Women's Health Commons^™

Trends In Diagnoses Of Neonatal Abstinence Syndrome At Newborn Hospitalization In Maine, 2009-2018, Emily C. Bauer Mph, Katherine Ahrens Phd, Jenny L. Carwile Mph, Scd

Journal of Maine Medical Center

Introduction: Incidence rates of neonatal abstinence syndrome (NAS) have increased in Maine, but whether this increase can be explained by use of different diagnosis codes over time is unknown. Our objective was to estimate trends in diagnoses of NAS at newborn hospitalization in Maine using different NAS case definitions.

Methods: We used International Classification of Diseases (ICD) diagnosis codes to identify newborns diagnosed with NAS in Maine between 2009 and 2018 using state-level hospital discharge data (n = 123 519). First, we considered only ICD-9 and ICD-10 codes used for confirmed NAS. Then we used an expanded ICD-10 NAS case …

The Impacts Of Terrorism On Maternal Health In Afghanistan, Kyla Rocanello-Snow

Global Sustainable Development Projects

Terrorism is both directly and indirectly harmful to maternal health. Terrorist attacks targeted at healthcare workers, hospitals and maternity wards are a direct impediment of maternal healthcare. Other terrorist activity and conflict produce overall instability, aggravating insecurity in the country. Attacks that disrupt functions within a community and a country at large indirectly impact maternal health as they target specific social determinants of health, including infrastructure for transportation, education, and healthcare. Terrorism and the influence of Islamic militia groups in Afghanistan continue to threaten the power and stability of the national government, making it difficult for policy enactment to improve …

A Systematic Review Of Approaches Used For Reproductive Health Interventions, Hanvit Park, Emma Hilbelink, Adejoke Ayoola

Summer Research

During 2011 in the United States, 48% of all pregnancies were unintended.1 This may be attributed to a lack of knowledge of women’sreproductive anatomy and bodily changes, and contraception. To promote women's reproductive health, it is essential for women to be educated about their reproductive system, associated bodily changes, risk of conception and contraceptive use.

Increasing Minority Representation In The Healthcare Field Through A Girl’S Summer Camp, Anna Christiansen, Dzifa Agbossey-Dimado, Adejoke Ayoola

Summer Research

• Despite increasing diversity among the United States’ population, the healthcare workforce, particularly in highly skilled roles, has failed to keep pace. The underrepresentation of minority groups within healthcare professions comes at the expense of quality and access to care, patient satisfaction, acceptability, general experience, and health outcomes.
• One promising approach to addressing this health inequity is increasing the diversity of the healthcare workforce across all skill-level roles so that it is representative of the population which it serves. Research suggests that exposing underrepresented groups to healthcare professions as a possible career path during formative career planning years (early middle school), …

An Assessment Of Kentucky Birth Records, Focusing On Early-Onset Hypertensive Disorders Of Pregnancy, Environmental Metal Exposures, And Geocoding Precision, 2008-2017, Courtney J. Walker

Theses and Dissertations--Epidemiology and Biostatistics

Using live and stillbirth records from Kentucky (2008-2017), this dissertation assessed the county-level prevalence and geospatial patterns of early-onset hypertensive disorders of pregnancy (eHDP); examined the geocoding precision of addresses recorded on birth records, and evaluated the association between individual risk factors and environmental metal exposures on eHDP prevalence. After adjusting for maternal demographic factors and pre-existing health conditions, we observed that eHDP prevalence was 38% higher (aPR=1.38, 95%CI:1.16, 1.64) in counties with the highest prevalence of married women (> 53.8%) compared to lower prevalence areas (31.6%) had a 20% higher prevalence of eHDP(aPR=1.20, 95%CI:1.00, 1.44) compared to counties with …

Addressing The Needs Of African American Grandparents: An Intersectionality Perspective, Dorothy Smith-Ruiz, Kendra Jason

The Journal of Sociology & Social Welfare

This study seeks to demonstrate the intersecting structural and compounding challenges African American custodial grandparents experience collectively, rather than as separate non-competing factors, which has been modeled in prior studies. Using a mixed-method research design, the study explored the challenges faced by African American and white custodial grandparents. These challenges included difficulties attaining different types of support, respite care, and programs for teens and special needs grandchildren. Results showed that caregiving challenges among African Americans were more pervasive than their White counterparts. These findings have significant implications for the development of intervention programs for custodial African American grandmothers and their …

