Women's Health Commons^™

Cbpr And A Multitrack Model Of Development: A Critical Ethnography Of A Community-Based Health Communication Project., Jeanette Dillon, Kate Magsamen-Conrad

Kate Magsamen-Conrad

Scholars in development communication have called for a more participatory approach in development programs. However, the traditional, generally top-down approach associated with the modernization paradigm still dominates in practice [1]. The mere existence of participatory models has not been enough to move the participatory approach to prominence. Sparks has noticed the discrepancy between theory and practice observing that although the dominant paradigm has been disparaged and the participatory paradigm praised since the 1970s, researchers have been slow to adopt participatory methods [1]. This discrepancy may be because in practice, participation is difficult to manipulate, control, analyze and evaluate. We argue …

Abortion/Reproductive Rights, Sandra Klein

Sandra S. Klein

The issue of a woman's right to choose whether or not to continue with a pregnancy has proven to be complicated for many reasons, not the least of which is the implications for a person's right to do with her body as she sees fit. The bibliography that follows provides the researcher with an in depth look at this issue, with an emphasis on the privacy aspects.

Acute Effects Of Whole-Body Vibration On Lower Extremity Muscle Performance In Persons With Multiple Sclerosis, Kurt Jackson, Harold Merriman, Paul Vanderburgh, C. Brahler

C. Jayne Brahler

Background and Purpose: Whole-body vibration (WBV) is a relatively new form of exercise training that may influence muscle performance. This study investigated the acute effects of high (26 Hz) and low (2 Hz) frequency WBV on isometric muscle torque of the quadriceps and hamstrings in persons with multiple sclerosis (MS).

Participants and Method: Fifteen individuals (mean age = 54.6 years, SD = 9.6) with MS and Expanded Disability Status Scale (EDSS) scores ranging from 0-6.5 (mean = 4.2, SD = 2.3) participated in this randomized cross-over study. Following baseline measures of isometric quadricep and hamstring torque, subjects were exposed to …

Gender Differences In Motivation To Resolve Eating And Body Image Concerns In College Students, Harold Merriman, C. Brahler, Laura Dinan, Lauren Finzer

C. Jayne Brahler

The objective of this study was to identify similarities and differences between college women and men with respect to their eating and body image concerns, weight fluctuation and level of motivation to resolve these concerns. 101 University of Dayton students participated in this study. Students completed an eating and body concern survey online.

Body image concerns were significantly greater for females compared to males (p=0.007) and significantly greater as motivation level to resolve the concerns increased (p=0.019). Eating concerns followed the same trends but did not reach statistical significance. Weight fluctuation in both genders increased significantly as motivation level increased …

The Mind-Body Connection: The Association Between Adolescent Locus Of Control And Indicators Of Physical Health, C. Brahler, James Cropper

C. Jayne Brahler

Locus of control (LOC) describes an individual’s generalized beliefs or expectancies that their reinforcements are under internal versus external control (1). An individual exhibits either an internal or external LOC. This study examines the link between LOC and selected health risk factors in adolescents. A convenience sample of 167 high school physical education students completed a 13-item LOC questionnaire based on Rotter’s 1966 instrument. Various anthropometric measurements, blood pressure, body mass index (BMI), and body fat were recorded on all subjects. A subsample of 61 female students received blood chemistry analysis that included a lipid profile, hemoglobin A1c (HbA1c), Apo …

Numerous Test Items In The Complete And Short Forms Of The Bot-2 Do Not Contribute Substantially To Motor Performance Assessments In Typically Developing Children Six To Ten Years Old, C. Brahler, Betsy Donahoe-Fillmore, Sara Mrowzinski, Susan Aebker, Megan Kreill

C. Jayne Brahler

The purposes of the current study were (1) to determine the magnitude of association between individual subtest items and the respective total subtest scores on the four subtests in the Bruininks-Oseretsky Test of Motor Proficiency, second edition (BOT-2) and (2) to review items on the BOT-2 Short Form. The correlation coefficients (r) between ranged from .865 to .071. Several items suffered from a ceiling effect, and four of the eight items on the Short Form for these four subtests had very low associations with their subtest total score. These results raise several issues with the BOT-2 that warrant further investigation.

