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Championing Reproductive And Perinatal Health With The Recovery Community: Improving Access To Healthcare And Health Promotion Resources To Support Recovery, Hartley C. Feld, Alex Elswick, Jeremy Byard, Whitney Beckett, Amanda Fallin-Bennett Jan 2025

Championing Reproductive And Perinatal Health With The Recovery Community: Improving Access To Healthcare And Health Promotion Resources To Support Recovery, Hartley C. Feld, Alex Elswick, Jeremy Byard, Whitney Beckett, Amanda Fallin-Bennett

Nursing Faculty Publications

Peer recovery support services are instrumental in the promotion of long-term recovery primarily by focusing on building the recovery capital of people with substance use disorders. Women may have specific health-related needs that are not generally part of recovery support staff training. Our team co-created a model by training people with lived experience as coaches to promote the health of women with SUD during the critical period of their reproductive years when mortality from overdose risk is high and can be compounded by issues surrounding pregnancy. We explored the outcomes of a small pilot test of this model to promote …


Challenges And Lessons Learned While Conducting A Diabetes Prevention Program Among Black Churches During The Covid-19 Pandemic, Erika R. Karle, Destiny Cozart, Bassema Abu Farsakh, Victor Afolayan, Treasure Ebikwo, Maranda Brooks, Lovoria B. Williams Jan 2025

Challenges And Lessons Learned While Conducting A Diabetes Prevention Program Among Black Churches During The Covid-19 Pandemic, Erika R. Karle, Destiny Cozart, Bassema Abu Farsakh, Victor Afolayan, Treasure Ebikwo, Maranda Brooks, Lovoria B. Williams

Nursing Faculty Publications

We share our experiences conducting a 5-year randomized controlled diabetes prevention project among 20 Black churches in central Kentucky during the COVID-19 pandemic and offer strategies to inform future church-based interventions. Researchers have long recognized the potential to reach Black adults in church settings for health promotion interventions and have implemented trials within this socially rich setting. However, there is a dearth of literature that describes the challenges and lessons learned while conducting these trials. We describe the challenges we experienced and the strategies we used to overcome them to successfully conduct the trial. During the study, we maintained detailed …


Differences In Mental Health Outcomes In Immigrant Vs. U.S.-Born Populations In Urban Vs. Rural Areas In The United States, Zoë Gentles Jan 2025

Differences In Mental Health Outcomes In Immigrant Vs. U.S.-Born Populations In Urban Vs. Rural Areas In The United States, Zoë Gentles

Electronic Theses & Dissertations (2024 - present)

Background

The immigration process to the United States creates distinct mental stressors. These stressors are influenced by socioeconomic factors including income, education level and insurance status. In rural America, these factors are intensified due to a poor healthcare infrastructure that is limited. This study examines the relationship between urban-rural residence and mental health outcomes among immigrants vs. native-born residents in the United States.

Methods

Data from the National Health Interview Survey (NHIS) from 2019 and 2022 were used to examine the relationship. The exposure of interest was place of birth, and the outcome of interest was the presence of clinically …


Predictors Of Viral Suppression Among People Living With Hiv (Plhiv) On Antiretroviral Treatment In Almaty, Kazakhstan, Ainur Kussainova Jan 2025

Predictors Of Viral Suppression Among People Living With Hiv (Plhiv) On Antiretroviral Treatment In Almaty, Kazakhstan, Ainur Kussainova

Electronic Theses & Dissertations (2024 - present)

ABSTRACT

Introduction

The Eastern Europe and Central Asia (EECA) region is experiencing the world’s fastest-growing HIV epidemic, with Kazakhstan among the countries most affected. Despite progress in HIV testing and treatment, Kazakhstan continues to face significant challenges in achieving optimal viral suppression among PLHIV. While 82% of PLHIV in Kazakhstan know their HIV status, only 73% are on ART, and just 67% of those on treatment achieve viral suppression. Adherence to ART remains a critical barrier, influenced by a complex interplay of individual, social, and structural factors, including mental health disorders such as depression, substance use, stigma and discrimination. Understanding …


Theoretical Foundations And Applied Performance Of Periodicity-Aware Imputation: Variable Bandpass Block Bootstrap Methods For Incomplete Time Series, Asmaa Ahmad Jan 2025

Theoretical Foundations And Applied Performance Of Periodicity-Aware Imputation: Variable Bandpass Block Bootstrap Methods For Incomplete Time Series, Asmaa Ahmad

Electronic Theses & Dissertations (2024 - present)

