Womens Health Issues最新文献

{"title":"Comparison of Health Outcomes Over Time Among Women 1990–1991 Gulf War Veterans, Women 1990–1991 Gulf Era Veterans, and Women in the U.S. General Population","authors":"Erin K. Dursa PhD, MPH ,&nbsp;Guichan Cao MS ,&nbsp;William J. Culpepper PhD, MA ,&nbsp;Aaron Schneiderman PhD, MPH, RN","doi":"10.1016/j.whi.2023.06.006","DOIUrl":"10.1016/j.whi.2023.06.006","url":null,"abstract":"<div><h3>Introduction</h3><p>The aim of this study is to examine health over almost 20 years of follow-up among women Gulf War veterans and women Gulf Era veterans and compare their health to that of women in the U.S. general population.</p></div><div><h3>Methods</h3><p>We used data from a health survey of 1,274 women Gulf War veteran and Gulf Era veteran participants of the Gulf War Longitudinal Study who responded to all three waves. Data on the U.S. population of women came from the 1999–2000, 2005–2006, and 2011–2014 National Health and Nutrition Examination Survey (NHANES). Generalized estimating equations (GEEs) were used to compare the report of disease over time in women Gulf War and Gulf Era veterans. Differences in prevalence at the three survey timepoints were calculated between women Gulf War veterans and the NHANES women population, and women Gulf War Era veterans and the NHANES women population.</p></div><div><h3>Results</h3><p>Women veterans who deployed to the 1990–1991 Gulf War report poorer health than women veterans who served during the same time but did not deploy. Women veterans reported a lower prevalence of hypertension, stroke, and diabetes than women in the NHANES sample. Women veterans also reported a higher prevalence of arthritis, chronic obstructive pulmonary disease, and skin cancer than women in the NHANES sample.</p></div><div><h3>Conclusions</h3><p>This study is the first to characterize the health of a population-based cohort of women Gulf War and women Gulf Era veterans over time and compare it with women's health in a civilian NHANES population. This demonstrates the value of epidemiological research on women veterans and the importance of developing longitudinal cohorts across genders.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"33 6","pages":"Pages 643-651"},"PeriodicalIF":3.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1049386723001238/pdfft?md5=4b23bd2e5788f1ef0e32388830af7fd0&pid=1-s2.0-S1049386723001238-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9876549","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/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}

{"title":"Characteristics Associated With Physician Bias in Contraceptive Recommendations","authors":"Natalie DiCenzo MD ,&nbsp;Kristyn Brandi MD, MPH ,&nbsp;Kylie Getz MPH ,&nbsp;Glenmarie Matthews MD, MBA, MS","doi":"10.1016/j.whi.2023.08.003","DOIUrl":"10.1016/j.whi.2023.08.003","url":null,"abstract":"<div><h3>Objective</h3><p>We aimed to examine associations between obstetrician-gynecologist (OBGYN) contraceptive recommendations and sociodemographic characteristics of patients and recommending physicians.</p></div><div><h3>Methods</h3><p>OBGYNs affiliated with residency programs across the United States were recruited via email to participate in an online exploratory survey depicting scenarios of reproductive-age women of differing race and socioeconomic status, all other factors identical, and were asked to provide contraceptive recommendations. The χ² test, Fisher's exact tests, and logistic regression were used to analyze recommendation differences based on physician and patient characteristics.</p></div><div><h3>Results</h3><p>Of 172 physician respondents, large proportions self-identified as white (74%) and attending physicians (56%) from the Mid-Atlantic (42%). In multivariate logistic regression, self-administered methods (odds ratio [OR], 0.5; 95% confidence interval [CI], 0.2–0.8) and condoms (OR, 0.5; 95% CI, 0.3–0.9) were recommended significantly less to Black high SES patients compared with white high SES patients. Non-white physicians recommended tubal ligation (OR, 0.7; 95% confidence interval [CI], 0.5–0.9) significantly less than white physicians, and recommended long-acting reversible contraception (OR, 3.3, CI 2.2–5.2) and condoms (OR, 1.4; 95% CI, 1.1–1.9) significantly more. Trainee physicians recommended self-administered methods (OR, 0.3; 95% CI, 0.2–0.4), condoms (OR, 0.2; 95% CI, 0.2–0.3), and tubal ligation (OR, 0.4; 95% CI, 0.3–0.6) significantly less than attending physicians.</p></div><div><h3>Conclusions</h3><p>OBGYN contraceptive recommendations differed based on patients’ perceived race and SES. Recommendations also differed based on race, training level, and geographic location of the recommending physician. Results suggest that physician bias contributes to contraceptive recommendations. OBGYNs should receive education about contraceptive coercion and patient-centered decision-making so that they provide high-quality counseling to all patients.