Womens Health Issues最新文献

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Florida Doulas’ Perspectives on Their Role in Reducing Maternal Morbidity and Health Disparities 佛罗里达州催乳师对其在降低产妇发病率和减少健康差异方面的作用的看法。
IF 2.8 2区 医学
Womens Health Issues Pub Date : 2024-07-01 DOI: 10.1016/j.whi.2024.01.003
{"title":"Florida Doulas’ Perspectives on Their Role in Reducing Maternal Morbidity and Health Disparities","authors":"","doi":"10.1016/j.whi.2024.01.003","DOIUrl":"10.1016/j.whi.2024.01.003","url":null,"abstract":"<div><h3>Background</h3><p><span><span>Maternal mortality rates continue to rise in the United States. Considerable </span>racial disparities<span> exist, as Black women face two to three times the risks of dying from pregnancy-related complications compared with white women. </span></span>Doulas have been associated with improved maternal outcomes. This study aimed to 1) investigate Florida doulas’ perspectives and influence on severe maternal morbidity/mortality and related inequities, as well as 2) identify opportunities for actionable change. The social ecological model, which acknowledges how individual, interpersonal, institutional, community, and public policy factors intersect, informed our analysis.</p></div><div><h3>Methods</h3><p>This qualitative study included seven online in-depth interviews and seven focus groups with doulas (<em>N</em><span><span> = 31) in Florida. Interview guides investigated how doulas perceive their role in the context of a) maternal morbidity and b) </span>health disparities.</span></p></div><div><h3>Results</h3><p><span><span>Doulas<span> associated maternal morbidity and </span></span>health disparities with Black pregnant people, identifying racism as a major contributor. Doulas identified their role as one that most often intersects with the individual and interpersonal levels of the social ecological model. Doulas report providing positive social surveillance and </span>emotional support<span><span>, contributing education and resources, and championing for advocacy in health care<span> settings. Actionable steps recommended by doulas to further mitigate health disparities include the integration of implicit bias training into doula certification programs, increasing </span></span>public health funding to bolster a doula workforce that can serve racial and ethnic communities, establishing doula–hospital partnerships to improve relational communication, providing tailored resources for clients featuring representative messaging, and doulas’ continued engagement in positive social surveillance of their clients.</span></p></div><div><h3>Conclusions</h3><p><span><span>Doulas perceived their role as integral to mitigating maternal morbidity and </span>health disparities, particularly in the context of supporting and advocating for </span>birthing persons on all levels of the social ecological model. Equitable access to doulas for low-income and/or minoritized populations may be one key strategy to improve maternal health equity.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 4","pages":"Pages 417-428"},"PeriodicalIF":2.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177189","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}
引用次数: 0
Interest in and Support for Alternative Models of Medication Abortion Provision Among Patients Seeking Abortion in the United States 美国寻求人工流产的患者对药物流产替代模式的兴趣和支持。
IF 2.8 2区 医学
Womens Health Issues Pub Date : 2024-07-01 DOI: 10.1016/j.whi.2024.03.003
{"title":"Interest in and Support for Alternative Models of Medication Abortion Provision Among Patients Seeking Abortion in the United States","authors":"","doi":"10.1016/j.whi.2024.03.003","DOIUrl":"10.1016/j.whi.2024.03.003","url":null,"abstract":"<div><h3>Introduction</h3><p>Medication abortion is safe and effective, but restrictions still limit patients from accessing this method. Alternative models of medication abortion provision, namely advance provision, over-the-counter (OTC), and online, could help improve access to care for some, although there is limited evidence about abortion patients’ interest in these models.</p></div><div><h3>Methods</h3><p>Between 2017 and 2019, we administered a cross-sectional survey to abortion patients at 45 clinics across 15 U.S. states to explore their interest in and support for advance provision, OTC, and online abortion access. We assessed relationships between sociodemographic characteristics and interest in and support for each model using bivariate logistic regressions and present perceived advantages and disadvantages of each model, as described by a subset of participants.