Women's Health Commons^™

The Impact Of Period Poverty On Low-Income Adolescents In The United States, Makayla Olson

University Honors Theses

Period poverty is an issue that impacts menstruators globally. This creates a significant health disparity for menstruators, including difficulties accessing menstrual products, inadequate menstrual and puberty health education, and shame and stigma that come from societal misunderstandings and misinformation regarding menstruation. This paper examines the effects of period poverty on low-income adolescents in the United States. It looks at the current literature that addresses how the financial and accessibility barriers that cause period poverty, as well as how these causes impact school-aged menstruators. It aims to address the role that schools play in creating safe environments for menstruators, including staff …

Determinants Of Modern Contraceptive Use Among Young Women In Ghana: A Mixed-Methods Study Design, Adjoa N. Manu

OHSU-PSU School of Public Health Annual Conference

Background: Only 20% of sexually active women aged 15-24 in Ghana used contraception during their last sexual intercourse. Young women are highly exposed to the risks associated with having unprotected sexual intercourse, such as unintended pregnancy and sexually transmitted infections.

Objective: To use an explanatory sequential mixed-methods design to examine the determinants of modern contraceptive use among young women in Ghana using population-based data and identify the types of contraceptive methods the population know and use.

QUAN Design: Analysis of the 2017 Ghana Maternal Health Survey data, a nationally representative cross-sectional survey.

QUAN Findings: The male …

Effects Of Hormone Replacement Therapy (Hrt) On Gene Expression In The Amyloid Processing Pathway Of Ovariectomized Rhesus Macaque Females Under An Obesogenic Diet, Megan Ball

University Honors Theses

Estrogens rapidly decline at the onset of menopause, putting women at higher risk of osteoporosis, obesity, and neurodegenerative diseases, including Alzheimer’s disease (AD). Estradiol hormone therapies (HT) have been suggested to limit these negative effects on women, with controversial findings as to their effectiveness. A study at OHSU recently found differentially expressed genes (DEGs) using RNAseq between ovariectomized/hysterectomized (OvH) old (range = 19.4–23.2 years) female rhesus macaques on HT and those on a placebo on chronic western style diet (WSD). The DEGs identified in the amyloid processing pathway of the amygdala were selected for validation using RT-qPCR because β-amyloid peptide …

The Relationship Between Regulation And Care Access In The Doula Industry, Charissa Billings

University Honors Theses

Birth doulas are unregulated service providers in the United States, who provide informational, emotional, and physical support before, during, and after birth. Currently, the United States has the highest maternal mortality rate amongst the most developed nations, as well as a serious racial gap, with Black women being twice as likely to die due to pregnancy-related complications when compared to White women. Birth doulas can help close the gaps with trained support and advocacy. Since over 40% of the births in the US are covered by Medicaid, providing birth doula services to Medicaid recipients could result in improved birth outcomes. …

A Hidden Crisis During Covid-19: How Have Intimate Partner Violence Screening Guidelines For Pregnant Patients Changed Since The Start Of The Global Covid-19 Pandemic?, Zayba Afshar

University Honors Theses

Introduction: Due to the risks of pregnancy outcomes in relation to IPV and the increased rates of IPV as a result of COVID-19 precautions, health care screening for IPV in the prenatal process is even more imperative for preventing negative healthcare outcomes for both the pregnant patient and children.

Background: Intimate partner violence (IPV) is a significant public health issue that puts both baby and pregnant patients at risk for severe negative healthcare outcomes. Healthcare screening is a tool to find a condition or to learn more about a patient before symptoms become severe.

Methods: Screening for …

Provider Perspectives On Persistent Urinary Incontinence Following Obstetric Fistula Repair In Ethiopia, Laura E. Jacobson, Melaku Abriha Marye, Elena Phoutrides, Rahel Nardos

OHSU-PSU School of Public Health Faculty Publications and Presentations

Each year an estimated 50,000 to 100,000 women worldwide are affected by obstetric fistula. This devastating but preventable maternal morbidity leaves women incontinent, stigmatized, isolated, and often with a still birth. While fistula rates in Ethiopia have declined in recent years, estimates range from 7 to 40 percent of women suffer from persistent urinary incontinence after successful closure of their fistula. Few studies have focused on the unique experiences and challenges that providers face treating fistula patients, particularly those who experience persistent urinary incontinence. The goal of this research is to characterize the fistula provider's accounts of how to manage, …

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 …

Mujeres Fuertes Y Corazones Saludables: Adaptation Of The Strongwomen—Healthy Hearts (Swhh) Program For Rural Latinas Using An Intervention Mapping Approach, Christie L. Jackson, Cynthia K. Perry, Jean Mccalmont, Emma Solanki, Rebecca Seguin, Judy P. Ward, Hannah-Dulya K. Menelas

Student Research Symposium

Objectives: To adapt Strong Women, Healthy Hearts (SWHH), an evidence-based physical activity and nutrition program to reflect the needs of rural Latinas.