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 1","pages":"Pages 51-58"},"PeriodicalIF":3.2,"publicationDate":"2023-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1049386723001378/pdfft?md5=9e67826db64d2f39c133e6d66a855f4e&pid=1-s2.0-S1049386723001378-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161826","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":"Social Determinant Pathways to Hypertensive Disorders of Pregnancy Among Nulliparous U.S. Women","authors":"Monica H. Keith PhD ,&nbsp;Melanie A. Martin PhD","doi":"10.1016/j.whi.2023.08.001","DOIUrl":"10.1016/j.whi.2023.08.001","url":null,"abstract":"<div><h3>Background</h3><p>Hypertensive disorders of pregnancy are a leading cause of maternal morbidity and mortality in the United States and impact Black mothers at disproportionately higher rates. Hypertensive disparities among racialized groups are rooted in systemic inequalities, and we hypothesize that clinical markers of allostatic load capture embodied disparities in stressors that can link upstream social determinants of health with downstream hypertensive outcomes.</p></div><div><h3>Methods</h3><p>We analyzed observational cohort data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (<em>n</em> = 6,501) and developed a structural equation model linking latent social determinants of health, longitudinal markers of allostatic load across gestation, and hypertensive pregnancy outcomes in a multigroup framework.</p></div><div><h3>Results</h3><p>Non-Hispanic Black mothers-to-be (<em>n</em> = 1,155) showed higher rates of hypertensive disorders of pregnancy (32%) than non-Hispanic white women (<em>n</em> = 5,346, 23%). Among both groups, the social environment showed stronger direct effects on allostatic markers than via behaviorally mediated dietary, exercise, or smoking pathways. Demographic aspects of the social environment (e.g., household income, partnered status) were the most salient predictor of hypertensive risk and showed stronger effects among Black women.</p></div><div><h3>Conclusions</h3><p>Embodied stress rooted in the social environment is a major path driving maternal hypertensive disparities in the United States, with effects that vary across racialized groups. These pathway findings underscore the greater impact of systemic stressors relative to individual health behaviors. More comprehensive and detailed analyses of sociostructural domains are needed to identify promising avenues for policy and intervention to improve maternal health.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"34 1","pages":"Pages 36-44"},"PeriodicalIF":3.2,"publicationDate":"2023-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1049386723001354/pdfft?md5=c14be38adaa64bc3bcc3c0aa3b82f518&pid=1-s2.0-S1049386723001354-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10278958","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":"Consent for Examinations Under Anesthesia With Learners at the Time of Abortion: Physician Perspectives","authors":"Kaitlin Ellis MD ,&nbsp;Kristin Pascoe MD ,&nbsp;Courtney Amegashie BA ,&nbsp;Adrianne Dade MD ,&nbsp;Victoria deMartelly MPH ,&nbsp;Julie Chor MD, MPH","doi":"10.1016/j.whi.2023.03.010","DOIUrl":"10.1016/j.whi.2023.03.010","url":null,"abstract":"<div><h3>Introduction</h3><p>Although obtaining specific consent for examinations under anesthesia with learners is recommended by major professional organizations and mandated by many state laws and institutions, it is not practiced universally. We sought to investigate physicians’ experiences using a formalized process to obtain consent from patients presenting for surgical abortions<span> under anesthesia for pelvic examinations with learners.</span></p></div><div><h3>Methods</h3><p><span>Semistructured qualitative interviews were conducted with residents, fellows, and faculty who work or have rotated in a single family planning clinic after the clinic introduced this consent process. Participants were asked about their experiences obtaining </span>informed consent<span> from patients for examinations under anesthesia with learners. Interviews were audiorecorded, transcribed, and analyzed using modified grounded theory. All study procedures were institutional review board approved.</span></p></div><div><h3>Results</h3><p>Twenty interviews were performed, achieving thematic saturation, with 14 residents, 4 fellows, and 2 faculty members. Participants described initial discomfort with the consent process and their wording choices, which improved with increased familiarity and almost universal patient acceptance. Some participants felt that an informal training or practice before obtaining informed consent may have been helpful. Participants stressed the importance of this consent process to foster patient autonomy and choice. Participants reported that the fact that patients were presenting for abortion care did not influence their overall process or comfort level obtaining consent for pelvic examinations under anesthesia with learners; however, some noted that they gave patients more time to process the consent or used more intentional language during these encounters.</p></div><div><h3>Conclusions</h3><p>Physicians desire and accept the integration of a formal consent process for examinations under anesthesia with learners at the time of abortion.