Womens Health Issues最新文献

{"title":"Breastfeeding-related Pain, Sensory Over-responsiveness, and Exclusive Breastfeeding at 6 Months: A Prospective Cohort Study","authors":"Adi Freund-Azaria PhD ,&nbsp;Orit Bart PhD ,&nbsp;Rivka Regev MD ,&nbsp;Tami Bar-Shalita PhD","doi":"10.1016/j.whi.2023.09.004","DOIUrl":"10.1016/j.whi.2023.09.004","url":null,"abstract":"<div><h3>Background</h3><p>Exclusive breastfeeding (EBF) is recommended for the first 6 months of life, yet EBF rates at 6 months (T3) in most developed countries are low. Painful and nonpainful sensory stimuli processing is linked, and while pain has been suggested to restrict breastfeeding, its coupling with sensory over-responsiveness (SOR) in relation to breastfeeding has not yet been reported.</p></div><div><h3>Objective</h3><p>We aimed to explore whether breastfeeding-related pain, SOR, and general pain sensitivity predict nonexclusive breastfeeding (NEBF) at T3.</p></div><div><h3>Study Design</h3><p>In this prospective study, participants were recruited at 2 days postpartum (enrollment). For the assessment of breastfeeding-related pain, participants completed the visual analogue scale and the Short-Form McGill Pain Questionnaire at enrollment, and at 6 weeks after birth. At T3, they completed the Pain Sensitivity Questionnaire and the Sensory Responsiveness Questionnaire-Intensity Scale and then provided information about their breastfeeding status. Participants were divided into two groups accordingly: EBF and NEBF.</p></div><div><h3>Results</h3><p>A total of 164 participants were reached at T3: EBF (<em>n</em> = 105) and NEBF (<em>n</em> = 59). The incidence of SOR was significantly higher among NEBF compared with EBF participants (25.4% vs. 11.4%; <em>p</em> = .020). Between enrollment and 6 weeks after birth, 72.3% of the EBF participants had reported a ≥30% pain reduction, compared with 44.8% of the NEBF participants (<em>p</em> = .001). Logistic regression modeling revealed that both breastfeeding-related pain reduction and SOR predicted NEBF at T3 (<em>p</em> &lt; .001), indicating a 3.2 times (<em>p</em> = .001) and 2.5 times (<em>p</em> = .041) odds ratio for NEBF, respectively.</p></div><div><h3>Conclusions</h3><p>SOR and sustained breastfeeding-related pain predict NEBF at T3 and may emerge as substantial breastfeeding barriers.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 1","pages":"Pages 80-89"},"PeriodicalIF":3.2,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1049386723001597/pdfft?md5=03a4f98a2e723bb9cd415df224dba54e&pid=1-s2.0-S1049386723001597-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of the Affordable Care Act on Prescription Contraceptive Use and Costs Among Privately Insured Women, 2006–2020","authors":"Cynthia H. Chuang MD, MSc ,&nbsp;Carol S. Weisman PhD ,&nbsp;Guodong Liu PhD ,&nbsp;Sarah Horvath MD, MSHP ,&nbsp;Diana L. Velott MPA, MS ,&nbsp;Amy Zheng BS ,&nbsp;Douglas L. Leslie PhD","doi":"10.1016/j.whi.2023.08.007","DOIUrl":"10.1016/j.whi.2023.08.007","url":null,"abstract":"<div><h3>Background</h3><p>In the years immediately following the Affordable Care Act (ACA)'s contraceptive coverage requirement, out-of-pocket costs fell for all Food and Drug Administration–approved contraceptive methods and use of long-acting reversible contraception (LARC) increased. This analysis examines whether these trends have continued through 2020 for privately insured women.</p></div><div><h3>Methods</h3><p>Using 2006–2020 MarketScan data, we examined trends in prescription contraceptive use and out-of-pocket costs among women 13 to 49 years old. Multivariable analyses model the likelihood of contraceptive use and paying $0 post-ACA requirement (vs. pre-ACA requirement) for contraception, controlling for age group, U.S. region, urban versus rural, and cohort year.</p></div><div><h3>Results</h3><p>The likelihood of LARC insertion increased post-ACA requirement (adjusted odds ratio [aOR] 1.127, 95% confidence interval [CI] 1.121–1.133), with insertion rates peaking at 3.73% for intrauterine devices (IUDs) and 1.08% for implants in 2019, before declining with the onset of the COVID-19 pandemic in 2020. Although the likelihood of paying $0 for LARC increased after the ACA requirement (IUD: aOR 5.495, 95% CI 5.278–5.716; implant: aOR 7.199, 95% CI 6.992–7.412), the proportion of individuals paying $0 declined to 69% for IUDs and 73% for implants in 2020, after having peaked at 88% in 2014 and 90% in 2016, respectively. For oral contraceptives, both use (aOR 1.028, 95% CI 1.026–1.030) and paying $0 (aOR 20.399, 95% CI 20.301–20.499) increased significantly after the ACA requirement.</p></div><div><h3>Conclusion</h3><p>With the exception of oral contraceptives, the proportion of individuals paying $0 for all contraceptive methods declined after peaking in 2014 for IUDs, 2016 for the implant, and 2019 for non-LARC methods. Future monitoring is needed to understand the continuing impact of the ACA requirement on prescription contraceptive use and costs.