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Zepro NB, Medhanyie AA, Probst-Hensch N, Chernet A, Tschopp R, Abongomera C, Paris DH, Merten S. Navigating challenges: a socioecological analysis of sexual and reproductive health barriers among Eritrean refugee women in Ethiopia, using a key informant approach. BMJ Open 2024; 14:e080654. [PMID: 38658003 PMCID: PMC11043775 DOI: 10.1136/bmjopen-2023-080654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Accepted: 03/28/2024] [Indexed: 04/26/2024] Open
Abstract
OBJECTIVES The study aimed to explore the experiences and perceptions of healthcare providers (HCPs) regarding the sexual and reproductive health (SRH) challenges of Eritrean refugee women in Ethiopia. DESIGN A qualitative exploratory design with the key informant approach. SETTING AND PARTICIPANTS The study was conducted in the Afar regional state, North East, Ethiopia. The study participants were HCP responsible for providing SRH care for refugee women. RESULTS Eritrean refugee women have worse health outcomes than the host population. The SRH needs were found to be hindered at multiple layers of socioecological model (SEM). High turnover and shortage of HCP, restrictive laws, language issues, cultural inconsistencies and gender inequalities were among the main barriers reported. Complex multistructural factors are needed to improve SRH needs of Eritrean refugee women. CONCLUSIONS A complex set of issues spanning individual needs, social norms, community resources, healthcare limitations and structural mismatches create significant barriers to fulfilling the SRH needs of Eritrean refugee women in Ethiopia. Factors like limited awareness, cultural taboos, lack of safe spaces, inadequate healthcare facilities and restrictive policies all contribute to the severe limitations on SRH services available in refugee settings. The overlap in findings underscores the importance of developing multilevel interventions that are culturally sensitive to the needs of refugee women across all SEM levels. A bilateral collaboration between Refugees and Returnees Service (RRS) structures and the Asayta district healthcare system is critically important.
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Affiliation(s)
- Nejimu Biza Zepro
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
- College of Health Sciences, Samara University, Afar, Ethiopia
| | - Araya Abrha Medhanyie
- School of Public Health, College of Health Sciences, Mekelle University, Tigray, Ethiopia
| | - Nicole Probst-Hensch
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Afona Chernet
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Rea Tschopp
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Charles Abongomera
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Daniel H Paris
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
| | - Sonja Merten
- Department of Epidemiology and Public Health, Swiss Tropical and Public Health Institute, Basel, Switzerland
- University of Basel, Basel, Switzerland
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Chandler R, Guillaume D, Francis S, Xue E, Shah K, Parker A, Hernandez N. "I care about sex, I care about my health": A mixed-methods pre-test of a HIV prevention mobile health app for Black women in the southern United States. PLoS One 2023; 18:e0289884. [PMID: 37851669 PMCID: PMC10584133 DOI: 10.1371/journal.pone.0289884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 07/27/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Black women experience higher rates of adverse sexual and reproductive health and HIV outcomes, however the use of mHealth to address these health disparities in this population has been inadequate. This study involved a one-month pre-test with Black women living in metro-Atlanta to evaluate the usability, acceptability, and engagement of an HIV prevention app SavvyHER. METHODS An explanatory mixed-methods design was employed in which quantitative data was collected through weekly cross-sectional surveys, and qualitative data was collected through semi-structured in-depth interviews. Descriptive and ANOVA analysis was conducted for the quantitative data using STATA software. Qualitative data was analyzed through qualitative descriptive methods on Atlas.ti. RESULTS Participants had high levels of acceptability towards the app and used SavvyHER moderately. The most frequently used features were live groups (2.96 ±0.22, 95% CI 2.51,3.41), viewing resources and educational information (2.77 ± 0.21, 95% CI 2.33,3.20), and mental health monitoring (2.73 ±0.21, 95% CI 2.29,3.12). The least used features were pregnancy symptom monitoring (1.92 ±0.27, 95% CI 1.38,2.47) and STI symptom monitoring (2.0 ±0.25, 95% CI 1.48,2.52). In qualitative interviews, several women discussed how the ability to engage in active discussions and join live sessions with other end-users was a favorable aspect of SavvyHER. Although the app's primary focus was on sexual and reproductive health and HIV prevention, women were more likely to access mental health monitoring and physical activity monitoring features. Women expressed their fondness of the app design and interface as it was reflective of the diversity of Black women. CONCLUSION Further research is needed to explore the efficacy in using SavvyHER and additional mHealth interventions to enhance Black women's sexual and reproductive health and overall wellness.
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Affiliation(s)
- Rasheeta Chandler
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States of America
| | - Dominique Guillaume
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States of America
- Center for Infectious Disease and Nursing Innovation, School of Nursing, Johns Hopkins University, Baltimore, MD, United States of America
| | - Sherilyn Francis
- School of Interactive Computing, College of Computing, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Eric Xue
- School of Interactive Computing, College of Computing, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Kewal Shah
- School of Interactive Computing, College of Computing, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Andrea Parker
- School of Interactive Computing, College of Computing, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Natalie Hernandez
- Center for Maternal Health Equity, Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia, United States of America
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Charron-Prochownik D, Moore KR, Stotz S, Akers A, Beirne S, Brega AG, Chalmers L, Fischl A, Garrow H, Gonzales K, Nadeau KJ, O'Banion N, Powell J, Seely E, Powell B, Abujaradeh H, Sereika SM. Comparing American Indian/Alaska Native Adolescent Daughters' and Their Mothers' Awareness, Knowledge, Attitudes, and Behaviors Regarding Risk for Gestational Diabetes: Implications for Mother-Daughter Communication on Reproductive Health. Sci Diabetes Self Manag Care 2023; 49:267-280. [PMID: 37332238 DOI: 10.1177/26350106231178837] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
PURPOSE The purpose of the study was to describe, compare, and examine associations at baseline of reproductive health awareness, knowledge, health beliefs, communication and behaviors related to gestational diabetes (GDM) and GDM risk reduction in a vulnerable population of both American Indian/Alaska Native (AIAN) adolescent girls and their mothers. METHODS Descriptive/comparative/correlational analyses examined multitribal baseline data on 149 mother-daughter (M-D) dyads (N = 298; daughter age = 12-24 years) enrolled in a longitudinal study to adapt and evaluate a culturally relevant diabetes preconception counseling (PC) program (Stopping-GDM). The associations between GDM risk reduction awareness, knowledge, health beliefs, and behaviors (eg, daughters' eating, physical activity, reproductive-health [RH] choices/planning, M-D communication, daughters' discussions on PC) were examined. Data collected online from 5 national sites. RESULTS Many M-D lacked awareness/knowledge of GDM and risk reduction. Both M-D were unaware of the girl's risk for GDM. Mothers' knowledge and beliefs on GDM prevention/RH were significantly higher than daughters. Younger daughters had greater self-efficacy healthy living. Overall sample reported low to moderate scores for both M-D communication and daughters' GDM and RH risk-reduction behaviors. CONCLUSIONS Knowledge, communication, and behaviors to prevent GDM were low in AIAN M-D, especially daughters. More than daughters, mothers perceive greater risk of GDM for daughters. Early culturally responsive dyadic PC programs could help decrease risk of developing GDM. Implications for M-D communication is compelling.
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Affiliation(s)
| | - Kelly R Moore
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Sarah Stotz
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Sandra Beirne
- Navajo Area Indian Health Service, Shiprock, New Mexico
| | - Angela G Brega
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | | | - Andrea Fischl
- University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
| | | | | | - Kristen J Nadeau
- University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Nancy O'Banion
- Indian Health Care Resource Center of Tulsa, Tulsa, Oklahoma
| | - Jeff Powell
- University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
| | - Ellen Seely
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Blair Powell
- Navajo Area Indian Health Service, Shiprock, New Mexico
| | - Hiba Abujaradeh
- University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
| | - Susan M Sereika
- University of Pittsburgh, School of Nursing, Pittsburgh, Pennsylvania
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Adebowale AS, Salawu AT, Fagbamigbe AF, Khasakhala AA, Palamuleni ME, Fawole OI. Demographic and epidemiological transitions and burden of adolescent healthcare in sub-Saharan Africa: A review. Afr J Reprod Health 2023; 27:109-126. [PMID: 37742339 DOI: 10.29063/ajrh2023/v27i7.11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
This review's main objective is to discuss how demographic and epidemiological transitions relate to the burden of adolescent healthcare in sub-Saharan Africa (SSA). The review explicitly discussed the burden of adolescent healthcare, the current African policies on adolescent healthcare, and gaps in the African policies compared with Europe and North America. We also examined how adolescent healthcare policies evolve and documented the recommended essential part of the policy for enhancing its sustainability. The burden of adolescent health is high in SSA with diseases and reproductive health-related problems prevailing among adolescents. However, variations exist in the burden of adolescent healthcare across countries in the region. While some SSA countries are currently undergoing demographic and epidemiological transition processes concerning adolescent health care, the majority are either at an early stage of the transition or yet to commence the process. Policy-makers should consider effective ways to improve adolescents' health in SSA through preventive mechanisms and a multi-dimensional approach.
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Affiliation(s)
- Ayo S Adebowale
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan
- Population and Health Research Entity, Faculty of Humanities, North-West University, Mafikeng, South Africa
| | - Adetokunbo T Salawu
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan
| | - Adeniyi F Fagbamigbe
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan
| | - Anne A Khasakhala
- Institute of Population Studies and Research, University of Nairobi, Kenya
| | - Martin E Palamuleni
- Population and Health Research Entity, Faculty of Humanities, North-West University, Mafikeng, South Africa
| | - Olufunmilayo I Fawole
- Department of Epidemiology and Medical Statistics, Faculty of Public Health, College of Medicine, University of Ibadan
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Bond KT, Chandler R, Chapman-Lambert C, Jemmott LS, Lanier Y, Cao J, Nikpour J, Randolph SD. Applying a Nursing Perspective to Address the Challenges Experienced by Cisgender Women in the HIV Status Neutral Care Continuum: A Review of the Literature. J Assoc Nurses AIDS Care 2021; 32:283-305. [PMID: 33929979 PMCID: PMC10688540 DOI: 10.1097/jnc.0000000000000243] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT The field of HIV research has grown over the past 40 years, but there remains an urgent need to address challenges that cisgender women living in the United States experience in the HIV neutral status care continuum, particularly among women such as Black women, who continue to be disproportionately burdened by HIV due to multiple levels of systemic oppression. We used a social ecological framework to provide a detailed review of the risk factors that drive the women's HIV epidemic. By presenting examples of effective approaches, best clinical practices, and identifying existing research gaps in three major categories (behavioral, biomedical, and structural), we provide an overview of the current state of research on HIV prevention among women. To illustrate a nursing viewpoint and take into account the diverse life experiences of women, we provide guidance to strengthen current HIV prevention programs. Future research should examine combined approaches for HIV prevention, and policies should be tailored to ensure that women receive effective services that are evidence-based and which they perceive as important to their lives.