Time series data are prevalent across a wide range of disciplines, including health surveillance, public policy, and environmental monitoring. In the presence of underlying cyclical patterns, the integrity of time series analysis depends critically on the ability to detect, model, and impute structured missing data without compromising the temporal structure. This dissertation introduces and validates a novel imputation framework that integrates the Variable Bandpass Periodic Block Bootstrap (VBPBB) into multiple imputation procedures, improving the accuracy, robustness, and interpretability of time series models under high rates of missingness and noise. The overarching goal of this dissertation was to develop and evaluate …


Disparities In Maternal Healthcare: Examining The Impact Of Social Determinants Of Health On Provider Care Quality, Rishita Anumukonda Jan 2025

Disparities In Maternal Healthcare: Examining The Impact Of Social Determinants Of Health On Provider Care Quality, Rishita Anumukonda

Honors Undergraduate Theses

Poor maternal health outcomes among racially and socioeconomically marginalized populations are a major public health concern in the United States. Effective clinician discussions during prenatal and postpartum care play an essential role in promoting maternal and infant well-being. However, the content of provider-patient discussions in maternal care and how it varies for patients exposed to different social determinants of health has not yet been well explored. This study aims to examine whether healthcare provider discussions about key maternal health topics, including preventative health tips, risk factors, and available resources, differ based on social factors such as income level and race. …


Quality Over Quantity: Doula Perspectives On Equity, Access, And Quality Of Care In Black Maternal Health Outcomes, Terry-Ann E. Lynch Jan 2025

Quality Over Quantity: Doula Perspectives On Equity, Access, And Quality Of Care In Black Maternal Health Outcomes, Terry-Ann E. Lynch

West Chester University Graduate Theses, Dissertations, and Final Projects

Black maternal mortality in the United States is a public health crisis. There are a plethora of reasons as to why maternal and fetal deaths disproportionately impact Black women. From a public health perspective, health disparities are an area of concern in marginalized communities, with Black maternal mortality being a risk factor. “According to the Centers for Disease Control and Prevention (CDC), in 2021, the maternal mortality rate for non-Hispanic Black (subsequently, Black) women was 69.9 deaths per 100,000 live births, 2.6 times the rate for non-Hispanic White (subsequently, White) women (26.6)” Maternal Mortality Rates in the United States, 2021” …


Caretaker Of Captors: The Experience Of Role Conflict Among State Correctional Officers, Camille M. Botticelli-Pohl Jan 2025

Caretaker Of Captors: The Experience Of Role Conflict Among State Correctional Officers, Camille M. Botticelli-Pohl

Antioch University Dissertations & Theses

A variety of policies at the national level over the last 70 years have resulted in the mass incarceration of various marginalized populations, inclusive of individuals with mental health problems or severe mental illness. Although Constitutional mandates require that psychology staff be available at all state and federal facilities, these providers spend a fraction of the time with incarcerated people than correctional officers do. Correctional officers seem to play an important, if often overlooked, supporting role in the management of the day-to-day lives of people in custody, including elements of their mental health care. They are also, theoretically, tasked with …


Micro/Nanoplastics And Cancer: Focus On Gastrointestinal Malignancies - A Narrative Review, Sana Rabeeah, Priyata Dutta, Ahmad Mahdi, Alejandra Vargas, Edward C. Oldfield, David A. Johnson Jan 2025

Micro/Nanoplastics And Cancer: Focus On Gastrointestinal Malignancies - A Narrative Review, Sana Rabeeah, Priyata Dutta, Ahmad Mahdi, Alejandra Vargas, Edward C. Oldfield, David A. Johnson

Department of Medicine Faculty Publications

Micro- and nanoplastics (MNPs) are plastic particles smaller than 5 mm and 1 μm, respectively, and are emerging environmental pollutants with growing implications for human health. These particles stem from either 'primary sources', such as intentionally manufactured microbeads and industrial abrasives, or 'secondary sources', where larger plastic items break down into smaller fragments over time. Human exposure primarily occurs through ingestion and inhalation, with contaminated seafood and plastic-laden food packaging representing key routes of entry. Once ingested, MNPs can cross the intestinal barrier, accumulate in gastrointestinal (GI) tissues, and trigger biological responses. Mechanistic studies reveal that MNPs induce oxidative stress, …


Development, Delivery, And Evaluation Of The Texas Epidemic Public Health Institute Pilot Infection Control Lecture Series, Kayla E Ruch, Anabel Rodriguez, Janelle Rios, Luis Ostrosky-Zeichner, Eric L Brown Jan 2025

Development, Delivery, And Evaluation Of The Texas Epidemic Public Health Institute Pilot Infection Control Lecture Series, Kayla E Ruch, Anabel Rodriguez, Janelle Rios, Luis Ostrosky-Zeichner, Eric L Brown

Faculty, Staff and Student Publications

Introduction: The Texas Epidemic Public Health Institute (TEPHI) aims to keep Texans healthy and the economy strong by preparing for the next infectious disease outbreak. TEPHI's Small Rural Healthcare Preparedness core developed, delivered, and evaluated a pilot infection prevention and control webinar series called Infection Control for rural-serving health professionals and organizations based on infection prevention and control field best practices.

