Digital Commons Network^™

A Culturally Responsive Sexual Health Education Framework For Community Clinics In The Inland Empire, Lilianna Mora Ledezma

Electronic Theses, Projects, and Dissertations

Sexually transmitted infections (STIs) continue to disproportionately affect underserved communities, where barriers such as limited healthcare access, stigma, healthcare anxiety, medical mistrust, and language differences may discourage individuals from seeking routine screening and timely treatment. This project examined current public health literature, surveillance data, and federal guidance to identify evidence-based strategies that community clinics can implement to improve patient engagement in sexual health services. The findings demonstrated that effective STI prevention extends beyond testing alone and is strengthened through culturally responsive care, stigma reduction, patient-centered communication, standardized clinic workflows, and effective patient navigation. As a result, this project developed a …

The Effect Of Telehealth Expansion On The Health Equity Of Underserved Populations, Mansi B. Satani

Electronic Theses, Projects, and Dissertations

The rapid expansion of telehealth, during and after the COVID-19 pandemic, has changed healthcare delivery in the United States. The use of telehealth can potentially decrease disparities related to isolation, shortage of providers and barriers to transportation, however, its impact on health equity in underserved populations is unknown. This paper explores how telehealth expansion impacts rural populations' access to healthcare, health outcomes, and equity. It also examines its impact on populations with low income, racial, ethnic minorities, and Medicaid recipients who frequently encounter obstacles to healthcare and digital access (Nouri et al., 2020; Shah et al., 2024). A mixed-method design …

Food Insecurity And Parent Engagement In Pediatric Therapy: A Comparative Study Of Feeding, Speech-Language, And Combined Services, Kendra Kendra Rosales

Open Access Theses & Dissertations

Pediatric feeding disorders and food insecurity represent two compounding challenges for families navigating pediatric therapy services, yet their intersection has received little empirical attention. This study examined food insecurity rates across three pediatric therapy groups and explored the relationship between food insecurity and parent engagement in therapy. A cross-sectional online survey was administered to 175 caregivers of children actively receiving feeding therapy only (n = 34), speech-language therapy only (n = 93), or combined feeding and speech-language therapy (n = 48). Food insecurity was assessed using the USDA Household Food Security Survey Module: Six-Item Short Form, and parent engagement was …

Balancing War And Peace In Taekwondo Athlete Development: A Multi-Criteria Coaching Decision Support Framework Using Leadership Scale For Sports And Fuzzy Ahp, King Harold A. Recto, Hazel Jade L. Antonio, Jhyrald Anthony P. Dalida

Electronics, Computer, and Communications Engineering Faculty Publications

Coaching effectiveness is frequently evaluated through competitive outcomes, with the assumption that coaching behaviors directly influence athlete performance. This study examined the relationship between perceived coaching behaviors and individual win percentage among collegiate Taekwondo athletes using the Leadership Scale for Sports (LSS). Descriptive statistics, correlation analysis, and regression analysis were conducted across five coaching dimensions: Training and Instruction, Democratic Behavior, Autocratic Behavior, Social Support, and Positive Feedback. Results showed that none of the coaching dimensions demonstrated a statistically significant relationship with win percentage. Although coaching behaviors did not significantly predict win percentage, the findings suggest that athlete development is shaped …

Musical Training Increases Anticipatory Responding And Predictive Control In Sequence Learning, Li Ann Leow, Jarrad Lum, Sara Johnson, Emily Corti, Welber Marinovic

Research outputs 2022 to 2026

Musicians demonstrate advantages in acquiring motor sequences, showing faster learning and better explicit sequence knowledge than non-musicians. However, it is unclear whether this advantage extends beyond acquisition to the consolidation phase, which is when newly learned skills stabilize and become resistant to interference. Additionally, while interference from executing competing motor tasks is well-established, less is known about whether purely sensory information presented after learning can disrupt consolidation of a bimodal motor sequence. We investigated how post-acquisition sensory interference affects performance of a learned audio-visual sequence, and whether musical training moderates this vulnerability. Participants first learned an explicit sequence in a …

Global Disparities In Neurosurgical Literature: A Narrative Review Of Underrepresentation Of Low- And Middle-Income Countries And Pathways To Research Equity, Tirath Patel, Naveed Ahmad, Abbas Hussain, Bisma Faraz, Amna Binte Naeem, Urooj Sheraz, Laiba Noor, Saleha Khan, Muhammad Seerat Ali, Nikhilesh Anand

