Dr Jane Frawley is a National Health and Medical Research Council (NHMRC) Early Career Fellow. Dr Frawley ia a member of the Australian Centre of Public and Population Health Research within the Faculty of Health at UTS.
Dr Frawley's research program applies rigorous public health and health services research methods to the areas of maternal and child health. Dr Frawley is working on a variety of maternal and child health projects including evaluating maternal and birth impacts from pertussis and influenza during pregnancy; examining midwives communication with parents about maternal and childhood vaccination; parental attitudes to vaccination; complementary medicine practitioner attitudes towards vaccination, as well as helping establish a longitudinal cohort study to follow the long term impacts of severe cardiovascular disease in pregnancy for women and their babies.
Adjunct investigator - Australian Longitudinal Study on Women’s Health | Adjunct investigator 45 and up | Therapeutic Goods Administration (TGA) - Advisory Committee
Can supervise: YES
Jane is currently working on various research projects including:
- Evaluating maternal and child impacts from pertusss an influenza during pregnancy
- Investigating parent’s attitudes and decision making in relation to health services for their children.
- Parental attitudes to childhood vaccination.
- Complementary medicine practitioner attitudes to vaccination
- Midwives conversations with parents about maternal vaccination
- Evaluating the long term impacts of severe cardiovascular disease in pregnancy
Maternity and child health | Infectious disease epidemiology | Health service utilisation | Health service research | Attitudes and decision making in relation to health care | Attitudes to vaccination.
Public health, infectious disease, epidemiology, research methodology
Attwell, K, Yusuf, A & Frawley, J 2019, 'Is immunisation education in midwifery degrees adequate?', Human Vaccines and Immunotherapeutics, vol. 15, no. 1, pp. 109-112.View/Download from: UTS OPUS or Publisher's site
Maternal and childhood vaccination decisions begin during pregnancy, and midwives are an important information resource. Their role is set to increase with the expansion of maternal immunisations into new jurisdictions, and new maternal vaccines in development. Meanwhile, other health providers are orienting parents towards vaccine acceptance, using strategies at odds with midwifery norms around information provision and maternal autonomy. To better understand and address the implications of these developments, we conducted a pilot study to ascertain how midwifery students in Australian universities are taught about immunisation, including dedicated time, assessment, who teaches it, and when. We also analysed teaching materials, looking for messaging regarding the importance of vaccination and whether midwives should be advocating for it. We found that education on immunisation comprises less than four hours of the degree, and encountered the norm of midwives informing about rather than recommending vaccination. The considerations we brought to our small project, and what it illuminated, suggest that midwifery university education is an important arena for developing future vaccine advocates. However, midwifery ideology and professional practice mean that such efforts will be challenging, and must commence from a position of respect for the values midwives hold.
Sullivan, E, Vaughan, G, Li, Z, Peek, MJ, Carapetis, JR, Walsh, W, Frawley, J, Rémond, MGW, Remenyi, B, Jackson Pulver, L, Kruske, S, Belton, S & McLintock, C 2019, 'The high prevalence and impact of rheumatic heart disease in pregnancy in First Nations populations in a high-income setting: a prospective cohort study.', BJOG : an international journal of obstetrics and gynaecology.View/Download from: Publisher's site
OBJECTIVE:To describe the epidemiology of rheumatic heart disease (RHD) in pregnancy in Australia and New Zealand (A&NZ). DESIGN:Prospective population-based study. SETTING:Hospital-based maternity units throughout A&NZ. POPULATION:Pregnant women with RHD with a birth outcome of 20 weeks' gestation or more between January 2013 and December 2014. METHODS:We identified eligible women using the Australasian Maternity Outcomes Surveillance System (AMOSS). De-identified antenatal, perinatal and postnatal data were collected and analysed. MAIN OUTCOME MEASURES:Prevalence of RHD in pregnancy. Perinatal morbidity and mortality. RESULTS:There were 311 pregnancies associated with women with RHD (4.3/10,000 women giving birth, 95% CI 3.9-4.8). In Australia, 78% were Aboriginal or Torres Strait Islander (60.4/10,000, 95% CI 50.7-70.0), while in New Zealand 90% were Māori or Pasifika (27.2/10,000, 95% CI 22.0-32.3). One woman (0.3%) died and one-in-ten was admitted to coronary or intensive care units postpartum. There were 314 births with seven stillbirths (22.3/1,000 births) and two neonatal deaths (6.5/1,000 births). Sixty-six (21%) live-born babies were preterm and one-in-three were admitted to neonatal intensive care or special care units. CONCLUSION:RHD in pregnancy persists in disadvantaged First Nations populations in A&NZ. It is associated with significant cardiac and perinatal morbidity. Preconception planning and counselling and RHD screening in at-risk pregnant women are essential for good maternal and baby outcomes. This article is protected by copyright. All rights reserved.
Adams, J, McIntyre, E, Frawley, J, Lauche, R, Broom, A & Sibbritt, D 2019, 'Formal and informal health care behaviours of women with chronic illness: A cross-sectional analysis of 1,925 women', International Journal of Clinical Practice, vol. 73, no. 4.View/Download from: UTS OPUS or Publisher's site
Fisher, CY, Adams, J, Frawley, JE, Hickman, LD & Sibbritt, DW 2019, 'Is there a role for Western herbal medicine in treating cyclic perimenstrual pain and discomfort?', Australian and New Zealand Journal of Obstetrics and Gynaecology, vol. 59, no. 1, pp. 154-156.View/Download from: UTS OPUS or Publisher's site
Conventional treatments for cyclic perimenstrual pain and discomfort, while numerous and diverse, have drawbacks including side effects, interference with women's reproductive function and, importantly, failure to address symptoms. Many women turn to herbal medicine to treat a myriad of menstrual symptoms. Clinical evidence supports the efficacy of Vitex agnus-castus but other medicinal herbs typically used by Western herbalists for treating menstrual symptoms are unsupported by clinical trials. This raises concerns around the efficacy and safety of these herbs. Women's treatment options need to be extended and individualised, where current conventional strategies fail, requiring appropriate clinical trials of potentially useful herbal medicines.
Meredith, S, Frawley, J, Adams, J & Sibbritt, D 2019, 'Risk Factors for Developing Comorbid Sleeping Problems: Results of a Survey of 1,925 Women Over 50 With a Chronic Health Condition', Journal of Aging and Health.View/Download from: Publisher's site
© The Author(s) 2019. Objective: To test the association between sleeping problems and multiple epidemiological factors among women over 50 with a chronic condition. Method: The Medical Outcomes Study Sleep Scale (MOS-SS) was employed to measure sleep problems among 1,925 participants with chronic conditions who also responded to questions about health service use, self-care and demographics. Results: About 43% of women reported sleeping problems. Women were more likely to have a sleeping problem if they reported some difficulties with available income, odds ratio (OR) = 1.61; 95% confidence interval (CI): [1.27, 2.04]; p <.005, or were struggling with available income (OR = 2.84; 95% CI: [2.04, 3.96]; p <.005). Women were less likely to have sleeping problems if they were highly physically active (OR =.63; 95% CI: [0.51, 0.79]; p <.005). Discussion: Medical professionals should be aware of the significant risk of sleeping problems among mid-age and older women with chronic health conditions, particularly those who have financial concerns, are sedentary, or are not highly physically active.
Frawley, JE, McKenzie, K, Cummins, A, Sinclair, L, Wardle, J & Hall, H 2019, 'Midwives' role in the provision of maternal and childhood immunisation information', Women and Birth.View/Download from: Publisher's site
© 2019 Australian College of Midwives Problem: Inactivated influenza vaccine and diphtheria-tetanus acellular pertussis vaccine are routinely recommended during pregnancy to protect women and their babies from infection. Additionally, the hepatitis B vaccine is recommended for infants within the first week of life; however, little is known about midwives' experiences of recommending and delivering these immunisations. Background: Midwives are a trusted source of vaccine information for parents and the confident provision of information about immunisation during antenatal clinic visits has been found to increase the uptake of antenatal and childhood vaccines. Aim: This study aims to explore midwives' experiences of discussing maternal and childhood immunisation with women and their partners and their confidence in answering parent's questions. Methods: We conducted 23 semi-structured interviews with registered Australian midwives working in public and private hospital settings, and in private practice. Findings: Midwives find negotiating the requirement to recommend immunisation within a women-centred framework challenging at times. The vast majority of midwives described their education on immunisation as inadequate and workplace issues, such as time pressure, were identified as further barriers to effective communication about immunisation. Discussion/conclusion: The provision of immunisation training within midwifery education and continued professional development is critical. Appropriately resourcing midwives with the necessary infrastructure, education and resources to fully inform parents about immunisation may have a positive impact on vaccine uptake.
