Public Health Commons^™

An Analysis Of Comprehensive Sex Education As A Means Of Reducing Teenage Pregnancy Rates, Ben Hiett, Adriana Parella

Scholarship in Medicine - All Papers

Teenage pregnancy rates have been declining since the 1990s, yet teenage pregnancy remains a pressing public health concern given its associated negative maternal and infant complications. Many experts and advocates have placed an increasing emphasis on school programs that provide teenagers with comprehensive education on healthy sexual functioning, safe sex practices, and effective contraceptive use, pointing to them as a means of reducing unplanned teen pregnancies. However, there is still some debate regarding the effectiveness of comprehensive sex education compared to more limited programs that focus primarily on promoting abstinence. Using data from County Health Rankings and SIECUS, we compared …

The Relationship Of Peer Recovery Support Specialists And Recovery Of Perinatal Women With A Substance Use Disorder, Mary C. Talbot

2025 Honors Symposium

Background: Substance use in pregnant and postpartum women is a growing issue in the United States. Drug use while pregnant can lead to birth defects, stillbirths, and problems providing positive parenting to their children. Many women with substance use disorders (SUD) feel extreme shame and stigma related to their substance use and have trouble accessing recovery-related treatment and other services. Peer recovery support treatment uses the lived experiences of individuals in current recovery from SUD to facilitate and support recovery in others. Purpose: The purpose of this review was to evaluate the impact of peer recovery support specialists on the …

Improving Knowledge And Confidence Of Family Nurse Practitioners In Offering The Hpv Vaccine, Leni Terano Fisher

Doctor of Nursing Practice (DNP) Scholarly Projects - Archive

Abstract

Introduction

Despite the recommendations of the United States Advisory Committee on Immunization Practices, HPV immunization lags behind other routine vaccines by up to 31%. Although there are many reasons for the low vaccine rate, provider hesitancy and lack of confidence significantly contribute to suboptimal HPV vaccine uptake.

Objectives

This project aimed to utilize evidence-driven interventions to increase family nurse practitioners' (FNPs) knowledge and confidence in offering the HPV vaccine.

Methods

Participants were given pre- and post-questionnaire surveys. The Wilcoxon Rank Test was used to compare, quantify, and measure the results of the eight-week data collection.

Results

The subjects were …

The Role Of Sexual Assault Nurse Examiners: Addressing The Shortage And Its Implications For Healthcare, Isabel Mary Mccarthy

Nursing | Senior Theses

Background: Sexual Assault Nurse Examiners (SANE) are registered nurses specifically trained to perform forensic examinations and provide medical and emotional support to sexual assault victims. Many nursing programs lack formal education on SANE practices, which can hinder students' preparedness to address such cases in their future careers.

Method: A mixed-methods, three-phase approach to evaluate the effectiveness of a Sexual Assault Nurse Examiner (SANE) training module within the Dominican University of California Nursing Program. 40- 60 nursing students will be separated into two separate community health classes with one given module in SANEs nursing and the other not. Both classes …

Ashwagandha And Sexual Health In Women With Hypoactive Sexual Desire Disorder: Exploring Extent Of Adaptogenic Properties, Rhea Chatterjee

AUCTUS: The Journal of Undergraduate Research and Creative Scholarship

Hypoactive Sexual Desire Disorder (HSDD) affects 40% of women and potentially decreases their quality of life. Currently, the primary treatment for HSDD is Flibanserin, which is a serotonergic agonist and an antidepressant. However, the limited efficacy of Flibanserin encourages the exploration of the utilization of traditional drugs such as Withania somnifera, otherwise known as Ashwagandha, as an alternative treatment for HSDD. Minimal studies examine ayurvedic medications or the symptoms of illnesses that traditional Western medicines are unable to treat. This comprehensive literature review investigated the efficacy of Ashwagandha in improving sexual function in women with HSDD. The paper evaluated …