Evening Snacking In Relation To Self-Reported Declines In Sleep Quality During Pregnancy: Preliminary Results From The Decision-Making, Eating, And Weight Gain During Pregnancy (Dew) Study, Wendy Mccallum, Bradley M. Appelhans, Tiffany A. Moore Simas, Rui Sherry Xiao, Shums Alikhan, Isabelle C. Pierre-Louis, Barbara C. Olendzki, Sherry L. Pagoto, Molly E. Waring

Tiffany A. Moore Simas

Background: Poor sleep in non-pregnant adults has been associated with increased evening snacking, which may contribute to weight gain. Sleep disturbances are common during pregnancy.

Objective: To examine the association between changes in sleep quality from pre-pregnancy and evening snacking.

Methods: In an ongoing prospective cohort study, pregnant women were recruited from UMMHC obstetric practices and the community. Participants are 18+ years, with singleton gestation <36 >weeks, pre-pregnancy BMI 18.5-40 kg/m2, English-speaking, and with plans to deliver at UMMHC. Participants were asked “compared to the three months before you became pregnant, how is your sleep quality now?”; we combined responses of …

Assessment Of Breast Cancer Treatment Delay Impact On Prognosis And Survival: A Look At The Evidence From Systematic Analysis Of The Literature, Faustine Williams

Faustine Williams

Ideas For A Healthy Baby--Reducing Disparities In Use Of Publicly Reported Quality Data: Study Protocol For A Randomized Controlled Trial, Sarah L. Goff, Penelope S. Pekow, Katharine O. White, Tara Lagu, Kathleen M. Mazor, Peter K. Lindenauer

Sarah L. Goff MD

BACKGROUND: Publicly reported performance on quality measures is intended to enable patients to make more informed choices. Despite the growing availability of these reports, patients' use remains limited and disparities exist. Low health literacy and numeracy are two barriers that may contribute to these disparities. Patient navigators have helped patients overcome barriers such as these in other areas, such as cancer care and may prove useful for overcoming barriers to using publicly reported quality data. METHODS/DESIGN: The goals of this study are: to determine the efficacy of a patient navigator intervention to assist low-income pregnant women in the use of …

Proyecto Mama: A Lifestyle Intervention In Overweight And Obese Hispanic Women: A Randomised Controlled Trial--Study Protocol, Lisa Chasan-Taber, Bess H. Marcus, Milagros C. Rosal, Katherine L. Tucker, Sheri J. Hartman, Penelope S. Pekow, Edward J. Stanek Iii, Barry Braun, Caren G. Solomon, Joanne Manson, Sarah L. Goff, Glenn Markenson

Sarah L. Goff MD

BACKGROUND: The proportion of women entering pregnancy overweight or obese has been rising and, in turn, is associated with adverse maternal and fetal outcomes. Gestational weight gain (GWG) exceeding Institute of Medicine (IOM) guidelines further increases health risks and has been independently associated with postpartum weight retention. Hispanic women are disproportionately affected by overweight and obesity, but have had limited access to interventions that promote healthy lifestyles due to cultural, socioeconomic, and language barriers. Therefore, the overall goal of this randomized controlled trial is to test the efficacy of a culturally and linguistically modified, individually-tailored lifestyle intervention to reduce excess …

Rural-Urban Difference In Female Breast Cancer Diagnosis In Missouri, Faustine Williams, Stephen Jeanetta, David J. O'Brien, John L. Fresen

Faustine Williams

Understanding Multifactorial Influences On The Continuum Of Maternal Weight Trajectories In Pregnancy And Early Postpartum: Study Protocol, And Participant Baseline Characteristics, Tiffany A. Moore Simas, Silvia Corvera, Mary M. Lee, Ningning Zhang, Katherine Leung, Barbara C. Olendzki, Bruce A. Barton, Milagros C. Rosal

Mary M. Lee

BACKGROUND: Maternal and offspring immediate and long-term health are affected by pregnancy weight gain and maternal weight. This study was designed to determine feasibility of: 1) recruiting a socio-economically and racially/ethnically diverse sample of pregnant women into a longitudinal observational study, including consenting the women for serial biologic specimen evaluations; 2) implementing comprehensive assessments (including biologic, anthropometric, behavioral, cognitive/psychosocial and socio-demographic, and cultural measures) at multiple time points over the study period, including collecting biologic specimens at planned and unplanned pregnancy delivery times; and 3) retaining the sample for one year into the postpartum period. Additionally, the study will provide …

Sex Differences In Circumstances And Consequences Of Outdoor And Indoor Falls In Older Adults In The Mobilize Boston Cohort Study, Rachel Duckham, Elizabeth Procter-Gray, Marian T. Hannan, Suzanne G. Leveille, Lewis A. Lipsitz, Wenjun Li

Suzanne G. Leveille

BACKGROUND: Despite extensive research on risk factors associated with falling in older adults, and current fall prevention interventions focusing on modifiable risk factors, there is a lack of detailed accounts of sex differences in risk factors, circumstances and consequences of falls in the literature. We examined the circumstances, consequences and resulting injuries of indoor and outdoor falls according to sex in a population study of older adults.