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 1","pages":"Pages 7-13"},"PeriodicalIF":3.2,"publicationDate":"2023-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1049386723001548/pdfft?md5=c4714bbdd0007bb35aa156b79de8e840&pid=1-s2.0-S1049386723001548-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71522984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Facility and Clinician Characteristics and Family Planning Services Provided During U.S. Outpatient Care Visits","authors":"Alex Schulte BS ,&nbsp;M. Antonia Biggs PhD","doi":"10.1016/j.whi.2023.06.008","DOIUrl":"10.1016/j.whi.2023.06.008","url":null,"abstract":"<div><h3>Introduction</h3><p>Recent guidelines from the Centers for Disease Control and Prevention emphasize the importance of access to comprehensive family planning services and recommend patient-centered contraceptive counseling be incorporated into routine primary care visits for reproductive-age individuals. This study aims to describe family planning service provision in outpatient care settings and assess differences by facility and clinician characteristics.</p></div><div><h3>Methods</h3><p>Using National Ambulatory Medical Care Survey data, a nationally representative survey of outpatient care visits, we assessed family planning service provision by facility location, facility type, physician specialty, types of clinicians seen, and whether the patient was seen by their primary care provider. We used random intercept logistic regression with robust standard errors, adjusting for patient characteristics, and state and year fixed effects.</p></div><div><h3>Results</h3><p>The analytic sample included 53,489 patient visits with reproductive-age (15–49 years) individuals between 2011 and 2019. Family planning services were provided at 8% of total sampled visits and were more likely to be provided in urban compared with rural areas (adjusted odds ratio, 1.45; <em>p</em> = .02) and at community health centers compared with private physician practices (adjusted odds ratio, 1.74; <em>p</em> = .00). Family planning services were also more likely to be provided when the patient saw a physician assistant or nurse compared with only a physician. After controlling for observed covariates, measures of between-clinician heterogeneity indicate wide variation in which clinicians provided family planning services.</p></div><div><h3>Conclusions</h3><p>Family planning services were more likely to be provided in urban areas, at community health centers, and when patients received team-based care. The wide variation between clinicians suggests a need to better incorporate family planning services into primary care and other outpatient settings to meet patient needs and preferences.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"33 6","pages":"Pages 573-581"},"PeriodicalIF":3.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1049386723001287/pdfft?md5=6c588635df1c96fec4777294d6e93bf2&pid=1-s2.0-S1049386723001287-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9938011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"“I Wasn't Presented With Options”: Perspectives of Black Veterans Receiving Care for Uterine Fibroids in the Veterans Health Administration","authors":"Cathea Carey MPH ,&nbsp;Molly Silvestrini MA ,&nbsp;Lisa S. Callegari MD, MPH ,&nbsp;Jodie G. Katon PhD, MS ,&nbsp;Andrew S. Bossick PhD, MPH ,&nbsp;Kemi M. Doll MD, MCSR ,&nbsp;Alicia Christy MD, MHSCR, FACOG ,&nbsp;Donna L. Washington MD, MPH, FACP ,&nbsp;Shanise Owens MA, MSc","doi":"10.1016/j.whi.2023.07.006","DOIUrl":"10.1016/j.whi.2023.07.006","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Black women with uterine fibroids<span> experience greater symptom severity and worse treatment outcomes compared with their White counterparts. Black veterans who use Veterans </span></span>Health Administration<span> (VA) health care<span> experience similar disparities. This study investigated the experiences of Black veterans receiving care for uterine fibroids at VA.</span></span></p></div><div><h3>Methods</h3><p><span>We identified Black veterans aged 18 to 54 years with newly diagnosed symptomatic uterine fibroids between the fiscal years 2010 and 2012 using VA medical record data, and we recruited participants for interviews in 2021. We used purposive sampling by the last recorded fibroid treatment in the data (categorized as </span>hysterectomy, other uterine-sparing treatments, and medication only/no treatment) to ensure diversity of treatment experiences. In-depth semistructured interviews were conducted to gather rich narratives of veterans’ uterine fibroid care experiences. Transcribed interviews were analyzed using content analysis.