Women's Health Commons^™

Treatment And Interventions For Sexual Assault In Humanitarian Contexts: Addressing Gaps In Refugee And Idp Camp Care In Myanmar, Erin Nash

Capstone Experience: Master of Public Health

Sexual and gender-based violence (SGBV) remains a pervasive yet under-addressed issue in humanitarian settings. Refugee and internally displaced person (IDP) camps along the Thai– Myanmar border represent a complex nexus of protracted displacement, ethnic conflict, and limited access to medical and psychosocial care. Although the prevalence of sexual assault in these contexts is well-documented, there is a critical gap in the literature regarding effective, context-specific treatment and intervention strategies. This capstone project conducts a comprehensive review of existing research on sexual assault care in humanitarian crises worldwide and assesses its applicability to displaced ethnic minorities from Myanmar. The analysis considers …

Implementation Of An Adolescent Women’S Health And Wellness Education Program, Lauren Acker, Laynee Conner, Jennifer Cera

Doctor of Nursing Practice Projects: College of Nursing

Objectives: The goal of this research study was to provide scientific evidence supporting the importance and effectiveness of implementing a women’s health and wellness education course and its effect on (1) adolescent knowledge of sexual health and hygiene, (2) self-efficacy in menstrual management, and (3) self-empowerment in managing their own reproductive health.

Design: This was a mixed methods pilot study utilizing a pre/post-test single intervention efficacy trial. Quantitative and qualitative data were obtained.

Setting: The setting included two different sites including one outpatient ambulatory obstetrics/gynecology clinic and one community outreach center. Both sites were located within a midwestern metropolitan …

The State Of Abortion Training In Medical School And Family Medicine Residency Curricula: A Scoping Literature Review, Eric James Reece

Capstone Experience: Master of Public Health

This project aims to assess how abortion education has been integrated into medical training over the past decade, with a particular focus on understanding its current state in medical schools and family medicine residencies, including those offering specialized programs affiliated with RHEDI (Reproductive Health Education in Family Medicine) and TEACH (Training in Early Abortion for Comprehensive Healthcare). Given the ever-evolving legal landscape following the June 4^th, 2022 Supreme Court case of Dobbs v. Jackson Women’s Health Organization, this review explores how both federal- and state-level legal restrictions impact access to abortion training and attempts to identify gaps …

Breaking Barriers To Smoking Cessation: Applying The Baby & Me - Tobacco Free Program To Improve Maternal And Child Health In Omaha, Nebraska, Madison Ravens

Capstone Experience: Master of Public Health

Smoking during pregnancy remains a pressing public health concern, contributing to adverse outcomes such as preterm birth, low birth weight, and developmental complications. In Nebraska, about 10% of pregnant women continue to smoke throughout pregnancy—above the national average, highlighting a critical gap in maternal health interventions. The Baby & Me – Tobacco Free (BMTF) program provides an evidence-based solution through structured counseling, carbon monoxide (CO) monitoring, and incentive-based rewards to support smoking cessation among pregnant women. This capstone project utilized the Getting to Outcomes framework to develop a detailed implementation plan to support Tobacco Free Nebraska (TFN) in launching the …

A Comprehensive Literature Review Of Barriers To Hormone Therapy Utilization: Strategies For Improving Menopause Management In Women Aged 40-60, Suhan Lee

Capstone Experience: Master of Public Health

Menopause is a natural transition marked by the cessation of ovarian activity, often accompanied by vasomotor symptoms (VMS), genitourinary syndrome of menopause (GSM), and psychological changes that significantly impact women’s quality of life. Hormone therapy (HT) has been the primary treatment for managing menopausal symptoms, particularly VMS, providing substantial relief when initiated within 10 years of menopause. Despite its effectiveness, HT usage has declined dramatically over the past two decades primarily due to barriers such as stigma, safety, misinformation, provider hesitancy, financial barriers, and cultural beliefs. This comprehensive literature review explores key factors influencing HT decision-making, including the media’s role …

The Association Between Economic Outcomes And Abortion: A Scoping Review, Larisa Nicole Stephenson

Capstone Experience: Master of Public Health

Background: Abortion access is not just an issue of autonomy, but an economic issue as well. Evidence of the intersectionality of abortion health care and economics has endured due to the financial cascading effects a denial of an abortion, or the inability to access an abortion, has on one’s personal, professional, and economic upward mobility. A change in recent policies impacting access to abortion warrants an updated synthesis examining the relationships between economic outcomes and abortion access for people of reproductive age in the United States (U.S.).