Assessment Of Cooking Matters Facebook Platform To Promote Healthy Eating Behaviors Among Low-Income Caregivers Of Young Children In The United States: A Pilot Study, Qi Zhang, Jill Panichelli, Leigh Ann Hall

Community & Environmental Health Faculty Publications

How best to deliver healthy-eating education through social media among a low-income population remains understudied. To assess the impact of the Cooking Matters (CM) Facebook page on healthy eating behaviors among low-income caregivers, we conducted a pre–post survey of new CM Facebook followers in early 2020. A convenience sample was recruited at baseline from WICShopper app users and the CM Facebook page. The recruited sample included 397 low-income caregivers of a child younger than 6 who never followed CM Facebook. Among the baseline caregivers, 184 completed the follow-up survey. Paired t-test and McNemar–Bowker tests were conducted to compare the outcomes …

Effects Of Resistance Training On Muscle Quality Index, Muscle Strength, Functional Capacity, And Serum Immunoglobulin Levels Between Obese And Non-Obese Older Women, Paulo Roberto Silva Junior, Dahan Da Cunha Nascimento, Ivo Vieira De Sousa Neto, Silvana Schwerz Funghetto, Ramires Alsamir Tibana, James W. Navalta, Fabiani Lage Rodrigues Beal, Jonato Prestes

Kinesiology and Nutrition Sciences Faculty Research

International Journal of Exercise Science 14(7): 707-726, 2021. Considering the negative impact of obesity on neuromuscular and immune systems, we sought to compare the effects of a 10-week resistance training (RT) program on muscle quality index (MQI), muscle strength, functional capacity, and immunoglobulins in older women with and without obesity. Thirty-nine older women participated in the present study (age: 69.02 ± 6.16, fat (%): 38.80% ± 6.28) and underwent a linear RT program performed on two non-consecutive days of the week. Body composition, functional tests, immunoglobulins, muscle quality of upper and lower limbs and absolute muscular strength of the upper …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Instruction Guide [Arabic], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

English Summary:
The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels and with different viewpoints, and build concrete and meaningful programming for adolescent girls. The toolkit contains all the materials needed to help make a preliminary assessment of the assets a girl should acquire and the age by which she should acquire them. This document contains the Building Assets Toolkit’s List of …

Nurse Home Visitation Program In Hamilton County, Oh To Increase Maternal And Child Health Outcomes, Hannah Widner

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Hamilton County Ohio currently has poor outcomes related to maternal and infant health, specifically among African Americans. Compared to the Healthy People 2020 goals, Hamilton County has higher rates of infant mortality, preterm birth, neonatal infant mortality, and conception within 18 months of previous pregnancies. These rates are disproportionate among African Americans. For instance, African American babies born in Ohio have higher infant mortality rate (14.3 per 1,000) prematurity as a cause of death (4 per 1,000) and neonatal mortality rate (9.2 per 1,000). These are compared to White babies in Ohio with infant mortality rate (5.1 per 1,000), prematurity …

Implementing The Mothers And Babies Program To Reduce Preterm And Low Birth Weight Deliveries, Tan Frison

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

Georgia ranks fourth (4th) in the nation for the highest low birth weight rate at 10%, and sixth (6th) in the nation for preterm birth rate at 11.7%, among the states. Based on statistical data Bulloch county has maintained an average low birth weight statistic of 10% for over a decade. In 2019, there were 107 preterm and 79 low weight births in Bulloch county, Georgia. These numbers confirm there is a need for more preventive resources for mothers and children within this community. To address this burden, the Bulloch County health department has decided to implement the Mothers and …

How Did We Learn About Sex? —— Sex Education And Sexual Health In Chinese Youth, Yujuan Liu

Theses and Dissertations (Comprehensive)

Attitudes toward sexuality among Chinese youth have become more liberal in recent generations, but sex education remains controversial and limited. Due to the lack of awareness of sexual risks, many Chinese youth engage in unprotected sexual activities resulting in unintended pregnancy, abortions, and STIs. Therefore, understanding successful pathways and unique challenges are crucial to develop adequate sex education for youth’s sexual health in China. The current study used semi-structured in-depth interviews and investigated 28 Chinese youths’ experiences of sex education and sexual health. The results mapped out youth’s sex education experiences by age and sources and demonstrated the impacts of …

Impact Of Smoking And Hpv Status On Cervical Cancer Survival In Women Living In Kentucky, 2004-2005 And 2014-2015, Brittany M. Mckinley

Theses and Dissertations--Public Health (M.P.H. & Dr.P.H.)

