ALSPAC

1. The Avon Longitudinal Study ALSPAC of Parents and Children www.bristol.ac.uk/alspac

2. Why Avon? • Defined geographical area • Low level of outward migration • Broadly representative of UK as a whole • Good mixture of: • Social background • Housing • Urban/rural • Enthusiastic health professionals • Supportive teachers and employers

3. Study design • Eligibility criteria: Mothers had to be resident in Avon and have an EDD between 01.04.1991 and 31.12.1992 • Methods of enrolment: • Posters in public places • Media coverage • Approach at routine scans or in hospital after birth • Community midwives • Enrolled 14,541 pregnancies Following 13,801 mothers, 13,971 children

4. ALSPAC Data • Self completion questionnaires • Health records • Biological samples • Environmental monitoring • Education records • Hands on assessments

5. Building a positive relationship • After 18 years - over 10,000 still participating • Re-enforcing the worth of taking part, reminding families & young people they are special • Relationship of trust with families invaluable in maintaining cohort • Involving participants in advising on study developments, including ethics • Feedback research findings via newsletters and press

6. ALSPAC FATHERS • Not directly enrolled when mother enrolled • Partner questionnaires sent to mother for her to pass on • Asked partner DOB in early quests + relationship to study child in later ones • Increasingly complicated family relationships

7. Age of partner at completion of FIRST Questionnaire Average = 30.65 (min=15; max=65)

8. Number Percentage I 1195 11.0 II 3702 34.0 III (non manual) 1185 10.9 III (manual) 3419 31.4 IV 1064 9.8 V 312 2.9 Armed forces 27 0.2 TOTAL 10904 100 Social class reported in Mum’s Questionnaire at 32 weeks

9. Highest educational qualification Number Percentage 1 CSE 1885 17.7 2 Vocational 1002 9.4 3 O level 2517 23.6 4 A level 3087 29.0 5 Degree 2153 20.2 TOTAL 10644 100 Education reported in Mum’s Questionnaire at 32 weeks

10. Q; Time point Number sent Completed Response rate 12 wks gest 8621 18 wks gest 9957 8 weeks 8350 8 mths 7099 21 mths 6153 33 mths 12085 5452 45.1% 47 mths (3y 11m) 11807 5101 43.2% 61 mths (5y) 11166 4522 40.5% 73 mths (6y 1m) 10282 4462 43.4% 85 mths (7y 1m) 9920 4036 40.7% 97 mths (8y 1m) 7766 4046 52.1% 110 mths (9y 2m) 8001 3664 45.8% 10 yr 7436 4161 56.0% 11 yr 7126 3639 51.1% 12 yr 7090 3297 46.5% Questionnaires to partners

11. Why dads/partners? • Much research internationally on “mother and child health/wellbeing”, little on fathers and children • Family level effects on men’s health as well as that of mothers and children • Considerable volume of data collected on men about their health and lifestyle from average age 30 makes this a powerful resource for studying modifiable factors related to health/wellbeing of the men in their own right

12. Study of fathers / partners allows improved interpretation of determinants of child outcomes • Genetic factors can be studied in relation to men’s own health and also to that of their children

13. Findings Depression in fathers in the postnatal period is associated with later psychiatric disorders in their children, independently of maternal postnatal depression. (Ramchandani et al, 2008) Increased paternal age is associated with delayed conception. (Ford et al, 2000) Children’s social development may be enhanced by time alone with fathers, but boys seem to suffer academically from long hours of paternal care when they are toddlers. (Washbrook et al, 2007)

14. Enrolment of Partners • Why now after 18 years? • Moving towards seeing each study participant as separate individuals • Want to approach fathers directly for data collection (DNA) + data linkage • How are we doing this? • Sending initial mailing via mother asking her to pass on to current partner • If that is not biological father, asking her to pass info on to him too

15. Who advised ALSPAC study team in devising protocol? • Fathers Focus group, ALSPAC Ethics & Law Committee • Need to consider complicated family relationships • Including current partner + biological father if not the same person

16. Data Collection on Fathers • In the next year or so • Sample collection for DNA • Questionnaire about own health and lifestyle • In the next 5 years • Hands on assessments • Record Linkage • Further questionnaire(s)

17. Issues • Will dads/partners take part? • What would improve uptake? • What discourages taking part? • What are the key issues in men’s lives that ALSPAC could contribute to studying? • What are best means of contact? • What publicity / participation campaigns would work? • What other incentives could there be?