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Smith H, Wilson M, Donovan B, Jones J, Butler T, Nathan S, Simpson P. Factors associated with unintended pregnancy and contraceptive practices in justice-involved adolescent girls in Australia. PLoS One 2024; 19:e0304825. [PMID: 38889164 PMCID: PMC11185493 DOI: 10.1371/journal.pone.0304825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Accepted: 05/17/2024] [Indexed: 06/20/2024] Open
Abstract
INTRODUCTION Despite a decline in unintended teenage pregnancy in Australia, rates remain higher amongst justice-involved adolescent girls, who are more likely to be from disadvantaged socio-economic backgrounds, have histories of abuse, substance use and/or mental health issues. Furthermore, exposure to the criminal justice system may alter access to education and employment and opportunities, potentially resulting in distinct risk-factor profiles. We examine factors associated with unintended pregnancy, non-contraceptive use and Long-Acting Reversible Contraception (LARC) in a sample of sexually active, justice-involved adolescent girls from Western Australia and Queensland. METHODS Data from the Mental Health, Sexual Health and Reproductive Health of Young People in Contact with the Criminal Justice System (MeH-JOSH) Study was analysed on 118 sexually active adolescent girls. Participants were aged between 14 and 17 years, purposefully sampled based on justice-system involvement and completed an anonymous telephone survey. We constructed two multivariate models taking reproductive outcomes as the dependent variables. RESULTS Over one quarter (26%, 30/118) reported a past unintended pregnancy, 54 did not use any contraception at their last sexual encounter, and 17 reported LARC use. Following adjustments in the multivariate analysis, lifetime ecstasy use was associated with both unintended pregnancy (aOR 3.795, p = 0.022) and non-contraception use (aOR 4.562, p = 0.004). A history of physical abuse was also associated with both any contraception (aOR 3.024, p = 0.041) and LARC use (aOR 4.892, p = 0.050). Identifying as Aboriginal & Torres Strait Islander, education/employment status and geographic location appeared to have no association. CONCLUSION Our findings suggest that justice-involved adolescent girls have distinct risk factors associated with unplanned pregnancy and contraception use compared to the general population, but more research is required to understand the mechanisms and contexts underlying these risk factors. How exposure to physical violence may encourage contraception and LARC use, in particular, warrants further attention as does the association with ecstasy use.
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Affiliation(s)
- Helene Smith
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Mandy Wilson
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Basil Donovan
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Jocelyn Jones
- National Drug & Research Institute, Curtin University, Perth, Australia
| | - Tony Butler
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Sally Nathan
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Paul Simpson
- School of Population Health, University of New South Wales, Sydney, Australia
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Monchalin R, Jubinville D, Pérez Piñán AV, Paul W, Wells M, Ross A, Law K, Chaffey M, Pruder H. "I would love for there not to be so many hoops … ": recommendations to improve abortion service access and experiences made by Indigenous women and 2SLGTBQIA+ people in Canada. Sex Reprod Health Matters 2023; 31:2247667. [PMID: 37799036 PMCID: PMC10561563 DOI: 10.1080/26410397.2023.2247667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/07/2023] Open
Abstract
Acknowledging the barriers in accessing sexual and reproductive health services that disproportionately impact Indigenous women and 2SLGTBQIA+ people, coupled with the lack of knowledge surrounding Indigenous peoples' experiences with abortion, we present qualitative findings from a pilot study investigating Indigenous experiences of accessing abortion services in Canada. We focus on findings related to participant recommendations for improving safety and accessibility of abortion services made by and for Indigenous people in Canada. Informed by an Indigenous Advisory Committee consisting of front-line service providers working in the area of abortion service access and/ or support across Canada, the research team applied an Indigenous methodology to engage with 15 Indigenous people across Canada utilising a conversational interview method, between September and November 2021. With representation from nine provinces and territories across Canada, participants identified with Anishinaabe, Cree, Dene, Haudenosaunee, Inuit, Métis and/ or Mi'kmaq Nations. Five cross-cutting recommendations emerged, including: (1) location, comfort, and having autonomy to choose where the abortion takes place; (2) holistic post-abortion supports; (3) accessibility, availability, and awareness of non-biased and non-judgemental information; (4) companionship, advocacy, and logistical help before and during the abortion from a support person; and (5) cultural safety and the incorporation of local practices and knowledges. Recommendations demonstrate that Indigenous people who have experienced an abortion carry practical solutions for removing barriers and improving access to abortion services in the Canadian context.
