Journal of women's health (2002)最新文献

{"title":"Local Estrogen Adherence: A Prospective Pilot Study.","authors":"Feven W Getaneh, Jon F Pennycuff, Hannah Kelly, Haley McCann, Paul Kolm, Robert E Gutman","doi":"10.1177/15409996251363800","DOIUrl":"https://doi.org/10.1177/15409996251363800","url":null,"abstract":"<p><p><b><i>Objectives:</i></b> Local estrogen therapy (LET) has many benefits, but little is known regarding adherence and reasons for discontinuation. We aimed to evaluate fill/continuation rates of LET and assess factors associated with not filling/discontinuation. <b><i>Materials and Methods:</i></b> Prospective observational study of adult women newly prescribed LET. Participants completed Pelvic Floor Distress Inventory 20 (PFDI-20) and the Day-to-Day Impact of Vaginal Aging (DIVA) at baseline, 3-, 6-, and 12-months from initial prescription. Participants who discontinued LET were queried regarding reason for discontinuation. <b><i>Results:</i></b> A total of 155 participants were included. Mean age was 65 (+/-10) and 57% had private insurance. The most common indications for prescription with LET were atrophic vaginitis 61 (39%) and recurrent urinary tract infection 34 (22%). At baseline, 94% filled initial prescription. Continuation rates were 78%, 90%, and 79% at 3-, 6-, and 12-months, respectively, but 93 (60%) were lost to follow-up over the study period. Common reasons for not starting LET included cost (33%) and concern for side effects (22%). Common reasons for discontinuing were mess of using therapy (19%) and concern for side effects (16%). PFDI-20 and DIVA domain scores except self-concept decreased across all timepoints for all participants with no difference between women who continued versus discontinued LET. Univariate analysis did not find any factors associated with LET discontinuation. <b><i>Conclusions:</i></b> LET use is associated with improved pelvic floor and vaginal symptoms up to 12 months following initiation. Prospective evaluation was challenging due to high loss to follow-up. A total of 26% discontinued LET over 1 year. Barriers to initiation and discontinuation such as cost, mess, and concern for side effects are potentially modifiable factors that physicians can address to improve adherence.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144746779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between Age of Menopause and Hysterectomy Status and Alzheimer's Disease Risk in a Cohort of Older White and Black Women.","authors":"Amalia Peterson, Eliza C Miller, Philip L De Jager, Justina Avila-Rieger, Miguel Arce Rentería, Aaliyah Reed, Timothy J Hohman, Angela L Jefferson, Lisa L Barnes, Zoe Arvanitakis, David A Bennett, Sarah E Tom","doi":"10.1177/15409996251363798","DOIUrl":"https://doi.org/10.1177/15409996251363798","url":null,"abstract":"<p><p><b><i>Background and Objectives:</i></b> To determine whether age at menopause and premenopausal hysterectomy status are associated with incident Alzheimer's disease (AD) dementia in a group of older community-dwelling women. <b><i>Materials and Methods:</i></b> Participants from the Rush Memory and Aging Project, the Religious Orders Study, and the Minority Aging Research Study were included (<i>n</i> = 2,862, baseline age 77.1 ± 7.7 years, follow-up 8.6 ± 5.6 years, 24% Black, and 75% White). Age at menopause and premenopausal hysterectomy status were based on self-report at study entry. AD dementia diagnosis was determined annually based on the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association criteria. The hazard of AD dementia was evaluated using Cox-proportional regression models, with age as the time axis, adjusted for race, early life socioeconomic status, and education. To explore possible differences in risk by race, models were repeated using White and Black women propensity score-matched on age at baseline, education, and number of follow-up visits. <b><i>Results:</i></b> Menopause before age 45 years was associated with a 33% greater hazard of AD dementia compared with menopause after age 50 years (hazard ratio [HR] = 1.33, 95% confidence interval [CI]: 1.10-1.59). Hysterectomy was not associated with hazard of AD dementia (HR = 1.08, CI: 0.94-1.26). The association between age at menopause and hysterectomy status and AD dementia was not different for White and Black women. <b><i>Conclusions:</i></b> Some sex-specific menopausal characteristics, such as age at menopause, relate to the hazard of AD dementia. Given the disproportionate burden of AD in women, research is needed to explore potential mechanisms for this finding.