Women's Health Commons^™

Association Between Breastfeeding And Child Stunting In Mexico, Ana Paola Campos, Mireya Vilar-Compte, Summer Sherburne Hawkins

Department of Public Health Scholarship and Creative Works

Background: Globally, the prevalence of child stunting has been decreasing over the past decades. How-ever, in low-and middle-income countries such as Mexico, stunting is still the most prevalent form of undernutrition affecting a large number of children in the most vulnerable conditions. Breastfeeding has been identified as one of the key affordable and modifiable maternal health behaviors protecting against child stunting. Objective: To examine the association between breastfeeding (defined as never breastfed, any breast-feeding for <6 months, and any breastfeeding for ≥6 months) and other individual-, household-, and area-level factors with child stunting (defined as length/height-for-age-z-score for sex under –2 standard deviations of the World Health Organization child growth standards’ median) in Mexico. Methods: Secondary data analysis using the 2012 Mexican Health and Nutrition Survey, which allowed representativeness of rural and urban areas at national level and among 4 regions in Mexico. Our subset included data on 2,089 singleton Mexican children aged 6–35 months with information on previously identified risk and protective factors for stunting. We conducted fixed-and mixed-effects logistic regression models sequentially controlling for each level of factors. Findings: Overall, 12.3% of children were stunted and 71.1% were breastfed for ≥6 months. Any breast-feeding and being female were consistent protective factors against child stunting across all models. In contrast, child low birthweight, maternal short stature, higher number of children aged <5 years per household, and moderate to severe food insecurity were consistent risk factors for child stunting across all models. Conclusions: According to our findings, efforts to reduce child stunting in Mexico should include prenatal strategies aiming to prevent low birthweight offspring particularly among short-stature women, moderate to severe food insecure households, families with a higher number of children aged <5 years, and indigenous communities. Postnatal components should include multilevel strategies to support breastfeeding.

Surfacing Contexts Of Violence In Novel Forms Of The Reproductive Justice Framework Through Lessons From Latin America: A Study Of Brutality, Migration And Bodily Autonomy And Progressive Solutions For Use In Public Health, Angelica M. Campos

CMC Senior Theses

In the last 5 years, Latin America has witnessed a tenacious wave of pañuelo verde and #NiUnaMenos activism. Sparked by increasing mortality rates associated with unsafe, clandestine abortions and femicide, the praxes and fundamental elements of these social movements have proven themselves useful not only in garnering international attention on issues relating to bodily autonomy, but in the synthesis of their respective sociopolitical solutions as well. In the United States, similar efforts have been spearheaded by the lauded reproductive justice framework, which has often been credited for centering the plight of women of color in both reproduction and social justice. …

Exploring Young Acb Women’S Experiences Of Navigating Sexual Health In The Greater Toronto Area., Natasha Afua Darko

Theses and Dissertations (Comprehensive)

This thesis explores the experiences of young African, Caribbean, and Black (ACB) women in the Greater Toronto Area (GTA) regarding how they navigate sexual health. Young ACB women face challenges that put them at increased risk for HIV and other sexually transmitted infections. Despite this, few studies have focused on the social contexts that affect sexual health for ACB women in Canada. This Community Based Participatory Research ( CBPR) study (N = 24) utilized focus groups to examine young ACB women's experiences navigating sexual health. In the following thesis document, I present two manuscripts where I share a) a reflection …

Know Before You Play: Associations Between Race, Education, And Hiv Susceptibility, Anfa Mohamed Diiriye

All Graduate Theses, Dissertations, and Other Capstone Projects

Black women are disproportionately affected by HIV in the United States. This paper analyzes the associations between race, education, and HIV susceptibility, furthering previous research to understand if educational attainment reduces HIV susceptibility and if reduction patterns are similar for Black and White women. The CDC’s National Survey of Family Growth 2015-2017 was used to analyze associations using binary logistic and multiple regression models. HIV susceptibility was operationalized through four measures: condom use, having a partner with concurrent sexual relationships, having had an STD, and age at first sex. Black women were not found to be significantly more susceptible to …

From The Legal Literature: If The Fetus Is A Person—Is It Relevant? An Argument On The Rights Of Pregnant Women, Francesca Laguardia

Department of Justice Studies Faculty Scholarship and Creative Works

No abstract provided.