School of Medicine Publications

The global neurosurgical literature is dominated by high-income countries, with low- and middle-income countries (LMICs) contributing minimally despite bearing the most significant share of the neurosurgical disease burden. Underrepresentation limits equitable knowledge dissemination and the relevance of guidelines. The objective of this review was to assess neurosurgical publication disparities, identify deterrents to LMIC participation, and outline initiatives that foster equity and inclusion in research. This narrative review synthesized evidence on global disparities in neurosurgical literature through a structured search of PubMed, Scopus, and Google Scholar (2010–2025). Eligible studies examined research output, authorship trends, publication barriers, or equity initiatives. Findings mapped …

Engagement Of Understudied Populations As Community Change: The South Texas Adrc Model, Gladys E. Maestre, Neela K. Patel, Rosa V. Pirela, Robin C. Hilsabeck, Kendra Stine, Neyra García, Roberto Reyes, Omar Oropeza, Cristian Maestre, Jesus D. Melgarejo, Sarah Williams-Blangero, Ney Alliey Rodriguez

School of Medicine Publications

Many populations experiencing the highest burdens of Alzheimer's disease and related dementias remain understudied, in part because traditional recruitment and retention models are insufficient to support sustained engagement. The Outreach, Recruitment, and Engagement Core (OREC) of the South Texas Alzheimer's Disease Research Center reconceptualized participant recruitment as a long-term system change in a Hispanic-majority, urban–rural region. OREC institutionalizes shared power through community advisory governance, aligns research protocols with local lived realities (through patient navigators, community health workers/promotores, and decentralized access points), and employs a data-driven feedback loop for continuous improvement. In 1 year, 46 outreach events touched 10,134 individuals (71% …

The Legacy, Importance, & Impact Of Lend: Evidence And Personal Stories, Emily Zalimeni, Emma Stone, Alexa Fortier, Leia Getchell, Nataliya Kloyzner, Asha Abdullahi, Elizabeth Barkoudah, Meghan Chapman, Meredith Close, Heather Engholm, Melissa Levin, Aanchal Sharma, Sarah Sparks, Patricia Rissmiller, Amy Szarkowski, Jason M. Fogler

Developmental Disabilities Network Journal

Leadership Education in Neurodevelopmental and related Disabilities (LEND) programs offer an interdisciplinary/interprofessional training opportunity for medical and allied health professionals, and individuals impacted by disability, including family members and self-advocates. Toward the aim of advocating for the enduring need of LEND and similar training programs, this article centers the voices of a subset of our alumni who have advanced the rights and improved the lives of persons with intellectual and developmental disabilities. These stories are intended to illustrate the key lessons and principles of LEND training, including attending to disability issues in education, growing skills within and between individuals working …

“It’S Not Just Cost”: Barriers To Mammography Screening Access Among Low-Income Women In The United States—A Scoping Review, Julia Messerman, Callia Nickels, Nigel C. James

Health Studies Faculty Publications

Despite the recognized importance of early detection, disparities in mammography access persist among low-income women in the United States. While financial barriers are often emphasized, less is known about how multiple barriers interact to shape access to screening. We conducted a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidelines to synthesize evidence on barriers to mammography access among low-income women in the United States. A systematic search of PubMed, CINAHL, and Google Scholar identified peer-reviewed studies published between 2010 and 2025, of which 47 met inclusion criteria. Extracted barriers were categorized into …

Nurse-Led Quality Improvement Asthma Self-Management In Primary Care, Jolene Steinert-Abderhalden

DNP Projects

Background:
Poorly controlled asthma contributes to preventable morbidity, yet many adults lack consistent self-management support. Local Problem: Baseline assessment at a rural Midwestern clinic revealed limited asthma knowledge, inconsistent action-plan use, and low confidence among adults with Asthma Control Test (ACT) scores below 20.

Methods:
This quality improvement project used a pre- and post-intervention design guided by Lean methodology and the Plan-Do-Study-Act (PDSA) framework. Interventions: Registered nurses delivered standardized asthma education, inhaler-technique review, and action plan reinforcement with monthly structured follow-up for 16 weeks.

