Women's Health Commons^™

Beyond Symptoms: Examining Perinatal Mental Health Care Among Black, Indigenous And People Of Color With Polyendocrine Metabolic Ovarian Syndrome, Vinaya Thomas

Electronic Theses and Dissertations

Perinatal mood and anxiety disorders (PMADs) are as a public health concern in the United States. Individuals from minoritized racial/ethnic groups face a significantly elevated risk of maternal morbidity, mortality, mental health disorders, and associated adverse outcomes. Emerging studies also reveal a higher likelihood of experiencing perinatal mental health concerns in individuals with polycystic ovarian syndrome (PCOS), currently known as polyendocrine metabolic ovarian syndrome (PMOS). People who identify as Black, Indigenous, or a person of color (BIPOC) face unique healthcare challenges given the added structural and social burdens. This online survey study aimed to 1) understand the relationship between PMOS …

Beyond Opioids: The Role Of Polysubstance Exposure In Neonatal Abstinence Syndrome Treatment And Hospitalization, Caelyn Harrison

Undergraduate Honors Theses

This thesis explores the impact of prenatal polysubstance exposure, specifically focusing on the need for pharmacological treatment for Neonatal Abstinence Syndrome (NAS) and the duration of their hospital stay. A retrospective analysis of 462 infants, including 121 exposed to polysubstances during pregnancy, showed significant associations between polysubstance exposure and adverse neonatal outcomes. Infants with prenatal polysubstance exposure were more likely to require pharmacological treatment for NAS (52.8%) compared to non-exposed infants (38.7%), as determined by chi-square analysis (χ²(1, N = 462) = 7.36, p = .007). Additionally, infants exposed to polysubstances experienced longer hospital stays on average (M = 14.88 …

Enriching The Pcos Lifestyle, Callie Coleman

Electronic Theses and Dissertations

Polycystic Ovary Syndrome (PCOS) is an endocrine disorder affecting approximately 4 – 20% of women worldwide. It is associated with insulin resistance, fertility problems, and an increased susceptibility to chronic conditions through multiple inflammatory pathways. Women with PCOS are also at increased risk for disordered eating. The Mediterranean diet is associated with decreased inflammation and risk of chronic conditions, and intuitive eating principles are associated with decreased disordered eating patterns. The purpose of this study was to determine if a six-week nutrition education workshop incorporating information and skills related to both the Mediterranean lifestyle and intuitive eating principles can improve …

Influence Of Medication Assisted Treatment Weaning On Neonatal Abstinence Syndrome And Outcomes Among Infants Born To Women With Opioid Use Disorder, Rakesh Adelli

Electronic Theses and Dissertations

Neonatal abstinence syndrome (NAS) is a drug withdrawal syndrome exhibited by infants born to mothers with opioid use disorder (OUD). The American College of Obstetricians and Gynecologists and other professional societies endorse opioid agonist pharmacotherapy (MATs) as the optimal treatment for OUD during pregnancy. This study focuses on impact of weaning of MAT drugs on the incidence of NAS and neonatal birth outcomes among babies born to women with opioid exposure.

The study population included eighty-six pregnant women with OUD, divided in to weaning and non-weaning groups based on their choice to wean the MATs during pregnancy. Univariate analysis was …

The Association Between Prenatal Care And Postpartum Depression: Current State And Future Directions, Esther Adebayo-Abikoye

Electronic Theses and Dissertations

Background

Postpartum depression (PPD) is a major public health challenge and associated with poor maternal and infant health outcomes. Quality prenatal care decreases adverse outcomes in pregnancy and may reduce PPD risk factors. This study critically reviews the evidence about the role of prenatal care practices in reducing PPD prevalence across population groups and examines the association between prenatal care timing and counseling content with PPD prevalence.

