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Carter-Brooks CM, Brown OE, Ackenbom MF. Pelvic Floor Disorders in Black Women: Prevalence, Clinical Care, and a Strategic Agenda to Prioritize Care. Obstet Gynecol Clin North Am 2024; 51:157-179. [PMID: 38267125 PMCID: PMC11093648 DOI: 10.1016/j.ogc.2023.11.002] [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] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
Pelvic floor disorders are a group of common conditions affecting women of all racial and ethnic groups. These disorders are undertreated in all women, but this is especially magnified in Black people who have been historically marginalized in the United States. This article seeks to highlight the prevalence of pelvic floor disorders in Black women, evaluate the clinical care they receive, examine barriers they face to equitable care, and present a strategic agenda to prioritize the care of Black women with pelvic floor disorders.
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Affiliation(s)
- Charelle M Carter-Brooks
- The George Washington School of Medicine and Health Sciences, 2150 Pennsylvania Avenue NW, Suite 6A- 416, Washington, DC 20037, USA.
| | - Oluwateniola E Brown
- Northwestern University Feinberg School of Medicine, 250 East Superior Avenue Suite 05-2113, Chicago, IL 60601, USA
| | - Mary F Ackenbom
- Magee-Womens Research Institute, University of Pittsburgh, 3240 Craft Place, Suite 226, Pittsburgh, PA 15213, USA
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2
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Ichite A, Jean-Gilles M, Rosenberg R, Abbamonte J, Dévieux JG. Assessing the Preliminary Efficacy of a Nonrandomized, Clinic-Based HIV Risk Reduction Pilot Intervention for PrEP-Initiated, Alcohol- and Other Drug-Using Women of Color in Miami, FL. J Racial Ethn Health Disparities 2023; 10:3077-3094. [PMID: 36648620 PMCID: PMC10645637 DOI: 10.1007/s40615-022-01482-5] [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] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/23/2022] [Accepted: 11/24/2022] [Indexed: 01/18/2023]
Abstract
In this paper, we assessed the preliminary efficacy and acceptability of a quasi-experimental, clinic-based sexual risk reduction pilot intervention for pre-exposure prophylaxis (PrEP)-initiated, alcohol- and other drug-using women of color and explored their self-reported barriers to, and facilitators of, PrEP use. Using a mixed methods design, analyses incorporated pre- and post-intervention study assessment data from 38 women and semi-structured process evaluations using a subsample of 25. The intervention administered over an 8-week period consisted of 4 one-on-one in person educational sessions, a process evaluation, and study assessments conducted at baseline and 3 and 6 months. Post intervention, statistically significant changes in sexual risk scores were not observed; however, we found significant decreases in alcohol use (Z = - 3.02, p = .003, η2 = .41). Process evaluation data revealed interpersonal relationships as a key motivator for PrEP initiation as well as a prominent barrier to PrEP use; these relationships rarely facilitated adherence. Overall, women found the intervention to be acceptable and reported a wide range of benefits of participation-most notably its therapeutic benefits. Findings from this study provide preliminary evidence of the potential for the Talking PrEP with Women of Color intervention to improve risky behaviors, knowledge, and attitudes related to sexual risk taking. Furthermore, findings suggest that interventions to increase PrEP uptake and adherence in at-risk women may benefit from supporting them in accurately estimating their risk for HIV and increasing their sense of social support.
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Affiliation(s)
- Amanda Ichite
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public, Health and Social Work, Florida International University, Miami, FL, 33199, USA.