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

Maternal Health Predictors In Ohio, Sritha Donepudi, Humza Khan

Scholarship in Medicine - All Papers

Background: Ohio has continued to have a maternal mortality rate higher than the average which has posed the question of how geographic location, socioeconomic status, and demographics affect these rates.
Objective: This paper aims to investigate the relationship between variables affecting maternal mortality rates in Ohio such as teen birth rates and primary care physician access with where one lives between Rural and Urban areas and their household income in order to provide more information for future research.
Methods: This paper utilized County Health Rankings and statistical and correlation analysis with SPSS to analyze rates across counties in Ohio.
Results: …

Racial Health Disparities Among Pregnant Women Of Color In New York City: Biological And Systemic Impacts, Kaylin Peña

Pitzer Senior Theses

Racial Health Disparities Among Pregnant Women of Color in New York City: Biological and Systemic Impacts

Abstract

This thesis aims to explore how racial health disparities, underrepresentation in gynecology, and socioeconomic barriers contribute to adverse pregnancy outcomes among women of color in New York City. Through an interdisciplinary approach that combines resources from medical anthropology and human biology, this research will examine the biological implications of chronic stress, specifically HPA axis dysregulation, and its role in maternal health outcomes. With the idea of intersectionality, as conceptualized by Kimberlé Crenshaw, the study analyzes the various effects of systemic inequities and social …

Medication Abortion And The Mails: The Ghost Of Anthony Comstock Rides Again?, Lars Noah

UF Law Faculty Publications

Mail-order dispensing of the prescription drug mifepristone has become the latest flashpoint in this country’s long-running debate over abortion access. It also has brought back from the dead one of the oldest federal statutes to address that contentious subject. In their fight to limit access to a drug approved by the FDA one quarter of a century ago, abortion opponents have rediscovered the Comstock Act. Although amended on several occasions since 1873, Congress never managed to repeal or clarify its ambiguous language relating to abortion. On its narrowest reading, this provision would have no impact whatsoever on access to mifepristone; …

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 …

Association Between Adverse Pregnancy Outcomes And Awareness Of Cardiovascular Risk Factors: A Numom2b-Hhs Secondary Analysis, Elizabeth M. Wendl, Amanda A. Allshouse, Ashley Goodwin, Bri Hobbs, Philip Greenland, Lisa Levine, William Grobman, George R. Saade, Natalie Cameron, C. Noel Bairey Merz, Caroline Rouse, Sarah Rogan, Judith H. Chung, Lauren H. Theilen, National Heart, Lung, And Blood Institute Numom2b Heart Health Study Network

Department of Obstetrics & Gynecology Faculty Publications

Background

Adverse pregnancy outcomes (APOs) affect 10%-20% of pregnancies and are associated with increased risk of cardiovascular disease.

Objective

To determine whether the history of APO is associated with a person's awareness of their cardiovascular risk factors (CRF) 2-7 years postpartum.

Methods

This is a secondary analysis of a multicenter cohort study in which nulliparous pregnant people were enrolled in the first trimester and followed prospectively. Participants with a CRF (hypertension, dyslipidemia, and/or prediabetes/diabetes) at follow-up were included. We excluded participants with: pre-gestational diabetes, chronic hypertension, dyslipidemia during the index pregnancy or subsequent pregnancy, and non-fasting blood draws. The exposure …

Perceptions Of The Health Care System As Mediators In The Association Between Experiences Of Discrimination, Communication From Providers, And Gaps In Mammography, Hannah Cohen-Cline

Articles, Abstracts, and Reports

No abstract provided.

Oregon Doula Workforce Analysis, Aisha K Gilmore, Apoorva Somayazulu, Lindsay Dickey, Rosemelty Jimenez Medal

Articles, Abstracts, and Reports

No abstract provided.

Educating Nurses On Culturally Competent Intimate Partner Violence Care, Nicole Lee

Nursing | Senior Theses

Purpose

The purpose of this research proposal is to examine the impact of mandatory training for labor and delivery nurses on culturally sensitive care for pregnant women who have experienced intimate partner violence. It aims to address gaps in provider training by evaluating improvement in screening rates, enhanced confidence, and effective interventions.

Methods

This study will recruit nurses from different labor and delivery units from different hospitals. This study will use a pre-test and post-test design to assess the effectiveness of the training. The evaluation will measure the changes in knowledge, confidence, and screening practices before and after training.