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Affiliation(s)
- Keosha T Bond
- Keosha T. Bond, EdD, MPH, CHES, is an Assistant Medical Professor, Department of Community Health and Social Medicine, City University of New York School of Medicine, New York, New York, USA. Rasheeta Chandler, PhD, RN, FNP-BC, FAANP, FAAN, is an Assistant Professor, School of Nursing, Emory University, Atlanta, Georgia, USA. Crystal Chapman-Lambert, PhD, CRNP, is an Associate Professor, School of Nursing, University of Alabama at Birmingham, Birmingham, Alabama, USA. Loretta Sweet Jemmott, PhD, RN, is Vice President, Health and Health Equity, and Professor, College of Nursing and Health Professions, Drexel University, Philadelphia, Pennsylvania, USA. Yzette Lanier, PhD, is an Assistant Professor, School of Nursing, New York University, New York, New York, USA. Jiepin Cao, MS, RN, is a Graduate Student, School of Nursing, Duke University, Durham, North Carolina, USA. Jacqueline Nikpour, BSN, RN, is a Graduate Student, School of Nursing, Duke University, Durham, North Carolina, USA. Schenita D. Randolph, PhD, MPH, RN, CNE, is an Assistant Professor, School of Nursing, and Co-director, Community Engagement Core, Duke Center for Research to Advance Healthcare Equity (REACH Equity), Duke University, Durham, North Carolina, USA
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Mikhail H, Kelly SE, Davison CM. Reproductive health interventions for Inuit youth in the north: a scoping review. Reprod Health 2021; 18:65. [PMID: 33743754 PMCID: PMC7981914 DOI: 10.1186/s12978-021-01119-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Accepted: 02/28/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Inuit have thrived in the northern regions of Canada and Alaska for thousands of years. Recent evidence suggests that Inuit in this region have experienced systemic barriers to reproductive health with resulting disparities in reproductive health-related outcomes including those among youth. Northern youth-focused reproductive health intervention research or evaluations have not to date been well summarized. The objective of this scoping review was to summarize the literature over the past twenty years focusing on reproductive health interventions for adolescents in northern Inuit communities. METHODS English-language articles from 2000 to 2020 were identified from seven scientific databases, a general internet search and a review of relevant websites. Two reviewers screened titles, abstracts and full texts and included articles if they mentioned a reproductive health intervention and pertained, directly or indirectly, to reproductive health for Inuit aged 10-19 in northern communities. RESULTS Seventeen articles met the inclusion criteria, across six themes: (1) Barriers to reproductive health interventions in the north; (2) Northern midwifery; (3) Northern birthing centres; (4) Fetal fibronectin tests for identifying high-risk pregnancies; (5) Prenatal education classes; and (6) Interventions to improve access to and quality of reproductive health supports. CONCLUSION Overall there is relatively limited evidence base specific to reproductive health interventions and northern Inuit youth. What does exist largely focuses on maternal health interventions and is inclusive of but not specific to youth. There is some evidence that youth specific educational programs, participatory action research approaches and the promotion of northern birthing centres and midwifery can improve reproductive health for adolescents and young mothers in northern Inuit communities. Future initiatives should focus on the creation and evaluation of culturally relevant and youth specific interventions and increasing community and youth participation in intervention research for better reproductive health.
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Affiliation(s)
- Hannah Mikhail
- Department of Public Health Sciences, Queen's University, 62 Fifth Field Company Lane, Carruthers Hall #203, Kingston, ON, K7L3N6, Canada
| | - Sarah E Kelly
- Department of Public Health Sciences, Queen's University, 62 Fifth Field Company Lane, Carruthers Hall #203, Kingston, ON, K7L3N6, Canada
| | - Colleen M Davison
- Department of Public Health Sciences, Queen's University, 62 Fifth Field Company Lane, Carruthers Hall #203, Kingston, ON, K7L3N6, Canada.
- Department of Global Development Studies, Queen's University, Kingston, ON, Canada.
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Abstract
The Canadian national identity is often understood as what it is not; American. Inundation with American history, news, and culture around race and racism imbues Canadians with a false impression of egalitarianism, resulting in a lack of critical national reflection. While this is true in instances, the cruel reality of inequity, injustice and racism is rampant within the Canadian sexual and reproductive health and rights realm. Indeed, the inequitable health outcomes for Black, Indigenous and people of color (BIPOC) are rooted in policy, research, health promotion and patient care. Built by colonial settlers, many of the systems currently in place have yet to embark on the necessary process of addressing the colonial, racist, and ableist structures perpetuating inequities in health outcomes. The mere fact that Canada sees itself as better than America in terms of race relations is an excuse to overlook its decades of racial and cultural discrimination against Indigenous and Black people. While this commentary may not be ground-breaking for BIPOC communities who have remained vocal about these issues at a grassroots level for decades, there exists a gap in the Canadian literature in exploring these difficult and often underlying dynamics of racism. In this commentary series, the authors aim to promote strategies addressing systemic racism and incorporating a reproductive justice framework in an attempt to reduce health inequities among Indigenous, Black and racialized communities in Canada.
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Affiliation(s)
- Ieman M. El-Mowafi
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Abdiasis Yalahow
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Dina Idriss-Wheeler
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, Canada
| | - Sanni Yaya
- School of International Development and Global Studies, Faculty of Social Sciences, University of Ottawa, 120 University Private, Ottawa, ON K1N 6N5 Canada
- The George Institute for Global Health, Imperial College London, London, UK
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Chandler R, Guillaume D, Parker AG, Carter S, Hernandez ND. Promoting Optimal Sexual and Reproductive Health with Mobile Health Tools for Black Women: Combining Technology, Culture and Context. Perspect Sex Reprod Health 2020; 52:205-209. [PMID: 33399277 PMCID: PMC8536956 DOI: 10.1363/psrh.12170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 09/04/2020] [Accepted: 09/10/2020] [Indexed: 06/12/2023]
Affiliation(s)
| | | | - Andrea G Parker
- School of Interactive Computing, College of Computing, Georgia Institute of Technology, Atlanta
- Rollins School of Public Health, Emory University, Atlanta
| | - Sierra Carter
- Department of Psychology, Georgia State University, Atlanta
| | - Natalie D Hernandez
- Center for Maternal Health Equity, Department of Community Health and Preventative Medicine, Office of Community Engagement, Morehouse School of Medicine, Atlanta
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Amiri M, El-Mowafi IM, Chahien T, Yousef H, Kobeissi LH. An overview of the sexual and reproductive health status and service delivery among Syrian refugees in Jordan, nine years since the crisis: a systematic literature review. Reprod Health 2020; 17:166. [PMID: 33115474 PMCID: PMC7592572 DOI: 10.1186/s12978-020-01005-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2019] [Accepted: 10/04/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The Syrian refugee crisis has led to massive displacement into neighboring countries including Jordan. This crisis has caused a significant strain on the sexual and reproductive health (SRH) services to the host communities and Syrian refugees. The Minimum Initial Service Package (MISP) is a standard package of services that should be implemented at the onset of an emergency. Due to their importance in protracted humanitarian crisis, this systematic review aimed to assess the utilization of SRH and MISP after 9 years of the crisis. METHODS We searched PubMed, Medline/Ovid and Scopus for both quantitative and qualitative studies from 1 January 2011 to 30 November 2019. Our search included both free text key words and Medical Subject Headings (MeSH) for various forms and acronmym of the following terms: (Sexual and) Reproductive Health, Sexual/Gender-based/Family/Intimate partner violence, Minimum Initial Service Package, MISP, Women, Girls, Adolescents, Syrian, Refugee, Jordan, Humanitarian crisis, War, (armed) conflict, and Disaster. Boolean operators and star truncation (*) were used as needed. We further conducted an in-depth review of the available grey literature published during the same timeframe. Using a narrative synthesis approach, two authors independently extracted and analyzed data from published papers. After removal of duplicates, screening, and assessing for eligibility of 161 initially identified citations, 19 papers were selected for review. RESULTS Findings from this review indicated a number of barriers to access, utilization, and implementation of SRH services, including lack of reliable information on sexual and gender-based violence (SGBV), aggravation of early marriages by crisis setting, gaps in the knowledge and use of family planning services, inadequate STIs and HIV coverage, and some issues around the provision of maternal health services. CONCLUSION The findings from this review are suggestive of a number of barriers pertaining to access, utilization, and implementation of SRH services. This is especially true for transitioning from MISP to comprehensive SRH services, and particularly for refugees outside camps. Following are needed to address identified barriers: improved inter-agency coordination, better inclusion/engagement of local initiatives and civil societies in SRH services delivery, improved quality of SRH services, adequate and regular training of healthcare providers, and increased awareness of Syrian women and adolescent girls. Also, more implementing research is required to identify ways to transition SRH provision from the MISP to comprehensive care for the Syrian refugee population in Jordan.
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Affiliation(s)
- Mirwais Amiri
- The Eastern Mediterranean Public Health Network (EMPHNET), Shmeisani, Abdallah Ben Abbas Street, Bldg No. 42, Amman, Jordan.
| | - Ieman M El-Mowafi
- Faculty of Health Sciences, The University of Ottawa, 75 Laurier Ave E, Ottawa, ON, K1N 6N5, Canada
| | - Tala Chahien
- The Eastern Mediterranean Public Health Network (EMPHNET), Shmeisani, Abdallah Ben Abbas Street, Bldg No. 42, Amman, Jordan
| | - Hind Yousef
- The Eastern Mediterranean Public Health Network (EMPHNET), Shmeisani, Abdallah Ben Abbas Street, Bldg No. 42, Amman, Jordan
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Hayward A, Cidro J, Dutton R, Passey K. A review of health and wellness studies involving Inuit of Manitoba and Nunavut. Int J Circumpolar Health 2020; 79:1779524. [PMID: 32543995 PMCID: PMC7480607 DOI: 10.1080/22423982.2020.1779524] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Revised: 04/16/2020] [Accepted: 06/01/2020] [Indexed: 01/22/2023] Open
Abstract
The purpose of this review is to summarise past Inuit health and wellness studies in Manitoba and the Kivalliq region of Nunavut to provide a snapshot of the types of studies available and identify the gaps in knowledge. Research to date has largely been disease-based and often provides comparisons between Indigenous and non-Indigenous people. Distinct Inuit experiences are rarely written about from an Inuit perspective. However, Inuit Tapiriit Kanatami, the national organisation of Inuit in Canada, and Pauktuutit Inuit Women of Canada have been leaders in strengths-based community research and publications that address priorities determined by the Inuit, including the 2018 Inuit Tapiriit Kanatami document National Inuit Strategy on Research (132).
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Affiliation(s)
- Ashley Hayward
- Student Peace and Conflict Studies, University of Winnipeg, Winnipeg, Canada
| | - Jaime Cidro
- Anthropology, University of Winnipeg, Canada Research Chair, Health and Culture, Winnipeg, Canada
| | | | - Kara Passey
- Development Practice: Indigenous Development (MDP) Student, University of Winnipeg, Winnipeg, Canada
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Abstract
BACKGROUND Women's fertility characteristics are affected by many different factors. AIM To gain an awareness of fertility characteristics of Syrian refugee women and the influential factors. METHODS This study was planned as a cross-sectional study to determine the efficiency and related factors of Syrian refugees living in Istanbul. The survey of 300 refugee women applying Arabs who migrated to Turkey, Kurds, Turkmen and Yezidi origin they receive. RESULT Average age of the women studied was 34.26 ± 10.15, 34.6% of the participants had not received any education, 37% had less than two-year inter-pregnancy interval, 58.6% have not received "Safe Motherhood" service, 43.6% have conceived their last child unwillingly. Women in the study group had in average 3±2,4 children and the number of children they wanted was 3±1,59. These values were substantially affected negatively by the women's education level and positively by the income level. Yezidis had significantly more children than other ethnic groups and did not have a "religious ban" on voluntary abortion. CONCLUSION It has been noted that fertility characteristics of refugee women who migrated to Turkey changed according to their ethnic backgrounds and were sustained in the country they migrated to. Along with harsh living conditions and insufficient access to health services the situation has been observed to pose serious risks on reproductive health.
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Affiliation(s)
- Anahit M Coşkun
- Haliç University, Faculty of Health Sciences, Department of Midwifery, Istanbul, Turkey
| | - Nebahat Özerdoğan
- Eskisehir Osmangazi University, Faculty of Health Sciences, Department of Midwifery, Eskisehir, Turkey
| | | | - Eda Yakıt
- Dicle University Atatürk Health Services Vocational School, Diyarbakır, Turkey
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Anastario M, FireMoon P, Ricker A, Holder S, Rink E. Self-reported Exposure to Sexual and Reproductive Health Information among American Indian Youth: Implications for Technology Based Intervention. J Health Commun 2020; 25:412-420. [PMID: 32584646 PMCID: PMC8018870 DOI: 10.1080/10810730.2020.1777599] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
While technology-based interventions show promise in certain populations of American youth, the technology may intrinsically widen intergenerational communication chasms associated with youth's increased access to Smartphone technologies. The authors examined self-reported exposure to sexual and reproductive health information and evaluated its relationship with sexual risk behaviors with American Indian youth. Approximately 296 students, ages of 15-18 years old, were surveyed to examine self-reported exposure and attitudes to information received about sexual intercourse, reproduction, and social media use in relation to sexual risk behaviors. Results indicate that information received regarding sexual intercourse and birth control from intra-familial network members was associated with more engagement in sex, and that increased social media use to talk or learn about sex was associated with not using a condom at the last sexual encounter. We advise that researchers and programmers considering technology-based interventions with AI communities carefully consider the gravity of investing preventive resources into technology-based interventions that may further deepen communication gaps that youth experience within their community networks.