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736578","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Latent Class Analysis of Well-Being in Older Women.","authors":"Eileen Rillamas-Sun, Nancy F Woods, Kenneth C Pike, Andrea Z LaCroix, Oleg Zaslavsky, Adrian Dobra, Marcia L Stefanick, Barbara B Cochrane","doi":"10.1177/15409996251363398","DOIUrl":"https://doi.org/10.1177/15409996251363398","url":null,"abstract":"<p><p><b><i>Background:</i></b> Previous efforts to assess well-being and health focused on individual indicators of hedonic, evaluative, or eudaemonic measures or summated scores reflecting all dimensions. The objectives of this study were to develop profiles that preserve distinct dimensions of hedonic, evaluative, and eudemonic well-being while permitting its exploration as a predictor of health endpoints. <b><i>Methods:</i></b> A total of 81,148 Women's Health Initiative (WHI) participants with well-being measures collected in 2011-2012 (mean age = 76.4 years) were included. Women were recruited to the WHI Clinical Trial and Observational Cohort, continued participation in WHI Extensions (2005-2010 and 2010-2015), and completed the 2011-2012 questionnaire. Classes were identified from hedonic (life enjoyment, happiness, life satisfaction, quality of life) and eudaemonic (personal growth, purpose in life, environmental mastery, self-mastery, self-control) measures using latent class analysis. Characteristics were described by classes, and associations with all-cause mortality were examined using logistic regression. <b><i>Results:</i></b> Four well-being classes were identified. Class 2 (17.8%) had the lowest (worst) well-being scores, and class 4 (53.9%) had the highest (best) well-being scores in all dimensions. Class 1 (6.4%) had high hedonic and moderate eudaemonic with low life enjoyment. Class 3 (21.9%) had high hedonic and moderate eudaemonic scores with low self-mastery. Women in class 4 were younger, more educated, reported higher annual incomes, least likely to smoke, and most likely to drink alcohol daily. Relative to class 4, odds ratios (95% confidence interval) of all-cause mortality were 1.33 (1.24-1.43), 1.75 (1.67-1.84), and 1.26 (1.20-1.31) for classes 1, 2, and 3, respectively, even after adjustment for demographic and behavioral confounders. <b><i>Conclusion:</i></b> Latent class analysis identified groups by levels of hedonic and eudaemonic indicators, preserving information about well-being dimensions while supporting interpretation of relationships with well-being important to older women and health research.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patterns of Yeast Infections and Antifungal Use in the First Trimester of Pregnancy: Findings from the Birth Defects Study to Evaluate Pregnancy exposureS, 2014-2019.","authors":"Eleni A Papadopoulos, Meredith M Howley, Sarah C Fisher, Martha M Werler, Paul A Romitti, Marilyn L Browne","doi":"10.1177/15409996251363394","DOIUrl":"https://doi.org/10.1177/15409996251363394","url":null,"abstract":"<p><p><b><i>Background:</i></b> Yeast infections are common during pregnancy. Understanding their current prevalence and corresponding treatments during pregnancy is important. We used data from a U.S. population-based retrospective study of recently pregnant people to describe patterns of first trimester maternal yeast infections and antifungal use. <b><i>Materials and Methods:</i></b> Using a cohort of control participants from the Birth Defects Study to Evaluate Pregnancy exposureS, self-reports of first trimester yeast infections and antifungal use were collected via computer-assisted telephone interviews for births during 2014-2019. We described maternal characteristics and examined the prevalence of yeast infections and antifungal use overall and by study site and birth year. Tests for trend were used to evaluate changes over the study period. <b><i>Results:</i></b> After exclusions, there were 1,524 control participants included in our sample. First trimester yeast infections (9.8%) and antifungal use (8.6%) were common. More participants reported prescription (52.7%) than over-the-counter (45.0%) antifungals; most users reported a topical antifungal (72.5%). Prevalence of yeast infections and antifungal use increased modestly, but nonsignificantly, over the study period, ranging from 7.8% to 10.9% for yeast infections and 7.2% to 9.8% for antifungal use. Prevalence of topical and over-the-counter antifungals significantly increased over the study period; use of oral and prescription antifungals modestly decreased. <b><i>Conclusions:</i></b> In our cohort, first trimester yeast infections and antifungal use were relatively common and modestly increased throughout the study period, although this trend was not significant. We observed significant increases for topical and over-the-counter antifungals. Additional research is needed to investigate the reasons behind these prevalence changes.