Womens Health Issues最新文献

{"title":"Community-dwelling Black Women's Experiences With Urinary Incontinence: A Qualitative Study","authors":"Gnankang Sarah Napoé MD, MS ,&nbsp;Courtney Judkins BA ,&nbsp;Flor de Abril Cameron PhD, MPH ,&nbsp;Megan E. Hamm PhD ,&nbsp;Judy C. Chang MD, MPH ,&nbsp;Pamela A. Moalli MD, PhD","doi":"10.1016/j.whi.2024.10.002","DOIUrl":"10.1016/j.whi.2024.10.002","url":null,"abstract":"<div><h3>Objectives</h3><div>We explored Black women's experiences, concerns, decisions, and challenges of seeking care for urinary incontinence (UI).</div></div><div><h3>Methods</h3><div>After screening for UI, we collected questionnaires confirming UI bother. We performed semistructured, one-on-one interviews via video or phone with adult participants who self-identify as Black women and had symptoms of UI. We asked about experiences with UI, perceived impact on quality of life, care-seeking behaviors, and any challenges to seeking care. Audio recordings were transcribed and coded. We then explored the patterns and relationships between codes to identify categories and themes.</div></div><div><h3>Results</h3><div>We interviewed 24 Black women with UI, aged 19 to 73 years. All had some college education, and more than one-half had degrees ranging from associate to graduate. Five themes emerged: 1) UI symptoms bring up negative emotions and require adaptations; 2) normalization of UI decreases symptom reporting and care seeking; 3) participants' UI and other medical symptoms were often minimized or dismissed by clinicians; 4) participants desire routine UI screening by clinicians and enhanced UI education; and 5) participants encourage more diversity and higher quality care to improve patient trust.</div></div><div><h3>Conclusions</h3><div>In addition to embarrassment, Black women's challenges to seeking UI care include prior experiences of trauma within the health care system. Routine screening of patients, enhanced UI education, and provider trust building could improve Black women's experiences and willingness to seek UI care.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 1","pages":"Pages 39-44"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142677269","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":"Women's Health Care Delivery and Coordination After Transitioning From One Electronic Health Record to Another: Perspectives From Staff in the Veterans Health Administration","authors":"Samantha K. Benson MPH ,&nbsp;Zoe H. Pleasure MPH ,&nbsp;Ann Guillory BSN ,&nbsp;Sharon K. Gill MD ,&nbsp;Kristen E. Gray PhD","doi":"10.1016/j.whi.2024.09.002","DOIUrl":"10.1016/j.whi.2024.09.002","url":null,"abstract":"<div><h3>Objectives</h3><div>The Veterans Health Administration (VA) is transitioning its 1,300 health care facilities from one electronic health record (EHR) to another. The transition aims to improve care delivery and interoperability; however, specific effects on women veterans, who comprise only 7.5% of the patient population, may be obscured without focused evaluation. We aimed to characterize the perspectives of VA staff regarding the impact of transitioning EHRs on women's health care delivery.</div></div><div><h3>Methods</h3><div>We conducted semistructured interviews with VA staff members involved in delivering or coordinating care for women at three sites that had transitioned EHRs within the past year. Interviews were audio-recorded and transcribed. We used a rapid, templated qualitative analytic approach to identify salient themes in the data.</div></div><div><h3>Results</h3><div>We interviewed 16 staff members across VA departments and roles. Although some participants felt the new EHR held promise, most identified challenges with the EHR rollout and implementation (e.g., insufficient training) and the EHR product (e.g., system inefficiencies and latency). Participants highlighted several ways the EHR transition disproportionately affected care delivery for women veterans, including via backlogs of community care referrals, insufficient opportunities for providers to gain proficiency with sex-specific workflows in the new EHR, and outdated listings for veterans who have changed their names. Participants reported that these issues affected their morale and contributed to decreases in productivity and delayed care.</div></div><div><h3>Conclusions</h3><div>Many of our findings reflect challenges that affect VA staff broadly, whereas others may be compounded among women veterans and the VA staff who serve them. To achieve the goal of delivering timely, equitable, high-quality, comprehensive health care services to women veterans, continued efforts to monitor and address the impacts of the EHR transition on this population are needed.