ECONOMIC AND SOCIAL RESEARCH COUNCIL IMPACT REPORT For awards ending on or after 1 November 2009 This Impact Report should be completed and submitted using the grant reference as the email subject to reportsofficer@esrc.ac.uk on or before the due date. Completion of this Impact Report is mandatory. It will not be possible to edit this Impact Report at a later date, as it is designed to provide a statement of the impacts of your project to date 12 months after your grant ends. Please note that the Impact Report will only be accepted if all sections have been completed in full. If a section does not apply to you, please enter n/a. Grant holders will not be eligible for further ESRC funding until the Report is accepted. (Please see Section 5 of the ESRC Research Funding Guide for details.) Please refer to the Guidance notes when completing this Impact Report. In particular, the notes explain what the ESRC means by impact. Grant Reference RES-355-25-0038 Grant Title His & Her Biological Clock: Reproductive Decision- Making and Reproductive Success in the 21st Century Grant Start Date 31 st March 2009 Total Amount 180,823.81 Grant End Date 30 th June 2010 Expended: Grant holding School of Psychology, Cardiff University Institution Grant Holder Dr Jacky Boivin Grant Holder s Contact Details Address Email School of Psychology Cardiff University Tower Building Park Place Cardiff CF10 3AT Co-Investigators (as per project application): Dr Karen Henwood Professor William Ledger Boivin@cardiff.ac.uk Telephone +44 (0)29 208 74007 Institution Cardiff University University of Sheffield 1
1. SCIENTIFIC IMPACT A Please summarise below the scientific impact(s) your project has had. [Max 250 words] The UIBEN networks facilitated interdisciplinary exchange and encouraged creative approaches to research and research processes. The Fertility Pathways network aimed to improve understanding of how individuals make decisions regarding their reproductive lives through a series of meetings with 27 academics from 7 diverse disciplines and backgrounds (e.g., psychology, theology, public health), methodological approaches (e.g., qualitative, quantitative) and varied work experience (early/mid/late-career). A number of scientific impacts arose: 1. Via our proposed working multi-factorial model for childbearing, a systematic review and pilot work we contributed to better understanding of the theoretical underpinnings of the childbearing process and consolidated a wealth of childbearing research and theory. Our model highlights the importance of macrolevel factors (e.g., societal), but also emphasises the need for attention to microlevel individual and couple decision-making. 2. Exploration of innovative quantitative and qualitative methods advanced understanding of the effective methodologies for accessing people in a childbearing decisional context. These methodologies were investigated taking a global perspective (>18 countries). 3. We identified new research partners: The World Health Organisation (WHO) to increase awareness about fertility health using a fertility awareness tool (FertiSTAT); Chair of the European Society for Human Reproduction and Embryology (ESHRE) on how ESHRE can disseminate network data to fertility medical practitioners; Merck-Serono S.A. (pharmaceutical company) to help them better help people currently trying to conceive; advocacy groups for childbearing couples to evaluated recruitment methods. 4. Network members benefited from the interdisciplinary nature of the network and diversity in research methodologies, increasing research capacity and fostering collaborative opportunities. B Please outline the findings and outputs from your project which have had the scientific impact(s) outlined in 1A. [Max 250 words] Starting families in the 21 st century is a complex affair. In our systematic review there were >25 determinants of childbearing (e.g., mainly demographic) but there remained a lack of clarity about the degree of influence of these factors on starting families. Our online survey (International Fertility Decision-Making Study [IFDMS], N=10,045) and literature review concurred that people require increasingly more time to feel ready to conceive. This body of work led to the proposal of a multi-factorial model for childbearing. People do not seem to be aware that their behaviour jeopardises their parenthood goals. 2
Our pilot work on the planning fallacy suggested that people might not realise that a long deliberation period comes at the potential cost of not achieving parenthood. A pilot study on fertility awareness using FertiSTAT (n=612) showed that young people were not behaving optimally in regards to their fertility (e.g., smoking) suggesting a need for fertility policies directed at tackling the causes of sub-optimal fertility behaviour, which led to a new collaboration with the WHO. Our feasibility/acceptability work indicated that all recruitment methods (e.g., media, social research panels, Facebook, Google Adwords) presented some biases. One needs to be mindful of these biases but having done so; data quality was high, costs reasonable and methods effective in generating cross-cultural comparisons of people currently trying to conceive (which is a typically difficult population to reach) including low resource countries. Network activities were documented (e.g., minutes, reports, abstracts) on our website (www.fertilitypathwaysnetwork.co.uk). C Please outline how these impacts were achieved. [Max 250 words] Dissemination of work through three oral (Annual Meeting ESHRE: July/2010, Rome) and two poster presentations (Spotlight on Social Sciences [SOSS] Conference May/2010, Cardiff; Annual Meeting of the American Society for Reproductive Medicine: October/2010, Denver). Presentations led to a nomination for an ESHRE award and first prize at the SOSS conference. In addition, Professor Boivin delivered lectures to the Centre for Family Research (Cambridge University) and Macquarie University. Due to important results concerning Japan, Professor Boivin presented to Yuko Obuchi, Minister for Declining Fertility at the Japanese Parliament. The systematic review was designed with SURE (Cardiff University) using Cochrane and NICE guidelines across 12 databases. A rapid review procedure was used to identify fertility policies. Additionally Professor Britten (Exeter University) gave a workshop on qualitative [meta] data synthesis. The IFDMS was designed to identify country-specific and universal facets of childbearing. Due to the time and financial constraints of the network, we formed a new collaboration with Merck Serono S.A., enabling the survey to be translated into 12 languages/18 countries (e.g., Europe, Japan, India, and China). Through diverse activities the network tested the feasibility/acceptability of strategies for research with people currently trying to conceive: types of advertising (e.g., Google, Facebook, newspaper), recruitment methods (e.g., online, social research panels) and experimental designs (e.g., survey, laboratory experiments, online longitudinal designs, textual data). Synergies among network members lead to new research questions which are currently being developed in grant applications (e.g., preconception lifestyle change [Macklon/Moss-Morris], neighbourhood impacts on childbearing patterns [Boivin/Iacovou], men and childbearing [Harrison/Shirani]). 3
D Please outline who the findings and outputs outlined above had an impact upon. This can include specific academics/researchers through to broader academic groups. [Max 250 words] The acquisition of contemporary data on reproductive decision-making and reproductive success in the general population and through the dissemination activities (conference presentations) has benefited researchers currently working on the social, psychological and biological epidemiology of reproductive trends and reproductive health outcomes and societies or special interest groups within societies with such interests (e.g., British Fertility Society, European Society for Human Reproduction and Embryology, International & European Sociological Association). Overall, the network members benefited from the interdisciplinary nature of the network, diversity in research methodologies and from the exchange and crossfertilisation of ideas which has led to future collaborations within the network. Knowledge gained here was significant in widening investigation of childbearing issues and methods (in particular training in qualitative methods). Further, network activities have had a substantial impact on a number of the junior members of the network acquiring additional research competencies. For example, junior members had the opportunity to present work at network meetings, and at international conferences. In addition, training was provided for many of the research activities conducted (e.g., systematic review). Concepts and ideas emerging from the network led to successful bids to the ESRC/MRC studentship and postdoctoral fellowship schemes, the latter for a junior member of the network (L Bunting) (see Ref. ES/H045775/1 and Ref. PTA-037-27-0192). 2. ECONOMIC AND SOCIETAL IMPACT A Please summarise below the economic and societal impact(s) your project has had. [Max 250 words] Through the successful media attention from the academic dissemination activities we have been able to distribute our results to non-academic communities. Further, the data collection from the IFDMS and FertiSTAT enabled us to assess the interest and reach our research has for the general population (e.g., via media) and individuals considering having children now or in the future. Using different methodologies we have provided people with information about fertility issues and in-turn increased our understanding about which media outlets are most relevant for fertility awareness campaigns. We have formed good links with Merck-Serono S.A. who are using our findings for segmentation analysis to better understand what people do when they cannot conceive. Ultimately these data should lead to better fit between client needs and service delivery, which will have benefits for people trying to conceive and the industrial partner. Collaborations with the media (e.g., FRaU, Japanese magazine) have enabled us to put our findings into practice. FertiSTAT is being used by FRaU to raise fertility awareness and we are currently measuring the impact of providing people with fertility specific information via the media on their day-to-day behaviour. 4
