Women's Health Commons^™

Post-Pandemic Needs Of Unpaid Family And Friend Caregivers To Effectively Continue Caregiving Duties In One Northern Ontario Health Authority, Jodi Webber, Erin Mulroney, Mark Tatasciore, Brianna Smith, Patti-Jo Duggan, Louis Ferron, Hannah Albani, Bianca Feitelberg, Laura Tenhagen, Sophia Myles

Patient Experience Journal

The Covid-19 pandemic had a significant impact on the support networks for older adults and caregivers as health and social care systems were forced to dramatically change the ways patients and clients interacted with providers, services, and programs. In Northern Ontario, caregivers are older, caring in more intense situations, more likely to be caring for multiple care recipients simultaneously and less likely to be in contact with health professionals. This research sought to explore the post-pandemic needs of caregivers in a Northern Ontario health catchment to better understand the needed supports. Using a collaborative and co-design approach with caregiver advisors …

Effects Of Sex And Estrous Cycle On Extended-Access Oxycodone Self-Administration And Cue-Induced Drug Seeking Behavior, Bhumiben P Patel, Jessica A Loweth

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Increasing evidence indicates that sex is a factor that impacts the abuse liability and relapse vulnerability of prescription opioids like oxycodone. However, while women are more likely than men to be prescribed and to use these drugs, the impact of sex and ovarian hormones on prescription opioid use and relapse vulnerability remains unclear. Accurately assessing these measures is complicated by the fact that chronic opioid exposure can lower ovarian hormone levels and cause cycle irregularities.

METHODS: Adult male and female Sprague-Dawley rats self-administered oxycodone (0.1 mg/kg/infusion) under extended-access conditions (6 h/day, 10 days) followed by forced abstinence. Separate groups …

Evaluation Of A Primary Care Community Health Center’S Mammogram Program In Relation To Current Evidence-Based Practice., Brianna Childress

Doctoral Dissertations & Projects

Breast cancer is the second leading cause of cancer deaths among women over 50 years of age. Although mammograms have been proven to be effective in early detection of breast cancer, compliance rates are declining in the United States making it an objective for Healthy People 2030 to achieve and maintain a national compliance rate of 80.3%. For early detection of breast cancer among women between 50 to 74 years old to occur, an effective breast cancer screening program is vital. To understand why mammogram compliance rates were below the national average at a primary care community health center in …

Successful Application Of Craniosacral Therapy In A Case Of Colic In An 8-Week-Old Baby, Caro O’Neill, Angie Butterfield

Journal of Transformative Touch

This case study reports on the effectiveness of CranioSacral Therapy (CST) for an eight-week-old baby boy experiencing colic. A CST pediatric protocol was utilized during two sessions, a week apart, in May 2023. An improvement in symptoms was recorded after the first treatment. After the second treatment the baby was no longer presenting with symptoms related to infant colic. This case suggests that CST can be an effective support for babies experiencing infant colic.

Word count: 75

Postpartum Post-Traumatic Stress Symptoms And Their Association With Mood And Parenting Stress, Sarah Heerboth, Katharine E Bruce, Terri L Fletcher, Alison M Stuebe, Alison N Goulding

Faculty, Staff and Students Publications

No abstract provided.

Demographic Characteristics, Perinatal Smoking Patterns, And Risk For Neonatal Health Complications Among Pregnant Smokers In The United States Who Begin Using Electronic Cigarettes During Pregnancy: A Descriptive Study Using Population-Based Surveillance Data., Hui Nian, Rachel Odland, Samantha Mindlin, Lin Ammar, Hilary Tindle, Angela M Miller, Kelli K Ryckman, Ethan Xie, Tina V Hartert, Brittney M Snyder, Steven M Brunwasser, Pingsheng Wu

Rowan-Virtua School of Osteopathic Medicine Departmental Research

INTRODUCTION: Health agencies have called for research evaluating e-cigarette (EC) use in supporting prenatal smoking cessation. This study aimed to describe (1) the characteristics of smokers who begin using electronic cigarettes (ECs) during pregnancy, (2) how frequently smokers reduce or eliminate pre- and post-natal combustible cigarette (CC) use, and (3) the risk for neonatal health complications among smokers who initiate ECs during pregnancy.