Results:
Among four enrolled participants, three completed follow-up. Mean ACT scores improved from 17.5 at baseline …

Naturalistic Aided Language Intervention For Children Who Have Multiple Disabilities Including Visual Impairment, Naomi Nattress

Speech and Hearing Sciences ETDs

ABSTRACT

This dissertation examined aided AAC interventions for individuals with multiple disabilities, including visual impairment, across three original studies. Chapter 2, a meta-analysis, found limited rigorous research for this population while showing that individuals at early symbolic stages with diverse visual profiles can successfully engage with AAC when appropriate adaptations are provided. The pilot study in Chapter 3 indicated that caregivers and graduate student clinicians can learn and implement naturalistic AAC techniques and VI accommodations with high fidelity through structured coaching. The mixed methods study in Chapter 4 introduced the ImPAACT-VI program, showing strong outcomes in educator performance, students’ symbolic …

Dnp Final Report: Community-Based Advance Care Planning Education For Older Adults: A Quality Improvement Project, Teresa Hill

DNP Final Reports

Background: Advance care planning (ACP) supports patient autonomy and promotes care aligned with individual values and preferences. Despite these benefits, fewer than half of adults aged 50–80 have completed formal ACP documentation, and community-dwelling older adults rarely engage in ACP before serious illness, representing a persistent gap in early engagement.

Purpose: This quality improvement (QI) project evaluated the effectiveness of a community-based ACP educational intervention in improving ACP knowledge, confidence, and engagement among older adults.

Methods: A nurse facilitator trained in the Five Wishes framework delivered a structured, 60-minute ACP workshop at a senior center in North Texas. A pre–post …

The Best Of Both Worlds: How Combining A Large Language Model And A Rule-Based Algorithm Makes Catheter-Associated Urinary Tract Infection Surveillance More Efficient, Joshua Nordman, Claire Najjuuko, Nicholas Jeschke, Rachael E Snyders, Maria Cristina Vazquez Guillamet, Hilary Babcock, Patrick Reich, Andrew Atkinson, Jonas Marschall, Abby Sung, Et Al.

2020-Current year OA Pubs

BACKGROUND: Catheter-associated urinary tract infection (CAUTI) surveillance is critical for patient safety. Many healthcare systems use electronic algorithms to flag candidate infection events but still require manual chart review to confirm CAUTI cases. We evaluated the use of a large language model (LLM) to enhance CAUTI surveillance.

METHODS: We analyzed 919 potential CAUTI cases flagged by the electronic surveillance algorithm at Barnes-Jewish Hospital from 2021 to 2024. These cases were previously classified as 291 CAUTIs and 628 non-CAUTIs by trained infection preventionists (IPs). Several approaches for applying the National Healthcare Safety Network (NHSN) CAUTI definition after extracting clinical data from …

A Phenomenological Study Of Parent Experiences During Transition From Early Intervention To School-Based Services, Kelly F. Gregoire, Halie Mayfield, Jeryl D. Benson, Johnna Estep

Graduate Student Research Symposium

Abstract

Importance: Occupational therapy (OT) practitioners and members of the Early Intervention (EI) to school-based transition should understand the barriers to a successful transition to better advocate for their clients and tailor their involvement in the transition process.

Objective: To explore the lived experience of parents of young children participating in the transition process.

Participants: Fourteen parents of young children (ages 2.5-6 years) with a developmental disability.

Outcomes and Measures: Semi-structured interviews focusing on parent and family experiences with the transition process.

Results: Seven resulting themes emerged from the data representing parent perceptions related to their experience of the system. …

Screening And Treatment Protocols Used In Nicus Across Minnesota For Perinatal Mood & Anxiety Disorders (Pmads), Rachael Witt

Journal of Justice-Informed Social Work Practice and Research

Parents of infants with prolonged neonatal intensive care unit (NICU) hospitalizations are a population that is overlooked in recommended routine screening for perinatal mood and anxiety disorders (PMADs), yet this population is at greater risk for developing diagnosable mental health disorders. Previous research shows that across the US, PMAD screening and treatment practices vary widely, with many NICUs not providing any routine PMAD screening, psychoeducation, or treatment options to parents. The objective of this study was to explore the current mental health screening and treatment protocols used in NICUs across the state of Minnesota to learn if there are areas …

Climate Anxiety And Nurses’ Awareness, Motivation, And Behaviors In Addressing Climate-Related Health Risks, Sarah Kaplan