Results …

Impacts Of Ramadan Fasting During Pregnancy On Pregnancy And Birth Outcomes: An Umbrella Review, Abdullah Al-Taiar, Md Estiar Rahman, May Salama, Ali H. Ziyab, Wilfried Karmaus

Epidemiology, Biostatistics, & Environmental Health Faculty Publications

Background

Despite a large number of primary research studies, and systematic and narrative reviews, there is no consensus on the impact of fasting during Ramadan while pregnant on pregnancy and birth outcomes. Currently, there is no evidence-based guideline for Muslim women regarding Ramadan fasting during pregnancy and clinicians cannot provide firm recommendations.

Objectives

To review the current evidence regarding the impact of Ramadan fasting during pregnancy on pregnancy and birth outcomes.

Search Strategy

We conducted an umbrella review of all systematic and narrative reviews examining the impacts of fasting during Ramadan while pregnant on pregnancy and birth outcomes by searching …

An Evaluation Of The Association Between Female Reproductive Health Policy And Children's Health Outcomes, Kira Markowski, Rachel Bobko

Scholarship in Medicine - All Papers

Background: As policy pertaining to female reproductive health and education continues to be a central issue concerning Americans and a divisive focus of political campaigns, it is important to fully understand the ramifications of female reproductive health legislation not only on women’s health outcomes but also the health outcomes of children and adolescents.
Objective: We set out to identify how legislation and policy related to female reproductive health and education impacts the health and well-being of children and adolescents. By evaluating this relationship, we aim to show whether variations in policy correlate with variations in a child’s well-being as lawmakers …

Examining Low Mammogram Rates In Native American Populations In Arizona And New Mexico, Mason Berges, Ayesha Ahmad

Scholarship in Medicine - All Papers

Introduction: Despite improvements in technology over the last several decades, breast cancer incidence and mortality rates have remained steady among the Native American population. This is in direct contrast to the general United States population which has seen substantial decreases in these incidence and mortality rates. A key factor in eliminating breast cancer and saving lives is undergoing mammogram screenings. While mammogram screenings are of crucial importance, many Native American women lack equitable access to healthcare resources and as a result face unnecessary health challenges. Several social determinants of health could be playing a key role in these mammogram screening …

Impact Of Abortion Restrictions On Childhood Health Outcomes, Rico Carter, Griffin Suppa

Scholarship in Medicine - All Papers

Abortion has been a topic for debate in the U.S. for decades. With the Supreme Court’s recent overturning of Roe v. Wade, many pro-abortion advocates fear for the looming effects this policy change will have on healthcare. In this study we aim to study how abortion access or lack thereof influences childhood healthcare outcomes. Past research has shown a negative impact of abortion restrictions on infant survival, future socioeconomic success, and the U.S. foster care system. Using data collected from County Health Rankings & Roadmaps and three abortion restriction levels created from Guttmacher, we found that states with restrictions had …

Social And Structural Determinants Of Mammography Screening Rates Among Female Medicare Beneficiaries: A Retrospective Analysis, Stephen Fuglsang, Rakhsha Khatri

Scholarship in Medicine - All Papers

Introduction: Despite Medicare fully covering annual mammogram costs, less than one half of female Ohio residents aged 65-74 sought yearly mammograms. As such, our analyses explore which social and structural determinants of health predict the likelihood that a woman aged 65-74 on Medicare will receive an annual mammogram.
Methods: This retrospective analysis utilized data from the County Health Rankings database, focusing on female Medicare enrollees aged 65-74. Mammography screening rates were compared across counties within Ohio, Michigan, and Missouri. Pearson and Spearman correlation tests were employed to examine relationships between English non-proficiency, high school graduation rates, residential segregation, primary care …

Exploring Dominican University Nursing Student’S Perceptions Of Economic Barriers To Accessing Essential Women’S Health Products, Annabelle E. Burke

Nursing | Student Research Posters

Access to essential feminine hygiene products, including menstrual supplies and hygiene items, is a growing economic and public health issue. Rising product prices and reliance on costly disposable products contribute to financial strain for many women. Period poverty is the lack of access to menstrual products, education, and hygiene facilities due to financial constraints, and it negatively affects women’s physical and mental health, particularly among students and low-income populations. Research shows that limited access to menstrual products affects dignity, sanitation, and emotional well-being and is compounded by social stigma and cultural silence surrounding menstruation (Brinkley & Niebuhr, 2023). Findings from …

Educating Nurses On Culturally Competent Intimate Partner Violence Care, Nicole Lee

Nursing | Student Research Posters

No abstract provided.