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Affiliation(s)
- Renée Monchalin
- Assistant Professor, School of Public Health and Social Policy, University of Victoria, Victoria, BCV8P 5C2, Canada
- Affiliate Scientist, Well Living House, Li Ka Shing Knowledge Institute of Unity Health Toronto, Toronto, ON, Canada
- Assistant Professor (Status Only), Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Danette Jubinville
- PhD Candidate, Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
- Full-Spectrum Doula, ekw’í7tl Doula Collective, Vancouver, BC, Canada
| | - Astrid V. Pérez Piñán
- Assistant Professor, School of Public Administration, University of Victoria, Victoria, BC, Canada
| | - Willow Paul
- Masters Candidate, School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | - Madison Wells
- Research Coordinator, School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | - Arie Ross
- Masters Candidate, School of Public Health and Social Policy, University of Victoria, Victoria, BC, Canada
| | - Kimberly Law
- Nurse Practitioner, Northern Health Authority, British Columbia, Canada
| | - Meagan Chaffey
- Abortion Doula, Abortion Support Services Atlantic, Halifax, NS, Canada
| | - Harlie Pruder
- Founder, Northern Reproductive Justice Network, Thompson, MB, Canada
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Baney L, Greene A, Sherwood-Laughlin C, Beckmeyer J, Crawford BL, Jackson F, Greathouse L, Sangmo D, Ward M, Kavaya S. "It Was Just Really Hard to Be Pregnant in a Smaller Town …": Pregnant and Parenting Teenagers' Perspectives of Social Support in Their Rural Communities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:16906. [PMID: 36554786 PMCID: PMC9778672 DOI: 10.3390/ijerph192416906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/13/2022] [Accepted: 12/13/2022] [Indexed: 06/17/2023]
Abstract
Teenage pregnancy has a history of being a "social problem" in the United States, with there being higher rates in rural communities. Social support, a contributor to improving mental health outcomes, can significantly impact a teenager's pregnancy and parenting experience. Using House's (1981) social support framework, this study explores the teenagers' perceptions of how their rural community reacted and responded to them as pregnant and parenting teenagers. The results were formulated through the thematic analysis of semi-structured interviews (n = 26) with current and former pregnant and/or parenting teenagers. The participants reported experiencing both positive and negative social support. There were more reports of emotional support and instrumental support among the forms of positive support than there were in the other categories. Informational support was lacking. The appraisal support from community members was negative. There is a need for rural communities to develop effective social support strategies to provide positive support for pregnant and parenting teenagers.