</p></div><div><h3>Results</h3><p>Among 1,965 people enrolled, 1,759 (90%) initiated the survey. Interest in and support for advance provision was highest (72% and 82%, respectively), followed by OTC (63% and 72%) and online access (57% and 70%). In bivariate analyses, non-Hispanic Black and Asian/Pacific Islander respondents expressed lower interest and support for the online model and Alaska Native/Native American respondents expressed higher interest in an OTC model, as compared with white respondents. Among 439 participants naming advantages and disadvantages of each model, the most common advantages included convenience and having the abortion earlier. The most common disadvantages were not seeing a provider first and possibly taking pills incorrectly.</p></div><div><h3>Conclusions</h3><p>Although most abortion patients expressed interest in and support for alternative models of medication abortion provision, variation in support across race/ethnicity highlights a need to ensure that abortion care service models meet the needs and preferences of all patients, particularly people from historically underserved populations.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 4","pages":"Pages 381-390"},"PeriodicalIF":2.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1049386724000239/pdfft?md5=23e6190e7b1838eff0d99ad2101f123d&pid=1-s2.0-S1049386724000239-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140866937","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}
引用次数: 0
Barriers to Accessing Paid Parental Leave Among Birthing Parents With Perinatal Health Complications: A Multiple-Methods Study 围产期健康并发症的分娩父母获得带薪育儿假的障碍:多重方法研究。
IF 2.8 2区 医学
Womens Health Issues Pub Date : 2024-07-01 DOI: 10.1016/j.whi.2024.02.002
{"title":"Barriers to Accessing Paid Parental Leave Among Birthing Parents With Perinatal Health Complications: A Multiple-Methods Study","authors":"","doi":"10.1016/j.whi.2024.02.002","DOIUrl":"10.1016/j.whi.2024.02.002","url":null,"abstract":"<div><h3>Introduction</h3><p>Even in the small number of U.S. states with paid parental leave (PPL) programs, studies have found awareness of PPL remains low and unevenly distributed among parents. Moreover, little is known about whether parents with perinatal health complications have unmet needs in obtaining information about and support for accessing parental leave during that time. This study aims to address this research gap. Given the strong evidence linking paid leave with improvements in maternal and infant health, it is critical to evaluate access among vulnerable populations.</p></div><div><h3>Methods</h3><p><span>We used a multiple methods approach, including a subset of the 2016–2017 Bay Area Parental Leave Survey of Mothers (analytic sample = 1,007) and interview data from mothers who stayed at a neonatal intensive care unit in 2019 (</span><em>n</em><span><span><span> = 7). All participants resided at that time in California, a state that offers PPL. The independent variable for the survey analysis was a composite measure of perinatal complications, quantified as binary with a value of 1 if respondents reported experiencing any of the four complications: poor maternal </span>mental health<span> during or after pregnancy, premature birth, or poor infant health. </span></span>Dependent variables<span> for the survey analysis measured lack of support or information for accessing PPL. We used linear probability models to assess the relationship between perinatal complications<span> and PPL support. Thematic analysis was conducted with the interview data to understand how perinatal complications shape the process of accessing PPL.</span></span></span></p></div><div><h3>Results</h3><p>Survey results revealed that parents with perinatal complications had a lower understanding of PPL benefits and low overall support for accessing leave, including from employers, compared with parents without perinatal complications. From interviews, we learned that perinatal complications present unique challenges to parents navigating PPL. There were multiple entities involved in managing leave and providing information, such as the benefits coordinator and employers. Supervisors were reported as providers of critical emotional and financial support.</p></div><div><h3>Conclusions</h3><p>Taken together, the findings from surveys and interviews suggest that health care and human resources personnel should be better equipped to provide information and support, particularly to those who experience perinatal complications and might struggle to complete paperwork while facing health challenges.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 4","pages":"Pages 331-339"},"PeriodicalIF":2.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859263","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}
