGE Publications
Date: 17-10-2021
Abstract: Both living with children and alcohol consumption are positively associated with intimate partner violence (IPV). We assessed their combined relationship with physical IPV (P-IPV) victimization and perpetration, and explored possible moderating roles of sex and culture. Data included 15 surveys of 13,716 men and 17,832 women in 14 countries from the GENACIS (Gender, Alcohol, and Culture: An International Study) collaboration. P-IPV was measured as victim of physical aggression by an intimate partner (Vic-Only), perpetrator of physical aggression toward a partner (Perp-Only), or both victim and perpetrator (i.e., bidirectional) (Bi-Dir). Participants reported whether they lived with children below 18 years of age, whether the participant was a drinker/abstainer, and, among drinkers, usual frequency and quantity of alcohol consumed. Multilevel multinomial logistic regression, controlling for age and nesting of data within countries, indicated that Vic-Only, Perp-Only, and Bi-Dir (compared with no P-IPV) were positively associated with living with children, being a drinker, and quantity/frequency of drinking among drinkers (especially higher quantity). The positive association of P-IPV with living with children and being a drinker was evident within most countries. Significant interactions with sex were found, with (a) living with children more strongly associated with Perp-Only for men and Vic-Only for women, and (b) Perp-Only and Bi-Dir more strongly associated with being a drinker for men but with quantity consumed for women. Also, alcohol consumption was more strongly related to Perp-Only and Bi-Dir than with Vic-Only. In conclusion, higher risk of P-IPV with alcohol consumption is compounded when living with children—putting children who live with drinkers, especially drinkers who consume large amounts per occasion, at special risk of exposure to P-IPV. This is an important area for future research and prevention.
Applying normalization process theory to understand implementation of a family violence screening and care model in maternal and child health nursing practice: A mixed method process evaluation of a randomised controlled trial
Publisher: Springer Science and Business Media LLC
Date: 28-03-2015
Sexual behaviour in early adolescence: A cross‐national comparison of Australian and United States youth
Publisher: Informa UK Limited
Date: 03-2017
DOI: 10.1111/AJPY.12118
Interventions for intimate partner violence
Publisher: Elsevier BV
Date: 2015
Intimate partner violence against women: What outcomes are meaningful?
Publisher: American Medical Association (AMA)
Date: 04-08-2010
Using theory to design, implement and evaluate sustained nurse domestic violence screening and supportive care
Publisher: SAGE Publications
Date: 02-08-2016
Abstract: Domestic violence is prevalent and harmful for abused women and children and damages women’s capacity to maintain wellbeing and parent effectively. As women’s health is likely to be poor, greater identification and support by nurses for abused women is needed. The aim of this study is to highlight the importance of theory in nursing intervention research on domestic violence and how the application of implementation theory can be used to promote programme sustainability. In particular, we discuss the use of Normalization Process Theory (NPT) in the MOVE (improving maternal and child health care for vulnerable mothers) study, a randomised controlled trial which aimed to increase nurse inquiry, safety planning and referral of abused women. NPT was used in the participatory action research and design stage of the trial, in the implementation and process evaluation phases. In conclusion, the use of implementation theory in nursing research can enhance the uptake of complex interventions, address the knowledge–practice gap and potentially improve outcomes for women experiencing domestic violence.
The preferences of women in Australia for the features of long-acting reversible contraception: results of a discrete choice experiment
Publisher: Informa UK Limited
Date: 28-07-2022
DOI: 10.1080/13625187.2022.2098947
Abstract: Long-acting reversible contraceptives (LARC), such as intrauterine devices (IUD) and implants, are highly effective. However, the uptake of LARC in Australia has been slow and the oral contraceptive pill (OC) remains the best known and most widely used contraceptive. Our aim was to investigate women's preferences for the features of LARC. We used a discrete choice experiment (DCE) in which each respondent completed 12 choice tasks. We recruited a general population s le of 621 women in Australia aged 18-49 using an online survey panel. A mixed logit model was used to analyse DCE responses a latent class model explored preference heterogeneity. Overall, 391 (63%) of women were currently using contraception 49.3% were using an OC. About 22% of women were using a LARC. Women prefer products that are more effective in preventing pregnancy, have low levels of adverse events (including negative effects on mood), and which their general practitioner (GP) recommends or says is suitable for them. Women have strong preferences for contraceptive products that are effective, safe, and recommended by their GP. The results indicate which characteristics of LARCs need to be front and centre in information material and in discussions between women and healthcare professionals.
Termination of pregnancy: associations with partner violence and other factors in a national cohort of young Australian women
Publisher: Elsevier BV
Date: 04-2007
DOI: 10.1111/J.1753-6405.2007.00031.X
Abstract: To examine the associations between termination and other reproductive events, socio-demographic characteristics and experience of violence among a community-based national s le of young Australian women. Using multiple logistic regression, we analysed data from the Younger cohort of the Australian Longitudinal Study on Women's Health comprising 14,776 young women aged 18-23 in survey 1 (1996), of whom 9,683 aged 22-27 also responded to survey 2 (2000). We stratified respondents into those aged below 20 and those who were older at survey 1. We compared the characteristics associated with terminations among teenage women in 1996 (survey 1) with those of women aged over 20 in 1996 who had not then reported a termination and who responded to survey 2 in 2000. Finally, we compared the characteristics of women reporting terminations, births, preterm births and miscarriages. Women reporting teenage terminations were more likely to be in a de facto relationship (OR = 1.94, 95% CI 1.17-3.21), less well educated (OR = 2.32, 95% CI 1.44-3.74), have no private health insurance, and be a victim of partner violence (OR = 3.11, 95% CI 1.76-5.49). Women reporting later terminations were also more likely to be abused by a partner (OR = 3.52, 95% CI 2.14-5.81).The relationship with violence held for the other reproductive events. Partner violence is a strong predictor of termination and other reproductive outcomes among young Australian women. Education has a protective effect. Prevention and reduction of partner violence may reduce the rate of unwanted pregnancy.
Screening women for intimate partner violence in healthcare settings
Publisher: Wiley
Date: 22-07-2015
Responding to violence against women: A qualitative study with midwives in Timor-Leste
Publisher: Elsevier BV
Date: 08-2019
DOI: 10.1016/J.WOMBI.2018.10.008
Abstract: The health sector is a critical partner in the response to violence against women, but little is known about how to translate international guidelines and sustainable good practice in remote and under-resourced health systems. This research explores the barriers and enablers that midwives report in responding to domestic and sexual violence in Timor-Leste, a country with a very high rate of violence against women. The aim is to inform a systems approach to health provider training and engagement applicable to Timor-Leste and other low-resource settings. In 2016 we conducted qualitative interviews and group discussions with 36 midwives from rural health settings, community health centres and hospitals in three municipalities of Timor-Leste. A range of in idual, health system and societal factors shape midwives' practice. While training provided the foundation for knowing how to respond to cases of violence, midwives still faced significant health system barriers such as lack of time, privacy and a supportive environment. Key enablers were support from colleagues and health centre managers. Health provider training to address violence against women is important but tends to focus on in idual knowledge and skills. There is a need to shift toward systems-based approaches that engage all staff and managers within a health facility, work creatively to overcome barriers to implementation, and link them with wider community-based resources.
