Women's health (London, England)最新文献

{"title":"Healthcare access among Bihari women in Bangladesh: A mixed-methods study of barriers and community-driven solutions.","authors":"Taha Husain, Maliha Momotaz, Md Zihad Mondol, Anika Taskin, Md Azizul Islam","doi":"10.1177/17455057261491887","DOIUrl":"10.1177/17455057261491887","url":null,"abstract":"<p><p>BackgroundBihari women in Bangladesh's northern districts of Rangpur and Saidpur represent a historically marginalized, Urdu-speaking ethnic minority who face compounding vulnerabilities in healthcare access. Despite progress under the Sustainable Development Goals, this population remains severely underserved due to intersecting socioeconomic, structural, cultural, and discriminatory barriers.ObjectivesThis study aimed to: (1) evaluate the availability, quality, and utilization of healthcare services among Bihari women; (2) examine socioeconomic, cultural, and systemic barriers, including financial constraints, transportation difficulties, gender norms, and discrimination; and (3) generate evidence-based recommendations for policymakers, healthcare providers, and community organizations to reduce these barriers.DesignConcurrent mixed-methods design integrating structured survey data with in-depth interviews and focus group discussions.MethodsWe administered a survey to 450 Bihari women across 12 camps in Rangpur (n = 200) and Saidpur (n = 250). Ten in-depth interviews (IDIs) and two focus group discussions (FGDs) provided qualitative depth. We analyzed quantitative data using descriptive statistics, chi-square tests, and multinomial and binary logistic regression in SPSS. Qualitative data were coded thematically using NVivo (inter-coder reliability: Cohen's κ > 0.80). Findings were triangulated across data sources. Reporting conforms to the STROBE and COREQ guidelines.ResultsPrivate clinics were the preferred care setting (68%), yet 38% managed ailments at home, primarily because of cost. Financial constraints were the most prevalent barrier (85%), followed by limited health education (70%), transportation difficulties (60%), cultural or social obstacles (45%), and perceived discrimination (40%). Among younger women (aged 18-35), cultural barriers were significantly higher, including the need for male approval (30%) and reproductive stigma (25%). A separate logistic regression model identified financial barriers as the strongest predictor of foregone care (adjusted OR = 3.20, 95% CI: 2.15-4.76), adjusting for age group and occupation. Community-prioritized solutions included financial assistance (90%), health education programs (80%), and camp-based clinics (65%).ConclusionHealthcare access among Bihari women is constrained by interacting financial, structural, cultural, and discriminatory factors, with younger women disproportionately affected by social barriers. Targeted, community-informed interventions, including financial subsidies, camp-based service delivery, and culturally sensitive health education, are required to address these inequities and promote inclusive healthcare within Bangladesh's universal health coverage agenda.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261491887"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149070727","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":"Empowering women through teach-back education: A protection motivation theory approach to breast cancer prevention in Northwest Iran.","authors":"Leila Mokhtari, Mohammad Saeed Jadgal, Rahim Sharafkhani, Morad Ali Zareipour, Hamideh Safaralizadeh","doi":"10.1177/17455057261490343","DOIUrl":"https://doi.org/10.1177/17455057261490343","url":null,"abstract":"<p><p>BackgroundBreast cancer is one of the most prevalent cancers among women, making its prevention a crucial public health priority. Health ambassadors serve as essential mediators, helping raise knowledge and promote preventive behaviors within households.ObjectiveThis study examined the impact of Teach-Back Education, grounded in PMT, on breast cancer prevention behaviors.DesignA quasi-experimental study with a pretest-posttest control-group design conducted among women health ambassadors in Khoy City, Iran.MethodsA total of 160 women health ambassadors were selected through simple random sampling and allocated to either the Teach-back education group (four weekly sessions, 45 min/session) or the control group (no intervention). Outcomes were measured using a validated Protection Motivation Theory (PMT)-based questionnaire at baseline and at the three-month follow-up. Data were analyzed using SPSS version 20.ResultsThe results indicated that the implementation of the Teach -Back Education grounded in the PMT led to a significant increase in knowledge, most components of the