AIMS AND METHODS: Pregnant women using CCs exclusively during prepregnancy, who participated in a U.S. surveillance study, were classified by their reported late-pregnancy smoking behavior as CC-exclusive users, EC initiators, or quitters. EC initiators were further subclassified …

93rd Annual Georgia Public Health Association Meeting And Conference Report, Jimmie H. Smith Jr, Angela Peden, Patrina L. Bowles

Journal of the Georgia Public Health Association

The 93^rd Annual Meeting and Conference of the Georgia Public Health Association (GPHA) was held in Jekyll Island, Georgia, at the Jekyll Island Convention Center, on May 3-5, 2023. The goal of the 2023 Georgia Public Health Association Annual Meeting and Conference was to assemble emerging public health professionals, current practitioners, academicians, governing entities, and community stakeholders for educational opportunities and networking to support the vision and mission of GPHA.

The theme for the 2023 Georgia Public Health Association Annual Meeting and Conference theme was selected by the GPHA Executive Board during a meeting in the early fall of …

A Unique Advantage Of A 24-Hour Surgical Delay In Autologous Breast Reconstruction, Devin M. Melancon, Daniel Yoo, Zachary Stern-Buchbinder, Samantha Morin, Hugo St. Hilaire, Robert J. Allen

School of Medicine Faculty Publications

Summary: The surgical delay technique can be used effectively in autologous breast reconstruction when there is unfavorable flap vascular anatomy or when the reconstruction necessitates a larger volume of donor tissue to obtain optimal results. The length of time between surgically delaying the flap to pedicle division and inset of the flap often varies based on surgeon preference but is typically approximately a week or longer. The authors present a case in which a 24-hour surgical delay was successfully used to augment deep inferior epigastric perforator flaps for autologous reconstruction. This technique is beneficial as it does not allow time …

Quality Improvement Of Breast And Cervical Cancer Screening Satisfaction Rate At A Utrgv Resident-Led Clinic., Eunbee Cho, Diana Othon Martinez, Jian Garcia Cruz, Nestor Gerardo Astorga, Martha Solis, Oliverio Abarca Guzman, Elimar Gonzalez Morales, Fatimah Bello

Research Colloquium

Background: In the US, 77.3% of women aged 21-65 years have had a Pap smear within the past three years and around 75.9% of women aged 50-74 years reported having a mammogram within the past two years as recommended according to the U.S. Preventive Services Task Force (USPSTF). In UTRGV Resident-led Clinic located in Hidalgo County, the quality metrics data demonstrated screening satisfactory rate for cervical and breast cancer to be 18% in August 2023. This Quality Improvement project is aimed at enhancing the screening satisfactory rate of breast and cervical cancer by 20% at UTRGV Knapp IM Clinic by …

Effect Of Aquatic Exercises On Patellofemoral Joint Dysfunction In Middle Age Obese Women, Akshaya Joshi, Sandeep Shinde, Sawani Aphale

Chulalongkorn Medical Journal

Background: The patellofemoral joint, known for its incongruence, is susceptible to dysfunction due to abnormal pathomechanics, especially with increased body mass causing excessive stress on knee cartilage, leading to degeneration and dysfunction. Dysfunction results in pain, limited range of motion, and diminished quality of life.

Objectives: To determine the effect of aquatic exercises on patellofemoral joint dysfunction in middle-aged obese women and to compare the effect of aquatic exercises with land-based exercises on patellofemoral joint dysfunction in middle-aged obese women.

Methods: In this experimental study, 100 subjects with patellofemoral joint dysfunction were separated into group …

Pelvic Floor Physical Therapy In Pregnant And Postpartum Women, Madison G. Kaup

Senior Theses

This project had three main goals: 1) Explore how pregnancy and childbirth affect the female pelvic floor anatomy and physiology, 2) Examine current practices through a literature review and interviews conducted with pelvic floor physical therapists currently practicing in various clinical settings across the United States, and 3) Develop suggestions to mitigate the challenges currently faced in the field by patients and therapists.