Our non-academic activities (article for Infertility Awareness Association of Canada, Fertility Show) have provided a platform for us to provide people with evidence-based messages about fertility issues but also for people trying to conceive to provide us with feedback about the research. Finally, the work has resulted in [unexpectedly] government interest in Japan and, as noted, presentation to Japanese government Ministers for fertility. B Please outline the findings and outputs from your project which have had the economic and societal impact(s) outlined in 2A. [Max 250 words] The network activities had a significant reach to the wider community. The research activities revealed that there is a great interest in projects concerning fertility health issues: 1. Over 10,000 (1690 men, 8355 women) people trying to get pregnant from more than 18 countries participated in an online study concerning childbearing (IFDMS). While we were unable to assess the adoption of the survey (i.e., participation rates compared to target populations in each country and recruitment source) the data quality was high, costs reasonable and methods highly effective in generating cross-cultural comparisons. 2. Our pilot work on the fertility awareness projects (FertiSTAT) was picked up by the media which allowed us to assess interest of this topic in the general population. For example, a short article in a weekly female magazine (Reveal, United Kingdom) resulted in over 600 women signing up for a prospective study to assess risk factors and chance of pregnancy. 3. The network activities were reported by a large number of national and international media outlets, resulting in a number of articles specific to the network activities (e.g., FRaU, Japan monthly female magazine). 4. Professor Boivin was invited to present the network findings in Japan to the Minister for Declining Fertility. In addition, the IFDMS dataset contains one of the largest datasets of male decisionmaking regarding fertility health issues providing an invaluable insight into the male perspective reproductive health issues, an area often neglected in the previous empirical literature. C Please outline how these impacts were achieved. [Max 250 words] To maximise the reach of the IFDMS the survey was available in 13 languages and recruitment was via online (e.g., Facebook, Google AdWords), fertility clinics and social research panels (e.g., IPSOS). The online IFDMS recruitment benefited from advertisement from patient leader groups websites (e.g., INUK). Academic dissemination activities of the IFDMS results led to media interest from a number of national and international newspapers and magazines, leading to Professor 5
Boivin being invited to present network activities in Japan to the general media (resulting in FRaU magazine conducting two articles about fertility awareness [July and August/2011]) and to the Minister for Declining Fertility. Network members organized a stand at the 2009 Fertility Show (London), which was attended by over 3000 members of the public interested in fertility health issues. Engaging with the public provided the network with the opportunity to distribute the research findings, providing feedback on what areas of fertility health people are interested in. Additional public dissemination of network results was through the publication of an article on fertility awareness in IAAC Creating Families, a quarterly patient organisation magazine. The Fertility Status Awareness Tool was released to the media at the European Society for Reproduction and Embryology (ESHRE) in 2009. To assess interest in raising awareness about fertility health and to measure the reach of the media on women trying to conceive an online survey was set-up (fertistat.com). Media were asked to reference website so we were able to monitor from which media source respondents came from. D Please outline who the findings and outputs outlined above had an impact upon. This can be at a broad societal level through to specific individuals or groups. [Max 250 words] Network activities (IFDMS and FertiSTAT) have raised interest in the media (e.g., Daily Mail, Guardian, Reveal magazine) and have resulted in a number of articles (e.g., FRaU magazine) disseminating the messages of raising fertility awareness to people who plan to have children now or in the future. These media outlets have large circulation rates nationally and internationally thus reaching a substantial percentage of our target audiences. Fertility patient leader groups (e.g., Infertility Network UK [INUK], Infertility Awareness Association of Canada [IAAC]) participated in the recruitment for the IFDMS. IAAC have since received a written article about raising fertility awareness from a network member for their quarterly magazine Creating Families. 3. UNEXPECTED AND POTENTIAL FUTURE IMPACTS A Unexpected Impacts Please note which, if any, of the impacts that your research has had were unexpected at the outset of the research, explaining where possible why you think this was the case. [Max 250 words] Given the objectives of the network grant (i.e., facilitate interdisciplinary exchange) we were enthused with the number of current (and future impacts) that have been born from the network activities. We feel this body of research has been able to (and will continue to) contribute to both scientific and societal understanding of contemporary childbearing decision-making. 6