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Affiliation(s)
| | | | | | - Shannon Holder
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA, Montana State University, Bozeman, MT, USA
| | - Elizabeth Rink
- Department of Health and Human Development, Montana State University, Bozeman, Montana, USA
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Abstract
Objective: To understand health disparities, it is important to use an intersectional framework that examines unique experiences of oppression faced by particular groups due to their intersecting identities and social positions linked to societal structures. We focus on Black and Latina women and their experiences with 'gendered racism' - unique forms of oppression due to the intersection of race/ethnicity and gender - to foster understanding of disparities between Black and Latina versus White women in sexual and reproductive health outcomes in the U.S. Specifically, we focus on stereotype-related gendered racism (ongoing discrimination and stereotype threat based on historically-rooted stereotypes about Black and Latina women's sexuality and motherhood) and birth control-related mistrust (ongoing mistrust of the government and medical system related to birth control due to historical and current abuses).Design: We analyzed data from two survey studies with adult women in New York (Study 1: paper-and-pencil community data collection, N = 135, Mage = 43.35) and across the U.S. (Study 2: online data collection, N = 343, Mage = 29.49) who were currently pregnant or had at least one child and identified as Black, Latina, or White.Results: Black and Latina women reported greater frequency of and concern over stereotype-related gendered racism (F(3,131) = 17.90, p < .001 Study 1; F(3,339) = 22.23, p < .001 Study 2) and greater birth control-related mistrust (F(3,131) = 7.55, p < .001 Study 1; F(3,339) = 17.32, p < .001 Study 2) than White women did. In turn, stereotype-related gendered racism was positively associated with pregnancy-specific stress (ß = .40, p < .001 Study 1; ß = .33, p < .001 Study 2), and birth control-related mistrust was negatively associated with sexual relationship power (ß = -.19, p = .002 Study 2), which are factors known to contribute to birth outcomes and sexual risk, respectively.Conclusion: Findings suggest that gendered racism may play an important role in existing racial/ethnic disparities in women's sexual and reproductive health outcomes, and interventions addressing gendered racism at multiple levels are needed to promote health equity.
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Affiliation(s)
- Lisa Rosenthal
- Psychology Department, Pace University, New York, NY, USA
| | - Marci Lobel
- Department of Psychology, Stony Brook University, Stony Brook, NY, USA
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Alomair N, Alageel S, Davies N, Bailey JV. Factors influencing sexual and reproductive health of Muslim women: a systematic review. Reprod Health 2020; 17:33. [PMID: 32138744 PMCID: PMC7059374 DOI: 10.1186/s12978-020-0888-1] [Citation(s) in RCA: 46] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2018] [Accepted: 02/18/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND In Islamic societies, issues related to sexual and reproductive health (SRH) are rarely discussed and considered sensitive subjects. This review aimed to identify any personal, religious, cultural, or structural barriers to SRH service and education among Muslim women worldwide. METHODS A search for qualitative and quantitative studies was conducted on seven electronic databases. A narrative synthesis using thematic analysis was conducted. RESULTS Fifty-nine studies were included from 22 countries: 19 qualitative, 38 quantitative and two mixed methods. Many Muslim women have poor SRH knowledge, and negative attitudes which influence their access to, and use of SRH services. Barriers to contraception use among Muslim women included a lack of basic reproductive knowledge, insufficient knowledge about contraception, misconceptions, and negative attitudes. Women had negative attitudes towards family planning for limiting the number of children but not for child spacing, which reflected religious views towards family planning. Religious and cultural beliefs were barriers to contraception use and access to SRH services and information. Family and the community have a significant impact on women's contraceptive use and access to SRH services. Husband and family opposition played a significant role in contraception access and use. Fear of stigmatization and being labelled as having pre-marital sexual relations among unmarried women acted as the main barrier to accessing contraception and seeking SRH information and services. CONCLUSION The findings reveal that there are multiple levels of factors that influence Muslim women's SRH. Poor SRH knowledge and practices among Muslim women is complex matter that is affected by personal, community, cultural, religious factors and existing policies and regulations. All these factors overlap and are affected by each other. There is an urgent need for interventions addressing modifiable barriers to SRH education and services to improve knowledge, informed choice and access to services to facilitate better sexual and reproductive wellbeing for Muslim women. It is important to note that while this review aimed to report findings on Muslim women, we acknowledge that significant variations exist within every culture and religion.
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Affiliation(s)
- Noura Alomair
- Research Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, Upper 3rd Floor, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK.
| | - Samah Alageel
- Community Health Sciences Department, College of Applied Medical Sciences, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - Nathan Davies
- Research Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, Upper 3rd Floor, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
| | - Julia V Bailey
- Research Department of Primary Care and Population Health, Institute of Epidemiology and Health Care, University College London, Upper 3rd Floor, Royal Free Campus, Rowland Hill Street, London, NW3 2PF, UK
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Abstract
There has been a call for research on migrant and refugee women's negotiation of diverse discourses and cultural constraints associated with sexual embodiment, including menopause, in order to facilitate sexual and reproductive health and understand gendered subjectivity. This study examined the construction and experience of menopause among migrant and refugee women who had settled in Australia or Canada in the last 10 years. Eighty-four individual interviews and 16 focus groups comprising 85 participants were conducted (total n = 169), with women aged 18 years and over from Afghanistan, India (Punjab), Iraq, Somalia, South Sudan, Sri-Lanka (Tamil), Sudan and various South American (Latina) backgrounds. Thematic decomposition identified three discursive themes: Menopause as the Age of Despair; a Discourse of Silence and Secrecy; and Menopause as a Life Stage - or when Life Starts. Negative constructions of menopause, associated with silence and secrecy, were evident across different cultural groups, with implications for women's positioning and experience of menopausal change and embodiment. However, resistance to negative discourse was also evident. This was primarily associated with having received menopause education and more open communication about menopausal change, suggesting that education and health information can facilitate affirming aspects of menopause.
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Affiliation(s)
- Jane M Ussher
- a Translational Health Research Institute, School of Medicine , Western Sydney University , Sydney , New South Wales , Australia
| | - Alexandra J Hawkey
- a Translational Health Research Institute, School of Medicine , Western Sydney University , Sydney , New South Wales , Australia
| | - Janette Perz
- a Translational Health Research Institute, School of Medicine , Western Sydney University , Sydney , New South Wales , Australia
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16
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Variations in reproductive events across life: a pooled analysis of data from 505 147 women across 10 countries. Hum Reprod 2019; 34:881-893. [PMID: 30835788 PMCID: PMC7571491 DOI: 10.1093/humrep/dez015] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 01/07/2019] [Accepted: 02/05/2019] [Indexed: 01/06/2023] Open
Abstract
STUDY QUESTION How has the timing of women's reproductive events (including ages at menarche, first birth, and natural menopause, and the number of children) changed across birth years, racial/ethnic groups and educational levels? SUMMARY ANSWER Women who were born in recent generations (1970-84 vs before 1930) or those who with higher education levels had menarche a year earlier, experienced a higher prevalence of nulliparity and had their first child at a later age. WHAT IS KNOWN ALREADY The timing of key reproductive events, such as menarche and menopause, is not only indicative of current health status but is linked to the risk of adverse hormone-related health outcomes in later life. Variations of reproductive indices across different birth years, race/ethnicity and socioeconomic positions have not been described comprehensively. STUDY DESIGN, SIZE, DURATION Individual-level data from 23 observational studies that contributed to the International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease Events (InterLACE) consortium were included. PARTICIPANTS/MATERIALS, SETTING, METHODS Altogether 505 147 women were included. Overall estimates for reproductive indices were obtained using a two-stage process: individual-level data from each study were analysed separately using generalised linear models. These estimates were then combined using random-effects meta-analyses. MAIN RESULTS AND THE ROLE OF CHANCE Mean ages were 12.9 years at menarche, 25.7 years at first birth, and 50.5 years at natural menopause, with significant between-study heterogeneity (I2 > 99%). A linear trend was observed across birth year for mean age at menarche, with women born from 1970 to 1984 having menarche one year earlier (12.6 years) than women born before 1930 (13.5 years) (P for trend = 0.0014). The prevalence of nulliparity rose progressively from 14% of women born from 1940-49 to 22% of women born 1970-84 (P = 0.003); similarly, the mean age at first birth rose from 24.8 to 27.3 years (P = 0.0016). Women with higher education levels had fewer children, later first birth, and later menopause than women with lower education levels. After adjusting for birth year and education level, substantial variation was present for all reproductive events across racial/ethnic/regional groups (all P values < 0.005). LIMITATIONS, REASONS FOR CAUTION Variations of study design, data collection methods, and sample selection across studies, as well as retrospectively reported age at menarche, age at first birth may cause some bias. WIDER IMPLICATIONS OF THE FINDINGS This global consortium study found robust evidence on variations in reproductive indices for women born in the 20th century that appear to have both biological and social origins. STUDY FUNDING/COMPETING INTEREST(S) InterLACE project is funded by the Australian National Health and Medical Research Council project grant (APP1027196). GDM is supported by the Australian National Health and Medical Research Council Principal Research Fellowship (APP1121844).
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Affiliation(s)
- InterLACE Study Team
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
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17
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Abstract
Ethnographic studies examining how women manage their sexual and reproductive health can inform strategies to address unmet needs, say Anita Hardon and colleagues
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Affiliation(s)
- Anita Hardon
- Centre for Social Science and Global Health, University of Amsterdam, Netherlands
- Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
| | - Christopher Pell
- Centre for Social Science and Global Health, University of Amsterdam, Netherlands
- Amsterdam Institute for Global Health and Development, Amsterdam, Netherlands
| | - Efenita Taqueban
- Department of Anthropology, University of the Philippines, Diliman, Quezon City, Philippines
| | - Manjulaa Narasimhan
- Reproductive Health and Research, World Health Organization, Geneva, Switzerland
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18
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Mayo-Gamble TL, Barnes PA, Cunningham Erves J, Middlestadt SE, Lin HC. 'It means everyone should know their status': exploring lay conceptions of sickle cell trait and sickle cell trait screening among African Americans within middle reproductive age. Ethn Health 2018; 23:813-829. [PMID: 28277026 DOI: 10.1080/13557858.2017.1295135] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE This study examined the meaning of sickle cell trait and sickle cell trait screening from the lay perspective of African Americans. DESIGN AND METHODS African Americans (N = 300), ages 18-35 and unaware of their sickle cell trait status, completed two open-ended questions from a larger survey. One question asked for their understanding of sickle cell trait; the other asked for their understanding of sickle cell trait screening. Content analysis occurred in two phases: (1) In vivo and holistic coding; and (2) focused coding. RESULTS Four categories emerged illustrating lay conceptions of sickle cell trait; (1) Perceived as an illness; (2) Perceived recognition of the inheritance pattern of sickle cell trait; (3) Perceived lack of knowledge of sickle cell trait; and (4) Perceived importance of sickle cell trait. Five categories emerged illustrating lay conceptions for sickle cell trait screening: (1) Perceived recognition that screening means getting tested for sickle cell trait; (2) Perceived lack of knowledge of sickle cell trait screening; (3) Perceived health benefit of sickle cell trait screening; (4) Perceived importance of sickle cell trait screening; and (5) Perceived barriers to sickle cell trait screening. CONCLUSIONS Sickle cell trait and sickle cell trait screening are concepts that are both regarded as important among this high-risk population. However, there is still misunderstanding concerning the hereditary nature and reproductive implications of sickle cell trait. Interventions seeking to improve communication on the need for sickle cell trait screening should begin by identifying what the population at large understands, knows and/or believes to improve their ability to make informed health decisions.
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Affiliation(s)
- Tilicia L Mayo-Gamble
- a Department of Family and Community Medicine , Meharry Medical College , Nashville , USA
| | - Priscilla A Barnes
- b Department of Applied Health Science , Indiana University , Bloomington , USA
| | | | - Susan E Middlestadt
- b Department of Applied Health Science , Indiana University , Bloomington , USA
| | - Hsien-Chang Lin
- b Department of Applied Health Science , Indiana University , Bloomington , USA
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Ngongalah L, Rankin J, Rapley T, Odeniyi A, Akhter Z, Heslehurst N. Dietary and Physical Activity Behaviours in African Migrant Women Living in High Income Countries: A Systematic Review and Framework Synthesis. Nutrients 2018; 10:nu10081017. [PMID: 30081522 PMCID: PMC6115772 DOI: 10.3390/nu10081017] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 07/31/2018] [Accepted: 08/01/2018] [Indexed: 11/16/2022] Open
Abstract
Dietary and physical activity behaviours during preconception and in pregnancy are important determinants of maternal and child health. This review synthesised the available evidence on dietary and physical activity behaviours in pregnant women and women of childbearing age women who have migrated from African countries to live in high income countries. Searches were conducted on Medline, Embase, PsycInfo, Pubmed, CINAHL, Scopus, Proquest, Web of Science, and the Cochrane library. Searches were restricted to studies conducted in high income countries and published in English. Data extraction and quality assessment were carried out in duplicate. Findings were synthesised using a framework approach, which included both a priori and emergent themes. Fourteen studies were identified; ten quantitative and four qualitative. Four studies included pregnant women. Data on nutrient intakes included macro- and micro-nutrients; and were suggestive of inadequacies in iron, folate, and calcium; and excessive sodium intakes. Dietary patterns were bicultural, including both Westernised and African dietary practices. Findings on physical activity behaviours were conflicting. Dietary and physical activity behaviours were influenced by post-migration environments, culture, religion, and food or physical activity-related beliefs and perceptions. Further studies are required to understand the influence of sociodemographic and other migration-related factors on behaviour changes after migration.