Theses and Dissertations

Background: Climate anxiety, the emotional distress associated with awareness of climate change and its consequences, is an emerging mental health concern that may influence how nurses perceive and respond to climate-related health risks. Climate change is largely driven by emissions of greenhouse gases which radiate and absorb heat. Human-caused climate change is leading to higher average global temperatures and increasing risk to health through poor air quality, changes in vector borne diseases, extreme weather events, and exacerbation and development of physical and mental illnesses. This study contributes to nursing science by examining climate anxiety and climate related health practices among …

Service Disruptions In Early Intervention Amid Covid-19: Understanding Challenges Faced By Families And Providers, Tiana T. Nguyen, Samantha Mong, Juliana Lainez, Domenique Embrey

The Open Journal of Occupational Therapy

Background: Infants at risk for developmental delays require early intervention (EI) services to support their development. However, many families face barriers to receiving services, which were exacerbated by the COVID-19 pandemic.

Objective: This qualitative study examined how COVID-19 impacted access to EI therapy services from the perspectives of families and EI providers in the San Francisco Bay Area. The study aimed to identify existing barriers and new pandemic-specific challenges to inform strategies for improving continuity and quality of EI care during future service disruptions.

Methods: Semi-structured virtual interviews were conducted with caregivers of eligible infants and EI providers. …

Ethical, Regulatory, And Equity Challenges Of Ai In Pharmaceutical Advertising, Samer Imad Mohammed, Fadia Thamir Ahmed

BioMed Visions Journal

Background: Artificial intelligence (AI) and chatbots are significantly altering pharmaceutical advertising by facilitating personalized patient engagement and enhancing treatment optimization. Their adoption presents substantial ethical, regulatory, and equity challenges that require thorough analysis. Objectives: The objectives of this review are to analyze: (1) the implementation of AI technologies, such as chatbots and predictive analytics, in pharmaceutical advertising; (2) ethical risks, including algorithmic bias and misinformation; (3) deficiencies in global regulatory frameworks, specifically those of the FDA and EMA; and (4) effects on health equity, with a focus on vulnerable populations. Methods: A narrative review was conducted using several databases with …

Correlation Between Voice Handicap Index-10 Score And Auditory Perceptual Evaluation In Lebanese And Iraqi Patients: Impact Of Cultural Disparity, Abdul-Latif Hamdan, Zeina Maria Semaan, Omar Aboul Hosn, Jonathan Abou Chaar, Maher Kasti, Batoul Jaber

Iraqi National Journal of Medicine

Background: Voice disorders are prevalent, impacting nearly 25% of adults, with even higher rates among who rely on their voices professionally. Contributing factors include smoking, poor vocal hygiene, and environmental conditions. These factors can disrupt laryngeal biomechanics, leading to functional and structural voice disorders, which can cause communication issues and diminished productivity. Evaluation methods encompass subjective evaluations, such as self-reported quality of life scales, alongside objective auditory perceptual evaluations. This study aims to establish a correlation between self-reported vocal handicap and perceptual voice evaluation, while also investigating the influence of cultural factors on auditory perceptual evaluation, specifically comparing Lebanese …

Llm-As-A-Judge For Infection Prevention And Control And Antimicrobial Resistance Impact: Comparing Three Main Llms Vs. Human Experts' Assessment, Marcello Di Pumpo, Leonardo Villani, Maria Rosaria Gualano, Danilo Buonsenso, Francesca Raffaelli, Daniele Donà, Patrizia Laurenti, Vittorio Maio, Stefania Boccia, Walter Ricciardi

College of Population Health Faculty Papers

BACKGROUND: Large language models (LLMs) are increasingly used to generate health information, yet their reliability as evaluators remains unclear. This study investigated the feasibility of an LLM-as-a-judge methodology in the context of infection prevention and antimicrobial resistance (AMR), comparing automated ratings with human expert benchmarks.