Methods

A scoping review was completed across eight databases to synthesize evidence about prenatal care and PPD across different contextual settings. National data from the Pregnancy Risk Assessment Monitoring System (PRAMS) was used …

Cost Saving And Resource Limited Public Health Interventions In Southeast Asia, Amanda Blackwelder

Electronic Theses and Dissertations

Background: Public health interventions are any activity with the objective of improving human health such as preventing or curing disease, reducing the severity or duration of a disease, or assisting in regaining function after a disease or injury. These interventions are known to be impactful; however, those living with the highest burden of disease such as individuals in low- and middle-income countries have limited money and resources to successfully implement these interventions. Southeast Asian countries are among some of the middle-income countries effected by the lack of affordable interventions. The aims of this study were to assess cost saving and …

Enhancing Rural Capacity For Contraceptive Provision Through Training, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Resources

No abstract provided.

Capacity-Building Among Safety-Net Family Planning Clinics During The Choose Well Initiative In South Carolina, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Issue Briefs

The aim of this study was to examine perceptions of Health Department and Federally Qualified Health Care clinic- and system-level staff regarding the impact of Choose Well-provided trainings on clinic organizational resources and clinic scope of services.

Contextual Evidence For Title X Services Within The United States South, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Issue Briefs

The purpose of this Policy Brief is to provide comprehensive contextual evidence for Title X services given the historical context and current policy landscape surrounding contraceptive care and access to services, particularly in the United States South.

Improving Adolescent Contraceptive Care In The South: Policy Brief, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Issue Briefs

Youth-friendly, person-centered contraceptive care (YFPCCC) improves the quality of care that youth receive. Research shows that clinic characteristics that support youth-friendly, person-centered care,like confidentiality and consent policies and trained providers, contribute to high quality contraceptive care for youth. As such, establishing or strengthening clinic policies requiring training and confidentiality will support a clinic’s capacity to provide YFPCCC. Understanding Southern safety-net clinics’ characteristics supporting YFPCCC and Southern youths’ perceptions of their care can highlight areas where policies may need to be established or strengthened.

Choose Well: Summary Of Mid-Point Evaluation Findings, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Reports

This report summarizes key findings related to the evaluation of the Choose Well Initiative at the mid-point. Results are not complete but provide a brief summary of key findings and evidence to date.

Impact Of Training For Contraceptive Provision At Title X Clinics: Evidence From South Carolina - October 2022, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Issue Briefs

Choose Well (CW), an ongoing statewide contraceptive access initiative in South Carolina, was launched in 2017 and aimed to implement contraceptive care best practices via training and funding for contraceptive methods. As part of the initiative, clinics within the South Carolina Health Department (DHEC clinics), which is the state’s Title X agency, received trainings in the areas of administrative support, contraceptive counseling, and device placement and removal, in addition to funding for contraceptive devices. Title X Family Planning program is a federal program that provides reproductive health services for low-income patients through a network of safety–net clinics. While Title X …

When The Costs Outweigh The Benefits: Examining Variations In Nulliparous, Term, Singleton, Vertex And Elective Cesarean Delivery Rates Across The United States, 2016-2020, Kathleen Tatro

Electronic Theses and Dissertations

The overutilization of cesarean deliveries is a major public health issue in the United States (U.S.). The rates of cesarean deliveries have increased substantially from the mid 1990s. Low-risk, defined as nulliparous, term, singleton, vertex (NTSV) pregnancies with no medical indication of need, and elective cesarean deliveries have been implicated as drivers of these increases. Elective cesarean deliveries are NTSV cesarean deliveries in which no trial of labor was attempted. There is a lack of clear rationale as to the noted increases in cesarean delivery rates as the evidence shows that these procedures provide no additional health benefits to mothers …

Evaluating The Effectiveness Of Restorative Justice Rehabilitative Services Available In Northeast Tennessee For Mothers Diagnosed With Substance Use Disorder, Claire Roberson

Undergraduate Honors Theses

Substance Use Disorder (SUD) has plagued families of rural Appalachia for many years, perpetuating involvement in the criminal justice system as well as generational trauma for people diagnosed with SUD and their children. This points to the necessity of a trauma-informed, restorative-justice based framework for rehabilitative services to most effectively heal families, address trauma, and re-integrate people diagnosed with SUD into society. A restorative justice-based program would provide health care services for addiction and any comorbid mental health disorders as well as teach parents how to properly provide for themselves and their families, manage finances, obtain employment, and further education. …