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Affiliation(s)
- Lem Ngongalah
- Institute of Heath & Society, Newcastle University, Newcastle-Upon-Tyne, Tyne and Wear NE2 4AX, UK.
| | - Judith Rankin
- Institute of Heath & Society, Newcastle University, Newcastle-Upon-Tyne, Tyne and Wear NE2 4AX, UK.
| | - Tim Rapley
- Department of Social Work, Education and Community Wellbeing, Northumbria University, Newcastle-Upon-Tyne, Tyne and Wear NE7 7XA, UK.
| | - Adefisayo Odeniyi
- Institute of Heath & Society, Newcastle University, Newcastle-Upon-Tyne, Tyne and Wear NE2 4AX, UK.
| | - Zainab Akhter
- Institute of Heath & Society, Newcastle University, Newcastle-Upon-Tyne, Tyne and Wear NE2 4AX, UK.
| | - Nicola Heslehurst
- Institute of Heath & Society, Newcastle University, Newcastle-Upon-Tyne, Tyne and Wear NE2 4AX, UK.
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20
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Chambers LC, Khosropour CM, Katz DA, Dombrowski JC, Manhart LE, Golden MR. Racial/Ethnic Disparities in the Lifetime Risk of Chlamydia trachomatis Diagnosis and Adverse Reproductive Health Outcomes Among Women in King County, Washington. Clin Infect Dis 2018; 67:593-599. [PMID: 29420716 PMCID: PMC6070060 DOI: 10.1093/cid/ciy099] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Accepted: 02/03/2018] [Indexed: 11/14/2022] Open
Abstract
Background Chlamydia trachomatis is the most common reportable infection in the United States and can cause pelvic inflammatory disease (PID) and tubal factor infertility (TFI). Methods We created life tables to estimate the "lifetime" risk of chlamydia diagnosis among women aged 15-34 years in King County, Washington, between 1992 and 2014. We estimated the lifetime risk of chlamydia-associated PID and TFI incorporating published estimates of the risk of sequelae. Results There were 51464 first chlamydia diagnoses in 1992-2014. For women born between 1980 and 1984, the lifetime risk of chlamydia diagnosis was 19.8% overall and 14.0% for non-Hispanic white, 64.9% for non-Hispanic black, and 32.6% for Hispanic women. The cumulative risk of chlamydia by age 24 increased overall from 13.9% to 17.3% among women born between 1975 and 1994 but declined among non-Hispanic black women, among whom risk by age 24 declined from 57.3% among women born between 1980 and 1984 to 38.6% among women born between 1990 and 1994. The lifetime risk of chlamydia-associated PID among women born between 1980 and 1984 ranged from 0.33% to 1.14%. Among non-Hispanic white, non-Hispanic black, and Hispanic women, the lifetime risk of chlamydia-associated TFI was 0.04%, 0.20%, and 0.10%, respectively. Conclusions Over 60% of non-Hispanic black women had at least 1 chlamydia diagnosis by age 34 in the birth cohorts most affected, a risk almost 5 times that in non-Hispanic whites. An estimated 1 in 500 non-Hispanic black women develops chlamydia-associated TFI. More effective control measures are needed.
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Affiliation(s)
| | | | - David A Katz
- Department of Medicine, University of Washington, University of Washington, Seattle
- Public Health-Seattle and King County HIV/STD Program, University of Washington, Seattle
| | - Julia C Dombrowski
- Department of Epidemiology, University of Washington, Seattle
- Department of Medicine, University of Washington, University of Washington, Seattle
- Public Health-Seattle and King County HIV/STD Program, University of Washington, Seattle
| | - Lisa E Manhart
- Department of Epidemiology, University of Washington, Seattle
- Department of Global Health, University of Washington, Seattle
| | - Matthew R Golden
- Department of Epidemiology, University of Washington, Seattle
- Department of Medicine, University of Washington, University of Washington, Seattle
- Public Health-Seattle and King County HIV/STD Program, University of Washington, Seattle
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21
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Herrick KA, Perrine CG, Aoki Y, Caldwell KL. Iodine Status and Consumption of Key Iodine Sources in the U.S. Population with Special Attention to Reproductive Age Women. Nutrients 2018; 10:E874. [PMID: 29986412 PMCID: PMC6073695 DOI: 10.3390/nu10070874] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 11/19/2022] Open
Abstract
We estimated iodine status (median urinary iodine concentration (mUIC (µg/L))) for the US population (6 years and over; n = 4613) and women of reproductive age (WRA) (15⁻44 years; n = 901). We estimated mean intake of key iodine sources by race and Hispanic origin. We present the first national estimates of mUIC for non-Hispanic Asian persons and examine the intake of soy products, a potential source of goitrogens. One-third of National Health and Nutrition Examination Survey (NHANES) participants in 2011⁻2014 provided casual urine samples; UIC was measured in these samples. We assessed dietary intake with one 24-h recall and created food groups using the USDA’s food/beverage coding scheme. For WRA, mUIC was 110 µg/L. For both non-Hispanic white (106 µg/L) and non-Hispanic Asian (81 µg/L) WRA mUIC was significantly lower than mUIC among Hispanic WRA (133 µg/L). Non-Hispanic black WRA had a mUIC of 124 µg/L. Dairy consumption was significantly higher among non-Hispanic white (162 g) compared to non-Hispanic black WRA (113 g). Soy consumption was also higher among non-Hispanic Asian WRA (18 g compared to non-Hispanic black WRA (1 g). Differences in the consumption pattern of key sources of iodine and goitrogens may put subgroups of individuals at risk of mild iodine deficiency. Continued monitoring of iodine status and variations in consumption patterns is needed.
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Affiliation(s)
- Kirsten A Herrick
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), Hyattsville, MD 20782, USA.
| | - Cria G Perrine
- Division of Nutrition, Physical Activity, and Obesity, CDC, Atlanta, GA 30341, USA.
| | - Yutaka Aoki
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), Hyattsville, MD 20782, USA.
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22
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Wallace HJ, McDonald S, Belton S, Miranda AI, da Costa E, da Conceicao Matos L, Henderson H, Taft A. Body Mapping to Explore Reproductive Ethno-Physiological Beliefs and Knowledge of Contraception in Timor-Leste. Qual Health Res 2018; 28:1171-1184. [PMID: 29290149 DOI: 10.1177/1049732317750382] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Maternal mortality remains a significant public health challenge for Timor-Leste. Although access to quality family planning measures may greatly reduce such deaths, consideration of indigenous perceptions, and how they influence reproductive health decision-making and behavior, is crucial if health services are to provide initiatives that are accepted and helpful in improving reproductive health outcomes. We aimed to demonstrate that body mapping is an effective method to traverse language and culture to gain emic insights and indigenous worldviews. The authors' two qualitative research projects (2013 and 2015) used a decolonizing methodology in four districts of Timor-Leste, body mapping with 67 men and 40 women to illuminate ethno-physiology and indigenous beliefs about conception, reproduction, and contraception. Body mapping provided a beneficial conduit for identifying established indigenous reproductive perceptions, understandings, and vocabulary, plus fears surrounding contraception. This may inform health service provision and engagement, ultimately improving the reproductive health of community members.
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Affiliation(s)
| | | | - Suzanne Belton
- 2 Charles Darwin University, Darwin, The Northern Territory, Australia
| | | | | | | | | | - Angela Taft
- 1 La Trobe University, Melbourne, Victoria, Australia
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23
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Holliday CN, Miller E, Decker MR, Burke JG, Documet PI, Borrero SB, Silverman JG, Tancredi DJ, Ricci E, McCauley HL. Racial Differences in Pregnancy Intention, Reproductive Coercion, and Partner Violence among Family Planning Clients: A Qualitative Exploration. Womens Health Issues 2018; 28:205-211. [PMID: 29631975 DOI: 10.1016/j.whi.2018.02.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2017] [Revised: 01/17/2018] [Accepted: 02/07/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND Unintended pregnancy (UIP) is a persistent public health concern in the United States disproportionately experienced by racial/ethnic minorities and women of low socioeconomic status. UIP often occurs with experiences of reproductive coercion (RC) and intimate partner violence (IPV). The purpose of the study was to qualitatively describe and compare contexts for UIP risk between low-income Black and White women with histories of IPV/RC. STUDY DESIGN Semistructured interviews were conducted with low-income Black and White women with histories of IPV or RC, ages 18 to 29 years, recruited from family planning clinics in Pittsburgh, Pennsylvania. RESULTS Interviews with 10 non-Hispanic Black women and 34 non-Hispanic White women (N = 44) were included in the analysis. Differences between White and Black women emerged regarding IPV/RC experiences, gender roles in intimate relationships, and trauma histories, including childhood adversity. Fatal threats and IPV related to childbearing were most influential among White women. Among Black women, pregnancy was greatly influenced by RC related to impending incarceration, subfertility, and condom nonuse, and decisions about contraception were often dependent on the male. Sexual abuse, including childhood sexual assault, in the context of sexual/reproductive health was more prominent among White women. Childhood experiences of neglect impacted pregnancy intention and love-seeking behaviors among Black women. CONCLUSIONS Racial differences exist in experiences of IPV/RC with regard to UIP even among women with similar economic resources and health care access. These findings provide much-needed context to the persistent racial/ethnic disparities in UIP and illustrate influences beyond differential access to care and socioeconomic status.
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Affiliation(s)
- Charvonne N Holliday
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Elizabeth Miller
- Division of Adolescent and Young Adult Medicine, University of Pittsburgh School of Medicine, Children's Hospital of Pittsburgh of UPMC, Pittsburgh, Pennsylvania
| | - Michele R Decker
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Jessica G Burke
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Patricia I Documet
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Sonya B Borrero
- Center for Health Equity, Research, and Promotion, VA Pittsburgh Health Care System, Pittsburgh, Pennsylvania; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania
| | - Jay G Silverman
- Division of Global Public Health, University of California, San Diego School of Medicine, La Jolla, California
| | - Daniel J Tancredi
- Department of Pediatrics, University of California, Davis School of Medicine, Sacramento, California
| | - Edmund Ricci
- Department of Behavioral and Community Health Sciences, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Heather L McCauley
- Department of Human Development and Family Studies, Michigan State University, East Lansing, Michigan
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24
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Okawa S, Mwanza-Kabaghe S, Mwiya M, Kikuchi K, Jimba M, Kankasa C, Ishikawa N. Sexual and reproductive health behavior and unmet needs among a sample of adolescents living with HIV in Zambia: a cross-sectional study. Reprod Health 2018; 15:55. [PMID: 29587791 PMCID: PMC5869779 DOI: 10.1186/s12978-018-0493-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 03/09/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Adolescents living with HIV face challenges, such as disclosure of HIV status, adherence to antiretroviral therapy, mental health, and sexual and reproductive health (SRH). These challenges affect their future quality of life. However, little evidence is available on their sexual behaviors and SRH needs in Zambia. This study aimed at assessing their sexual behaviors and SRH needs and identifying factors associated with marriage concerns and a desire to have children. METHODS This cross-sectional study was conducted at the University Teaching Hospital from April to July 2014. We recruited 200 adolescents aged 15-19 years who were aware of their HIV-positive status. We collected data on their first and recent sexual behavior, concerns about marriage, and desire to have children. We used the Generalized Linear Model to identify factors associated with having concerns about marriage and desire to have children. We performed thematic analysis with open-ended data to determine their perceptions about marriage and having children in the future. RESULTS Out of 175 studied adolescents, 20.6% had experienced sexual intercourse, and only 44.4% used condoms during the first intercourse. Forty-eight percent had concerns about marriage, and 87.4% desired to have children. Marriage-related concerns were high among those who desired to have children (adjusted relative risk [ARR] = 2.51, 95% CI = 1.02 to 6.14). Adolescents who had completed secondary school were more likely to desire to have children (ARR = 1.35, 95% CI = 1.07 to 1.71). Adolescents who had lost both parents were less likely to want children (ARR = 0.80, 95% CI = 0.68 to 0.95). Thematic analysis identified that major concerns about future marriage were fear of disclosing HIV status to partners and risk of infecting partners and/or children. The reasons for their willingness to have children were the desire to be a parent, having children as family assets, a human right, and a source of love and happiness. CONCLUSIONS Zambian adolescents living with HIV are at risk of engaging in risky sexual relationships and have difficulties in meeting needs of SRH. HIV care service must respond to a wide range of needs.