BACKGROUND/ OBJECTIVE: Cervical cancer is the fourth most commonly occurring malignancy in women worldwide, with an estimated 530,000 new cases and 270,000 new deaths each year (Small et al, 2017). While the incidence of cervical cancer has decreased by approximately 1.9% per year between 2007 and 2011, the death rate has remained stable (Bernard et al, 2014). Studies have shown that nearly all cervical cancer cases are associated with the Human Papilloma Virus (HPV). Many studies support the association of smoking with increased risk of invasive cervical cancer in women with high-risk HPV (Castle et al, 2002; Fang et al, …

Data On Breastfeeding And State Policies In The United States, Chun Chen, Hong Xue, Qi Zhang

Community & Environmental Health Faculty Publications

Breastfeeding is critically important to maternal and child health in the United States. Examining the relationship between breastfeeding outcomes and state policies requires multidisciplinary efforts to link data from various sources. This article describes an integrated dataset that was used to understand the relationship between participation in a nutrition assistance program and low-income children's breastfeeding outcomes [1]. This dataset merged public health information from the National Immunization Surveys Data from 2006 to 2016 and matching state policy data from the Correlates of State Policy Project (CSPP), the U.S. Department of Agriculture/Economic Research Services (USDA/ERS) Supplemental Nutrition Assistance Program (SNAP) Policy …

Neither “Post-War” Nor Post-Pregnancy Paranoia: How America’S War On Drugs Continues To Perpetuate Disparate Incarceration Outcomes For Pregnant, Substance-Involved Offenders, Becca S. Zimmerman

Pitzer Senior Theses

This thesis investigates the unique interactions between pregnancy, substance involvement, and race as they relate to the War on Drugs and the hyper-incarceration of women. Using ordinary least square regression analyses and data from the Bureau of Justice Statistics’ 2016 Survey of Prison Inmates, I examine if (and how) pregnancy status, drug use, race, and their interactions influence two length of incarceration outcomes: sentence length and amount of time spent in jail between arrest and imprisonment. The results collectively indicate that pregnancy decreases length of incarceration outcomes for those offenders who are not substance-involved but not evenhandedly -- benefitting white …

Psychological Distress And Relationship Satisfaction Among Survivors Of Sexual Violence, Alyssa Campbell

Theses and Dissertations--Family Sciences

The World Health Organization (WHO; 2002) has indicated that sexual violence is a serious public health concern, and both the WHO and the United Nations (UN) have declared that violence against women, in particular, is a profound violation of human rights (UN General Assembly, 1993; WHO, 2017). Although the systemic and negative impact of trauma on family and intimate relationships have been well documented, the empirical literature regarding the effects of adult sexual trauma on relationship satisfaction is less robust. These studies are designed to address this gap and will do so with analyses centered on an understudied population: the …

Medical Knowledge As A Recalcitrant Epistemological System: An Application Of Standpoint Epistemology In The Analysis Of Marginalization Within U.S Healthcare, Abby Deshazo

CMC Senior Theses

Research on healthcare disparities outside the field of epistemology tend to miss the true origins of oppressions imposed on marginalized individuals by the U.S healthcare system. This happens because of the false belief that these oppressions are reducible to social or political oppressions. By employing the perspective of a standpoint epistemologist, we can better identify the origins of these oppressions and subsequently consider more appropriate solutions. The standpoint epistemologist’s perspective (1) provides an intuitive case for the role individuals’ schemas play in the evaluation of what healthcare professionals know; (2) situates medical knowledge within epistemology, leading us to …

The Association Of Pregnancy Control, Emotions, And Beliefs With Pregnancy Desires, Meredith G. Manze, Diana R. Romero, Prabal De, Josette Hartnett, Lynn Roberts

Publications and Research

Context

Standard pregnancy intentions measures do not always align with how people approach pregnancy. Studies that have investigated beyond a binary framework found that those with “ambivalent” feelings towards pregnancy are less likely to use contraception consistently, but the reasons for this are unclear. We sought to gain a nuanced understanding of pregnancy desires, and how perceptions about pregnancy are associated with contraceptive use.