The female pelvic floor undergoes extensive changes throughout pregnancy as its structures are targeted by laxity-inducing hormones and mechanical stress from the growing fetus. During childbirth, the system is stretched beyond its physiological limit, causing damage to …

Healthcare Worker Practices For Hpv Vaccine Recommendation: A Systematic Review And Meta-Analysis, Damola Bakare, Elisa Gobbo, Kofoworola Akinsola, Ayobami Bakare, Julius Salako, Claudia Hanson, Sibylle Herzig Van Wees, Adegoke Falade, Carina King

Centre of Excellence in Women and Child Health

Healthcare workers (HCWs) are trusted sources of information for vaccination and their attitude toward vaccination is thus critical. We aimed to synthesize existing literature on healthcare workers’ HPV vaccine confidence and their practices of recommending this vaccine. We conducted a systematic literature review and meta-analysis, with the search conducted last in March 2024. For the inclusion criteria, the studies needed to include healthcare worker practices or behaviors on recommending the HPV vaccination. Seventy-three articles were included. The proportions of HCWs recommending varied considerably by region and gender of the recipient, but there was no statistically significant difference in income level …

Hormone Replacement Therapy And Risk Of Pancreatic Cancer In Postmenopausal Women: Evidence From The Us National Inpatient Sample 2008–2018, Lei Liu, Xinyu Wang, Dekai Guo, Ruirui Ma, Haibing Gong, Congjun Wang

Faculty, Staff and Student Publications

BACKGROUND: Pancreatic cancer is a serious, usually fatal disease and one of the most aggressive malignancies. Research into whether hormone replacement therapy (HRT) might protect against pancreatic cancer has yielded mixed results. This study aimed to investigate the potential association between HRT and the risk of pancreatic cancer in postmenopausal women.

METHODS: This population-based, retrospective study extracted data from the US National Inpatient Sample (NIS) 2008-2018. Hospitalized females aged ≥55 years were eligible for inclusion. Associations between HRT, other study variables, and pancreatic cancer diagnosis were determined using univariate and multivariable regression analyses.

RESULTS: After 1:4 matching by age, data …

Molecular Targets For Breast Cancer Therapy, Hamidreza Montazeri Aliabadi

Pharmacy Faculty Articles and Research

"Breast cancer is by far the most common cancer in women, and for a while, it surpassed lung cancer as the most diagnosed cancer, regardless of gender, in 2020 [1]. Chemotherapy and hormone therapy are still the first line of treatment, despite extensive research in molecularly targeted drugs. Therefore, triple negative breast cancer (TNBC) is still known as the most challenging type for treatment due to the limited identified targets. Inherent and acquired resistance are still major hurdles in breast cancer therapy, which further highlights the importance of identifying new molecular targets in this battle. The inherent resistance of unresponsive …

Genomic And Socioeconomic Determinants Of Racial Disparities In Breast Cancer Survival: Insights From The All Of Us Program, Nubaira Rizvi, Hui Lyu, Leah Vaidya, Xiao Cheng Wu, Lucio Miele, Qingzhao Yu

School of Public Health Faculty Publications

Background: Breast cancer outcomes are worse among Black women in the U.S. compared to White women. While extensive research has focused on risk factors contributing to breast cancer; the role of genomic elements in health disparities between these racial groups remains unclear. This study aims to identify genomic variants and socioeconomic status (SES) determinants influencing racial disparities in breast cancer survival through multiple mediation analyses. Methods: Our investigation is based on the NIH-supported All of Us (AoU) program and analyzes 7452 female participants with malignant tumors of breast, including 5073 with genomic data. A log-rank test reveals significant racial differences …

Crizotinib Enhances Parp Inhibitor Efficacy In Ovarian Cancer Cells And Xenograft Models By Inducing Autophagy, Janice M Santiago-O'Farrill, Alicia Blessing Bollu, Hailing Yang, Vivian Orellana, Marc Pina, Xudong Zhang, Jinsong Liu, Robert C Bast, Zhen Lu

Faculty, Staff and Student Publications

Poly (ADP-ribose) polymerase inhibitors (PARPi) can encounter resistance through various mechanisms, limiting their effectiveness. Our recent research showed that PARPi alone can induce drug resistance by promoting autophagy. Moreover, our studies have revealed that anaplastic lymphoma kinase (ALK) plays a role in regulating the survival of ovarian cancer cells undergoing autophagy. Here, we explored whether the ALK-inhibitor crizotinib could enhance the efficacy of PARPi by targeting drug-induced autophagic ovarian cancer cell and xenograft models. Our investigation demonstrates that crizotinib enhances the anti-tumor activity of PARPi across multiple ovarian cancer cells. Combination therapy with crizotinib and olaparib reduced cell viability and …

