Family Medicine Commons^™

Assessment Of Breastfeeding Education In Medical Training, Saranya Madan, Abigail Kuplicki

Medical Student Research Symposium

In 2019, the Academy of Breastfeeding Medicine issued a revised set of educational objectives for medical trainees at various stages of education. In this statement, objectives for medical school were broken down into preclinical and clinical training objectives. In this project, our goal is to assess the degree to which medical training at Wayne State University School of Medicine is addressing these aims.

The assessment of breastfeeding education is accomplished by surveying medical students at various stages of training (M1-M4) and eliciting their level of confidence in and understanding of the topics outlined in the objectives by the Academy of …

The Education Prescription: Exploring The Potential Of Patient Education To Reduce Mental Health Issues In Hormonal Contraceptive Users, Maria Abraham

Nursing | Senior Theses

The many birth control options available impact a woman’s life, as hormonal contraceptives are commonly used but often misunderstood. These contraceptives, which contain progestin only, or estrogen and progestin combined, can come in various forms such as pills, implants, IUDs, injections, the vaginal ring, and skin patches. They offer benefits such as reduced menstrual cramps and ectopic pregnancy risk. However, they may lead to adverse side effects which can include increased blood pressure, nausea, headaches, breakthrough bleeding, and a higher risk of blood clots, with research indicating a potential link between oral contraceptive use and a decline in the user’s …

Multilevel Community Engagement To Inform A Randomized Clinical Trial, Kirby L. Wycoff, Jabina G. Coleman, Christine M. Santoro, Leah L. Zullig, Niesha Darden, Porsche M. Holland, Jane F. Cruice, Shukriyyah Mitchell, Michelle Smith, Saleemah J. Mcneil, Sharon J. Herring

Counseling and Behavioral Health Faculty Papers

OBJECTIVE: To explore how patients, community-based perinatal support professionals, and health system clinicians and staff perceived facilitators and barriers to implementation of a randomized clinical trial (RCT) designed to optimize Black maternal heart health.

METHODS: This article describes the formative work that we believed needed to occur before the start of the Change of H.E.A.R.T (Here for Equity, Advocacy, Reflection and Transformation) RCT. We used a qualitative, descriptive design and community-based, participatory approach, the latter of which allowed our team to intentionally focus on avoiding harm and equalizing power dynamics throughout the research process. Data were collected between November 2021 …

Calcium Carbonate As A Potential Intervention To Prevent Labor Dystocia: Narrative Review Of The Literature, Sabahat Raees, Marie Forgie, Rita Mitchell, Emily Malloy

Journal of Patient-Centered Research and Reviews

Anecdotally, there are attestations from clinicians of calcium carbonate being used successfully for laboring people experiencing labor dystocia. The goal of this narrative review was to provide a synopsis of pertinent literature on calcium use in obstetrics to explore the potential benefit of calcium carbonate as a simple and low-cost intervention for prevention or treatment of labor dystocia. To answer how calcium and carbonate physiologically contribute to myometrium contractility, we conducted a literature search of English-language peer-reviewed articles, with no year limitation, consisting of the keywords “calcium,” “calcium carbonate,” “calcium gluconate,” “pregnancy,” “hemorrhage,” and variations of “smooth muscle contractility” and …

A Single Bout Of Breast Milk Expression Does Not Increase Resting Metabolic Rate, Leryn J. Reynolds, Kayla R. Powell, Taskina Akhter, Hannah M. Twiddy, Patrick B. Wilson

Human Movement Sciences Faculty Publications

Introduction: Breastfeeding women have elevated resting metabolic rate (RMR); however, whether a single bout of lactation increases RMR is unknown. This study aimed to determine if a single bout of lactation acutely increased RMR.

Methods: Twenty-two lactating women (age: 31 ± 0.9 year, body mass index: 27.3 ± 1.2 kg/m²) were recruited. RMR was assessed at baseline and at 1- and 2-h following breast milk expression.

Results: RMR was unchanged in lactating women following a single bout of lactation (baseline: 1437 ± 39; 1 h: 1425 ± 37 2 h: 1440 ± 31 kcal/day) (p > .05). RMR was …

An Analysis Of Georgia Mothers Who Gave Birth In 2015 And 2016 Without Receiving Prenatal Care, Joncel Stephens, Shanta R. Dube, Merrilee Gober

Journal of the Georgia Public Health Association

Background: The present study characterizes the population of women residing in the state of Georgia who did not receive prenatal care before giving birth to a live infant. The association between mother’s place of residence (rural/non-rural) and preterm delivery was also examined.