McIntyre, E, Lauche, R, Frawley, J, Sibbritt, D, Reddy, P & Adams, J 2019, 'Physical activity and depression symptoms in women with chronic illness and the mediating role of health-related quality of life.', Journal of affective disorders, vol. 252, pp. 294-299.View/Download from: UTS OPUS or Publisher's site
BACKGROUND:The aim of this study was to determine the impact of physical activity on depression symptom severity in women 45 years and older with a chronic illness diagnosis, and explore relations between physical activity and psychological and health-related characteristics predicting depression symptoms. METHODS:1932 women diagnosed with one of five chronic illnesses: asthma, depression, diabetes, osteoarthritis, or osteoporosis participated in a sub-study of the 45 and Up Study-a cross-sectional study of people aged 45 years and older. The survey included items measuring demographics, depression symptoms, health-related quality of life (HRQoL), health-related hardiness, sleep quality, and health behaviours, such as physical activity. RESULTS:A multiple regression model explained 43% of the variance in depression symptoms (R2 = 0.43, F (18) = 61.72, p < .001); intensity of physical activity was a significant predictor of depression symptoms (p < .001), and HRQoL was found to explain the most variance (B = -10.00) in depression symptoms. Mediation analysis confirmed that HRQoL partially mediated the relation between physical activity and depression symptoms; however, the effect was very small. LIMITATIONS:Cross-sectional data and self-report measures limit the implications of the findings. CONCLUSION:Women with chronic illness engaging in more vigorous physical activity had less severe depression symptoms. Findings suggest that improving HRQoL is critical to the prevention and management of depression symptoms in women with chronic illness. Psychological and health-related factors that influence HRQoL, such as sleep quality and health-related hardiness, are important clinical considerations for health practitioners.
Frawley, JE, Foley, H & McIntyre, E 2018, 'The associations between medical, allied and complementary medicine practitioner visits and childhood vaccine uptake.', Vaccine, vol. 36, no. 6, pp. 866-872.View/Download from: UTS OPUS or Publisher's site
Vaccination rates have remained steady for a number of years in Australia, however geographical areas of lower vaccine coverage remains a day-to-day challenge. The study explores parental attitudes, beliefs and intentions in relation to vaccination and examines the early effects of recent No Jab No Pay legislation.A national survey of was conducted, using an online questionnaire. Parents from all states in Australia with at least one child aged <6 years were invited to participate.A total of 429 parents participated in the study. The substantial majority of participants reported having their youngest child's vaccination status up to date (n = 401, 93.5%). A child's vaccinations were more likely to be up to date if they had consulted a paediatrician in the previous 12-months (OR 5.01; 95%CI 1.05, 23.92; p = .043). Conversely they were less likely to be vaccinated if they were influenced by information from a complementary medicine (CM) practitioner (OR 0.03; 95%CI 0.01, 0.15; p < .001) or had visited a CM-practitioner (OR 0.09; 95%CI 0.02, 0.33; p < .001) in the previous 12-months. A total of 2.6% of parents had immunised their child as a result of the No Jab No Pay legislation, while 3.9% stated the legislation had no effect, and 1.2% said it had made them less likely to vaccinate. A further 1.2% of parents stated they are considering vaccination as a result of the legislative changes.Parents who have not vaccinated their children appear to trust non-mainstream sources of information such as CM-practitioners. Further research is required to determine how to manage the challenges and opportunities of CM-practitioners as a source of vaccine information.
Fisher, C, Adams, J, Frawley, J, Hickman, L & Sibbritt, D 2018, 'Western herbal medicine consultations for common menstrual problems; practitioner experiences and perceptions of treatment.', Phytotherapy Research, vol. 32, no. 3, pp. 531-541.View/Download from: UTS OPUS or Publisher's site
To explore the prevalence with which Australian Western herbalists treat menstrual problems and their related treatment, experiences, perceptions, and interreferral practices with other health practitioners. Members of the Practitioner Research and Collaboration Initiative practice-based research network identifying as Western Herbalists (WHs) completed a specifically developed, online questionnaire. Western Herbalists regularly treat menstrual problems, perceiving high, though differential, levels of effectiveness. For menstrual problems, WHs predominantly prescribe individualised formulas including core herbs, such as Vitex agnus-castus, and problem-specific herbs. Estimated clients' weekly cost (median = $25.00) and treatment duration (median = 4-6 months) covering this Western herbal medicine treatment appears relatively low. Urban-based women are more likely than those rurally based to have used conventional treatment for their menstrual problems before consulting WHs (p = .001). Only 19% of WHs indicated direct contact by conventional medical practitioners regarding treatment of clients' menstrual problems despite 42% indicating clients' conventional practitioners recommended consultation with WH. Western herbal medicine may be a substantially prevalent, cost-effective treatment option amongst women with menstrual problems. A detailed examination of the behaviour of women with menstrual problems who seek and use Western herbal medicine warrants attention to ensure this healthcare option is safe, effective, and appropriately co-ordinated within women's wider healthcare use.
Frawley, JE, McIntyre, E, Sibbritt, D, Wardle, J, Schloss, J, Lauche, R & Adams, J 2018, 'Associations Between Cancer Screening Behavior and Complementary Medicine Use: Results of a National Cross-Sectional Survey of 9151 Australian Women.', Integrative cancer therapies, vol. 17, no. 3, pp. 979-985.View/Download from: UTS OPUS or Publisher's site
Complementary medicine (CM) use has been found to influence the uptake of conventional cancer treatment. This study examines associations between CM use and cancer screening rates.Women aged 62 to 67 years from the Australian Longitudinal Study on Women's Health were surveyed regarding their use of cancer screening initiatives. Associations between cancer screening behavior and visits to CM practitioners were analyzed.Of the 9151 women, 9049 (98.9%) completed questions about cancer screening. A total of 65.1% of women had received a clinical skin examination, 54.3% colorectal cancer screening, 56.2% Pap test (within past 2 years), 83.3% mammogram (within past 2 years), 55.8% clinical breast examination, and 55.8% had conducted breast self-examination. Women who had consulted a massage therapist were more likely to undergo clinical skin examination ( P = .002), clinical breast examination ( P = .018), and mammogram ( P = .001). Women who had consulted a chiropractor were more likely to undergo a clinical skin examination ( P = .001), colorectal cancer screening ( P = .020), and mammogram ( P = .011). Women who had consulted an acupuncturist were more likely to undergo colorectal cancer screening ( P = .019), and those who consulted with an osteopath were more liable to have a Pap test ( P = .049).Women who visit CM practitioners are more likely to participate in cancer screening initiatives. Research is required to understand the current and potential role that CM practitioners (can) have as public health advocates, recommending preventative health measures such as cancer screening. Such an examination will help ensure optimal screening utilization and effective, timely care for all cancer patients.
Meredith, S, Frawley, J, Adams, J & Sibbritt, D 2018, 'The Utilization of Health Services and Self-Care by Older Women With Sleeping Problems: Results From a Nationally Representative Sample of 9,110 Women', Journal of Aging and Health, vol. 30, no. 4, pp. 540-558.View/Download from: UTS OPUS or Publisher's site
OBJECTIVE: This research aims to investigate the health service use-including complementary and alternative medicine (CAM)-and self-care by women aged 62 to 67 with sleeping problems. METHOD: In total, 9,110 participants (99.6%) responded to questions about sleeping problems, health service utilization and self-care (e.g., herbal medicines and vitamins), demographics, and chronic illnesses. RESULTS: In all, 48.2% ( n = 4,394) women indicated that they had a sleeping problem. Women with sleeping problems consulted a general practitioner (GP) more frequently (odds ratio [OR] = 1.72; 95% confidence interval [CI] = [1.36, 2.17]; p < .005) and were more likely to be using herbal medicines (OR = 1.24; 95% CI = [1.13, 1.36]; p < .005) than women without sleeping problems. DISCUSSION: Health professionals, particularly GPs, may need to actively inquire with older patients in their care with sleeping problems about the use of herbal medicines, to ensure their sleeping problems are being directly and effectively treated, particularly in light of increased risks associated with sleeping problems for this age cohort.
Peng, W, Lauche, R, Frawley, J, Sibbritt, D & Adams, J 2018, 'Utilization of complementary and alternative medicine and conventional medicine for headache or migraine during pregnancy: A cross-sectional survey of 1,835 pregnant women', Complementary Therapies in Medicine, vol. 41, pp. 192-195.View/Download from: UTS OPUS or Publisher's site
Objectives: Little is known about women's use of health services affected by headache or migraine during pregnancy. This paper directly addresses the research gap reporting on the healthcare utilization among Australian pregnant women experiencing headache or migraine.
Design and setting: In this retrospective observational study, data on 1,835 Australian pregnant women were obtained from the nationally-representative Australian Longitudinal Study on Women's Health. Information on quality of life and health seeking behaviors regarding conventional medicine and complementary and alternative medicine providers was identified among these participants. Factors associated with healthcare use were analyzed using regression analyses.
Results: A total of 16% of the pregnant women surveyed experienced headache or migraine, and over 20% sought help from more than two types of healthcare practitioners for their headache or migraine. General practitioners (37.8%) were the most commonly consulted providers of pregnant women for their headache or migraine. Women with headache or migraine during pregnancy had worse health-related quality of life than those without. Education level and private health insurance status of pregnant women are the predictors of the use of healthcare practitioners for their management of headache or migraine (both p<0.05).