METHODS: Men and women 65 years and older (N = 743) were followed for fall events from the Maintenance of Balance, Independent Living, Intellect, and Zest in the Elderly (MOBILIZE) Boston prospective cohort …

Concepts Of Health In Older Urban African American Women With Chronic Health Conditions: A Focus Group Study, Priscilla T. Ryder, Linda Ellis, Doshia Harris, Anita Ohmit, Kathleen M. Russell, Amber Scott

Priscilla T. Ryder

The purpose of this report is to relate the findings of the study ‘Concepts of Health in Older Urban African American Women with Chronic Health Conditions.’ This investigation, undertaken at the request of the Indiana Minority Health Coalition, Inc. (IMHC) is collaboration between IMHC, Butler University College of Pharmacy and Health Sciences, and the community partner, the Black Nurses Association of Indianapolis, Inc. (BNA). The purpose of the study is to gain an understanding of the ways older African American women from medically underserved areas of Indianapolis characterize the various parts of the concept of health; how they understand and …

Is It Abuse? Deaf Female Undergraduates' Labeling Of Partner Violence, Melissa Anderson, Caroline Kobek Pezzarossi

Melissa L. Anderson

The current study investigated the labeling of abuse experiences in a sample of 97 Deaf female undergraduate students, exploring the following questions: What is the prevalence of violent behaviors experienced by Deaf female undergraduates in their past-year relationships, what proportion of these relationships are identified as "abuse," and what scripts and strategies do Deaf female undergraduates utilize to label their experiences of partner violence? Results indicated that over half of the sample chose not to label past-year experiences of psychological aggression, physical assault, and sexual coercion as abuse, even when these experiences included severe violence. Implications for the Deaf education …

Intimate Partner Violence Against Deaf Female College Students, Melissa Anderson, Irene Leigh

Melissa L. Anderson

It has been estimated that roughly 25% of all Deaf women in the United States are victims of intimate partner violence (Abused Deaf Women's Advocacy Services [ADWAS]), a figure similar to annual prevalence rates of 16% to 30% for intimate partners in the general population. One goal of the present study was to ascertain the prevalence of intimate partner violence victimization in a sample of Deaf female college students. When comparing the prevalence of physical assault, psychological aggression, and sexual coercion victimization to hearing female undergraduates, the current sample was approximately two times as likely to have experienced victimization in …

An Outcome Study Of Seeking Safety With Rural Community-Based Women, Beverly Patitz, Melissa Anderson, Lisa Najavits

Melissa L. Anderson

This pilot study investigated the impact of Seeking Safety (SS) on rural women with comorbid substance abuse and trauma problems. SS is an evidence-based, present-focused therapy that provides coping skills and psychoeducation. Despite its demonstrated effectiveness, this is the first known study using SS with rural women. Investigating the efficacy of evidence-based treatments with rural populations is especially important because, compared with urban residents, they are more likely to meet criteria for comorbid mental illness and substance abuse, exhibit more severe symptoms of both disorders, but are much less likely to receive formal treatment. Such disparities highlight the need for …

Intimate Partner Violence Against Deaf Women: A Review, Melissa Anderson, Irene Leigh, Vincent Samar

Melissa L. Anderson

A common theme among writings on intimate partner violence against Deaf women is the concern that there is little empirical work conducted in this field in comparison to research conducted with hearing populations. However, it is important to acknowledge that an increased amount of research has been conducted in recent years and that a foundation of research has been established, on which future researchers can build and expand. The goal of the current review is to summarize and synthesize the recent work in this area, as well as identify remaining gaps and needs for future empirical work. While there are …

Does Seeking Safety Reduce Ptsd Symptoms In Women Receiving Physical Disability Compensation, Melissa Anderson, Lisa Najavits

