Women's Health Commons^™

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 …

No More Baby Steps: Preventing Unintended Pregnancies Of Los Angles Minorities And Adolescents, Rachel Bass

Master's Projects and Capstones

Previous studies have identified pregnancy intention to correlate with both maternal and fetal health. Though unintended pregnancy rates are dropping in America, they remain high among minority and young women. Contraceptive usage, a leading protective factor for unintended pregnancies, has been found to vary greatly by age and ethnicity. These two projects aimed to decrease unintended pregnancy rates through increasing patient knowledge of contraceptive options and correct usage. The first project focused on creating a comprehensive, oral contraceptive pill instructional handout for research participants of the birth control pill study. This handout was created through the analysis of compliance errors …

Quality And Access To Care For Cardiovascular Disease Prevalence In Women Veterans: Population Estimate Using Electronic Health Records, Meena Marie Kim-Dopp, Vanessa Gow-Lee, Linda Ferry, Sharon Jamie, Ralph Clark, Suma Singh

Loma Linda University Student Journal

Electronic Health Records are used to measure quality indicators for cardiovascular disease (CVD), but have not been tested for sensitivity and specificity. Computerized Patient Record System (CPRS) used by the Veterans Health Affairs (VHA), has active CVD clinical reminders from Healthcare Effectiveness Data & Information Set (HEDIS) that are compared nationally. San Bernardino County, CA has a 7.8% prevalence of self-reported CVD in both genders. For HEDIS measures, there is only a 4 point CVD composite score gender difference for VHA nationally, but at the Loma Linda VHA there is an 18 point gender difference (2016). Women Veterans (WV) are …

Vietnamese American Women’S Beliefs And Perceptions On Cervical Cancer, Cervical Cancer Screening, And Cancer Prevention Vaccines: A Community-Based Participatory Study, Connie Kim Yen Nguyen-Truong, Kim Quy Vo Nguyen, Thai Hien Nguyen, Tuong Vy Le, Anthony My Truong, Keara Rodela, Rachael Allan

Asian/Pacific Island Nursing Journal

Cervical cancer remains commonly diagnosed in Vietnamese American women. Despite efforts to increase cervical cancer screening among Vietnamese American women, participation rates are persistently lower than the national goal. The objective of this study is to explore beliefs of Vietnamese American women about cervical cancer, cervical cancer screening, and cancer prevention vaccines. A qualitative descriptive investigation captured group perceptions about meaning and beliefs of cervical cancer, screening, and cancer prevention vaccines, and participants’ stories using a community-based participatory research approach.

Forty Vietnamese American women were recruited from the Portland, Oregon metropolitan area into four focus groups. Using a process of …

Beyond The End Line - Putting The Mental Health Of Female Athletes First, Katherine Scholten

Honors Projects

Currently one in five adults are affected by mental illness. Student-athletes are a population that is under diagnosed for mental illness. In the world of college athletics, mental pain is as regular as physical pain. Coaches often push their athletes to suffer in silence for the betterment of the team. The NCAA has recognized the importance of mental health in college athletics, yet there is still much work to be done among universities across the country. This document is to serve as a resource and a guide on the effects of mental health among female student athletes and the best …

The Change In Mental Health Status Of Indonesian Health Care Migrant Worker In Japan, Susiana Nugraha, Yuko Hirano, Honda Sumihisha

Kesmas

Under the Japan – Indonesia Economic Partnership Agreement, more than 1,000 of Indonesian health care workers have migrated to Japan. Social adjustment during the process of migration is linked to mental health changes. This study aimed to figure out the strongest predictor that influences the change in mental health status as a result of migration. Baseline data were collected in Jakarta in 2013 during pre-departure orientation. Follow-up study was conducted one year after the study participants migrated to Japan in 2014. Using longitudinal design, this study employed 92 participants consisting of nurse and certified care worker candidates. The multiple linear …