| | - Michèle Jean-Gilles
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public, Health and Social Work, Florida International University, Miami, FL, 33199, USA
| | - Rhonda Rosenberg
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public, Health and Social Work, Florida International University, Miami, FL, 33199, USA
| | - John Abbamonte
- Department of Educational and Psychological Studies, Counseling Psychology Area, University of Miami, Coral Gables, FL, 33146, USA
| | - Jessy G Dévieux
- Department of Health Promotion and Disease Prevention, Robert Stempel College of Public, Health and Social Work, Florida International University, Miami, FL, 33199, USA
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3
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Wong B, Copsey-Blake M. Pragmatic, Persistent, and Precarious: The Pathways of Three Minority Ethnic Women in STEM Higher Education. Int J Sci Math Educ 2022; 21:1-20. [PMID: 36467619 PMCID: PMC9708507 DOI: 10.1007/s10763-022-10337-8] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 11/04/2022] [Indexed: 06/17/2023]
Abstract
Minority ethnic women are underrepresented in Science, Technology, Engineering, and Mathematics (STEM) higher education. Whilst existing studies, mostly in the US context, have provided valuable insights into racial and gender inequalities, there appears to be limited research in the UK. Through the lens of science identity, this article draws on qualitative data which was collected over three years, to appreciate how minority ethnic women develop their identity and belonging in STEM higher education, from the start to the end of their degrees. We present three case studies: (1) Nancy, a British East Asian Computer Science student, who appears pragmatic as she understands the extrinsic value of her degree, despite negative feelings and experiences; (2) Carol, a Black British Biomedical student, who can be seen as persistent, as supported by her intrinsic commitment to work in healthcare; and (3) Mawiya, a British Middle Eastern Mathematics student, whose experiences are somewhat precarious, because she must continuously negotiate her mathematics identity, which is often in question by herself and others. We discuss and compare the similarities and differences in the higher education pathways of these students. We also highlight the nuances of identity development and identity management, and consider multiple social inequalities for minority ethnic women. We conclude with a discussion of the implications of the findings for policy and practice.
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Affiliation(s)
- Billy Wong
- Institute of Education, University of Reading, London Road Campus, 4 Redlands Road, Reading, RG1 5EX UK
| | - Meggie Copsey-Blake
- Institute of Education, University of Reading, London Road Campus, 4 Redlands Road, Reading, RG1 5EX UK
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4
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Nkrumah T, Scott KA. Mentoring in STEM higher education: a synthesis of the literature to (re)present the excluded women of color. Int J STEM Educ 2022; 9:50. [PMID: 35919282 PMCID: PMC9336123 DOI: 10.1186/s40594-022-00367-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 07/21/2022] [Indexed: 06/15/2023]
Abstract
UNLABELLED Mentoring initiatives for undergraduate and graduate women of color (WOC) have provided peer-to-peer relationships and counterspaces to disrupt the inequitable treatment of students in STEM higher education (HE). This literature synthesis explores intersectionality in STEM HE mentoring through pursuing the following research questions: (1) What impact do the social contexts of WOC have on their mentoring experiences in STEM HE? (2) What role does intersectionality play in the structural organization of WOC mentoring models in STEM HE? (3) How has intersectionality shaped the life experiences of WOC mentors and mentees? and (4) How can mentoring models utilize intersectionality to incorporate the experiences of WOC in STEM HE? Thematic findings from literature related to STEM HE mentoring suggest a reinforcement of deficit mentoring models (Fix the URM), a symbolic application of intersectionality (branding gender-race), and a lack of paradigmatic shifts (catch-all). Our specific recommendations presented in this article challenge the epistemic oppression and epistemic violence that current STEM HE mentoring models operationalize. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1186/s40594-022-00367-7.
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Affiliation(s)
- Tara Nkrumah
- Center for Gender Equity in Science and Technology, Arizona State University, Community Services Building, Room 361A, 200 E. Curry Road, Tempe, AZ 85281 USA
| | - Kimberly A. Scott
- Center for Gender Equity in Science and Technology, Arizona State University, Community Services Building, Room 361A, 200 E. Curry Road, Tempe, AZ 85281 USA
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5
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Rajabiun S, Myers J, Goldberg J, Fortu K, Sullivan M, Berthaud V, Wahome R, Downes A, Cabral HJ. Outcomes from the Adaptation of an Evidence-Based Peer Linkage & Re-Engagement Intervention for Women of Color with HIV in Three Urban Clinics. AIDS Behav 2022; 26:415-24. [PMID: 34609629 DOI: 10.1007/s10461-021-03395-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
Peer interventions have demonstrated efficacy with improving HIV health outcomes. Yet, little is known about factors associated with their uptake into the clinic setting. Three urban sites in the US were funded to adapt, implement and evaluate a peer intervention to improve HIV health outcomes for 173 out of care and newly diagnosed women of color. Peers worked with cis and transgender women of color for four months to achieve the goals of linkage and retention in HIV case management and medical care. Results were 96% of women were linked to medical care, 73% were retained in care and 81% were virally suppressed post 12 months. The average duration of the peer intervention was seven months. Women who received four peer encounters had a 10% increase in retention in care and viral suppression. The findings highlight key elements such as dose and duration of client interaction for peer staff as part of the health care team.
