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This article is part of the supplement: Navigating complexity in public health

Open Access Research

Looking back in time: conducting a cohort study of the long-term effects of treatment of adolescent tall girls with synthetic hormones

Fiona J Bruinsma1*, Jo-Anne Rayner1, Alison J Venn2, Priscilla Pyett3 and George Werther4

Author affiliations

1 Mother and Child Health Research, La Trobe University, 215 Franklin St, Melbourne, Victoria 3000, Australia

2 Menzies Research Institute, University of Tasmania, Private Bag 23 Hobart, Tasmania 7001, Australia

3 School of Population Health, The University of Melbourne, Level 5, 207 Bouverie Street, Carlton, Victoria 3010, Australia

4 Department of Endocrinology and Diabetes and Centre for Hormone Research, Royal Children's Hospital and Murdoch Childrens Research Institute, Flemington Rd, Parkville, Victoria 3052, Australia

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Citation and License

BMC Public Health 2011, 11(Suppl 5):S7  doi:10.1186/1471-2458-11-S5-S7

Published: 25 November 2011



Public health research is an endeavour that often involves multiple relationships, far-reaching collaborations, divergent expectations and various outcomes. Using the Tall Girls Study as a case study, this paper will present and discuss a number of methodological, ethical and legal challenges that have implications for other public health research.


The Tall Girls Study was the first study to examine the long-term health and psychosocial effects of oestrogen treatment for tall stature.


In undertaking this study the research team overcame many hurdles: in maintaining collaboration with treating clinicians and with the women they had treated as girls - groups with opposing points of view and different expectations; using private practice medical records to trace women who had been patients up to forty years earlier; and exploring potential legal issues arising from the collection of data related to treatment.


While faced with complex challenges, the Tall Girls Study demonstrated that forward planning, ongoing dialogue between all stakeholders, transparency of processes, and the strict adherence to group-developed protocols were keys to maintaining rigour while undertaking pragmatic research.


Public health research often occurs within political and social contexts that need to be considered in the planning and conduct of studies. The quality and acceptability of research findings is enhanced when stakeholders are engaged in all aspects of the research process.