From silence to sensitivity: A new Identity Disclosure model to facilitate disclosure for same-sex attracted women in general practice consultations
Publisher: Elsevier BV
Date: 07-2012
DOI: 10.1016/J.SOCSCIMED.2012.02.037
Abstract: Women's same-sex attraction is rarely raised within general practice consultations, despite a common desire for its inclusion. Same-sex attracted women are significantly more likely than heterosexual women to suffer a range of health inequalities, making disclosure of sexual orientation often clinically relevant. This research explored the influences on disclosure from the perspectives of GPs and their regular same-sex attracted female patients. We conducted in-depth semi-structured interviews between mid 2005 and late 2006 with 33 same-sex attracted Australian women, 27 GPs and 1 psychiatrist, including 24 patient-GP pairs. Analysis revealed three disclosure patterns by same-sex attracted women with their preferred GPs, which we labelled open (telling), passive (waiting to be asked) and private (not telling). The three main influences on disclosure patterns were women's sexual identity experience, the risk of disclosure perceived by women and GPs, and the quality of the patient-doctor relationship. We developed the Identity Disclosure model to explain the interactions between these three influences. The more important a woman's sexual identity, the more likely she was to prefer an open disclosure approach, while a lower level of identity importance led to a passive or private approach. Risk and relationship then counterbalanced the disclosure decision. A high level of perceived risk for women or GPs would reduce women's openness, or GPs' willingness to facilitate disclosure. Reciprocal knowing within the relationship would attenuate risk and increase openness. Reciprocity had the capacity to increase GPs' shared responsibility for disclosure, which was desired by many women. We suggest that the Identity Disclosure model will facilitate GPs' understanding of the complex influences on disclosure, and ultimately transform their consultations with same-sex attracted women beyond the habitual silence to a new level of sensitivity.
Current contraceptive management in Australian general practice: An analysis of BEACH data
Publisher: AMPCo
Date: 07-2012
DOI: 10.5694/MJA11.11599
Abstract: To determine current contraceptive management by general practitioners in Australia. Analysis of data from a random s le of 3910 Australian GPs who participated in the Bettering the Evaluation and Care of Health (BEACH) survey, a continuous cross-sectional survey of GP activity, between April 2007 and March 2011. Consultations with female patients aged 12-54 years that involved all forms of contraception were analysed. GP and patient characteristics associated with the management of contraception types of contraception used rates of encounters involving emergency contraception. Increased age, ethnicity, Indigenous status and holding a Commonwealth Health Care Card were significantly associated with low rates of encounters involving management of contraception. The combined oral contraceptive pill was the most frequently prescribed method of contraception, with moderate prescription of long-acting reversible contraception (LARC), especially among women aged 34-54 years. Rates of consultations concerned with emergency contraception were low, but involved high rates of counselling, advice or education (48%) compared with encounters for general contraception (> 20%). A shift towards prescribing LARC, as recommended in clinical guidelines, has yet to occur in Australian general practice. Better understanding of patient and GP perspectives on contraceptive choices could lead to more effective contraceptive use.
Introduction to COMPASS: navigating complexity in public health research
Publisher: Springer Science and Business Media LLC
Date: 2011
What influences a woman’s decision to access contraception in Timor-Leste? Perceptions from Timorese women and men
Publisher: Informa UK Limited
Date: 06-03-2018
DOI: 10.1080/13691058.2018.1433330
Abstract: Timor-Leste's Maternal Mortality Ratio remains one of the highest in Asia. There is le evidence that maternal deaths may be reduced substantially through the provision of good-quality modern methods of contraception. Many Timorese women wish to stop or delay having children. However, even when health services make contraception available, it does not mean that people will use it. Collaborating with Marie Stopes Timor-Leste, this qualitative research project used decolonising methodology to explore perceived influences contributing to contraceptive choices, and gain insight into how women's decisions to access contraception in Timor-Leste occur. Over two fieldwork periods (2013 and 2015), we used focus group discussions and structured interviews to speak with 68 women and 80 men, aged 18-49 years, across four districts of Timor-Leste. Findings demonstrate that the decision to access contraception is often contentious and complicated. These tensions echo concerns and ambiguities contained within global and national reproductive health policy. Overwhelmingly, participants emphasised that despite her wishes, a woman can only rarely exercise her right to access contraception freely and independently. She is most often constrained by family, cultural, traditional and educational influences.
Does drinking modify the relationship between men's gender-inequitable attitudes and their perpetration of intimate partner violence? A meta-analysis of surveys of men from seven countries in the Asia Pacific region
Publisher: Wiley
Date: 28-04-2021
DOI: 10.1111/ADD.15485
Abstract: Although men's alcohol misuse and less gender‐equitable attitudes have been identified as risks for perpetration of intimate partner violence (IPV), less is known about how men's gender‐equitable attitudes and drinking act together to increase risk of IPV. This study aimed to assess the independent relationships of lower gender‐equitable attitudes and drinking to perpetration of IPV and their interaction among men in seven countries. Secondary analysis of the United Nations Multi‐Country Study on Men and Violence (UNMCS) and Nabilan Study databases consisting of (1) unadjusted and adjusted logistic regression to measure the association of perpetration of IPV with gender‐equitable men (GEM) scale score and regular heavy episodic drinking (RHED) and (2) meta‐analyses of prevalence and effect estimates adjusted for country‐level sites and countries. A total of 9148 ever‐partnered 18–49‐year‐old men surveyed in 2011–15 from 18 sites in Bangladesh, Cambodia, China, Indonesia, Papua New Guinea, Sri Lanka and Timor Leste. The outcome variable is reported perpetration of physical or sexual IPV in the previous year. Independent variables: GEM scale scores RHED, defined as six or more drinks in one session at least monthly (compared with other drinkers and abstainers). Pooled past‐year prevalence of perpetration of IPV was 13% [95% confidence interval (CI) = 9–16%]. GEM scores and RHED were independently associated with perpetration of IPV overall and in most sites. Pooled odds ratios (ORs) for perpetration of IPV with less equitable GEM scores were 1.07 (95% CI = 1.04, 1.09) and with RHED were 3.42 (95% CI = 2.43, 4.81). A significant interaction between GEM score and RHED ( P = 0.001) indicated that RHED increased the relationship of less gender‐equitable attitudes and perpetration of IPV. Both gender‐inequitable attitudes and drinking appear to be associated with perpetration of intimate partner violence by men, with regular heavy episodic drinking increasing the likelihood of intimate partner violence among men with less equitable gender attitudes.