Methods: This study examined data obtained from the Georgia Department of Public Health which includes data for 7,062 mothers who did not receive prenatal care before giving birth to a live infant in Georgia in the years 2015 and 2016. Data on the resulting births was also studied. Descriptive analyses of the following variables were used …

Patient And Clinician Characteristics That Predict Breast Cancer Screening Behavior In 40–49-Year-Old Women, Sarina Schrager, Claudia Evaristo, Terry Little, Lori Dubenske, Elizabeth S. Burnside

Journal of Patient-Centered Research and Reviews

Guidelines recommend that clinicians practice shared decision-making (SDM) with women in their 40s to discuss breast cancer screening. Traditionally, SDM includes discussion of values and preferences to help determine a decision that is congruent with what the patient desires. We analyzed 54 women’s breast cancer screening decisions after a SDM conversation with their clinician. We looked at both patient and clinician characteristics that predicted whether or not a woman would get a screening mammogram. Women with a family history of breast cancer or who had a previous abnormal mammogram had higher rates of screening. Screening rates also varied widely between …

The Ways In Which Women’S Suffrage Affected Healthcare, Madison M. Weber

The Review: A Journal of Undergraduate Student Research

The 19th Amendment had and continues to have a major impact on women’s healthcare in the United States. Prior to suffrage, women had little to no ability to voice their thoughts on and change policies that regarded their own health. This essay addresses the way in which the vote both directly and indirectly impacted healthcare; including workplace conditions, maternal and reproductive rights, racial disparities, political advocacy and healthcare, the different waves of feminism, and how this has all affected modern healthcare for women. From progressive articles being published in women's magazines, to the establishment of marital rape, to the availability …

The Role Of Primary Care Physicians In Post-Partum Depression (Ppd), Elizabeth Bowman

Rowan-Virtua Research Day

Background

• Symptoms of depression lasting longer than 2 weeks following birth
• 10-15% of new mothers affected yet 50% of cases go undiagnosed
• Long-lasting consequences for the mother, baby, and father
• Multi-factorial condition

Conclusion

• Primary care providers are the first-line defense against PPD
• Many providers are resistant to PPD screenings
• Interventions from primary care providers are effective

The Impact Of Exercise On Pregnant Women Aged 18-40 And Fetal Development, Jinisha Patwa

Rowan-Virtua Research Day

68% of those who performed minimum level exercise prior to pregnancy stopped completely during early pregnancy.

Women stop exercising during pregnancy due to worries about the impact it may have on the development of the fetus.

Starting moderate-intensity, weight-bearing exercise early in pregnancy increases placental growth rate and volume.

Exercise reduces the risks of excess gestational weight gain and high maternal body weight before pregnancy.

Physical exercise reduces the risk of gestational diabetes mellitus.

Innovations In U.S. Health Care Delivery To Reduce Disparities In Maternal Mortality Among African American And American Indian/Alaskan Native Women, Swapna Reddy, Nina Patel, Mary Saxon, Nina Amin, Rizwana Biviji

Journal of Patient-Centered Research and Reviews

Despite spending more on health care than any other country, the United States has the worst maternal mortality rate among all developed nations. African American and American Indian/Alaskan Native women have the worst outcomes by race, representing a stark health disparity within the country. Contributing factors disproportionately experienced by these minority populations include challenges of access to consistent and high-quality prenatal care, prevalence of underlying conditions, toxic stress due to systemic racism, and unconscious bias in health care. While many of these factors lie upstream in the lives of women, and seemingly beyond the scope of the clinical walls, the …

Association Of Cardiovascular Health And Epigenetic Age Acceleration, Tess D. Pottinger, Sadiya S. Khan, Yinan Zheng, Wei Zhang, Hilary A. Tindle, Matthew Allison, Gretchen Wells, Aladdin H. Shadyab, Rami Nassir, Lisa Warsinger Martin, Joann E. Manson, Donald M. Lloyd-Jones, Philip Greenland, Andrea A. Baccarelli, Eric A. Whitsel, Lifang Hou

Nursing Faculty Publications

BACKGROUND: Cardiovascular health (CVH) has been defined by the American Heart Association (AHA) as the presence of the "Life's Simple 7" ideal lifestyle and clinical factors. CVH is known to predict longevity and freedom from cardiovascular disease, the leading cause of death for women in the United States. DNA methylation markers of aging have been aggregated into a composite epigenetic age score, which is associated with cardiovascular morbidity and mortality. However, it is unknown whether poor CVH is associated with acceleration of aging as measured by DNA methylation markers in epigenetic age.