Methods: Data from the first year of the Infection Control series was collected through attendee registration forms, attendance records, knowledge, and post-lecture evaluation surveys using Qualtrics. The data were analyzed using Qualtrics software. Lectures were free and open to …


Journey To Well-Being: An Exploration Of Thrivership Post-Domestic Violence, Kader Gumus Jan 2025

Journey To Well-Being: An Exploration Of Thrivership Post-Domestic Violence, Kader Gumus

Antioch University Dissertations & Theses

Domestic violence profoundly affects multiple facets of a survivor’s life. While most existing literature on survivorship addresses the immediate aftermath of domestic violence, this study delves into the extended process following the trauma of abuse to attain “thrivership,” a new concept in the scholarly and practice literature that emphasizes enduring well-being and flourishing. This dissertation examines the journeys from surviving to thriving for 13 women who transformed themselves and their lives to achieve well-being after traumatic domestic violence. Bronfenbrenner’s ecological systems theory was applied to examine the multiple layers of environmental influences on an individual’s development, including the micro, meso, …


Stigma Of Obesity And Healthcare Utilization, Moya A. O'Leary Jan 2025

Stigma Of Obesity And Healthcare Utilization, Moya A. O'Leary

Antioch University Dissertations & Theses

The impact of personal factors on healthcare utilization is an essential area of research to improve overall health outcomes among the population. This study explored the relationship between perceived stigma and healthcare avoidance among men and evaluated the relationship between self-reported body mass index (BMI) and avoidance of healthcare appointments due to weight-related stigma and other reasons. This study found no significant relationship between BMI and avoidance of preventive medical appointments due to perceived stigma. However, men from all weight categories endorsed avoiding preventive healthcare appointments due to weight-related reasons and for other reasons. This study explored the reported reasons …


Post-Migration Living Distress And Suicidal Behavior In Refugee Populations Resettled In Vermont, Phoebe K. Lewis Jan 2025

Post-Migration Living Distress And Suicidal Behavior In Refugee Populations Resettled In Vermont, Phoebe K. Lewis

Antioch University Dissertations & Theses

The study of refugee psychology and suicidal distress is a comparatively nascent field when compared with the body of research concerning non-refugee populations. Over the past fifty years, however, the post-migration refugee experience has been the subject of growing clinical interest. In particular, the construct of post-migration living distress (PMLD) has been identified as a salient factor contributing to psychological distress in refugee populations. This dissertation explores the relationship between PMLD and suicidality in a sample of refugees resettled in a New England city. Guided by the Interpersonal Theory of Suicide (IPTS), this dissertation considers how elements of the post-migration …


Black Birth Work As Radical Praxis: A Hermeneutic Phenomenological Inquiry Of Leadership Among Black Birth Workers, Lesa C. Clark Jan 2025

Black Birth Work As Radical Praxis: A Hermeneutic Phenomenological Inquiry Of Leadership Among Black Birth Workers, Lesa C. Clark

Antioch University Dissertations & Theses

This hermeneutic phenomenological study explores the leadership experiences of Black birth workers (BBWs), revealing critical insights into leadership dynamics within maternal healthcare. Through a theoretical framework integrating African feminism, Black feminism, and anti-racist feminism, the research examines how BBWs conceptualize and enact leadership through embodied, relational, and liberatory approaches. This study addresses a significant gap in leadership literature, particularly regarding generational knowledge and practices of BBWs, which remain understudied despite their vital role in Black maternal healthcare. This study reveals distinct leadership perspectives and methodologies through in-depth interviews with eight BBWs and a detailed interpretive analysis. The findings contribute to …


Geriatric Care In Corrections: An Exploratory Study Of Cross-Disciplinary Perspectives On The Needs Of An Aging Prison Population, Cynthia A. Scheiderer Jan 2025

Geriatric Care In Corrections: An Exploratory Study Of Cross-Disciplinary Perspectives On The Needs Of An Aging Prison Population, Cynthia A. Scheiderer