Managing maternal and child health nurses undertaking family violence work in Australia: A qualitative study.
Publisher: Hindawi Limited
Date: 19-09-2022
DOI: 10.1111/JONM.13466
Abstract: To explore the experience of nurse managers managing maternal and child health nurses undertaking family violence work in Victoria, Australia. Health care practitioners' ability to address violence against women is strengthened by health service systems that include effective staff management and leadership. Maternal and child health nurses work with women experiencing abuse however, their support by the health system and their managers has not been examined. Semi-structured interviews with 12 nurse managers in 2019-2020 explored how they supervised and managed nurses. The data were analysed using reflexive thematic analysis. We identified three themes-(a) managing the service: being resourceful (b) supporting nurses' emotional safety and (c) hitting the ground running: the demands on the manager. Inadequate support for nurse managers undermines workplace well-being and role satisfaction, impacting the safety and supervision of nurses doing family violence work. An integrated family violence systems approach must include improved training and support for nurse managers to enable reflective practice and ensure effective support for nurses working with women experiencing abuse.
Excessive alcohol use and its association with risky sexual behaviour: a cross‐sectional analysis of data from Victorian secondary school students
Publisher: Elsevier BV
Date: 02-2013
Alcohol interventions, alcohol policy and intimate partner violence: A systematic review
Publisher: Springer Science and Business Media LLC
Date: 27-08-2014
Enhanced maternal and child health nurse care for women experiencing intimate partner/family violence: protocol for MOVE, a cluster randomised trial of screening and referral in primary health care
Publisher: Springer Science and Business Media LLC
Date: 20-09-2012
Intimate partner violence and the experience of early motherhood: A cross-sectional analysis of factors associated with a poor experience of motherhood
Publisher: Elsevier BV
Date: 03-2016
DOI: 10.1016/J.MIDW.2015.12.011
Abstract: to examine the relationship between intimate partner violence and other factors associated with the experience of early motherhood. cross sectional secondary data analysis (n=1534) from MOVE: a cluster randomised controlled trial that evaluated a model of enhanced nurse screening and supportive care for abused women. Victoria, Australia. postpartum women attending community based maternal and child health clinics. survey included the Experience of Motherhood Questionnaire measures of partner abuse, depression, anxiety, stress and social support. Multivariable robust regression analysis used. independent of other factors, abused women were more likely to have a poorer mothering experience (Adj b=2.01, 95% CI=0.78, 3.25). Poor mental health, abuse as a child and being born overseas were also associated with a poor experience. Busy mothers who had a multiple birth and those balancing work and study simultaneously had higher experience of motherhood scores, indicating a poorer experience. Social support was protective. exposure to partner violence is adversely associated with early motherhood, independent of other correlates of poor motherhood experience. Greater awareness of factors associated with intimate partner violence and mothering would enable health care professionals and policy makers to improve support for women and children experiencing violence.
Increasing the uptake of long-acting reversible contraception in general practice: The Australian Contraceptive ChOice pRoject (ACCORd) cluster randomised controlled trial protocol
Publisher: BMJ
Date: 10-2016
Ethical complexities of screening for depression and intimate partner violence (IPV) in intervention studies
Publisher: Springer Science and Business Media LLC
Date: 2011
The power of social connection and support in improving health: Lessons from social support interventions with childbearing women
Publisher: Springer Science and Business Media LLC
Date: 2011
Physical and social predictors of partner abuse in women attending general practice: A cross-sectional study
Publisher: Royal College of General Practitioners
Date: 07-2008
Voices from low-income and middle-income countries: A systematic review protocol of primary healthcare interventions within public health systems addressing intimate partner violence against women
Publisher: BMJ
Date: 03-2018
DOI: 10.1136/BMJOPEN-2017-019266
Abstract: Intimate partner violence (IPV) considerably harms the health, safety and well-being of women. In response, public health systems around the globe have been gradually implementing strategies. In particular, low-income and middle-income countries (LMIC) have been developing innovative interventions in primary healthcare (PHC) addressing the problem. This paper describes a protocol for a systematic review of studies addressing the impacts and outcomes of PHC centre interventions addressing IPV against women from LMIC. A systematic search for studies will be conducted in African Index Medicus, Africa Portal Digital Library, Cumulative Index to Nursing and Allied Health Literature (CINAHL), Embase, Index Medicus for the Southeast Asia Region, IndMed, Latin American and Caribbean Health Science Literature Database (LILACS), Medecins Sans Frontieres, MEDLINE, Minority Health and Health Equity Archive, ProQuest, PsycINFO, Scientific Electronic Library Online, (SciELO) and Social Policy and Practice. Studies will be in English, Spanish and Portuguese, published between 2007 and 2017, addressing IPV against women from LMIC, whose data quantitatively report on the impacts and outcomes for survivors and/or workers and/or public health systems preintervention and postintervention. Two trilingual reviewers will independently screen for study eligibility and data extraction, and a librarian will cross-check for compliance. Risk of bias and quality assessment of studies will be measured according to: (1) the Cochrane Collaboration’s tool for assessing risk of bias for randomised controlled trials and (2) the Methodological Index for Non-Randomised Studies (MINORS). Data will be analysed and summarised using meta-analysis and narrative description of the evidence across studies. This systematic review will be reported according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols(PRISMA P) guidelines. This systematic review will be based on published studies, thus not requiring ethical approval. Findings will be presented in conferences and published in a peer-reviewed journal. CRD42017069261 .
Violence between intimate partners: working with the whole family
Publisher: BMJ
Date: 04-08-2008
DOI: 10.1136/BMJ.A839
The impact of violence against women on reproductive health and child mortality in Timor‐Leste
Publisher: Elsevier BV
Date: 04-2015
Abstract: To determine differences in reproductive health and infant and child mortality and health between abused and non-abused ever-married women in Timor-Leste. Secondary data analysis of Timor-Leste Demographic Health Survey (1,959 ever-married women aged 15-49 years). Associations with violence estimated using multinomial logistic regression adjusted for sociodemographic variables and age of first intercourse. Overall, 45% of ever-married women experienced violence: 34% reported physical only and 11% reported combined physical, sexual and/or emotional violence. Compared to non-abused women, women reporting physical violence only were more likely to use traditional contraception (AdjOR 2.35, 95%CI 1.05-5.26) or report: a sexually transmitted infection (AdjOR 4.46, 95%CI 3.27-6.08) a pregnancy termination (AdjOR 1.42, 95%CI 1.03-1.96) a child who had died (AdjOR 1.30, 95%CI 1.05-1.60), a low birth weight infant (AdjOR 2.08, 95%CI 1.64-2.64) and partially vaccinated children (AdjOR 1.35, 95%CI 1.05-1.74). Women who reported combined abuse were more likely to report: a sexually transmitted infection (AdjOR 3.51, 95%CI 2.26-5.44) a pregnancy termination (AdjOR 1.95, 95%CI 1.27-3.01) few antenatal visits (AdjOR 1.76 95%CI 1.21-2.55) and a child who had died (AdjOR 1.45, 95%CI 1.06-2.00). Violence exposes women to poor reproductive health, infant and child mortality and poor infant and child health. Preventing and reducing violence against women should improve women and children's health outcomes in Timor-Leste.