A Time-Stratified, Case–Crossover Study Of Heat Exposure And Perinatal Mortality From 16 Hospitals In Sub-Saharan Africa, Claudia Hanson, Jeroen De Bont, Kristi Sidney Annerstedt, Maria Del Rosario Alsina, Federica Nobile, Nathalie Roos, Peter Waiswa, Andrea Pembe, Jean-Paul Dossou, Hussein Kidanto

Centre of Excellence in Women and Child Health

Growing evidence suggests that extreme heat events affect both pregnant women and their infants, but few studies are available from sub-Saharan Africa. Using data from 138,015 singleton births in 16 hospitals in Benin, Malawi, Tanzania and Uganda, we investigated the association between extreme heat and early perinatal deaths, including antepartum and intrapartum stillbirths, and deaths within 24 h after birth using a time-stratified case–crossover design. We observed an association between an increase from the 75th to the 99th percentile in mean temperature 1 week (lag 0–6 d) before childbirth and perinatal mortality (odds ratio (OR) = 1.34 (95% confidence interval …

Optimal Timing Of Delivery For Pregnant Individuals With Mild Chronic Hypertension, Torri D Metz, Hui-Chien Kuo, Lorie Harper, Baha Sibai, Sherri Longo, George R Saade, Lorraine Dugoff, Kjersti Aagaard, Kim Boggess, Kirsten Lawrence, Brenna L Hughes, Joseph Bell, Rodney K Edwards, Kelly S Gibson, David M Haas, Lauren Plante, Brian Casey, Sean Esplin, Matthew K Hoffman, Kara K Hoppe, Janelle Foroutan, Methodius Tuuli, Michelle Y Owens, Hyagriv N Simhan, Heather Frey, Todd Rosen, Anna Palatnik, Susan Baker, Phyllis August, Uma M Reddy, Wendy Kinzler, Emily J Su, Iris Krishna, Nguyet A Nguyen, Mary E Norton, Daniel Skupski, Yasser Y El-Sayed, Dotun Ogunyemi, Ronald Librizzi, Leonardo Pereira, Everett F Magann, Mounira Habli, Shauna Williams, Giancarlo Mari, Gabriella Pridjian, David S Mckenna, Marc Parrish, Eugene Chang, Joanne Quiñones, Zorina S Galis, Namasivayam Ambalavanan, Rachel G Sinkey, Jeff M Szychowski, Alan T N Tita

Faculty, Staff and Students Publications

Objective: To investigate the optimal gestational age to deliver pregnant people with chronic hypertension to improve perinatal outcomes.

Methods: We conducted a planned secondary analysis of a randomized controlled trial of chronic hypertension treatment to different blood pressure goals. Participants with term, singleton gestations were included. Those with fetal anomalies and those with a diagnosis of preeclampsia before 37 weeks of gestation were excluded. The primary maternal composite outcome included death, serious morbidity (heart failure, stroke, encephalopathy, myocardial infarction, pulmonary edema, intensive care unit admission, intubation, renal failure), preeclampsia with severe features, hemorrhage requiring blood transfusion, or abruption. The primary …

Infertility’S Impact On Couples’ Functioning, Elizabeth Sanders

Dissertations

Historically, infertility has been a taboo topic of discussion and is often avoided in conversation because of the stigmatization of the diagnosis. According to the World Health Organization (2022), infertility affects 186 million individuals globally. However, there seems to be a gap in the research as it pertains to the psychological well-being and treatment of men and women diagnosed with this condition. While it has become less of a feared topic, it still is not discussed or researched enough, thus further exacerbating the gap in research on mental health and treatment options. The following dissertation completed a critical review of …

Exploring Perinatal Ketamine For Postpartum Depression Following Cesarean Section: A Systematic Review, Jaylyn Thompson, David F Lo, Alexis Foschini, Suvan Sundaresh

Rowan-Virtua School of Osteopathic Medicine Departmental Research

The aim of this study was to explore the use of perinatal ketamine to see if it can be used for the reduction of postpartum depression (PPD) following cesarean section (C-section). PubMed, Cochrane, and Web of Science were the primary databases used for this review. Search terms used on January 5, 2024 incorporated "ketamine," "C-section," "postpartum depression," and related synonyms. The criteria for inclusion centered on studies published between January 1, 2008 and January 5, 2024. The final selection of articles was screened based on extraction criteria leaving eight randomized control trials in the final review. The selected data from …

