18/06/2026
How important is preconception care?
Info from https://profiles.uts.edu.au/Amie.Steel/publications
Fulfilling the potential of traditional, complementary and integrative medicine for global health: addressing structural inequities within the research ecosystem.
Apr 2026Lancet Reg Health Eur63:101649
Co-authors:Adams J, Steel A, Gilman N...3 more
DOI: 10.1016/j.lanepe.2026.101649
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Establishing a consensus on the clinical assessment of Hippocratic temperaments in the French-speaking naturopathic community: a Delphi study.
29 Mar 2026BMC Complement Med Ther26(1)
Co-authors:Colas L, Gimalac A, Bucher C...3 more
DOI: 10.1186/s12906-026-05353-y
BackgroundThe concept of Hippocratic temperaments is widely used in Europe for naturopathic clinical assessment. However, there is currently no consensus model for understanding the application of Hippocratic temperaments in this context, although this would seem to be an essential step towards the scientific evaluation of this traditional humoral theory. The aim of this study is to reach a consensus on how French-speaking naturopaths currently define the concept of temperament, apply humoral theory and characterize the four Hippocratic temperaments in naturopathic assessment.MethodsA Delphi study was conducted over a 19-month period in four rounds with 66 expert panelists. Consensus was defined as a median value of 75% or greater agreement with the relevant statement.ResultsConsensus was met with 217 statements describing the concept of temperament and the four temperaments in terms of psycho-emotional dimension, behavior, physiology, morphology and susceptibility to disease.ConclusionsThis data highlights the relevance of this model for French-speaking practitioners, while also illustrating the major potential of such a holistic approach to health prevention, individualized care and interdisciplinary work. Although further research phases are still required, it is our intention that these results will contribute to creating a scientific assessment tool...see more
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Contemporary clinical practice, ethnobotanical and traditional evidence and pre-clinical research-alignment, limitations and opportunities
Mar 202673rd International Congress and Annual Meeting of the Society for Medicinal Plant and Natural Product Research (GA)Planta Medica92(03):270Thieme
Co-authors:Bugarcic A, Redmond R, Steel A...3 more
DOI: 10.1055/s-0045-1815051
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Feasibility of a randomized clinical trial comparing 5-methyltetrahydrofolate and folic acid prenatal multivitamins in couples with recurrent pregnancy loss.
Feb 2026Nutr Res146:68-81
Co-authors:Ledowsky C, Scarf V, Rogers K...1 more
DOI: 10.1016/j.nutres.2025.12.008
To assess the feasibility of a randomized controlled trial (RCT) comparing 5-methyltetrahydrofolate (5-MTHF) and folic acid (FA) in couples with recurrent pregnancy loss. Pregnancy loss affects up to 15% of pregnancies, with over half of cases remaining unexplained. Emerging evidence suggests that folate metabolism, particularly in individuals carrying methylenetetrahydrofolate reductase polymorphisms such as C677T and A1298C variants, may influence reproductive outcomes. A double-blind, RCT feasibility trial was conducted in Australia with 22 reproductive dyads randomized to receive either 5-MTHF or FA prenatal multivitamins. Participants adhered to dietary restrictions, abstained from conception for two cycles, and completed regular assessments. Primary outcomes included feasibility, adherence, acceptability, and preliminary efficacy based on biochemical markers and pregnancy outcomes. The trial demonstrated high acceptability (86% in arm A [MTHF-A] and 94% in arm B [FA-B]) and adherence rates for supplement use over 78% in each arm. Unmetabolized FA concentration decreased in the 5-MTHF group but rose significantly in the FA group. A critical finding was the degradation of 5-MTHF in retained samples, highlighting formulation instability as a confounder. A fully online RCT comparing 5-MTHF and FA is feasible. Future trials should address formulation stability and expand sample size to evaluate clinical efficacy and personalized folate strategies...see more
11 citation on Dimensions.
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The Preconception Health and Health Behaviors of Australian First-Time Fathers: A Cross-Sectional Study.
24 Jan 2026Health Educ Behav10901981251414635
Co-authors:Carter T, Schoenaker D, Adams J...1 more
DOI: 10.1177/10901981251414635
Preconception health can be optimized through preconception care, which is considered an effective catalyst for behavior change prior to parenthood and is of paramount importance due to the influence that health behaviors can have on pregnancy and offspring outcomes. The preconception health and preconception health behaviors of males before they become fathers for the first time remain underexplored and are an emerging area of interest for public health and reproductive health research. This article is the first report and quantitative cross-sectional analysis of the national dataset pertaining to male health, Ten to Men, reporting data relevant to male health across the life course, during preconception. This report offers research foresight into the health behaviors (e.g., smoking or alcohol), health conditions, health consultations, medications, health information, and health literacy of Australian males prior to becoming a father (n = 572). The findings of this research support an undervalued albeit indispensable research area by providing up-to-date evidence-based information regarding paternal preconception health and health behaviors. This public health research with a focus on paternal preconception health behaviors and health behavior change can only strengthen the call for preventive health and offer preconception health and preventive knowledge about males for the research community and practitioners...see more
11 citation on Dimensions.
