Melissa L. Harris

Recruiting Online: Lessons From a Longitudinal Survey of Contraception and Pregnancy Intentions of Young Australian Women

Recruitment of young people for epidemiologic research remains challenging, with marked decreases in the effectiveness of face-to-face, mail, and telephone recruitment methods. We report on the implementation and feasibility of an innovative and flexible approach used to recruit participants for a longitudinal cohort study about contraceptive use and pregnancy (the Contraceptive Use, Pregnancy Intention, and Decisions (CUPID) Study). Australian women aged 18-23 years were recruited using a range of online, networking, and offline methods, including social media (primarily Facebook (Facebook Inc., Menlo Park, California; http://www.facebook.com)), face-to-face events, distribution of promotional material, and media releases. Over the course of the 1-year recruitment period (beginning in September 2012), a total of 3,795 eligible women were recruited to complete the online survey, at a cost of approximately A

Online and offline recruitment of young women for a longitudinal health survey: Findings from the australian longitudinal study on women's health 1989-95 cohort

11 per participant. This sample was found to be broadly representative of the Australian population of women aged 18-23 years in terms of demographic characteristics, with the exception of an overrepresentation of tertiary-educated women (88.7% compared with 72.6%). This study demonstrated that although current recruitment strategies are required to be innovative and flexible in order to engage young people in epidemiologic research, representative samples can be achieved online at reasonable cost.

Neurobiological basis of parenting disturbance

Background In 2012, we set out to recruit a cohort of at least 10,000 women aged 18-23 from across Australia. With recent research demonstrating the inadequacy of traditional approaches to recruiting women in this age group, we elected to conduct open recruiting. Objective Our aim was to report on the overall success of open recruiting and to evaluate the relative success of a variety of recruitment methods in terms of numbers and demographics. Methods We used referrals, Facebook, formal advertising, and incentives in order to recruit the cohort. Results In all, 17,069 women were recruited for the longitudinal online survey, from 54,685 initiated surveys. Of these women, most (69.94%, n=11,799) who joined the longitudinal cohort were recruited via Facebook, 12.72% (n=2145) via the fashion promotion, 7.02% (n=1184) by referral, 4.9% (n=831) via other Web activities, and 5.4% (n=910) via traditional media. Conclusions Facebook was by far the most successful strategy, enrolling a cohort of women with a similar profile to the population of Australian women in terms of age, area of residence, and relationship status. Women recruited via fashion promotion were the least representative. All strategies underrepresented less educated women—a finding that is consistent with more traditional means of recruiting. In conclusion, flexibility in recruitment design, embracing new and traditional media, adopting a dynamic responsive approach, and monitoring the results of recruiting in terms of sample composition and number recruited led to the successful establishment of a new cohort.

The Influence of Perceived Stress on the Onset of Arthritis in Women: Findings from the Australian Longitudinal Study on Women’s Health

Objective: It has been proposed that early attachment relationships shape the structure and reactivity of social brain structures that underlie later social capacities. We provide a review of the literature surrounding the development of neurological regulatory systems during infancy and outline recent research suggesting these systems go on to underlie adaptive parental responses. Method: We review evidence in the peer-reviewed psychiatric literature including (i) observational human literature on the neurobiological and social sequelae of early parenting experiences, (ii) experimental animal literature on the effects of early maternal care on neurological development, (iii) experimental animal literature on the neurobiological underpinnings of parenting behaviours, (iv) observational and fMRI evidence on the neurobiological correlates of parenting behaviours, (v) functional and volumetric imaging studies on adults affected by borderline personality disorder. Results: The development of infant regulatory systems is influenced by early parenting experiences. These frontolimbic regulatory systems are also heavily implicated in normal parental responses to infant cues. These frontolimbic disturbances are also observed in studies of borderline personality disorder; a disorder associated with poor emotional regulation, early trauma and disturbed parenting. Conclusions: While the current literature is limited to animal models of abnormal care giving, existing disorders associated with deficits in regulatory capacity and abnormal frontolimbic functioning may yet provide a human model of the neurobiology of parenting disturbance.

Recruiting young women for health surveys: traditional random sampling methods are not cost-effective.

BackgroundPsychosocial factors are considered as risk factors for some chronic diseases. A paucity of research exists surrounding the role of perceived stress in arthritis onset.PurposePerceived stress as a risk factor for arthritis development was explored in an ageing cohort of Australian women.MethodsThis study focused on 12,202 women from the 1946–1951 cohort who completed the Australian Longitudinal Study on Women’s Health surveys in 2001, 2004 and 2007. Longitudinal associations were modelled, with and without a time lag.ResultsFindings from the multivariate time lag modelling, excluding women with persistent joint pain, revealed that perceived stress predicted the onset of arthritis, with women experiencing minimal and moderate/high stress levels having a 1.7 and 2.4 times greater odds of developing arthritis 3 years later, respectively (p’s < 0.001).ConclusionChronically perceiving life as stressful is detrimental to future health. The findings provide support for perceived stress to be considered alongside other modifiable risk factors.

What qualities of long-acting reversible contraception do women perceive as desirable or undesirable? A systematic review.