A Metabolite-Based Liquid Biopsy For Detection Of Ovarian Cancer, Johannes F Fahrmann, Seyyed Mahmood Ghasemi, Chae Y Han, Ranran Wu, Jennifer B Dennison, Jody Vykoukal, Joseph Celestino, Karen Lu, Zhen Lu, Charles Drescher, Kim-Anh Do, Samir Hanash, Robert C Bast, Ehsan Irajizad

Faculty, Staff and Student Publications

Serial CA125 and second line transvaginal ultrasound (TVS) screening in the UKCTOCS indicated a shift towards detection of earlier stage ovarian cancer (OvCa), but did not yield a significant mortality reduction. There remains a need to establish additional biomarkers that can complement CA125 for even earlier and at a larger proportion of new cases. Using a cohort of plasma samples from 219 OvCa cases (59 stage I/II and 160 stage III/IV) and 409 female controls and a novel Sensitivity Maximization At A Given Specificity (SMAGS) method, we developed a blood-based metabolite-based test consisting of 7 metabolites together with CA125 for …

Accessible Dietary Interventions For The Prevention And Management Of Common Menstrual Disorders: A Systematic Review, Ella R. Motzko

Theses and Graduate Projects

Objective: This systematic review aims to provide healthcare providers with evidence-based dietary recommendations that can be easily implemented by patients across diverse populations to address a critical gap in the management of common menstrual disorders like premenstrual syndrome (PMS) and primary dysmenorrhea (PD).

Methods: A comprehensive search was conducted using UpToDate, American College of Obstetrics and Gynecology (ACOG) Green Journal, Google Scholar, and PubMed electronic databases to identify randomized-controlled trials (RCTs) that investigated the effects of specific essential nutrients or diet-related behavioral or educational interventions on PMS or PD symptoms.

Results: Following the PRISMA guidelines, the identification process began with …

Exploration Of Positive Deviance In Prevention Of Underweight In The Under-Five: A Qualitative Study On Low-Income Urban Families, Irwan Budiono, Lukman Fauzi, Dewi Sari Rochmayani

Kesmas

Children under the age of five (the under-five) from low-income families are more vulnerable to experience underweight. This nutritional vulnerability is evident in the preliminary study, where 35.1% of the under-five experience underweight, and 28.48% are low-income families. This study aimed to explore Positive Deviance (PD) behaviors in preventing underweight among the under-five. The study applied a qualitative approach with a case study design. Data collection took place in July-August 2022, focusing on low-income families in the Gunung Brintik area. Data were collected through two focus group discussions, seven in-depth interviews, and five key informant interviews. Coding, subtheme, and theme …

Risk Factors For Cognitive Impairment In Adult Population Of Coastal Area: A Cross-Sectional Study In Maringkik Island, Indonesia, Herpan Syafii Harahap, Arina Windri Rivarti, Nurhidayati Nurhidayati, Fitriannisa Faradina Zubaidi, Dini Suryani, Legis Ocktaviana Saputri, Yanna Indrayana, Athalita Andhera, Muhammad Hilam, Abiyyu Didar Haq

Kesmas

Cognitive impairment is a medical condition commonly found in elderly populations, which can be due to vascular risk factors in patients. There remains limited data on risk factors for cognitive impairment among coastal region populations. This study aimed to investigate risk factors for cognitive impairment in the adult population of Maringkik Island, West Nusa Tenggara Province, Indonesia. Data collected were age, sex, education level, hypertension, antihypertensive treatment, diabetes mellitus, cigarette smoking, and body mass index status. A total of 114 participants were recruited using a consecutive sampling method. The participants’ cognitive function assessment used the Mini-Cog instrument. The cognitive impairment …

Microvascular Autologous Breast Reconstruction With The Lateral Thigh Perforator Flap, Stefania M.H. Tuinder, Joep A.F. Van Rooij, Robert J. Allen

School of Medicine Faculty Publications

The lateral thigh perforator flap is an excellent alternative to the deep inferior epigastric artery perforator (DIEP) flap for patients with absolute or relative contraindications for a DIEP flap and adequate volume at the lateral thigh. Preoperative physical examination, preoperative markings, and radiological perforator mapping are essential for adequate surgical preparation. The flap is based on septocutaneous perforators of the lateral circumflex femoral artery, located in the posterior septum between the tensor fascia latae and the gluteus medius muscle. Being relatively stiff, septocutaneous perforators are sensitive to kinking and compression, which is important to keep in mind during flap inset. …