METHODS AND RESULTS: We performed a cross-sectional analysis …

Patient Recommendations For Providers To Avoid Stigmatizing Weight In Rural-Based Women With Low Income, Declan Watson, Katherine Hughes, Emma Robinson, Jacqueline Billette, Andrea E. Bombak

Journal of Patient-Centered Research and Reviews

Purpose: Weight stigma has become widespread within health care and disproportionately affects women, who are under greater appearance-based scrutiny than men. It is also well established that rural-based individuals with low incomes suffer greater health disparities compared with urban, higher-income counterparts, yet studies examining recommendations for nonstigmatizing health care among higher-weight women from low-income rural settings are lacking. This study examined the experiences and recommendations of higher-weight, low-income, rural women, with the aim of improving health care for similar populations.

Methods: In-depth, semi-structured interviews were conducted in a rural region of the Midwestern United States to explore participants’ recommendations for …

Dancing During Labor: Are Women Down To Boogie?, Drew A. Horter, Kayla Heslin, Marie Forgie, Emily Malloy, Jessica J. F. Kram

Journal of Patient-Centered Research and Reviews

Recent social media trends have demonstrated increased interest in dancing during the final weeks of pregnancy and labor. However, there is limited evidence about dancing during labor and its impact on labor pain and duration as well as patient satisfaction. Before conducting a prospective study, given that enrollment is often challenging, our feasibility study aimed to assess the willingness of pregnant women to participate in a future study evaluating low-impact dance during labor. We anonymously surveyed a convenience sample of English-speaking/reading pregnant women who presented for prenatal care at 1 of 3 clinics from June 2019 to July 2019. Questions …

Hpv Vaccination In Females: The Role Of Primary Health Care And Primary Health Care Providers, Brooke Bouza

Graduate Theses and Dissertations

Two reasons for subpar coverage of the Human papillomavirus (HPV) vaccine are missed clinical opportunities and nonacceptance of the vaccine upon recommendation from a medical provider. The purpose of study one was to examine factors associated with access and adherence to physician’s recommendations in association with HPV vaccine uptake. Data were obtained from National Health Interview Survey (2017). Variables theoretically related to clinical opportunities and adherence to physician’s recommendations were examined in association with HPV vaccine uptake. Univariate logistic regressions were run to determine the associations between the aforementioned variables and uptake of the HPV vaccine. Multinomial logistic regressions were …

Provider-Led Intervention For Overweight Or Obese African American Women Ages 18-65 With A Bmi 25 Kg/ M₂, Tonya A. Harvey

Evidence-Based Practice Project Reports

Overweight and obese African American women tend to suffer most from the impacts of diseases, health disparities, disabilities, and decreased qualities of life (Sutton et al., 2016). Most weight loss programs are not culturally specific, despite the benefits of dietary changes and increased physical activity for all groups. The purpose of this EBP project was to implement a provider-led program including lifestyle, dietary, and activity components to decrease weight, BMI, waist circumference and blood pressure in African American women. The Iowa Model of Evidence-Based Practice to promote quality care was used to guide the EBP project, aimed to address obesity …

Addressing Postpartum Smoking Relapse Among Low-Income Women: A Randomized Control Trial, Kristine Alaniz, Bruce Christiansen, Tingting Sullivan, Lisette Khalil, Michael C. Fiore

Journal of Patient-Centered Research and Reviews

Purpose: Smoking during pregnancy can have dire consequences for both the baby and mother. Low-income pregnant women smoke at particularly high rates. Among women who quit during pregnancy, postpartum relapse is high. This randomized control trial tested the effect of adding postpartum assistance to an existing smoking cessation program (First Breath) designed for low-income women.