Diabetes Risk Status And Physical Activity In Pregnant Women: U.S. Brfss 2011, 2013, 2015, 2017, Bethany Rand

UNF Graduate Theses and Dissertations

Objective: We sought to examine differences in aerobic activity (AA) and muscle-strengthening activity (MSA) by diabetes risk status (DRS) among pregnant women in the United States.

Background: Pregnant women without complications are advised to engage in physical activity (PA) to mitigate adverse outcomes. Differences may exist among pregnant women of diverging diabetes status in meeting national PA recommendations.

Methods: The sample (n=9,597) included pregnant women ages 18-44, who participated in 2011, 2013, 2015, and 2017 Behavioral Risk Factor Surveillance System. Levels of DRS were: no diabetes (ND), high risk for diabetes (HRD) due to self-reported gestational diabetes or …

Cost-Effectiveness Of A Mobile Health-Supported Lifestyle Intervention For Pregnant Women With An Elevated Body Mass Index, Elizabeth O'Sullivan, Salwa Rokicki, Maria Kennelly, Kate Ainscough, Fionnuala M. Mcauliffe

Articles

Objective To assess the cost-effectiveness of a mobile health-supported lifestyle intervention compared with usual care.

Methods We conducted a cost-effectiveness analysis from the perspective of the publicly-funded health care system. We estimated costs associated with the intervention and health care utilisation from first antenatal care appointment through delivery. We used bootstrap methods to quantify the uncertainty around cost‐effectiveness estimates. Health outcomes assessed in this analysis were gestational weight gain (GWG; kg), incidence of excessive GWG, quality-adjusted life years (QALYs), and incidence of large-for-gestational-age (LGA). Incremental cost-effectiveness ratios (ICERs) were calculated as cost per QALY gained, cost per kg of GWG …

Knowledge Of Breast Cancer And Screening Methods Among Rural Women In Southwest Nigeria: A Mixed Method Analysis, Rowland Edet, Oluwayimika Ekundina, Obasanjo Afolabi Bolarinwa, Julianah Babajide, Juliet Amarachukwu Nwafor

Department of Sociology: Faculty Publications

The objective of this study was to assess the awareness of rural women on breast cancer and its screening methods in Southwest Nigeria. Descriptive cross-sectional survey design with the aid of a semi-structured questionnaire was used to generate data among 422 rural women in selected communities in Egbeda local government area of Ibadan. The qualitative data was generated through in-depth interviews among rural women and key informant interviews among health workers in the communities. The study revealed that only 63.7% were aware of breast cancer screening methods compared to 31.6% who were not aware of it. The commonly known screening …

Condom Dispenser Program, Madilynn Turner

Capstone Projects and Master's Theses

Health and Wellness Services (HWS) at California State University Monterey Bay (CSUMB) takes an integrative health approach to support the CSUMB campus community. There six entities that make up HWS, however, the Condom Dispenser Program (CDP) was implemented under Health Promotion and Education (HPE). The mission of HPE is to ensure that CSUMB community members are reaching holistic wellness through the adoption of healthy behaviors. This goal is met through programming, outreach, and education that is provided.

The need that was discovered through analysis of the National Collegiate Health Assessment (NCHA) was that students are not using condoms to prevent …

Public Health Research Priorities To Address Female Genital Mutilation Or Cutting In The United States, Holly G. Atkinson, Deborah Ottenheimer, Ranit Mishori

Publications and Research

Female genital mutilation or cut- ting (FGM/C), an age-old tradition that is still widely practiced around the world, is gaining recognition as an important public health issue in the United States. Increasingly, because of migration, women and girls affected by FGM/C have become members of host communities where the practice is not culturally acceptable.