Melissa L. Anderson

OBJECTIVE: This secondary analysis investigated the impact of 12 sessions of Seeking Safety (SS) on reducing posttraumatic stress disorder (PTSD) symptoms in a sample of dually diagnosed women with physical disabilities versus nondisabled (ND) women. SS is an evidence-based and widely implemented manualized therapy for PTSD and/or substance use disorder. It is a present-focused model that promotes coping skills and psychoeducation. DESIGN: As part of the National Institute on Drug Abuse Clinical Trials Network (NIDA CTN), 353 participants with current PTSD and substance use disorder (SUD) were randomly assigned to partial-dose SS or Women's Health Education (WHE) group therapy conducted …

Violence Against Deaf Women: Effect Of Partner Hearing Status, Melissa Anderson, Caroline Kobek Pezzarossi

Melissa L. Anderson

Using a sample of Deaf female undergraduate students, the current study sought to investigate the prevalence, correlates, and characteristics of intimate partner violence victimization in hearing-Deaf and Deaf-Deaf relationships. Initial results suggest that similarities in hearing status and communication preference are associated with increased levels of negotiation within these relationships. However, compatibility in these areas did not co-occur with significant decreases in physical, psychological, or sexual partner violence. Recommendations for future research as well as implications for clinical and educational practice are outlined.

Making Women's Health Connections: Between Researchers And To Resources, Martha E. Meacham, Len L. Levin, Lisa A. Palmer, Elaine Martin

Lisa A. Palmer

The Lamar Soutter Library at the University of Massachusetts Medical School has recently completed the second year of a National Library of Medicine grant funded project; the Women’s Health Resources Dissemination Outreach Project. The goals include assisting women’s health researchers by providing them with access to information and making them more aware of opportunities and available resources. This, ultimately, enables both an improvement in women’s health and the advancement of women in academic medicine. Moreover, by supporting women’s health research and women researchers through the objectives of this project, women researchers build connections, knowledge, and skills. This facilitates meaningful contributions …

Ideas For A Healthy Baby--Reducing Disparities In Use Of Publicly Reported Quality Data: Study Protocol For A Randomized Controlled Trial, Sarah L. Goff, Penelope S. Pekow, Katharine O. White, Tara Lagu, Kathleen M. Mazor, Peter K. Lindenauer

Peter Lindenauer MD

BACKGROUND: Publicly reported performance on quality measures is intended to enable patients to make more informed choices. Despite the growing availability of these reports, patients' use remains limited and disparities exist. Low health literacy and numeracy are two barriers that may contribute to these disparities. Patient navigators have helped patients overcome barriers such as these in other areas, such as cancer care and may prove useful for overcoming barriers to using publicly reported quality data. METHODS/DESIGN: The goals of this study are: to determine the efficacy of a patient navigator intervention to assist low-income pregnant women in the use of …

Attitudes Of Women In Their Forties Toward The 2009 Uspstf Mammogram Guidelines: A Randomized Trial On The Effects Of Media Exposure, Autumn Davidson, Xun Liao, B. Magee

B. Dale Magee

OBJECTIVE: The objective of the study was to assess women's attitudes toward 2009 US Preventive Services Task Force mammography screening guideline changes and evaluate the role of media in shaping opinions. STUDY DESIGN: Two hundred forty-nine women, aged 39-49 years, presenting for annual examinations randomized to read 1 of 2 articles, and survey completion comprised the design of the study. RESULTS: Eighty-eight percent overestimated the lifetime breast cancer (BrCa) risk. Eighty-nine percent want yearly mammograms in their 40s. Eighty-six percent felt the changes were unsafe, and even if the changes were doctor recommended, 84% would not delay screening until age …

Role Of Multiple Births In Very Low Birth Weight And Infant Mortality, B. Magee

B. Dale Magee

OBJECTIVE: To determine the percentage of very-low-birth-weight (VLBW) infants (g) and infant deaths attributable to multiple births in the general population and in women aged 35+. STUDY DESIGN: The year 2000 Massachusetts birth certificate database with linked births-deaths was examined. Etiologic fractions (EF) for VLBW and infant mortality attributable to multiples were calculated for the general population and the 35+ age group. The percentages of multiples occurring in the 35+ age group were calculated. Infant deaths due to congenital anomalies and "perinatal conditions" were calculated. RESULTS: There were 81,582 resident births in Massachusetts in 2000. Of them 4.3% were multiples. …

Missed Opportunities In Hpv Vaccination, B. Dale Magee, Autumn S. Davidson, Leslie Regh

