Women's Health Commons^™

Menstruation Behind Bars: A Mixed-Methods Study On Menstrual Product Access And Distribution Practices In Mississippi County Jails, Eron Hendrix

Honors Theses

This study examines menstrual product access and distribution practices in Mississippi county jails. It highlights the impact of period poverty as a critical yet underexplored public health and human rights issue within the corrections system. While existing research documents widespread inequities in access to menstrual products women’s healthcare in the correctional system, limited attention has been given to menstrual health at the local jail level. Using a mixed-methods approach, this study combines qualitative interviews with jail correctional staff and quantitative survey data from formerly incarcerated women to better understand institutional practices and lived experiences.

Interviews were conducted with sheriffs, jail …

It’S Up To The States: The Role Of State-Based Safety Net Programs In Maternal Health Outcomes, Brooklyn Hall

Honors Theses

This thesis explores the relationship between state-based safety net programs and maternal health outcomes in the United States. Using the case studies of five states, namely Mississippi, Alabama, Wisconsin, Minnesota, and California, this research examines how variations in programs such as Medicaid, the Earned Income Tax Credit (EITC), Temporary Assistance for Needy Families (TANF), and Paid Family Leave (PFL) influence maternal mortality rates and overall maternal health outcomes. The analysis shows that states with more generous and comprehensive safety net programs, like California and Minnesota, tend to report lower maternal mortality rates. In contrast, states with less robust programs, such …

Menstrual Hygiene Screening Needs Assessment In South Dakota, Mariah Shafer, Denyelle Kenyon

Scholarship Pathways Program

Menstrual Hygiene Screening Needs Assessment In South Dakota

Mariah M. Shafer, MD | DenYelle Kenyon Ph.D. Assoc Dean, Community Health and Engagement, MPH Program Director.

 Introduction: Menstrual hygiene management (MHM) is essential to women’s reproductive health; literature demonstrates there are mental, social, and economic consequences to inadequate MHM in rural and developing countries. Emerging studies show that US women who are impoverished, experiencing homelessness, or incarcerated also face poor MHM. To understand implications of poor MHM in South Dakota, a largely rural state, a thorough gynecologic health history is essential; this needs assessment explores the scope of MHM questions asked …

The Ethical Imperative Of Public Health Institutions To Protect The Reproductive Autonomy Of Vulnerable Populations, Kennethea Wilson

Electronic Theses and Dissertations

This dissertation establishes the ethical responsibility of public health institutions to safeguard reproductive autonomy, especially among vulnerable populations. While reproductive decision-making is traditionally framed within individual clinical encounters, this work contends that reproductive autonomy is fundamentally a matter of public health ethics. Socioecological determinants, including social, legal, environmental, and structural factors, often constrain individuals’ ability to make meaningful reproductive choices, leading to preventable harm.

Reproductive autonomy is defined as the capacity to make informed decisions about whether and when to conceive, as well as how to parent. The dissertation critiques the sufficiency of clinical ethics frameworks, such as informed consent …

Premenstrual Disorders In Females With Neurodevelopmental Conditions: A Systematic Review, Akhila Archakam, Nikhila Archakam, Harshal Parmar, Wesley Kim

Rowan-Virtua Research Day

Background: Premenstrual syndrome (PMS) and premenstrual dysphoric disorder (PMDD) are prevalent conditions associated with substantial functional impairment and psychiatric morbidity. Symptoms are driven by heightened sensitivity to cyclical fluctuations in estrogen and progesterone rather than absolute hormone levels. Individuals with neurodevelopmental conditions, particularly attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD), may exhibit altered neurobiological and emotional regulation pathways that increase vulnerability to these hormonal changes; however, this relationship has not been systematically synthesized.

Methods: A systematic review was conducted in accordance with PRISMA guidelines. PubMed, Embase, and Cochrane CENTRAL were searched from 2000–2026 for studies evaluating associations between ADHD, …

Demographic Disparities In Contraceptive Use: Insights From Female Nsfg Respondents, 2015–2023, Adira Brenner

Rowan-Virtua Research Day

Disparities in contraceptive use persist in the United States despite expanded access to family planning services. Historical policies and ongoing social determinants of health (SDOH) are significant drivers of the continued inequality in reproductive healthcare access and utilization. This study examines demographic trends in contraceptive use using data from the National Survey of Family Growth (NSFG) between 2015 and 2023.