According to recent conservative estimates, more than 513 000 immigrant women and girls living in the United States have undergone or are at risk for FGM/C, a significant increase from the 1990 estimate of 168 000. The arrests of physicians in Michigan in 2017 for performing …

Contraceptive Use Following Unintended Pregnancy Among Ugandan Women Living With Hiv, Jana Jarolimova, Jerome Kabakyenga, Kara Bennett, Winnie R. Muyindike, Annet Kembabazi, Jeffrey N. Martin, Peter W. Hunt, Yap Boum, Jessica E. Haberer, David Bangsberg, Angela Kaida, Lynn T. Matthews

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Preventing unintended pregnancy is critical for women living with HIV (WLWH) to safely achieve their reproductive goals. Family planning services should support WLWH at risk of repeat unintended pregnancies. We examined the relationship between unintended pregnancy and subsequent contraception use among WLWH in Uganda.

Study design: This was a retrospective analysis of data from a longitudinal cohort of individuals initiating antiretroviral therapy (ART), restricted to women with pregnancy (confirmed via urine β-hcg testing) between 2011–2013. The exposure of interest was intended vs unintended pregnancy, and the outcome was self-report of modern contraceptive use (hormonal methods, intrauterine device, sterilization, and/or …

A Study Protocol For An Mhealth, Multi-Centre Randomized Control Trial To Promote Use Of Postpartum Contraception Amongst Rural Women In Punjab, Pakistan, Xaher Gul, Waqas Hameed, Sharmeen Hussain, Ishaque Sheikh, Junaid-Ur-Rehman Siddiqui

Community Health Sciences

Background: Provision of family planning services during the immediate post-partum phase is considered effective and cost-efficient for promoting healthy timing and spacing of pregnancies. This research aims to test the effectiveness of mobile phone-based interventions in promoting use of postpartum contraception. Moreover, it will also test the non-inferiority of text and voice messages compared to interactive phone-based counselling.
Methods: A three-arm, 10-month, multicentre, randomized controlled trial will be conducted at 15 social franchise (SF) health facilities in Punjab province of Pakistan. Pregnant women aged 15-44 years who are in their first or second trimester and have a mobile phone for …

Availability Of Long Acting Reversible Contraceptives For Adolescents In Urban Vs Rural West Virginia Counties, Brooke Andrews, Cameron Ross, Jennie L. Yoost

Marshall Journal of Medicine

The study objective was to evaluate long acting reversible contraceptive (LARC) method availability and access for adolescents in rural and urban counties in West Virginia (WV). A cross-sectional survey of Title X family planning providers throughout WV was conducted from January 2016-July 2017. This survey was sent to 226 family planning providers in WV to assess patterns of LARC availability. The survey assessed provider training level, LARC services provided and frequency, clinical practice, referral patterns, and comfort level providing adolescent LARC services. Survey results were analyzed by providers’ rural vs urban status, based on US census county codes. Survey responses …

Polyhydramnios Among Women In A Cluster-Randomized Trial Of Ultrasound During Prenatal Care Within Five Low And Low-Middle Income Countries: A Secondary Analysis Of The First Look Study, Melissa Bauserman, Robert Nathan, Adrien Lokangaka, Elizabeth M. Mcclure, Janet Moore, Daniel Ishoso, Antoinette Tshefu, Lester Figueroa, Sarah Saleem, Waseem Mirza

Community Health Sciences

Background: In many low and low-middle income countries, the incidence of polyhydramnios is unknown, in part because ultrasound technology is not routinely used. Our objective was to report the incidence of polyhydramnios in five low and low-middle income countries, to determine maternal characteristics associated with polyhydramnios, and report pregnancy and neonatal outcomes.
Methods: We performed a secondary analysis of the First Look Study, a multi-national, cluster-randomized trial of ultrasound during prenatal care. We evaluated all women enrolled from Guatemala, Pakistan, Zambia, Kenya and the Democratic Republic of Congo (DRC) who received an examination by prenatal ultrasound. We used pairwise site …