Conclusions: Headache or migraine during pregnancy significantly impacts upon pregnant women's quality of life. The use of multiple healthcare practitioners, including conventional medicine and complementary and alternative medicine practitioners, highlights the need for further research investigating health services utilization of pregnant women with headache or migraine in different severity and frequency to help inform effective and safe treatment.
Sibbritt, D, Peng, W, Lauche, R, Ferguson, C, Frawley, J & Adams, J 2018, 'Efficacy of acupuncture for lifestyle risk factors for stroke: A systematic review.', PloS one, vol. 13, no. 10, pp. e0206288-e0206288.View/Download from: UTS OPUS or Publisher's site
BACKGROUND:Modifications to lifestyle risk factors for stroke may help prevent stroke events. This systematic review aimed to identify and summarise the evidence of acupuncture interventions for those people with lifestyle risk factors for stroke, including alcohol-dependence, smoking-dependence, hypertension, and obesity. METHODS:MEDLINE, CINAHL/EBSCO, SCOPUS, and Cochrane Database were searched from January 1996 to December 2016. Only randomised controlled trials (RCTs) with empirical research findings were included. PRISMA guidelines were followed and risk of bias was assessed via the Cochrane Collaboration risk of bias assessment tool. The systematic review reported in this paper has been registered on the PROSPERO (#CRD42017060490). RESULTS:A total of 59 RCTs (5,650 participants) examining the use of acupuncture in treating lifestyle risk factors for stroke met the inclusion criteria. The seven RCTs focusing on alcohol-dependence showed substantial heterogeneity regarding intervention details. No evidence from meta-analysis has been found regarding post-intervention or long-term effect on blood pressure control for acupuncture compared to sham intervention. Relative to sham acupuncture, individuals receiving auricular acupressure for smoking-dependence reported lower numbers of consumed cigarettes per day (two RCTs, mean difference (MD) = -2.75 cigarettes/day; 95% confidence interval (CI) = -5.33, -0.17; p = 0.04). Compared to sham acupuncture those receiving acupuncture for obesity reported lower waist circumference (five RCTs, MD = -2.79 cm; 95% CI: -4.13, -1.46; p<0.001). Overall, only few trials were considered of low risk of bias for smoking-dependence and obesity, and as such none of the significant effects in favour of acupuncture interventions were robust against potential selection, performance, and detection bias. CONCLUSIONS:This review found no convincing evidence for effects of acupuncture interventions for improving lifestyle risk factors for s...
Steel, A, McIntyre, E, Harnett, J, Foley, H, Adams, J, Sibbritt, D, Wardle, J & Frawley, J 2018, 'Complementary medicine use in the Australian population: Results of a nationally-representative cross-sectional survey', Scientific Reports, vol. 8, no. 1, pp. 1-7.View/Download from: UTS OPUS or Publisher's site
In order to describe the prevalence and characteristics of complementary medicine (CM) practice and product use by Australians, we conducted a cross-sectional online survey with Australian adults aged 18 and over. Rates of consultation with CM practitioners, and use of CM products and practices were assessed. The sample (n = 2,019) was broadly representative of the Australian population. Prevalence of any CM use was 63.1%, with 36% consulting a CM practitioner and 52.8% using any CM product or practice. Bodywork therapists were the most commonly consulted CM practitioners (massage therapists 20.7%, chiropractors 12.6%, yoga teachers 8.9%) and homeopaths were the least commonly consulted (3.4%). Almost half of respondents (47.8%) used vitamin/mineral supplements, while relaxation techniques/meditation were the most common practice (15.8%). CM users were more likely to be female, have a chronic disease diagnosis, no private health insurance, a higher education level, and not be looking for work. Prevalence of CM use in Australia has remained consistently high, demonstrating that CM is an established part of contemporary health management practices within the general population. It is critical that health policy makers and health care providers acknowledge CM in their attempts to ensure optimal public health and patient outcomes.
Steel, A, Wardle, J, Frawley, J, Adams, J, Sibbritt, D & Lauche, R 2018, 'Associations between complementary medicine utilisation and the use of contraceptive methods: Results of a national cross-sectional survey', Complementary Therapies in Clinical Practice, vol. 33, pp. 100-106.View/Download from: UTS OPUS or Publisher's site
Background and purpose
This study examines the relationship between the use of complementary medicine (CM) interventions or consultations with CM practitioners and women's choice of contraceptive method.
Materials and methods
A secondary analysis of a cross-sectional survey of Australian Women aged 34–39 years from the Australian Longitudinal Study on Women's Health (ALSWH) was conducted. Associations between use of CM and contraception were analysed using Chi-squared tests and multivariate logistic regression.
Based on the responses from the included women (n = 7299), women who consulted a naturopath/herbalist were less likely to use implant contraceptives (OR 0.56; 95% confidence interval (CI) 0.33; 0.95). Those consulting a chiropractor (OR 1.54; 95%CI 1.05; 2.25) or an osteopath (OR 2.16; 95% CI 1.32; 3.54) were more likely to use natural contraception.
There may be a link between women's choice of contraceptive method and their use of CM, in particular, with CM practitioner consultations.
Frawley, JE, McIntyre, E, Wardle, J & Jackson, D 2018, 'Is there an association between the use of complementary medicine and vaccine uptake: results of a pilot study.', BMC research notes, vol. 11, no. 1, pp. 217-217.View/Download from: UTS OPUS or Publisher's site
Despite the incredible success of paediatric immunisation, support is not universal. It has been suggested that complementary medicine practitioners enable vaccine rejection and his study aims to explore the relationship between complementary medicine use and paediatric vaccination. A total of 149 Australian parents were recruited via a parenting website and Facebook groups to complete an online questionnaire.The majority of parents (66.4%) stated that their children's vaccination status was up-to-date. Vaccination status was associated with parental education, area of residence, income, private health insurance, and having a Health Care Card (p < 0.05). Children's vaccinations were more likely to be up-to-date if they had consulted a general practitioner in the previous 12 months (OR 21.75; p < 0.001), and less likely to be up-to-date if they had consulted a complementary medicine practitioner (OR 0.10; p < 0.001) in the same period. Concerns about vaccine safety and efficacy were the most common reasons for a child's immunisation status not being up-to-date. These findings highlight an interface between lower vaccine uptake and visits to complementary medicine practitioners. These results emphasise the need to examine the routine paediatric care practices of complementary medicine practitioners as a crucial piece of the puzzle in understanding vaccine rejection.
Hall, H, Brosnan, C, Frawley, J, Wardle, J, Collins, M & Leach, M 2018, 'Nurses' communication regarding patients' use of complementary and alternative medicine', Collegian, vol. 25, no. 3, pp. 285-291.View/Download from: UTS OPUS or Publisher's site
© 2017. Background:: Many people integrate complementary and alternative medicine (CAM) into their health care. Nurses potentially play a significant role in communicating with patients about their CAM utilisation. Aim:: The study aimed to explore whether, how and why nurses working in Australia communicate about patients' CAM use. Methods:: This paper reports on phase one of a mixed methods study. Qualitative data was obtained, via interviews, with nineteen registered nurses who work in a wide variety of clinical environments across all states of Australia. Findings:: Four themes related to nurses' communication with patients about CAM, were developed from the qualitative data; engaging with patients about CAM, communication with doctors about patients' use of CAM, connecting with CAM practitioners and barriers to CAM communication. Discussion:: Despite their positive attitudes, nurses are often not comfortable discussing or documenting patients' CAM use. Furthermore, nurses perceive that patients may be apprehensive about disclosing their use. CAM communication with colleagues is moderated by the workplace culture and the perceived attitude of co-workers. There is very little evidence of nurses referring or collaborating with CAM practitioners. Professional expectation, time restraints and the nurses' lack of relevant CAM knowledge all have a powerful effect on limiting CAM communication. Conclusion:: Communication about patients' use of CAM is imperative to support safe therapeutic decisions. Currently, this is limited in the Australian healthcare workplace. The nursing professional needs to consider introducing basic CAM education and flexible guidelines to enable nurses' to respond appropriately to the patient driven demand for CAM.
Frawley, JE, Anheyer, D, Davidson, S & Jackson, D 2017, 'Prevalence and characteristics of complementary and alternative medicine use by Australian children.', Journal of Paediatrics and Child Health, vol. 53, no. 8, pp. 782-787.View/Download from: UTS OPUS or Publisher's site
This study was conducted to evaluate the use of complementary and alternative medicine (CAM) among Australian children within the previous 12 months.Parents with children up to the age of 18 years were recruited from online parenting groups. Questions addressed demographic factors, socio-economic status, conventional health service use, including vaccination status and use of CAM.A total of 149 parents responded to the study of which 73.8% (n = 110) had taken their child to visit a CAM practitioner or given their child a CAM product in the previous 12 months. The two most frequently visited CAM practitioners were naturopath/herbalist (30.4%) and chiropractor (18.4%). The most commonly used products were vitamins/minerals (61.7%), and herbal medicine (38.8%). Children had also consulted with a general practitioner (89.8%), community health nurse (31.29%) and paediatrician (30.3%) over the same period. A total of 52% of parents did not disclose their child's use of CAM to their medical provider. Children's vaccination status was less likely to be up-to-date if they visited a CAM practitioner (OR 0.16; CI 0.07, 0.36; P < 0.001) or used a CAM product (OR 0.25; CI 0.09, 0.64; P = 0.004).Despite a lack of high quality research for efficacy and safety, many children are using CAM products and practices in parallel with conventional health services, often without disclosure. This highlights the need to initiate conversations with parents about their child's use of CAM in order to ensure safe, coordinated patient care. The association between vaccine uptake and CAM use requires further investigation.