Data were obtained from the NSFG and the National Center for Health Statistics (NCHS) datasets. A cross-comparison was conducted, focusing on variables such as age, race/ethnicity, and educational attainment.

The consensus was that contraceptive use increased to approximately 65% in …

What Are The Correlations Between The Severity Of A Woman's Major Menopausal Symptoms And Their Eating Habits?, Kiely Hoyt, Philip Collins, Do

Rowan-Virtua Research Day

BACKGROUND

Menopause is a naturally occurring process during a woman’s life that is associated with a variety of symptoms that can significantly impact daily life.  Although hormone based therapies are available, they are not always effective or appropriate for all women.  As a result, there is growing interest in diet as a potential non-pharmacologic method to manage symptoms, though current evidence is limited.

HYPOTHESIS

Dietary habits are associated with menopause symptom severity, with certain dietary patterns potentially influencing symptom burden.

METHODS

A cross-sectional, survey study was conducted using an online questionnaire distributed through social media. A total of 129 menopausal …

Determining The Impact Fitness Training Has On Cardiovascular Health Program For New Jersey Women With Socioeconomic Disadvantages, Aishwarya Muppoor, Amy Glasofer, Lisa Rosenberry, Emma Palma, Dawn Mcmath

Rowan-Virtua Research Day

WISEWOMAN is a 3-year federally funded program offered through Virtua Health to address lifestyle changes in women age 35-64 at risk for heart disease. The purpose of this project was to evaluate the additional of a fitness program to the standard nutrition program offered through Virtua Health’s WISEWOMAN program. Nutrition programming occurred during years 1 and 2 of the WISEWOMAN program, and fitness programming was offered to women in program year 3. Women who received nutrition + exercise (intervention) will have improved outcomes compared to those who receive nutrition programming only (control). We conducted a retrospective chart review to compare …

Evaluating The 4mm Endometrial Thickness Threshold: Racial Disparities In Ultrasound Sensitivity And Diagnostic Delay, Ngozi Ikpeama, Sophia Vogiatzidakis, Xuezhi Jiang, Elizabeth Hertz, Vitoria Chaves, Peter Schnatz

Rowan-Virtua Research Day

Title: Evaluating the 4mm Endometrial Thickness Threshold: Racial Disparities in Ultrasound Sensitivity and Diagnostic Delay

Background: Current ACOG guidelines utilize a 4mm endometrial thickness (ET) threshold via transvaginal ultrasound (TVUS) to exclude malignancy in postmenopausal women. However, recent evidence suggests these standardized thresholds may not be equally effective across all racial cohorts. This systematic review evaluates the diagnostic performance of the 4mm threshold specifically in Black patients.

Methods: A systematic search of peer-reviewed literature was conducted to identify studies comparing TVUS sensitivity and clinical outcomes between racial groups. Data were extracted focusing on the diagnostic sensitivity of the 4mm threshold, …

De-Epithelialization Versus Pedicle De-Skinning In Reduction Mammoplasty: Comparative Outcomes From The Literature, Samantha Fry, Karina Vizzoni

Rowan-Virtua Research Day

Background- Reduction mammoplasty treats symptomatic macromastia. A key step involves pedicle preparation before breast mound reconstruction. Two main techniques include: De-epithelialization: Removes epidermis, preserves dermis, De-skinning: Excises both epidermal and dermal layers. Evidence comparing surgical outcomes between these techniques is limited.

Hypothesis- De-epithelialization will result in fewer vascular complications but longer operative times than de-skinning; thus, superiority depends on case selection.

Methods- A literature review identified studies on skin removal techniques in breast reduction mammoplasty.