Empowering Birth: Comparing Nurse-Led Holistic And Pharmacologic Pain Relief Approaches​, Jessica C. Moore

Nursing | Student Research Posters

Childbirth is often described as one of the most meaningful experiences in a woman’s life. During this time, effective pain management is essential not only for reducing discomfort, but also for improving maternal satisfaction and minimizing unnecessary obstetric interventions. While childbirth is frequently approached as a purely physical process, it is inherently holistic, influenced by cultural, social, psychological, and emotional factors.

Growing evidence highlights the value of incorporating and educating patients and providers on non-pharmacologic strategies such as breathing techniques, massage, aromatherapy, hydrotherapy, positioning ,ambulation, and continuous emotional support.

For example, a study in Sweden that found that a group …

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 …

Longitudinal Assessment Of Intravillous Arterioles In Normal Pregnancy Using Superb Microvascular Imaging, R. Horgan, E. Sinkovskaya, G. Saade, E. Kalafat, A. Heeze, A. Abuhamad

Department of Obstetrics & Gynecology Faculty Publications

Objective

To use superb microvascular imaging (SMI) to longitudinally evaluate blood flow in intravillous arterioles (IVA) in pregnancy, and to develop reference ranges for IVA pulsatility index (PI) and peak systolic velocity (PSV) from 12 to 38 weeks' gestation.

Methods

The data for this study were obtained from the National Institutes of Health-funded Human Placenta Project. Eligible for inclusion were women aged 18-35 years, with a body mass index of <  30 kg/m², without comorbidities, with a singleton pregnancy conceived spontaneously and a gestational age of ≤ 13 + 6 weeks. Exclusion criteria were maternal or neonatal complications, fetal or umbilical cord anomalies, abnormal placental implantation and delivery <  37 weeks. Each participant underwent eight ultrasound examinations during pregnancy. Using SMI technology, the total number of IVA identified was recorded in a sagittal placental section at the level of cord insertion. The PI and PSV were measured in a total of six IVA (two in the central portion of the placenta, two peripherally towards the uterine fundal portion and two peripherally towards the lower uterine segment). Umbilical artery (UA)-PI was also obtained. Multilevel regression models were used to create reference ranges for IVA-PI and IVA-PSV at 12-38 weeks' gestation.

Results

A total of 90 women fulfilled the study criteria. IVA-PI decreased throughout pregnancy from a mean ± SD of 1.04 ± 0.23 in the first trimester (at 12-13 weeks) …

The Association Between Pain Sensitivity And Low Energy Availability, Sleep, Mental Health, And Stress In Female Endurance Athletes, Taylor R. Moler

Honors Undergraduate Theses

The disruption of certain physiological functions due to low energy availability (LEA) in female endurance athletes is a prominent concern. This condition resulting from LEA has been described as Relative Energy Deficiency in Sport (RED-S), which can include alterations in metabolism, menstrual function, bone deposition and resorption, mental well-being, and more. The goal of this study was to determine whether pain sensitivity was associated with LEA, sleep, mental health, and stress in female endurance athletes. Participants completed a demographic survey, the Low Energy Availability in Females Questionnaire (LEAF-Q), the Pittsburgh Sleep Quality Index (PSQI), the Patient Health Questionnaire (PHQ-4), and …