Melissa L. Harris,1 Danielle Herbert,2 Deborah Loxton,1 Annette Dobson,3 Britta Wigginton,4 Jayne C. Lucke4,5 1. Research Centre for Gender, Health and Ageing, Faculty of Health and Medicine, University of Newcastle, New South Wales 2. School of Public Health & Institute of Health and Biomedical Innovation, Queensland University of Technology 3. School of Population Health, Faculty of Medicine and Biomedical Sciences, The University of Queensland 4. UQ Centre for Clinical Research, The University of Queensland 5. Australian Research Centre in Sex, Health and Society, Faculty of Health Sciences, La Trobe University, Victoria

Quality of life impact of cardiovascular and affective conditions among older residents from urban and rural communities

Little research examining qualities of contraception that make them attractive or unattractive to users, particularly young women, exists. The aim of this study is to systemically review the evidence regarding desirable and undesirable qualities of long-acting reversible contraception (LARC), including intrauterine devices, the implant and the injection, as perceived by women. Five electronic databases were searched in May 2015 using terms related to LARC and method preference or decision-making. Studies were included if they concerned women aged 18-23 years from developed countries and reported on perceived positive or negative qualities of LARC. Thirty articles were deemed relevant. Five key themes emerged under which qualities were categorised; including: (1) impact on bleeding; (2) impact on the body; (3) device-specific characteristics; (4) general characteristics; and (5) perceptions and misbeliefs. Fit and forget, high efficacy and long-term protection were considered the top desirable qualities of LARC. Undesirable qualities varied among the LARC methods; however, irregular bleeding, painful insertion and removal procedure, weight gain and location in the body were among those most commonly reported. The contraceptive benefits of LARC, including their high efficacy and longevity, are generally considered to be positive qualities by women, while the potential impact of side-effects on the body are considered as negative qualities. This information is crucial in the clinical setting as it provides practitioners with a greater understanding of the qualities women do and do not like about LARC methods. Discussion about these qualities, positive and negative, during consultations about contraception may increase rates of uptake.

The feminisation of contraceptive use: Australian women’s accounts of accessing contraception

BackgroundThe demographic, health and contextual factors associated with quality of life impairment are investigated in older persons from New South Wales, Australia. We examine the impact of cardiovascular and affective conditions on impairment and the potential moderating influence of comorbidity and remoteness.MethodsData from persons aged 55 and over were drawn from two community cohorts sampling from across urban to very remote areas. Hierarchical linear regressions were used to assess: 1) the impact of cardiovascular and affective conditions on physical and psychological quality of life impairment; and 2) any influence of remoteness on these effects (N = 4364). Remoteness was geocoded to participants at the postal code level. Secondary data sources were used to examine the social capital and health service accessibility correlates of remoteness.ResultsPhysical impairment was consistently associated with increased age, male gender, lower education, being unmarried, retirement, stroke, heart attack/angina, depression/anxiety, diabetes, hypertension, current obesity and low social support. Psychological impairment was consistently associated with lower age, being unmarried, stroke, heart attack/angina, depression/anxiety and low social support. Remoteness tended to be associated with lower psychological impairment, largely reflecting overall urban versus rural differences. The impacts of cardiovascular and affective conditions on quality of life were not influenced by remoteness. Social capital increased and health service accessibility decreased with remoteness, though no differences between outer-regional and remote/very remote areas were observed. Trends suggested that social capital was associated with lower psychological impairment and that the influence of cardiovascular conditions and social capital on psychological impairment was greater for persons with a history of affective conditions. The beneficial impact of social capital in reducing psychological impairment was more marked for those experiencing financial difficulty.ConclusionsCardiovascular and affective conditions are key determinants of physical and psychological impairment. Persons affected by physical-psychological comorbidity experience greater psychological impairment. Social capital is associated with community remoteness and may ameliorate the psychological impairment associated with affective disorders and financial difficulties. The use of classifications of remoteness that are sensitive to social and health service accessibility determinants of health may better inform future investigations into the impact of context on quality of life outcomes.

A qualitative analysis of women's explanations for changing contraception: the importance of non-contraceptive effects

The oral contraceptive pill remains the most widely used contraceptive method. We consider The Pill’s depiction as variously revolutionary and liberating, oppressive for women, and more recently, a ‘lifestyle drug’. Drawing on discourses of (hetero)sex, heterosexuality and gender performance, we discuss how contraceptive use has been feminised and consider the current gap in understanding how women negotiate their positioning as responsible for contraception. To begin to fill this gap, we conducted a thematic discourse analysis using 75 free-text responses (to a general question in a wider contraceptive survey) to explore how women account for their agency and responsibility in discussions of accessing contraception. We identified two themes: responsibility for education and information and ‘finding contraceptive fit’. Women’s discussions of responsibility for education and information highlight the need for transparency from educational bodies, which are positioned as lacking in their delivery of contraceptive information. Women describe “finding contraceptive fit” as an embodied process of experimentation with contraception to ultimately find one with minimal negative side effects. We situate our findings within critiques of the gendered nature and production of health, conceptualising contraceptive use as a distinctly feminine practice, which promotes self-surveillance and embodied awareness.

The relative importance of psychosocial factors in arthritis: findings from 10,509 Australian women.

Background Women commonly report changing contraceptive methods because of side-effects. However, there is a lack of literature that has thoroughly examined womens perspectives, including why they changed contraception. Aim Using qualitative data from a contraceptive survey of young Australian women, we explored womens explanations for their recent changes in contraception. Method A thematic analysis of 1051 responses to a question about why women recently changed contraception was conducted. Results Themes reflected reasons for changing contraception which included: both contraceptive and non-contraceptive (4%); relationship/sexual (9%); medical (11%); contraceptive (18%); non-contraceptive (41%). A minority of responses were uncoded (17%). Non-contraceptive effects (effects unrelated to pregnancy prevention) featured most frequently in womens reasons for changing contraception. Conclusions While cessation of various contraceptives due to unwanted side-effects is a well-known phenomenon, this analysis provides evidence of the changing of contraception for its non-contraceptive effects and reframes the notion of ‘side-effects’.