Methods

We used non-probability quota sampling based on sex, age, and geographic region for a web-based survey of heterosexual men and women, aged 21–44 years, who could become pregnant/impregnate and were not currently pregnant (n = …

Safety And Efficacy Of Bioidentical Hormone Therapy In Menopause: A Literature Review, Kathryn Akre

All Graduate Theses, Dissertations, and Other Capstone Projects

Vasomotor symptoms (VMS) experienced during menopause can negatively impact a woman’s quality of life, productivity, sleep, and mood. Systemic hormone therapy (HT) is the most effective treatment for moderate to severe VMS, however safety concerns raised by the 2002 Women’s Health Initiative (WHI) trial have led to a decrease in overall HT use and a growing demand for custom-compounded bioidentical HT. Misconceptions regarding the superior safety and efficacy of custom-compounded hormones and lack of clinician expertise in menopause management contribute to ongoing uncertainty and low uptake of United States (U.S.) Food and Drug Administration (FDA) approved bioidentical HT products. This …

Reducing Disease Exacerbation In Women With Confirmed Copd: A Systematic Literature Review, Jill Essay

All Graduate Theses, Dissertations, and Other Capstone Projects

Abstract

A systematic literature review was conducted to establish whether gender specific treatment exists for patients with Chronic Obstructive Pulmonary Disease (COPD), specifically, women with (COPD). The PICO question developed for this review is as follows: In women with confirmed diagnoses of COPD, does gender-specific treatment, compared to standard treatment, impact the frequency of exacerbations? Could the number of COPD exacerbations in women be reduced by incorporating interventions designed with (female) gender in mind? Four databases were included in the search: CINAHL, Pubmed, Medline, and Nursing and Allied Health. Articles included addressed gender differences in relation to the disease process, …

Building Assets Toolkit: Developing Positive Benchmarks For Adolescent Girls—Asset Cards [Arabic], Judith Bruce, Sarah Engebretsen, Kimberly Glazer

Poverty, Gender, and Youth

[In Arabic] The Building Assets Toolkit is an approach for developing programs for specific segments of girls that will prepare them to better face the challenges of growing up. It will help program managers understand the needs of the girls in their community, engage stakeholders at different levels and with different viewpoints, and build concrete and meaningful programming for adolescent girls.

This document contains the Building Assets Toolkit’s Asset Cards (110), set of Age Cards (age 6 to 20), and Program Planning Worksheet (sample provided). The Age Cards are to be printed out and placed according to the instructions. The …

Extending Postpartum Medicaid: State And Federal Policy Options During And After Covid-19, Jamie R. Daw, Emily Eckert, Heidi Allen, Kristen Underhill

Faculty Scholarship

The United States is facing a maternal health crisis with rising rates of maternal mortality and morbidity and stark disparities in maternal outcomes by race and socioeconomic status. Among the efforts to address this issue, one policy proposal is gaining particular traction: extending the period of Medicaid eligibility for pregnant women beyond 60 days after childbirth. The authors examine the legislative and regulatory pathways most readily available for extending postpartum Medicaid, including their relative political, economic, and public health trade-offs. They also review the state and federal policy activity to date and discuss the impact of the COVID-19 pandemic on …

The Southern Hospitals Report, Elizabeth Reiner Platt, Katherine M. Franke, Candace Bond-Theriault, Amy Littlefield

Faculty Scholarship

When research for this report was first initiated, it was intended to answer a narrow question: is abortion care restricted at historically Protestant hospitals in the U.S. South? Strict limits on access to abortion at Catholic hospitals — and the ways in which this can obstruct and delay even emergency medical care — are already well documented in legal and medical literature and news media. In contrast, restrictions at Protestant hospitals have not been extensively studied and are not well understood. Our research sought to fill this gap in knowledge. We focused on the U.S. South because Catholic hospitals are …

The Ideology Of Baby-Mama Phenomenon: Assessing Knowledge And Perceptions Among Young People From Educational Institutions, Opeyemi S. Adeojo, Daniel Egerson, Gabriel Mewiya, Rowland Edet

Department of Sociology: Faculty Publications

This study investigated the knowledge and perception of the ideology of baby-mama concept among the youths. Particularly, this paper assessed the knowledge of the concept of baby mama among youths and also their opinion on the acceptability of this style of family structure. The study employed a qualitative approach through an in-depth interview research method. Forty respondents between the ages of 16 and 40 years were selected across three educational institutions in Oyo state, south-west Nigeria. The participants of the study voluntarily agreed to participate in the research and everything said during the course of the interview was transcribed and …