Partner violence and postnatal mental health: cross-sectional analysis of factors associated with depression and anxiety in new mothers
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/PY17174
Abstract: Intimate-partner violence and poor mental health are common, harmful issues for women of childbearing age. Although the prevalence and correlates of postpartum depression are well established, far less is known about postpartum anxiety. We aimed to investigate the association between postnatal depression and anxiety, and intimate-partner violence among women attending Victorian Maternal and Child Health services, using data from a randomised control trial: Improving Maternal and Child Health care for Vulnerable Mothers (MOVE). These data included postnatal women who had given birth between May and December 2010. Multiple logistic regression was used to estimate the association between intimate partner violence (using the Composite Abuse Scale) and postnatal depression and anxiety (Depression, Anxiety and Stress Scale), controlling for participant socio-demographic characteristics. Findings showed that abused women were more likely to report postnatal depressive and anxiety symptoms. There was an almost two-fold (odds ratio (OR) 1.76, 95% CI 1.03–3.01) and three-fold (OR 2.6, 95% CI 1.58–4.28) increase in the odds of reporting depressive and anxiety symptoms respectively, among abused compared with non-abused women. Abused women are at a higher risk of mental health problems. This study validated findings that intimate-partner violence is strongly associated with an increased risk of postnatal depression and highlighted the previously under-reported relationship with postnatal anxiety.
Depression and termination of pregnancy (induced abortion) in a national cohort of young Australian women: The confounding effect of women's experience of violence
Publisher: Springer Science and Business Media LLC
Date: 26-02-2008
Abortion and mental health: Established facts reconsidered
Publisher: Royal College of Psychiatrists
Date: 08-2009
Protocol for a randomised controlled trial of a web-based healthy relationship tool and safety decision aid for women experiencing domestic violence (I-DECIDE)
Publisher: Springer Science and Business Media LLC
Date: 08-2015
Intimate Partner Violence and the Association with Very Preterm Birth
Publisher: Wiley
Date: 03-2013
DOI: 10.1111/BIRT.12024
Abstract: Intimate partner violence is a major public health problem. It occurs commonly in pregnancy, resulting in adverse events for women and their fetus or children. The objective of this study was to examine the association between intimate partner violence and very preterm birth. This population-based, case-control study was conducted in Victoria, Australia, from 2002 to 2004. Interviews were conducted with 603 women who had a singleton very preterm birth (20-31 weeks' gestation), 770 women who had a singleton term birth (37 or more completed weeks' gestation), 139 women who had a very preterm twin birth, and 214 women who had a term twin birth. Intimate partner violence was measured using the Composite Abuse Scale, and questions were also asked about fear of partners and violence from others. Prevalence of intimate partner violence in the past 12 months was 14.9 percent in singleton case women, 11.7 percent in singleton control women, 9.5 percent in twin case women, and 14.7 percent in twin control women. Fear of a previous partner and reporting similar violence experience with someone else were more likely in singleton births (AOR = 1.36 95% CI 1.03, 1.79) and (AOR = 1.44 95% CI 1.12, 1.86), respectively. No differences between twin case women and twin control women were observed. When the precipitating cause of very preterm birth was investigated, antepartum hemorrhage was significantly associated with intimate partner violence and all its subscales. The heterogeneity of causes of very preterm birth may explain the lack of association found with intimate partner violence in pregnancy. Pregnant women have a significant risk of intimate partner violence, which should be a serious concern for all care providers.
Women’s satisfaction with and ongoing use of hormonal long‐acting methods compared to the oral contraceptive pill: Findings from an Australian general practice cluster randomised trial (ACCORd)
Publisher: Wiley
Date: 18-02-2021
DOI: 10.1111/AJO.13319
Abstract: The Australian Contraceptive ChOice pRoject (ACCORd) aimed to assess the impact of a complex general practice intervention on the uptake of long‐acting reversible contraceptives (LARC). Using survey data from enrolled women, we aimed to compare the ongoing use and satisfaction of women who chose one of the hormonal LARC methods including the levonorgestrel intrauterine system (LNG‐IUS) or levonorgestrel implant compared to the oral contraceptive pill (OCP). We used the data from participants’ baseline, six and 12‐month surveys to identify new users of implants, LNG‐IUS or OCP. We included demographic information, ongoing use of the contraceptive method, reasons for dissatisfaction and discontinuation and experience of side‐effects. Proportions were compared using χ 2 tests. Of the 740 women enrolled in ACCORd, 176 started using a hormonal LARC or OCP in the study’s first six months with 76 using the IUS (43%), 60 the implant (34%) and 40 (23%) the OCP. Twelve‐month continuation rates for the LNG‐IUS, implant and OCP were 93, 83 and 65% respectively ( P 0.001). Satisfaction was highest among the LNG‐IUS users 86% were very/somewhat satisfied compared to 75% of implant users and 61% of OCP users ( P 0.001). Main reasons for method dissatisfaction were irregular bleeding and mood changes which were similar for all methods. This study provides further evidence that hormonal LARC methods have higher continuation and satisfaction rates compared to the OCP with similar side‐effects. Since hormonal LARC methods have the highest contraceptive efficacy, these should be offered first‐line to women.