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Affiliation(s)
- Lauren Baney
- School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Alison Greene
- School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | | | - Jonathon Beckmeyer
- College of Applied Human Sciences, West Virginia University, Morgantown, WV 26506, USA
| | - Brandon L. Crawford
- School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Frederica Jackson
- School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Lisa Greathouse
- Community Health, Indiana University Health, Bloomington, IN 47401, USA
| | - Dechen Sangmo
- School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Michaella Ward
- School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405, USA
| | - Susan Kavaya
- School of Public Health, Indiana University-Bloomington, Bloomington, IN 47405, USA
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Okeke SR. "It was protected, except, it wasn't [with] a condom": a mixed-methods study of BBVs/STIs protective practices among International University Students in Sydney, Australia. BMC Public Health 2022; 22:2168. [PMID: 36434571 PMCID: PMC9700902 DOI: 10.1186/s12889-022-14512-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 11/01/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND A number of previous sex-related studies among international students in Australia and other Western societies may be limited by conflating students from conservative and non-conservative sexual backgrounds. Such conflation leads to situations where nuances and complexities around sex-related experiences are lost or, at most, tangentially investigated. To address this research problem, this study used a mixed-methods design to examine protective practices against blood-borne viruses and sexually transmissible infections (BBVs/STIs) among Sydney-based East Asian and sub-Saharan African international students. METHODS This mixed-methods study generated quantitative data using anonymous online survey (n = 149), and qualitative data through in-depth interviews (n = 20). The main recruitment strategy involved advertising the study through paper and electronic flyers. Quantitative data were analysed using logistic regression, while interviews data were analysed using reflexive thematic analysis. RESULTS Self-reported BBVs/STIs protective practices in the last 12 months include abstinence (28.7%), consistent condom use (19.9%), occasional condom use (18.7%), single partner fidelity (25.1%), other strategies (1.8%), and nothing (5.8%). Further, findings from the bivariate analysis showed higher BBVs/STIs prevention knowledge, lower acculturation into Australian sexual culture, greater access to sexual health information, less conservative sexual norms, greater emotional social support and older age were significantly associated with increased protective practices. Variables significant at bivariate level were entered into a logistic regression. The model was statistically significant, (X2(6) = 31.33, p < 0.01) and explained 33.1% of the variance in BBVs/STIs protective practices. However, only acculturation to sexual norms in Australia (OR = 0.883, 95% CI = 0.820-0.952) was found to be independent predictor of BBVs/STIs protective practices. The results of the study based on the quantitative data, indicated condom use (consistent and occasional) was the most reported BBVs/STIs protective behaviour among sexually active participants. Therefore, interviews data was used to explore condom-use motives and practices. The interviews results showed participants primary concern as regards condom use was around pregnancy and not BBVs/STIs. Thus, some participants described safe sex largely as contraception, with BBVs/STIs constituting a secondary concern or no concern at all. CONCLUSIONS Based on the results of this study, tailored sexual health interventions for international students; which incorporate strategies for modifying perceived sexual norms in Australia, are advocated. In addition, this study recommends sexual health interventions that promote dual protection of condoms for both contraception and BBVs/STIs.
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Affiliation(s)
- Sylvester Reuben Okeke
- grid.1005.40000 0004 4902 0432Centre for Social Research in Health, UNSW Sydney, Sydney, Australia
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5
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Mahanaimy M, Gerdts C, Moseson H. What constitutes a good healthcare experience for unintended pregnancy? A qualitative study among young people in California. CULTURE, HEALTH & SEXUALITY 2022; 24:330-343. [PMID: 33252315 PMCID: PMC10387493 DOI: 10.1080/13691058.2020.1840631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2020] [Accepted: 10/19/2020] [Indexed: 06/12/2023]
Abstract
Little is known about young people's experiences accessing healthcare for unintended pregnancy in the USA. To address this gap, we conducted in-depth interviews with 25 young people in California who had experienced at least one unintended pregnancy at or before 25 years of age. Participants were asked about their interactions with healthcare providers during the pregnancy, their thoughts on the determinants of their perceived quality of care, and the ways in which their healthcare experience could have been improved. Thematic analysis was used to organise information within and across interview transcripts. Two important determinants of participants' satisfaction with their healthcare experience were identified during analysis: (1) receiving comprehensive information about their pregnancy options and what to expect from each, and (2) having an empathetic, non-judgemental provider. Regarding abortion, participants described an unmet need for accurate information and frequent stigmatising experiences with dismissive and judgemental care providers. These findings highlight the importance of providing comprehensive, non-judgemental pregnancy options counselling to all pregnant people, regardless of age and desired pregnancy outcome; and reinforce the need for providers to consider ways in which their own bias may influence the quality of care they provide.