Aim: This scoping review summarizes evidence pertaining to the association …

Utilizing The Health Belief Model To Design A Community-Based Program To Increase Cervical Cancer Screening Rates Among 21 To 25-Year-Olds In The Omaha Metro Area, Karli Baker

Capstone Experience: Master of Public Health

The 2021 Douglas County Community Health Needs Assessment found that cervical cancer screening rates have been on a downward trend since 2011. Previous studies on cervical cancer screening interventions have examined refugee populations, and current programs in Douglas County offer assistance to uninsured women, typically aged 40 and older. However, interventions have overlooked young women aged 21 to 25 in the Omaha metro area, who exhibit the lowest cervical cancer screening rates. We will use the PRECEDE-PROCEED Model as a framework to design an educational program for young women aged 21 to 25, guided by the theoretical underpinnings of the …

Building Empathy Through Storytelling: A Living Library Program Focused On Women’S Health, Jess King, Belinda Boelter, Catherine Medici-Thiemann

Posters and Presentations: Leon S. McGoogan Health Sciences Library

An academic health sciences library hosted a grant-funded living library program titled “Bringing Stories of Women’s Health to the Forefront.” With a campus that is increasingly focused on incorporating the humanities into medical education, the library added to this momentum by offering a program which encouraged empathy through the art of storytelling. The program was delivered via three routes: an in-person event for the city’s metro community, a virtual event for the university community and their clinical partners, and oral interview video recordings that are hosted on the library website. In order to host a successful event that met the …

Sparkled: Social Programming In Kids Affects Risk Of Latent Endothelial Disease, Rebecca Drakowski

Theses & Dissertations

Background: Social Health Programming (SHP) is a holistic intervention that can empower communities to address modifiable risk factors for poor cardiovascular health, including suboptimal nutrition or psychosocial stressors. SHP participation has been shown to increase dietary intake of fruits and vegetables, decrease perceived stress, and improve cardiovascular endurance. However, it is unknown how SHP participation during adolescence affects carotenoid serum levels, hair cortisol concentrations (biological marker of chronic stress), or vascular reactivity index (VRI; measure of subclinical cardiovascular health).

Methods: Adolescent girls and young adult women (12–29-year-old) were enrolled in this observational cohort study. Serum, hair, and saliva samples were …

Implementation Of A Doula-Supported Postpartum Wellness Toolkit In A Black Community-Based Maternal Wellness Program, Janice Luethje, Leslie Torres

Doctor of Nursing Practice Projects: College of Nursing

Objective: The objective of this project was to expand the areas of focus within a maternal wellness program at a Black community center and to evaluate the satisfaction levels of the doulas who utilized the material during postpartum home visits. The toolkit covers a range of postpartum topics in the areas of nutrition, exercise, sexual health, mindfulness, and social support as well as a postpartum mental health screening tool.

Design: This quality improvement project included three distinct phases: The pre-implementation phase, the implementation phase, and the post-implementation phase.

Setting: The project location was a Black community center in Lincoln, Nebraska. …

Effects Of An Educational Evidence-Based Website To Improve Breast Health Knowledge And Self-Efficacy Of Breast Self-Examination: Interim Analysis, Mackenzie Koch, Jennifer Cera, Brooke Hancock, Elizabeth Graham

Doctor of Nursing Practice Projects: College of Nursing

Purpose and Aims

Breast disease, whether benign or malignant, encompasses a wide array of diagnoses. Breast self- examination (BSE) is a simple screening assessment that improves early recognition and diagnosis. With changes in the 2021 ACOG practice guidelines from mandatory to optional provider-performed clinical breast examinations (CBE), it is imperative for patients to possess basic breast health knowledge and accurate BSE techniques. Current standard patient education is provided via brochures or pamphlets. An educational multimedia website was created using ACOG guidelines to impart knowledge and demonstrate proper BSE techniques. Aims were to evaluate changes in participant’s (1) breast health knowledge …

