Womens Health Issues最新文献

{"title":"Engaging Rural Women Veterans in Mental Health Research: A Call to Action.","authors":"Alexandra B Caloudas, Juinell B Williams, Giselle Day, Rajinder Sonia Singh, Mary Shapiro, Amanda McCorkindale, Deleene Menefee, Jan A Lindsay, Derrecka Boykin","doi":"10.1016/j.whi.2025.03.004","DOIUrl":"https://doi.org/10.1016/j.whi.2025.03.004","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evolving the Health Care Service Model for Menopause With Digital Health.","authors":"Constance Guille, Hannah Jahnke, Neel Shah, Natalie Henrich","doi":"10.1016/j.whi.2025.03.005","DOIUrl":"https://doi.org/10.1016/j.whi.2025.03.005","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144041729","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Provision of Person-Centered Contraceptive Care at Publicly Supported Clinics Providing Contraceptive Services in the United States.","authors":"Jennifer Mueller, Priscille Osias, Madeleine Haas, Alicia VandeVusse","doi":"10.1016/j.whi.2025.03.003","DOIUrl":"https://doi.org/10.1016/j.whi.2025.03.003","url":null,"abstract":"<p><strong>Introduction: </strong>We sought to understand the extent to which the contraceptive care provided at publicly supported family planning clinics in the United States aligns with aspects of person-centered care.</p><p><strong>Materials and methods: </strong>We conducted a descriptive study with a national sample of U.S. family planning clinics between November 2022 and December 2023. We measured person-centeredness by the scope of services offered, including the extent to which providers solicit and prioritize patients' contraceptive intentions, preferences, and goals; the dispensing protocols for various contraceptive methods; and the availability of social services such as intimate partner violence screening and housing insecurity support. We fielded an online survey to a sample of 2,146 clinics, and our analytic sample was 422 clinics.</p><p><strong>Results: </strong>Our results highlight that most publicly supported family planning clinics provide contraception using counseling protocols that support patient-centeredness, such as assessing patients' contraceptive preferences during contraceptive counseling. However, we found statistically significant variation by clinic type within many of these measures, with a higher proportion of Planned Parenthood clinics following patient-centered protocols than other clinic types, particularly federally qualified health centers and community health centers.</p><p><strong>Conclusions: </strong>Publicly supported family planning clinics provide contraception using some person-centered care protocols, although there is room for improvement. Furthermore, person-centered practices vary by clinic type. More research should be done with patients to assess additional elements of person-centered contraceptive care.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Contraception Coverage Policy in the United States: History and Current Challenges.","authors":"Carol S Weisman, Diana Velott, Amy Zheng, Sarah Horvath, Douglas Leslie, Cynthia H Chuang","doi":"10.1016/j.whi.2025.03.002","DOIUrl":"https://doi.org/10.1016/j.whi.2025.03.002","url":null,"abstract":"<p><strong>Background: </strong>State and federal policies have aimed to expand access to contraception by providing coverage of its costs in both public and private health insurance. Yet barriers to contraception coverage remain and are expected to increase after the 2022 U.S. Supreme Court decision in Dobbs v. Jackson Women's Health Organization. This paper describes the history of these policies and current challenges.</p><p><strong>Methods: </strong>We constructed a chronology of federal and state policies providing coverage of the cost of contraception in both public and private health insurance, from establishment of the federal right to contraception through 2024, using published sources and public datasets. We aligned the chronology with the history of the development of contraception technology and practices, as described by historians and social scientists, and with political and legal challenges.</p><p><strong>Results: </strong>Following establishment of a federal right to contraception after nearly a century of restrictions under the 1873 Comstock Act, three waves of contraception coverage policymaking sought to increase access to contraception by making it more affordable to consumers. These waves included options for states to expand coverage for contraception within the Medicaid program; passage of state contraception coverage equity laws to ensure parity for contraceptive coverage in private health plans; and the Affordable Care Act's national contraceptive coverage requirement and its subsequent modifications, clarifications, and codifications. Post-Dobbs, challenges to contraception coverage include efforts to redefine certain contraceptives as abortifacients and to resurrect some of the restrictions of the Comstock Act. The requirement of no-cost coverage of preventive services is also threatened.