Methods: Using a community-based participatory approach and an intervention mapping process, we partnered with a community advisory board of rural Latinas to identify and adapt a nutrition and physical activity program. A needs assessment and a logic model determined which program best aligned with community objectives and most fit for adaptation. SWHH was adapted; using feedback from the community advisory board to reflect the community’s culture, resources, and needs. We collaborated with one of developers of SWHH in …

Factors Associated With Sexual Dysfunction In Taiwanese Females With Rheumatoid Arthritis, Miao-Chiu Lin, Ming-Chi Lu, Hanoch Livneh, Ning-Sheng Lai, How-Ran Guo, Tzung-Yi Tsai

Counselor Education Faculty Publications and Presentations

Background: Patients with rheumatoid arthritis (RA) may experience sexual dysfunction because of symptoms or adverse effects from treatments. Data on female sexual dysfunction (FSD) in Asian females with RA issue are limited. This study investigated the prevalence and factors associated with FSD in Taiwanese patients with RA.

Methods: This cross-sectional study used a purposive sampling method to recruit 195 females with RA from a single hospital in southern Taiwan. Demographic and clinical characteristics were obtained by review of medical records and a structured questionnaire. The Chinese version of the Female Sexual Function Index and the Taiwanese Depression Questionnaire were …

Racial And Ethnic Disparities In Desire For Reversal Of Sterilization Among U.S. Women, Ginny Garcia-Alexander, Kelly Gonzales, Elizabeth Carol Hauck

Sociology Faculty Publications and Presentations

Purpose: Female sterilization rates and subsequent desire for reversal of the procedure are substantially higher in minorities, low-income women, and those who use public insurance. Despite the disproportionate distribution of these outcomes, few studies in this area have considered the extent to which such disparities are attributable to a restricted set of contraceptive options among medically underserved populations, which may in turn explain higher rates of desire for reversal. Methods: We use the most recent wave of NSFG data (2011-2013) to estimate odds ratios for race/ethnicity on the likelihood of desire for reversal of sterilization, while controlling for an array …

Dietary Fat Intake And Reproductive Hormone Concentrations And Ovulation In Regularly Menstruating Women, Sunni L. Mumford, Jorge E. Chavarro, Cuilin Zhang, Neil J. Perkins, Lindsey A. Sjaarda, Anna Z. Pollack, Karen C. Schliep, Kara A. Michels, Shvetha M. Zarek, Torie C. Plowden, Rose G. Radin, Lynne C. Messer, Robyn A. Frankel, Jean Wactawski-Wende

Community Health Faculty Publications and Presentations

Background: Emerging evidence suggests potential links between some dietary fatty acids and improved fertility, because specific fatty acids may affect prostaglandin synthesis and steroidogenesis.

Objective: The objective of this exploratory study was to evaluate associations between total and specific types of dietary fat intake and 1) hormone concentrations and 2) the risk of sporadic anovulation in a cohort of 259 regularly menstruating women in the BioCycle Study.

Design: Endogenous reproductive hormones were measured up to 8 times/cycle for up to 2 cycles, with visits scheduled with the use of fertility monitors. Dietary intake was assessed with up to …

Exploring The Impact Of An Ld Diagnosis On The Self-Determination Of Women In Poverty, Cynthia Jakes Stadel

Dissertations and Theses

This collective case study explored the impact of a later-in-life learning disability (LD) diagnosis on women in poverty. The study focused on the perspectives of four women who were not identified with LD as children but accessed assessment services as adults receiving Oregon's Temporary Assistance for Needy Families (TANF). All four reported painful awareness of learning differences as youths; as adults they voluntarily engaged in a "labeling event," furthering a process toward personal transformation and enhanced well-being initiated by their own awareness and curiosity. The women described critical social and emotional support systems and relationships that helped them integrate understanding …

Trauma-Informed Research And Planning: Understanding Government And Urban Native Community Partnerships To Addressing Substance-Exposed Pregnancies In Portland, Or, Amanda Mercier

Dissertations and Theses

In 2011, representatives from the Multnomah County Health Departments and several Native-serving organizations came together to address substance-exposed pregnancies among urban Native Americans in Portland, Oregon. From these partnerships, the Future Generations Collaborative was formed representing a significant shift toward community-led maternal child health research and planning. Additionally, the Future Generations Collaborative adopted a historical trauma-informed community based participatory research and planning process. This is particularly significant considering government agencies' role in colonization within Native communities. The purpose of this case study is to explore partnerships between government agencies and the Portland Native community within the Future Generations Collaborative. Given …

Patients’ Perception Of Patient–Provider Communication In Fertility Preservation Decision Making Among Young Women With Cancer, Aakrati Mathur, E. Roberto Orellana, Amy Frohnmayer, Pauline Jivanjee, Lillian Nail, Brandon Hayes-Lattin, Rebecca G. Block

School of Social Work Faculty Publications and Presentations

Fertility preservation (FP) for patients with cancer is an emerging field. With the advancement of technology, patients may face a complex decision-making process about whether to preserve fertility. The purpose of this article is to explore how young women with cancer perceive patient–provider communication in FP decision making. In this study, 25 women between the ages of 18 and 39 were interviewed retrospectively. They were interviewed one time to learn about their decision-making process related to FP. Results of this analysis indicate that patients seek support and involvement from providers throughout the process of decision making. They prefer providers to …

Perceived Experiences Of Discrimination In Health Care: A Barrier For Cancer Screening Among American Indian Women With Type 2 Diabetes, Kelly Gonzales, Anna K. Harding, William E. Lambert, Rongwei Fu, William G. Henderson

OHSU-PSU School of Public Health Faculty Publications and Presentations

Purpose - Breast and cervical cancer-mortality disparities are prominent among American Indian women. These disparities, in part, may result from patients perceived experiences of discrimination in health care. This report evaluates the impact of perceived discrimination on screening for breast and cervical cancer in a sample of 200 American Indian women with type 2 diabetes.