PMT, and the overall breast cancer prevention behavior score in the intervention group compared to the control group (<i>P</i><0.05). Subgroup analysis revealed that the educational intervention had a more pronounced impact on older health ambassadors, had lower education levels, or were housewives (<i>P</i><0.05).ConclusionThis study demonstrated that educational interventions based on the PMT, utilizing Teach-Back Education, effectively enhanced knowledge and motivation and improved breast cancer prevention behaviors among women health ambassadors. Expanding Teach-Back Education programs based on PMT across various communities is recommended to raise knowledge, enhance sensitivity, and promote preventive behaviors against breast cancer.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261490343"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149018993","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 Indonesian midwives' training experiences and knowledge related to cervical screening and HPV DNA testing in East Nusa Tenggara province.","authors":"Sandra Olivia Frans, Ariane Utomo, Linda Rae Bennett","doi":"10.1177/17455057261487155","DOIUrl":"https://doi.org/10.1177/17455057261487155","url":null,"abstract":"<p><p>BackgroundIndonesia has the highest rates of cervical cancer mortality in Southeast Asia, mainly due to poor access to and low uptake of cervical screening. Indonesian midwives are primarily responsible for conducting cervical screening, yet there is very limited research on their relevant knowledge, training and capacity to provide screening.ObjectiveThis study explored midwives' experiences of cervical screening training and their knowledge related to CC, cervical screening using Visual Inspection with Acetic Acid (VIA), and Human Papillomavirus (HPV) DNA testing in East Nusa Tenggara, Indonesia.DesignA qualitative study design was employed, based on primary data collected through fieldwork using semi-structured interviews and supplemented by a knowledge assessment questionnaire.MethodsTwenty-four midwives across two districts, one semi-urban and one rural, participated. Qualitative data were analysed using a codebook thematic analysis approach, and questionnaire data were descriptively analysed.ResultsMidwives' mean knowledge score was 75%, with midwives trained in cervical screening scoring higher than untrained midwives. Our findings highlighted inequitable access to training, with midwives in the more urban district having more access to training and higher knowledge. Midwives emphasised that adequate training and continuous practice of the VIA were crucial to building confidence in service delivery. Key knowledge gaps included poor understanding of the relationships between HPV infection, pre-cancer lesions, cervical cancer and its prevention. Midwives' poor knowledge of cervical cancer aetiology and asymptomatic pre-cancer lesions resulted in only recruited women who came with associated symptoms.ConclusionsGeographical inequality in human resource investment in remote areas limits women's access to quality cervical screening and impedes progress towards cervical cancer elimination. Supporting midwives through thorough and up-to-date training, including HPV DNA testing, is essential to increase screening access and uptake, and for the transition to HPV DNA testing.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261487155"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148901633","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":"Predicting health facility deliveries using explainable machine learning in Sidama Region, Ethiopia: A prospective cohort study.","authors":"Mehretu Belayneh, Yohannes Seifu Berego, Francisco Guillen-Grima, Amanuel Yoseph","doi":"10.1177/17455057261442711","DOIUrl":"10.1177/17455057261442711","url":null,"abstract":"<p><strong>Background: </strong>Health facility delivery (HFD) is a key intervention for reducing maternal and neonatal morbidity and mortality. However, a substantial proportion of women in Ethiopia continue to give birth at home. Early identification of women at risk of home delivery is essential to support targeted maternal health interventions.</p><p><strong>Objective: </strong>This study aimed to predict HFD utilization using machine learning (ML) models and to identify key determinants of delivery service uptake in the Sidama Region of Ethiopia.</p><p><strong>Design: </strong>A prospective cohort study was conducted among 3855 pregnant women who initiated antenatal care (ANC) in public health facilities across 4 districts of the Sidama Region between January 2021 and January 2025.