Implementation Of Cigarette Excise Policy Against Cigarette Consumption Reduction Among Adolescent In Kuningan, Indonesia, Jani Ramjani, Fitri Kurnia Rahim, Icca Stella Amalia, Wahyu Manggala Putra

Kesmas

Indonesia has the highest prevalence of smoking (50.68%) compared to other ASEAN countries. On January 1st, 2017, the Indonesian government raised cigarette excise taxes. The purpose of this study was to analysis the impact of cigarette excise increase on cigarette consumption among adolescents aged 17 to 25 years. The study design used cross-sectional survey. A total of 153 adolescents were recruited in this study through simple random sampling technique. Questionnaires and observation papers were used in this study. A face-to-face interview was conducted to fulfill the data collection through home visit for each respondent. The data were obtained during May …

Increasing Use Of Research Findings In Improving Evidence-Based Health Policy At The National Level, Meiwita Budiharsana

Kesmas

In February 2016, the Minister of Health decided to increase the use of research findings in improving the quality of the national health policy and planning. The Ministry of Health has instructed the National Institute of Health Research and Development or NIHRD to play a stronger role of monitoring and evaluating all health programs, because “their opinion and research findings should be the basis for changes in national health policies and planning”. Compared to the past, the Ministry of Health has increased the research budget for evidence-based research tremendously. However, there is a gap between the information needs of program …

Husband’S Education Level And Alcohol Drinking Habit As Risk Factors Of Hiv Infection Among Housewives In Pati District, Nurul Aeni, Annemarie Westendorp

Kesmas

Cases of Human Immunodeficiency Virus (HIV) infection in Pati District increase, particularly among housewives. The aim of this study was to analyse the risk factors of HIV infection among housewives in Pati District using case-control study design. The respondents were 90 housewives divided into case and control group. The case group consisted of 30 housewives living with HIV, while the control group comprised 60 housewives living in the similar area of the counterparts. The data collection was focused on demographic, sexual behaviour, and sociocultural variables possessed by housewives and their husbands. The study resulted that the risk factors of HIV …

Effect Of Health Education On Community Participation To Eradicate Aedes Aegypti-Breeding Sites In Buahbatu And Cinambo Districts, Bandung, Zahratul Elsa, Uun Sumardi, Lia Faridah

Kesmas

Dengue hemorrhagic fever (DHF) is still a major public health problem in many regions in Indonesia including Bandung City. Community participation in implementing Eradication of Mosquito-Breeding Sites is still needed as it is considered the most effective method in controlling the dengue fever. This study aimed to determine the influence of health education towards community participation to eradicate mosquito-breeding sites, which was measured by knowledge level and larva index conducted in Bandung, specifically in two different locations with the highest and the lowest incidence rates of DHF. This study used quasi-experimental method. Samples were 100 people living in Cijawura and …

Spatial Analysis Of Determinants Of Filariasis-Endemic Areas In West Sumatra, Masrizal Masrizal, Fivi Melva Diana, Rosfita Rasyid

Kesmas

West Pasaman District and Agam District are filariasis-endemic areas in West Sumatra with prevalence of 12.40 per 100,000 cases and 11.27 per 100,000 cases respectively. This study aimed to determine risk factors associated with the prevalence of filariasis and mapping the vulnerability of the area in West Sumatra. A case control study design was conducted in the West Pasaman District and Agam District. The study used a sample of 74 cases and 74 controls taken by simple random sampling for the case and purposive random sampling for control. Data analysis used univariate, bivariate, multivariate and spatial. The results in Agam …

Maternal Energy Intake At The Sixth Month As Dominant Factor Of Exclusive Breastfeeding Success, Devi Suryanti Sihite, Sandra Fikawati, Ahmad Syafiq