Results- De-skinning was faster than de-epithelialization, though energy-assisted modalities were fastest. Nipple–areola complex (NAC) ischemia and necrosis rates were low across all methods. Superficial de-epithelialization …

Hormonal Contraceptives And Menstrual Symptom Severity Among Women With Elevated Cardiovascular Disease Risk: Global And Daily Assessment, Maria Cox, Danielle Arigo, Gabrielle M. Salvatore

Rowan-Virtua Research Day

Hormonal contraceptive (HC) use is primarily for pregnancy prevention and may reduce menstrual symptoms in some individuals, though evidence is inconsistent. The aim of the study was to examine differences in symptom presence and severity among 64 menstruating women with ≥1 CVD risk factor (e.g., hypertension), including HC users (20.63%) and non-users (79.37%; sample M_age= 31.88 ± 9.89, M_bmi= 31.79 ± 7.6). Participants completed the global Premenstrual Screening Tool at baseline and then reported the presence and severity of 16 menstrual symptoms (1=Not Present to 4 = Severe) in end-of-day surveys over 45 days. In a …

Breastfeeding Support For Mothers Of Low Birthweight Infants In Hospitals In Rural Western Kenya: An Exploratory Study, Fiona Dickinson, Florence Were, Alloys K’Oloo, Iwaret Otiti, Linda Tindi, Mwanamvua Boga, Mary Kimani, Laura Kiige, Kathy Mellor, Helen Nabwera

Centre of Excellence in Women and Child Health

Background One in ten newborns in sub-Saharan Africa weigh < 2500 g (i.e. low birthweight [LBW]). Breastfeeding difficulties from birth are common among LBW infants. This study explored the use of trained peer mothers to deliver breastfeeding support to mothers of LBW infants in healthcare facilities in rural Kenya.

Methods Five trained peer mothers provided breastfeeding support to 23 mothers of LBW infants across eight healthcare facilities in Homa Bay County. Qualitative, semi-structured interviews were conducted with 11 mothers, 10 healthcare providers and 5 peer mothers prior to and during the breastfeeding support intervention. Inductive thematic analysis was used.

Results Three key themes were discovered: mothers valued the confidence the peer mothers gave them to breastfeed their LBW infants, peer mothers found that the training and their previous experience caring for LBW infants enabled them to work collaboratively with mothers …

Beyond The Cycle: How Menstruation Influences Gender Identity And Well-Being In Binary And Non-Binary Adults, Rin Nguyen

College of Education and Human Sciences: Dissertations, Theses, and Student Research

Approximately 1.8 billion people worldwide menstruate, including transgender and gender-diverse (TGD) people, yet their experiences remain underrepresented in research. Given that menstruation can affect gender alignment and psychological well-being, understanding its impact on TGD people is critical. Gender congruence, or alignment between one’s gender identity and expression, is a key factor influencing well-being, with research linking it to reduced depression and anxiety. Furthermore, emerging research on gender euphoria, the joy experienced when gender congruence is experienced, suggests it may serve as a protective factor for mental health and well-being. Gender euphoria has been associated with reduced psychological distress and increased …

Prevalence And Determinants Of Fully Vaccinated Status For Covid-19 Among Pregnant Women In Brazil, Ghana, Kenya, And Pakistan, Vaishnavi Mathur, Jessica Schue, Berhaun Fesshaye, Prachi Singh, Emily Miller, Caroline Badzi, Emefa Modey, Marleen Temmerman, Ferdinand Okwaro, Renato Souza

Centre of Excellence in Women and Child Health

Maternal immunization provides essential maternal and fetal protection for several infectious diseases. The variability in vaccination guidelines for pregnant women across countries and through the course of the COVID-19 pandemic influenced the perception of both the general public and broader health care systems towards COVID-19 vaccination in pregnancy and moreover shaped the accessibility and decision-making trajectory of pregnant women to become fully vaccinated. As part of a larger multi-country, mixed-methods study, the purpose of this cross-sectional analysis is to assess what factors are associated with pregnant women being fully vaccinated for COVID-19 in Brazil, Ghana, Kenya, and Pakistan. In each …

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

Capstone Experience: Master of Public Health

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

Abortion Politics And Policy: Stigma And Access In The Silver State, Celene Fuller

Lincy Institute Events

In the aftermath of the Supreme Court’s Dobbs v. Jackson Women’s Health Organization (2022) overturning Roe V. Wade, states have taken divergent paths in regulating access to abortion services. In 2024, Nevada voters overwhelmingly passed Question 6 proposing to codify abortion rights into the state constitution. In November 2026, Question 6 will again be on the ballot for final confirmation. If it passes, these rights will be protected from future legislative action.

