Journal of women's health (2002)最新文献

{"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}

{"title":"Postpartum Tubal Sterilization in Sickle Cell Disease in the 2012-2019 National Inpatient Sample.","authors":"Amy Luo, Alison Gemmill, Jayla L Scott, Anne E Burke, Lydia H Pecker","doi":"10.1177/15409996251359820","DOIUrl":"https://doi.org/10.1177/15409996251359820","url":null,"abstract":"<p><p><b><i>Background:</i></b> Sickle cell disease (SCD) is associated with high-risk pregnancy and low rates of hormonal contraception use. Intersectional vulnerabilities among individuals with SCD in the United States raise historically and socially contingent questions about tubal sterilization (TS), yet immediate postpartum TS rates among individuals with SCD remain unknown. <b><i>Methods:</i></b> Using the 2012-2019 National Inpatient Sample, we conducted a repeated cross-sectional study to estimate the rate of TS among delivery hospitalizations for people with SCD, without SCD (non-SCD), Black people with and without SCD, and people with cystic fibrosis (CF). Logistic regression models estimated the adjusted odds of TS between SCD and comparison groups. Interaction analyses examined whether severe maternal morbidity (SMM) modified the association between TS and SCD. <b><i>Results:</i></b> After adjusting for patient and hospital characteristics, SCD had higher odds of TS compared with non-SCD deliveries (adjusted odds ratio [aOR] = 1.38 [1.06, 1.79]). Among deliveries coded with Black race, SCD deliveries had higher odds of TS than non-SCD deliveries (aOR = 1.42 [1.06, 1.90]). There was no difference in the odds of TS between SCD and CF deliveries (aOR = 1.0 [0.51, 2.24]). SMM more than doubled the odds of TS in SCD deliveries (interaction: aOR = 2.34 [1.57, 3.47]; aOR = 2.14 [1.40, 3.24] in Black race deliveries). <b><i>Conclusion:</i></b> Even after accounting for patient and hospital characteristics, people with SCD have higher odds of immediate postpartum TS compared with comparison groups. Possibly, SMM severity, patient preference, or clinician recommendations inform this finding. SMM is three to seven times more common in SCD than non-SCD pregnancies and may be a modifiable risk factor for TS in SCD deliveries.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144610951","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":"Toward Sex Inclusivity: Perspectives on Sex as a Biological Variable.","authors":"Shanen M Mulles, Daniel Z Aziz, C Chase Binion, Neha Pai, Sophia L Maragos, Meredith E Flattum, Monica Kowalczyk, Anna Volerman, Teresa K Woodruff, Melina R Kibbe","doi":"10.1089/jwh.2024.1009","DOIUrl":"https://doi.org/10.1089/jwh.2024.1009","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> The National Institutes of Health (NIH) policy on sex as a biological variable (SABV) was implemented in 2016 to encourage researchers to consider both sexes within their study design. However, there continues to be ongoing debate regarding the utility of this initiative. This study aimed to evaluate opinions of the SABV policy among study section members and how these varied by self-reported sex. <b><i>Method:</i></b> An 18-question survey was sent <i>via</i> email in 2023 to 20,803 study section members who participated in a review session from May 15 to July 15 in 2020, 2021, 2022, or 2023. Survey questions were based on a previously published study surveying study section members from 2016 to 2017 to allow for comparison of results. <b><i>Results:</i></b> A total of 3,699 individuals responded to the survey (17.7%). Among respondents, 52.1% self-identified as male, and 69.8% conduct basic/translational research. Fewer respondents received resources to learn about the policy in 2020-2023 compared to 2016-2017 (<i>n</i> = 2,147, 58.0% versus <i>n</i> = 848, 73.0%, <i>p</i> < 0.001). More respondents in 2020-2023 felt that considering SABV would improve the rigor and reproducibility of NIH-funded research compared to 2016-2017 (<i>n</i> = 2,630, 71.1% versus <i>n</i> = 654, 56.3%, <i>p</i> < 0.001). However, only 2,358 (63.7%) respondents felt it was important for all NIH-funded research to consider SABV within experimental design, similar to 2016-2017 (<i>n</i> = 766, 66.0%, <i>p</i> = 0.2). Fewer male respondents compared to female respondents felt considering SABV would improve rigor and reproducibility (<i>n</i> = 1,325, 68.8% versus <i>n</i> = 1,285, 74.6%, <i>p</i> < 0.001), and fewer male compared to female respondents felt it was important for all NIH-funded research to consider SABV within their experimental design (<i>n</i> = 1171, 60.9% versus <i>n</i> = 1170, 67.9%, <i>p</i> < 0.001). <b><i>Conclusions:</i></b> Since the implementation of the SABV policy, diverse perspectives continue to exist among study section members. Continued efforts are required in order to understand how sex can be incorporated into research for the benefit of all people.