Improving Intimate Partner Violence Screening In A Women’S Health Practice Through Implementation Of An Evidence-Based Screening Tool, Jasmine Weber

Doctor of Nursing Practice Projects: College of Nursing

The purpose of this quality improvement project was to implement intimate partner violence screening in an outpatient women’s health clinic with no prior screening process in place. Current recommendations are to screen all reproductive age women for intimate partner violence 6 . During a three-month period 170 patients out of 260 eligible patients were screened using the HARK screening tool, 7 of those patients screened positive and were offered referrals to social work. While universal IPV screening was not achieved, a screening rate of 64% is a remarkable improvement from an apparent absence of screening prior to project implementation.

Exploring The Mental Health Experience Of Perinatal Military Spouses Based In Sigonella, Italy, Lyndsey Dannenberg

Capstone Experience: Master of Public Health

The perinatal period can have a profound impact on the mental health of women, their infants, and their families, especially when it comes to depression and anxiety disorders. This study aims to delve into the experiences of perinatal mental health among military spouses stationed overseas, on Naval Air Station Sigonella, Italy, and contribute to the limited research on active-duty military spouses and their perinatal mental health while stationed overseas. The research uses a qualitative phenomenological approach, seeking to provide valuable insights into the lived experiences of military spouses and their perinatal mental health. Risk factors associated with perinatal mental illness …

Certified Midwives: An Exploration Of Their Impact On Maternal Health Outcomes – A Comprehensive Literature Review, Heather Hollister

Capstone Experience: Master of Public Health

Maternal health outcomes in the United States have been consistently worse than other high-income countries, with a disproportionate impact on women of color. Midwives have long played an important role in maternal health worldwide. The literature review examines the evidence for midwives as key contributors to improving maternal health outcomes. The paper reviews the existing literature on midwifery, including the impact on maternal health, labor and delivery outcomes, and patient satisfaction. Electronic searches were conducted through Cochrane Library, CINAHL, Medline and Embase. Articles were screened according to inclusion and exclusion criteria including that they must be a randomized study; participants …

Understanding The Compositional And Contextual Factors Influencing Maternal Health Experiences And Outcomes, Tambudzai P. Ndashe

Theses & Dissertations

Despite being preventable, adverse maternal health outcomes continue to be a problem in the United States, which fares worse at preventing these issues than other industrialized nations. Although our understanding of the factors that play a role in the etiology of adverse maternal health outcomes has improved over time, there is still a lot left to understand regarding the role of contextual factors, the upward trajectory of outcomes such as severe maternal morbidity (SMM), and the disproportionate impact of adverse maternal health outcomes on non-Hispanic Black women. This thesis attempted to evaluate the factors that influence procedure-related severe maternal morbidity …

Overlaps And Gaps Of Preterm Birth Programs In The Triangle Area Of North Carolina, Amber Bobbitt

Capstone Experience: Master of Public Health

Background: Preterm birth rates are a long-standing issue that has yet to be adequately addressed and prioritized. Nationally about 1 in every 10 infants are born prematurely in the United States. In the state of North Carolina, 1 in every 9 live births was preterm in the year 2020. The aim of the study was to determine the strategies organizations use in North Carolina to reduce preterm births in comparison to the CDC’s Five Strategy framework and to understand how the organizations address health equity and measure/evaluate the success of their initiatives.

Methods: Semi-structured one-on-one interviews were conducted with four …

Association Of Health Literacy And Provider Education With Knowledge Of Breast And Cervical Cancer Screening In An Underserved Female Population, Mallory Gandy, Karly A. Meyer, Jennifer Liu, Jenenne Geske

EMET Projects

No abstract provided.