METHODS: We performed a secondary analysis of an expert-annotated dataset of health messages. Three leading LLMs (ChatGPT, Claude, Gemini) independently evaluated the same messages using an adapted DISCERN tool across five domains: information reliability, quality, AMR impact, persuasiveness, and overall score. We utilized descriptive statistics, intra-rater reliability tests, and mixed-effects ordinal regression to analyze divergence …

Feasibility Study Of An Artificial Intelligence Chatbot-Powered Cognitive-Behavioral Lifestyle Modification Program, Evans Forman, Charlotte Hagerman, Asher Hong, Zhuoran Huang, Hannah Mccausland, Jasmine Sun, Lauren Taylor, Meghan Butryn, Preetha Chatterjee, Ramtin Ehsani, Nawal Syed

Department of Family & Community Medicine Faculty Papers

Background: Approximately 2 billion adults seek lifestyle modification to improve their health and well-being. However, because of cost and access barriers, only a tiny fraction receive gold-standard lifestyle modification programs led by trained coaches. Digital programs without human coaches are more disseminable but have limited efficacy. Recent advances in large language model (LLM) AI chatbots have the potential to revolutionize digital programs by emulating human coaches, offering a safe, low-cost, and scalable lifestyle modification intervention. Yet, no studies have developed and tested such a program. Purpose: This study aims to evaluate the feasibility, safety, and user engagement of a new …

Awareness Of The Mediterranean Diet And Its Perceived Effect On Cardiovascular Health In The Western Region, Saudi Arabia, Abdullah M. Alharbi, Mohammed S. Alsaedi, Mutaz S. Alharbi, Faisal F. Almutairi, Adeeb M. Aloufi, Azzam M. Alharbi, Rakan D. Alsaedi, Hatim F. Alhejaili, Motasem M. Alyamani

Saudi Medical Journal

Objective: To increase awareness of mediterranean diet (MD) and its perceived effects on cardiovascular health, enhance knowledge and inform public health efforts aimed at improving the population's health outcomes of. The MD comprises heart-healthy eating patterns high in vegetables, legumes, nuts and seeds, and fruits. Methods: This cross-sectional study involved adult participants who were living in the Western region of the Kingdom of Saudi Arabia. The data were collected online through social media platforms, then cleaned, coded, and analyzed using Statistical Package for the Social Sciences, version 21 to generate key insights. Results: A total of 390 participants were included …

Effectiveness And Implementation Of The Shield Integrated Multi-Level Model To Reduce Adolescent Depression And Internet Addiction: A Cluster Randomized Waitlist-Controlled Trial In Wangchin District, Phrae Province, Seubtrakul Tantalanukul, Amornpan Samorn

Chulalongkorn Medical Journal

Background: Adolescent depression and internet addiction represent significant comorbid mental health challenges in rural Thailand, where access to evidence-based interventions remains limited. Traditional single-modality approaches often fail to address the complex interplay between individual, family, and systemic factors contributing to these conditions.

Objectives: To evaluate the effectiveness and implementation outcomes of the SHIELD (Screening & Surveillance, Health Literacy Enhancement, Internet Wellness Program, Empowering Families, Linkage to Care, Data-driven Monitoring) integrated multi-level intervention for reducing depression and internet addiction among at-risk adolescents in rural Thailand.

Methods: A cluster randomized waitlist-controlled trial was conducted across eight secondary schools in Wangchin District, Phrae …

Adapting And Delivering An Extension Diabetes Self-Management Support Program To Serve The Hispanic Community, Camden Bryan, Samantha Kanny, Christina Dietz, Danielle Mcfall, Michelle Parisi, Michelle Stancil, Johanna Bruen, Rhonda Matthews, Windsor W Sherrill

Journal of Extension

Expanding Extension education programs to serve the Hispanic community will be important as this population continues to grow. The rate of diabetes is higher among the Hispanic population than the non-Hispanic population; however, the barriers to implementing a health education program and recruiting participants are plentiful. This paper highlights the work conducted by the Clemson Cooperative Extension Service, in partnership with organizations across South Carolina, to adapt and deliver the Health Extension for Diabetes program to the Hispanic community. It offers insights into effective strategies for program adaptation, recruitment, and delivery that agents can use to overcome barriers and increase …

The Role Of Social Determinants Of Health In Hydroxyurea Adherence Among Persons With Sickle Cell Disease: A Systematic Review, Doreen O. Ugwu, Lori L. Vick, Terika Williams, Aurela Nikaj, Seyi Omeh, Benjamin Becerra Dr., Tilicia Mayo-Gamble

Journal of the Georgia Public Health Association

Objective: Georgia has one of the highest prevalences of sickle cell disease (SCD). For Georgians living with SCD, inadequate medication adherence is associated with important clinical outcomes. One important area that is understudied in SCD is the impact of social determinants of health (SDoH) on medication adherence. A foundational understanding of SDoH is needed to introduce, inform and carry out programs and interventions designed to facilitate hydroxyurea adherence through the state of Georgia.