Maternal and child health nurse screening and care for mothers experiencing domestic violence (MOVE): a cluster randomised trial
Publisher: Springer Science and Business Media LLC
Date: 25-06-2015
Mothers' AdvocateS in the Community (MOSAIC)-non-professional mentor support to reduce intimate partner violence and depression in mothers: A cluster randomised trial in primary care
Publisher: Springer Science and Business Media LLC
Date: 23-03-2011
Domestic violence against women, public policies and community health workers in Brazilian Primary Health Care
Publisher: FapUNIFESP (SciELO)
Date: 2018
DOI: 10.1590/1413-81232018231.16562015
Abstract: Abstract Domestic violence creates multiple harms for women's health and is a ‘wicked problem’ for health professionals and public health systems. Brazil recently approved public policies to manage and care for women victims of domestic violence. Facing these policies, this study aimed to explore how domestic violence against women is usually managed in Brazilian primary health care, by investigating a basic health unit and its family health strategy. We adopted qualitative ethnographic research methods with thematic analysis of emergent categories, interrogating data with gender theory and emergent Brazilian collective health theory. Field research was conducted in a local basic health unit and the territory for which it is responsible, in Southern Brazil. The study revealed: 1) a yawning gap between public health policies for domestic violence against women at the federal level and its practical application at local/decentralized levels, which can leave both professionals and women unsafe 2) the key role of local community health workers, paraprofessional health promotion agents, who aim to promote dialogue between women experiencing violence, health care professionals and the health care system.
Pharmacy access to the emergency contraceptive pill: A national survey of a random sample of Australian women
Publisher: Elsevier BV
Date: 02-2011
DOI: 10.1016/J.CONTRACEPTION.2010.06.003
Abstract: The emergency contraceptive pill (ECP) has the potential to assist in reducing unintended pregnancy and abortion rates. Since its rescheduling to pharmacy availability without prescription in Australia in January 2004, there is little information about Australian women's knowledge, attitudes and use of the ECP. The aim of this study was to measure the knowledge about the ECP and sociodemographic patterns of and barriers to use of the ECP. A cross-sectional study, using a computer-assisted telephone interview (CATI) survey conducted with a national random s le of 632 Australian women aged 16-35 years. Most women had heard of the ECP (95%) and 26% had used it. The majority of women agreed with pharmacy availability of the ECP (72%) however, only 48% were aware that it was available from pharmacies without a prescription. About a third (32%) believed the ECP to be an abortion pill. The most common reason for not using the ECP was that women did not think they were at risk of getting pregnant (57%). Logistic regression showed that women aged 20-29 years (OR 2.58 CI: 1.29-5.19) and 30-35 years (OR 3.16 CI: 1.47-6.80) were more likely to have used the ECP than those aged 16-19 years. Women with poor knowledge of the ECP were significantly less likely to have used it than those with very good knowledge (OR 0.28 CI: 0.09-0.77). Those in a de facto relationship (OR 2.21 CI: 1.27-3.85), in a relationship but not living with the partner (OR 2.46 95% CI 1.31-4.63) or single women (OR 2.40 CI: 1.33-4.34) were more likely to have used the ECP than married women. Women in Australia have a high level of awareness of the ECP, but more information and education about how to use it and where to obtain it are still needed.
The decision to seek care antenatally and during labour and birth – Who and what influences this in Timor-Leste? A qualitative project exploring the perceptions of Timorese women and men
Publisher: Elsevier BV
Date: 10-2018
DOI: 10.1016/J.MIDW.2018.05.013
Abstract: While global maternal deaths have decreased significantly, hundreds of thousands of women still die from pregnancy and birth complications. Interventions such as skilled birth attendants, emergency transportation to health facilities and birth preparedness have been successful at reducing such deaths, however barriers to seeking, reaching, and receiving respectful care persist. This study aimed to identify what influences people's decisions to seek antenatal care and care during labour and birth in Timor-Leste, a low-middle income newly independent nation in South East Asia with a high maternal death rate. The study aimed to provide emic/local insights to help midwives and maternal health providers tailor care and resources appropriately, thus improving maternal health. This qualitative study with a decolonising methodology, was designed to explore the perceptions of reproductive aged Timorese women and men, situating Timorese worldviews in the centre of the research process. Data collection occurred in four municipalities of Timor-Leste in October 2015 and included 9 focus group discussions with 80 men, and 17 in idual reproductive history interviews with women. An expanded 'Three Delays' model was used to frame the findings. The study found multiple factors impacting on decisions to seek antenatal care and care during labour and birth. Husbands, history, minimal birth preparedness, ethno-physiological beliefs (personal perceptions of how the body works), infrastructure limitations, geographical location, hospital policies and staff attitudes influenced and potentially delayed the decision to seek or reach care. Policies and programs that increase accessibility of midwives and encourage birth preparedness are vital. Given the current locus of power in families in Timor-Leste, it is imperative that men are educated regarding the importance of care from skilled providers, and supported to access such care with their partners. Culturally respectful, inclusive and quality care needs to be emphasised so that trust is established between health providers and communities.
Authors' reply to Whitehouse and Fabre
Publisher: BMJ
Date: 18-06-2014
DOI: 10.1136/BMJ.G3943
I-DECIDE: An Online Intervention Drawing on the Psychosocial Readiness Model for Women Experiencing Domestic Violence
Publisher: Elsevier BV
Date: 03-2015
DOI: 10.1016/J.WHI.2015.07.011
Abstract: Domestic violence (DV) perpetrated by men against women is a pervasive global problem with significant physical and emotional consequences. Although some face-to-face interventions in health care settings have shown promise, there are barriers to disclosure to health care practitioners and women may not be ready to access or accept help, reducing uptake. Similar to the mental health field, interventions from clinical practice can be adapted to be delivered by technology. This article outlines the theoretical and conceptual development of I-DECIDE, an online healthy relationship tool and safety decision aid for women experiencing DV. The article explores the use of the Psychosocial Readiness Model (PRM) as a theoretical framework for the intervention and evaluation. This is a theoretical article drawing on current theory and literature around health care and online interventions for DV. The article argues that the Internet as a method of intervention delivery for DV might overcome many of the barriers present in health care settings. Using the PRM as a framework for an online DV intervention may help women on a pathway to safety and well-being for themselves and their children. This hypothesis will be tested in a randomized, controlled trial in 2015/2016. This article highlights the importance of using a theoretical model in intervention development and evaluation.
Interventions to support recovery after domestic and sexual violence in primary care
Publisher: Informa UK Limited
Date: 09-08-2016
DOI: 10.1080/09540261.2016.1210103
Abstract: Experiences of domestic and sexual violence are common in patients attending primary care. Most often they are not identified due to barriers to asking by health practitioners and disclosure by patients. Women are more likely than men to experience such violence and present with mental and physical health symptoms to health practitioners. If identified through screening or case finding as experiencing violence they need to be supported to recover from these traumas. This paper draws on systematic reviews published in 2013-2015 and a further literature search undertaken to identify recent intervention studies relevant to recovery from domestic and sexual violence in primary care. There is limited evidence as to what interventions in primary care assist with recovery from domestic violence however, they can be categorized into the following areas: first line response and referral, psychological treatments, safety planning and advocacy, including through home visitation and peer support programmes, and parenting and mother-child interventions. Sexual violence interventions usually include trauma informed care and models to support recovery. The most promising results have been from nurse home visiting advocacy programmes, mother-child psychotherapeutic interventions, and specific psychological treatments (Cognitive Behaviour Therapy, Trauma informed Cognitive Behaviour Therapy and, for sexual assault, Exposure and Eye Movement Desensitization and Reprocessing Interventions). Holistic healing models have not been formally tested by randomized controlled trials, but show some promise. Further research into what supports women and their children on their trajectory of recovery from domestic and sexual violence is urgently needed.