Kesmas

Breastfeeding mothers needed adequate energy intake to provide 6-month exclusive breastfeeding that is necessary for infant growth and development. This study aimed to investigate real intake at the first and sixth month of breastfeeding and determine the dominant factor affecting 6-month exclusive breastfeeding provision. The design of this study was cross-sectional conducted in March-April 2015 among 109 mothers with 6-12- month-old infant living and registered at integrated health care in Kalangan Primary Health Care area. Data were collected through interview using questionnaires. Breastfeeding mothers’ intake was asked using Semi-Quantitative Food Frequency Questionnaire. The study found that 6-month exclusive breastfeeding proportion …

Equity Level Of Health Insurance Ownership In Indonesia, Risky Kusuma Hartono

Kesmas

Social health insurance from government program are expected to be able to reduce inequalities access to health services in the middle of rising of health care cost, while private health insurance is still limited for up and middle class population. This study aimed to analyze the equity level of health insurance ownership including social and private health insurance in Indonesia. This study examined the condition of Indonesia in the middle of entering National Health Insurance (NHI) era. This study used data of Indonesian Socio-Economic Survey 2012. Data were analyzed by using econometric approach through multinomial logit analysis. The results showed …

Combinational Sirna Delivery Using Hyaluronic Acid Modified Amphiphilic Polyplexes Against Cell Cycle And Phosphatase Proteins To Inhibit Growth And Migration Of Triple-Negative Breast Cancer Cells, Manoj B. Parmar, Daniel Nisakar Meenakshi Sundaram, Remant Bahadur Kc, Robert Maranchuk, Hamidreza Montazeri Aliabadi, Judith C. Hugh, Raimar Löbenberg, Hasan Uludağ

Pharmacy Faculty Articles and Research

Triple-negative breast cancer is an aggressive form of breast cancer with few therapeutic options if it recurs after adjuvant chemotherapy. RNA interference could be an alternative therapy for metastatic breast cancer, where small interfering RNA (siRNA) can silence the expression of aberrant genes critical for growth and migration of malignant cells. Here, we formulated a siRNA delivery system using lipid-substituted polyethylenimine (PEI) and hyaluronic acid (HA), and characterized the size, ζ-potential and cellular uptake of the nanoparticulate delivery system. Higher cellular uptake of siRNA by the tailored PEI/HA formulation suggested better interaction of complexes with breast cancer cells due to …

The Dynamics Of Stress And Fatigue Across Menopause: Attractors, Coupling, And Resilience, Lisa Taylor-Swanson, Alexander E. Wong, David Pincus, Jonathan E. Butner, Jennifer Hahn-Holbrook, Mary Koithan, Kathryn Wann, Nancy F. Woods

Psychology Faculty Articles and Research

Objective:

The objective of this study was to evaluate the regulatory dynamics between stress and fatigue experienced by women during the menopausal transition (MT) and early postmenopause (EPM). Fatigue and perceived stress are commonly experienced by women during the MT and EPM. We sought to discover relationships between these symptoms and to employ these symptoms as possible markers for resilience.

Methods:

Participants were drawn from the longitudinal Seattle Midlife Women's Health Study. Eligible women completed questionnaires on 60+ occasions (annual health reports and monthly health diaries) (n = 56 women). The total number of observations across the sample was 4,224. …

Mode Of Delivery And Child And Adolescent Psychological Well-Being: Evidence From Hong Kong’S “Children Of 1997” Birth Cohort, Cherry Y. Leung, Gabriel M. Leung, C. Mary Schooling

Publications and Research

Mode of delivery (vaginal or cesarean section) is thought to affect gut microbiota, which in turn may affect psychological well-being. As such, mode of delivery is potentially a modifiable factor for psychological well-being. Here we examined the association of mode of delivery with child and adolescent psychological well-being. We used multivariable linear regression in a populationrepresentative Hong Kong Chinese birth cohort, “Children of 1997,” to examine the adjusted associations of mode of delivery with behavioral problems assessed from parent-reported Rutter score at ~7 (n = 6294) and ~11 years (n = 5598), self-esteem assessed from self-reported Culture-Free Self- Esteem Inventory …