Method: We conducted a systematic literature review to synthesize the literature on SDoH addressed in studies to improve hydroxyurea adherence in persons with SCD. SDoH were based …

Fostering Inclusion: Supporting Children With Hearing Loss In Social Interactions, Danielle Kaletta, Mary Jan Greer

Summer 2026 OTD Capstone Symposium

This project provided an open-access online program for caregivers of children with hearing loss to facilitate social engagement. Qualitative methods were used to conduct a needs assessment and identify areas of concern, barriers, and limited resources that affect participation in social activities. Based on the needs assessment, a 6-module website was created and published. Occupational therapy-based evidence, research, interventions, and best practices were compiled and adapted to target identified areas. Participants reported overall favorable feedback, stating an increase in knowledge, confidence, and participation.

Pragmatic Measures In Aided Language Measurement: Aac Clinical Expert Perspectives, Makayla Hydiea Smith

Speech and Hearing Sciences ETDs

Purpose: The augmentative and alternative communication (AAC) discipline currently lacks psychometrically sound aided language measures. This thesis is designed to address one step in developing such measures: to begin to establish the clinical feasibility of three pragmatic measures – communicative intent, independence/co-construction, and imitation/non-imitation. Therefore, the objective of this thesis is to identify the useability of these pragmatic measures.

Method: A qualitative approach in the form of a focus group was used to examine the perceptions of SLP practitioners who are experts in AAC. Rapid qualitative analysis (RQA) was used to identify relevant themes and subthemes.

Results: Overall, the themes …

A Multifaceted Approach To Human Papillomavirus (Hpv) Vaccine Uptake Among Adolescents Ages 10-14 In A Public Health Clinic, Amy T. Norris

Doctor of Nursing Practice Projects

Background: Human papillomavirus (HPV) is the most common sexually transmitted infection in the United States and a leading cause of several preventable cancers. Although the HPV vaccine is safe, highly effective, and routinely recommended for adolescents, vaccination rates remain below national targets, particularly in rural and public health settings. Multiple internal and external factors contribute to low HPV vaccination rates in public health settings.

Purpose: The Doctor of Nursing Practice quality improvement project aimed to increase HPV vaccine uptake through the implementation of a multifaceted, evidence-based intervention.

Project Design: Guided by Pender’s Health Promotion Model and the Reach, Effectiveness, Adoption, …

Two Years Of Ocrelizumab Treatment In Black And Hispanic People With Multiple Sclerosis In Chimes: A Single-Arm Clinical Trial, Lilyana Amezcua, Anthony Reder, Evanthia Bernitsas, Nancy Monson, Timothy Vartanian, Gregory Wu, Mansoor Saleh, Annette Okai, Ahmed Obeidat, Dilraj Sokhi

Haematology and Oncology, East Africa

Objective To evaluate the effectiveness and safety of ocrelizumab in self-identified black and Hispanic people with relapsing multiple sclerosis.

Methods The Characterization of Ocrelizumab in Minorities with Multiple Sclerosis (CHIMES) trial, a prospective, open-label, single-arm, phase 4 study, intentionally recruited underrepresented populations in the US, Puerto Rico, and Kenya. Black and Hispanic people with relapsing multiple sclerosis aged 18–65 years with Expanded Disability Status Scale score 0–5.5 received ocrelizumab for 2 years. The primary endpoint was the proportion of participants with no evidence of disease activity in 3 components at week 48: protocol-defined relapse, 24-week confirmed disability progression, and disease …

Just Opt For Caesarean Section And Pick The Birthdate': A Qualitative Study Exploring Women's Delivery Preferences After Caesarean Section In Urban Tanzania, Daudi Gidion, Columba Mbekenga, Miriam Mgonja, Marleen Temmerman, Muzdalfat Abeid

Obstetrics and Gynaecology, East Africa

Objectives To explore perspectives, preferences and decision-making regarding mode of delivery after a previous caesarean section among women in urban Tanzania.

Design A descriptive qualitative study using semi-structured in-depth interviews. Data were analysed using thematic analysis.

Setting A private tertiary hospital in Dar es Salaam, Tanzania.

Participants 11 women with one previous caesarean section who delivered at the study site were interviewed on the third day after delivery. Participants were purposively sampled to include both modes of delivery: five women underwent repeat caesarean section and six attempted a trial of labour after caesarean (TOLAC).

Results Thematic analysis identified four key …