Giving Birth At A Critical Time: Assessing Perinatal Depression Among Syrian Refugees In Low Resource Settings, Nada Alnaji

Theses & Dissertations

Refugee mothers are at an increased risk of suffering from stress and mental health conditions during the first year after giving birth to a child. The objective of this study is to enhance the early identification of treatable mental health conditions among perinatal women living within humanitarian settings. The central hypothesis is that a culturally specific approach can be helpful for the long-term success of mental health efforts. In this study, we use qualitative interview methods to understand the cultural paradigms and predisposing factors for perinatal depression related to being a Syrian refugee in Lebanon during the COVID-19 pandemic. In …

Population-Level Prevalence Of Depression And Summary Statistics Of Women With At Least A Year Post-Final Menstruation With And Without Hysterectomy, Happiness Kingi

Capstone Experience: Master of Public Health

Background: Depression is associated with estrogen hormonal changes. There are few comparisons studies on the population-level prevalence of depression in women at least a year post final menstruation with and without hysterectomy.

Objectives: 1) To determine the population-level prevalence of depression in women with at least a year post final menstruation with and without hysterectomy and 2) to calculate the summary statistics of women with at least a year post final menstruation with and without hysterectomy

Methods: A population-based cross-sectional design was used. Respondents were female participants of the U.S. National Health and Nutrition Examination Survey (NHANES) …

Impact Of Simple Breastfeeding Initiatives Led By Nurses In A Primary Care Setting, Jessica Semin, Carolyn Hanus, Megan Scott, Amy Ford, Leeza Struwe

Doctor of Nursing Practice Projects: College of Nursing

Background: Breastfeeding is recognized by health experts as the preferred infant feeding method. Health professionals, especially nurses, play a vital role in influencing mothers’ infant feeding decisions. This quality improvement project designed, implemented, and evaluated by nurses explores how the implementation of three simple initiatives impacted healthcare staff’s attitudes, beliefs, and perceptions related to breastfeeding.

Materials and Methods: The project was led by three Doctor of Nursing Practice (DNP) students with guidance from their DNP prepared advisor. It took place in a primary care setting at a federally qualified health center. Prior to and after implementation, staff were …

Evaluating A Community-Based Breastfeeding Support Organization In Nebraska, Katelyn Elaine Goodroe

Capstone Experience: Master of Public Health

Specific Aims: The aims of this evaluation plan are to investigate the role of the Nebraska nonprofit organization, MilkWorks, in promoting breastfeeding and family support programming and to identify future internal and external growth opportunities through an assessment of the organizational practices using stakeholder perspectives and marketing structure to better promote infant and parental health.

Significance: As a best practice, evaluation of MilkWorks is critical to providing proper services for promoting infant development and parental health in urban and rural Nebraska communities.

Background: MilkWorks was founded in Lincoln, Nebraska, by mothers with the intention of promoting breastfeeding by offering support …

Developing A Program Evaluation Plan For Medicaid Prenatal Care Management Programs, Shardae Sims

Capstone Experience: Master of Public Health

Prenatal care management (PNCM) is an intervention that targets women during the perinatal period to improve birth outcomes. PNCM has the potential to address social determinants of health issues and gaps or barriers to care that could lower incidences of adverse birth outcomes in Nebraska. There is currently a gap in the literature for studies that fully assess the impact of prenatal care management programs and the program’s ability to reach set goals. The purpose of this research is to develop an evaluation plan and potential implementation strategies that can be utilized by the Medicaid PNCM program in Nebraska. The …

Trends Of Endometrial Cancer Among Adult Women In The United States, Fnu Kanishka

Capstone Experience: Master of Public Health

Background: Endometrial cancer also referred to as uterine corpus cancer is the fourth most common cancer diagnosed among US women. It is also one of the few cancers in the US that has an increasing incidence and mortality rate. This study examined the overall and race specific age-adjusted incidence rate as well as incidence-based mortality rate of endometrial cancer in the United States from 1975-2016.

Methods: Surveillance, Epidemiology, and End Results (SEER) 1975-2016 data were used. Overall and race specific age-adjusted incidence rate, incidence-based mortality rates and 95% confidence intervals were calculated Trend graphs were created, annual average percent change …

Examining Barriers To Sexual And Reproductive Health Services For Adolescents And Young Adults In Nebraska, Marisa Rosen

Theses & Dissertations

Despite recent declines in unintended pregnancy rates among adolescent and young adult women, barriers to family planning services and contraception continue to exist for young women living in the United States. Various initiatives have been implemented over the years from programmatic interventions to enactment of policies around family planning, yet more work needs to be done to help adolescent and young adult women successfully prevent unintended pregnancy. The Contraceptive Access Project (CAP) is a multi-component initiative in Nebraska to reduce unintended pregnancy among women aged 15-24. This dissertation comprises three separate studies each of which contributes to the overall objective …

Symptom Clusters And Quality Of Life Trajectories In Breast Cancer Patients Before And After Chemotherapy, Gaurav Kumar

Capstone Experience: Master of Public Health

Context. Breast cancer patients experience multiple concurrent symptoms before and after chemotherapy (CTX). Physical and psychological symptoms may persist after treatment and reduce the quality of life (QOL) of survivors.