Methods: Of 185 study participants, 94 women were randomly assigned to the standard First Breath program (control) and 91 to an enhanced program. First Breath consisted of evidence-based smoking cessation counseling provided at every prenatal visit. The enhanced program included all First Breath services plus …

Patient And Provider Perspectives On Sexual History Taking During Gynecological Care: A Pilot Study In An Academic Family Medical Setting In New York City, Ashley M. Chastain

Dissertations and Theses

Background: In the United States (US), women face a number of serious issues concerning sexual health. Current surveillance data indicates that overall rates of bacterial sexually transmitted infections (STIs) are increasing rapidly. While rates of new diagnoses have decreased, the risks of acquiring HIV are still relatively high for some females, specifically Black/African-American women. In New York City (NYC), where this dissertation research was conducted, similar HIV/STI rates exist among females of reproductive age (aged 15-44). Among women in the US, there are also high estimated rates of other sexual health problems, such as sexual anxiety, sexual dysfunction, and intimate …

Initiating Patient Discussions About Oocyte Cryopreservation: Attitudes Of Obstetrics And Gynaecology Resident Physicians, Brennan Peterson, C. Gordon, Julia K. Boehm, M. C. Inhorn, P. Patrizio

Marriage and Family Therapy Faculty Articles and Research

This study examined the attitudes of obstetrics and gynaecology (OB/GYN) resident physicians to initiating patient discussions regarding medical and elective oocyte cryopreservation (OC). The study used a cross-sectional online survey of OB/GYN medical residents in the USA, sampled from residency programmes approved by the American Council for Graduate Medical Education. In total, 208 medical residents, distributed evenly between postgraduate years 1–4, participated in the study. Residents' fertility knowledge and attitudes to initiating discussions about OC were gathered. Forty percent (n = 83) believed that OB/GYN residents should initiate discussions about OC with patients (initiators), while 60% (n = 125) did …

Improving Obstetrics In Family Medicine Residency Clinics: A Quality Improvement Study, Garima Chawla, Jessica J.F. Kram, Bonnie Bobot, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

Background: Prenatal care/deliveries within our family medicine clinics have declined, perhaps because patients are unaware that our clinics provide these services. With lower volumes, clinicians may feel less comfortable with current skills/knowledge of obstetric (OB) care.

Purpose: Increase family medicine clinic OB numbers, patient awareness, and clinician comfort/knowledge in OB.

Methods: English-facile patients (18–50 years), residents and faculty at Aurora family medicine residency clinics were included. Patients were provided preintervention surveys upon check-in. Residents/faculty were surveyed via Survey Monkey. Changes made based on initial survey results were: 1) increasing systemwide awareness that our caregivers provide OB care, through fliers at …

Improving Obstetrics In Family Medicine Residency Clinics: A Quality Improvement Study, Garima Chawla, Jessica J.F. Kram, Bonnie Bobot, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Background: Prenatal care/deliveries within our family medicine clinics have declined, perhaps because patients are unaware that our clinics provide these services. With lower volumes, clinicians may feel less comfortable with current skills/knowledge of obstetric (OB) care.

Purpose: Increase family medicine clinic OB numbers, patient awareness, and clinician comfort/knowledge in OB.

Methods: English-facile patients (18–50 years), residents and faculty at Aurora family medicine residency clinics were included. Patients were provided preintervention surveys upon check-in. Residents/faculty were surveyed via Survey Monkey. Changes made based on initial survey results were: 1) increasing systemwide awareness that our caregivers provide OB care, through fliers at …

Identificando Los Limites Del Acceso A La Salud Reproductiva: Un Análisis Sobre Las Experiencias Vividas Por Las Mujeres Guaraníes Con Los Servicios De La Salud Reproductiva En La Villa 31 De Buenos Aires, Amelia Mitchell

Independent Study Project (ISP) Collection

In order to serve the ‘public’, public health services must be accessible to everyone, without discrimination based on race, gender, social class, or geographic location, among other facets of identity. Reproductive health services, in particular, are a key service that must be adequately supplied in order to guarantee the health and wellbeing of a population. Reproductive healthcare not only allows individuals to decide if and when they wish to have a child, it also contributes to cancer prevention and the detrimental effects of sexually transmitted diseases. This investigation examines the experiences of Guaraní women that live within “Villa 31” of …

The Disappearance Of Nyoman And Ketut, Laura Michelle Garvie

Independent Study Project (ISP) Collection

No abstract provided.

Group Medical Visits To Provide Gynecologic Care For Women Affected By Breast Cancer, Sally R. Greenwald, Sarah Watson, Mindy Goldman, Tami S. Rowen

Journal of Patient-Centered Research and Reviews

Purpose

Women with breast cancer have complex and unique gynecologic needs that are challenging to effectively and comprehensively meet in a traditional gynecology visit format. Group medical visits are an effective and well-received model of care in other disease settings and can provide comprehensive health education as an adjunct to one-on-one evaluation and treatment. There are limited data regarding the use of this type of health care delivery in providing gynecology-focused care to women affected by breast cancer.