</p><p><strong>Conclusion: </strong>Contraception coverage policy will be impacted by ongoing challenges to contraception and abortion access, as well as changing contraceptive technology and modes of delivery.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144040948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Financial, Social, and Demographic Factors Associated With Obtaining an Abortion: A Longitudinal Study in Indiana in 2021-2022.","authors":"Alexandra Wollum, Bria Goode, Caitlin McKenna, Megan Jeyifo, Lizz Perkins, Meg Sasse Stern, Qudsiyyah Shariyf, Tracey A Wilkinson, Heidi Moseson","doi":"10.1016/j.whi.2025.03.001","DOIUrl":"https://doi.org/10.1016/j.whi.2025.03.001","url":null,"abstract":"<p><strong>Objectives: </strong>We aimed to 1) characterize those who did and did not obtain an abortion and reasons why, and 2) evaluate the association between various facilitators, including financial and social support, and accessing an abortion.</p><p><strong>Methods: </strong>Between June 2021 and April 2022, we recruited pregnant Indiana residents considering abortion through online posts, abortion funds, and abortion clinics. Respondents completed an online baseline survey and a follow-up survey 1 month later. Surveys collected information on sociodemographic characteristics, barriers and facilitators to abortion, and pregnancy outcome.</p><p><strong>Results: </strong>Among 221 participants, 77% obtained an abortion within 1 month. Among online and abortion fund recruits, those who identified as Black or African American or Hispanic/Latinx and those without insurance were less likely to have had an abortion than were white and insured participants. Financial support from abortion funds and clinics and social support from peer networks were associated with higher odds of accessing abortion care 1 month later. Among participants still seeking abortion at 1 month or who had given birth, 64% reported that needing to gather money to pay for the abortion or travel expenses/lodging was a barrier to care. Among those who were no longer considering abortion at 1 month and planned to continue their pregnancy, 28% reported doing so because they did not have the money for an abortion.</p><p><strong>Conclusions: </strong>In a restrictive state policy environment, receipt of financial and social support was associated with greater likelihood of obtaining abortion within a month of reporting considering or seeking it among a sample of pregnant people in Indiana.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Promoting Improved Access to Tailored Hormonal Contraceptive Regimens for Menstrual Suppression.","authors":"Beth Sundstrom, Angela Dempsey","doi":"10.1016/j.whi.2025.02.009","DOIUrl":"https://doi.org/10.1016/j.whi.2025.02.009","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143811977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived Infertility and Contraceptive Use Among Reproductive-Aged Women in Ohio.","authors":"Kayla M Alvis, Jess Keesee, Marta Bornstein, Abigail Norris Turner, Meredith Pensak, Priya R Gursahaney","doi":"10.1016/j.whi.2025.02.007","DOIUrl":"https://doi.org/10.1016/j.whi.2025.02.007","url":null,"abstract":"<p><strong>Objective: </strong>This study examines the association between sociodemographic factors and perceived infertility, as well as between perceived infertility, contraceptive use, and contraceptive method type.</p><p><strong>Study design: </strong>We analyzed the Ohio Survey of Women baseline data collected in 2018-2019 (N = 2,568). Using logistic regression, we assessed the association between sociodemographic characteristics and perceived infertility. We then used multivariate logistic regression and multinomial regression to estimate the association between perceived infertility and any contraceptive use and contraception method type (long-acting reversible, hormonal short-acting reversible, and coital-dependent methods).</p><p><strong>Results: </strong>Age, race, marital status, household income, and prior pregnancies were associated significantly with odds of perceived infertility. Of those who said they were not at all likely to be infertile, 73% reported using any contraception compared to 63% of those who said they were somewhat to very likely to be infertile. In multivariable analyses, those who reported perceived infertility had 31% lower odds of using contraception than those who did not (adjusted odds ratio = 0.7; 95% confidence interval [0.5, 1.0]). Those with perceived infertility had twice the odds of using no contraception than using long-acting reversible methods compared with those without perceived infertility.</p><p><strong>Conclusions: </strong>Reproductive-aged women in Ohio who perceive they may have difficulty becoming pregnant or be infertile have lower odds of using contraception, particularly long-acting reversible methods, compared with those who do not perceive they may be infertile. Improved education on infertility may be warranted to support individuals, particularly in groups with higher odds of perceived infertility, in making informed choices about contraception.