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144577598","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":"Recent Trends in Tubal Ligation Incidence Among Active-Duty Servicewomen.","authors":"Tracey Pérez Koehlmoos, Amandari Kanagaratnam, Amanda Banaag","doi":"10.1089/jwh.2025.0021","DOIUrl":"https://doi.org/10.1089/jwh.2025.0021","url":null,"abstract":"<p><p><b><i>Background:</i></b> <i>Dobbs v. Jackson Women's Health Organization</i> (<i>Dobbs</i>) has had far-reaching effects on reproductive health care in the United States. Studies have shown increased demand for permanent contraception following <i>Dobbs</i>. In the Military Health System (MHS), vasectomy incidence increased significantly post-<i>Dobbs</i>. No research has yet evaluated the impact of <i>Dobbs</i> on permanent contraception for women (tubal ligation/sterilization) in the MHS. <b><i>Methods:</i></b> We queried health care data from the MHS Data Repository to identify active-duty servicewomen (ADSW) ages 18-45 between fiscal years 2020 and 2023. Study analyses included descriptive statistics, monthly incidence rates of tubal ligation/sterilization per 1,000 ADSW overall and at the state level to compare trends in Texas and Virginia, and <i>t-</i>test and chi-square tests to assess demographic differences before and after <i>Dobbs</i>. <b><i>Results:</i></b> Of the 339,052 ADSW included in the study, less than 2% received tubal ligations/sterilizations during the study period. The majority of these were aged 30-34 years, non-Hispanic White, married, senior enlisted, and in the Air Force. There was an abrupt increase in tubal ligations/sterilizations among ADSW within 2 months after <i>Dobbs</i>, and the rate remained above pre-<i>Dobbs</i> levels for 4 months. No differences were observed in the rate of tubal ligation/sterilizations in Texas and Virginia. <b><i>Conclusions:</i></b> The trend in tubal ligations/sterilizations among ADSW mirrors the general population. The abrupt increase indicates an association between <i>Dobbs</i> and changes to contraceptive decision-making. It is important to consider these changes to understand the short- and long-term effects of <i>Dobbs</i> on reproductive health care in the MHS and the nation.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144562643","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 Adenomyotic Abnormal Bleeding and Prevalence of Bacterial Vaginosis.","authors":"Arielle N Valdez-Sinon, Aileen Zhang, Yunzhi Wang, Miranda R Jones, Sarah Olson, Kristin Voegtline, Marie Bielman, Anna M Powell, Bhuchitra Singh, James H Segars","doi":"10.1089/jwh.2025.0115","DOIUrl":"https://doi.org/10.1089/jwh.2025.0115","url":null,"abstract":"<p><p><b><i>Background:</i></b> Bacterial vaginosis (BV) is one of the most common vaginal conditions and is associated with significant obstetric and gynecological risks. Previous studies have demonstrated an association between menses and the vaginal dysbiosis underlying the development of BV. Given this association, we hypothesized that increased vaginal bleeding, such as abnormal uterine bleeding (AUB) caused by adenomyosis, might increase the risk of developing BV. <b><i>Objective:</i></b> This study assesses whether AUB in patients with adenomyosis was associated with BV diagnoses. <b><i>Methods:</i></b> We performed a retrospective study of 372 patients diagnosed with adenomyosis between 2016 and 2020 at a tertiary care center. Characteristics of patients who developed BV within 3 years of adenomyosis diagnosis were compared to patients without subsequent BV diagnoses. <b><i>Results:</i></b> The prevalence of BV in patients diagnosed with adenomyosis between 2016 and 2020 was 19.4%. Patients who developed BV following their diagnosis of adenomyosis had higher rates of menorrhagia than those who did not develop BV (<i>p</i> < 0.01). While patients with BV were primarily diagnosed with adenomyosis by radiological findings, patients without BV were mostly diagnosed with adenomyosis by post-hysterectomy histopathologic evaluation. Treatment of adenomyosis-related symptoms was significantly different between the two study groups. There was also a positive association between the prevalence of menorrhagia and the number of BV episodes, demonstrating a relationship between AUB and BV. <b><i>Conclusions:</i></b> This study provides evidence for an association between the menorrhagia caused by adenomyosis and a diagnosis of BV. Based on these findings, prospective studies are needed to assess the contribution of abnormal uterine bleeding pathologies to the development of BV.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144532831","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":"Exploring Allostatic Load as an Objective Measure of Stress Among U.S. Women With and Without HIV: A Pilot Study.","authors":"Katherine C Hall, Masoumeh Karimi, Laree M Hiser, Wondwosen Yimer, Ilene Brill, Pariya L Fazeli, Maria L Alcaide, Marlene Camacho-Rivera, Aruna Chandran, Mardge H Cohen, Andrew Edmonds, Anjali Sharma, Amanda Spence, Sheri D Weiser, Gina Wingood, Deborah Konkle-Parker","doi":"10.1089/jwh.2024.0814","DOIUrl":"https://doi.org/10.1089/jwh.2024.0814","url":null,"abstract":"<p><p><b><i>Background:</i></b> Stress has been found to be linked to adverse health outcomes. Having an objective measure of stress to complement validated