The Female Brain Health And Endocrine Research In Africa Study (Fember-Africa): Identifying Endocrinological, Lifestyle, Psychosocial And Socio-Cultural Targets For Alzheimer’S Disease Prevention In Women Of African Ancestry, Chinedu Momoh, Rachel Maina, Edna Bosire, Linda Khakali, Sarah Gregory, Karen Blackmon, Thomas Thesen, Samuel Gitau, Anne Njogu, Cynthia Smith, Sylvia Mbugua, Sheila Waa, Jasmit Shah, Kendi Muchungi, Zul Merali

Brain and Mind Institute

Background The Global Dementia Action Plan 2017-2025 specifies key targets, with an emphasis on building research infrastructure and capability across the Global South. However, to date, only 0.1% of total research in Africa constitutes dementia research, the lowest volume of all LMIC regions. Several biomarker and risk models of the preclinical and prodromal stages of Alzheimer’s disease (AD) are proposed as optimal junctures for disease prevention, yet they ignore the influence of biological sex/gender on cognitive and disease processes, despite female sex/gender constituting a major AD modifier. Similarly, the application of these models in ethno-racial and culturally diverse cohorts is …

Barriers To Postpartum Depression Treatment: Availability And Accessibility Of Maternal Behavioral Health-Inclusive Support Groups For Low-Income Populations, Radhika S. Venkatesan

Honors Undergraduate Theses

The maternal health crisis is a prevalent and concerning issue in the United States. The lack of efficient availability and accessibility to health care services plays a significant role in augmenting this problem. One health care service that is often understudied is support groups, for prevalent issues like postpartum depression. Considering the socioeconomic burdens of low-income mothers, this paper analyzed the accessibility and availability of maternal health support groups across counties in Florida, with varying amounts of individuals below the federal poverty level (%BPL). Essentially, Florida counties were divided into one of four categories depending on their %BPL. A Fisher’s …

Relative Energy Deficiency In Sport: Risk Assessment In Collegiate Female Athletes Using The Reds Cat2 Tool, Kelsea Elizabeth Nunes

All Master's Theses

Context: Alterations in energy intake (EI) and high exercise energy expenditure (EEE) may increase the risk of low energy availability (LEA) in Division II female collegiate ball sport athletes. Furthermore, chronic LEA can transition to problematic LEA, leading to Relative Energy Deficiency in Sport (REDs).

Objective: The purpose of this study was to assess the current severity and prevalence of REDs using the REDs CAT2 Tool and the Female Athlete Triad using the FAT CRA in Division II collegiate female volleyball, basketball, soccer, and rugby athletes.

Design: Cross-sectional design.

Setting: Research laboratory.

Patients or Other Participants …

Frequency And Perceived Influence Of Menopausal Symptoms On Training And Performance In Female Endurance Athletes, Heather M. Hamilton, Natalie M. Yarish, Kristin E. Heron

Rehabilitation Sciences Faculty Publications

Menopause is associated with several negative health concerns and common menopausal symptoms. Physical activity is essential to mitigate these negative effects, but menopausal symptoms may interfere with participation in physical activity. The purpose of this study was to determine the frequency and the perceived negative effect of menopausal symptoms among female endurance athletes. Female runners, cyclists, swimmers, and triathletes 40–60 years of age were recruited (N = 187). Participants completed an online, anonymous survey that included self-reported menopausal status; the Menopausal Rating Scale (MRS), a validated measure for assessing menopausal symptoms; and the perceived effect of menopausal symptoms on …

'I Did Not Know We Could Exercise This Small Premature Baby': Challenges Experienced By Parents While Implementing Early Intervention For Their Preterm Infants-A Qualitative Perspective, Manasa Kolibylu Raghupathy, Selim Jahangir, Sonia Khurana, Leslie Edward S. Lewis, Bhamini Krishna Rao

Rehabilitation Sciences Faculty Publications

Background

Preterm birth is a highly stressful experience for both parents and infants. Parental participation in care enhances developmental outcomes, fosters parent-infant interactions and builds parental confidence. However, low parental adherence has always been a challenge in the successful implementation of intervention programs both in the NICU and at home. It is imperative to understand parents' perspectives and view the challenges that they experience through their lens while providing early intervention to their infants born preterm. This study is aimed at identifying new parents' challenges when implementing early intervention programs for their infants during the transition from hospital to home. …