Factorial Trial To Optimize An Internet-Delivered Intervention For Sexual Health After Breast Cancer: Protocol For The Wf-2202 Sexual Health And Intimacy Enhancement (Shine) Trial, Kelly M. Shaffer, Jennifer Barsky Reese, Emily V. Dressler, Jillian V. Glazer, Wendy Cohn, Shayna L. Showalter, Anita H. Clayton, Suzanne C. Danhauer, Michelle Loch, Mai Kadi, Caleigh Smith, Kathryn E. Weaver, Glenn J. Lesser, Lee M. Ritterband

School of Medicine Faculty Publications

Background: Although most survivors of breast cancer report substantial sexual concerns following treatment, few receive support for these concerns. Delivering sexual health care to survivors of breast cancer via the internet could overcome many of the barriers to in-person treatment. Even when delivered remotely, survivor time constraints remain a leading barrier to sexual health intervention uptake. Objective: Guided by the multiphase optimization strategy methodological framework, the primary objective of this study is to identify the most efficient internet-delivered sexual health intervention package that is expected to provide survivors of breast cancer the greatest benefit with the fewest (and least-intensive) intervention …

A Social Media Game To Increase Physical Activity Among Older Adult Women: Protocol Of A Randomized Controlled Trial To Evaluate Challenge, Michael C Robertson, Maria Chang Swartz, Karen M Basen-Engquist, Yisheng Li, Kristofer Jennings, Debbe Thompson, Tom Baranowski, Elena Volpi, Elizabeth J Lyons

Faculty, Staff and Student Publications

BACKGROUND: Older adult women often do not engage in sufficient physical activity (PA) and can encounter biological changes that exacerbate the negative effects of inadequate activity. Wearable activity monitors can facilitate PA initiation, but evidence of sustained behavior change is lacking. Supplementing wearable technologies with intervention content that evokes enjoyment, interest, meaning, and personal values associated with PA may support long term adherence. In this paper, we present the protocol of an NIA-funded study designed to evaluate the efficacy of CHALLENGE for increasing step count and motivation for PA in insufficiently active older women (Challenges for Healthy Aging: Leveraging Limits …

The Status Of Abortion Care Training For Medical Providers Amidst The Current Abortion Access Crisis: A Literature Review, Leah Johnson

Theses and Graduate Projects

Background: While a common, safe, and essential aspect of reproductive healthcare, abortions have been subject to countless legal restrictions and bans in the United States, especially after the overturn of Roe v. Wade. This has also exacerbated the current shortage of abortion providers. Within this crisis of worsening abortion access, it is imperative to appropriately train future clinicians to provide abortion care. Purpose: This literature review will investigate the status of abortion training in medical schooling. It will explore physician-specific education in abortion and look specifically at the impact of recent legal threats on the availability of this training. Finally, …

Cycle Syncing: Optimizing Women's Quality Of Life, Megan Francois

Theses and Graduate Projects

A woman’s hormones are in constant fluctuation throughout the menstrual cycle. This 28-day, on average, fluctuation can cause major shifts in mood, cognition, exercise tolerance, and nutrition needs. Because of this, there is potential to optimize quality of life if each phase is synced with diet, exercise, and complementary medicine utilizing holistic methods. Implications for further research include a need for additional longitudinal and prospective studies. Factors that need to be addressed include further analysis of the windows of vulnerability over the menstrual cycle according to female hormone fluctuations, effects of hormonal contraceptives, and effects of pathology on the cycle.

Addressing The Increased Prevalence Of Gestational Diabetes Among Hispanic/Latino Pregnant Persons In The Central Valley Of California, Kathleen Janise Farrell Wardell

Master's Projects and Capstones

Gestational Diabetes (GDM) is a preventable noncommunicable disease that has been on the rise over the last 60 years. Pregnant persons with gestational diabetes are 10 times higher of acquiring Type 2 Diabetes after pregnancy (Ionannou et al., 2024). There is an urgent need to address this public health threat because of its increase in mortality. To address this complex chronic disease, this literature review explored multi-level interventions using the socioecological model to mitigate GDM in the Central Valley’s, Tulare County. Tulare County is disproportionately affected by chronic diseases like diabetes especially among the Hispanic and Latinx communities. Therefore, it …