</p><p><strong>Methods: </strong>Data were analyzed using the R software version 4.3.1 (R Core Team, R Foundation for Statistical Computing, Vienna, Austria). Predictive models - including logistic regression, random forest, gradient boosting, and extreme gradient boosting (XGBoost) were developed to predict HFD utilization. Model performance was assessed using accuracy, sensitivity, specificity, F1-score, and the area under the receiver operating characteristic curve (AUC-ROC). SHapley Additive exPlanations (SHAP) were used to identify the most influential predictors.</p><p><strong>Results: </strong>Overall, 59.2% of women delivered in health facilities, while 40.8% delivered at home. Among the evaluated models, XGBoost demonstrated the highest predictive performance, achieving an accuracy of 86.9% (95% confidence interval (CI): 85.6-88.1) and an AUC-ROC of 0.91 (95% CI: 0.90-0.93). SHAP analysis identified place of residence, maternal education, timing of ANC initiation, parity, and distance to the nearest health facility as the most influential predictors. Rural residence, lower educational attainment, late ANC initiation, higher parity, and greater distance to health facilities were associated with a lower likelihood of HFD utilization.</p><p><strong>Conclusion: </strong>Despite improvements in HFD utilization, a substantial proportion of women in the Sidama Region continue to deliver at home. ML models offer a robust approach for identifying women at high risk of home delivery and supporting targeted, data-driven interventions. Strategies that promote early ANC engagement, maternal education, improved geographic access to health facilities, and integration of predictive analytics into health systems may enhance HFD utilization.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261442711"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13100381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147725047","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genitourinary syndrome of lactation: An underrecognized postpartum condition affecting women's vulvovaginal, urinary and sexual health.","authors":"Rodrigo Orozco Fernández, Santiago Palacios Gil-Antuñano","doi":"10.1177/17455057261490606","DOIUrl":"https://doi.org/10.1177/17455057261490606","url":null,"abstract":"<p><p>Postpartum care is increasingly viewed as a continuum of maternal recovery rather than a single visit at six weeks. Within this broader view, however, the genitourinary and sexual health of breastfeeding women remains insufficiently addressed. Genitourinary syndrome of lactation (GSL) has recently been proposed to describe postpartum and lactation-related vulvovaginal, urinary and sexual symptoms that may be linked to the hypoestrogenic hormonal environment of breastfeeding. During lactation, suckling-related prolactin secretion suppresses hypothalamic-pituitary-ovarian activity and may maintain low estradiol levels, particularly during amenorrhea. Although the term deliberately echoes genitourinary syndrome of menopause, GSL belongs to a different clinical setting: a woman recovering from pregnancy and birth, adapting to breastfeeding, living with sleep deprivation and body changes, and gradually rebuilding sexual intimacy. This narrative perspective review summarizes the emerging evidence on GSL and offers a practical framework for recognition, differential diagnosis, screening and breastfeeding-supportive management. GSL should not be reduced to vaginal dryness, nor should every postpartum sexual or urinary symptom be attributed to lactation-related hormonal deprivation. Assessment should consider perineal scar pain, pelvic floor dysfunction, vestibulodynia, vulvovaginal infections, vulvar dermatoses, urinary tract disorders, hormonal contraception and psychosocial contributors; bowel symptoms may indicate broader pelvic floor or obstetric injury rather than GSL itself. Management is best approached in a stepped and individualized manner, beginning with education, validation, vulvar care, lubricants, vaginal moisturizers, pelvic floor physiotherapy and sexual counselling when indicated. For persistent moderate-to-severe mucosal symptoms, low-dose vaginal estrogen is a reasonable option after shared decision-making, particularly once lactation is established. Vaginal prasterone lacks lactation-specific safety and efficacy evidence and cannot currently be recommended routinely. Recognizing GSL is not an argument against breastfeeding; it is a way to make postpartum care more complete.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261490606"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148984477","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":"We care about Brooklyn: A remote precision support intervention designed to improve maternal health and well-being.","authors":"Aimee Afable, Sandra Bruening, Breanna Watson, Faven Araya, Christina Pardo","doi":"10.1177/17455057261435755","DOIUrl":"10.1177/17455057261435755","url":null,"abstract":"<p><strong>Background: </strong>Black maternal mortality is an urgent public health crisis in the United States. Community-based interventions show promise in addressing this crisis but remain underutilized.