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Affiliation(s)
- Sumiyo Okawa
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sylvia Mwanza-Kabaghe
- Department of Educational Psychology, Sociology, and Special Education, School of Education, University of Zambia, Lusaka, Zambia
- Paediatric HIV Centre of Excellence, University Teaching Hospital, Lusaka, Zambia
| | - Mwiya Mwiya
- Paediatric HIV Centre of Excellence, University Teaching Hospital, Lusaka, Zambia
| | - Kimiyo Kikuchi
- Institute of Decision Science for a Sustainable Society, Kyushu University, Fukuoka, Japan
| | - Masamine Jimba
- Department of Community and Global Health, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Chipepo Kankasa
- Paediatric HIV Centre of Excellence, University Teaching Hospital, Lusaka, Zambia
| | - Naoko Ishikawa
- Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
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Robbins C, Boulet SL, Morgan I, D’Angelo DV, Zapata LB, Morrow B, Sharma A, Kroelinger CD. Disparities in Preconception Health Indicators -
Behavioral Risk Factor Surveillance System, 2013-2015, and Pregnancy Risk Assessment Monitoring System, 2013-2014. MMWR Surveill Summ 2018; 67:1-16. [PMID: 29346340 PMCID: PMC5829866 DOI: 10.15585/mmwr.ss6701a1] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PROBLEM/CONDITION Preconception health is a broad term that encompasses the overall health of nonpregnant women during their reproductive years (defined here as aged 18-44 years). Improvement of both birth outcomes and the woman's health occurs when preconception health is optimized. Improving preconception health before and between pregnancies is critical for reducing maternal and infant mortality and pregnancy-related complications. The National Preconception Health and Health Care Initiative's Surveillance and Research work group suggests ten prioritized indicators that states can use to monitor programs or activities for improving the preconception health status of women of reproductive age. This report includes overall and stratified estimates for nine of these preconception health indicators. REPORTING PERIOD 2013-2015. DESCRIPTION OF SYSTEMS Survey data from two surveillance systems are included in this report. The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing state-based, landline and cellular telephone survey of noninstitutionalized adults in the United States aged ≥18 years that is conducted by state and territorial health departments. BRFSS is the main source of self-reported data for states on health risk behaviors, chronic health conditions, and preventive health services primarily related to chronic disease in the United States. The Pregnancy Risk Assessment Monitoring System (PRAMS) is an ongoing U.S. state- and population-based surveillance system administered collaboratively by CDC and state health departments. PRAMS is designed to monitor selected maternal behaviors, conditions, and experiences that occur before, during, and shortly after pregnancy that are self-reported by women who recently delivered a live-born infant. This report summarizes BRFSS and PRAMS data on nine of 10 prioritized preconception health indicators (i.e., depression, diabetes, hypertension, current cigarette smoking, normal weight, recommended physical activity, recent unwanted pregnancy, prepregnancy multivitamin use, and postpartum use of a most or moderately effective contraceptive method) for which the most recent data are available. BRFSS data from all 50 states and the District of Columbia were used for six preconception health indicators: depression, diabetes (excluded if occurring only during pregnancy or if limited to borderline/prediabetes conditions), hypertension (excluded if occurring only during pregnancy or if limited to borderline/prehypertension conditions), current cigarette smoking, normal weight, and recommended physical activity. PRAMS data from 30 states, the District of Columbia, and New York City were used for three preconception health indicators: recent unwanted pregnancy, prepregnancy multivitamin use, and postpartum use of a most or moderately effective contraceptive method by women or their husbands or partners (i.e., male or female sterilization, hormonal implant, intrauterine device, injectable contraceptive, oral contraceptive, hormonal patch, or vaginal ring). Heavy alcohol use during the 3 months before pregnancy also was included in the prioritized set of 10 indicators, but PRAMS data for each reporting area are not available until 2016 for that indicator. Therefore, estimates for heavy alcohol use are not included in this report. All BRFSS preconception health estimates are based on 2014-2015 data except two (hypertension and recommended physical activity are based on 2013 and 2015 data). All PRAMS preconception health estimates rely on 2013-2014 data. Prevalence estimates of indicators are reported for women aged 18-44 years overall, by age group, race-ethnicity, health insurance status, and reporting area. Chi-square tests were conducted to assess differences in indicators by age group, race/ethnicity, and insurance status. RESULTS During 2013-2015, prevalence estimates of indicators representing risk factors were generally highest and prevalence estimates of health-promoting indicators were generally lowest among older women (35-44 years), non-Hispanic black women, uninsured women, and those residing in southern states. For example, prevalence of ever having been told by a health care provider that they had a depressive disorder was highest among women aged 35-44 years (23.1%) and lowest among women aged 18-24 years (19.2%). Prevalence of postpartum use of a most or moderately effective method of contraception was lowest among women aged 35-44 years (50.6%) and highest among younger women aged 18-24 years (64.9%). Self-reported prepregnancy multivitamin use and getting recommended levels of physical activity were lowest among non-Hispanic black women (21.6% and 42.8%, respectively) and highest among non-Hispanic white women (37.8% and 53.8%, respectively). Recent unwanted pregnancy was lowest among non-Hispanic white women and highest among non-Hispanic black women (5.0% and 11.6%, respectively). All but three indicators (diabetes, hypertension, and use of a most or moderately effective contraceptive method) varied by insurance status; for instance, prevalence of current cigarette smoking was higher among uninsured women (21.0%) compared with insured women (16.1%), and prevalence of normal weight was lower among women who were uninsured (38.6%), compared with women who were insured (46.1%). By reporting area, the range of women reporting ever having been told by a health care provider that they had diabetes was 5.0% (Alabama) to 1.9% (Utah), and women reporting ever having been told by a health care provider that they had hypertension ranged from 19.2% (Mississippi) to 7.0% (Minnesota). INTERPRETATION Preconception health risk factors and health-promoting indicators varied by age group, race/ethnicity, insurance status, and reporting area. These disparities highlight subpopulations that might benefit most from interventions that improve preconception health. PUBLIC HEALTH ACTION Eliminating disparities in preconception health can potentially reduce disparities in two of the leading causes of death in early and middle adulthood (i.e., heart disease and diabetes). Public health officials can use this information to provide a baseline against which to evaluate state efforts to improve preconception health.
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Affiliation(s)
- Cheryl Robbins
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Sheree L. Boulet
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Isabel Morgan
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Denise V. D’Angelo
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Lauren B. Zapata
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
- U.S. Public Health Service Commissioned Corps
| | - Brian Morrow
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
| | - Andrea Sharma
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
- U.S. Public Health Service Commissioned Corps
| | - Charlan D. Kroelinger
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, CDC
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Hall KS, Manu A, Morhe E, Harris LH, Loll D, Ela E, Kolenic G, Dozier JL, Challa S, Zochowski MK, Boakye A, Adanu R, Dalton VK. Development and Validation of a Scale to Measure Adolescent Sexual and Reproductive Health Stigma: Results From Young Women in Ghana. J Sex Res 2018; 55:60-72. [PMID: 28266874 PMCID: PMC5901672 DOI: 10.1080/00224499.2017.1292493] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Young women's experiences with sexual and reproductive health (SRH) stigma may contribute to unintended pregnancy. Thus, stigma interventions and rigorous measures to assess their impact are needed. Based on formative work, we generated a pool of 51 items on perceived stigma around different dimensions of adolescent SRH and family planning (sex, contraception, pregnancy, childbearing, abortion). We tested items in a survey study of 1,080 women ages 15 to 24 recruited from schools, health facilities, and universities in Ghana. Confirmatory factor analysis (CFA) identified the most conceptually and statistically relevant scale, and multivariable regression established construct validity via associations between stigma and contraceptive use. CFA provided strong support for our hypothesized Adolescent SRH Stigma Scale (chi-square p value < 0.001; root mean square error of approximation [RMSEA] = 0.07; standardized root mean square residual [SRMR] = 0.06). The final 20-item scale included three subscales: internalized stigma (six items), enacted stigma (seven items), and stigmatizing lay attitudes (seven items). The scale demonstrated good internal consistency (α = 0.74) and strong subscale correlations (α = 0.82 to 0.93). Higher SRH stigma scores were inversely associated with ever having used modern contraception (adjusted odds ratio [AOR] = 0.96, confidence interval [CI] = 0.94 to 0.99, p value = 0.006). A valid, reliable instrument for assessing SRH stigma and its impact on family planning, the Adolescent SRH Stigma Scale can inform and evaluate interventions to reduce/manage stigma and foster resilience among young women in Africa and beyond.
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Affiliation(s)
- Kelli Stidham Hall
- a Department of Behavioral Sciences and Health Education, Rollins School of Public Health , Emory University
| | - Abubakar Manu
- b Department of Population, Family and Reproductive Health, University of Ghana School of Public Health
| | - Emmanuel Morhe
- c Komfo Anokye Teaching Hospital , Kwame Nkrumah University of Science and Technology
| | - Lisa H Harris
- d Department of Obstetrics and Gynecology, University of Michigan
| | - Dana Loll
- d Department of Obstetrics and Gynecology, University of Michigan
| | - Elizabeth Ela
- d Department of Obstetrics and Gynecology, University of Michigan
| | - Giselle Kolenic
- d Department of Obstetrics and Gynecology, University of Michigan
| | - Jessica L Dozier
- d Department of Obstetrics and Gynecology, University of Michigan
| | - Sneha Challa
- d Department of Obstetrics and Gynecology, University of Michigan
| | - Melissa K Zochowski
- f Health Services Research Division, Department of Obstetrics and Gynecology , University of Michigan
| | - Andrew Boakye
- c Komfo Anokye Teaching Hospital , Kwame Nkrumah University of Science and Technology
| | | | - Vanessa K Dalton
- f Health Services Research Division, Department of Obstetrics and Gynecology , University of Michigan
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Dhar CP, Kaflay D, Dowshen N, Miller VA, Ginsburg KR, Barg FK, Yun K. Attitudes and Beliefs Pertaining to Sexual and Reproductive Health Among Unmarried, Female Bhutanese Refugee Youth in Philadelphia. J Adolesc Health 2017; 61:791-794. [PMID: 28935387 PMCID: PMC5931208 DOI: 10.1016/j.jadohealth.2017.06.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/22/2017] [Accepted: 06/05/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE We explored attitudes and beliefs pertaining to sexual and reproductive health (SRH) among unmarried, female, resettled Bhutanese refugees 16-20 years. METHODS Fourteen interviews were analyzed using the constant comparison method, and major themes were identified. RESULTS SRH was stigmatized for unmarried youth, making seeking information about SRH or accessing family planning difficult. There were many misconceptions about access to SRH. CONCLUSIONS Universal, culturally, and linguistically appropriate comprehensive SRH education is recommended for female Bhutanese refugee youth. Terminology used should take into account differences in conceptualization of concepts like dating. Educators and health care providers should clearly describe consent and confidentiality laws regarding adolescent SRH services.
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Affiliation(s)
- Cherie Priya Dhar
- University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania; Department of Pediatrics, The Children's Hospital of Pittsburgh, Pittsburgh, Pennsylvania.
| | - Dilu Kaflay
- Bhutanese American Organization-Philadelphia, Philadelphia, Pennsylvania
| | - Nadia Dowshen
- Craig-Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Victoria A Miller
- Craig-Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Kenneth R Ginsburg
- Craig-Dalsimer Division of Adolescent Medicine, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Frances K Barg
- Family Medicine and Community Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Department of Anthropology, University of Pennsylvania School of Arts and Sciences, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Katherine Yun
- PolicyLab, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania; Division of General Pediatrics, The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Coleman-Minahan K, Scandlyn JN. The role of older siblings in the sexual and reproductive health of Mexican-origin young women in immigrant families. Cult Health Sex 2017; 19:151-164. [PMID: 27684216 PMCID: PMC8153403 DOI: 10.1080/13691058.2016.1212997] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
In the USA, young people of Mexican-origin are more economically disadvantaged and experience higher birth rates than many other Latino groups. In this paper, we examine the influence of older siblings on the sexual and reproductive health of Mexican-origin immigrant women. Qualitative data were drawn from life history interviews with 21 first- and second-generation Mexican-origin women, aged 27-41 years old, resident in the Metro Denver area. Data suggest that older siblings may protect younger sisters from risky sexual behaviours through older siblings' responsibility and care for younger siblings, close and supportive sibling relationships, older siblings' advice about both sexual health and academic success, and sibling modelling. These mechanisms appear particularly protective due to the social and economic hardships immigrant families often face. Implications include fostering healthy sibling relationships and involving older siblings more fully in the sexuality education of younger siblings.