Who decides to have sex? Exploring the perceptions of Timorese women and men through a reproductive justice lens
Publisher: Informa UK Limited
Date: 26-02-2020
DOI: 10.1080/13691058.2019.1578414
Abstract: Despite national policies to support sexual rights, Timorese women are constrained when making sexual and reproductive health decisions. Contextual understanding of sexual decision making is vital for effective engagement by sexual and reproductive health service providers with communities. An intersectional reproductive justice approach broadens the sexual rights lens allowing for an examination of multi-system factors impacting on sexual rights and health. Using the Matrix of Domination as a conceptual framework, we explored Timorese perceptions around decisions to have sex, and examined intersecting systems of oppression impacting on these decisions. Our study adopted a critical medical anthropological approach using ethnographic methods. A decolonising methodology aimed to make Timorese worldviews central to the analysis. Nine focus group discussions with 80 men and 17 in idual reproductive history interviews with women were held in 4 of Timor-Leste's 13 municipalities during October 2015. Findings suggest that decisions to have sex are framed in terms of wishes and rights however, it was the perceived entitlements of men that were prioritised and predominantly men who made these decisions. Violence, coercion and unwanted pregnancies were linked to decisions about sex, and identified as potential consequences for women, impacting on women's health and sexual rights.
Effect of Type and Severity of Intimate Partner Violence on Women's Health and Service Use: Findings From a Primary Care Trial of Women Afraid of Their Partners
Publisher: SAGE Publications
Date: 27-08-2013
Abstract: Intimate partner violence (IPV) has major affects on women’s wellbeing. There has been limited investigation of the association between type and severity of IPV and health outcomes. This article describes socio-demographic characteristics, experiences of abuse, health, safety, and use of services in women enrolled in the Women’s Evaluation of Abuse and Violence Care (WEAVE) project. We explored associations between type and severity of abuse and women’s health, quality of life, and help seeking. Women (aged 16–50 years) attending 52 Australian general practices, reporting fear of partners in last 12 months were mailed a survey between June 2008 and May 2010. Response rate was 70.5% (272/386). In the last 12 months, one third (33.0%) experienced Severe Combined Abuse, 26.2% Physical and Emotional Abuse, 26.6% Emotional Abuse and/or Harassment only, 2.7% Physical Abuse only and 12.4% scored negative on the Composite Abuse Scale. A total of 31.6% of participants reported poor or fair health and 67.9% poor social support. In the last year, one third had seen a psychologist (36.6%) or had 5 or more general practitioner visits (34.3%) 14.7% contacted IPV services and 24.4% had made a safety plan. Compared to other abuse groups, women with Severe Combined Abuse had poor quality of life and mental health, despite using more medications, counseling, and IPV services and were more likely to have days out of role because of emotional issues. In summary, women who were fearful of partners in the last year, have poor mental health and quality of life, attend health care services frequently, and domestic violence services infrequently. Those women experiencing severe combined physical, emotional, and sexual abuse have poorer quality of life and mental health than women experiencing other abuse types. Health practitioners should take a history of type and severity of abuse for women with mental health issues to assist access to appropriate specialist support.
Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse
Publisher: John Wiley & Sons, Ltd
Date: 08-07-2009
Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse
Publisher: Wiley
Date: 03-12-2015
Primary care-based training and support interventions are successful in increasing identification and referral of women experiencing domestic violence
Publisher: BMJ
Date: 06-05-2012
Provision of the emergency contraceptive pill without prescription: Attitudes and practices of pharmacists in Australia
Publisher: Elsevier BV
Date: 02-2011
DOI: 10.1016/J.CONTRACEPTION.2010.07.001
Abstract: As 5 years have elapsed since the emergency contraceptive pill (ECP) was made available without prescription in Australia, information was sought about the current attitudes and practices of pharmacists in relation to their increased role in ECP provision. A mail survey was implemented questionnaires were distributed to 750 pharmacies across Australia during 2008-2009. Descriptive statistics were calculated and multiple logistic regression was used to examine factors associated with declining to dispense ECP. Response rate was 29%. Most pharmacists used a protocol to guide ECP dispensing (77.3%) and the majority had declined ECP provision (75.1%) in certain circumstances. Many usually counselled where confidentiality could be assured (62.8%), and agreed that it is a pharmacist's role to counsel on regular contraception (81.9%). Factors significantly associated (p ≤.05) with dispensing practices included pharmacists' attitudes towards acceptability of advance prescription, their age, gender and pharmacy accessibility. New information about Australian pharmacists' current attitudes and practices towards ECP dispensing was identified. Pharmacists had stronger, more conservative attitudes than overseas pharmacists however, the issues that emerged were similar to those reported overseas. To address these, revised training for local pharmacists is recommended.
The prevalence and variations in unintended pregnancy by socio-demographic and health-related factors in a population-based cohort of young Australian women
Publisher: Elsevier BV
Date: 06-2023
Impact of violence against women on severe acute maternal morbidity in the intensive care unit, including neonatal outcomes
Publisher: BMJ
Date: 03-2018
DOI: 10.1136/BMJOPEN-2017-020147
Abstract: Preventing and reducing violence against women (VAW) and maternal mortality are Sustainable Development Goals. Worldwide, the maternal mortality ratio has fallen about 44% in the last 25 years, and for one maternal death there are many women affected by severe acute maternal morbidity (SAMM) requiring management in the intensive care unit (ICU). These women represent the most critically ill obstetric patients of the maternal morbidity spectrum and should be studied to complement the review of maternal mortality. VAW has been associated with all-cause maternal deaths, and since many women (30%) endure violence usually exerted by their intimate partners and this abuse can be severe during pregnancy, it is important to determine whether it impacts SAMM. Thus, this study aims to investigate the impact of VAW on SAMM in the ICU. This will be a prospective case-control study undertaken in a tertiary healthcare facility in Lima-Peru, with a s le size of 109 cases (obstetric patients admitted to the ICU) and 109 controls (obstetric patients not admitted to the ICU selected by systematic random s ling). Data on social determinants, medical and obstetric characteristics, VAW, pregnancy and neonatal outcome will be collected through interviews and by extracting information from the medical records using a pretested form. Main outcome will be VAW rate and neonatal mortality rate between cases and controls. VAW will be assessed by using the WHO instrument. Binary logistic followed by stepwise multivariate regression and goodness of fit test will assess any association between VAW and SAMM. Ethical approval has been granted by the La Trobe University, Melbourne-Australia and the tertiary healthcare facility in Lima-Peru. This research follows the WHO ethical and safety recommendations for research on VAW. Findings will be presented at conferences and published in peer-reviewed journals.