Anheyer, D, Frawley, J, Koch, AK, Lauche, R, Langhorst, J, Dobos, G & Cramer, H 2017, 'Herbal Medicines for Gastrointestinal Disorders in Children and Adolescents: A Systematic Review.', Pediatrics, vol. 139, no. 6.View/Download from: UTS OPUS or Publisher's site
Gastrointestinal disorders are common childhood complaints. Particular types of complementary and alternative medicine, such as herbal medicine, are commonly used among children. Research information on efficacy, safety, or dosage forms is still lacking.To systematically summarize effectiveness and safety of different herbal treatment options for gastrointestinal disorders in children.Medline/PubMed, Scopus, and the Cochrane Library were searched through July 15, 2016.Randomized controlled trials comparing herbal therapy with no treatment, placebo, or any pharmaceutical medication in children and adolescents (aged 0-18 years) with gastrointestinal disorders were eligible.Two authors extracted data on study design, patients, interventions, control interventions, results, adverse events, and risk of bias.Fourteen trials with 1927 participants suffering from different acute and functional gastrointestinal disorders were included in this review. Promising evidence for effectiveness was found for Potentilla erecta, carob bean juice, and an herbal compound preparation including Matricaria chamomilla in treating diarrhea. Moreover, evidence was found for peppermint oil in decreasing duration, frequency, and severity of pain in children suffering from undifferentiated functional abdominal pain. Furthermore, evidence for effectiveness was found for different fennel preparations (eg, oil, tea, herbal compound) in treating children with infantile colic. No serious adverse events were reported.Few studies on specific indications, single herbs, or herbal preparations could be identified.Because of the limited number of studies, results have to be interpreted carefully. To underpin evidence outlined in this review, more rigorous clinical trials are needed.
Frawley, J, Sibbritt, D, Steel, A, Chang, S & Adams, J 2017, 'Complementary and Conventional Health-care Utilization Among Young Australian Women With Urinary Incontinence.', Urology, vol. 99, pp. 92-99.View/Download from: UTS OPUS or Publisher's site
OBJECTIVE: To examine the relationship between health status and health service utilization (including conventional and complementary and alternative medicine [CAM]) accessed by women experiencing urinary incontinence (UI). Although a high number of younger women report symptoms of UI, such as leaking urine, only a small proportion seek help for these symptoms. MATERIALS AND METHODS: The Australian Longitudinal Study on Women's Health is a large nationally representative study that investigates the health and well-being of women. The 2 most recent surveys (2006 and 2009) of the young cohort (women aged 28-33 and 31-36 respectively) were analyzed. RESULTS: The presence of UI was 8.5% in 2006 (n = 859) and 23.3% in 2009 (n = 1878), whereas the percentage of women who sought help for their UI was 18.6% (n = 160) and 2.2% (n = 182) respectively. Women with UI had poorer health compared with women without UI (P < .005), and women who sought help for their symptoms had poorer physical functioning than women who did not (P < .005). Women who sought help were greater users of conventional and CAM health services (P < .005), including a general practitioner, specialist, hospital doctor, physiotherapist, and naturopath. CONCLUSION: UI is relatively common in younger women. However, many do not seek help. Of the women who do seek care, a large number visit CAM professionals as well as conventional medical professionals, despite a lack of research evaluating the efficacy of CAM treatment. Research is needed to explore CAM practitioner approaches to the treatment of UI and to evaluate the efficacy of these treatments.
Adams, J, Steel, A, Frawley, J, Broom, A & Sibbritt, D 2017, 'Substantial out-of-pocket expenditure on maternity care practitioner consultations and treatments during pregnancy: estimates from a nationally-representative sample of pregnant women in Australia.', BMC Pregnancy and Childbirth, vol. 17, no. 114, pp. 1-8.View/Download from: UTS OPUS or Publisher's site
BACKGROUND: A wide range of health care options are utilised by pregnant women in Australia. The out-of-pocket costs of maternity care in Australia vary depending on many factors including model of care utilised, health insurance coverage, and women's decision to access health services outside of conventional maternity care provision. METHODS: Women from the 1973-78 cohort of the Australian Longitudinal Study on Women's Health (ALSWH) who identified as pregnant or as recently having given birth in 2009 were invited to complete a sub-study questionnaire investigating health service utilisation during their most recent pregnancy. RESULTS: A total of 1,835 women agreed to participate in the sub-study. The majority of women (99.8%) consulted with a conventional health care practitioner during pregnancy, 49.4% consulted with a complementary and alternative medicine practitioner at least once during pregnancy and 89.6% of the women used a complementary and alternative medicine product. Women reported an average of AUD$781.10 in out-of-pocket expenses for consultations with conventional health care practitioners, AUD$185.40 in out-of-pocket expenses for consultations with complementary and alternative medicine practitioners and AUD$179.60 in out-of-pocket expenses for complementary and alternative medicine products. From the study data we estimate Australian pregnant women spend over AUD$337 M on out-of-pocket health services. CONCLUSION: While the majority of pregnant women in Australia may obtain health services via the publically-funded health care system and/or private health insurance coverage, our analysis identifies substantial out-of-pocket expenditure for health care by pregnant women - a trend in public spending for maternity care of importance to policy makers, health administrators, and health professionals.
Frawley, J, Hall, H, Adams, J & Sibbritt, D 2017, 'Health care utilization of women who experience pregnancy related reflux, nausea and/or vomiting.', The Journal of Maternal-Fetal and Neonatal Medicine, pp. 1938-1943.View/Download from: UTS OPUS or Publisher's site
Nausea, vomiting and reflux are common conditions experienced by women during pregnancy. The objective of this project was to examine women's use of health services for these conditions.The study sample was obtained via the Australian Longitudinal Study on Women's Health. A total of 2,445 women who were pregnant or who had recently given birth in 2009 were invited to complete a sub-survey in 2010 about pregnancy and health service utilization. A response rate of 79.2% was obtained.During their pregnancy, 604 (32.9%) respondents experienced nausea, with 255 (42.2%) of these women seeking help from a health care practitioner. A total of 201 women (11%) reported repeated vomiting, and 637 women (34.7%) reported reflux, of which 78.6% and 59.2% sought help respectively. There were no significant differences in the mental and physical health measures between women with nausea, vomiting and/or reflux who sought help and women who did not. Having private health insurance with obstetric cover was associated with seeking help for reflux; this was the only demographic measure significantly associated with seeking help for any condition.Research is required to understand why many women do not seek professional help for common gastrointestinal conditions during pregnancy.
Lauche, R, Peng, W, Ferguson, C, Cramer, H, Frawley, J, Adams, J & Sibbritt, D 2017, 'Efficacy of Tai Chi and qigong for the prevention of stroke and stroke risk factors: A systematic review with meta-analysis', Medicine, vol. 96, no. 45.View/Download from: UTS OPUS or Publisher's site
Background: This review aims to summarize the evidence of Tai Chi and qigong interventions for the primary prevention of stroke, including the effects on populations with major stroke risk factors.
Methods: A systematic literature search was conducted on January 16, 2017 using the PubMed, Scopus, Cochrane Library, and CINAHL databases. Randomized controlled trials examining the efficacy of Tai Chi or qigong for stroke prevention and stroke risk factors were included. Risk of bias was assessed using the Cochrane Risk of Bias tool.
Results: Twenty-one trials with n=1604 patients with hypertension, hyperlipidaemia, diabetes, overweight or obesity, or metabolic syndrome were included. No trials were found that examined the effects of Tai Chi/qigong on stroke incidence. Meta-analyses revealed significant, but not robust, benefits of Tai Chi/qigong over no interventions for hypertension (systolic blood pressure: -15.55mm Hg (95% CI: -21.16; -9.95); diastolic blood pressure: -10.66mm Hg (95% CI: -14.90, -6.43); the homeostatic model assessment (HOMA) index (-2.86%; 95% CI: -5.35, -0.38) and fasting blood glucose (-9.6mg/dL; 95% CI: -17.28, -1.91), and for the body mass index compared with exercise controls (-1.65kg/m2; 95% CI: -3.11, -0.20). Risk of bias was unclear or high for the majority of trials and domains, and heterogeneity between trials was high. Only 6 trials adequately reported safety. No recommendation for the use of Tai Chi/qigong for the prevention of stroke can be given.
Conclusion: Although Tai Chi and qigong show some potential more robust studies are required to provide conclusive evidence on the efficacy and safety of Tai Chi and qigong for reducing major stroke risk factors.