</p></div><div><h3>Results</h3><p>Twenty Black veterans completed interviews. Key themes that emerged included the amplified impact of severe fibroid symptoms in male-dominated military culture; the presence of multilevel barriers, from individual to health care system factors, that delayed access to high-quality treatment; insufficient treatments offered; experiences of interpersonal racism and provider bias; and the impact of fertility loss related to fibroids on mental health and intimate relationships. Veterans with positive experiences stressed the importance of finding a trustworthy provider and self-advocacy.</p></div><div><h3>Conclusions</h3><p>System-level interventions, such as race-conscious and person-centered care training, are needed to improve care experiences and outcomes of Black veterans with fibroids.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"33 6","pages":"Pages 652-660"},"PeriodicalIF":3.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10246732","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":"Canadian Newspapers Support Mifepristone Medication Abortion to Improve Fulfillment of the AAAQ Right to Health Framework (2015–2019)","authors":"Tamil Kendall PhD ,&nbsp;Pallavi Sriram MD ,&nbsp;Amrit Parmar BA ,&nbsp;Wendy V. Norman MD, MHSc","doi":"10.1016/j.whi.2023.05.008","DOIUrl":"10.1016/j.whi.2023.05.008","url":null,"abstract":"<div><h3>Background</h3><p>In 2015, mifepristone in combination with misoprostol, the international gold standard for medication abortion, was approved for use in Canada. By 2019, all Canadian provinces had included the medication as a publicly insured health benefit.</p></div><div><h3>Methods</h3><p>Our content analysis of Canadian newspaper coverage describes arguments in favor of or against medication abortion and the evolving regulatory framework for mifepristone from 6 months before regulatory approval until the last significant regulatory barrier to use was removed (2015–2019).</p></div><div><h3>Results</h3><p>Our study found an exceptionally high level of support for the approval of, introduction of, and removal of regulatory barriers to mifepristone for medication abortion. Of 402 pieces, 67% were pro-medication abortion, 25% presented balanced or neutral coverage, and only 8% presented solely anti-medication abortion viewpoints. Of the 761 individuals quoted, more than 90% made positive or neutral statements about medication abortion. Most pieces discussed medication abortion as a health issue and described how liberalization of the regulatory framework would improve abortion availability (68%), accessibility (87%), acceptability (34%), and quality (28%).</p></div><div><h3>Conclusions</h3><p>Rather than formal balance, which presents contrasting arguments as equally valid even when the scientific evidence for one vastly outweighs the other, our study identified evidentiary balance, in which coverage aligned with the weight of evidence and expert opinion. Our results differ from analyses in other high-income countries (United Kingdom, United States) where media outlets frame abortion in relation to morality or electoral politics rather than as a health issue. The Canadian print media presented overwhelmingly favorable arguments toward the expansion of mifepristone medication abortion and framed the introduction and universal coverage of medication abortion as advancing the “Availability, Accessibility, Acceptability, and Quality” (AAAQ) Right to Health Framework that establishes international human rights standards for health information, facilities, goods, and services.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"33 6","pages":"Pages 592-599"},"PeriodicalIF":3.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1049386723001081/pdfft?md5=36454b459400b4547671e4e552556479&pid=1-s2.0-S1049386723001081-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10114395","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"(Re)Framing Strength: How Superwoman Schema May Impact Perinatal Anxiety and Depression among African American Women","authors":"Tamara Nelson PhD, MPH ,&nbsp;Cecelela L. Tomi MSW ,&nbsp;Samrawit B. Gebretensay BA","doi":"10.1016/j.whi.2023.05.003","DOIUrl":"10.1016/j.whi.2023.05.003","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"33 6","pages":"Pages 568-572"},"PeriodicalIF":3.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9630289","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":"Racial/Ethnic and Nativity Inequalities in Gestational Diabetes Mellitus: The Role of Psychosocial Stressors","authors":"Kristin Erbetta PhD, MPH, MSW ,&nbsp;Joanna Almeida ScD, MPH, MSW,&nbsp;Kristie A. Thomas PhD, MSW","doi":"10.1016/j.whi.2023.06.007","DOIUrl":"10.1016/j.whi.2023.06.007","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Racial/ethnic and nativity disparities in </span>gestational diabetes mellitus (GDM) persist in the United States. Identified factors associated with these differences do not fully explain them. Research has recognized psychosocial stress as a potentially modifiable risk factor for GDM.