Women's Health Commons^™

Proximity To Comprehensive Emergency Obstetric Care And The Utilization Of Facility-Based Delivery Services Across Six Low-And-Middle Income Countries, Chioma T. Amadi

Dissertations and Theses

Background: More than 90% of maternal deaths occur in low-and-middle-income countries (LMICs) and are largely attributed to preventable pregnancy-related causes. Comprehensive emergency obstetric care (EmOC), also known as signal functions, is the most effective life-saving intervention for managing obstetric and newborn emergencies. Health facilities offering delivery services are generally classified as having either comprehensive, basic or less than basic EmOC capacity based on their obstetric resources. Multiple EmOC methods are regularly utilized in characterizing facility obstetric capacity and this introduces inconsistencies that pose significant public health and policy implications for access to delivery care among women within a service environment. …

The Reproductive Health And Academic Impact Of The New York City School-Based Health Center Reproductive Health Project For Adolescents, Michelle Silverio

Dissertations and Theses

Background: Gaining an understanding of how school reproductive health policies impact adolescent sexual health and academic outcomes is a public health priority in the United States (U.S.) since it has the highest rates of adolescent pregnancy and sexually transmitted infections among developed nations. Adolescence is a critical developmental period and influences in this period affect reproductive health and social well-being over a person’s entire lifespan. Almost all adolescents spend the majority of their time in school settings; therefore local school reproductive health policies may have substantial lifetime impacts. Policies such as providing comprehensive sexual health education and contraceptive access in …

Patient And Provider Perspectives On Sexual History Taking During Gynecological Care: A Pilot Study In An Academic Family Medical Setting In New York City, Ashley M. Chastain

Dissertations and Theses

Background: In the United States (US), women face a number of serious issues concerning sexual health. Current surveillance data indicates that overall rates of bacterial sexually transmitted infections (STIs) are increasing rapidly. While rates of new diagnoses have decreased, the risks of acquiring HIV are still relatively high for some females, specifically Black/African-American women. In New York City (NYC), where this dissertation research was conducted, similar HIV/STI rates exist among females of reproductive age (aged 15-44). Among women in the US, there are also high estimated rates of other sexual health problems, such as sexual anxiety, sexual dysfunction, and intimate …

Use Of And Access To Abortion Services Among Asian And Immigrant Populations In The United States, Sheila Desai

Dissertations and Theses

Background: Abortion is common in the United States (U.S.) and a critical component of comprehensive reproductive health care. Yet, little research has documented patterns of abortion use among Asian populations or potential barriers to abortion care among immigrants in the U.S., two rapidly growing but understudied populations. In response, this dissertation aims to examine use of and access to abortion services among individuals obtaining abortions in the U.S., focusing specifically on Asians in New York City (NYC), immigrants in the U.S., and individuals living in high immigrant concentration neighborhoods in the U.S.

Methods: Using vital statistics data from …

Whether, When, And How: Fertility Intentions And Age In The U.S., Andrea Melnikas

Dissertations and Theses

Thinking about, planning for, and having children is a deeply personal experience influenced by myriad factors at individual, intrapersonal, community and larger social levels. Examining fertility intentions is of interest to researchers from numerous social science disciplines in part because these intentions are potentially tied to larger demographic and economic shifts. In recent years in the U.S. the mean age at first birth has been increasing, with more women of older ages (age 35 and older) giving birth, due to both delays in childbearing that accompanied larger social trends such as increased educational and career opportunities and a decrease in …

Exploring The Health Effects Of Precarious Employment By Sex/Gender Using Mixed Methods, Kathleen Flandrick

Dissertations and Theses

Employment in the United States has changed dramatically since the mid-1970s. Labor market forces like globalization and diversification of the American workforce have led to a heavily segmented labor market where new types of flexible employment such as temporary, contingent, and nonstandard work arrangements are increasingly common. These newer types of work are often on the lower end of the precarious employment continuum, categorizing jobs by their degree of: 1) temporariness, 2) disempowerment, 3) vulnerability, 4) compensation (wages), 5) rights, and 6) ability to exercise worker rights. The increase in precarious employment likely disproportionately affects women when compared to men, …

Sexual Behavior And Substance Use Among Women Across The Spectrum Of Sexual Orientation, Margaret M. Wolff

Dissertations and Theses

Background: Compared to non-sexual minority women, sexual minority women are at greater risk for substance use and abuse, sexual risk behaviors, and unplanned teen pregnancy; few studies measure differing associations by sexual orientation (e.g., identity, behavior, attraction) or discordance (e.g., heterosexually-identified women with female partners) components. Minority stress may explain sexual minority women’s health disparities; thus, as U.S. policies evolve to reflect growing acceptance of all sexual minorities, research should examine sexual minority women’s health risk behaviors using multidimensional constructs of sexual orientation.

Methods: Using the female sample of the 2002-2013 National Survey of Family Growth (Aims 1-2 n=25,523; …

An Evaluation Of The Effect Of Abortion Laws On The Timing Of Abortion, Elizabeth Fuentes

Dissertations and Theses

A record number of restrictive abortion laws, particularly those known as Targeted Regulation of Abortion Providers (TRAP), have been passed in US states in the past half-decade. TRAP laws differ from abortion laws that target patients, such as parental involvement and waiting period policies, because they are often expensive, difficult, or impossible for providers to comply with, resulting in the reduction or elimination of abortion services. This can result in farther travel to and higher costs of abortion services for patients; however, there are no studies assessing whether one consequence of reduced geographic accessibility of abortion services is delays in …

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 …

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 …

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.