self-reported stress measures is helpful for assessing the impact of interventions aimed at reducing stress and measuring its associations with health outcomes. Allostatic load is an objective measure that summarizes stress's impact on multiple physiological systems. However, inconsistent combinations of indicators in an allostatic load index (ALI) are found in literature. The purpose was to (1) explore the ability to identify a set of indicators for inclusion in an ALI related to perceived stress and (2) explore the ability of the calculated ALI to identify an association between ALI and Perceived Stress Scale (PSS) score category among a small sample of women with HIV and comparable women without HIV. <b><i>Materials and Methods:</i></b> Data were from participants of the Women's Interagency HIV Study in the United States during 2014-2019 whose PSS score on the PSS-10 questionnaire were in the highest (<i>n</i> = 103) and lowest (<i>n</i> = 103) quartiles for the cohort. The pilot study explored an ALI based on a combination of 15 indicators selected from a literature review. Stepwise regression and logistic regression were used to perform the preliminary analysis. <b><i>Results:</i></b> Stepwise regression models identified five indicators for an ALI based on PSS scores. A positive association was found where the ALI predicted membership in the higher stress group (odds ratio = 1.62; 95% confidence interval: 1.11, 2.37; <i>p</i> = 0.012). <b><i>Conclusion:</i></b> This pilot study identified a concise set of ALI indicators that may be useful for future stress research and practice. Although preliminary, the identification of an ALI for operationalizing stress may provide a cost-effective and straightforward tool for future research. With further refinement, this measure could offer a method for researchers studying chronic stress, with potential for future clinical application for managing stress-related health outcomes.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144510353","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":"Update in Breast Cancer.","authors":"Melissa McNeil","doi":"10.1089/jwh.2025.0258","DOIUrl":"https://doi.org/10.1089/jwh.2025.0258","url":null,"abstract":"<p><p>The goal in selecting these recent articles was to help identify literature that may change the clinical practice of women's health for practitioners in the primary care setting. Articles were identified by reviewing the high-impact medical and women's health journals, national guidelines, ACP JournalWise, and NEJM Journal Watch. In this Clinical Update, recent publications relevant to the screening for and treatment of breast cancer were selected.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144500297","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":"Factors Associated with Cervical Cancer Screening for Women in New York State: Analyzing the 2022 NYS BRFSS.","authors":"Aaron Shaykevich, Martha Wojtowycz","doi":"10.1089/jwh.2025.0027","DOIUrl":"https://doi.org/10.1089/jwh.2025.0027","url":null,"abstract":"<p><p><b><i>Introduction:</i></b> Cervical cancer remains a significant public health challenge despite being largely preventable through early screening and treatment and is one of the largest causes of cancer-related deaths among women aged 20-39. New York State, with its diverse population, may have unique differences and disparities that can impact cervical cancer screening rates. <b><i>Methods:</i></b> Using the 2022 NYS Behavioral Risk Factor Surveillance System, we analyzed data from 3,968 participants. Bivariate analysis and logistic regression assessed the associations between demographic, general health, economic, and health behavior with cervical cancer screening. <b><i>Results:</i></b> Among the predictors of screening, we found that younger women were significantly less likely to screen compared with older women (aOR: 2.03; confidence interval [CI]: 1.67-2.46). Disparities were also observed by race (aOR: 1.55; CI: 1.27-1.89), income (aOR: 1.81; CI: 1.33-2.47), as well as type of insurance (aOR: 0.71; CI: 0.56-0.89). Health behaviors, such as having a prior checkup (aOR: 1.42; CI: 1.13-1.79) or flu vaccination (aOR: 1.32; CI: 1.10-1.57), were strongly associated with adherence, whereas personal economic barriers and general health challenges were largely not significant. <b><i>Discussion:</i></b> This study highlights health behaviors and engagement with the medical system as a significant predictor, suggesting that promoting trust in health care may enhance screening rates. The study also identified systemic barriers, such as insurance type and provider access, as determinants of cervical cancer screening. <b><i>Conclusion:</i></b> Addressing cervical cancer screening disparities in NYS requires interventions that consider behavioral and systemic factors. In particular, emphasizing trust in health care systems. These findings highlight areas of improvement in screening.</p>","PeriodicalId":520699,"journal":{"name":"Journal of women's health (2002)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144478542","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}