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6
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Lin PS, Kennette LN. Creating an inclusive community for BIPOC faculty: women of color in academia. SN Soc Sci 2022; 2:246. [PMID: 36339527 PMCID: PMC9618268 DOI: 10.1007/s43545-022-00555-w] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 10/18/2022] [Indexed: 11/16/2022]
Abstract
Institutions of higher education are increasingly diverse with more women and people of color hired, but there remains much work to be done to ensure that underrepresented faculty feel supported in their careers, evaluated fairly for tenure and/or promotion, and made to feel appreciated and valued in their institutions. This perspective paper will review how interpersonal and institutional prejudice disadvantage women of color in academia in aspects of their professional responsibilities including teaching, mentoring students, research, and service. The combination of these challenges explains why women of color are not rewarded in the same way and do not advance as quickly in their academic careers compared to white men. After considering the subtle and direct ways that biases cause harm to women of color, we present recommendations to better support women of color in faculty roles with the goal of combating prejudice pertaining to both racial/ethnic and gender biases.
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Affiliation(s)
- Phoebe S. Lin
- grid.417997.50000 0001 0578 1801Framingham State University, 100 State St., Framingham, MA 01701 United States of America
| | - Lynne N. Kennette
- grid.420705.40000 0000 8994 0947Durham College, 2000 Simcoe St. N., Oshawa, ON L1G 0C5 Canada
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7
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Hawkey AJ, Ussher JM, Liamputtong P, Marjadi B, Sekar JA, Perz J, Ryan S, Schmied V, Brook E, Dune T. Trans Women's Responses to Sexual Violence: Vigilance, Resilience, and Need for Support. Arch Sex Behav 2021; 50:3201-3222. [PMID: 34697692 DOI: 10.1007/s10508-021-01965-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 02/18/2021] [Accepted: 02/19/2021] [Indexed: 05/12/2023]
Abstract
Despite experiencing high rates of sexual violence, there is limited research that explores coping and support needs among trans women of color and those from migrant backgrounds. This article examines the impact of sexual violence, as well as responses and support needs in relation to sexual violence, among 31 trans women of color, aged between 18-54 years, living in Australia. Women were recruited using purposive and snowball sampling, local LGBTQI + networks, and social media. Study advertisements invited participation from people 18 years and older, who identified as a "trans woman of color" or "trans woman from a non-English speaking background," to take part in a study about their lives as trans women of color and experiences of sexual violence. In-depth interviews and photovoice took place between September 2018 and September 2019. Findings were analyzed through thematic analysis, drawing on intersectionality theory. Sexual violence was reported to be associated with fear, anxiety, and depression, and, for a minority of women, self-blame. While women reported hypervigilance and avoiding going out in public as measures to anticipate and protect themselves from sexual violence, they also demonstrated agency and resilience. This included putting time and effort into appearing as a cisgender woman, naming violence, seeking support, rejecting self-blame, and engaging in self-care practices to facilitate healing. Trans women highlighted the need for multi-faceted sexual violence prevention activities to encourage education, empowerment and cultural change across the general population and support services, in order to promote respect for gender, sexuality and cultural diversity.
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Affiliation(s)
- Alexandra J Hawkey
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia.
| | - Jane M Ussher
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Pranee Liamputtong
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Brahmaputra Marjadi
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Jessica Aasha Sekar
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Janette Perz
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Samantha Ryan
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Virginia Schmied
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | | | - Tinashe Dune
- Translational Health Research Institute, Western Sydney University, Penrith, NSW, Australia
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8
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Danquah R, Lopez C, Wade L, Castillo LG. Racial Justice Activist Burnout of Women of Color in the United States: Practical Tools for Counselor Intervention. Int J Adv Couns 2021; 43:519-533. [PMID: 34465931 PMCID: PMC8390016 DOI: 10.1007/s10447-021-09449-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2021] [Indexed: 12/02/2022]
Abstract
The pervasive racially hostile climate in society can bring severe mental health ramifications, such as burnout, to racial justice activists. For women of color (WOC), intersecting identities presents additional challenges. Due to the significant psychological impact burnout can have on WOC activists, counselors need the knowledge and tools to address this mental health issue. This article aims to provide counselors with a guide to working with WOC racial justice activists in the United States by outlining challenges faced by this population, health and mental health effects of burnout, and counseling interventions.