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Affiliation(s)
- Kate Coleman-Minahan
- Population Research Center, University of Texas at Austin, Austin, Texas, USA
- College of Nursing University of Colorado Denver, CO, USA
| | - Jean N. Scandlyn
- Departments of Health and Behavioral Sciences and Anthropology, University of Colorado Denver, CO, USA
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Paul M, Essén B, Sariola S, Iyengar S, Soni S, Klingberg Allvin M. Negotiating Collective and Individual Agency: A Qualitative Study of Young Women's Reproductive Health in Rural India. Qual Health Res 2017; 27:311-324. [PMID: 26531879 PMCID: PMC5302084 DOI: 10.1177/1049732315613038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The societal changes in India and the available variety of reproductive health services call for evidence to inform health systems how to satisfy young women's reproductive health needs. Inspired by Foucault's power idiom and Bandura's agency framework, we explore young women's opportunities to practice reproductive agency in the context of collective social expectations. We carried out in-depth interviews with 19 young women in rural Rajasthan. Our findings highlight how changes in notions of agency across generations enable young women's reproductive intentions and desires, and call for effective means of reproductive control. However, the taboo around sex without the intention to reproduce made contraceptive use unfeasible. Instead, abortions were the preferred method for reproductive control. In conclusion, safe abortion is key, along with the need to address the taboo around sex to enable use of "modern" contraception. This approach could prevent unintended pregnancies and expand young women's agency.
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Affiliation(s)
- Mandira Paul
- Uppsala University, Uppsala, Sweden
- Mandira Paul, Department of Women’s and Children’s health/IMCH, Uppsala University, Akademiska Sjukhuset, SE-751 85 Uppsala, Sweden.
| | | | | | - Sharad Iyengar
- Action Research & Training for Health, Udaipur, Rajasthan, India
| | - Sunita Soni
- Action Research & Training for Health, Udaipur, Rajasthan, India
| | - Marie Klingberg Allvin
- Karolinska Institutet/Karolinska University Hospital, WHO collaborating Centre, Stockholm, Sweden
- Dalarna University, Falun, Sweden
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30
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Åkerman E, Essén B, Westerling R, Larsson E. Healthcare-seeking behaviour in relation to sexual and reproductive health among Thai-born women in Sweden: a qualitative study. Cult Health Sex 2017; 19:194-207. [PMID: 27684388 DOI: 10.1080/13691058.2016.1214746] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Thailand is one of the most common countries of origin among immigrants in Sweden and Thai immigrants comprise the immigrant group most frequently diagnosed with HIV. Little is known about their healthcare-seeking behaviour and views on HIV prevention. This study explored Thai women's healthcare-seeking behaviour in relation to sexual and reproductive health and their views on HIV prevention. Nineteen in-depth interviews were conducted with Thai-born women in the Stockholm area. Three themes were identified: (1) poor access to healthcare in Sweden, preferring to seek care in Thailand; (2) partners playing a key role in women's access to healthcare; (3) no perceived risk of HIV, but a positive attitude towards prevention. Despite expressing sexual and reproductive healthcare needs, most women had not sought this type of care, except for the cervical cancer screening programme to which they had been invited. Identified barriers for poor access to healthcare were lack of knowledge about the healthcare system and language difficulties. To achieve 'healthcare on equal terms', programmes and interventions must meet Thai women's healthcare needs and consider what factors influence their care-seeking behaviour. Integrating HIV prevention and contraceptive counselling into the cervical screening programme might be one way to improve access.
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Affiliation(s)
- Eva Åkerman
- a Department of Public Health and Caring Sciences, Social Medicine , Uppsala University , Uppsala , Sweden
| | - Birgitta Essén
- b Department of Women's and Children's Health, International Maternal and Child Health , Uppsala University , Uppsala , Sweden
| | - Ragnar Westerling
- a Department of Public Health and Caring Sciences, Social Medicine , Uppsala University , Uppsala , Sweden
| | - Elin Larsson
- c Department of Women's and Children's Health , Karolinska Institutet , Stockholm , Sweden
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Abstract
Approximately 60-80% of college students in the USA report a hookup experience in the form of a casual sexual encounter between individuals without the expectation of a dating or romantic relationship. Given the potential health risk posed by these sexual encounters, the need exists to critically examine this cultural phenomenon on college campuses. Yet, the existing hookup literature is overwhelming White and often exclusive of historically marginalised populations such as Black women. Accordingly, this paper examines the role of the intersecting identities of race and gender and other social factors that influence the sexual health and wellbeing of Black women on US college campuses. Specifically, we explore issues related to the gender ratio disparities present on college campuses, relationship power imbalances, inconsistent condom use and low sexual-risk perception. Moving forward, hookup research needs to utilise an intersectional approach; we offer specific suggestions for the important inclusion of Black women in the broader hookup discourse and future research.
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Affiliation(s)
- Wendasha Jenkins Hall
- a Department of Public Health Education , The University of North Carolina at Greensboro , Greensboro , USA
| | - Amanda E Tanner
- a Department of Public Health Education , The University of North Carolina at Greensboro , Greensboro , USA
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32
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Rahimi-Naghani S, Merghati-Khoei E, Shahbazi M, Khalajabadi Farahani F, Motamedi M, Salehi M, Karimi M, Hajebi A. Sexual and Reproductive Health Knowledge Among Men and Women Aged 15 to 49 Years in Metropolitan Tehran. J Sex Res 2016; 53:1153-1164. [PMID: 27077496 DOI: 10.1080/00224499.2016.1148110] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Sexual and reproductive health (SRH) knowledge is an important predictor of an individual's sexual behavior; however, little is known regarding this issue among Iranians. This study assessed sexual and reproductive health knowledge among men and women aged 15 to 49 years in Tehran. A total of 755 men and women aged 15 to 49 years were recruited using multistage, random cluster sampling in June 2014. An illustrative anonymous questionnaire endorsed by the World Health Organization (WHO) was used to collect the data. Bivariate and multivariate analyses were performed. The results showed that men and women were moderately knowledgeable about sexual and reproductive health (mean score of SRH knowledge = 39, range: 26 to 52); however, myths and misperceptions prevailed in different aspects of SRH. For example, only 45% of women and 38.7% of men accurately knew that a person infected with human immunodeficiency virus (HIV) can look healthy. Friends were identified as the primary or secondary source of knowledge about puberty and sex-related issues. A multivariate analysis showed that being female (coefficient = 0.139, p < 0.001) and being married (coefficient = 0.180, p < 0.001) were significant predictors of better SRH knowledge, while being young (age group 15 to 24) was a significant determinant of poor SRH knowledge (coefficient = -0.161, p < 0.001) when other influencing factors were controlled. Culturally appropriate and age-specific comprehensive education is recommended, particularly for men, the unmarried, and the younger generation in Iran.
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Affiliation(s)
- Shahrzad Rahimi-Naghani
- a Institute of Tropical Medicine and International Health at Charité , Universitätsmedizin Berlin
| | - Effat Merghati-Khoei
- b Iranian Center for Addiction Studies, Institution of Risk Behaviour Reduction , Tehran University of Medical Sciences
- c Community-Based Participatory Research Center, Institution of Risk Behaviour Reduction , Tehran University of Medical Sciences
| | | | | | - Mahnaz Motamedi
- f Student Research Center, School of Nursing and Midwifery , Isfahan University of Medical Sciences
| | - Mehrdad Salehi
- g Department of Psychiatry , Isfahan University of Medical Sciences
| | - Mehrdad Karimi
- h Department of Epidemiology and Biostatistics, School of Public Health , Tehran University of Medical Sciences
| | - Ahmad Hajebi
- i Mental Health Research Center, Tehran Institute of Psychiatry, School of Behavioral Sciences and Mental Health , Iran University of Medical Sciences
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Ivanova O, Cordova-Pozo K, Segura ZE, Vega B, Chandra-Mouli V, Hindin MJ, Temmerman M, Decat P, De Meyer S, Michielsen K. Lessons learnt from the CERCA Project, a multicomponent intervention to promote adolescent sexual and reproductive health in three Latin America countries: a qualitative post-hoc evaluation. Eval Program Plann 2016; 58:98-105. [PMID: 27347640 PMCID: PMC4987454 DOI: 10.1016/j.evalprogplan.2016.06.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Revised: 04/16/2016] [Accepted: 06/03/2016] [Indexed: 06/06/2023]
Abstract
The Community-Embedded Reproductive Health Care for Adolescents (CERCA) Project was implemented in Bolivia, Ecuador and Nicaragua (2011-2014) to test the effectiveness of interventions preventing teenage pregnancies. As the outcome evaluation showed limited impact, a post-hoc process evaluation was carried out to determine if and how CERCA's design, implementation, monitoring and evaluation affected the results. We did a document analysis and conducted 18 in-depth interviews and 21 focus group discussions with stakeholders and beneficiaries. Transcripts were analyzed using directed content analysis. Data showed that CERCA sensitized stakeholders and encouraged the discussion on this sensitive issue. In terms of design, a strong point was the participatory approach; a weak point was that the detailed situation analysis was completed too late. In terms of implementation, a strong point was that multifaceted activities were implemented; a weak point was that the activities were not pilot tested for feasibility/acceptability and evolved substantially throughout the Project. In terms of monitoring, strong points were that regular monitoring kept the Project on track administratively/financially; a weak point was that monitoring indicators did not change as the intervention package changed. In terms of evaluation, weak points were the substantial attrition rate and narrow focus on adolescents. This study provides recommendations for future projects.
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Affiliation(s)
- Olena Ivanova
- International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 UZP 114, Ghent 9000, Belgium.
| | | | | | - Bernardo Vega
- University of Cuenca (UC), Av. 12 de Abril y Agustín Cueva, Cuenca, Ecuador.
| | - Venkatraman Chandra-Mouli
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 avenue Appia, 1211 Geneva 27, Switzerland.
| | - Michelle J Hindin
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 avenue Appia, 1211 Geneva 27, Switzerland.
| | - Marleen Temmerman
- Department of Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, 20 avenue Appia, 1211 Geneva 27, Switzerland.
| | - Peter Decat
- International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 UZP 114, Ghent 9000, Belgium.
| | - Sara De Meyer
- International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 UZP 114, Ghent 9000, Belgium.
| | - Kristien Michielsen
- International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 UZP 114, Ghent 9000, Belgium.
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Crowell CN, Delgado-Romero EA, Mosley DV, Huynh S. 'The full has never been told': building a theory of sexual health for heterosexual Black men of Caribbean descent. Cult Health Sex 2016; 18:860-874. [PMID: 26907581 DOI: 10.1080/13691058.2016.1146335] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
Research on Black sexual health often fails to represent the heterogeneity of Black ethnic groups. For people of Caribbean descent in the USA, ethnicity is a salient cultural factor that influences definitions and experiences of sexual health. Most research on people of Caribbean descent focuses on the relatively high rate of STIs, but sexual health is defined more broadly than STI prevalence. Psychological and emotional indicators and the voice of participants are important to consider when exploring the sexual health of a minority culture. The purpose of this study was to qualitatively explore how heterosexual Black men of Caribbean descent define and understand sexual health for themselves. Eleven men who self-identified as Black, Caribbean and heterosexual participated in three focus groups and were asked to define sexual health, critique behaviours expertly identified as healthy and address what encourages and discourages sexual health in their lives. Findings point to six dimensions of sexual health for heterosexual Black men of Caribbean descent. These include: heterosexually privileged, protective, contextual, interpersonal, cultural and pleasurable dimensions. There were some notable departures from current expert definitions of sexual health. Recommendations for further theory development are provided.