A Mixed Methods Approach To Examine Racial Disparities In Adherence To Surveillance Mammography Among Breast Cancer Survivors, Megan C. Edmonds

Theses and Dissertations

PURPOSE: Annual surveillance mammography is a critical part of routine cancer care for breast cancer (BC) survivors; reducing mortality by 39%. However, disparities exist with regard to adherence to surveillance mammograms among BC survivors; Black women are 44% less likely to adhere than their White counterparts. Despite the existence of this racial disparity for over a decade, little is known about factors that explain reasons for Black BC survivors’ non-adherence. This is because most studies have not evaluated the role of healthcare delivery or psychosocial factors. Guided by the Behavioral Model for Vulnerable Populations, the purpose of this mixed methods …

Policies Addressing Barriers To Low-Income Women And Children’S Health Care Utilization In The United States And Kenya: The Role Of Physician Payments And Cash Transfer Programs, Muloongo Simuzingili

Theses and Dissertations

This dissertation examined two policies to improve low-income women and children’s healthcare utilization: physician payments and cash transfer programs. Higher physician payments increase the supply of healthcare services while cash transfers increase individuals’ demand for healthcare services. Cash transfer programs can improve health outcomes, yet the extent to which they are a cost-effective strategy is largely understudied. Therefore, this dissertation examines three overarching research questions:

1. Are Medicaid physician fees associated with access to substance abuse disorder (SUD) treatment among low-income women of reproductive age?
2. Do economic preferences moderate cash transfer program effects on children’s health care utilization? Evidence from a …

Population Assessment To Determine The Eligibility For Birth Center Care At University Of Kentucky Midwife Clinic, Dolores Polito

DNP Projects

Background: The COVID-19 crisis prompted patients to inquire about their options to avoid going to the hospital for birth. Outside of the hospital, birth center care has been identified as an evidence-based model for healthy women during pregnancy and birth, but it is not available in Kentucky.

Purpose The purpose of this study was to determine if there are women eligible for birth center care who have been part of a nurse midwifery service and given birth in a large, academic, tertiary care setting.

Methods: A retrospective chart review was used for this study. It involved a collection of …

Factors Influencing Contraception Use In Sexual Minority Women: A Systematic Literature Review, Grace M. Hudson

All Graduate Theses, Dissertations, and Other Capstone Projects

Contrary to widespread beliefs that lesbian, gay, bisexual, transgender, queer, plus (LGBTQ+) women do not need contraceptive care, sexual minority women (SMW) engage in vaginal-penile sexual contact which puts them at risk for unintended pregnancy. SMW assigned female gender at birth are at higher risk for less reliable and consistent contraceptive use and thus unintended pregnancy (Everett et al., 2017). This leads to the question of factors which cause SMW to be less engaged in contraceptive services. Through synthesis of studies addressing SMW and contraceptives, four themes developed: attitudes towards contraception, obstacles to care, knowledge gaps, and ways to improve …

Choosing Between Medical Surveillance And Preventive Surgical Interventions Among Asymptomatic Brca Positive Women, Hillary Zupan

All Graduate Theses, Dissertations, and Other Capstone Projects

Women with a known BRCA 1 or BRCA 2 genetic mutation are at an increased risk for the development of cancer, most commonly breast and uterine types. Risk reduction strategies to manage cancer risk include increased medical surveillance and various preventive surgeries. This is a deeply personal decision and one that is influenced by a variety of factors. The aim of this literature review is to identify the key factors impacting the decision-making process of a woman with a BRCA mutation and how a woman ultimately decides between the cancer risk management strategies. Six electronic databases were used to obtain …

Perceived Barriers And Facilitators To Cervical Cancer Screening In Asian American Women, Bouathong Thepsombath

All Graduate Theses, Dissertations, and Other Capstone Projects

The purpose of this systematic review is to explore barriers and facilitators of cervical cancer screening in Asian-American women. Articles selected for review were found using a database search method using select predetermined key terms. The clinical question this review sought to answer is: In Asian-American women (21-65 years of age), how does perception of cervical cancer screening impact screening compliance? Nine articles addressing the topic of interest were included in the review. Emerging themes related to answering the question under study included the health literacy of Asian-American women, modesty, acculturation, income comfortability, and self-efficacy. This review found information that …