“You Come Back To The Same Ole Shit:” A Qualitative Study Of Smoking Cessation Barriers Among Women Living With Hiv: Implications For Intervention Development, Faith E. Fletcher, Damon J. Vidrine, Meredith K. Buchberg Trejo, Yamile' Molina, Beverly E. Sha, Brenikki R. Floyd, Noreen Sarhene, Jamesetta Mator, Alicia K. Matthews

Journal of Health Disparities Research and Practice

Although tobacco use among women living with HIV (WLWH) is decreasing, the prevalence is more than double that of women in the general population and remains an important health behavior to target among WLWH. Few smoking cessation interventions specifically focus on the unique social and medical needs of women living with HIV (WLWH). Thus, the investigative team engaged WLWH (N=18) in qualitative focus groups to: 1) understand barriers and facilitators to smoking cessation; and 2) inform intervention structure and content priorities. Participants identified salient reasons for smoking and barriers to smoking cessation, which included coping mechanisms for life stressors, HIV-related …

Challenges Of Implementing An Individual Randomized Controlled Trial (Women First: Preconception Maternal Nutrition Study) In A Rural Study Site: A Case Study From Pakistan, Sumera Aziz Ali, Umber S. Khan, Farina Abrejo, Sarah Saleem, Michael K. Hambidge, Nancy F. Krebs, Jamie E. Westcott, Robert L. Goldenberg, Elizabeth M. Mcclure, Omrana Pasha

Community Health Sciences

Persistent global disparities in maternal and neonatal outcomes associated with poor maternal nutrition provided the genesis of the Women First (WF) study, an individually randomized controlled trial on preconceptional maternal nutrition. This article describes the challenges that arose in implementing this trial related to nutrition or diet of the mother, in District Thatta-Pakistan. During different phases of the study, we encountered problems in identifying the eligible participants, taking consent from couples, randomizing participants in different arms, conducting biweekly follow-up visits on time, ensuring compliance to the intervention, and measuring the primary outcome within the 24 hours of birth. Each challenge …

Building Financial Management Capacity For Community Ownership Of Development Initiatives In Rural Zambia, Viviane Sakanga, Parker S. Chastain, Kathleen L. Mcglasson, Jeanette L. Kaiser, Misheck Bwalya, Melvin Mwansa, Kaluba Mataka, David Kalaba, Nancy Scott, Taryn Vian

Nursing and Health Professions Faculty Research and Publications

Background: Building financial management capacity is increasingly important in low- and middle-income countries to help communities take ownership of development activities. Yet, many community members lack financial knowledge and skills.

Methods: As part of a larger health intervention, we designed and conducted financial management training for 83 members from 10 community groups in rural Zambia. Change scores between pre- and post-tests on financial knowledge were calculated and multivariate linear regression models run. Qualitative feedback was elicited.

Results: The training significantly improved knowledge of financial concepts. Participants with some or more than some secondary education had greater improvements …

Adolescent Sexual Reproductive Health Course: A Mixed Media Intervention And Quality Improvement Project In A School-Based Setting, Stephanie Calabrese

Doctor of Nursing Practice (DNP) Projects

Section I: Abstract

Problem: California’s adolescents carry a significant burden of newly acquired sexually transmitted infections (STIs) and gaps in adolescent sexual and reproductive health (SRH) knowledge have led to poor adolescent health outcomes. (CDE, 2019). Context: The California Healthy Youth Act (AB 329) was enacted on January 1, 2016, calling all school districts to ensure that all pupils receive comprehensive sexual health education, and HIV prevention education (CDE, 2019). In a proactive motion, parents from a northern California middle school approached a university to provide a Doctor of Nursing Practice (DNP) student to instruct its sixth grade’s …

Pro-Anorexia Website Harm, Jane C. Silva Ramirez

Journal of Critical Issues in Educational Practice

This paper explores the nature of websites that glorify eating disorders, or EDs. These websites are often referred to as “pro-ED” (pro-eating disorder), “pro-ana” (pro-anorexia), or “pro-mia” (pro-bulimia). For the purpose of this paper, only pro-ED, pro-ana, and pro-recovery website research were the focus. Scholarly articles found in California State University San Bernardino’s database were used to distinguish the different ways that these websites help and cause harm to individuals. Articles about pro-ED and pro-ana websites helped prove harmful to individuals, claiming the disorder as a “lifestyle”. It also showed the support these communities feel when interacting through blogs, comments, …