Antioch University Dissertations & Theses

The incarcerated population in the United States is aging. The proportion of adults 55 or older in prison rose from 3% in 1993 to 16% at year-end 2022 (Carson & Sabol, 2016; Carson & Kluckow, 2024). Researchers have consistently found evidence that the prevalence of disabilities and functional impairment is higher among older adults who are incarcerated than among those in the community. As the incarcerated population ages, corrections professionals responsible for providing safety, housing, and health care must respond to the needs of the population. In this qualitative study, 21 corrections professionals from the disciplines of custody, classification, medical, …


Associations Between Perceived Discrimination And Sleep Health: Results From The Future Of Families And Child Wellbeing Young Adult Sleep Study, Angel I.M. Collie, Adwoa Dadzie, David A. Reichenberger, Lindsay A. Master, Gina M. Mathew, Lauren E. Hale, Anne-Marie Chang, Orfeu M. Buston Jan 2025

Associations Between Perceived Discrimination And Sleep Health: Results From The Future Of Families And Child Wellbeing Young Adult Sleep Study, Angel I.M. Collie, Adwoa Dadzie, David A. Reichenberger, Lindsay A. Master, Gina M. Mathew, Lauren E. Hale, Anne-Marie Chang, Orfeu M. Buston

Department of Preventive Medicine Faculty Publications

Objectives. We investigated cross-sectional associations between perceived discrimination and actigraphic sleep health among young adults.

Methods. Data from the age 22 wave (mean±SD age=22.1±0.4 years) of the Future of Families and Child Wellbeing Young Adult Sleep Study, a national birth cohort originally drawn from 20 U.S. cities, included young adults (n=334; 68.9% Black, 14.7% Hispanic/Latino) who self-reported experiences of discrimination. Wrist-worn actigraphy was collected across ~2 weeks from 2020-2024 and measures included sleep duration, onset, midpoint, maintenance efficiency (SMeff), and wake after sleep onset (WASO). Multiple linear regression models examined the association between experiencing a specific type of …


Loneliness Associates With Endothelial Dysfunction In A Community-Based Cohort: A Pilot Study And Translational Approach, Yvonne Baumer, Brian A. Tirado, Lola R. Ortiz-Whittingham, Andrew S. Baez, Cristhian A. Gutierrez-Huerta, Laurel G. Mendelsohn, Abhinav Saurabh, Joshua A. Jacobs, Marcus R. Andrews, Valerie M. Mitchell, Billy S. Collins, Antwan Jones, Danielle M. Schwartz, Anca D. Dobrian, Michael V. Stanton, Tiffany M. Powell-Wiley Jan 2025

Loneliness Associates With Endothelial Dysfunction In A Community-Based Cohort: A Pilot Study And Translational Approach, Yvonne Baumer, Brian A. Tirado, Lola R. Ortiz-Whittingham, Andrew S. Baez, Cristhian A. Gutierrez-Huerta, Laurel G. Mendelsohn, Abhinav Saurabh, Joshua A. Jacobs, Marcus R. Andrews, Valerie M. Mitchell, Billy S. Collins, Antwan Jones, Danielle M. Schwartz, Anca D. Dobrian, Michael V. Stanton, Tiffany M. Powell-Wiley

Department of Biomedical and Translational Sciences Faculty Publications

Loneliness is known to be an important contributor to cardiovascular disease (CVD). However, little is known about the impact of loneliness on endothelial barrier integrity, a crucial hallmark of CVD development and progression. In this study, we aimed to investigate how loneliness might impact the endothelium. We found greater perceived loneliness associated with the product of circulating epinephrine and TNFα (E/T), which, in turn, associated with lower VE-cadherin on endothelial cells in an ex vivo experiment. Additionally, circulating plasma levels of soluble VE-cadherin were associated significantly with subclinical CVD. To explore the mechanistic aspects of these associations, we measured the …


Barriers To Seeking Medical Care And Their Effects Among Fat Patients With A Fat Liberation Praxis In The United States, Christina Seiko Cook Jan 2025

Barriers To Seeking Medical Care And Their Effects Among Fat Patients With A Fat Liberation Praxis In The United States, Christina Seiko Cook

College of Graduate Studies: Theses & Dissertations

Weight stigma and weight bias have significant effects on the health of individuals (Alberga et al., 2019; Pearl, 2018; Puhl & Heuer, 2010; Schwartz et al., 2003; Udo et al., 2016). These biases can show up in the form of fatphobia or anti-fat bias. Physicians who hold anti-fat bias can affect their relationship with their patients, leading to poorer health outcomes and worse patient experiences for larger-bodied and fat people (Phelan et al., 2015). The purpose of this study is to contribute to the current literature regarding the positive and negative experiences of fat patients with a fat liberation praxis …