</p><p><strong>Objective: </strong>Using New York City (NYC) as a case study, we describe a formative study of a comprehensive community health worker (CHW)-led intervention, We Care About Brooklyn (WeCAB), designed to address structural drivers of NYC's maternal health crisis: fragmented care and unmet health-related social needs (HRSNs), such as food insecurity and unstable housing.</p><p><strong>Design: </strong>Guided by the transcreation framework, we conducted a community-engaged, mixed methods formative study to design an intervention prototype.</p><p><strong>Methods: </strong>We conducted a document review (<i>N</i> = 7 HRSN screening tools), documentary film analysis, and primary qualitative data collection. We interviewed 10 key informants representing diverse community expertise. Interpretative phenomenology guided qualitative data analysis.</p><p><strong>Results: </strong>Analysis elaborated on five central themes-trust and rapport building, frequency of patient engagement and critical time periods, system fragmentation and care coordination challenges, technology for care coordination, and provider and client expectations. These findings, along with the document review, results of the film analysis, and evidence-based intervention inputs, informed the design of a remote precision support intervention with two core activities: (1) a digital closed-loop care navigation platform (Unite Us^©) using a 41-item maternal HRSN screener, and (2) CHW check-in schedules based on gestational age and social risk, including care reminders, escalation protocols for patient concerns, urgent warning signs education, and linkage to urgent care.</p><p><strong>Conclusion: </strong>WeCAB was designed to enable CHWs to function as a human safety net and provide continuity of care in the context of a fragmented healthcare landscape. We propose that this approach fosters trust and patient empowerment, promoting physical and emotional well-being and engagement in care.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261435755"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13125848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of a patient navigation intervention for rural patients diagnosed with endometrial cancer: An intervention mapping approach.","authors":"Lisa P Spees, Victoria M Petermann, Brianna D Taffe, Blen M Biru, Sharon M Bigelow, Jhalak Dholakia, Stephanie B Wheeler, Victoria L Bae-Jump, Jennifer Leeman","doi":"10.1177/17455057261476904","DOIUrl":"10.1177/17455057261476904","url":null,"abstract":"<p><p>BackgroundPatient navigation is an equity-focused solution the provides personalized assistance to patients. To be effective, patient navigation needs to address variations across diverse contexts and populations.ObjectivesWe aimed to systematically design a patient navigation intervention for rural individuals with endometrial cancer (EC).DesignWe employed an intervention mapping methodology.MethodsThis multi-step process included conducting a needs assessment, identifying program objectives and outcomes, designing and producing the navigation program, and developing implementation and evaluation plans. We collaborated with an advisory board, who provided iterative feedback on intervention content, structure, and delivery.ResultsThrough our needs assessment, we identified 25 modifiable determinants of rural EC care grouped into five themes: poor patient-provider communication, barriers related to travel burden, lack of quality medical services, lack of/inaccessible supportive care resources, and insurance-related barriers. Our advisory board prioritized 15 determinants. A logic model of change outlined targeted determinants to improve receipt of high-quality treatment and reduce morbidity and mortality. The navigation program was designed to support rural patients from diagnosis through treatment completion. Key elements of the navigation program included rapport-building and longitudinal assessments to identify evolving barriers, address financial and transportation barriers, and provide emotional and informational support. Intervention materials developed included informational patient-facing materials, resource guides for navigators, and navigator scripts. Implementation strategies included clinical champions, a learning collaborative, and ongoing feedback. Our evaluation plan incorporated implementation outcomes (e.g., reach, fidelity, cost, acceptability) and effectiveness measures (e.g., patient-reported outcomes, treatment timeliness).ConclusionIntervention mapping provided a systematic framework for designing a patient navigation program targeting the barriers to care experienced by rural EC patients. Future work will test the intervention to assess feasibility, acceptability, and effectiveness in diverse clinical settings. This approach provides a replicable, evidence-based method to create navigation interventions for addressing the needs of high-risk populations.