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 1","pages":"Pages 54-60"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477829","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":"Consensus Preconception Educational Domains for People With Mobility Disabilities: A Delphi Study","authors":"Amelia Gabor MS ,&nbsp;Jennifer Stephens RN ,&nbsp;Michael M. McKee MD, MPH ,&nbsp;Hilary K. Brown PhD ,&nbsp;Kara B. Ayers PhD ,&nbsp;Anne Valentine PhD ,&nbsp;Willi Horner-Johnson PhD ,&nbsp;Monika Mitra PhD ,&nbsp;John A. Harris MD, MSc","doi":"10.1016/j.whi.2024.11.001","DOIUrl":"10.1016/j.whi.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>Preconception health education is critical to improve pregnancy and neonatal outcomes, but people with mobility disabilities have specific, often unique issues related to preparing for pregnancy. This study sought to develop consensus-based domains for a preconception education curriculum for people with mobility disabilities.</div></div><div><h3>Methods</h3><div>We used a mixed-methods approach, including a literature review and a Delphi method to develop consensus. Delphi panel members and domains were identified by a systematic review and purposive sampling and the panel included physicians, researchers, and individuals with lived experience of mobility disabilities. A Delphi method was used to reach consensus on domains for a preconception education curriculum for people with mobility disabilities.</div></div><div><h3>Results</h3><div>The systematic review identified 53 domains of preconception health education. Seventeen individuals participated in the Delphi panel process. After three rounds of quantitative and qualitative consensus feedback, 13 educational domains were selected for preconception education for people with mobility disabilities. The domains were 1) Pregnancy Interest; 2) Infertility and Obstetric History; 3) Genetic History and Screening; 4) Medical History; 5) Medication History; 6) Mental Health History; 7) Nutrition and Weight History; 8) Social Determinants of Health; 9) Intimate Partner Violence and Caregiver Abuse; 10) Functional Mobility and Physical Accommodations; 11) Musculoskeletal and Skin Health; 12) Bowel and Bladder Surgery; and 13) Neurological and Neurosurgical History.</div></div><div><h3>Conclusions</h3><div>A consensus preconception education curriculum for people with mobility disabilities includes standard domains plus additional domains focused on functional mobility and physical accommodations: musculoskeletal and skin health, bowel and bladder surgery, and neurological and neurosurgical history.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 1","pages":"Pages 20-27"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142878155","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":"Corrigendum to: Development of a Maternal Health Toolkit for Emergency Department Education in Illinois [Women’s Health Issues 34 (2024), 553-561]","authors":"Katherine A. Craemer MPH ,&nbsp;Lauren Sayah MPH ,&nbsp;Emilie Glass MA ,&nbsp;Shirley Scott DNP ,&nbsp;Daniel R. Wachter MD, MPH ,&nbsp;Cara J. Bergo PhD, MPH ,&nbsp;Stacie E. Geller PhD, MPA","doi":"10.1016/j.whi.2025.01.004","DOIUrl":"10.1016/j.whi.2025.01.004","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 1","pages":"Page 61"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143014085","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":"Gibbs Leadership Prize: Best Manuscript of 2024 in Women’s Health Issues","authors":"","doi":"10.1016/j.whi.2025.01.001","DOIUrl":"10.1016/j.whi.2025.01.001","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"35 1","pages":"Pages 1-2"},"PeriodicalIF":2.8,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143230089","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":"Protective Factors Associated With Lower Likelihood of Injection Drug Use and Experiencing Overdose Among Incarcerated Women","authors":"Michele Staton PhD, MSW ,&nbsp;Martha Tillson PhD ,&nbsp;Mary M. Levi MS ,&nbsp;Carl Leukefeld DSW ,&nbsp;Megan Dickson PhD ,&nbsp;Carrie B. Oser PhD ,&nbsp;Laura Fanucchi MD ,&nbsp;Jaxin Annett MA ,&nbsp;Erin Winston MPA ,&nbsp;J. Matthew Webster PhD","doi":"10.1016/j.whi.2024.09.001","DOIUrl":"10.1016/j.whi.2024.09.001","url":null,"abstract":"<div><h3>Purpose</h3><div>Prior studies evaluated protective factors individually as they relate to fewer drug use risk behaviors and related consequences. This is the first study to examine protective factors as part of a multilevel framework along a risk continuum among women involved in the criminal legal system who use drugs. This study describes factors within the socio-ecological framework that are protective against engaging in injection drug use and experiencing nonfatal overdose.