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Traditional, integrative and complementary medicine use in the UK population: results of a nationally representative cross-sectional survey.
16 Jan 2026BMJ Open16(1):e104334
Co-authors:van der Werf ET, Foley H, Carter T...3 more
DOI: 10.1136/bmjopen-2025-104334
OBJECTIVES: To describe the prevalence and characteristics of traditional, complementary and integrative medicine (TCIM) practice and product use by the population of the UK providing up-to-date data on the landscape of TCIM use in the UK.
DESIGN, SETTING AND PARTICIPANTS: A cross-sectional online survey, administered using the Qualtrics platform, among adults (aged 18 years and over) residing in the UK (England, Wales, Scotland or Northern Ireland). Data were collected between May and October 2024. The 40-item instrument covered four domains: demographics, health status, use of health products and practices, and use of health services. Descriptive statistics were used to summarise survey responses, and χ² tests were applied to assess associations between participant characteristics and TCIM use. Backwards stepwise logistic regression was conducted to identify predictors of TCIM use across four outcome categories (p≤0.05).
RESULTS: The sample (n=1559) was broadly representative of the UK population. Prevalence of any TCIM use over a 12-month period was 65.9% with 19.1% consulting a TCIM practitioner and 63.3% using any TCIM product or practice. Bodywork therapists (massage therapists 9.4%, chiropractors 7.9%, yoga teachers 5.0%) and homeopaths (4.1%) were the most commonly consulted TCIM practitioners and Anthroposophic doctors were the least commonly consulted (2.1%). Among TCIM products, vitamin and mineral supplements were the most commonly used (37.3%) and relaxation or meditation practices were reported by 19.4% of respondents. TCIM users were more likely to be female, identify as Asian or Black, have a chronic disease diagnosis, report good health, possess private health insurance, have a higher education level, be employed (or seeking employment) and sometimes experience financial management difficulties.
CONCLUSIONS: There is substantial use of TCIM across the UK adult population and there is a need for more research on integrating TCIM into mainstream healthcare and the National Health Service. Clear strategies are necessary to enhance communication between TCIM and conventional healthcare providers, ensure patient safety and promote person-centred, coordinated models of care...see more
11 citation on Dimensions.
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The health beliefs, attitudes, and intentions of males toward pregnancy planning and preconception health and care: a systematic review.
15 Jan 2026BMC Public Health26(1):555
Co-authors:Carter T, Schöenaker D, Adams J...1 more
DOI: 10.1186/s12889-026-26238-2
IntroductionThe preconception period is an opportunity to address health-related behaviours to optimise pregnancy and child health outcomes. However, preconception health research and practice are primarily focused on females while similar attention on males remains underdeveloped. To address evidence gaps and inform effective paternal preconception health support, the aim of this systematic review was to identify the health beliefs, attitudes, and intentions of males toward pregnancy planning and preconception health and care.MethodsA literature search was conducted in seven databases: Medline, Embase, PubMed, CINAHL, PsycINFO, Scopus, and Web of Science to identify original research regarding pregnancy planning or preconception health beliefs, attitudes, and/or intentions among generally healthy adult males. Methodological rigour of included studies was assessed using the Newcastle Ottawa Scale (NOS) and the Critical Appraisal Skills Programme (CASP) Qualitative Studies checklist. ResultsNine studies were included; cross sectional studies (n=6); a qualitative exploratory case study (n=1); a mixed method study (n=1) and a study incorporating qualitative and quantitative surveys (n=1). Analysis identified three broad themes: 1) Importance of Preconception Health and Care; 2) Paternal Preconception Behaviours; and 3) Inequalities in Preconception Health and Preconception Care. Findings reveal 1) Many males did not attend a preconception care consultation and believed it was not needed, or they already knew enough about a healthy pregnancy. 2) Males often agreed that smoking and alcohol consumption can affect the quality of their s***m and sometimes agreed it is important to consume a healthy preconception diet and to be physically active to achieve a healthy weight before conception. 3) For many males, there was a tendency to direct a greater level of responsibility to the female than to themselves regarding preconception health. African American males can feel marginalised. Conclusion Males do not always opt for a preconception consultation and many believe they are adequately prepared for a healthy pregnancy. Further, many males place a greater level of responsibility for planning and preparing for pregnancy on their partners rather than themselves. Further research focused upon male experiences and perspectives around preconception health is needed to inform targeted preconception health education, policy and care...see more
11 citation on Dimensions.