B. Dale Magee

Objective: To use the 3 dose Human Papillomavirus (HPV) vaccine administration (given at 0, 1-2 and 6 months) to quantify opportunities to improve efficacy in the delivery of preventive health services. Methods: This was a retrospective, claims-based analysis using data provided by a single managed care plan. Female patients aged 9-26 who were continuously enrolled between 2009 through 2011 and received ≥ dose of the HPV vaccine during 2010 were analyzed. The proportion of initiators who did and did not completed the vaccine series, the timing and location of doses, and the number of outpatient visits during which the vaccine …

Doing The Best With What We Have: We Need Better: Informing Obstetric Policy With Administrative Data, Tiffany Moore Simas, B. Magee, Ellen Delpapa

B. Dale Magee

In this issue of Medical Care, Backes Kozhimannil and colleagues present data from the National Inpatient Sample on differences between rural and urban obstetric care. We applaud their efforts in examining this issue and agree that all women should be afforded safe deliveries, and ideally each woman’s experience would not be different. That being said, there are some practical considerations that must be applied to their analyses and recommendations. We would like to take this opportunity to capitalize on their efforts and speak to 2 other highly related implications for policy and practice.

Role Of Smoking In Low Birth Weight, B. Magee, Dale Hattis, Nancy Kivel

B. Dale Magee

OBJECTIVE: To assess the role of smoking on low birth weight (LBW). STUDY DESIGN: From Massachusetts for 1998, 79,904 birth certificates were reviewed. Birth weight, gestational age, plurality and maternal race were analyzed in relation to the mother's smoking status during the pregnancy. The etiologic fraction (EF) was calculated for smoking and LBW for the group as a whole as well as for various subgroups. RESULTS: A total of 11.7% of women acknowledged smoking during pregnancy. The overall LBW rate was 6.83%. The relative risk (RR) of LBW among smokers was 1.58. For all births the EF for smoking was …

Associations Of Adipose Tissue Architecture, Adipokines And Inflammatory Markers With Body Mass Index And Gestational Weight Gain In Non-Diabetic Pregnancies, Tiffany A. Moore Simas, Crina Boeras, Ningning Zhang, Olga Gaelikman, Katherine G. Leung, Nicole M. Wedick, Laura Robidoux, Jodi Adams Puleo, Mary M. Lee, Silvia Corvera, Milagros C. Rosal

Mary M. Lee

Background: Some pregnancy weight gain is stored as adipose tissue (AT). Human AT depots vary in their capacity for expansion. Data suggests that subcutaneous (SQ) is adapted for healthy lipid storage. Conversely visceral (V) accumulation is associated with inflammation, obesity-related co-morbidities and Type 2 diabetes (T2DM) risk. We investigated SQ and VAT histologic architecture along with insulin, adipokines and inflammatory markers in relationship to prepregnancy BMI and gestational weight gain (GWG). Methods: Subset of non-diabetic singleton gravidas from the Pregnancy & Postpartum Observational Dietary Study (PPODS), undergoing Cesareans and consenting to SQ & VAT biopsies were included. Average adipocyte size …

Meaning Of The Family-Cap Policy For Poor Women: Contraceptive And Fertility Decision-Making, Diana Romero, Hannah Fortune-Greely, Jorge Verea, Debbie Salas-Lopez

Debbie Salas-Lopez MD, MPH

In 1996 the US Congress enacted welfare reform legislation. In addition to new lifetime time limits and work requirements for those receiving cash and other forms of social assistance, the states could impose policies pertaining to reproductive-related behaviors of poor women. One such policy is the so-called “family-cap,” which denies additional income support to poor women who have a baby while receiving cash assistance; 24 states have implemented such policies. The ostensible goal of the policy is to limit fertility among current cash assistance recipients. This pilot study sought to explore whether poor women in a family-cap state (NJ) base …

Sourcebook: Women Veterans In The Veterans Health Administration. Volume 2: Sociodemographics And Use Of Vha And Non-Va Care (Fee), Susan M. Frayne, Kristin M. Mattocks

Kristin M. Mattocks

Describes sociodemographic characteristics and health care utilization patterns of women Veteran patients in the VHA. Its primary purpose is to present data to inform policy and program planning as VHA implements and evaluates new ways of providing care to women Veterans. Provides data about women residing in rural versus urban areas and by examining use of health care through VHA’s “Non-VA Care (Fee)” system, which is comprised of services provided to Veterans by non-VHA providers but reimbursed through VHA. Produced by the Women’s Health Evaluation Initiative, Women’s Health Services, Veterans Health Administration, Department of Veterans Affairs, Washington DC.