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Affiliation(s)
- Candice N Crowell
- a Department of Educational, School, and Counseling Psychology , University of Kentucky , Lexington , USA
| | | | - Della V Mosley
- a Department of Educational, School, and Counseling Psychology , University of Kentucky , Lexington , USA
| | - Sophia Huynh
- b Department of Counseling and Human Services , University of Georgia , Athens , USA
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Prather C, Fuller TR, Marshall KJ, Jeffries WL. The Impact of Racism on the Sexual and Reproductive Health of African American Women. J Womens Health (Larchmt) 2016; 25:664-71. [PMID: 27227533 PMCID: PMC4939479 DOI: 10.1089/jwh.2015.5637] [Citation(s) in RCA: 89] [Impact Index Per Article: 11.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
African American women are disproportionately affected by multiple sexual and reproductive health conditions compared with women of other races/ethnicities. Research suggests that social determinants of health, including poverty, unemployment, and limited education, contribute to health disparities. However, racism is a probable underlying determinant of these social conditions. This article uses a socioecological model to describe racism and its impact on African American women's sexual and reproductive health. Although similar models have been used for specific infectious and chronic diseases, they have not described how the historical underpinnings of racism affect current sexual and reproductive health outcomes among African American women. We propose a socioecological model that demonstrates how social determinants grounded in racism affect individual behaviors and interpersonal relationships, which may contribute to sexual and reproductive health outcomes. This model provides a perspective to understand how these unique contextual experiences are intertwined with the daily lived experiences of African American women and how they are potentially linked to poor sexual and reproductive health outcomes. The model also presents an opportunity to increase dialog and research among public health practitioners and encourages them to consider the role of these contextual experiences and supportive data when developing prevention interventions. Considerations address the provision of opportunities to promote health equity by reducing the effects of racism and improving African American women's sexual and reproductive health.
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Affiliation(s)
- Cynthia Prather
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Taleria R. Fuller
- Division of Reproductive Health, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Khiya J. Marshall
- Division of Violence Prevention, National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - William L. Jeffries
- Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
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Inoue K, Kelly M, Bateson D, Rutherford A, Stewart M, Richters J. Contraceptive choices and sexual health of Japanese women living in Australia: A brief report from a qualitative study. Aust Fam Physician 2016; 45:523-527. [PMID: 27610438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
BACKGROUND There is a lack of research focused specifically on the contraceptive and sexual health practices of Japanese women living in Australia. OBJECTIVE This paper reports findings from a cohort of migrant Japanese women who participated in a study of Australian women's understanding and experience of contraceptives. METHODS In-depth, open-ended interviews were conducted between August 2012 and June 2013 in New South Wales. Audio-recorded interviews of seven Japanese women were transcribed verbatim and analysed thematically. RESULTS The four prominent themes were the condom and withdrawal methods, varying attitudes to contraceptive practices, discussing contraception and sexual issues with general practitioners (GPs), and the unspoken topic of sexually transmissible infections (STIs). DISCUSSION Japanese migrants tend to choose the condom and withdrawal methods, which they perceive to be 'standard practice' in Japan. A greater understanding by Australian GPs of Japanese women's attitudes to contraception and sexual health issues could enhance the sexual health of Japanese women.
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Agu J, Lobo R, Crawford G, Chigwada B. Migrant Sexual Health Help-Seeking and Experiences of Stigmatization and Discrimination in Perth, Western Australia: Exploring Barriers and Enablers. Int J Environ Res Public Health 2016; 13:ijerph13050485. [PMID: 27187423 PMCID: PMC4881110 DOI: 10.3390/ijerph13050485] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 04/25/2016] [Accepted: 05/03/2016] [Indexed: 11/26/2022]
Abstract
Increasing HIV notifications amongst migrant and mobile populations to Australia is a significant public health issue. Generalizations about migrant health needs and delayed or deterred help-seeking behaviors can result from disregarding the variation between and within cultures including factors, such as drivers for migration and country of birth. This study explored barriers and enablers to accessing sexual health services, including experiences of stigma and discrimination, within a purposive sample of sub-Saharan African, Southeast Asian, and East Asian migrants. A qualitative design was employed using key informant interviews and focus group discussions. A total of 45 people with ages ranging from 18 to 50 years, participated in focus group discussions. Common barriers and enablers to help seeking behaviors were sociocultural and religious influence, financial constraints, and knowledge dissemination to reduce stigma. Additionally, common experiences of stigma and discrimination were related to employment and the social and self-isolation of people living with HIV. Overcoming barriers to accessing sexual health services, imparting sexual health knowledge, recognizing variations within cultures, and a reduction in stigma and discrimination will simultaneously accelerate help-seeking and result in better sexual health outcomes in migrant populations.
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Affiliation(s)
- Josephine Agu
- School of Public Health, Curtin University, Kent Street, Bentley, Western Australia 6102, Australia.
| | - Roanna Lobo
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Kent Street, Bentley, Western Australia 6102, Australia.
| | - Gemma Crawford
- Collaboration for Evidence, Research and Impact in Public Health, School of Public Health, Curtin University, Kent Street, Bentley, Western Australia 6102, Australia.
| | - Bethwyn Chigwada
- HepatitisWA (Inc.), 134 Aberdeen Street, Northbridge, Western Australia 6003, Australia.
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Arousell J, Carlbom A. Culture and religious beliefs in relation to reproductive health. Best Pract Res Clin Obstet Gynaecol 2015; 32:77-87. [PMID: 26542927 DOI: 10.1016/j.bpobgyn.2015.08.011] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 08/10/2015] [Accepted: 08/11/2015] [Indexed: 11/19/2022]
Abstract
An increasing number of contemporary research publications acknowledge the influence of religion and culture on sexual and reproductive behavior and health-care utilization. It is currently hypothesized that religious influences can partly explain disparities in sexual and reproductive health outcomes. In this paper, we will pay particular attention to Muslims in sexual and reproductive health care. This review reveals that knowledge about devout Muslims' own experience of sexual and reproductive health-care matters is limited, thus providing weak evidence for modeling of efficient practical guidelines for sexual and reproductive health care directed at Muslim patients. Successful outcomes in sexual and reproductive health of Muslims require both researchers and practitioners to acknowledge religious heterogeneity and variability, and individuals' possibilities to negotiate Islamic edicts. Failure to do so could lead to inadequate health-care provision and, in the worst case, to suboptimal encounters between migrants with Muslim background and the health-care providers in the receiving country.
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Affiliation(s)
- Jonna Arousell
- Department of Women's and Children's Health (IMCH), Uppsala University, Sweden.
| | - Aje Carlbom
- Faculty of Health and Society, Malmö University, Sweden
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Wagoner KG, Downs M, Alonzo J, Daniel-Ulloa J, Rhodes SD. Latino men's qualitative perspectives on a lay health advisor intervention to promote their sexual health. Health Soc Care Community 2015; 23:304-312. [PMID: 25475213 PMCID: PMC4390418 DOI: 10.1111/hsc.12148] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/11/2014] [Indexed: 05/30/2023]
Abstract
Lay health advisor (LHA) approaches are a promising strategy to reduce health disparities among communities considered 'hard to reach' by researchers and practitioners. LHAs have addressed a variety of health issues, but limited studies have included men as LHAs. The purpose of this study was to better understand the roles of male LHAs and their male-helping relationships. We used an inductive approach to explore Latino men's perspectives on serving as LHAs for other Latino men and Latino men's views on receiving sexual health information from a male LHA. We collected qualitative data in 2009 and 2010 as part of an LHA intervention designed to reduce the risk of HIV infection among immigrant Latinos through the social networks of soccer teams. We analysed and interpreted data from 30 in-depth interviews with Latino men who served as LHAs and their social networks in North Carolina, USA. Participants shared perceptions on social network importance for immigrant Latinos, facilitators and challenges of helping other men, recommendations for intervention modification and suggestions for future work involving the Latino community. Findings revealed that Latino men are receptive to fulfilling the roles of health advisors and opinion leaders, and can effectively serve as LHAs. Social network members valued the social support they received. Working through sports teams and identifying existing leaders to be LHAs may be a culturally congruent approach to meeting Latino community needs. More research is needed on the potential of male LHAs to address other health issues.
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Affiliation(s)
- Kim G. Wagoner
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Mario Downs
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Jorge Alonzo
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
| | - Jason Daniel-Ulloa
- Department of Community and Behavioral Health, College of Public Health, University of Iowa, Iowa City, Iowa
| | - Scott D. Rhodes
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC
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Abstract
Community health worker (CHW) programs have existed for over 50 years across the world. However, only recently has research evidence documented their effectiveness. Research is still needed to identify issues related to implementation and sustainability of CHW programs. This article explores the role and challenges of U.S. Latino CHWs trained to deliver a comprehensive sexual and reproductive health educational intervention to Latino families. We conducted a semistructured interview with a purposive convenience sample of 19 CHWs. Findings suggest that CHWs occupy roles that go beyond those they were trained for. CHWs serve not only as educators but also as providers of social support, facilitators of access to resources, patient navigators, and civil rights advocates. Lack of clarity of the role of a CHW influenced perceptions of adequacy of compensation, training, and integration into the agency that trained them. Policy facilitating the standardization of the CHW occupational category and role expectations is imperative to ensure successful implementation and sustainability of U.S. CHW programs.
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Affiliation(s)
| | - Dina Garcia
- The Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jill Owczarzak
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Córdova Pozo K, Chandra-Mouli V, Decat P, Nelson E, De Meyer S, Jaruseviciene L, Vega B, Segura Z, Auquilla N, Hagens A, Van Braeckel D, Michielsen K. Improving adolescent sexual and reproductive health in Latin America: reflections from an International Congress. Reprod Health 2015; 12:11. [PMID: 25616439 PMCID: PMC4320614 DOI: 10.1186/1742-4755-12-11] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2014] [Accepted: 01/14/2015] [Indexed: 11/12/2022] Open
Abstract
In February 2014, an international congress on Promoting Adolescent Sexual and Reproductive Health (ASRH) took place in Cuenca, Ecuador. Its objective was to share evidence on effective ASRH intervention projects and programs in Latin America, and to link this evidence to ASRH policy and program development. Over 800 people participated in the three-day event and sixty-six presentations were presented.This paper summarizes the key points of the Congress and of the Community Embedded Reproductive Health Care for Adolescents (CERCA) project. It aims at guiding future ASRH research and policy in Latin America. 1. Context matters. Individual behaviors are strongly influenced by the social context in which they occur, through determinants at the individual, relational, family, community and societal levels. Gender norms/attitudes and ease of communication are two key determinants. 2. Innovative action. There is limited and patchy evidence of effective approaches to reach adolescents with the health interventions they need at scale. Yet, there exist several promising and innovative examples of providing comprehensive sexuality education through conventional approaches and using new media, improving access to health services, and reaching adolescents as well as families and community members using community-based interventions were presented at the Congress. 3. Better measurement. Evaluation designs and indicators chosen to measure the effect and impact of interventions are not always sensitive to subtle and incremental changes. This can create a gap between measured effectiveness and the impact perceived by the targeted populations. Thus, one conclusion is that we need more evidence to better determine the factors impeding progress in ASRH in Latin American, to innovate and respond flexibly to changing social dynamics and cultural practices, and to better measure the impact of existing intervention strategies. Yet, this Congress offered a starting point from which to build a multi-agency and multi-country effort to generate specific evidence on ASRH with the aim of guiding policy and program decision-making. In a region that contains substantial barriers of access to ASRH education and services, and some of the highest adolescent pregnancy rates in the world, the participants agreed that there is no time to lose.