MOSAIC (mothers' advocates in the community): Protocol and sample description of a cluster randomised trial of mentor mother support to reduce intimate partner violence among pregnant or recent mothers
Publisher: Springer Science and Business Media LLC
Date: 27-05-2009
The broader context of preventing alcohol-related intimate partner violence
Publisher: Wiley
Date: 28-06-2016
DOI: 10.1111/DAR.12422
Intimate partner violence against women and healthcare in Australia: charting the scene
Publisher: FapUNIFESP (SciELO)
Date: 04-2012
DOI: 10.1590/S1413-81232012000400025
Abstract: Intimate partner violence against women is a common problem in all countries and generates a challenging agenda for the health sector. Exchanging experiences between different countries, specifically strategies to respond to this problem, can constitute a tool for stimulating debate and promoting reflection. The scope of this article is to present and reflect on aspects of the Australian health sector response to intimate partner violence, and chart the scenario that surrounds this issue. We draw on a range of methods, combining a literature review and a dialogue with different stakeholders and site visits. We describe historical, contemporary and conceptual aspects of healthcare responses to intimate partner violence in Australia. Further we present some of the strategies, public policies and innovative projects that have been developed in this field in Australia. Some of the strategies include: screening vs. case-finding primary care approaches for dealing with all family members respect for ersity and new randomized trials aiming for sustainable health system change for enhanced health professional care of people experiencing intimate partner violence. Despite the limitations of this approach to such a complex theme, we hope to stimulate thinking and discussion.
Debate
Publisher: Springer Science and Business Media LLC
Date: 09-11-2008
Intimate-partner violence and reproductive decision-making by women attending Victorian Maternal- and Child-Health services: a cross-sectional study
Publisher: CSIRO Publishing
Date: 2018
DOI: 10.1071/PY17183
Abstract: The reproductive years are a critical period where women experience greater risk of intimate-partner violence (IPV). Most studies investigating the association between IPV and reproductive health have been completed in low- and middle-income countries. This study aimed to examine the relationship between IPV and women’s reproductive decision-making in Victoria, Australia. We analysed secondary data from a cluster-randomised trial of IPV screening that surveyed new mothers attending Maternal- and Child-Health centres in Melbourne. Survey measures included the experience of partner abuse in the past 12 months using the Composite Abuse Scale and four reproductive decision-making indicators. Results showed that IPV affects reproductive decision-making among postpartum women. Women who reported abuse were less likely to plan for a baby (adjusted Odds Ratio 0.48, 95% CI: 0.31–0.75) than were non-abused women, significantly more likely to have partners make decisions for them about contraception (Risk ratio (RR) 4.09, 95% CI: 1.31–12.75), and whether and when to have a baby (RR 12.35, 95% CI: 4.46–34.16), than they were to make decisions jointly. Pregnant and postpartum women need to be screened for partner violence that compromises women’s decision-making power regarding their reproductive rights.
Emergency contraception in Australia: The desired source of information versus the actual source of information
Publisher: AMPCo
Date: 04-2014
DOI: 10.5694/MJA13.10983
Abstract: To determine long-term trends in emergency contraception (EC) management by general practitioners in Australia. Data from April 2000 to March 2012 were drawn from the BEACH (Bettering the Evaluation and Care of Health) program, a continuous cross-sectional survey of GP activity. We analysed consultations involving EC management, unwanted pregnancy management and emergency contraceptive pill (ECP) prescribing per 1000 GP encounters with women aged 14-54 years. Summary statistics were calculated with 95% confidence intervals. In 2000-2001, GPs managed EC problems at a rate of 5.50 per 1000 encounters (95% CI, 4.37-6.63). From 2004, after the ECP became available over the counter (OTC) in pharmacies, EC management, which includes ECP prescription, progressively declined. By 2011-2012, only 1.43 EC problems were managed per 1000 encounters (95% CI, 0.84-2.02) and only 0.48 ECP prescriptions were provided per 1000 encounters (95% CI, 0.14-0.82). Yet the management rate of unwanted pregnancy problems stayed relatively constant (rate in 2000-2001, 0.95 per 1000 encounters 95% CI, 0.40-1.50 rate in 2011-2012, 0.88 per 1000 encounters 95% CI, 0.41-1.36). Low rates of EC management by GPs since ECP became available OTC suggest that women may be obtaining information on EC elsewhere. Further investigation is needed to uncover the sources of this information and its acceptability and application by Australian women.
HARMONY: a pragmatic cluster randomised controlled trial of a culturally competent systems intervention to prevent and reduce domestic violence among migrant and refugee families in general practice:
Publisher: BMJ
Date: 07-2021
DOI: 10.1136/BMJOPEN-2020-046431
Abstract: Domestic violence and abuse (DVA) is prevalent, harmful and more dangerous among diaspora communities because of the difficulty accessing DVA services, language and migration issues. Consequently, migrant/refugee women are common among primary care populations, but evidence for culturally competent DVA primary care practice is negligible. This pragmatic cluster randomised controlled trial aims to increase DVA identification and referral (primary outcomes) threefold and safety planning (secondary outcome) among erse women attending intervention vs comparison primary care clinics. Additionally, the study plans to improve recording of DVA, ethnicity, and conduct process and economic evaluations. Recruitment of ≤28 primary care clinics in Melbourne, Australia with high migrant/refugee communities. Eligible clinics need ≥1 South Asian general practitioner (GP) and one of two common software programmes to enable aggregated routine data extraction by GrHanite. Intervention staff undertake three DVA training sessions from a GP educator and bilingual DVA advocate/educator. Following training, clinic staff and DVA affected women 18+ will be supported for 12 months by the advocate/educator. Comparison clinics are trained in ethnicity and DVA data entry and offer routine DVA care. Data extraction of DV identification, safety planning and referral from routine GP data in both arms. Adjusted regression analysis by intention-to-treat by staff blinded to arm. Economic evaluation will estimate cost-effectiveness and cost–utility. Process evaluation interviews and analysis with primary care staff and women will be framed by Normalisation Process Theory to maximise understanding of sustainability. Harmony will be the first primary care trial to test a culturally competent model for the care of erse women experiencing DVA. Ethical approval from La Trobe University Human Ethics Committee (HEC18413) and dissemination by policy briefs, journal articles and conference and community presentations. ANZCTR- ACTRN12618001845224 Pre-results.