Peng, W, Lauche, R, Ferguson, C, Frawley, J, Adams, J & Sibbritt, D 2017, 'Efficacy of Chinese herbal medicine for stroke modifiable risk factors: a systematic review', Chinese Medicine, vol. 12, no. 25, pp. 1-29.View/Download from: UTS OPUS or Publisher's site
Background: The vast majority of stroke burden is attributable to its modifiable risk factors. This paper aimed to systematically summarise the evidence of Chinese herbal medicine (CHM) interventions on stroke modifiable risk factors for stroke prevention.
Methods: A literature search was conducted via the MEDLINE, CINAHL/EBSCO, SCOPUS, and Cochrane Database from 1996 to 2016. Randomised controlled trials or cross-over studies were included. Risk of bias was assessed according to the Cochrane Risk of Bias tool.
Results: A total of 46 trials (6895 participants) were identified regarding the use of CHM interventions in the management of stroke risk factors, including 12 trials for hypertension, 10 trials for diabetes, eight trials for hyperlipidemia, seven trials for impaired glucose tolerance, three trials for obesity, and six trials for combined risk factors. Amongst the included trials with diverse study design, an intervention of CHM as a supplement to biomedicine and/or a lifestyle intervention was found to be more effective in lowering blood pressure, decreasing blood glucose level, helping impaired glucose tolerance reverse to normal, and/or reducing body weight compared to CHM monotherapy. While no trial reported deaths amongst the CHM groups, some papers do report moderate adverse effects associated with CHM use. However, the findings of such beneficial effects of CHM should be interpreted with caution due to the heterogeneous set of complex CHM studied, the various control interventions employed, the use of different participants' inclusion criteria, and low methodological quality across the published studies. The risk of bias of trials identified was largely unclear in the domains of selection bias and detection bias across the included studies.
Conclusion: This study showed substantial evidence of varied CHM interventions improving the stroke modifiable risk factors. More rigorous research examining the use of CHM products for sole or multiple ma...
Wardle, J, Frawley, J, Adams, J, Sibbritt, D, Steel, A & Lauche, R 2017, 'Associations between complementary medicine utilization and influenza/pneumococcal vaccination: Results of a national cross-sectional survey of 9151 Australian women', Preventive Medicine, vol. 105, pp. 184-189.View/Download from: UTS OPUS or Publisher's site
Influenza and pneumococcal vaccination is recommended for all adults, with older adults considered a high-risk group for targeted intervention. As such it is important for factors affecting vaccine uptake in this group to be examined. Complementary medicine (CM) use has been suggested as a possible factor associated with lower vaccination uptake. To determine if associations exist between influenza and pneumococcal vaccine uptake in older Australian women and the use of CM, data from women aged 62–67 years surveyed as part of the Australian Longitudinal Study on Women's Health (ALSWH) were analyzed in 2013 regarding their health and health care utilization. Associations between the uptake of influenza and pneumococcal vaccinations and the use of CM were analyzed in 2016 using chi-squared tests and multiple logistic regression modelling. Of the 9151 women, 65.6% and 17.7% reported that they had influenza and pneumococcal vaccination within the past 3 years respectively. Regression analyses show that women who consulted naturopaths/herbalists (OR = 0.64) and other CM practitioners (OR = 0.64) were less likely to have vaccination (influenza only), as were women who used yoga (OR = 0.77–0.80) and herbal medicines (OR = 0.78–0.83) (influenza and pneumococcal). Conversely, women using vitamin supplements were more likely to receive either vaccination (OR = 1.17–1.24) than those not using vitamin supplements. The interface between CM use and influenza and pneumococcal vaccination uptake in older women appears complex, multi-factorial and often highly individualized and there is a need for further research to provide a rich examination of the decision-making and motivations of stakeholders around this important public health topic.
Frawley, JE 2016, 'Complementary and alternative medicine in Australia: An overview of contemporary workforce features', Australian Journal of Herbal Medicine, vol. 28, no. 4, pp. 103-105.View/Download from: UTS OPUS
The use of complementary and alternative medicine (CAM) is popular in Australia, with CAM practitioners making up the third largest
group of health professionals nationwide. Practice characteristics, education, and regulatory requirements differ widely, and this
article provides a snapshot of the contemporary Australian CAM workforce.
Frawley, J 2016, 'Editorial', Australian Journal of Herbal Medicine, vol. 28, no. 2, p. 35.
Frawley, J 2016, 'Editorial: Bush medicine: A journey to the centre of Australia', Australian Journal of Herbal Medicine, vol. 28, no. 4, pp. 101-102.
Cramer, H, Hall, H, Leach, M, Frawley, J, Zhang, Y, Leung, B, Adams, J & Lauche, R 2016, 'Prevalence, patterns, and predictors of meditation use among US adults: A nationally representative survey', SCIENTIFIC REPORTS, vol. 6.View/Download from: UTS OPUS or Publisher's site
Frawley, J, Peng, W, Sibbritt, D, Ward, L, Lauche, R, Zhang, Y & Adams, J 2016, 'Is there an association between women's consultations with a massage therapist and health-related quality of life? Analyses of 1800 women aged 56-61 years', JOURNAL OF BODYWORK AND MOVEMENT THERAPIES, vol. 20, no. 4, pp. 734-739.View/Download from: UTS OPUS or Publisher's site
Frawley, J, Sibbritt, D, Broom, A, Gallois, C, Steel, A & Adams, J 2016, 'Complementary and alternative medicine practitioner use prior to pregnancy predicts use during pregnancy.', Women and Health, vol. 56, no. 8, pp. 926-939.View/Download from: UTS OPUS or Publisher's site
The objective of this study was to determine if prior visits to a complementary and alternative medicine (CAM) practitioner were associated with CAM use during pregnancy. The study sample comprised the Australian Longitudinal Study on Women's Health. Women were surveyed prior to pregnancy in 2006, and then again in 2010 if they were pregnant or had recently given birth, and asked a range of questions relating to demographic variables, health status and use of CAM. A multivariable analysis identified significant covariates associated with visits to specific CAM practitioner modalities during pregnancy. Of the 447 women who consulted a CAM practitioner prior to pregnancy, 62.4% (n = 279) continued this use during pregnancy. Prior use of massage therapy, acupuncture, herbalist/naturopath or chiropractor was related to use of the same service during pregnancy. Higher income and working full-time were associated with the continued use of massage, while continued visits to a chiropractor were associated with having depressive symptoms, a urinary tract infection and living in a rural community. Prior use of CAM was highly related to continuing use during pregnancy. Further research is required to elucidate the benefits women attain from a CAM-model of care that they do not get from their conventional maternity care providers alone.
Frawley, J, Sibbritt, D, Broom, A, Gallois, C, Steel, A & Adams, J 2016, 'Women's attitudes towards the use of complementary and alternative medicine products during pregnancy.', Journal of Obstetrics and Gynaecology, vol. 36, no. 4, pp. 462-467.View/Download from: UTS OPUS or Publisher's site
The aim of this study was to analyse women's attitudes towards the use of complementary and alternative medicine (CAM) products during pregnancy. The study sample was obtained via the Australian Longitudinal Study on Women's Health or ALSWH. A response rate of 79.2% (n = 1,835) was attained. Women who use herbal medicines (34.5%, n = 588) view CAM as a preventative measure, are looking for something holistic and are concerned about evidence of clinical efficacy when considering the use of these products during pregnancy. Women who use aromatherapy (17.4%, n = 319) and homoeopathy (13.3%, n = 244) want more personal control over their body and are concerned more about their own personal experience of the efficacy of CAM than clinical evidence of efficacy. As CAM use in pregnancy appears to be increasingly commonplace, insights into women's attitudes towards CAM are valuable for maternity healthcare providers.
Frawley, J, Sundberg, T, Steel, A, Sibbritt, D, Broom, A & Adams, J 2016, 'Prevalence and characteristics of women who consult with osteopathic practitioners during pregnancy; a report from the Australian Longitudinal Study on Women's Health (ALSWH).', Journal of Bodywork and Movement Therapies, vol. 20, no. 1, pp. 168-172.View/Download from: UTS OPUS or Publisher's site
The use of complementary medicine (CM) is common during pregnancy with visits to osteopathic practitioners growing in recent years. This study was conducted to investigate the prevalence and characteristics of women who consult osteopathic practitioners during pregnancy.The study sample was obtained via the Australian Longitudinal Study on Women's Health (ALSWH). The women answered questions about consultations with osteopathic practitioners, pregnancy-related health concerns and attitudes to CM use.A total response rate of 79.2% (1835) was obtained. Of these, 104 women (6.1%) consulted with an osteopath during pregnancy for a pregnancy-related health condition. Women were more likely to consult an osteopath if they suffered from back pain, sadness, weight management issues, or had a history of retained placenta.Women are visiting osteopaths for help with common pregnancy health complaints, highlighting the need for research to evaluate the safety, clinical and cost effectiveness of osteopathy in pregnancy.