引用次数: 0
United States Doula Programs and Their Outcomes: A Scoping Review to Inform State-Level Policies 美国的 Doula 计划及其成果:为州级政策提供信息的范围审查。
IF 2.8 2区 医学
Womens Health Issues Pub Date : 2024-07-01 DOI: 10.1016/j.whi.2024.03.001
{"title":"United States Doula Programs and Their Outcomes: A Scoping Review to Inform State-Level Policies","authors":"","doi":"10.1016/j.whi.2024.03.001","DOIUrl":"10.1016/j.whi.2024.03.001","url":null,"abstract":"<div><h3>Background</h3><p>The field of maternal health has advanced significantly over the past decades. However, the United States continues to have poor outcomes in comparison with other industrialized nations. With emerging evidence on the promise of doula care, states are including doula care under their Medicaid programs.</p></div><div><h3>Methods</h3><p>We conducted a scoping review across four academic databases and gray literature published between January 1, 2012, and March 10, 2022, to describe the landscape of literature on U.S. doula programs and their outcomes in order to inform state policy makers considering laws or programs related to doula care.</p></div><div><h3>Findings</h3><p>Of 740 records identified, 100 met inclusion criteria. Outcomes fell into four areas: birthing people's outcomes, infant outcomes, systems of care and implementation, and cross-cutting issues. Data on outcomes related to doula care in the literature were predominantly clinical, even though doulas are not clinical providers. Although some studies have found associations between doula care and improved clinical outcomes for birthing people and infants, the evidence is limited due to small sample sizes, study methodology, or conflicting conclusions. Doula outcomes are underexplored in the literature, with mainly qualitative data describing low levels of diversity and equity within the doula workforce and ineffective payment models. When cost-effectiveness estimates have been calculated, they largely rely on savings realized from averted cesarean births, preterm births, and neonatal intensive care unit admissions.</p></div><div><h3>Conclusions</h3><p>As state Medicaid programs expand to include doula care, policymakers should be aware of the limitations in the evidence as they plan for successful implementation, such as the narrow focus on certain clinical outcomes to quantify cost savings and conflicting conclusions on the impact of doula care. An important consideration is the impact of the reimbursement rate on the adoption of doula care, which is why it is important to engage doulas in compensation determinations, as well as the development of improved metrics to untangle the components that contribute to maternal health outcomes in the United States.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 4","pages":"Pages 350-360"},"PeriodicalIF":2.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1049386724000215/pdfft?md5=1b5bbb128ae26b1b8ef8b1d1de055cf1&pid=1-s2.0-S1049386724000215-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140899252","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}
引用次数: 0
Socioeconomic and Racial/Ethnic Inequalities in Infertility Prevalence, Help-Seeking, and Help Received Since 1995 自 1995 年以来,不孕症患病率、寻求帮助和获得帮助方面的社会经济和种族/族裔不平等现象。
IF 2.8 2区 医学
Womens Health Issues Pub Date : 2024-07-01 DOI: 10.1016/j.whi.2024.03.005
{"title":"Socioeconomic and Racial/Ethnic Inequalities in Infertility Prevalence, Help-Seeking, and Help Received Since 1995","authors":"","doi":"10.1016/j.whi.2024.03.005","DOIUrl":"10.1016/j.whi.2024.03.005","url":null,"abstract":"<div><h3>Background</h3><p>In the United States, infertility and treatment for infertility are marked by racial/ethnic and socioeconomic inequalities. Simultaneously, biomedical advances and increased public health attention toward preventing and addressing infertility have grown. It is not known, however, whether the racial/ethnic and socioeconomic inequalities observed in infertility prevalence, help-seeking, or help received have changed over time.