Innovation And Equity In Public Health Research : Testing Arts-Based Methods For Trauma-Informed, Culturally-Responsive Inquiry., Tasha Golden

Electronic Theses and Dissertations

As the field of Public Health has shifted from a biomedical paradigm to a social ecological approach, focusing on health equity and social determinants of health, it has increasingly acknowledged the roles of culture and trauma in health outcomes. The field has responded by modifying some research practices, but continues to prioritize conventional methodologies—with few options designed to foreground trauma- and cultural-responsiveness. Unfortunately, to the extent that conventional approaches require health to be defined, communicated, or valued according to dominant norms, they risk perpetuating inequities. Health equity therefore requires the development of research methodologies that increase inclusivity and access, elicit …

Preventive Health Service Use Among Rural Women, Erika C. Ziller Phd, Jennifer D. Lenardson Mhs, Nathan Paluso Mph, Jaclyn Janis Bsn, Rn

Access / Insurance

Preventive health services and screenings are an important component in the continuum of care provided to individuals across all ages. Yet, research has shown that rural residents generally use fewer preventive health services and screenings. This study used the National Health Interview Survey to examine receipt of preventive health services (cholesterol check, fasting blood sugar test, mammogram, pap smear, and receipt of the HPV vaccine) by rural and urban women over the age of 18. Findings indicate that rural women were less likely than their urban peers to receive preventive health services, and that some of the differences may be …

Be Your Best S.E.L.F., Rachel Wood, Casey Hasenbein

Senior Theses

The goal of our thesis was to use our knowledge as Exercise Science students and personal trainers to improve the health of an underserved population in South Carolina. We created a voluntary exercise and self-defense program for the girls residing at Epworth Children’s Home. The program began on October 1, 2018 and concluded on April 29, 2019 with data collecting taking place between October 8th and March 18th. Every other week SASS Defense taught their self-defense program, and on the alternating weeks we facilitated an exercise class. The program also included a mentorship aspect to create a supportive social environment …

Cancer Management In Kenya - Awareness And The Struggles Patients Face To Access Treatment, Care & Support, Ashley Nmoh

Independent Study Project (ISP) Collection

The amount of cancer cases in Africa, and Kenya specifically, are rising at an alarming rate. This study was conducted to determine the challenges that patients with cancer in Kenya face to access treatment, care and support. Thirty-nine cancer patients were interviewed and thirty cancer patients filled out a questionnaire about their experiences of having cancer in Kenya. In addition, twenty key informants were interviewed including doctors, caregivers, cancer NGO executives, a researcher, a psychologist, a National Health Insurance Fund official and a director from the Ministry of Health. A breast cancer awareness survey was also administered to fifty-nine women …

Are Family Planning Vouchers Effective In Increasing Use, Improving Equity And Reaching The Underserved? An Evaluation Of A Voucher Program In Pakistan, Moazzam Ali, Syed Khurram Azmat, Hasan Bin Hamza, Md Mizanur Rahman, Waqas Hameed

Community Health Sciences

Background: Low modern contraceptive prevalence rate and high unmet need in Pakistan aggravates the vulnerabilities of unintended pregnancies and births contributing to maternal morbidity and mortality. This research aims to assess the effectiveness of a free, single-purpose voucher approach in increasing the uptake, use and better targeting of modern contraceptives among women from the lowest two wealth quintiles in rural and urban communities of Punjab province, Pakistan.
Methods: A quasi-interventional study with pre- and post-phases was implemented across an intervention (Chakwal) and a control district (Bhakkar) in Punjab province (August 2012-January 2015). To detect a 15% increase in modern contraceptive …

Built Food Environment And Perinatal Depression: An Integrative Literature Review, Rachel N. Mileski

Grace Peterson Nursing Research Colloquium

Background: Built food environment contributes to food access and insecurity, which impactsmaternal health due to increased rates of perinatal depression.