Steel, A, Adams, J, Frawley, J, Wardle, J, Broom, A, Sidebotham, M & Sibbritt, D 2016, 'Does Australia's Health Policy Environment Create Unintended Outcomes for Birthing Women?', BIRTH-ISSUES IN PERINATAL CARE, vol. 43, no. 4, pp. 273-276.View/Download from: UTS OPUS or Publisher's site
Steel, A, Frawley, J, Sibbritt, D, Broom, A & Adams, J 2016, 'The characteristics of women who use hypnotherapy for intrapartum pain management: Preliminary insights from a nationally-representative sample of Australian women', Complementary Therapies in Medicine, vol. 25, pp. 67-70.View/Download from: UTS OPUS or Publisher's site
Wardle, J, Frawley, J, Steel, A & Sullivan, E 2016, 'Complementary medicine and childhood immunisation: A critical review.', Vaccine, vol. 34, no. 38, pp. 4484-4500.View/Download from: UTS OPUS or Publisher's site
Vaccination is one of the most significant and successful public health measures of recent times. Whilst the use of complementary medicine (CM) continues to grow, it has been suggested that CM practitioners hold anti-vaccination views. The objective of this critical review is to examine the evidence base in relation to CM practitioner attitudes to childhood vaccination alongside attitudes to vaccination among parents who visit CM practitioners and/or use CM products.A database search was conducted in MEDLINE, PubMed, CINAHL, EMBASE and AMED for research articles published between January 2000 and September 2015 that evaluated either CM practitioner or CM user attitudes and intention towards childhood vaccination.A total of 23 articles were found that detailed the attitudes of CM practitioners to vaccination. A further 16 papers examined the association between the use of CM products and visits to CM practitioners, and immunisation. The interface between CM and vaccination is complex, multi-factorial and often highly individualised. The articles suggest that there is no default position on immunisation by CM practitioners or parents who use CM themselves, or for their children. Although CM use does seem positively associated with lower vaccination uptake, this may be confounded by other factors associated with CM use (such as higher income, higher education or distrust of the medical system), and may not necessarily indicate independent or predictive relationships.Although anti-vaccination sentiment is significant amongst some CM practitioners, this review uncovers a more nuanced picture, and one that may be more agreeable to public health values than formerly assumed.
Frawley, J 2015, 'Editorial: We need to talk about vaccination', Australian Journal of Herbal Medicine, vol. 27, no. 2, pp. 45-46.
Frawley, J 2015, 'Letters to the editor', Australian Journal of Herbal Medicine, vol. 27, no. 3, pp. 91-92.
Frawley, J 2015, 'Editorial: The 9th International Conference on Herbal Medicine', Australian Journal of Herbal Medicine, vol. 27, no. 1, p. 1.
Frawley, J 2015, 'Editorial: The pluralistic nature of contemporary maternity care in Australia', Australian Journal of Herbal Medicine, vol. 27, no. 3, pp. 89-90.
Frawley, J 2015, 'Editorial: The need to characterise paediatric visits to complementary medicine practitioners', Australian Journal of Herbal Medicine, vol. 27, no. 4, pp. 125-126.
Grant, SJ, Frawley, J & Bensoussan, A 2015, 'Process of care in outpatient Integrative healthcare facilities: a systematic review of clinical trials', BMC Health Services Research, vol. 15, pp. 1-18.View/Download from: UTS OPUS or Publisher's site
© 2015 Grant et al. Abstract Background: Patients currently integrate complementary medicine (CM) and allopathic, choosing a combination of therapies rather than a single therapy in isolation. Understanding integrative healthcare (IHC) extends beyond evaluation of specific therapies to encompass evaluations of multidisciplinary complex interventions. IHC is defined as a therapeutic strategy integrating conventional and complementary medical practices and practitioners in a shared care setting to administer an individualized treatment plan. We sought to review the outcomes of recent clinical trials, explore the design of the interventions and to discuss the methodological approaches and issues that arise when investigating a complex mix of interventions in order to guide future research. Method: Five databases were searched from inception to 30 March 2013. We included randomized and quasi-experimental clinical trials of IHC. Data elements covering process of care (initial assessment, treatment planning and review, means for integration) were extracted. Results: Six thousand two hundred fifty six papers were screened, 5772 were excluded and 484 full text articles retrieved. Five studies met the inclusion criteria. There are few experimental studies of IHC. Of the five studies conducted, four were in people with lower back pain. The positive findings of these studies indicate that it is feasible to conduct a rigorous clinical trial of an integrative intervention involving allopathic and CM treatment. Further, such interventions may improve patient outcomes. Conclusions: The trials in our review provide a small yet critical base from which to refine and develop larger studies. Future studies need to be adequately powered to address efficacy, safety and include data on cost effectiveness.
Adams, J, Frawley, J, Steel, A, Broom, A & Sibbritt, D 2015, 'Use of pharmacological and non-pharmacological labour pain management techniques and their relationship to maternal and infant birth outcomes: Examination of a nationally representative sample of 1835 pregnant women', Midwifery, vol. 31, no. 4, pp. 458-463.View/Download from: UTS OPUS or Publisher's site
© 2015 Elsevier Ltd. Women use various labour pain management techniques during birth. The objective of this study is to investigate women's use of pharmacological and non-pharmacological labour pain management techniques in relation to birth outcomes. Methods: a sub-survey of a nationally representative sample of pregnant women (. n=1835) from the Australian Longitudinal Study on Women's Health. Results: our analysis identified women's use of water for labour pain management as decreasing the likelihood of their baby being admitted to special care nursery (OR=0.42, p<0.004) whereas the use of epidural increased this likelihood (OR=3.38, p<0.001) as well as for instrumental childbirth (OR=7.27, p<0.001). Epidural and pethidine use decreased women's likelihood of continuing breast-feeding (ORs=0.68 and 0.59, respectively, both p<0.01) whereas the use of breathing techniques and massage for pain control increased the likelihood of women continuing breast-feeding (ORs=1.72 and 1.62, respectively, both p<0.01). Conclusions: our study illustrates associations between the use of both pharmacological and non-pharmacological labour pain management techniques and selected birth outcomes while controlling for confounding variables. There remain significant gaps in the evidence base for the use of non-pharmacological labour pain control methods and our findings provide a platform with which to develop a broad clinical research programme around this topic.
Cramer, H, Frawley, J, Steel, A, Hall, H, Adams, J, Broom, A & Sibbritt, D 2015, 'Characteristics of women who practice yoga in different locations during pregnancy', BMJ Open, vol. 5, no. 8, pp. e008641-e008641.View/Download from: UTS OPUS or Publisher's site
Frawley, J, Adams, J, Steel, A, Broom, A, Gallois, C & Sibbritt, D 2015, 'Women's Use and Self-Prescription of Herbal Medicine during Pregnancy: An Examination of 1,835 Pregnant Women', Women's Health Issues, vol. 25, no. 4, pp. 396-402.View/Download from: UTS OPUS or Publisher's site
Murthy, V, Sibbritt, D, Broom, A, Kirby, E, Frawley, J, Refshauge, KM & Adams, J 2015, 'Back pain sufferers' attitudes toward consultations with CAM practitioners and self- prescribed CAM products: A study of a nationally representative sample of 1310 Australian women aged 60-65 years', Complementary Therapies in Medicine, vol. 23, no. 6, pp. 782-788.View/Download from: UTS OPUS or Publisher's site
Steel, A, Adams, J, Frawley, J, Broom, A & Sibbritt, D 2015, 'The characteristics of women who birth at home, in a birth centre or in a hospital labour ward: A study of a nationally-representative sample of 1835 pregnant women', Sexual & Reproductive Healthcare, vol. 6, no. 3, pp. 132-137.View/Download from: UTS OPUS or Publisher's site
Steel, A, Frawley, J, Adams, J & Diezel, H 2015, 'Trained or professional doulas in the support and care of pregnant and birthing women: A critical integrative review', Health and Social Care in the Community, vol. 23, no. 3, pp. 225-241.View/Download from: UTS OPUS or Publisher's site
© 2014 John Wiley & Sons Ltd. The professionalisation of doula care and research interest in this area of maternity care/support have both grown internationally in recent years highlighting important broader issues around the access, continuity and delivery of maternity care services. However, no work to date has provided a critical appraisal of the international literature on this topic. In response, this paper presents the first critical review of international empirical literature examining professional doula care for pregnant and birthing women. A database search of AMED, CINAHL, Maternity and Infant Care, and MEDLINE using the search term, "doula" was undertaken. A total of 48 papers published between 1980 and March 2013 involving trained or professional doulas were extracted. Four descriptive categories were identified from the review: 'workforce and professional issues in doula care'; 'trained or professional doula's role and skill'; 'physical outcomes of trained or professional doula care'; and 'social outcomes of trained or professional doula care'. Of the studies evaluating outcomes of doula care, there were a number with design and methodology weaknesses. The review highlights a number of gaps in the research literature including a lack of research examining doula workforce issues; focus upon the experience and perspective of significant stakeholders such as expectant fathers with regard to trained or professional doula care; clinical trials measuring both subjective experiences and physical outcomes of trained or professional doula support; synergy between the design of clinical trials research examining trained or professional doula care and the clinical reality of professional doula practice. It is imperative that key aspects of trained doula care be subject to further rigorous, empirical investigation to help establish an evidence base to guide policy and practice relating to this area of support and care for pregnant and birthing women.