In Danger: Hiv Vaccine Research And Development In Europe, Roger Tatoud, Yves Lévy, Roger Le Grand, Jose Alcami, Giorgio Barbareschi, Christian Brander, Andrea Cara, Behazine Combadière, François Dabis, Sarah Fidler, Tomáš Hanke, Carolina Herrera, Gunilla B. Karlsson Hedestam, Hester Kuipers, Sheena Mccormack, Christiane Moog, Giuseppe Pantaleo, Laura Richert, Rogier W. Sanders, Robin Shattock, Hendrik Streeck, Rodolphe Thiebaut, Alexandra Trkola, Klaus Üeberla, Marit J. Van Gills, Ralf Wagner, Winfried Weissenhorn, Yazdan Yazdanpanah, Gabriella Scarlatti, Jean Daniel Lelièvre Jan 2025

In Danger: Hiv Vaccine Research And Development In Europe, Roger Tatoud, Yves Lévy, Roger Le Grand, Jose Alcami, Giorgio Barbareschi, Christian Brander, Andrea Cara, Behazine Combadière, François Dabis, Sarah Fidler, Tomáš Hanke, Carolina Herrera, Gunilla B. Karlsson Hedestam, Hester Kuipers, Sheena Mccormack, Christiane Moog, Giuseppe Pantaleo, Laura Richert, Rogier W. Sanders, Robin Shattock, Hendrik Streeck, Rodolphe Thiebaut, Alexandra Trkola, Klaus Üeberla, Marit J. Van Gills, Ralf Wagner, Winfried Weissenhorn, Yazdan Yazdanpanah, Gabriella Scarlatti, Jean Daniel Lelièvre

Department of Obstetrics & Gynecology Faculty Publications

Highly effective antiretroviral-based HIV prevention plays an important role in ending the global HIV/AIDS epidemic. However, the sustainable control of the epidemic is hampered by unequal access to prevention options, including HIV testing, alongside with drug resistance and ongoing barriers to accessing sustainable HIV treatment. Therefore, an HIV vaccine, combined with effective prevention and treatment, remains an absolute necessity to control the epidemic. Yet, the recent discontinuation of four major vaccine efficacy studies is raising concerns about the future of HIV vaccine research and development globally, and particularly in the European region where funding for vaccine research and development has …


Association Between The Social Vulnerability Index And Adverse Pregnancy Outcomes, Tetsuya Kawakita, Misa Hayasaka, Lindsay Robbins, Juliana Martins, George Saade Jan 2025

Association Between The Social Vulnerability Index And Adverse Pregnancy Outcomes, Tetsuya Kawakita, Misa Hayasaka, Lindsay Robbins, Juliana Martins, George Saade

Department of Obstetrics & Gynecology Faculty Publications

Objective: To assess the association between the Social Vulnerability Index (SVI) and racial disparities in pregnancy outcomes across U.S. counties and to quantify these racial disparities.

Methods: This was a cross-sectional study using restricted Centers for Disease Control and Prevention data sets, including natality data sets, fetal death data sets, and all-cause mortality data sets from 2016 to 2021. We limited analyses to Black or White individuals aged 15-44 years from 3,114 U.S. counties. Participants were categorized into quartiles based on county-level SVI. The primary outcome was maternal mortality rate while pregnant or within 42 days of the end of …


Exposure To Phthalates And Replacements During Pregnancy In Association With Gestational Blood Pressure And Hypertensive Disorders Of Pregnancy, Erin E. Mcnell, Danielle R. Stevens, Barrett M. Welch, Emma M. Rosenthal, Suzanne Fenton, Antonia M. Calafat, Julianne Cook Botelho, Elena Sinkovskaya, Ann Przybylska, George Saade, Alfred Abuhamad, Kelly K. Ferguson Jan 2025

Exposure To Phthalates And Replacements During Pregnancy In Association With Gestational Blood Pressure And Hypertensive Disorders Of Pregnancy, Erin E. Mcnell, Danielle R. Stevens, Barrett M. Welch, Emma M. Rosenthal, Suzanne Fenton, Antonia M. Calafat, Julianne Cook Botelho, Elena Sinkovskaya, Ann Przybylska, George Saade, Alfred Abuhamad, Kelly K. Ferguson