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144736653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preconception and Prenatal Medicaid Coverage for Medicaid-Insured Births.","authors":"Emily F Gregory, Adya I Maddox, Laura Gibson, Molly Passarella, Eric T Roberts, Scott A Lorch","doi":"10.1177/15409996251362599","DOIUrl":"https://doi.org/10.1177/15409996251362599","url":null,"abstract":"<p><p><b><i>Background:</i></b> Medicaid provides insurance for 40% of U.S. births. Patterns of preconception Medicaid enrollment are not well-described. <b><i>Methods:</i></b> Using Medicaid Analytic Extract files, this retrospective cohort study of individuals with a 2014 Medicaid-insured birth examined months of Medicaid enrollment and changes in enrollment status during 84 months prior to birth. We used linear regression to assess the association between enrollment months and 2014 age, race and ethnicity, rural residence, any Medicaid eligibility due to disability, foster care involvement, or pregnancy, chronic health conditions, and state of residence. We examined variation across states in the relationship between enrollment months and changes in enrollment status. <b><i>Results:</i></b> We identified 944,068 individuals in 30 states. Individuals had a median of 40.6 (SD 27.3) enrollment months of Medicaid and 3.2 (SD 2.3) changes in enrollment status. Twenty-eight percent were enrolled in Medicaid for ≥63 months. In regression analysis, age, race and ethnicity, and chronic health conditions were associated with enrollment months. Each year of age was associated with -0.93 enrollment months (95% CI -1.27, -0.60). For chronic conditions, hypertension was associated with an additional 3.12 enrollment months (95% CI 2.53, 3.71), diabetes with 3.28 (95% CI 2.24, 4.32), and mental health with 6.27 (95% CI 5.55, 6.98). The relationship between enrollment months and changes in enrollment status varied across states. <b><i>Conclusions:</i></b> Medicaid plays a substantial role in preconception health insurance for individuals with Medicaid-insured births. This is particularly true for younger individuals and those with comorbidities associated with adverse birth outcomes.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144715251","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practice-Level Severity Case Mix and Treatment Patterns for Premenopausal Noncancerous Hysterectomy.","authors":"Joacy G Mathias, Natalie A Rivadeneira, Kemi M Doll, Chanelle J Howe, Annie Green Howard, Mollie E Wood, Lauren Anderson, Michael Green, Erin T Carey, Evan Myers, Timothy S Carey, Til Stürmer, Whitney R Robinson","doi":"10.1177/15409996251360548","DOIUrl":"https://doi.org/10.1177/15409996251360548","url":null,"abstract":"<p><p><b><i>Background:</i></b> Hysterectomy for noncancerous conditions is a patient-preference-sensitive procedure. Therefore, gynecological practices may provide hysterectomy at varying levels of symptom severity. We assess whether practice-level severity case mix associates with segregation of patients by race and ethnicity or insurance status. <b><i>Methods:</i></b> In this case series, we analyzed electronic health records of 1,590 noncancerous hysterectomy patients across 20 clinical practices within a large health care system in the U.S. South (2014-2017). By abstracting 12-month presurgical medical notes, we developed severity scores for bleeding, pain, and bulk symptoms. The practice-level severity case mix measure distinguished six practices where ≥18% of patients had below median scores for bleeding, pain, and bulk. Log-binomial models estimated prevalence ratios (PRs) for severity case mix by race and ethnicity and insurance, adjusting for age, body mass index, gynecological conditions, previous abdominal surgeries, and prior uterine sparing treatments. <b><i>Results:</i></b> Patients at practices with lower severity case mix differed in surgical indications, had fewer uterine-sparing treatments before undergoing hysterectomy, and were largely (96%) privately insured. Compared to White patients, Hispanic patients underwent hysterectomy less frequently at lower severity practices (PR: 0.52 [0.33-0.82]) while Black patients showed no difference based on the point estimate (PR: 1.00 [0.87-1.14]). Publicly-insured and uninsured patients were less likely than privately-insured patients to receive hysterectomy at lower severity practices (PR: 0.13 [0.05-0.36] and PR: 0.28 [0.12-0.68], respectively). <b><i>Conclusions:</i></b> Publicly insured and uninsured patients receiving hysterectomy-including nearly all Hispanic patients-were concentrated in practices with a higher symptom severity case mix.