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Asiimwe R, Tseng C, Murray SM, Ojuka JC, Arima EG, Familiar‐Lopez I. Association of pregnancy‐related stigma and intimate partner violence with anxiety and depression among adolescents. J Adolesc 2022; 94:270-275. [DOI: 10.1002/jad.12008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 12/24/2021] [Indexed: 11/10/2022]
Affiliation(s)
- Ronald Asiimwe
- Department of Human Development and Family Studies Michigan State University East Lansing Michigan USA
| | - Chi‐Fang Tseng
- Department of Human Development and Family Studies Michigan State University East Lansing Michigan USA
| | - Sarah M. Murray
- Department of Mental Health Johns Hopkins School of Public Health Baltimore Maryland USA
| | | | - Ethan G. Arima
- Makerere University Johns Hopkins University Research Collaboration Kampala Uganda
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Miller LE, Zamudio-Haas S, Otieno B, Amboka S, Odeny D, Agot I, Kadede K, Odhiambo H, Auerswald C, Cohen CR, Bukusi EA, Truong HHM. "We Don't Fear HIV. We Just Fear Walking around Pregnant.": A Qualitative Analysis of Adolescent Sexuality and Pregnancy Stigma in Informal Settlements in Kisumu, Kenya. Stud Fam Plann 2021; 52:557-570. [PMID: 34766351 DOI: 10.1111/sifp.12178] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
In Kenya, adolescent pregnancy rates are high, contraception utilization is low, and adolescent sexuality is stigmatized. We describe how perceptions of sexuality and pregnancy stigma influence decision-making among adolescents in the informal settlements of Kisumu. We used purposive sampling to recruit 120 adolescent boys and girls aged 15-19 for focus group discussions. A semistructured interview guide was used to elicit social norms and community attitudes about sexual and reproductive health. We analyzed the data using the Framework Approach. The social stigma of adolescent sexuality and the related fear of pregnancy as an unambiguous marker of sexual activity emerged as main themes. This stigma led adolescents to fear social retribution but did not lead to more frequent contraception use due to additional stigma. The intensity of this fear was most acutely expressed by girls, leading some to seek unsafe, sometimes fatal, abortions, and to contemplate suicide. Fear of pregnancy outweighed fear of contracting HIV that was viewed as both treatable and less stigmatized. Our findings illustrate how fear of pregnancy among these adolescents is driven primarily by fears that their community will discover that they are sexually active. Interventions are urgently needed to address adolescent sexual stigma and to prevent negative outcomes.
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McLean E, Singer J, Laurita E, Kahler J, Levin C, Papa A. Perception of grief responses: Are maladaptive grief responses and the stages of grief considered normal? DEATH STUDIES 2021; 46:1414-1423. [PMID: 34632956 DOI: 10.1080/07481187.2021.1983890] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Literature indicates laypeople hold strong opinions about how persons should grieve. This study examined how individuals perceive normal grief. Participants across two distinct samples (Study 1: N = 510 via MTurk; Study 2: N = 210 via Qualtrics panels) completed the Perception of Grief Scale and Grief Expectations Questionnaire. Findings indicated participants endorsed maladaptive grief responses as normal relative to other responses to loss. Endorsement of maladaptive grief responses as normal predicted endorsement of grief work beliefs. If social expectations deem maladaptive grief to be normal, as this study suggests, bereaved individuals might implicitly push themselves to grieve maladaptively.
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Affiliation(s)
| | - Jonathan Singer
- Department of Psychology, Texas Tech University, Lubbock, TX, USA
| | - Emily Laurita
- Department of Psychology, University of Nevada, Reno, NV, USA
| | - Julie Kahler
- Health Services Research and Development, Center to Improve Veteran Involvement in Care, VA Portland Health Care System, Portland, OR, USA
| | - Crissa Levin
- Department of Psychology, Utah State University, Logan, UT, USA
| | - Anthony Papa
- Department of Psychology, University of Hawai'i at Mānoa, Honolulu, HI, USA
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Bowling J, Simmons M, Blekfeld-Sztraky D, Bartelt E, Dodge B, Sundarraman V, Lakshmi B, Herbenick D. “It’s a walk of shame”: Experiences of unintended pregnancy and abortion among sexual- and gender-minoritized females in urban India. MEDICINE ACCESS @ POINT OF CARE 2021; 5:23992026211027698. [PMID: 36204507 PMCID: PMC9413609 DOI: 10.1177/23992026211027698] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/08/2021] [Indexed: 11/30/2022] Open
Abstract
Background: Unintended pregnancy and safe abortion access in India remain critical public
health concerns. The health of sexual- and gender-minoritized females (SGMF;
those assigned female at birth and identify as other than heterosexual
and/or as other than cisgender women) in India is understudied. Aim: We examined experiences of unintended pregnancy and abortion among SGMF
individuals in urban India. Methods: We used focus group discussions (n = 8 individuals in two
groups) and interviews (n = 20) with SGMF individuals. Data
were collected in December 2017. Transcripts were analyzed using a priori
thematic analysis and then open thematic analysis in Dedoose online
software. Results: Nine participants experienced or suspected they had unintended pregnancies.