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Affiliation(s)
- Kathya Córdova Pozo
- />South Group, C. Ecuador O-138, Edificio Holanda, A-3A, Cochabamba, Bolivia
| | - Venkatraman Chandra-Mouli
- />Reproductive Health and Research, World Health Organization, 20 Avenue Appia, CH - 1211 Geneva 27, Switzerland
| | - Peter Decat
- />International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 6 K4, 9000 Gent, Belgium
| | - Erica Nelson
- />Center for Social Science and Global Health, University of Amsterdam, Nieuwe Achtergracht 166, 1018 WV Amsterdam, The Netherlands
| | - Sara De Meyer
- />International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 6 K4, 9000 Gent, Belgium
| | - Lina Jaruseviciene
- />Department of Family Medicine, Lithuanian University of Health Sciences, Kaunas, 44307 Lithuania
| | - Bernardo Vega
- />University of Cuenca- Facultad de Ciencias Médicas, Avenida 12 de abril S/N sector El Paraíso, Cuenca, Ecuador
| | - Zoyla Segura
- />Instituto Centroamericano de la Salud, Reparto Los Robles, Restaurante La Marsellaise 1 c. al norte 1 c. al este, casa # 77, Managua, Nicaragua
| | - Nancy Auquilla
- />University of Cuenca- Facultad de Ciencias Médicas, Avenida 12 de abril S/N sector El Paraíso, Cuenca, Ecuador
| | - Arnold Hagens
- />South Group, C. Ecuador O-138, Edificio Holanda, A-3A, Cochabamba, Bolivia
| | - Dirk Van Braeckel
- />International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 6 K4, 9000 Gent, Belgium
| | - Kristien Michielsen
- />International Centre for Reproductive Health (ICRH), Ghent University, De Pintelaan 185 6 K4, 9000 Gent, Belgium
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Rogers C, Earnest J. Sexual and reproductive health communication among Sudanese and Eritrean women: an exploratory study from Brisbane, Australia. Cult Health Sex 2014; 17:223-36. [PMID: 25346993 DOI: 10.1080/13691058.2014.967302] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This exploratory study piloted in Brisbane, Australia, reports on findings from in-depth focus-group discussions conducted with Sudanese and Eritrean women in Brisbane. We investigated and documented their experiences and knowledge of sexual and reproductive health and contraception, and explored their views on sexuality and relationships education within the family environment of minority ethnic communities in Australia. Underpinned by a qualitative psychosocial framework, the study also involved key-informant interviews with health and multicultural not-for-profit sector professionals. Through the knowledge and experiences shared by the participants, the key themes of cultural insensitivity, exclusion and poor communication within the family were highlighted by participants as determining factors in the achievement of sexual and reproductive health and good quality sex and relationships education. Participants proposed recommendations for how minority ethnic communities in Australia can more effectively support and communicate within the family environment to increase their own and their children's knowledge and understanding.
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Affiliation(s)
- Claire Rogers
- a International Health Program, Curtin University , Perth , Australia
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Schmidt N C, Fargnoli V. [Reproductive health among migrant women in Geneva: what are the challenges for Community-based participatory research]. Rev Med Suisse 2014; 10:1985-8. [PMID: 25518208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Community-based participatory research (CBPR) focuses on inequalities in health by involving community members and researchers in all parts of the research process. The project COMIRES (COmmunity Migrant RESearch), based in the Department of Obstetrics and Gynecology at the University Hospitals of Geneva, engages academic researchers and migrant communities in Geneva in a co-learning process to understand barriers to reproductive health services and evaluate the role of the community. The article illustrates the methodological approach, but also advantages and challenges of CBPR.
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Biello KB, Rosenberger JG, Novak DS, Robertson AM, Mayer KH, Mimiaga MJ. Epidemiology of sexual health in the virtual environment: a multinational online survey of Spanish- and Portuguese-speaking men who use an internet sexual networking site. AIDS Behav 2014; 18:1675-85. [PMID: 24980249 DOI: 10.1007/s10461-014-0844-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
There is limited data on the sexual health of users of sexual networking websites for men who have sex with men (MSM) in Latin America. Members of a MSM-targeted social/sexual networking website in Latin America, Spain, and Portugal participated in an online sexual health survey. Among 36,063 respondents, nearly 90 % reported having anal or vaginal intercourse in the past 3 months. Among sexually active men, 53.2 % used condoms inconsistently. In the past year, 54 % of respondents reported undergoing sexually transmitted infections (STI) testing and 67 % reported testing yearly or more often for HIV. Self-reported HIV prevalence was 9.1 %. Differences were seen by geographic region. Unprotected intercourse with partners of different or unknown HIV status was associated with recent STI diagnosis (OR = 1.83, t = 13.15, d.f. = 21, p < .001) and HIV diagnosis (OR = 2.20, t = 14.00, d.f. = 21, p < .001). Online surveys are a promising tool for HIV/STI surveillance and prevention internationally to reach an important subset of MSM.
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Affiliation(s)
- Katie B Biello
- Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA,
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Golden AG, Pomerantz A. Interpretative repertoires that shape low-income African American women's reproductive health care seeking: "don't want to know" and "taking charge of your health". Health Commun 2014; 30:746-757. [PMID: 25144501 DOI: 10.1080/10410236.2014.898363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
In the context of reproductive and sexual health, African American women have higher incidence of disease and poorer outcomes on key indicators when compared with White women. In this study, we used discourse analysis to identify and examine the workings of two clusters of interpretive resources ("interpretative repertoires") associated with reproductive/sexual health care seeking among low-income African American women who participated in semistructured interviews as part of a health promotion initiative. Interpretative repertoires are ways of accounting for engaging in or refraining from engaging in actions, which are shared by people in a community. We labeled the two interpretative repertoires "Don't Want to Know," and "Take Charge of Your Health." Within the "Don't Want to Know" repertoire, that testing would lead to threatening findings was assumed, a chain of devastating consequences was imagined, and a preference for uncertainty over certain knowledge was expressed. Conversely, the "Take Charge of Your Health" repertoire valued certainty over uncertainty, though in both interpretive frameworks, knowledge-based and emotion-based decision-making were intertwined. We conclude that health promotion initiatives--if they are to succeed in encouraging women to obtain valuable preventive health care services--must respond, in their choices of language and outreach strategies, to the expressed dilemma of wishing for reassurance but fearing bad news, to the intertwining of emotional reasoning and technorationality in health decision making, and to the particular relational experiences of African American women. Failure to do so will contribute to the continuation of reproductive and sexual health disparities.
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Affiliation(s)
- Annis G Golden
- a Department of Communication , University at Albany, State University of New York
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Ireland S, Narjic CW, Belton S, Saggers S, McGrath A. 'Jumping around': exploring young women's behaviour and knowledge in relation to sexual health in a remote Aboriginal Australian community. Cult Health Sex 2014; 17:1-16. [PMID: 25115988 DOI: 10.1080/13691058.2014.937747] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Sexual health indicators for young remote-living Aboriginal women are the worst of all of Australian women. This study aimed to describe and explore young women's behaviour and knowledge in relation to sexual health, as well as to provide health professionals with cross-cultural insights to assist with health practice. A descriptive ethnographic study was conducted, which included: extended ethnographic field work in one remote community over a six-year period; community observation and participation; field notes; semi-structured interviews; group reproductive ethno-physiology drawing and language sessions; focus-group sessions; training and employment of Aboriginal research assistants; and consultation and advice from a local reference group and a Cultural Mentor. Findings reveal that young women in this remote community have a very poor biomedical understanding of sexually transmitted infections and contraception. This is further compounded by not speaking English as a first language, low literacy levels and different beliefs in relation to body functions. In their sexual relationships, young women often report experiences involving multiple casual partners, marijuana use and violence. Together, the findings contribute to a better understanding of the factors underlying sexual health inequity among young Aboriginal women in Australia.
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Affiliation(s)
- Sarah Ireland
- a Menzies School of Health Research , Darwin , Australia
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Abstract
While research suggests youth prefer parents and family members to serve as the primary sources of sexual health information, fear and discomfort around discussing sex with their parents may leave youth misinformed and underinformed. This study explored sexual heath communication within religious African-American families. Thirty adolescents participated in four focus groups, and 19 adults and 30 adolescents participated in six focus groups, at two predominantly African-American Christian churches in Flint, MI. All data were analyzed inductively using a constant comparison approach. Nearly all participants reported attending church weekly. Three themes emerged and are described: initiating sex talks, using mistakes as teaching tools, and clarifying prevention messages. Participants highlighted the need for religious parents to offer both religious and practical guidance to adolescents about sexual health. Findings from this study may be used to inform future sexual health promotion interventions for religious African-American families.
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Abstract
BACKGROUND Rates of sexually transmitted infections (STIs) and unplanned pregnancy are high in Kenya, and limited reproductive health education exists in schools. METHODS We designed and implemented a 6-week reproductive health curriculum in Laikipia District, Kenya, in 2011, which included didactic sessions, educational games, and open discussions. We applied a mixed quantitative and qualitative methods to evaluate this curriculum including a comprehensive 35-item survey to assess pre- and post-training knowledge, attitudes, and practices of female teenagers regarding STIs/HIV and family planning using paired t-test as well as complementary focus groups (n=42) and individual interviews (n=20). RESULTS Average age for 42 female teenagers was 16.5 (± 1.31) years. Pre-test questionnaires revealed lack of knowledge about different types of STIs, specifically chlamydia, but adequate knowledge of basic contraception including abstinence and condom use. By the conclusion of the study, we observed improvement in following educational domains: general knowledge of HIV/AIDS (85% ± 7.5% to 94% ± 5.6%) (p<0.001); general knowledge of teen pregnancy and STIs (57% ± 19% to 82% ± 13%) (p<0.001); and overall scores of knowledge, attitude, and self-efficacy (81% ± 6.6% to 90% ± 5%) (p<0.001). Focus group discussions, however, revealed persistent misconceptions and knowledge gaps with themes regarding HIV transmission risk factors, perceived difficulty negotiating condom use, masturbation and its perceived consequences, and issues surrounding female circumcision. CONCLUSIONS Important misconceptions and gaps in reproductive practices were identified and addressed using a mixed methods approach. Despite prior basic knowledge and positive attitudes on STI prevention and family planning, complementary teaching approaches were instrumental in improving overall knowledge of STIs other than HIV as well as family planning. The curriculum was feasible, well received, and achieved its educational goals.
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Abstract
INTRODUCTION Indigenous peoples in the state of Chihuahua, Mexico, are known to outsiders as the Tarahumaras. The Tarahumaras are one of the few cultural groups known to have no traditional birth attendants, and Tarahumara women often give birth alone and outdoors. Currently, little is known about this group, their health status or their culture. OBJECTIVE The objective of this study was to assess the state of reproductive health outcomes, risks, protective factors, beliefs and behaviors in the Tarahumara population. DESIGN This paper reports on the qualitative results of a mixed methods study, comprised of focus groups, interviews, participatory exploratory methods, ethnographic observation and household surveys investigating the reproductive health status of the Tarahumara peoples and contextual factors influencing it. Qualitative data is presented, supported by preliminary quantitative findings. RESULTS This study supports speculation that the Tarahumara population is burdened by severe maternal health problems. The sample size was too small to definitively assess risk factors for the outcome of maternal mortality, but qualitative findings point to some important contextual issues that contribute to participants' perceptions of susceptibility to and severity of the problem, their reproductive health beliefs and behaviors, and barriers to behavior change. Major issues included disparities in biomedical knowledge, trust between non-indigenous providers and indigenous patients, and structural issues including access to medical facilities and infrastructure. CONCLUSION Qualitative data is drawn upon to make recommendations and identify lessons applicable to similar situations where cultural minorities suffer serious health inequities. This study underscores the importance of needs and assets assessment, as it reveals unique contextual factors that must be taken into account in intervention design. Also, collaborative partnership with community members and leaders proved to be invaluable in the research, warranting further collaboration by both governmental and non-governmental groups attempting to improve the health of this population. This becomes especially important when making and enforcing health policy.
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Affiliation(s)
- Alison M Chopel
- a School of Public Health , University of California , Berkeley , CA , USA
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50
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Gottschalk LB, Ortayli N. Interventions to improve adolescents' contraceptive behaviors in low- and middle-income countries: a review of the evidence base. Contraception 2014; 90:211-25. [PMID: 24916724 DOI: 10.1016/j.contraception.2014.04.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2014] [Revised: 04/01/2014] [Accepted: 04/29/2014] [Indexed: 11/18/2022]
Abstract
OBJECTIVE(S) Many adolescents in developing countries have an unmet need for contraception, which can contribute to poor reproductive health outcomes. Recent literature reviews have not adequately captured effective contraceptive services and interventions for adolescents in low- and middle-income countries (LMICs). This study aims to identify and evaluate the existing evidence base on contraceptive services and interventions for adolescents in LMICs that report an impact on contraceptive behavior outcomes. STUDY DESIGN Structured literature review of published and unpublished papers about contraceptive services and interventions for adolescents in LMICs that report an impact on contraceptive behavior outcomes. RESULTS We identify common elements used by programs that measured an impact on adolescent contraceptive behaviors and summarize outcomes from 15 studies that met inclusion criteria. Effective programs generally combined numerous program approaches and addressed both user and service provision issues. Overall, few rigorous studies have been conducted in LMICs that measure contraceptive behaviors. Few interventions reach the young, the out of school and other vulnerable groups of adolescents. CONCLUSION(S) Though the evidence base is weak, there are promising foundations for adolescent contraceptive interventions in nearly every region of the world. We offer recommendations for programmers and identify gaps in the evidence base to guide future research.
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