Objectives: The purpose of this integrative literature review will be to (1) identify contributing factors of built food environments in communities that increase the rate of perinatal depression and (2) evaluate the current intervention programs and methods addressing these factors in order to provide recommendations for further research.

Method: An integrative literature review will be used, in accordance with the Ecological Model, to evaluate contributing factors and suggestions.

Results: Findings from this integrative literature review revealed a link that connects …

Factors Associated With Anemia Among Women Of The Reproductive Age Group In Thatta District: Study Protocol, Sumera Aziz Ali, Zahid Abbasi, Anam Feroz, K Michael Hambidge, Nancy F. Krebs, Jamie E. Westcott, Sarah Saleem

Community Health Sciences

Background: Maternal anemia is a leading public health issue placing pregnant women at higher risk of low birth weight, preterm birth, perinatal mortality, and neonatal mortality. Women in developing countries are at higher risk of anemia which could be either due to micronutrient deficiencies, hemoglobinopathies, infections or other socio-demographic factors. Thus, it is highly essential to explore the factors of anemia among women of the reproductive age group in order to design suitable interventions. The primary objective of this study is to assess the biological and socio-demographic factors that are associated with anemia among the women of the reproductive age …

Evaluating Quality Of Contraceptive Counseling: An Analysis Of The Method Information Index, Karen T. Chang, Mulenga Mukanu, Ben Bellows, Waqas Hameed, Amanda M. Kalamar, Karen A. Grépin, Xaher Gul, Nirali M. Chakraborty

Community Health Sciences

The Method Information Index (MII) is calculated from contraceptive users' responses to questions regarding counseling content-whether they were informed about methods other than the one they received, told about method-specific side effects, and advised what to do if they experienced side effects. The MII is increasingly reported in national surveys and used to track program performance, but little is known about its properties. Using additional questions, we assessed the consistency between responses and the method received in a prospective, multicountry study. We employed two definitions of consistency: (1) presence of any concordant response, and (2) absence of discordant responses. Consistency …

Betrayed Partners And Men With Poisoned Souls: Interview With A Former Sex Buyer In Germany, Ingeborg Kraus

Dignity: A Journal of Analysis of Exploitation and Violence

No abstract provided.

Intimate Partner Violence Among Expectant Adolescent Couples: Psychological And Relational Predictors And Sexual Risk, Jessica Lewis

Dissertations, Theses, and Capstone Projects

BACKGROUND/PURPOSE: Intimate partner violence (IPV) is prevalent and tends to be bilateral in adolescent relationships. Expectant adolescent couples are at even higher risk. Using the Actor-Partner Interdependence Model (APIM), this study sought to: (1) describe the patterns of physical/sexual and psychological IPV victimization of women and men in expectant adolescent couples from pregnancy through twelve months postpartum; (2) examine the associations between psychosocial and relational factors during pregnancy and postpartum IPV; and (3) investigate the relationship between IPV victimization and later sexual risk across the perinatal period.

METHODS: Data were collected from pregnant adolescents and their male partners (N=296) recruited …

Health Systems Changes After Decentralisation: Progress, Challenges And Dynamics In Pakistan, Shehla Zaidi, Maryam Bigdeli, Etienne V. Langlois, Atif Riaz, David W. Orr, Nasir Idrees, Jesse B. Bump

Community Health Sciences

Decentralisation is widely practised but its scrutiny tends to focus on structural and authority changes or outcomes. Politics and process of devolution implementation needs to be better understood to evaluate how national governments use the enhanced decision space for bringing improvements in the health system and the underlying challenges faced. We use the example of Pakistan's radical, politically driven provincial devolution to analyse how national structures use decentralisation opportunities for improved health planning, spending and carrying out transformations to the health system. Our narrative draws on secondary data sources from the PRIMASYS study, supplemented with policy roundtable notes from Pakistan. …