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261476904"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13659311/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148820489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence and determinants of surgical site infection following cesarean section in africa: Umbrella review.","authors":"Melkamu Addis, Habtamu Ayele, Geremew Bishaw Mekonen, Worku Misganaw Kebede, Melaku Laikemariam, Abraham Keffale Mengistu, Tesfahun Ayenew","doi":"10.1177/17455057261496373","DOIUrl":"10.1177/17455057261496373","url":null,"abstract":"<p><p>BackgroundSurgical site infection following cesarean section remains a major contributor to maternal morbidity, particularly in low- and middle-income countries. Although several systematic reviews and meta-analyses have evaluated its burden and determinants in Africa, findings remain heterogeneous and have not previously been synthesized through an umbrella review.ObjectiveTo synthesize evidence on the prevalence and determinants of surgical site infection following cesarean section in Africa.DesignUmbrella review.MethodsA comprehensive search of PubMed, HINARI/Research4Life, African Journals Online, ScienceDirect, Google Scholar, and Ethiopian scholarly repositories was conducted from March 1, 2026 to March 30, 2026. Systematic reviews and meta-analyses reporting the prevalence and/or determinants of surgical site infection following cesarean section in African populations were eligible. Methodological quality was assessed using AMSTAR 2, and overlap among primary studies was evaluated using the corrected covered area method.ResultsSeven systematic reviews and meta-analyses, comprising 71 primary studies and 61,485 participants, were included. Across the included reviews, reported pooled prevalence estimates consistently clustered around 10%. Maternal anemia, chorioamnionitis, prolonged labor, prolonged rupture of membranes, vertical skin incision, and general anesthesia were the determinants most consistently associated with increased surgical site infection risk following cesarean section. Methodological quality varied across reviews (five high quality and 2 moderate quality), and substantial heterogeneity with slight overlap among primary studies was identified.ConclusionThe available evidence indicates that surgical site infection remains an important maternal health concern following cesarean section in Africa. However, the findings should be interpreted cautiously because of heterogeneity and methodological limitations within the existing evidence base. Strengthening evidence-based perioperative infection prevention, standardized surgical site infection surveillance, and high-quality multicounty prospective research are important priorities.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261496373"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149171082","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":"Learning from the experiences of midwifery students and recent graduates in humanitarian and conflict-affected settings: A prospective cohort study protocol.","authors":"Hannah Tappis, Emilia Iwu, Hawa Abdullahi, Charity Maina, Asia Mohammed, Shatha Elnakib","doi":"10.1177/17455057261438787","DOIUrl":"10.1177/17455057261438787","url":null,"abstract":"<p><strong>Background: </strong>Health workforce shortages are a serious impediment to the delivery of effective and person-centered care, particularly in conflict settings. Midwives are a critical cadre who can help avert maternal and child death, but face persistent barriers to education, employment, regulation, and professional development-challenges that are especially pronounced in conflict-affected areas. Few studies have systematically explored midwives' experiences in these settings.</p><p><strong>Objectives: </strong>The EQUAL midwifery cohort study was established to systematically examine midwives' educational and professional trajectories in Northeast Nigeria and in Central and Southeast Somalia, with the goal of identifying context-specific factors influencing retention, deployment and professional growth.