Why Women Suffer Domestic Violence In Silence: Web-Based Responses To A Blog, Salima Farooq, Tazeen Saeed Ali, Yasmin Parpio, Nasreen Lalani, Muecke Marjorie

School of Nursing & Midwifery

Background & Aim: Domestic violence (DV) is a global socio-cultural concern faced by a majority of women. DV has a negative impact on women’s social, physical, and psychological wellbeing. Objective was to explore perceptions regarding contributing factors to domestic violence among women.
Methods & Materials: A qualitative descriptive exploratory method was applied for the study. Purposive sampling was used to select participants through emails to respond to the web based blog created for the study. 41 worldwide participants shared their perceptions through the blogs in the study. The data were collected using a web-based discussion forum on the Urban Women …

Improving Obstetrics In Family Medicine Residency Clinics: A Quality Improvement Study, Garima Chawla, Jessica J.F. Kram, Bonnie Bobot, Dennis J. Baumgardner

Journal of Patient-Centered Research and Reviews

Background: Prenatal care/deliveries within our family medicine clinics have declined, perhaps because patients are unaware that our clinics provide these services. With lower volumes, clinicians may feel less comfortable with current skills/knowledge of obstetric (OB) care.

Purpose: Increase family medicine clinic OB numbers, patient awareness, and clinician comfort/knowledge in OB.

Methods: English-facile patients (18–50 years), residents and faculty at Aurora family medicine residency clinics were included. Patients were provided preintervention surveys upon check-in. Residents/faculty were surveyed via Survey Monkey. Changes made based on initial survey results were: 1) increasing systemwide awareness that our caregivers provide OB care, through fliers at …

Robustness Of A Newly Proposed Risk Schema For Lymphatic Dissemination In Endometrioid Endometrial Cancer, Danielle M. Greer, Jessica J.F. Kram, Callie M. Cox Bauer, Scott A. Kamelle

Journal of Patient-Centered Research and Reviews

Background: Surgical management for endometrioid endometrial cancer (EEC) includes complete lymph node dissection for all patients at risk of lymphatic dissemination. The standard risk schema, defined by Mayo Clinic, identifies low-risk patients as those with grade 1/2 EEC, myometrial invasion (MI) ≤ 50%, and tumor diameter (TD) ≤ 2 cm. We recently proposed (and published) a risk schema containing modified forms of grade, MI and TD that suggests a significant decrease in false-negative rate and need for lymphadenectomy in low-risk women.

Purpose: Evaluate robustness of our proposed schema for lymphatic dissemination risk stratification in a subsequent EEC patient cohort.

Methods: …

Quality Improvement Study For Postpartum Hypertension Readmissions, Molly K. Lepic, Sara M. Stanenas, Carla J. Kelly, Deborah Simpson, Jeffrey A. Stearns

Journal of Patient-Centered Research and Reviews

Background: Hospital readmission rates are a focus of the Centers for Medicare and Medicaid Services. This was identified as a system opportunity to improve health care quality and patient education in order to reduce preventable readmissions. In 2009, 27% of obstetric readmissions were due to hypertensive disease, and preventable readmissions regarding hypertension are flagged as an area for quality improvement in our health care system. There is limited evidence on specific management of postpartum hypertension.

Purpose: Identify risk factors in our community and reduce postpartum readmissions for hypertension within our hospital.

Methods: We performed a retrospective chart review from November …

Reducing The Rate Of Cesarean Delivery On Maternal Request Through Institutional And Policy Interventions In Wenzhou, China, Yushan Yu, Xiangyang Zhang, Caixia Sun, Huijie Zhou, Qi Zhang, Chun Chen