Methods - Data were collected from patient report and medical records. Prevalence of breast and cervical cancer screening were assessed. Unadjusted and adjusted logistic regression analyses were used to assess associations between perceived discrimination, cancer screening status, and patients' health care-seeking behaviors.

Findings - Substantial …

Oral Health Knowledge, Attitudes, And Behaviors: Investigation Of An Educational Intervention Strategy With At-Risk Females, Susan Romano Rustvold

Dissertations and Theses

A self-perpetuating cycle of poor health literacy and poor oral health knowledge and behavior affects approximately 90 million people in the United States, most especially those from low-income groups and other at-risk populations such as those with addiction. Poor oral health can result from lack of access to regular preventive dental appointments, lack of access to restorative care when dental diseases are treatable, and low oral health knowledge that leads to poor oral health self-care behaviors. In addition, patients' dental anxiety can impede care, because highly anxious people often avoid dental appointments. To address these issues, this inquiry examined oral …

Anticipated Effects Of The U.S. Mexico City Policy On The Attainability Of The Millennium Development Goals And Future Development Efforts In Sub-Saharan Africa, Katherine Clare Alexander

Anthós

In the low-income countries of sub-Saharan Africa, the performance of pyramidal reproductive health and family planning services with public outreach initiatives has not met the expectations or the needs of the communities they serve. Insufficient case management, limited management capacity and referral and communication failures are challenges faced on the delivery level, while on the policy level these health clinics face insufficient coordination among organizations and weak links between programs (Schneider, 2006). The Mexico City Policy, first introduced by President Reagan in 1984, only exacerbated these challenges for organizations that offer comprehensive contraception and family planning programs by denying any …

Pregnancy Outcomes: A Study Testing A Model For Predicting Health Outcomes In Pregnancy, Tamera Ann Hart-Johnson

Dissertations and Theses

There is a persistent relationship between socioeconomic status and physical health outcomes found in the literature; however the variables mediating this relationship are many, and ways that they interact with each other are complex. The goal of understanding this relationship is to decrease the disparity in health by socioeconomic status.

This study tested a biopsychosocial model proposed by David Williams (1990) to explain the relationship between socioeconomic status and physical health outcomes. The model included the following latent factors: demographics, socioeconomic status, biomedical risk, medical care, psychosocial variables, and health outcomes. The model was tested through a secondary data analysis. …

The Development And Effects Of An Educational Audiovisual Presentation On Female Masturbation Upon The Attitudes And Masturbatory Behavior Of College Females, Catherine Ann Hogan

Dissertations and Theses

The current study was designed: (1) to develop an educational tool on female masturbation capable of reaching a wide audience of women with accurate and complete information on female masturbation; (2) to provide initial validation for the further educational usefulness of this tool and (3) to assess its potential ability for improving overall sexual functioning in women by possibly altering negative attitudes toward masturbation and/or by dis-inhibiting masturbatory behavior.

A Descriptive Study Of The Relationship Between Age And Problems Expressed By Women Seeking Out-Patient Mental Health Services, Linda M. Rodgers, Joyce Carey

Dissertations and Theses

The purpose of this study is to provide a descriptive analysis of the problems presented by a specific group of women seeking out-patient mental health treatment and to relate these problems to the ontogenetic (age-related) developmental issues presented in a study of the literature. The researcher's involvement in this area developed from interest in current literature on adult development, and a personal commitment to life-long growth and acceptance of the inherent changes. In order to investigate whether developmental issues exist for this group of women, and if so to describe them, two distinct age groups--the decades of the 20's and …

Moving Toward Integration: A Study Of Theory And Practice In Feminist Therapy, Susan Amelia Thomas

Dissertations and Theses

This thesis describes a study designed to explore the emerging field of feminist therapy. The goal was not to test the validity of feminist therapy, to probe the assumptions on which it is based, or to compare it to other forms of therapy but to characterize the theory and practice of feminist therapy as it now exists. Feminist therapy was seen as growing out of the cultural and historical context of the feminist movement, which includes a critique of society with emphasis on the particular psychological consequences for women, and a critique of psychotherapy, particularly Freudian psychotherapy, as oppressive to …

Marital Status As A Discriminator And Treatment Variable Among Female Alcoholics, James C. Knapp

Dissertations and Theses

In this study marital status and the alcoholism or non-alcoholism of the spouse are hypothesized to be important factors affecting the female alcoholic's personality and treatability.