Objectives. Identify differences in prevalence and severity of symptoms at three times within 1- year of starting CTX; and identify symptom cluster and QOL trajectories over these times in breast cancer patients.

Methods. Symptoms were identified in breast cancer patients (N=219) before the start of CTX (baseline), 30 days after the last CTX, and 1-year after the first CTX. Hospital Anxiety and Depression Scale and Symptom Experience Scale …

Public Health Perspectives On Sexual Health And Family Planning, Molly Mccarthy

Theses & Dissertations

Large bodies of evidence document the importance of sexual and reproductive health (SRH) in the lives of individuals and among populations. Of particular interest are sexually transmitted diseases (STDs), due to their potential for long-term health consequences, and unintended pregnancy because of its association with social and economic outcomes for women and families.

This dissertation addressed three distinct but related areas of reproductive health and family planning: counseling for condom use following an STD test, counseling for contraception following a pregnancy test in a clinical setting, and the effect of abortion on having and achieving long-term plans. These topics are …

Structural Violence And Gender-Based Violence In The United States, Sarbinaz Z. Bekmuratova

Theses & Dissertations

Three components of the dissertation project examined the relationship between three different constructs of structural violence and women’s experience of different violence types in their lifetime in the United States. The violence types examined in the study included psychological aggression, coercive control and entrapment, physical violence, stalking, sexual violence, and rape. 2010 National Intimate Partner Violence and Sexual Violence Survey with the final sample size of 9,827 was used for all three portions of the study to analyze the association of structural violence with six types of violence. Additional datasets used were Institute for Women’s Policy Research’s Status of Women …

Epigenetic Modifications Of Human Placenta Associated With Preterm Birth, Drissa Toure

Theses & Dissertations

Preterm birth is a complex multifactorial process. Despite the well-known role of the placenta in supporting the fetal development and maternal-fetal tolerance, the placental epigenetic modifications and preterm birth (PTB) remains poorly understood and under investigated. Various maternal and environment factors can influence epigenetic programming during fetal development to affect the functioning and structures of organs, including the placenta, which can lead to adverse pregnancy outcomes, including PTB. The understanding of the placental epigenetic alterations and maternal determinants associated with PTB are apparently indispensable for the development of actual diagnosis and methods of prevention and treatment of premature labor. The …

Sex And Sexuality Of Breast Cancer Survivors, Aja D. Kneip Pelster

Theses & Dissertations

With new diagnostic technologies and treatment modalities available, more people than ever are living as cancer survivors in the United States. A large group of this population consists of breast cancer survivors. The purpose of this research was to explore the intersection of breast cancer survivorship, at points beyond the termination of treatment, and sexuality, including expressions and performance of gender, relationships, and sexual behavior. The current study used semi-structured interviews, conducted with 21 Midwestern women at least 6-months post-treatment, to better understand the intersection of these two concepts. Following traditions of narrative and phenomenological qualitative research, the women’s own …

Epidemiologic And Clinical Profiles Of Uterine Cancer In The Gharbiah Province Of Egypt, Saad Alshahrani

Theses & Dissertations

Background: Uterine cancer is one of the top-ranking cancers of women with wide international variations in incidence rates. Egypt has a lower incidence of uterine cancer than other countries in the Middle East. In addition to the international incidence variation, there are also wide variations in incidence by rural and urban areas within countries. Therefore, this research project focused on the Gharbiah province, north of Cairo in the Nile Delta, with the aims of investigating demographic and clinical characteristics of uterine cancer, assessing rural/urban variation in incidence rates, and evaluating the possible role of hysterectomy in under-estimating the disease incidence …