Community & Environmental Health Faculty Publications

The objective of this study was to evaluate the effect of institutional and policy interventions on reducing the rate of cesarean delivery on maternal request (CDMR) in Wenzhou, China. Institutional interventions included health education, painless delivery introduction, and doula care. Additionally, a series of health policies were developed by the Chinese central and local governments to control cesarean section rates, mostly through controlling CDMR rates. We conducted a pre-/post-intervention study using 131,312 deliveries between 2006 and 2014 in three tertiary-level public hospitals in Wenzhou, China. Chi-square tests and predictive models were used to examine changes in the CDMR rate before …

Partner Relationships And Injection Sharing Practices Among Rural Appalachian Women, Michele Staton, Justin C. Strickland, Martha Tillson, Carl Leukefeld, J. Matthew Webster, Carrie B. Oser

Behavioral Science Faculty Publications

Background—The role of relationships in initiating and maintaining women’s risk behaviors has been established. However, understanding factors that may underlie partner relationships and women’s risky drug use, particularly in rural contexts, is limited. This study is the first to examine the association between injecting partners and women’s risky injection practices as a function of relationship power perception.

Methods—Female participants were recruited from three rural jails in the Appalachian region. Women were randomly selected, provided informed consent, and screened for study eligibility criteria. This cross-sectional analysis focuses on women who inject drugs (WWID) during the year before entering jail …

Nutritional Status Of Infants At Six Months Of Age Following Maternal Influenza Immunization: A Randomized Placebo-Controlled Trial In Rural Nepal., Joanne Katz, Janet A Englund, Mark C Steinhoff, Subarna K Khatry, Laxman Shrestha, Jane Kuypers, Luke C Mullany, Helen Y Chu, Steven C Leclerq, Naoko Kozuki, James M Tielsch

Global Health Faculty Publications

Background

Maternal influenza vaccination has increased birth weight in two randomized trials in South Asia but the impact on infant growth is unknown.

Methods

A randomized placebo-controlled trial of year round maternal influenza immunization was conducted in two annual cohorts in Sarlahi District, southern plains of Nepal, from April 2011 through April 2014. Infants born to women enrolled in the trial had weight, length, and head circumference measured at birth and 6 months of age. The study was powered for the 3 primary trial outcomes but not for stunting and wasting at 6 months of age.

Results

3693 women received …

Contingency Management For Smoking Cessation In Pregnancy, Jacob Miller, Brady Reynolds, Courtney Crain, Hisham Keblawi, Lynne J. Goebel

Marshall Journal of Medicine

This pilot study examined the feasibility of applying Contingency Management (CM), where the woman receives financial compensation for abstinence from smoking. Eleven subjects were recruited from Marshall’s OB clinic for the program. CO levels were measured daily using online video recording. Quit rates were determined at the end of pregnancy. Birth outcomes were measured at delivery. 21 pregnant smokers from Marshall’s OB clinic were used as the control group. The results demonstrated a trend toward improved rates of smoking abstinence in CM participants as compared with the control group. Our study also showed a trend towards improved birth outcomes in …

Influenza Epidemiology And Immunization During Pregnancy: Final Report Of A World Health Organization Working Group, Deshayne B. Fell, Eduardo Azziz-Baumgartner, Michael G. Baker, Maneesh Batra, Julien Beauté, Philippe Beutels, Niranjan Bhat, Zulfiqar Ahmed Bhutta, Cheryl Cohen, Rehana Salam

Department of Paediatrics and Child Health

From 2014 to 2017, the World Health Organization convened a working group to evaluate influenza disease burden and vaccine efficacy to inform estimates of maternal influenza immunization program impact. The group evaluated existing systematic reviews and relevant primary studies, and conducted four new systematic reviews. There was strong evidence that maternal influenza immunization prevented influenza illness in pregnant women and their infants, although data on severe illness prevention were lacking. The limited number of studies reporting influenza incidence in pregnant women and infants under six months had highly variable estimates and underrepresented low- and middle-income countries. The evidence that maternal …

Impact Of Maternal Vaccination Timing And Influenza Virus Circulation On Birth Outcomes In Rural Nepal., Naoko Kozuki, Joanne Katz, Janet A Englund, Mark C Steinhoff, Subarna K Khatry, Laxman Shrestha, Jane Kuypers, Luke C Mullany, Helen Y Chu, Steven C Leclerq, James M Tielsch

Global Health Faculty Publications

Objective

To describe the effect of maternal vaccination on birth outcomes in rural Nepal, modified by timing of vaccination in pregnancy and influenza virus activity.