</div></div><div><h3>Method</h3><div>Data were collected from 900 women with a history of opioid use disorder who were incarcerated and enrolled in the National Institutes of Health/National Institute on Drug Abuse–funded Justice Community Opioid Innovation Network cooperative. Analysis focused on the relationship among individual, interpersonal, and community- or institutional-level protective factors associated with not injecting drugs and not experiencing an overdose in the 90 days before incarceration using multinomial logistic regression.</div></div><div><h3>Findings</h3><div>Findings from this study suggest that, even among a sample of women who use drugs, there are a number of factors associated with being less likely to report higher-risk injection behavior and/or overdose experiences at the individual level (age, religiosity, and less polysubstance use), interpersonal level (not having a partner who injects drugs), and community or institutional level (fewer months incarcerated, less treatment utilization, and less enacted stigma by health care workers).</div></div><div><h3>Conclusions</h3><div>Findings from this study underscore the importance of being able to target prevention interventions to women at different stages of substance use severity and to capitalize on protective factors for those at lower-risk levels to reduce the trajectory of risk of injection practices and overdose experiences.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 6","pages":"Pages 636-644"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142407018","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":"“Women's Lives Are on the Line, and Our Hands Are Tied”: How Television Is Reckoning With a Post-Dobbs America","authors":"Stephanie Herold MPH","doi":"10.1016/j.whi.2024.09.004","DOIUrl":"10.1016/j.whi.2024.09.004","url":null,"abstract":"<div><h3>Background</h3><div>Since the 2022 <em>Dobbs v. Jackson Women’s Health Organization</em> Supreme Court decision revoked federal protection for abortion rights, many states have restricted abortion. Although news media covers this shifting landscape through reporting, this article documents how entertainment content is responding to this new reality in its storytelling.</div></div><div><h3>Methods</h3><div>The sample is from a public database of abortion plotlines on American television (<span><span>abortiononscreen.org</span><svg><path></path></svg></span>). I separated the sample of 150 plotlines into two groups: plotlines that filmed and/or aired pre-<em>Dobbs</em> (January 2020–August 2022) and those that aired post-<em>Dobbs</em> (September 2022–December 2023). Coding occurred in Microsoft Excel.</div></div><div><h3>Results</h3><div>Post-<em>Dobbs</em>, there was an increase in the proportion of abortion plotlines that depicted procedural abortions compared with pre-<em>Dobbs</em>, but no change in the consistently low proportion of medication abortion depictions. The post-<em>Dobbs</em> sample included a 10% increase in teen characters compared with pre-<em>Dobbs</em>. Pre-<em>Dobbs</em>, the vast majority of plotlines (77%) did not portray any barriers to abortion care. Post-<em>Dobbs</em>, 33% depicted barriers. The most common reason for abortion seeking in both samples was age (11%). Pre-<em>Dobbs</em>, the next most common was a mis-timed pregnancy (10%). Post-<em>Dobbs</em>, the next most common was health concerns (11%).</div></div><div><h3>Conclusions</h3><div>Since <em>Dobbs</em>, more television plotlines are portraying obstacles to abortion care, yet they continue to tell stories of white, non-parenting teenagers who make up a small percentage of real abortion patients. Plotlines overrepresent procedural abortion over the more common medication abortion. Depictions of health-related reasons for abortion seeking obscure more commonly provided reasons for abortions, such as mistimed pregnancies, caregiving responsibilities, and financial concerns. Considering the low levels of abortion knowledge nationwide, understanding what (mis)information audiences encounter onscreen is increasingly important.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 6","pages":"Pages 589-596"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142477827","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":"Uncertainty in Postpartum Permanent Contraception Decision-Making: Physician and Patient Perspectives","authors":"Brooke W. Bullington BA ,&nbsp;Madeline Thornton MD, MPH ,&nbsp;Madison Lyleroehr MA ,&nbsp;Kristen A. Berg PhD, CRC ,&nbsp;Kari White PhD, MPH ,&nbsp;Margaret Boozer MD ,&nbsp;Tania Serna MD, MPH ,&nbsp;Emily S. Miller MD ,&nbsp;Jennifer L. Bailit MD, MPH ,&nbsp;Kavita Shah Arora MD, MBE, MS","doi":"10.1016/j.whi.2024.06.005","DOIUrl":"10.1016/j.whi.2024.06.005","url":null,"abstract":"<div><h3>Purpose</h3><div>We sought to understand how patients and physicians conceptualize uncertainty in the permanent contraception decision-making process.