The large media interest in the IFMDS project was unexpected. The media interest allowed us to have been able to benefit from this media interest through invited presentations of network work (e.g., Japan) and articles within the press to test potential methodologies for future research (e.g., FertiSTAT media interest generated an online sample of 612 women trying to conceive). B Potential Future Impacts If you have a clear idea of the impact your research is likely to have in the future please detail these below. [Max 250 words] Scientific impacts: 1. Contribution to empirical and theoretical literature on childbearing and fertility issues: a. Edited book. We are negotiating a contract offered by Cambridge University Press for an edited book: Childbearing & Decision-Making: Whether, when, why and how people have children. b. Research articles. Manuscripts are in preparation detailing the outputs (e.g., systematic review, development of the model, IDFMS results and prospective validation of the FertiSTAT). c. Grant applications in development: i. Social motives elicited by children (PI:G. Maio, E. Webb, J. Karremans, and C. Leygue) ii. Preconceptional interventions prior to fertility treatment (PI:N. Macklon, R. Moss-Morris) iii. Systematic review and ethical analysis of fertility enhancing policies (R. Turley) iv. The decisional black box of childbearing (J Boivin) d. Oral and poster presentation at the Annual Meeting ESHRE July/2011, Stockholm. Economic and societal impacts: 1. Policy work. a. Dissemination events with stakeholders (people currently trying to conceive, policy makers, etc) once we have consolidated our knowledge from the grant. We will seek funding for these activities from various sources including our industrial partner. 2. Evaluation of impact of fertility awareness campaigns a. Monitor the impact of the fertility awareness articles (e.g., intentions to change behaviour). These results will be fed back into future magazine publications to inform women about fertility health issues. 3. Low-cost provider tools: a. Collaboration with the WHO using FertiSTAT will provide a low-cost primary assessment tool that can be used in low resource countries where medical diagnostic tests are often unavailable due to limited access. 7
4. IMPACT LIMITATIONS A Limited scientific impact Please state below any major scientific difficulties that have limited the scientific impact of your research. The statement should refer to an effect on impact rather than simply detail research difficulties. [Max 250 words] As the primary aim of the network was to facilitate interdisciplinary exchange and encourage creative approaches to research and research processes, many of the activities that arose from network discussions are still in their infancy stages and thus many of the scientific impacts are not yet finalised (i.e., grant applications, publications, conference presentations). However, all members are committed to completing these outputs. There was less policy and ethical debate than we had planned due to limited understanding of the decision-making process. However, we did conduct a rapid review of the policy literature and had one meeting on the topic by Professor Guido Pennings. B Limited economic and societal impact ESRC recognises that some of the research it funds will not have an economic or societal impact in the short term. Please explain briefly below if this is the case for your project, and refer to your grant application where relevant. [Max 250 words] The full impact of the network activities on the economic and societal impact has yet to be fully measured. We are currently running an evaluation study to assess the impact of two articles about fertility awareness regarding the FertiSTAT in a female Japanese magazine (FRaU). In addition, we are continuing to work with Merck Serono to disseminate the IFDMS results to non-academic communities. Finally, our collaboration with the WHO will measure the impact of raising awareness using the FertiSTAT in low resource countries. All these activities will continue the work of the Fertility Pathways Network to disseminate our findings to the wider non-academic communities. We have yet to explore the possibilities of the network activities within regulators and policy makers. However, we are waiting to see if the dissemination activities in Japan to the Minister for fertility rates results in any policy recommendations. 8
C No impact to date This project has had no impact to date Please note that ESRC projects are evaluated on the basis of their scientific and/or economic and societal impact. Grant holders are expected to report any future impacts as they occur using the Impact Record, downloadable from the ESRC Society Today website. If you have no impacts at this stage, please give reasons below. [Max 250 words] N/A 9
5. DECLARATIONS Please read the statements below. Submitting this Impact Report to reportsofficer@esrc.ac.uk confirms your agreement. i) This Impact Report is an accurate statement of the impacts of the research project to date. All co-investigators named in the proposal to ESRC or appointed subsequently have seen and approved the Report. ii) Details of any subsequent impacts will be submitted via an Impact Record as they occur. Thank you for completing this Impact Report. Your Impact Report will be considered along with your End of Award Report in the evaluation of your research. You are now invited to complete the confidential Nominations form, which will assist with the evaluation of your project. 10
NOMINATED OUTPUTS Please nominate a maximum of two outputs from your research which you would like to be considered as part of the evaluation. Output type (eg journal article, book, newspaper article, conference proceedings) Working paper Publication details (eg author name, date, publisher details) Childbearing report: Boivin, Bunting, Kalebic, Harrison and Tsibulsky (In prep.) What makes people ready to conceive? Findings from the International Fertility Decision-Making Study. Uploaded to ESRC Society Today? (Yes/No) No. Journal manuscript in preparation Please email your completed Impact Report, including the Nominations section, to reportsofficer@esrc.ac.uk, using your grant reference number as the email subject. 11