</p></div><div><h3>Methods</h3><p><span>We used New York City Pregnancy Risk and Assessment Monitoring System data (2009–2014) linked with birth certificate items (</span><em>n</em> = 7,632) in bivariate and multivariate analyses to examine associations between 12 psychosocial stressors (modeled three ways: individual stressors, grouped stressors, stress constructs) and GDM across race/ethnicity and nativity, and if stressors explain racial/ethnic/nativity differences in GDM.</p></div><div><h3>Results</h3><p>U.S. and foreign-born Black and Hispanic women reported higher stressors relative to U.S.-born White women. In fully adjusted models, the financial stress construct was associated with a 51% increased adjusted risk of GDM, and adding all stressors doubled the risk. Psychosocial stressors did not explain the elevated risk of GDM among foreign-born Black (adjusted risk ratio, 2.18; 95% confidence interval, 1.53–3.11), Hispanic (adjusted risk ratio, 1.57; 95% confidence interval, 1.10–2.25), or Asian/Pacific Islander (adjusted risk ratio, 4.10; 95% confidence interval, 3.04–5.52) women compared with U.S.-born White women.</p></div><div><h3>Conclusions</h3><p>Historically minoritized racial/ethnic and immigrant women have an increased risk of psychosocial stressors and GDM relative to U.S.-born White women. Although financial and all stressors predicted higher risk of GDM, they did not explain the increased risk of GDM among immigrant women and women from minoritized racial/ethnic groups. Further examination into racial/ethnic and nativity inequalities in stress exposure and rates of GDM is warranted to promote healthier pregnancies and birth outcomes.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"33 6","pages":"Pages 600-609"},"PeriodicalIF":3.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9938016","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":"Trends in Maternal Weight Disparities: Statewide Differences in Rural and Urban Minnesota Residents From 2012 to 2019","authors":"Rebecca L. Emery Tavernier PhD ,&nbsp;Marcia B. McCoy MPH ,&nbsp;Catherine A. McCarty PhD, MPH, HEC-C ,&nbsp;Susan M. Mason PhD, MPH","doi":"10.1016/j.whi.2023.07.001","DOIUrl":"10.1016/j.whi.2023.07.001","url":null,"abstract":"<div><h3>Introduction</h3><p><span>Despite research showing substantial weight disparities along the rural–urban continuum, little work has attempted to identify differences in prepregnancy weight status or </span>gestational weight gain<span> (GWG) outcomes between rural and urban birthing people. As such, the goals of this research were to 1) document the prevalence of prepregnancy overweight and obesity and excessive GWG in rural and urban birthing people and 2) examine changes in rural and urban prepregnancy overweight or obesity and excessive GWG over time.</span></p></div><div><h3>Methods</h3><p>Birth certificate data provided sociodemographic variables, prepregnancy body mass index<span>, GWG, and rurality status on 465,709 respondents who gave birth in Minnesota from 2012 to 2019. A series of regression models estimated risk differences in 1) prepregnancy weight status and 2) excessive GWG between rural and urban respondents over time, controlling for relevant covariates.</span></p></div><div><h3>Results</h3><p>Rural individuals had a 4.9 percentage-point (95% confidence interval, 4.5–5.3) higher risk of having prepregnancy overweight or obesity compared with urban individuals, and a 2.6 percentage-point (95% confidence interval, 1.9–3.3) higher risk of gaining excessive gestational weight. The disparities in prepregnancy overweight or obesity and excessive gestational weight between rural and urban individuals widened over time.</p></div><div><h3>Conclusions</h3><p><span>These findings contribute to accumulating evidence documenting notable health disparities between rural and urban individuals during the </span>perinatal period<span> and support the need to develop prevention and treatment efforts focused on improving the weight-related health of individuals living in rural communities.</span></p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"33 6","pages":"Pages 636-642"},"PeriodicalIF":3.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10016001","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":"Veteran Caretaker Perspectives of the Need for Childcare Assistance During Health Care Appointments","authors":"Megan Shepherd-Banigan PhD, MPH ,&nbsp;Shay Cannedy PhD ,&nbsp;Adriana Rodriguez PhD ,&nbsp;Madison Burns BS ,&nbsp;Sandra Woolson MPH ,&nbsp;Alison Hamilton MPH, PhD ,&nbsp;Ismael Quiroz MPA ,&nbsp;Hanh Matthews MHA, MLS, MB (ASCP) ,&nbsp;Diane Garber-Cardwell ,&nbsp;Kaileigh G. Byrd BS ,&nbsp;Adrian Brown BA ,&nbsp;Karen M. Goldstein MD, MSPH","doi":"10.1016/j.whi.2023.08.005","DOIUrl":"10.1016/j.whi.2023.08.005","url":null,"abstract":"<div><h3>Purpose</h3><p>In 2020, Congress passed legislation to establish the national Veterans Child Care Assistance Program (VCAP) targeting eligible veterans receiving care through the Veterans Health Administration (VA). This needs assessment describes the childcare needs of veteran caretakers of young children and explores the implications of inadequate childcare on health care engagement.