</div></div><div><h3>Basic Procedures</h3><div>In 2022–2023, we interviewed postpartum patients with a documented desire for permanent contraception (<em>n</em> = 81) and their delivering physicians (<em>n</em> = 67). Eligible patients gave birth at one of our four study hospitals in California, Ohio, Illinois, and Alabama. We used rapid content analysis and thematic content analysis to develop and refine themes related to uncertainty in permanent contraceptive decision-making.</div></div><div><h3>Main Findings</h3><div>Most patients reported full certainty in their decision regarding permanent contraception, although some expressed doubts. After receiving permanent contraception, some patients discussed grief but overall affirmed their decision. One patient said they wished they had considered other contraceptive options. Physicians reported using a range of strategies to safeguard from patient regret, including ensuring patients were 100% certain with their decision, inferring certainty based on their characteristics, asking patients to think through all scenarios that could affect decision-making, and repeat counseling during multiple interactions.</div></div><div><h3>Principal Conclusions</h3><div>Patient experiences reveal the depth, fluidity, and nuance of patients' contraceptive decision-making processes. Physicians sometimes failed to grapple with this nuance by centering potential regret in their counseling. Personalized and supportive contraceptive counseling that acknowledges the complexity of contraceptive decision-making is imperative. Shared decision-making can help ensure patients can make informed and autonomous decisions about their reproductive lives.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 6","pages":"Pages 572-579"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141879609","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":"Hair and Health Among African American Women: Historical and Sociocultural Considerations for Physical Activity and Mental Health","authors":"Patricia O'Brien-Richardson PhD, MS Ed","doi":"10.1016/j.whi.2024.07.005","DOIUrl":"10.1016/j.whi.2024.07.005","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 6","pages":"Pages 549-552"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142134219","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":"Exploring the Experience of Pain and Pain Management for Pregnant and Postpartum Veterans with Chronic Musculoskeletal Pain","authors":"Aimee Kroll-Desrosiers PhD ,&nbsp;Kate F. Wallace MPH ,&nbsp;Diana M. Higgins PhD ,&nbsp;Steve Martino PhD ,&nbsp;Valerie Marteeny MS ,&nbsp;Lorrie Walker MA ,&nbsp;Kristin M. Mattocks PhD, MPH","doi":"10.1016/j.whi.2024.07.004","DOIUrl":"10.1016/j.whi.2024.07.004","url":null,"abstract":"<div><h3>Background</h3><div>To examine how veterans experience and treat pain during the perinatal period, we conducted a qualitative study to explore the experiences of pain, pain management, and facilitators and barriers to treatment among perinatal veterans.</div></div><div><h3>Methods</h3><div>We identified veterans who received care at any of the 15 Veterans Health Administration (VHA) facilities across the United States and were enrolled in an ongoing cohort study. All participants gave birth to a newborn between March 2016 and June 2021 and met the inclusion criteria for having a prepregnancy pain-related musculoskeletal condition. We completed interviews with 30 veterans between November 2021 and January 2022. We used a framework approach to our qualitative analysis.</div></div><div><h3>Results</h3><div>Veterans in our sample were, on average, 31 years of age, married (80%), and white (47%). The most common type of pain diagnoses were back pain (93%) and joint disorders (73%). We identified the following major themes: 1) veteran experiences of pain during pregnancy, 2) challenges to pain care during the perinatal period, and 3) veteran recommendations for VHA perinatal pain care. Experiences of pain during pregnancy varied and several barriers to pain care were identified. Veterans suggested several ways the VHA could improve pain care during the perinatal period, including more training for VHA providers on perinatal pain care and greater complementary and integrative health coverage.</div></div><div><h3>Conclusions</h3><div>Understanding the unique needs of pregnant veterans with chronic pain is important to provide high-quality care during the perinatal period. Veterans who participated in this study highlighted several areas where the VHA could improve pain management during pregnancy and postpartum.</div></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 6","pages":"Pages 628-635"},"PeriodicalIF":2.8,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142146593","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}