Despite Nevadans’ strong support for abortion rights, the state’s dearth of abortion providers limits access to these services. As this lecture explores, both providers and individuals seeking abortions, …

Occupational Therapy For Maternal Pelvic Floor And Mental Health: A Holistic Approach To Recovery, Diana S. Theodore

Student Capstone Papers

Maternal pelvic floor dysfunction (PFD) is highly prevalent yet often underrecognized in occupational therapy practice, despite its significant impact on mental health, daily function, and quality of life. Many postpartum women experience symptoms such as urinary incontinence, pain with intimacy, and pelvic organ prolapse, which are frequently normalized or left untreated. Occupational therapy practitioners often have limited training in addressing the complex relationship between pelvic floor function and maternal mental health, contributing to gaps in care. The purpose of this capstone project was to develop a comprehensive handbook for occupational therapy students and practitioners integrating pelvic floor function and maternal …

Long Work Hours, Suboptimal Diabetes Management, And Differences By Sex And Race/Ethnicity, Nhanes (2011-2018), Tailisha Gonzalez, Margrethe Horlyck-Romanovsky, Terry T.-K. Huang, Sandra E. Echeverria

Publications and Research

In the United States (US), occupational segregation by sex and race/ethnicity can contribute to health disparities. Although work schedule characteristics have been previously linked to elevated cardiovascular risk, little is known about the effects on chronic disease management in women and minoritized workers. We examined the association between work hours and diabetes management among US workers, testing for differences by sex and race/ethnicity. We utilized 2011–2018 National Health and Nutrition Examination Survey (NHANES) data on working adults (age ≥20 years) with diagnosed diabetes (n = 1041). Suboptimal diabetes management was defined as HbA1c ≥7%. Work hours were categorized per WHO …

First Covid-19 Vaccination Rates Among Pregnant Tennessee Women By Month Of Conception And Urbanization Level: March 2021 – November 2021, Claudia Valenzuela, Anne K. Driscoll, Elizabeth Harvey, Heather Wingate

Journal of Appalachian Health

Introduction: Throughout the pandemic, COVID-19 vaccination coverage was lower for the general population living in rural counties than in urban counties. In Tennessee (TN), COVID-19 vaccinations became available to pregnant women in March 2021. Little is known about rates of COVID-19 vaccination in pregnancy during the pandemic, or whether these rates changed or differed by urbanization level.

Purpose: The purpose of this study is to describe COVID-19 vaccination rates among pregnant women in TN by month of conception and urbanization level.

Methods: COVID-19 vaccination data from the TN Immunization Information System and the TN Surveillance for Emerging Threats to Mothers …

The Effect Of A Low-Glycemic Index Diet On Polycystic Ovary Syndrome Symptoms Among University-Aged Women, Angelika A. Gonzalez, Annalise M. Sankar, Noelle D. Nguyen

Department of Nutrition Student Projects

Polycystic Ovary Syndrome is an endocrine disorder among women of reproductive age and is associated with insulin resistance, menstrual irregularities, hyperandrogenism, and metabolic dysfunction. Dietary modifications targeting glycemic response have emerged as a nonpharmacologic approach for PCOS management. However, long-term randomized controlled trials targeting young adult populations remain limited.

The purpose of this study is to evaluate long-term effects of adherence to a low-glycemic index diet on the frequency and severity of PCOS symptoms among female college students ages 18-22. This 12-month randomized controlled trial will recruit participants meeting the Rotterdam criteria from university health clinics. Participants will be randomly …