</p><p><strong>Design: </strong>Multiple cohorts of students and recent graduates will be enrolled, complete an intake survey, and be followed with additional surveys approximately 6 months after enrollment and then annually. Focus group discussions and in-depth interviews with a sub-set of participants will follow each round of surveys to expand on survey findings.</p><p><strong>Methods and analysis: </strong>Qualitative data analysis will focus on the lived experiences of participants, and how these experiences shape their professional identities and career trajectories. Survey analysis will assess levels of attrition, including withdrawal from training and exit from the profession post-graduation. Cox regression models will estimate hazard ratios and 95% confidence intervals for these outcomes, and median survival time in the profession will be calculated to determine when attrition is most likely. Risk factors for attrition during both training and professional practice will be examined.</p><p><strong>Ethics: </strong>Ethical approval was obtained from John Hopkins Bloomberg School of Public Health, the Somali Research and Development Institute, and Yobe State Health Ministry of Health Ethics Committee.</p><p><strong>Discussion: </strong>This research will offer insights into a critical yet under-explored segment of the global health workforce: early career midwives in conflict-affected settings. It serves as a proof-of-concept for the feasibility of longitudinal health workforce research in conflict-affected areas of Nigeria and Somalia, offering unprecedented evidence on the lived experiences and expressed needs of midwives to inform the improvement of midwifery education, working conditions, and support networks in these settings.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261438787"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13129333/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147791874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Self-reported and tracker-estimated physical activity outcomes in women with chronic pelvic pain disorders: A longitudinal evaluation of construct validity.","authors":"Tanisee Nagaldinne, Samia Shahnawaz, Suzanne R Bakken, Noemie Elhadad, Emma N Horan, Carol Ewing-Garber, Jovita Rodrigues, Matteo Danieletto, Kyle Landell, Ipek Ensari","doi":"10.1177/17455057261496048","DOIUrl":"https://doi.org/10.1177/17455057261496048","url":null,"abstract":"<p><p>BackgroundFemale chronic pelvic pain disorders (CPPDs) are associated with reduced physical activity (PA), contributing to adverse health outcomes. Accurate assessment of PA in this population is thus clinically important. Although the International Physical Activity Questionnaire (IPAQ) is widely used due to its low burden and cost, its validity in CPPD has not been established.ObjectivesThis study evaluates the construct validity of the short-form IPAQ among women with CPPDs by comparing against objectively-estimated PA outcomesDesignThis is a secondary analysis using a longitudinal, observational design.MethodsThe sample included 966 weeks of data from 112 women with CPPDs in a 14-week mHealth-based study. Participants wore Fitbit® trackers continuously and completed the IPAQ weekly. IPAQ-reported walking, total activity, sitting, light-, moderate-, and vigorous PA minutes were compared to corresponding Fitbit® estimates for concordance and divergence. We evaluated temporal consistency using intraclass correlation coefficients. We used linear mixed-effects regression models with random intercept and slope terms to quantify the magnitude of agreement between the two methods and between-individual variance.ResultsIPAQ walking minutes were associated with Fitbit® step counts, moderate- and moderate-to-vigorous PA (MVPA; p <0.05). IPAQ total activity minutes were associated with Fitbit® vigorous- and MVPA (p <0.05). IPAQ moderate PA was predictive of vigorous PA (p = 0.043), adjusted for habitual MVPA. IPAQ-reported sitting minutes were negatively associated with step counts and MVPA (p <0.05). IPAQ sitting minutes were predictive of steps, light PA, and MVPA. Habitual weekly PA level moderated these associations.ConclusionThese findings support using IPAQ-reported PA and sitting minutes to monitor PA minutes in women with CPPDs in research and clinical settings, but indicate that the IPAQ sitting item might not be an appropriate substitute for objective sedentary time estimates. This discrepancy might in part be due to IPAQ's focus on sitting-based activities.Registration statementNot applicable; observational study.</p>","PeriodicalId":75327,"journal":{"name":"Women's health (London, England)","volume":"22 ","pages":"17455057261496048"},"PeriodicalIF":2.9,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149217507","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}