</p></div><div><h3>Methods</h3><p><span>Using National Survey of Family Growth data (1995 through 2017–2019 cycles), this study applied multivariable logistic regression with interaction terms to investigate whether and how racial/ethnic and socioeconomic inequalities in 1) the prevalence of infertility, 2) ever seeking help to become pregnant, and 3) use of common types of medical help (advice, testing, medication for </span>ovulation, surgery for blocked tubes, and artificial insemination) have changed over time.</p></div><div><h3>Results</h3><p>The results showed persisting, rather than narrowing or increasing, inequalities in the prevalence of infertility and help-seeking overall. The results showed persisting racial/ethnic inequalities in testing, ovulation medication use, and surgery for blocked tubes. By contrast, the results showed widening socioeconomic inequalities in testing and narrowing inequalities in the use of ovulation medications.</p></div><div><h3>Conclusions</h3><p>There is little evidence to suggest policy interventions, biomedical advances, or increased public health awareness has narrowed inequalities in infertility prevalence, treatment seeking, or use of specific treatments.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 4","pages":"Pages 401-408"},"PeriodicalIF":2.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872990","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}
引用次数: 0
Neighborhood Racialized Economic Polarization, Home Visiting Coverage, and Adverse Birth Outcomes in a Medicaid-eligible Population 符合医疗补助资格人群中的邻里种族经济两极分化、家访覆盖率和不良生育结果》(Nighborhood Racialized Economic Polarization, Home Visiting Coverage, and Adverse Birth Outcomes in a Medicaid-eligible Population)。
IF 2.8 2区 医学
Womens Health Issues Pub Date : 2024-07-01 DOI: 10.1016/j.whi.2024.05.001
{"title":"Neighborhood Racialized Economic Polarization, Home Visiting Coverage, and Adverse Birth Outcomes in a Medicaid-eligible Population","authors":"","doi":"10.1016/j.whi.2024.05.001","DOIUrl":"10.1016/j.whi.2024.05.001","url":null,"abstract":"<div><h3>Background</h3><p>Residential polarization shaped by racial segregation and concentrations of wealth (hereafter neighborhood racialized economic polarization) results in both highly deprived and highly privileged neighborhoods. Numerous studies have found a negative relationship between neighborhood racialized economic polarization and birth outcomes. We investigated whether community-informed home visiting programs achieve high rates of service coverage in highly deprived neighborhoods and can attenuate the deleterious effect of neighborhood polarization on birth outcomes.</p></div><div><h3>Methods</h3><p>We used 2016–2019 data from Michigan's statewide database that links birth records, Medicaid claims, and program participation (<em>N</em><span><span> = 211,412). We evaluated whether 1) home visiting programs achieved high rates of service coverage in highly deprived neighborhoods, 2) participation in home visiting may help to mitigate the negative relationship between neighborhood polarization and birth outcomes, and 3) the reductions in preterm birth and low birthweight were larger among Black </span>birthing individuals. Data were examined using multilevel generalized linear models and mediation analysis.</span></p></div><div><h3>Results</h3><p>The statewide home visiting program achieved higher rates of coverage in the most deprived neighborhoods (21.0% statewide, 28.3% in the most deprived vs. 10.4% in the most privileged neighborhoods). For all, home visiting participation was associated with a decrease in the relationship between neighborhood polarization and preterm birth by 6.8% (mean indirect effect, −0.008; 95% confidence interval, −0.011 to −0.005), and by 5.2% (mean indirect effect, −0.013; 95% confidence interval, −0.017 to −0.009) for low birthweight, adjusting for individual-level risk factors. The decrease was larger among Black individuals.</p></div><div><h3>Conclusions</h3><p>A statewide Medicaid-sponsored home visiting program achieved high rates of service coverage in highly deprived neighborhoods. Program participation may help to mitigate the negative relationship between neighborhood polarization and birth outcomes, and more so among Black individuals. Continued support for home visiting services is required to better engage birthing individuals in neighborhoods with concentrated deprivation and to decrease disparities.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 4","pages":"Pages 340-349"},"PeriodicalIF":2.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285027","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}