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Osteopaths' Perceptions and Practice Behaviours Regarding Preventive Health in Their Clinical Practice.
Jan 2026Health Promot J Austr37(1):e70149
Co-authors:Steel A, Foley H, Carter T...3 more
DOI: 10.1002/hpja.70149
BACKGROUND: Australia's National Preventive Health Strategy (NPHS) explicitly highlights the important role of primary care in screening for and supporting behaviour change to help reach preventive health goals. Given osteopaths' position as primary care providers in Australia, their role in fulfilling the NPHS warrants consideration. In response, this study aims to investigate osteopaths' perceptions regarding their role in preventive health and their practice behaviours regarding the key priority areas outlined in the NPHS.
METHODS: This online cross-sectional 63-item survey was completed by registered osteopaths practising in Australia. Data were descriptively analysed. Participants rated each determinant on a 7-point Likert scale ranging from 'no role at all' (1) to 'a very significant role' (7). Participants rated each determinant on a 7-point Likert scale ranging from 'no role at all' (1) to 'a very significant role' (7).
RESULTS: Participants (n = 220) identified all levels of preventive health as highly relevant for osteopathic practice, with the greatest relevance attributed to secondary prevention (Mean [M]: 6.2; Standard deviation [SD]: 1.2) and the lowest to quaternary prevention (M: 5.7; SD 1.6). When considering the seven priority preventive health topics outlined in the NPHS, participants reported most frequently screening for physical activity (M: 4.7; SD: 0.6) and least for immunisation status (M: 2.1; SD: 1.0). Participants rated patients explicitly asking them about changing their behaviour as having the greatest influence on their decision-making regarding discussing 'healthy eating' (M: 4.5; SD: 0.8), 'physical activity' (M: 4.4; SD: 0.9), 'mental health' (M: 4.4; SD: 0.9) and 'immunisation' (M: 3.8; SD: 1.3) with their patients. Participants reported being likely to undertake a range of actions in response to identifying patient need.
CONCLUSIONS: This study suggests osteopaths play a role in preventive health that may be broader than previously assumed yet is still not inclusive of the full range of behaviours required of health professionals if the Australian government is to fulfil the goals and objectives outlined in the NPHS. SO WHAT?: Government initiatives to implement the NPHS must ensure they are leveraging health professionals to their fullest potential...see more
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Global research funding for traditional, complementary and integrative medicine.
1 Nov 2025Bulletin of the World Health Organization103(11):649-661DThe World Health Organization
Co-authors:Steel A, Baker K, Adams J...17 more
DOI: 10.2471/BLT.25.293527
Objective: To explore the global research funding landscape for traditional, complementary and integrative medicine.
Methods: We conducted a three-part study to assess the global research funding landscape. First, we searched the Dimensions database and online sources using Microsoft Copilot and Google between 12 November 2024 and 22 January 2025 for relevant grants. Second, we analysed national research infrastructure using World Health Organization (WHO) data, verified by regional contacts (14 January-28 February 2025). Third, we appraised selected funders across WHO regions, evaluating funding schemes for innovation, capacity-building and alignment with traditional medicine paradigms.
Findings: We identified 39 927 grants in the Dimensions database, with funding data available for 27 019 grants totalling 24.5 billion United States dollars (US$) for the years 1960 to 2024. Most grants (42.6%; 11 548) were valued under US$ 100 000, and half had a duration of 2-4 years. Cancer and cardiovascular diseases accounted for over half (8385/15 273) of topic-categorized grants, receiving US$ 5.8 billion and US$ 2.2 billion, respectively. Funders were concentrated in the Region of the Americas, and European and Western Pacific Regions. Only seven countries had schemes explicitly funding research for traditional, complementary and integrative medicine. Case study analysis of 40 schemes across 12 countries revealed limited support for traditional medicine paradigms, with few schemes meeting criteria for innovation, capacity-building or sensitivity to traditional knowledge systems.
Conclusion: Funding for traditional medicine research remains disproportionately low relative to its global use. Strengthening support from research funding agencies is essential to achieving the goals of the WHO Global traditional medicine strategy 2025-2034...see more
55 total citations on Dimensions.