Methods

A secondary analysis was conducted using data from two annual cohorts of a randomized controlled trial. A total of 3693 pregnant women from Sarlahi District were enrolled between April 25, 2011, and September 9, 2013. All participants were aged 15–40 years and received a trivalent inactivated influenza vaccine or placebo. The outcome measures included birth weight, pregnancy length, low birth weight (<2500 g), preterm birth, and small‐for‐gestational‐age birth.

Results

Data were available on birth weight for 2741 births and on …

Pololeo Y Protección: Las Barreras De Acceso A Métodos Anticonceptivos Para Adolescentes Vulnerables En La Comuna De Macul, Santiago De Chile / Pololeo Y Protección: Barriers To Access Contraceptive Methods For Vulnerable Adolescents In The District Of Macul, Santiago De Chile, Louisa Boswell

Independent Study Project (ISP) Collection

El embarazo adolescente sigue siendo un problema de salud pública al nivel nacional en Chile. Aunque por ley, todos tienen el derecho a una educación sexual y a elegir un método de control de fecundidad, todavía existen casos de embarazos no planificados, particularmente entre adolescentes. Este estudio investigó las barreras que limitan el acceso a métodos anticonceptivos para adolescentes, enfocando primariamente en el sistema público en la Región Metropolitana. Específicamente, la investigación consideró las adolescentes de la comuna de Macul, utilizando muestras de un colegio local y dos centros de salud familiar para hacer conclusiones. La investigadora entrevistó a matronas …

Women Of Leh Town, Ladakh: An Overview Of Perceptions Of Health, Health-Seeking Behaviors, And Access To Health Care, Sophia Marion

Independent Study Project (ISP) Collection

The following study seeks to investigate access to health care services and perceptions of health care among women residing in traditional farming communities around the Ladakh region, and to analyze perspectives on health, health-seeking behavior, and access to health care. This project was prompted by the fact that health care in this region is understudied. This study also focuses on marginalized communities including local women and immigrant women. Methods used for the collection of data were qualitative interviews conducted with 24 women, as well as an amchi worker, doctors, and informal and formal conversations with people from different nongovernmental Organizations …

Sex Work And Compromised Health: Health Conditions And The Barriers To Accessing Treatment Services In Pelourinho, Salvador, Amelia Fox

Independent Study Project (ISP) Collection

Sex workers remain one of the most marginalized populations in Brazilian society, both coming from and living within realities defined by poverty and poor health. Through partnership with Força Feminina – an organization located in Salvador, dedicated to aiding local sex workers– I explored the day-to-day health complications sex workers encounter and the impact these problems have on quality of life. I then questioned how discrimination and stigma impact a woman’s willingness to prioritize her health and seek out healthcare services. To pursue these questions, I utilized participant observation, interviews with 4 staff members – a pastoral educator, financial coordinator, …

Tibetan Women’S Experiences With Childbirth: A Comparative Study Of Present-Day Shangri-La And Previous Studies In Tibetan Communities, Billie Dunn-Mcmartin

Independent Study Project (ISP) Collection

What are the experiences of Tibetan women living in and around Shangri-La with pregnancy, childbirth, and motherhood? In order to explore this topic, one must first understand the context in which this topic exists: Tibetan Buddhism and culture. This paper gives a short background on women and the female body in Tibetan Buddhism, the Tibetan Medical system, and the current accessibility and regulation of hospitals, before entering into the topic of Tibetan women’s experiences with childbirth. The experiences and traditional practices of childbirth are important, as birth is universally significant as well as particularly religiously significant in Tibetan Buddhism, and …