引用次数: 0
Contraceptive Attitudes and Beliefs of Women With Sickle Cell Disease: A Qualitative Study 镰状细胞病妇女的避孕态度和信念:定性研究。
IF 2.8 2区 医学
Womens Health Issues Pub Date : 2024-07-01 DOI: 10.1016/j.whi.2024.03.007
{"title":"Contraceptive Attitudes and Beliefs of Women With Sickle Cell Disease: A Qualitative Study","authors":"","doi":"10.1016/j.whi.2024.03.007","DOIUrl":"10.1016/j.whi.2024.03.007","url":null,"abstract":"<div><h3>Objectives</h3><p><span>We aimed to qualitatively explore factors influencing contraceptive use in women living with </span>sickle cell disease (SCD).</p></div><div><h3>Study Design</h3><p>We conducted a semi-structured qualitative study using data from interviews with reproductive-aged women with SCD. The Theory of Planned Behavior, which describes an individual's attitudes, subjective norms, and perceived behavioral control as drivers of a health behavior, served as a framework for data collection and thematic analysis.</p></div><div><h3>Results</h3><p>We analyzed interviews from 20 participants. Attitudes toward contraception showed skepticism regarding hormonal contraception<span> and concern about adverse effects of contraception related to SCD. The role of subjective norms in contraceptive choice depended on whether participants possessed trusted sources of information, such as health care providers, family, and friends, or whether they relied on themselves alone in their contraceptive decision-making. The influence of health care providers was complicated by inconsistent and sometimes conflicting counseling. Finally, with regard to participants’ perceived control in their contraceptive choices, some were motivated to alleviate menstrual pain or prevent SCD-related pregnancy risks, but many reported feeling disempowered in contraceptive decision-making settings because of ways that healthcare providers exerted pressure or responded to participants’ demographic characteristics.</span></p></div><div><h3>Conclusions</h3><p><span>Women living with SCD are influenced by many factors similar to those documented for other populations when making decisions about contraception. However, SCD amplifies both the importance and risks of contraception and may also complicate individuals' autonomy and contraceptive access. Hematology and </span>reproductive health<span> providers should recognize the risk of coercion, maximize patients’ reproductive agency, and coordinate reproductive health counseling for patients with SCD.</span></p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 4","pages":"Pages 409-416"},"PeriodicalIF":2.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140870301","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}
引用次数: 0
Pregnancy Care Utilization, Experiences, and Outcomes Among Undocumented Immigrants in the United States: A Scoping Review 美国无证移民的孕期保健使用情况、经历和结果:范围审查》。
IF 2.8 2区 医学
Womens Health Issues Pub Date : 2024-07-01 DOI: 10.1016/j.whi.2024.02.001
{"title":"Pregnancy Care Utilization, Experiences, and Outcomes Among Undocumented Immigrants in the United States: A Scoping Review","authors":"","doi":"10.1016/j.whi.2024.02.001","DOIUrl":"10.1016/j.whi.2024.02.001","url":null,"abstract":"<div><h3>Background</h3><p>Undocumented immigrants face many barriers in accessing pregnancy care, including language differences, implicit and explicit bias, limited or no insurance coverage, and fear about accessing services. With the national spotlight on maternal health inequities, the current literature on undocumented immigrants during pregnancy requires synthesis.</p></div><div><h3>Objective</h3><p>We aimed to describe the literature on pregnancy care utilization, experiences, and outcomes of undocumented individuals in the United States.</p></div><div><h3>Methods</h3><p>We performed a scoping review of original research studies in the United States that described the undocumented population specifically and examined pregnancy care utilization, experiences, and outcomes. Studies underwent title, abstract, and full-text review by two investigators. Data were extracted and synthesized using descriptive statistics and content analysis.