Department of Obstetrics & Gynecology Faculty Publications

Exposure to endocrine-disrupting chemicals such as phthalates may increase risk of hypertensive disorders of pregnancy (HDP). Prior studies lack investigation of chemical mixtures, phthalate replacements, or key periods of susceptibility including early pregnancy. In the present study, we used a longitudinal approach to evaluate gestational exposure to phthalates and replacements, as both single-pollutants and mixtures, in association with blood pressure and diagnosis of preeclampsia or any HDP. The Human Placenta and Phthalates prospective pregnancy cohort includes 291 participants recruited from two U.S. clinics. Urinary metabolites of ten phthalates and replacements were quantified at up to 8 time points per individual …


Methodological And Clinical Concerns In The Study On Postpartum Hypertension Management, Takaki Tanamoto, Kyosuke Kamijo, Yusuke Tsutsumi, Tetsuya Kawakita Jan 2025

Methodological And Clinical Concerns In The Study On Postpartum Hypertension Management, Takaki Tanamoto, Kyosuke Kamijo, Yusuke Tsutsumi, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

[Introduction] We read with interest the recent study by Rosenfeld et al.¹ However, we have several clinical and methodological concerns about this study.¹

First, this study's propensity score matching (PSM) lacked key clinical confounders, including perinatal risk factors and the highest systolic/diastolic blood pressures. Smoking, alcohol use, and multifetal gestation, which influence blood pressure during pregnancy,²,³ potentially affect both primary and secondary outcomes. Additionally, the authors did not report standardized mean differences before and after PSM, which are essential for assessing balance.⁴


Mobile Health Intervention Tools Promoting Hiv Pre-Exposure Prophylaxis Among Adolescent Girls And Young Women In Sub-Saharan Africa: Scoping Review, Alex Emilio Fischer, Homaira Hanif, Jacob B. Stocks, Aimee E. Rochelle, Karen Dominguez, Eliana Gabriela Armora Langoni, H. Luz Mcnaughton Reyes, Gustavo F. Doncel, Kathryn E. Muessig Jan 2025

Mobile Health Intervention Tools Promoting Hiv Pre-Exposure Prophylaxis Among Adolescent Girls And Young Women In Sub-Saharan Africa: Scoping Review, Alex Emilio Fischer, Homaira Hanif, Jacob B. Stocks, Aimee E. Rochelle, Karen Dominguez, Eliana Gabriela Armora Langoni, H. Luz Mcnaughton Reyes, Gustavo F. Doncel, Kathryn E. Muessig

Department of Obstetrics & Gynecology Faculty Publications

Background:

In 2022, 3100 adolescent girls and young women in sub-Saharan Africa experienced new HIV infections each week. HIV pre-exposure prophylaxis (PrEP) is effective at preventing HIV but has limited uptake and persistence. Mobile health (mHealth) interventions can improve medication adherence; however, their utility to improve PrEP adherence among adolescent girls and young women is not well established.

Objective:

This scoping review synthesizes evidence supporting mHealth for PrEP among adolescent girls and young women in sub-Saharan Africa and identifies strategies for further evaluation.

Methods:

We searched PubMed and Google Scholar databases, expert referrals, and reference lists using the following eligibility …


Association Between The Intensity Of Exercise In The First Trimester And Early Second Trimester And The Risk Of Gestational Diabetes, Takaki Tanamoto, Misa Hayasaka, Tetsuya Kawakita Jan 2025

Association Between The Intensity Of Exercise In The First Trimester And Early Second Trimester And The Risk Of Gestational Diabetes, Takaki Tanamoto, Misa Hayasaka, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

Although some studies show that exercise decreases the incidence of gestational diabetes mellitus (GDM), the optimal exercise intensity during pregnancy remains unclear. We examined GDM risk according to exercise intensity in pregnant individuals.

Methods

We analyzed data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers‐to‐Be (nuMoM2b), a prospective study enrolling nulliparous individuals in the first trimester. Participants with pregestational diabetes or delivery before 20 weeks were excluded. Exercise intensity during the first (6–13 weeks’ gestation) and early second (16–21 weeks’ gestation) trimesters was categorized by metabolic equivalent of task hours per week (MET‐hr/week) as none, low intensity (< 7.5), moderate intensity (7.5–14.9), or high intensity (≥ 15). The primary outcome was GDM; secondary outcomes included preeclampsia, gestational hypertension, preterm birth, small‐for‐gestational‐age birth, and stillbirth. Adjusted relative risks (aRRs) with 95% confidence intervals (CIs) were calculated using a generalized linear mixed‐effects model with a Poisson distribution and robust error variance, controlling for the random effects of individuals and potential confounders.