Methods

A group medical visit model was created for gynecology providers to see new breast cancer patient consults. From May 2012 to …

Syrian Refugee Women In Jordan: Family Planning Preferences And Barriers In A Host Community, Hilary Smith

Independent Study Project (ISP) Collection

The aims of this pilot study were to research and analyze the availability of birth control and family planning resources among Syrian refugee women at a reproductive age. This study took place in the host community of Karak, Jordan. Syrian women are a vulnerable population based solely on their gender. But being refugee women makes them more vulnerable and sometimes, their needs do not get met. This study is important because it will look into reproductive health aspects for this vulnerable population to ensure that there is satisfaction among women about their own health. This cross-sectional study sought to answer …

Access Is Not Enough: Family Planning In Dar Es Salaam, Claire Burrus

Independent Study Project (ISP) Collection

Population growth is a large problem, both globally and at local levels. The global population is growing at an unsustainable rate, particularly in developing nations. Tanzania, as a developing nation, is one of the fastest growing countries in the world, and as a result, faces many hardships related to high population. The Tanzanian government, non-governmental organizations, and private institutions have made attempts to address these concerns by encouraging family planning. Even so, the national population continues to rise. Many social and cultural factors have contributed to this phenomenon. This study was performed in the Women’s Clinic at Sanitas Hospital in …

A Preliminary Study Of Intergenerational Differences In Masxha Regarding Practice And Attitudes Towards Zulu Traditions During Pregnancy And Birth, Momoko Oyama

Independent Study Project (ISP) Collection

In the Zulu culture, several traditions and rituals are practiced during a woman’s pregnancy and perinatal period. However, as urbanization spreads and western influences strengthen, these rituals risk being lost. This project aims to capture existing knowledge of these traditions and to assess the intergenerational changes in practice and attitudes towards practicing the rituals.

Information on Zulu traditions practiced during a woman’s pregnancy and perinatal period was collected through two interviews and a focus group consisting of three elderly women in Masxha, a Black township in KwaZulu-Natal. Following the interviews and focus group, 32 Masxha residents were recruited to complete …

Continuous Care In Complex Contexts: Access To Health Services For Noncommunicable Diseases Among Syrian Refugee Women In Jordanian Host Communities, Jennifer Ostrowski

Independent Study Project (ISP) Collection

This study examines how, when and where Syrian refugee women living in a host community in central Jordan access health services related to noncommunicable diseases. Noncommunicable diseases are the leading cause of death and disability worldwide, but can be effectively managed through timely treatment. Examining access to care for these diseases in the context of humanitarian emergencies, such as war and displacement, is particularly important because they require continuous care, which may be interrupted during emergencies, and because they can cause acute complications, which may be exacerbated by emergencies (WHO, 2016).

Previous studies indicate a high burden of NCDs among …

Maternal Healthcare In Eastern Uganda: The Three Delays, Mothers Making Empowered Choices, And Combatting Maternal Mortality, Emma Gier

Independent Study Project (ISP) Collection

Maternal and child health has been noted as an international concern and issue. While access to maternal healthcare has improved in Uganda since 2000, maternal mortality rates have remained high in the country as of 2015. However, maternal and child healthcare are inherently important in promoting sustainable and positive development. For that reason, I have explored maternal healthcare in Uganda’s Eastern region, specifically in Mbale Town and surrounding rural areas including Kween and Manafwa districts. Specifically I have looked at what factors influence women’s decision to give birth in a health centre or hospital, versus at home. I have also …

Education Intervention Of Preconception Screening In Primary Care, Tracy Schuler

Doctor of Nursing Practice (DNP) Projects

Problem: The risk of a poor pregnancy outcome among women of reproductive age in Providence, Rhode Island is indicated by the high rates of unintended pregnancies, low multivitamin use prior to pregnancy, obesity, and smoking. Although recommended, health professionals often fail to routinely screen and educate women of reproductive age for preconception risk factors. Purpose: Evaluate the efficacy of an educational intervention on preconception risk factors, lifestyle modifications, and current screening recommendations; and introduce a preconception tool and education sheet among a population of health care providers. Method: Preconception health material and a modified preconception screening tool …