Pregnancy circumstances were mostly due to sex without using a barrier
method. Participants discussed using traditional methods to induce abortion
or changing their approach to contraception. Social support was often
lacking, though partners were supportive of abortion choices. Participants
reported stigma and surveillance from family, friends, providers, and
community members. Conclusion: These findings highlight the effects of stigma in relation to abortion and
unintended pregnancy on health and relationships.
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Affiliation(s)
- Jessamyn Bowling
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
| | | | - Donna Blekfeld-Sztraky
- Department of Public Health Sciences, University of North Carolina at Charlotte, Charlotte, NC, USA
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Manso-Córdoba S, Pickering S, Ortega MA, Asúnsolo Á, Romero D. Factors Related to Seeking Help for Postpartum Depression: A Secondary Analysis of New York City PRAMS Data. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17249328. [PMID: 33322171 PMCID: PMC7763494 DOI: 10.3390/ijerph17249328] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/03/2020] [Accepted: 12/10/2020] [Indexed: 12/12/2022]
Abstract
Postpartum depression (PPD) affects 13% of mothers and can have a major impact on their lives and those of their children. However, most cases go undiagnosed, and the risk factors for this underdiagnosis are not yet fully known. We intended to analyze the influence of different sociodemographic and health factors associated with symptoms of postpartum depression. Data from the New York City Pregnancy Risk Assessment Monitoring System (PRAMS) for 2016–2017 were analyzed. 618 women met the inclusion criterion of recurring depressive symptoms. Most women who experienced PPD symptoms did not seek help. Seeking help was a much better predictor of the diagnosis of PPD when compared to questions regarding symptoms. The most important factors related to a decreased risk of not asking for help were having a previous mental health history and having doctor visits for a chronic illness. The racial group most at risk of not asking for help were Asian/Pacific Islander (API) women. Interventions aimed at reducing the stigma and increasing knowledge of PPD should be incorporated into the antenatal education of expectant mothers, particularly among women who may not have previously sought care for mental or chronic illnesses.
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Affiliation(s)
- Silvia Manso-Córdoba
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28801 Madrid, Spain;
| | - Sarah Pickering
- Graduate School of Public Health and Health Policy, City University of New York (CUNY), New York, NY 10010, USA;
| | - Miguel A. Ortega
- Department of Medicine and Medical Specialties, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28801 Madrid, Spain;
- Ramón y Cajal Institute of Healthcare Research (IRYCIS), 28034 Madrid, Spain
- University Center for the Defense of Madrid (CUD-ACD), 28047 Madrid, Spain
| | - Ángel Asúnsolo
- Department of Surgery, Medical and Social Sciences, Faculty of Medicine and Health Sciences, University of Alcalá, Alcalá de Henares, 28801 Madrid, Spain;
- Ramón y Cajal Institute of Healthcare Research (IRYCIS), 28034 Madrid, Spain
- Department of Community Health and Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, NY 10010, USA
- Correspondence: (Á.A.); (D.R.); Tel.: +34-619587458 (Á.A.); +1-646-364-9522 (D.R.)
| | - Diana Romero
- Department of Community Health and Social Sciences, City University of New York (CUNY) Graduate School of Public Health and Health Policy, New York, NY 10010, USA
- Correspondence: (Á.A.); (D.R.); Tel.: +34-619587458 (Á.A.); +1-646-364-9522 (D.R.)
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