Results …


Racial Disparities In Maternal Mortality Before, During, And After The Covid-19 Pandemic In The United States: A Difference-In-Difference Analysis, Kyosuke Kamijo, Misa Hayasaka, Tetsuya Kawakita Jan 2025

Racial Disparities In Maternal Mortality Before, During, And After The Covid-19 Pandemic In The United States: A Difference-In-Difference Analysis, Kyosuke Kamijo, Misa Hayasaka, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Background

This study aimed to examine changes in racial disparities in pregnancy-related and maternal mortality before, during, and after the COVID-19 pandemic in the United States.

Methodology

This was a cross-sectional study using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) data from January 2018 to June 2024. We focused on pregnancy-related and maternal mortality among Black and White individuals to examine racial disparities. The study periods were defined as pre-pandemic (January 2018-March 2020), pandemic (April 2020-March 2022), and post-pandemic (April 2022-June 2024). We applied interrupted time series analysis and difference-in-difference (DID) models …


Association Of Mean Arterial, Systolic, And Diastolic Blood Pressure Trends In Early Pregnancy With Superimposed Preeclampsia With Severe Features In Pregnancies Complicated By Chronic Hypertension, Tetsuya Kawakita, Justin M. Leach, George R. Saade, Kim Boggess, Lorraine Dugoff, Brenna L. Hughes, Joseph Bell, Kjersti Aagaard, Rodney K. Edwards, Kelly Gibson, David M. Haas, Lauren Plante, Torri Metz, Brian Casey, Sherri Longo, Matthew K. Hoffman, Kara K. Hoppe, Methodius Tuuli, Michelle Y. Owens, Heather Frey, Todd Rosen, Uma M. Reddy, Wendy Kinzler, Emily Su, Iris Krishna, Mary E. Norton, Daniel Skupski, Yasser Y. El-Sayed, Ronald Librizzi, Mounira Habli, Shauna Williams, Gabriella Pridjian, David S. Mckenna, Sarah Osmundson, Joanne Quinones, Zorina Galis, Lorie Harper, Namasivayam Ambalavanan, Jeff M. Szychowski, Alan T.N. Tita Jan 2025

Association Of Mean Arterial, Systolic, And Diastolic Blood Pressure Trends In Early Pregnancy With Superimposed Preeclampsia With Severe Features In Pregnancies Complicated By Chronic Hypertension, Tetsuya Kawakita, Justin M. Leach, George R. Saade, Kim Boggess, Lorraine Dugoff, Brenna L. Hughes, Joseph Bell, Kjersti Aagaard, Rodney K. Edwards, Kelly Gibson, David M. Haas, Lauren Plante, Torri Metz, Brian Casey, Sherri Longo, Matthew K. Hoffman, Kara K. Hoppe, Methodius Tuuli, Michelle Y. Owens, Heather Frey, Todd Rosen, Uma M. Reddy, Wendy Kinzler, Emily Su, Iris Krishna, Mary E. Norton, Daniel Skupski, Yasser Y. El-Sayed, Ronald Librizzi, Mounira Habli, Shauna Williams, Gabriella Pridjian, David S. Mckenna, Sarah Osmundson, Joanne Quinones, Zorina Galis, Lorie Harper, Namasivayam Ambalavanan, Jeff M. Szychowski, Alan T.N. Tita

Department of Obstetrics & Gynecology Faculty Publications

OBJECTIVE: To evaluate the association of longitudinal systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) in early pregnancy with later development of superimposed preeclampsia with severe features in pregnancies complicated by mild chronic hypertension.

METHODS: This secondary analysis used data from the CHAP (Chronic Hypertension and Pregnancy) trial, a multicenter randomized controlled trial that involved pregnant individuals with chronic hypertension. Participants were categorized based on the development of superimposed preeclampsia with severe features. Longitudinal blood pressure measurements from enrollment to the development of superimposed preeclampsia with severe features or delivery were assessed using regression models. …


Longitudinal Assessment Of Fetal Myocardial Performance Index In Normal Pregnancy Using Spectral Tissue Doppler, R. Horgan, E. Sinkovskaya, E. Kalafat, G. Saade, A. Abuhamad Jan 2025

Longitudinal Assessment Of Fetal Myocardial Performance Index In Normal Pregnancy Using Spectral Tissue Doppler, R. Horgan, E. Sinkovskaya, E. Kalafat, G. Saade, A. Abuhamad

Department of Obstetrics & Gynecology Faculty Publications

Objective

Although spectral tissue Doppler imaging is recognized as the optimal method for assessing the fetal myocardial performance index (MPI), longitudinal reference ranges for fetal MPI measured using spectral tissue Doppler have not been established. Our objective was to use spectral tissue Doppler data to establish gestational-age-specific reference ranges from 12–33 weeks for left and right ventricular fetal MPI.