</p></div><div><h3>Methods</h3><p>Survey data were collected from 2,000 VA users with dependent children; data were analyzed using standard descriptive statistics. Qualitative data were collected from 19 veterans through focus groups and analyzed using rapid thematic analysis.</p></div><div><h3>Findings</h3><p>More than 75% of veterans surveyed indicated that they required childcare assistance during health care appointments and 73% reported barriers to finding childcare. Prominent barriers included the high cost of childcare and not having a trusted source of childcare. Nearly 58% of survey respondents reported missed or canceled VA health care appointments due to childcare challenges. Furthermore, 35% of surveyed veterans reported that their children had accompanied them to an appointment in the past year. Among these veterans, 59% brought their children into the exam room. Focus group participants discussed how having children present during their health care appointments hampered communication with health care providers.</p></div><div><h3>Conclusions</h3><p>Veterans report that lack of childcare keeps them from attending and remaining focused on the provider during their health care visits, which could compromise quality of care. As one of the only health systems in the United States that will offer childcare assistance, VCAP presents an opportunity to improve health care access and quality by reducing missed appointments and suboptimal care.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 1","pages":"Pages 98-106"},"PeriodicalIF":3.2,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1049386723001524/pdfft?md5=cd90924f260b9cc3ff7143e4de96e698&pid=1-s2.0-S1049386723001524-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41216221","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Ethnic Disparities in Patient Experience and Diabetes Self-Management Among Nonpregnant Women of Childbearing Age With Diabetes in the United States: A Scoping Review, 1990 to 2020","authors":"Grace E. Brannon PhD ,&nbsp;Tiffany B. Kindratt PhD, MPH ,&nbsp;Godfred O. Boateng PhD, MPhil ,&nbsp;Bala Yadu Vamsi Sankuratri BDS, MPH ,&nbsp;Kyrah K. Brown PhD","doi":"10.1016/j.whi.2023.08.004","DOIUrl":"10.1016/j.whi.2023.08.004","url":null,"abstract":"<div><h3>Objective</h3><p>This scoping review aimed to identify any empirical literature describing racial and ethnic disparities in patient experience and diabetes self-management among nonpregnant women (aged 18–49 years) of childbearing age with diabetes in the United States.</p></div><div><h3>Methods</h3><p>This scoping review followed the Arksey and O'Malley methodological framework. We used a comprehensive search strategy to identify articles published from 1990 to 2021 in PubMed, CINAHL, EMBASE, Web of Science, the Cochrane Library, and Proquest Digital Dissertation and Theses. Two independent reviewers used Covidence, a web-based review management software, to screen articles by title and abstract, and then by full-text articles based on inclusion and exclusion criteria. A third reviewer arbitrated any disagreements.</p></div><div><h3>Results</h3><p>Of the original 6,115 peer-reviewed studies identified, eight fit the eligibility criteria. In research on nonpregnant women of childbearing age in the United States, four studies investigated racial and ethnic disparities in patient experience, and seven of the eight eligible studies investigated racial and ethnic disparities in diabetes self-management outcomes. No eligible studies examining racial and ethnic variations in the association between patient experience and diabetes self-management were found.</p></div><div><h3>Conclusions</h3><p>This scoping review identified limited available studies examining racial and ethnic disparities in patient experience and diabetes self-management among nonpregnant women of childbearing age in the United States. Future studies should examine these relationships to fill the gap in research. These findings are relevant as the prevalence of diabetes is increasing worldwide and racially/ethnically minoritized women are disproportionately affected.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 1","pages":"Pages 26-35"},"PeriodicalIF":3.2,"publicationDate":"2023-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1049386723001512/pdfft?md5=7a736d303a01729a876ff358cf49b349&pid=1-s2.0-S1049386723001512-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41180255","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}