Tennessee Abortion Policy Summary - May 2022, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Issue Briefs

With the U.S. Supreme Court anticipated to overturn the 1973 Roe v. Wade decision (and the modifications to that decision by Planned Parenthood of Southeastern Pennsylvania v. Casey from 1992), the protection, regulation, or prohibition of abortion would likely default to state laws and state constitutions. Therefore, to understand how this upcoming Supreme Court decision could impact access to abortion in Tennessee, it is useful to examine both key current state laws in effect related to abortion access, as well as the current state of access to abortion in Tennessee. This brief intends only to summarize current Tennessee state laws …

Perceptions, Knowledge, And Attitudes About Long-Acting Reversible Contraceptives (Larcs) Among Women In Appalachian Tennessee, Fenose Osedeme

Electronic Theses and Dissertations

In Tennessee (TN), the rate of unintended pregnancies remains higher than the national rate (32.4% vs. 30.3%). Although long-acting reversible contraceptives (LARCs) are 99% effective in preventing undesired pregnancies; uptake remains low in rural and underserved communities. Previous research has provided some insight into women’s perceptions of LARCs; however, those guided by conceptual frameworks to understand the multiple influences that impact perceptions towards LARCs, especially among rural regions, are scarce. This multimethod qualitative study explored multiple influences that impact northeast Tennessee women’s perceptions and attitudes toward LARCs using the Socio-ecological Model (SEM) as a guiding framework.

The study comprised six …

The Effects Of Exercise And Nursing Care On Postpartum Depression, Greyson Whaley

Epsilon Sigma at-Large Research Conference

Abstract

Introduction and Background: According to the Centers for Disease Control and Prevention (2020), “postpartum depression is depression that occurs after having a baby which is more intense and lasts longer than those of “baby blues,” a term used to describe the worry, sadness, and tiredness many women experience after having a baby.” It also states, “1 in 8 women report symptoms of depression after giving birth, about 1 in 5 (20%) women were not asked about depression during a prenatal visit, and over half (50%) of pregnant women with depression were not treated.”

Purpose Statement: The purpose of this …

Telehealth For Contraceptive Counseling During The Covid-19 Pandemic Among Federally Qualified Health Centers, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Issue Briefs

During the COVID-19 pandemic, one in three women delayed contraceptive care or had difficulty obtaining contraception. To improve access, reimbursement and HIPAA policies were relaxed to facilitate implementation of telehealth services across the health care system nationally. Federally Qualified Health Centers (FQHCs) are part of the nation's health care safety-net and provide contraceptive care services to underserved patient populations. As such, it is important to study access to services at these clinics, particularly at the onset of the COVID-19 pandemic. This study aimed to examine telehealth service provision for contraceptive services at rural and urban FQHC clinics in South Carolina …

Contraceptive Counseling During The Covid-19 Pandemic (2020) At Choose Well Participating Clinical Partners In South Carolina, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Issue Briefs

In January-August 2021, staff at Choose Well participating clinical partners were asked about their experiences with Choose Well in 2020, including perceptions about access to contraceptive counseling and facilitators and barriers to contraceptive counseling. Interviews were conducted over the phone, audio recorded with permission, and transcribed. The aim of this issue brief is to examine access to contraceptive counseling across three sectors, hospitals, health departments, and Federally Qualified Health Centers (FQHCs), that provided contraceptive counseling and partnered with Choose Well during the COVID-19 pandemic (2020). Findings from each sectors’ perceptions of contraceptive counseling are presented.

Scope Of Provision And Practice: How Policy Changes Increased Iud Provision At Alabama Department Of Public Health Clinics From 2016 To 2019, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Issue Briefs

Over 300,000 low-income women in Alabama live in a contraceptive desert (counties where a full range of contraceptive methods is not readily accessible to patients). In 2019, Alabama introduced funding of a full range of contraceptive methods (long-acting, short-acting, and barrier methods) via Title X funding to family planning health department (HD) clinics. The goal is for this implementation to be statewide, though clinics may have different resources for facilitation. This policy change required no additional funding, just new permissions for nurse practitioners (NPs) and reallocation of Title X funds.