Methods

This was a prospective longitudinal study of women aged 18–35 years, with a body mass index below 30 kg/m² and a singleton pregnancy conceived spontaneously. Fetal MPI measurements were obtained in the first, second and third trimesters and MPI was …


Maternal Mortality According To State Abortion Legislative Climate Following The Us Supreme Court's Dobbs V. Jackson Women's Health Organization Ruling, Emily Nuss, Mari Iwasaki, Lindsay Robbins, Peggy Ye, Misa Hayasaka, George Saade, Tetsuya Kawakita Jan 2025

Maternal Mortality According To State Abortion Legislative Climate Following The Us Supreme Court's Dobbs V. Jackson Women's Health Organization Ruling, Emily Nuss, Mari Iwasaki, Lindsay Robbins, Peggy Ye, Misa Hayasaka, George Saade, Tetsuya Kawakita

Department of Obstetrics & Gynecology Faculty Publications

Objective

We aimed to evaluate how maternal mortality rates have evolved across US states following the Dobbs ruling, while accounting for the confounding influence of the coronavirus disease 2019 (COVID-19) pandemic.

Study Design

We conducted a retrospective analysis of publicly available data from the Centers for Disease Control and Prevention Wide-ranging ONline Data for Epidemiologic Research (CDC WONDER) database from January 2018 to December 2024. This study period was divided into three intervals: (1) pre-COVID (January 2018 to February 2020), (2) pandemic (March 2020 to September 2022), and (3) post-Dobbs (October 2022 to December 2024). Using the Kaiser Family Foundation …


Dance-Related Fractures Occur In The Upper And Lower Extremities At Similar Rates: An Analysis Of The 2004-2023 National Electronic Injury Surveillance System Database, Senah E. Stephens, Joshua F. Edwards, Lisa K. Cannada Jan 2025

Dance-Related Fractures Occur In The Upper And Lower Extremities At Similar Rates: An Analysis Of The 2004-2023 National Electronic Injury Surveillance System Database, Senah E. Stephens, Joshua F. Edwards, Lisa K. Cannada

Department of Medicine Faculty Publications

Introduction

In the United States, 21% of adolescents participate in dance. Dancers are susceptible to injuries, particularly of the lower extremity, due to extreme positioning, dynamic overload, and repetitive movements.

Objectives

(1) to report the prevalence and describe demographic characteristics of dance-related fractures and (2) to analyze variables associated with disposition status.

Methods

The National Electronic Injury Surveillance System (NEISS) database, published by the US Consumer Product Safety Commission, was used to investigate dance-related fractures diagnosed in a sample of 100 emergency departments over 20 years. Descriptive statistics and demographic variables were analyzed using chi square tests. Age was analyzed …


Group Antenatal Care Positively Transforms The Care Experience: Results Of An Effectiveness Trial In Malawi, Crystal L. Patil, Kathleen F. Noor, Esnath Kapito, Li C. Liu, Xiaohan Mei, Elizabeth Chodzaza, Genesis Chorwe-Sungani, Ursula Kafuulafula, Elizabeth T. Abrams, Allissa Desloge, Ashley Gresh, Rohan D. Jeremiah, Dhruvi R. Patel, Anne Batchelder, Heidy Wang, Jocelyn Faydenko, Sharon S. Rising, Ellen Chirwa Jan 2025

Group Antenatal Care Positively Transforms The Care Experience: Results Of An Effectiveness Trial In Malawi, Crystal L. Patil, Kathleen F. Noor, Esnath Kapito, Li C. Liu, Xiaohan Mei, Elizabeth Chodzaza, Genesis Chorwe-Sungani, Ursula Kafuulafula, Elizabeth T. Abrams, Allissa Desloge, Ashley Gresh, Rohan D. Jeremiah, Dhruvi R. Patel, Anne Batchelder, Heidy Wang, Jocelyn Faydenko, Sharon S. Rising, Ellen Chirwa

Department of Medicine Faculty Publications

Background

We developed and tested a Centering-based group antenatal (ANC) model in Malawi, integrating health promotion for HIV prevention and mental health. We present effectiveness data and examine congruence with only the Group ANC theory of change model, which identifies key processes as supportive relationships, empowered partners in learning and care, and meaningful services, leading to better ANC experiences and outcomes.

Methods

We conducted a hybrid effectiveness-implementation trial at seven clinics in Blantyre District, Malawi, comparing outcomes for 1887 pregnant women randomly assigned to Group ANC or Individual ANC. Group effects on outcomes were summarized and evaluated using t-tests, Mann-Whitney, …