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661750","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Contraceptive Counseling Quality and Contraceptive Use in a National Survey of Women Veterans.","authors":"Samantha K Benson, Siobhan Mahorter, Xinhua Zhao, Eleanor Bimla Schwarz, Sonya Borrero, Lisa S Callegari","doi":"10.1177/15409996251360153","DOIUrl":"https://doi.org/10.1177/15409996251360153","url":null,"abstract":"<p><p><b><i>Background:</i></b> Contraceptive counseling quality is associated with trust in providers, method satisfaction, and method continuation. Little is known, however, about associations between counseling quality and method choice, particularly for methods requiring a high level of involvement of providers to initiate and stop the method. <b><i>Objective(s):</i></b> Investigate associations between experiences of high- or low-quality counseling and contraceptive method type. <b><i>Research Design:</i></b> We analyzed data from a national survey of women veterans ages 18-44 receiving care at the Veterans Health Administration (VA). Among participants who received contraceptive services at VA in the past year (<i>n</i> = 358), counseling quality was assessed with six Likert-scale items capturing key elements of patient-centered care. We explored two independent counseling quality variables: (1) high-quality (strongly agree on all items) versus all other responses and (2) low-quality (neutral/disagree/strongly disagree on ≥4 items) versus all other responses. Contraceptive methods were categorized based on the level of provider involvement required for initiation and discontinuation: long-acting reversible contraceptive (LARC) procedures, prescription methods, and those that require no provider involvement. We examined associations between quality and method type used using logistic regression models, controlling for potential confounding covariates. <b><i>Results:</i></b> Veterans reporting high-quality counseling were more likely (aOR: 1.95; 95% CI: 1.09, 3.48), and those reporting low-quality counseling were less likely (aOR: 0.12; 95% CI: 0.02, 0.90), to have undergone LARC placement. Veterans reporting low-quality counseling were more likely to have used a method that required no provider involvement (aOR: 2.71; 95% CI: 1.26, 5.83). <b><i>Conclusions:</i></b> High-quality contraceptive counseling is associated with use of LARC methods, while low-quality counseling is associated with use of contraceptives that require no provider involvement.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144661749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Reproductive Factors with Osteoarthritis and the Mediating Effect of Body Mass Index Among Postmenopausal Women.","authors":"Renyang Liu, Yang Hu, Ximing Zhang, Jun Li","doi":"10.1177/15409996251360149","DOIUrl":"https://doi.org/10.1177/15409996251360149","url":null,"abstract":"<p><p><b><i>Background:</i></b> Osteoarthritis (OA) is the leading cause of disability worldwide, with a higher prevalence and severity of functional impairment observed in women over the age of 50. However, the reasons for this gender disparity are not well understood. This study aims to investigate the potential association between reproductive factors and OA prevalence in postmenopausal women, as well as whether body mass index (BMI) mediates this relationship. <b><i>Methods:</i></b> Public data from 6,066 postmenopausal women collected by the National Health and Nutrition Examination Survey from 1999 to 2018 were used for the analysis. Weighted multivariable logistic regression assessed the association between reproductive factors and OA prevalence, with restricted cubic splines (RCS) analyzing nonlinear associations, and mediation analysis examining BMI's mediating role. <b><i>Results:</i></b> RCS models revealed a W-shaped relationship between OA risk and age at menopause, a U-shaped relationship with age at first birth, and an inverted W-shaped relationship with age at last birth. Weighted multivariable logistic regression showed that postmenopausal women with bilateral oophorectomy (odds ratio [OR] = 1.29), exogenous hormone use (OR = 1.44), or a history of breastfeeding (OR = 1.31) had a higher risk of OA, while a later age at menarche was significantly associated with a lower risk (OR = 0.93). Mediation analysis indicated that BMI mediated 34.53% of the association between age at menarche and OA and 18.39% between bilateral oophorectomy and OA. <b><i>Conclusions:</i></b> Multiple reproductive factors are independent risk factors for OA. Early surveillance and preventive interventions for OA might be strengthened in high-risk populations with specific reproductive characteristics.