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The State of VA-funded Women Veterans' Health Systems Research.","authors":"Amanda E Borsky, Aimee Kroll-Desrosiers, Adriana Rodriguez, Karissa Fenwick, Jessica K Friedman, Elizabeth M Yano","doi":"10.1016/j.whi.2025.02.006","DOIUrl":"https://doi.org/10.1016/j.whi.2025.02.006","url":null,"abstract":"<p><strong>Background: </strong>Women veterans are the fastest-growing population of new users within the Department of Veterans Affairs (VA) health care delivery system. This paper aims to characterize the scope of women's health research funded by VA Health Systems Research (HSR) over the past 10 years.</p><p><strong>Methods: </strong>Ten years of data (2014-2023) were obtained from a VA financial database that captures research projects that started on or after January 1, 2014. Projects were coded for topical areas and study types.</p><p><strong>Results: </strong>VA HSR funded 91 women's health studies over the past 10 years. The number of active projects grew from 7 in 2014 to 50 in 2023, with a parallel increase in total funding amount for women's health-focused research projects (nearly $570,000 in 2014 and $8.1 M in 2023). Descriptive or epidemiological studies were the most prominent study type (55% of active projects) and there was a steady increase in intervention and implementation studies. The most common topics were mental health and/or substance use (22% of projects), followed by reproductive health (13%), access/rural health (13%), other chronic conditions (12%), violence and trauma exposure (10%), primary care and prevention (8%), pain (7%), other (5%), comorbidities (3%), post-deployment health (3%), aging and long-term care (2%), and cancer (2%).</p><p><strong>Conclusions: </strong>Overall, our findings indicate that HSR funding for studies focused on women veterans' health has grown over the last decade, and those studies have diversified in topics and types of study designs. As a learning health system, VA can use these findings to prioritize its future women's health research funding to meet the health needs of women veterans.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143744265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Markers of Maternal Morbidity: Research Recommendations for Severe Perineal Lacerations, Severe Maternal Morbidity, and Other Complications.","authors":"Suzan L Carmichael, Peiyi Kan, Jonathan M Snowden","doi":"10.1016/j.whi.2025.02.005","DOIUrl":"https://doi.org/10.1016/j.whi.2025.02.005","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711630","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Out-of-Pocket Insurance Costs and Psychotherapy Utilization Among Commercially Insured Birthing Individuals.","authors":"Stephanie V Hall, Andrea Pangori, Anca Tilea, Kara Zivin, Anna Courant, Amy Schroeder, A Mark Fendrick, Vanessa K Dalton","doi":"10.1016/j.whi.2025.02.003","DOIUrl":"https://doi.org/10.1016/j.whi.2025.02.003","url":null,"abstract":"<p><strong>Background: </strong>Perinatal mood and anxiety disorders (PMADs) are common, burdensome, and costly pregnancy complications, yet few receive treatment. Out-of-pocket costs (OOPCs) may represent a significant barrier to PMAD treatment.</p><p><strong>Objectives: </strong>In a population of commercially insured enrollees with a documented live birth, we sought to determine whether commercial insurance plans with above-median OOPCs had lower rates and amounts of psychotherapy utilization than plans with below-median OOPCs and whether utilization differed by income or mental health status.</p><p><strong>Methods: </strong>This serial, cross-sectional study used Optum's de-identified Clinformatics® Data Mart Database (2016-2020). We tested associations using logistic regression predicting psychotherapy utilization. Our sample included 219,043 unique births from 199,022 enrollees in 38,512 insurance plans. We categorized all enrollees as having low or high OOPCs, income below 400% of the federal poverty level or at or above 400% federal poverty level, and claims indicating a PMAD or not.</p><p><strong>Results: </strong>The median OOPC for psychotherapy rose from $49 in 2016 to $54 in 2020. Enrollees in low OOPC plans were 1.12, 95% confidence interval [1.10, 1.15] times more likely to utilize psychotherapy than those in high OOPC plans. Lower-income enrollees with PMADs attended the same number of psychotherapy visits regardless of OOPC level (five visits for low and high OOPC plans). Higher-income enrollees attended more psychotherapy by OOPC plan level (seven visits for low OOPC plans vs. six visits for high OOPC plans).</p><p><strong>Discussion: </strong>Higher OOPCs were associated with lower psychotherapy utilization among higher-income enrollees, whereas lower-income enrollees used less psychotherapy regardless of OOPC level. Reducing or eliminating cost sharing for PMADs may improve access and enhance equity.</p>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693946","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}