Article has an altmetric score of 45
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Protecting pregnant women from extreme heat: A content analysis of heat health action plans
1 Nov 2025International Journal of Disaster Risk Reduction130:1-13Elsevier
Co-authors:Dalugoda Y, Vilcins D, Darssan D...2 more
DOI: 10.1016/j.ijdrr.2025.105831
Extreme heat exposure increases maternal vulnerability to adverse health outcomes. Heat Health Action Plans (HHAPs) are crucial to risk reduction and adaptive strategies for this vulnerable population. This study analyses the content of HHAPs to assess the extent to which they recognise pregnant women as a heat-vulnerable population, identify any maternal heat-health interventions, and develop recommendations to enhance HHAPs from a maternal health perspective. The grey literature search combined three strategies: 1) Google advanced searches for all HHAPs, 2) customised searches for country-specific HHAPs, and (3) targeted website searches for well-known HHAPs. The search included two phases: Phase 1 identified HHAPs published until August 2023; Phase 2 verified updates to the Phase 1 plans and identified newly released HHAPs from September 2023 to June 2025. Our analysis identified 36 HHAPs across thirteen countries that acknowledged the heightened vulnerability of pregnant women to extreme heat. Among these, 36 % (13/36) provided heat-health education interventions, 33 % (12/36) offered heat-risk communication interventions, 31 % (11/36) included support for health and social care and governance, while only 8 % (3/36) focused on indoor heat reduction for pregnant women. No plans included early warning systems, long-term plans or real-time surveillance targeting pregnant women. Our findings highlight the need to strengthen maternal health resilience in HHAPs through targeted communication, education, integrated health and social care, and indoor heat reduction strategies, along with governance frameworks for early warning systems, long-term heat-health interventions, and real-time surveillance...see more
22 total citations on Dimensions.
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The practitioner research and collaboration Initiative (PRACI): Updated characteristics of the world's largest complementary medicine practice-based research network.
1 Nov 2025Complementary Therapies in Clinical Practice61:1-9Elsevier
Co-authors:Steel A, Lee B, Carter T...2 more
DOI: 10.1016/j.ctcp.2025.102021
BACKGROUND AND PURPOSE: The Practitioner Research and Collaboration Initiative (PRACI), established in 2014, recruited the largest range of complementary medicine (CM) professions in a practice-based research network (PBRN) worldwide. The ongoing success of PRACI and its ability to accurately reflect current CM practice and use requires an updated practitioner membership. This paper aims to report the demographic and practice characteristics of the recently refreshed PRACI membership.
MATERIALS AND METHODS: A cross-sectional survey was administered to those currently in clinical practice within one of nine CM professions: acupuncture, Bowen therapy, Chinese herbal medicine, kinesiology, massage therapy, myotherapy, naturopathy, nutrition, and Western herbal medicine. Responders provided consent to join membership of the PRACI PBRN. The survey covered practitioner demographics, clinical identity and qualifications, clinical career and practice, and practice characteristics.
RESULTS: A total of 922 practitioners across all nine targeted CM professions were recruited with the majority identifying as female and reported practicing in an urban locality. Most common areas of clinical interest were general health and wellbeing, musculoskeletal health, pain management, and women's health.
CONCLUSION: The refreshed PRACI membership provides world-leading infrastructure to facilitate urgently needed research activity and capacity-building focused upon issues and challenges grounded in CM clinical practice. Such value will build upon and extend the numerous PRACI sub-studies successfully completed, and collaborations successfully undertaken to date...see more
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Development of a research mentorship program for Australian osteopaths
1 Sep 2025International Journal of Osteopathic Medicine57
Co-authors:Eaves S, Steel A
DOI: 10.1016/j.ijosm.2025.100779
Current initiatives to support osteopathic clinicians’ endeavours to increase their research engagement are lacking. Following investigation of current mentorship programs run by professional, health, and academic institutions in addition to available literature, Osteopathy Australia established a formal mentorship program to support and facilitate the research interests of osteopaths in Australia. This manuscript describes the development of this program, including criteria for both mentors and mentees, the participant matching process, mentor and mentee training, the role of the organisation, and plans for program evaluation. The program is expected to promote research culture in osteopathy by building research engagement among osteopaths and enhancing networking and research collaboration opportunities between osteopaths and established health researchers across Australia. Implementation and evaluation of the voluntary program will occur between 2023 and 2024. Feedback received from participants is expected to be incorporated into changes in ongoing rounds to ensure continuous quality improvement of the program...see more
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Health effects of excess folic acid use and high blood folate during preconception and pregnancy: a systematic review
Sep 2025Reproductive BioMedicine Online105240Elsevier
Co-authors:Ledowsky C, Scarf V, Sobczyńska-Malefora A...3 more
DOI: 10.1016/j.rbmo.2025.105240
Adequate folate is essential for preventing neural tube defects (NTDs), therefore supplementation with folic acid (FA), is widely recommended for women during preconception and early pregnancy