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical Cancer Screening Rates Within a Large National Network of Community-Based Health Care Organizations: A Cross-Sectional Study.","authors":"Keely Ulmer, Kristin Scott, Taona P Haderlein, Amanda Bruegl","doi":"10.1177/15409996251359829","DOIUrl":"https://doi.org/10.1177/15409996251359829","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Insufficient cervical cancer screening contributes to increased cervical cancer rates, particularly among disadvantaged groups, yet research on screening practices by race and ethnicity is underreported. Our objectives were to find the rates of up-to-date (UTD) cervical cancer screening within a nationwide network. <b><i>Methods:</i></b> A cross-sectional study was conducted using data from OCHIN, a diverse, national database consisting of over 6 million publicly or underinsured patients in rural and medically underserved communities that provides electronic health records to over 34,500 U.S. providers. We included all females between the ages of 21 and 65 with a cervix and at least one encounter at an OCHIN clinic from January 2015 to December 2023. UTD cervical cancer screening was the primary outcome. <b><i>Results:</i></b> Of the 2,464,565 patients with OCHIN, 2,279,808 met the inclusion criteria. The 2015-2023 rates of UTD cervical cancer screening for all races and ethnic groups were below the Healthy People 2030 goal of 84.3% and below the 2021 national screening average of 75.2%. Screening varied by race/ethnicity, with Hispanic individuals having the highest rates of UTD screening. Geographic location (urban, large rural, or isolated rural) did not show statistically significant differences in screening rates. <b><i>Conclusions:</i></b> In our analysis, we noted lower rates of participation in cervical cancer screening than national goals and the national average among all ages and racial/ethnic groups. Efforts to increase access and participation in cervical cancer screening programs are critical to eliminating preventable cervical cancer health inequities.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144639514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reducing Burnout in Women Physicians: An Organizational Roadmap from the Harvard Radcliffe Institute Exploratory Seminar.","authors":"Ashwini Nadkarni, Mary Shen, Sarah Temkin, Amy Vinson, Kevin M Simon, Elizabeth I O Garner, Julie D Cantor, Marie Brown, Ishani Ganguli, Julie K Silver, John A Fromson","doi":"10.1177/15409996251360551","DOIUrl":"https://doi.org/10.1177/15409996251360551","url":null,"abstract":"<p><p><b><i>Background:</i></b> Women physicians comprise more than half of graduating medical students in the United States, yet their rates of burnout and attrition from academic medicine are higher than for men physicians across every career stage. <b><i>Objective:</i></b> In May 2024, the Radcliffe Institute for Advanced Study at Harvard University convened international experts on physician gender inequity and well-being for an exploratory seminar. The goal was to establish consensus on an institutional roadmap to mitigate burnout in women physicians. <b><i>Methods:</i></b> We addressed 3 main questions through presentations, roundtable discussions, and the screening of an award winning physician-directed and -produced film on the subject: (1) What are major organizational drivers of women physician burnout and institutional best practices to address these drivers? (2) What barriers hinder successful implementation of best practices? (3) How can institutions overcome these barriers? Through iterative dialogue during the seminar and post-hoc discussions on the conceptualization of this manuscript, our group reached a consensus on an institutional roadmap to diminish burnout in all physicians identifying as women. <b><i>Results:</i></b> We conceived a budget neutral, easily adopted, and sustainable institutional roadmap to mitigate burnout in women physicians. The roadmap is grounded in a learning health system and leverages data collection to drive iterative, structural changes that achieve meaningful impact on a culture of well-being. <b><i>Conclusions:</i></b> Organizational accountability for a culture of well-being is critical to diminish burnout in women physicians and should be approached through intentional, multi-pronged, structural changes which restore trust and achieve belonging.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144629405","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}