Steel, AE, Adams, J, Sibbritt, D, Broom, A, Gallois, C & Frawley, JE 2015, 'Managing the pain of labour: factors associated with the use of labour pain management for pregnant Australian women.', Health Expectations, vol. 18, no. 5, pp. 1633-1644.View/Download from: UTS OPUS or Publisher's site
Despite high rates of women's use of intrapartum pain management techniques, little is known about the factors that influence such use. ... Examine the determinants associated with women's use of labour pain management. ... Cross-sectional survey of a substudy of women from the 'young' cohort of the Australian Longitudinal Study of Women's Health (ALSWH). ... Women aged 3135 years who identified as being pregnant or recently given birth in the 2009 ALSWH survey (n = 2445) were recruited for the substudy. The substudy survey was completed by 1835 women (RR = 79.2%).
Frawley, J 2014, 'Editorial', Australian Journal of Herbal Medicine, vol. 26, no. 4, p. 134.
Frawley, J 2014, 'Bachelor degree now minimum qualification for naturopathy and western herbal medicine in Australia', Australian Journal of Herbal Medicine, vol. 26, no. 3, p. 84.
Frawley, J 2014, 'Editorial: Herbal medicine use in pregnancy by Australian women: High rates of self-prescription and low rates of disclosure?', Australian Journal of Herbal Medicine, vol. 26, no. 1, pp. 2-3.
Frawley, J 2014, 'Editorial: Give a man a fish - an innovative and sustainable new herbal medicine programme in Ethiopia', Australian Journal of Herbal Medicine, vol. 26, no. 2, p. 48.
Steel, A, Adams, J, Broom, A, Sibbritt, D, Frawley, J & Gallois, C 2014, 'Marginalization and Companionable Silence: CAM Practitioners' Perspectives of Their Interprofessional Relationships with Maternity Care Providers', The Journal of Alternative and Complementary Medicine, vol. 20, no. 5, pp. A111-A111.View/Download from: UTS OPUS or Publisher's site
Frawley, J, Adams, J, Broom, A, Steel, A, Gallois, C & Sibbritt, D 2014, 'Majority of Women Are Influenced by Nonprofessional Information Sources When Deciding to Consult a Complementary and Alternative Medicine Practitioner During Pregnancy', Journal of Alternative and Complementary Medicine, vol. 20, no. 7, pp. 571-577.View/Download from: UTS OPUS or Publisher's site
Frawley, JE, Steel, A, Adams, J, sibbritt, D, Broom, A & Gallois, C 2014, 'The Association between women's choice of birth setting and their use of CAM during labor and birth.', Journal of Alternative and Complementary Medicine, vol. 20, no. 5, pp. 1-1.View/Download from: UTS OPUS or Publisher's site
Purpose: Contemporary maternity care often means women are
able to choose a number of settings for their birth including
hospitals, birth centers, and community settings. There is also
evidence that many women utilised complementary and alternative
medicine (CAM) during pregnancy and birth. The purpose
of this study is to examine the association between
women's choice of birth setting and their use of CAM during
labor and birth.
Methods: Longitudinal data from a sub-study of women
(n = 2445) from the nationally-representative Australian Longitudinal
Study of Women's Health (ALSWH) was analyzed for
relationships between women's birth setting (hospital, birth
center, or community) and their demographics, attitudes towards
maternity care (including CAM), and use of CAM during
pregnancy and birth.
Results: The characteristics associated with women's choice of
birth setting include some demographic features such as employment
status, health care subsidy, and level of education.
Women's birth setting choice was also linked to a preference for
CAM practitioner by women birthing in birth centers and
community settings. In contrast, women birthing in hospitals
held more positive views towards obstetric care. There was a
higher use of CAM during pregnancy by women birthing in birth
centers and community but this was not consistent across all
CAMs investigated. Naturopaths, herbal medicines, homeopathy
and flower essences were more commonly used by women
birthing in community compared with those in a birth center.
There was also a higher rate of CAM use for intrapartum pain
management for women birthing outside of a hospital setting,
although women attending a birth center were more likely than
those birthing in community to use pharmacological pain management
Conclusion: There are characteristic differences between women
birthing in different birth settings which seems to be
influenced as much by preference for maternity care and interest
in CAM use as it is by...
Peng, W, Adams, J, Sibbritt, DW & Frawley, JE 2014, 'Critical review of complementary and alternative medicine use in menopause: focus on prevalence, motivation, decision-making, and communication', Menopause, vol. 21, no. 5, pp. 536-548.View/Download from: UTS OPUS or Publisher's site
This article presents the first critical review of complementary and alternative medicine (CAM) use among menopausal women (a term here used to include premenopausal, perimenopausal and postmenopausal women) by focusing on the prevalence of CAM use and CAM users' characteristics, motivation, decision-making, and communication with healthcare providers.
Steel, A, Adams, J, Sibbritt, D, Broom, A, Frawley, J & Gallois, C 2014, 'Relationship between complementary and alternative medicine use and incidence of adverse birth outcomes: An examination of a nationally representative sample of 1835 Australian women', Midwifery, vol. 30, no. 12, pp. 1157-1165.View/Download from: UTS OPUS or Publisher's site
Objective: there is evidence of high use of complementary and alternative medicine (CAM) by pregnant women. Despite debate and controversy regarding CAM use in pregnancy there has been little research focus upon the impacts of CAM use on birth outcomes. This paper reports findings outlining the incidence of adverse birth outcomes among women accessing CAM during pregnancy.
Design: a survey based cohort sub study from the nationally representative Australian Longitudinal Study on Women's Health (ALSWH) was undertaken in 2010.
Participants.: women (aged 31-36 years) who identified in 2009 as pregnant or recently given birth (n=2445) from the younger cohort (n=8012) of ALSWH were recruited for the study.
Measurements and findings: participants' responses were analysed to examine the relationship between use of CAM and adverse birth outcomes from their most recent pregnancy. Of the respondents (n=1835; 79.2%), there were variations in birth outcomes for the women who used different CAM. Notably, the outcome which was most commonly associated with CAM use was emotional distress. This was found to occur more commonly in women who practised meditation/yoga at home, used flower essences, or consulted with a chiropractor. In contrast, women who consulted with a chiropractor or consumed herbal teas were less likely to report a premature birth, whilst participation in yoga classes was associated with an increased incidence of post parturn/intrapartum haemorrhage.
Key conclusions: the results emphasise the necessity for further research evaluating the safety and effectiveness of CAM for pregnant women, with a particular focus on birth outcomes. Implications for practice: health professionals providing care need to be aware of the potential birth outcomes associated with CAM use during pregnancy to enable the provision of accurate information to women in their care, and to assist in safely supporting women accessing CAM to assist with pregnancy, labour and birth.
Steel, A, Adams, J, Sibbritt, D, Broom, A, Frawley, J & Gallois, C 2014, 'The Influence of Complementary and Alternative Medicine Use in Pregnancy on Labor Pain Management Choices: Results from a Nationally Representative Sample of 1,835 Women', JOURNAL OF ALTERNATIVE AND COMPLEMENTARY MEDICINE, vol. 20, no. 2, pp. 87-97.View/Download from: UTS OPUS or Publisher's site
Steel, A, Adams, J, Sibbritt, D, Broom, A, Gallois, C & Frawley, J 2014, 'Determinants of Women Consulting with a Complementary and Alternative Medicine Practitioner for Pregnancy-Related Health Conditions', Women and Health, vol. 54, no. 2, pp. 127-144.View/Download from: UTS OPUS or Publisher's site
Frawley, J 2013, 'Editorial', Australian Journal of Herbal Medicine, vol. 25, no. 2, p. 49.
Frawley, J 2013, 'Editorial: The australian journal of herbal medicine: Manuscript submission and the peer review process', Australian Journal of Herbal Medicine, vol. 25, no. 3, pp. 97-98.
Frawley, J 2013, 'Editorial', Australian Journal of Herbal Medicine, vol. 25, no. 1, p. 1.
Case studies or case reports are valuable to complementary and alternative medicine practitioners as they contribute to the evolving evidence base and disseminate important clinical information. The format of these reports differs from journal to journal; however they normally contain the following components: introduction, case presentation, discussion and conclusion. Case studies are a neglected form of communicating clinical findings in complementary and alternative medicine and may be useful as a starting point to determine clinical relevance by providing information that may lead to more stringent investigation. © National Herbalists Association of Australia 2013.