Workforce Capacity At Fqhc Clinics In South Carolina During The Choose Well Contraceptive Access Initiative, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Issue Briefs

In the initial two years of the Choose Well initiative, partnered South Carolina Federally Qualified Health Center (FQHC) clinics reported that efforts directed toward expanding workforce capacity positively impacted contraceptive service provision and patient access. We conducted key informant interviews with FQHC clinical and administrative staff (N= 45) to assess progress in achieving this aim during the first two years of program implementation (2017 and 2018). Several respondents highlighted how funding to expand clinic workforce directly increased capacity for contraceptive provision. Other key findings supporting contraceptive provision noted that funding allowed enhanced hiring practices due to expanded service lines, increased …

Covid-19 Impact On Contraceptive & Clinic Services At Health Departments & Federally Qualified Health Centers In South Carolina, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Resources

No abstract provided.

Facilitator Of Contraceptive Access At Fqhc Clinics In South Carolina During The Choose Well Initiative, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Issue Briefs

The Choose Well initiative aims to improve contraceptive access at partnered Federally Qualified Health Centers (FQHCs) in South Carolina. We conducted key informant interviews with FQHC clinical and administrative staff (N= 45) to assess progress in achieving this aim during the first two years of program implementation (2017 and 2018). The interviews were recorded, transcribed and analyzed for emerging themes. Respondents highlighted facilitators of contraceptive access during Choose Well including: enhanced contraceptive counseling, funding for implants and IUDs, the availability of same-day implant and IUD placement procedures, and increased patients enrolling in Medicaid.

Covid-19 Impact On Contraceptive & Clinic Services At Health Departments & Federally Qualified Health Centers In Alabama, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Resources

No abstract provided.

Early Impact Of The Covid-19 Pandemic On Contraceptive Services In South Carolina And Alabama, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Issue Briefs

The COVID-19 pandemic has significantly affected access to and the delivery of health care services, including contraceptive service2s. Despite the need for adequate and timely pandemic response, maintaining the safe and effective delivery of contraceptive services remains essential. This issue brief highlights findings from interviews conducted with 45 staff and providers at Federally Qualified Health Centers (FQHCs) and Health Department clinics, in South Carolina and Alabama, to assess the impact of the COVID-19 pandemic on contraceptive services in their clinics. The brief focuses on the following indicators: Overall Patient Volume, Contraceptive Care Patient Volume, Contraceptive Service Provision, Staffing Capacity, Medical …

Publicly Funded Contraceptive Care Services In Alabama (2017), Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Reports

State-wide clinic survey findings from Federally Qualified Health Center (FQHC) and Alabama Department of Public Health (ADPH) family planning clinics in Alabama. Findings include: contraceptive patient characteristics, contraceptive method provision, clinic policies and practices, and other markers of contraceptive care.

Publicly Funded Contraceptive Care Services In South Carolina (2017), Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Reports

State-wide clinic survey findings from Federally Qualified Health Center and Department of Health and Environmental Control family planning clinics in South Carolina. Findings include: contraceptive patient characteristics, contraceptive method provision, clinic policies and practices, and other markers of contraceptive care.

A Mixed-Methods Analysis Of Abortion Attitudes And Perceptions Among Women Living In Alabama And South Carolina, Anthony Peluso

Electronic Theses and Dissertations

Legal induced abortion is a safe option for terminating a pregnancy for women of reproductive age in the United States (U.S.), though access has varied since the Roe v. Wade and Doe v. Bolton cases in 1973. Information is lacking on women’s attitudes toward and perceptions of abortion as well as on related constructs such as pregnancy attitudes and contraceptive use. Exploring these constructs is important in that it can provide much needed context to women’s reproductive life planning. This research aimed to explore perceptions of abortion access and safety and examine the potential associations between attitudes toward abortion access …

Contraceptive Care In Alabama At Publicly Funded Family Planning Clinics, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Resources

No abstract provided.

Contraceptive Care In South Carolina At Publicly Funded Family Planning Clinics, Center For Applied Reasearch And Evaluation In Women's Health, East Tennessee State University

Center for Applied Research and Evaluation (CARE) in Women's Health Resources

No abstract provided.