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Affiliation(s)
- Rudney Danquah
- Department of Educational Psychology, Texas A&M University, College Station, TX 77843-4225 USA
| | - Cristal Lopez
- Department of Educational Psychology, Texas A&M University, College Station, TX 77843-4225 USA
| | - Laurel Wade
- Department of Educational Psychology, Texas A&M University, College Station, TX 77843-4225 USA
| | - Linda G Castillo
- Department of Educational Psychology, Texas A&M University, College Station, TX 77843-4225 USA
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9
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Nace A, Johnson G, Eastwood E. Comparison of HIV Viral Suppression Between a Sample of Foreign-Born and U.S.-Born Women of Color in the United States. J Immigr Minor Health 2021; 23:1129-1135. [PMID: 33974177 DOI: 10.1007/s10903-021-01213-8] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2021] [Indexed: 10/21/2022]
Abstract
We investigate the association between nativity status (U.S.- vs foreignborn) and viral suppression among women of color (WOC) with HIV (HIV +) and whether this association was modified by education and housing. METHODS Data were from 549 HIV + WOC, who participated in the Health Resources and Services Administration-funded WOC Initiative 2009-2013. We used generalized estimating equation models to quantify the association between the respondents' nativity status and viral suppression. RESULTS After adjusting for covariates, foreign-born WOC were 2.2 times (95% confidence interval: 1.25, 3.85) more likely to achieve viral suppression than U.S.-born WOC. This association was not modified by education or housing status. CONCLUSIONS Despite facing barriers to care, foreign-born WOC were more likely to achieve viral suppression than U.S.-born WOC. Programs aiming to end the HIV epidemic and reduce HIV disparities in the U.S. should consider these findings as they provide a more nuanced understanding of HIV + WOC.
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Affiliation(s)
- Amanda Nace
- CUNY Graduate School of Public Health and Health Policy, Health Policy and Management, 55 W 125 th Street, 5 th Fl. NY, New York, 10027, USA.
| | - Glen Johnson
- CUNY Graduate School of Public Health and Health Policy, Health Policy and Management, 55 W 125 th Street, 5 th Fl. NY, New York, 10027, USA
| | - Elizabeth Eastwood
- CUNY Graduate School of Public Health and Health Policy, Health Policy and Management, 55 W 125 th Street, 5 th Fl. NY, New York, 10027, USA
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10
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Davis DS, Robinson C, Callender VD. Skin cancer in women of color: Epidemiology, pathogenesis and clinical manifestations. Int J Womens Dermatol 2021; 7:127-134. [PMID: 33937476 PMCID: PMC8072498 DOI: 10.1016/j.ijwd.2021.01.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/11/2021] [Accepted: 01/20/2021] [Indexed: 11/30/2022] Open
Abstract
Malignant melanoma and nonmelanoma skin cancers (NMSC), which include basal cell carcinoma and squamous cell carcinoma, account for 40% of all neoplasms in white patients, making these cancers the most common malignancy in the United States. Given the large number of NMSC cases in white patients, there is a correspondingly large body of literature addressing various aspects of epidemiology, pathogenesis, and treatment. The incidence of both malignant melanoma and NMSC is well established and remains significantly lower in patients with skin of color (SoC) when compared with white patients. Although there is a lower incidence of skin cancer in SoC, there is often a poorer prognosis among this group. There is even more limited data focusing on women of color, making an accurate determination of incidence and mortality difficult. This gender disparity causes decreased skin cancer awareness and index of suspicion among patients and providers, hindering appropriate evaluation and care. Therefore, there is a need for an increased understanding of skin cancer in women of color. In the traditional sense, SoC refers to people of African, Asian, Native American, Middle Eastern, and Hispanic backgrounds. Patients in these ethnic groups have richly pigmented skin that is usually categorized as Fitzpatrick types III through VI and thus have notable differences in skin disease and presentation compared with fair-skinned individuals. We present this review of skin cancer in women of color to give a reasonably comprehensive representation of the literature to advance our understanding and knowledge in this unique population.