</p></div><div><h3>Results</h3><p>A total of 5,940 articles were retrieved and 3,949 remained after de-duplication. After two investigators screened and reviewed the articles, 29 studies met inclusion criteria. The definition of undocumented individuals varied widely across studies. Of the 29 articles, 24 showed that undocumented status and anti-immigrant policies and rhetoric are associated with lower care utilization and worse pregnancy outcomes, while inclusive health care and immigration policies are associated with higher levels of prenatal and postnatal care utilization as well as better pregnancy outcomes.</p></div><div><h3>Conclusions</h3><p>The small, heterogeneous literature on undocumented immigrants and pregnancy care is fraught with inconsistent definitions, precluding comparisons across studies. Despite areas in need of further research, the signal among published studies is that undocumented individuals experience variable access to pregnancy care, heightened fear and stress regarding their status during pregnancy, and worse outcomes compared with other groups, including documented immigrants.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 4","pages":"Pages 370-380"},"PeriodicalIF":2.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140140886","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}
引用次数: 0
Delays in Care by Race, Ethnicity, and Gender Before and During the COVID-19 Pandemic Using Cross-Sectional Data From the National Institutes of Health's All of Us Research Program 利用美国国立卫生研究院 "我们所有人 "研究计划的横断面数据,按种族、民族和性别分列 COVID-19 大流行之前和期间的护理延误情况。
IF 2.8 2区 医学
Womens Health Issues Pub Date : 2024-07-01 DOI: 10.1016/j.whi.2024.02.003
{"title":"Delays in Care by Race, Ethnicity, and Gender Before and During the COVID-19 Pandemic Using Cross-Sectional Data From the National Institutes of Health's All of Us Research Program","authors":"","doi":"10.1016/j.whi.2024.02.003","DOIUrl":"10.1016/j.whi.2024.02.003","url":null,"abstract":"<div><h3>Purpose</h3><p>Delays in receiving medical care are an urgent problem. This study aims to determine whether the odds of, and reasons for, experiencing care delays differ by gender, race-ethnicity, and survey completion before versus during the COVID-19 pandemic.</p></div><div><h3>Methods</h3><p>We conducted a cross-sectional analysis of survey data from participants age ≥18 in the National Institutes of Health's All of Us Research Program collected from May 6, 2018, to January 1, 2022. Logistic regressions were performed to assess the association of gender, race-ethnicity, and survey completion date with any of nine reasons for delaying care in the past 12 months.</p></div><div><h3>Results</h3><p>Of 119,983 participants, 37.8% reported delaying care in the past 12 months. After adjusting for employment status, education, income, marital status, health insurance, and age, women of every race-ethnicity and Black and other race-ethnicity men were more likely than white men to report delays in care: Asian women (odds ratio [OR] 1.23; 95% confidence interval [CI] [1.13, 1.34]), Black men (OR 1.15; 95% CI [1.05, 1.25]) and women (OR 1.46; 95% CI [1.38, 1.54]), Hispanic women (OR 1.36; 95% CI [1.28, 1.44]), white women (OR 1.55; 95% CI [1.50, 1.60]), and other race-ethnicity men (OR 1.15; 95% CI [1.05, 1.27]) and women (OR 1.79; 95% CI [1.67, 1.91]). A small but statistically significant difference was seen in reports of care delays for non-pandemic-related reasons during versus before the COVID-19 pandemic (OR 0.88; 95% CI [0.83, 0.93]).</p></div><div><h3>Conclusions</h3><p>In this study of a diverse group of U.S. participants, women and Black and other race-ethnicity men were more likely than white men to report delays in care, both before and during COVID-19. Addressing care delays may be necessary to ameliorate health disparities by race-ethnicity and gender.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 4","pages":"Pages 391-400"},"PeriodicalIF":2.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859381","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}
引用次数: 0
A Multipronged Approach to Caring for Women Veterans With Military Environmental Exposures 多管齐下,关爱接触军事环境的女退伍军人。
IF 2.8 2区 医学
Womens Health Issues Pub Date : 2024-07-01 DOI: 10.1016/j.whi.2024.05.002
{"title":"A Multipronged Approach to Caring for Women Veterans With Military Environmental Exposures","authors":"","doi":"10.1016/j.whi.2024.05.002","DOIUrl":"10.1016/j.whi.2024.05.002","url":null,"abstract":"","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 4","pages":"Pages 325-330"},"PeriodicalIF":2.8,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141421454","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}
引用次数: 0
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