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"33 5","pages":"Pages 560-565"},"PeriodicalIF":3.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10183772","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":"A Mixed-Methods Evaluation of Virtually Delivered Group-Based Mothers and Babies for Latina Immigrant Mothers","authors":"Rheanna Platt MD, PhD ,&nbsp;Caroline P. Martin PhD ,&nbsp;Olivia Perry MSPH ,&nbsp;Lindsay Cooper MA ,&nbsp;Darius Tandon PhD ,&nbsp;Rebecca Richman MSN/MPH, RN ,&nbsp;Amie F. Bettencourt PhD ,&nbsp;Sarah Polk MD, ScD","doi":"10.1016/j.whi.2023.05.005","DOIUrl":"10.1016/j.whi.2023.05.005","url":null,"abstract":"<div><h3>Background</h3><p>Immigrant Latinas are at higher risk for postpartum depression<span> (PPD) than the general perinatal population, yet face numerous barriers to accessing mental health services. The goal of this study was to pilot an enhanced virtual group delivery of a PPD prevention program, Mothers and Babies (MB), among immigrant Latinas engaged in early childhood programming.</span></p></div><div><h3>Methods</h3><p>Forty-nine Spanish-speaking mothers participated in one of four MB virtual groups, facilitated by trained bilingual staff at affiliated early learning centers. MB was enhanced to also target social determinants of health. A mixed-methods design was used to evaluate MB using participant interviews and pre–post surveys measuring depressive symptoms, parenting distress, and self-efficacy to manage emotions.</p></div><div><h3>Results</h3><p>On average, participants attended 69% of MB virtual sessions and rated group cohesiveness at a 4.6 on a 5-point scale. Paired-samples <em>t</em> tests showed significant reductions in depressive symptoms (Cohen's <em>d</em> = 0.29; <em>p</em> = .03) and parenting distress (Cohen's <em>d</em> = 0.31; <em>p</em> = .02), and improved self-efficacy to manage emotions (Cohen’s <em>d</em> = −0.58; <em>p</em> &lt; .001). Participants reported both benefits and drawbacks of the virtual format and provided largely favorable feedback on program enhancements.</p></div><div><h3>Conclusions</h3><p>Results provide initial evidence for the acceptability, feasibility, and effectiveness of an enhanced virtual group PPD prevention program for immigrant Latinas, delivered in partnership with local early learning centers. These findings have important implications for extending the reach of preventive interventions among a population that faces many structural and linguistic barriers to traditional forms of mental health service delivery.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"33 5","pages":"Pages 465-473"},"PeriodicalIF":3.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10194614","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":"Levonorgestrel Emergency Contraception Information Accuracy From West Virginia Community Pharmacies: A Mystery Caller Approach","authors":"Amie M. Ashcraft PhD, MPH ,&nbsp;Charles D. Ponte PharmD ,&nbsp;Caitlin Montgomery MPH ,&nbsp;Sara Farjo DO ,&nbsp;Pamela J. Murray MD, MHP","doi":"10.1016/j.whi.2023.04.001","DOIUrl":"10.1016/j.whi.2023.04.001","url":null,"abstract":"<div><h3>Background</h3><p><span>To ensure access to effective levonorgestrel (LNG) </span>emergency contraception<span> (EC), pharmacies must keep medication in stock or available for quick delivery, and pharmacists must be knowledgeable about sales restrictions and the therapeutic window<span> for EC. We conducted a mystery caller study to assess LNG EC availability and information accuracy provided by staff in West Virginia community pharmacies.</span></span></p></div><div><h3>Methods</h3><p>A female research team member posed as a 16-year-old caller to ask pharmacy staff questions about whether LNG EC was in stock, the requirements for purchase, and when it should be taken for effectiveness. Data were analyzed with SPSS using the Pearson's χ² test to determine if there was a relationship between pharmacy type and response accuracy to our questions about point-of-sale requirements and timing for effectiveness for LNG EC.</p></div><div><h3>Results</h3><p>Of the 506 pharmacies in the sample, 275 (54.3%) were chain pharmacies and 231 (45.7%) were independent. Overall, chain pharmacies provided significantly more accurate answers than independent pharmacies on all point-of-sale requirements. Regarding timing for effectiveness, 49.2% of all pharmacies provided an accurate response (62.9% for chain pharmacies vs. 32.9% for independent pharmacies).</p></div><div><h3>Conclusions</h3><p>Overall, availability and accuracy regarding LNG EC were poor in West Virginia pharmacies. Pharmacists, particularly those at independent pharmacies serving rural communities, are in a critical and powerful position to influence community health by providing accurate and timely information and access to all contraceptive options, including LNG EC.</p></div>","PeriodicalId":48039,"journal":{"name":"Womens Health Issues","volume":"33 5","pages":"Pages 489-496"},"PeriodicalIF":3.2,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10191923","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}