Frawley, JE, Adams, J, Sibbritt, D, Steel, AE, Broom, A & Gallois, C 2013, 'Prevalence and determinants of complementary and alternative medicine use during pregnancy: Results from a nationally representative sample of Australian pregnant women', Australian and New Zealand Journal of Obstetrics and Gynaecology, vol. 53, no. 4, pp. 347-352.View/Download from: UTS OPUS or Publisher's site
Background: Pregnant women have been identi?ed as high users of complementary and alternative medicine (CAM). However, no research to date has provided a detailed analysis of the prevalence and determinants of CAM consumption amongst pregnant women. Aim: To examine the prevalence and determinants of CAM use by pregnant women, utilising a national representative sample. Methods: The study sample was obtained via the Australian Longitudinal Study on Womens Health. This paper is based on a sub-study of 1,835 pregnant women, administered in 2010. The women answered questions about CAM use, demographics, pregnancy-related health concerns and health service utilisation. Results: Complementary and alternative medicine use was found to be high with 48.1% (n = 623) of pregnant women consulting a CAM practitioner and 52.0% (n = 842) of women using CAM products (excluding vitamins and minerals) during pregnancy. CAM practitioner visits were more likely for selected pregnancy-related health concerns, namely back pain or back ache, neck pain and labour preparation. Women were less likely to consult a CAM practitioner if they suffered with headaches/migraines. Employment was also found to be predictive of pregnant womens visits to a CAM practitioner. Signi?cant health history and demographic predictors of CAM product use were tiredness and fatigue, embarking on preparation for labour and having a university education. Conclusion: Most pregnant women are utilising CAM products and/or services as part of their maternity care and obstetricians, general practitioners and midwives need to enquire with women in their care about possible CAM use to help promote safe, effective coordinated maternity care.
Steel, AE, Frawley, JE, Sibbritt, D & Adams, J 2013, 'A preliminary profile of Australian women accessing doula care: Findings from the Australian Longitudinal Study on Women's Health', Australian and New Zealand Journal of Obstetrics & Gynaecology, vol. 53, no. 6, pp. 589-592.View/Download from: UTS OPUS or Publisher's site
Despite growing interest and controversy regarding the value of doulas in contemporary maternity care, little is known about the profile of women who choose to involve a doula in their care team. This preliminary analysis indicates that women's attitudes towards maternity care may influence their use of a doula more so than demographic factors. Further research examining these
Steel, AE, Adams, J, Sibbritt, D, Broom, A, Gallois, C & Frawley, JE 2012, 'Utilisation of complementary and alternative medicine (CAM) practitioners within maternitycare provision: results from a nationally representative cohort study of 1,835 pregnant women', BMC Pregnancy and Childbirth, vol. 12, pp. 146-146.View/Download from: UTS OPUS or Publisher's site
Background: There is little known about women's concurrent use of conventional and complementary health care during pregnancy, particularly consultation patterns with complementary and alternative medicine (CAM). This study examines health service utilisation among pregnant women including consultations with obstetricians, midwives, general practitioners (GPs) and CAM practitioners.
Daley, JE 2010, 'Dairy derivatives', Jornal of Complementary Medicine, vol. 8, no. 4, pp. 32-37.
Daley, JE 2009, 'Phytoestrogens and hormonal health', The Journal of Complementary Medicine: the independent peer-reviewed journal for healthcare professionals, vol. 8, no. 6, pp. 30-33.
Daley, JE 2009, 'Adaptogens', The Journal of Complementary Medicine: the independent peer-reviewed journal for healthcare professionals, vol. 8, no. 1, pp. 36-40.
Rosengarten, OS, Lamed, Y, Zisling, T, Feigin, A & Jacobs, JM 2009, 'Author reply', Journal of Palliative Care, vol. 25, no. 3, p. 229.
Daley, JE 2008, 'Chronic venous insufficiency', The Journal of Complementary Medicine: the independent peer-reviewed journal for healthcare professionals, vol. 7, no. 4, pp. 4-20.
Daley, JE 2008, 'Managing a rotation diet', The Journal of Complementary Medicine: the independent peer-reviewed journal for healthcare professionals, vol. 7, no. 1, pp. 26-30.
Daley, JE 2007, 'Natural analgesia', The Journal of Complementary Medicine: the independent peer-reviewed journal for healthcare professionals, vol. 6, no. 4, pp. 34-41.
Daley, JE 2007, 'Korean ginseng,', The Journal of Complementary Medicine: the independent peer-reviewed journal for healthcare professionals, vol. 6, no. 2, pp. 60-64.
Daley, JE 2007, 'Head lice', The Journal of Complementary Medicine: the independent peer-reviewed journal for healthcare professionals, vol. 6, no. 1, pp. 22-29.
McIntyre, E, Frawley, J & Lauche, R 2018, 'Women's mental health and complementary and integrative medicine' in Adams, J, Steel, A, Frawley, J & Broom, A (eds), Women's Health and Complementary and Integrative Medicine, Routledge, London.
The aim of this chapter is to explore complementary and integrative medicine (CIM) use for the two most prevalent mental health conditions: depression and anxiety. The model of integrative mental health care (IMHC) is explored, and is an important model for providing optimal mental health outcomes for women. The large variability in prevalence estimates was due to a range of factors such as culture, age, area of residence (urban or rural), economic status, and gender. Mind-body medicine is an umbrella term covering a wide variety of therapeutic techniques focusing on the ways in which emotional, mental, social, spiritual, experiential, and behavioural factors can directly affect health. Herbal medicines have been used since antiquity for anxiety and depression symptoms, and a variety of herbs are available for these conditions with varying levels of efficacy. Evidence for the efficacy of acupuncture for mental health is very limited, and considered insufficient for depression.
Frawley, JE & Adams, J 2017, 'Traditional, Complementary, Alternative, and Integrative Medicine (TCAIM)' in In Oxford Bibliographies in Public Health, Oxford University Press, UK.View/Download from: Publisher's site
Steel, AE, Frawley, JE, Adams, J, Sibbritt, D & Broom, A 2013, 'Primary Health Care, Complementary and Alternative Medicine and Women's Health: A Focus Upon Menopause' in Adams, J, Magin, P & Broom, A (eds), Primary Health Care and Complementary and Integrative Medicine, Imperial College Press, London, pp. 11-33.View/Download from: Publisher's site
Australian Women are integrating primary health care and complementary and alternative medicine to alleviate a range of symptoms and conditions. This chapter introduces the use of CAM for women's health in general and more particularly, explores the integration of CAM alongside mainstream primary health care
Frawley, JE & Davidson, S 2016, 'Is vaccine-hesitancy associated with the use of complementary medicine among Australian parents?', PHAA 15th National Immunisation Conference.
Steel, A, Frawley, J, Adams, J, Sibbritt, D & Broom, A 2015, 'The labour and birth outcomes associated with the use of herbal medicine in pregnancy.', NHAA International Conference on Herbal Medicine., Sydney,.View/Download from: UTS OPUS
Frawley, J & Steel, A 2014, 'Complementary and alternative medicine (CAM) use during pregnancy: Navigating safe maternity care', PHAA 43rd Annual Conference, The future of public health: big challenges, big opportunities, Public Health Association of Australia Annual Conference, Perth, Australia.
Steel, A, Adams, J, Broom, A, Sibbritt, D & Frawley, J 2014, ''Marginalization and Companionable Silence: CAM Practitioners' Perspectives of Their Interprofessional Relationships with Maternity Care Providers.'', 2014 International Research Congress on Integrative Medicine and Health, Miami, USA.
Steel, A, Sibbritt, D, Adams, J & Frawley, J 2014, 'The Association Between Women's Choice of Birth Setting and Their Use of CAM During Labor and Birth.', International Research Congress on Integrative Medicine and Health, Miami, Florida, USA.View/Download from: UTS OPUS
Frawley, JE 2013, 'Writing for publication; how to publish your research.', NHAA Annual General Meeting.
Frawley, JE 2013, 'Young women's use of complementary and alternative medicine (CAM) products for chronic health conditions: results from a nationally representative survey of 8,009 women', International Research Congress on Integrative Medicine and Health, London, UK.
Frawley, JE 2013, 'Self-care practices of women using Complementary and Alternative Medicine (CAM) in pregnancy: A nationally representative sample of 1,835 women', International Research Congress on Integrative Medicine and Health, London, UK.
Frawley, JE 2013, 'The use of Complementary and Alternative Medicine (CAM) for Inflammatory Bowel Disease: an Australian survey', International Research Congress on Integrative Medicine and Health, London, UK.
Steel, A, Adams, J, Sibbritt, D, Broom, A & Frawley, JE 2013, 'The influence of complementary and alternative medicine use in pregnancy on pain management in labour and birth outcomes', International Research Congress on Integrative Medicine and Health, London, UK.
Frawley, JE 2012, 'Women's sources of Information for CAM use during pregnancy', International Research Congress on Integrative Medicine and Health, Portland, Oregon, U.S..View/Download from: UTS OPUS or Publisher's site
Frawley, JE 2012, 'Women's key information sources when deciding to use complementary medicine during pregnancy', Seattle, Washington, USA.
Steel, A, Frawley, J & Frawley, JE 2013, Steel A, Frawley J, Dobson A, Jackson C, Lucke J, Tooth L, Brown W, Byles J, Mishra G. (2013). Women's health in NSW – a life course approach: an Evidence Check rapid review brokered by the Sax Institute. NSW Ministry of Health. https://www.saxinstitute.org.au/wp-content/uploads/Womens-health-in-NSW….