An examination of femicides in Peru between 2009 and 2014
Publisher: Wiley
Date: 09-2016
Women's evaluation of abuse and violence care in general practice: A cluster randomised controlled trial (weave)
Publisher: Springer Science and Business Media LLC
Date: 02-01-2010
The emergency contraceptive pill rescheduled: A focus group study of women's knowledge, attitudes and experiences
Publisher: BMJ
Date: 04-2009
DOI: 10.1783/147118909787931672
Abstract: The levonorgestrel-containing emergency contraceptive pill (ECP), amongst other strategies, has the potential to assist in reducing unintended pregnancy and abortion rates. Since the rescheduling of the ECP in January 2004 to over-the-counter (OTC) status from pharmacies in Australia, there is little information about Australian women's ECP knowledge, attitudes or practice. The aim of the study was to explore Australian women's knowledge of, attitudes towards and experiences of using the ECP, particularly since it has been available OTC. This paper reports a qualitative study using six focus groups, which were conducted between February and June 2007 in four Australian states with 29 women aged 16-29 years. Participants had a lack of specific knowledge about the ECP. Most were positive about the ECP being available OTC, however some expressed concerns about younger women misusing it. Women's experiences obtaining the ECP from the pharmacy were both positive and negative. Most women said they would use the ECP again if required and would recommend it to a friend. Pharmacists were seen as important suppliers of the ECP but women felt it was not their role to provide advice about contraception or sexually transmitted infections. The findings from this study confirm views from other studies, which suggest that although women have some concerns in relation to OTC supply of the ECP, they believe that the deregulation of the ECP is a positive step. The data also suggest that women need to be provided with more information and education about the ECP.
Longitudinal Changes in Self-Efficacy, Mental Health, Abuse, and Stages of Change, for Women Fearful of a Partner: Findings From a Primary Care Trial (WEAVE)
Publisher: SAGE Publications
Date: 04-2016
Abstract: Women seeking healthcare while experiencing intimate partner violence (IPV) often report a mismatch between healthcare received and desired. An increase in detection of women experiencing IPV through routine screening has not consistently shown a parallel increase in uptake of referrals or decreased abuse. This study investigates relationships between women’s stage of change (SOC), mental health, abuse, social support, and self-efficacy. This study used data from a randomized-controlled trial (RCT) of an intervention to improve outcomes for women afraid of their partners ( n = 225 WEAVE). Women’s progress toward change was categorized into pre-contemplation/contemplation (pre-change SOC) or preparation/action/maintenance of change (change-related SOC). Characteristics of women ending the 2-year study in pre-change SOC were compared with those always in change-related and those ending in change-related SOC. Variables were analyzed using multinomial logistic regressions at baseline, 6, 12, and 24 months. Compared with women in pre-change SOC, women always in change-related SOC or ending in change-related SOC are significantly more likely to have higher levels of self-efficacy at 6 (AdjOR = 1.19, confidence interval [CI] = [1.08, 1.30]) and 24 months (AdjOR = 1.21, CI = [1.04, 1.40]). Women always in change-related SOC are always significantly less likely to live with an intimate partner. Women ending in change-related SOC are less likely to live with a partner at 12 (AdjOR = 0.30, CI = [0.12, 0.75]) and 24 (AdjOR = 0.22, CI = [0.06, 0.80]) months. Clinicians should focus on enhancing abused women’s self-efficacy, supporting them to create and maintain positive changes.
Selecting outcomes for intimate partner violence intervention trials: Overview and recommendations
Publisher: Elsevier BV
Date: 11-2014
Factors associated with induced abortion over time: secondary data analysis of five waves of the Australian Longitudinal Study on Women’s Health
Publisher: Elsevier BV
Date: 04-2019
Abstract: A trend analysis of associations with induced abortion. Secondary analysis of the 1973/78 cohort of the Australian Longitudinal Study of Women's Health of women responding to two or more consecutive surveys out of five (N=9,042), using generalised estimating equations. New abortions dropped from 7% to 2% at surveys 4 and 5. By survey 5, 16% of respondents reported abortions, only 2% of them new. Women aged in their twenties were more likely to terminate a pregnancy if they reported less-effective contraceptives (aOR2.18 CI 1.65-2.89) increased risky drinking (aOR1.65 CI 1.14-2.38) illicit drugs ≤12 months (aOR3.09 CI 2.28-4.19) or recent partner violence (aOR2.42 CI 1.61-3.64). By their thirties, women were more likely to terminate if they reported violence (aOR2.16 CI 1.31-3.56) or illicit drugs <12 months (aOR2.69 CI 1.77-4.09). Women aspiring to be fully- (OR1.58 CI 1.37-1.83) or self-employed (OR1.28 CI 1.04-1.57), with no children (OR1.41 CI 1.14-1.75) or further educated (OR 2.08 CI 1.68-2.57) were more likely to terminate than other women. Abortion remains strongly associated with factors affecting women's control over reproductive health such as partner violence and illicit drug use. Implications for public health: Healthcare providers should inquire about partner violence and illicit drug use among women seeking abortion, support women experiencing harm and promote effective contraception.
Healthcare system responses to intimate partner violence in low and middle-income countries: evidence is growing and the challenges become clearer
Publisher: Springer Science and Business Media LLC
Date: 12-07-2017
Preventing and reducing violence against women: Innovation in community-level studies
Publisher: Springer Science and Business Media LLC
Date: 10-2014
Women's journey to safety - The Transtheoretical model in clinical practice when working with women experiencing Intimate Partner Violence: A scientific review and clinical guidance
Publisher: Elsevier BV
Date: 12-2013
DOI: 10.1016/J.PEC.2013.08.004
Abstract: Review the applicability of the Transtheoretical model and provide updated guidance for clinicians working with women experiencing intimate partner violence. Critical review of related primary research conducted from 1990 to March 2013. Women's experiences of creating change within abusive relationships can be located within a stages of change continuum by identifying dominant behavioral clusters. The processes of change and constructs of decisional-balance and turning-points are evident in women's decision-making when they engage in change. Clinicians can use the stages of change to provide a means of assessing women's movement toward their nominated outcomes, and the processes of change, decisional-balance and turning-points, to enhance understanding of, and promote women's movement across stages in their journey to safety. Clinicians should assess women in idually for immediate and ongoing safety and well-being, and identify their overarching stage of change. Clinicians can support women in identifying and implementing their personal objectives to enhance self-efficacy and create positive change movement across stages. The three primary objectives identified for clinician support are: 1. Minimizing harm and promoting well-being within an abusive relationship, 2. Achieving safety and well-being within the relationship halting the abuse, or 3. Achieving safety by ending/leaving intimate relationships.
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