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Affiliation(s)
- DiAnne S. Davis
- North Dallas Dermatology Associates, Dallas, TX, United States
| | - Camille Robinson
- Duke University School of Medicine, Durham, NC, United States
- Corresponding author.
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11
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Wiznia LE, Wang J, Steuer AB, Elbuluk N. Direct-to-consumer dermatology-related advertising differs in magazines targeted to women of color: A cross-sectional analysis of top-circulating consumer magazines. Int J Womens Dermatol 2021; 7:191-194. [PMID: 33937491 PMCID: PMC8072494 DOI: 10.1016/j.ijwd.2021.01.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 12/23/2020] [Accepted: 01/06/2021] [Indexed: 11/26/2022] Open
Abstract
Background Advertisements for dermatology-related products in consumer magazines serve as a potential source of health literacy, which varies by demographic group. Objective This study sought to examine differences in advertisements for dermatology-related products in the top U.S. consumer magazines targeted at women of color compared with three other demographic groups: teenagers, adult women, and adult men. Methods Dermatology advertisements in the most circulated U.S. consumer magazines targeting these four demographic groups were analyzed. Descriptive statistics were obtained. Simple logistic regressions were used to compare the product indications, language used, and the sex, age, ethnicity, and skin type of models between magazine categories. Limitations of this study included that certain magazines could not be included due to a lack of accessibility, and subjective assessments were made when necessary because not all data collected were explicitly stated. Results Significant differences exist in print media advertising for women of color in comparison with other demographic groups, including skin-of-color magazines having an increased number of darker-skin models, more advertisements related to products that target pigmentation, and differences in advertisement word choices. Conclusion The differences in print media advertising for women of color in comparison with other demographic groups may influence the dermatologic concerns of this population, including their dermatology-related knowledge base, grooming practices, beauty perceptions, and utilization of dermatology as a specialty.
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Affiliation(s)
- Lauren E Wiznia
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, United States
| | - Jenny Wang
- University of Pennsylvania, Philadelphia, PA, United States
| | - Alexa B Steuer
- The Ronald O. Perelman Department of Dermatology, New York University Grossman School of Medicine, New York, NY, United States
| | - Nada Elbuluk
- USC Department of Dermatology, Keck School of Medicine, Los Angeles, CA, United States
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12
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Franck LS, McLemore MR, Williams S, Millar K, Gordon AY, Williams S, Woods N, Edwards L, Pacheco T, Padilla A, Nelson F, Rand L. Research priorities of women at risk for preterm birth: findings and a call to action. BMC Pregnancy Childbirth 2020. [PMID: 31928534 DOI: 10.1186/s12884-0192664-1] [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: 05/08/2023] Open
Abstract
BACKGROUND Traditional hierarchical approaches to research give privilege to small groups with decision-making power, without direct input from those with lived experience of illness who bear the burden of disease. A Research Justice framework values the expertise of patients and communities as well as their power in creating knowledge and in decisions about what research is conducted. Preterm birth has persisted at epidemic levels in the United States for decades and disproportionately affects women of color, especially Black women. Women of color have not been included in setting the agenda regarding preterm birth research. METHODS We used the Research Priorities of Affected Communities protocol to elicit and prioritize potential research questions and topics directly from women of color living in three communities that experience disproportionately high rates of preterm birth. Women participated in two focus group sessions, first describing their healthcare experiences and generating lists of uncertainties about their health and/or healthcare during pregnancy. Women then participated in consensus activities to achieve 'top-priority' research questions and topic lists. The priority research questions and topics produced by each group were examined within and across the three regions for similarities and differences. RESULTS Fifty-four women participated in seven groups (14 sessions) and generated 375 researchable questions, clustered within 22 topics and four overarching themes: Maternal Health and Care Before, During, and After Pregnancy; Newborn Health and Care of the Preterm Baby; Understanding Stress and Interventions to Prevent or Reduce Stress; and Interpersonal and Structural Health Inequities. The questions and topics represent a wide range of research domains, from basic science, translational, clinical, health and social care delivery to policy and economic research. There were many similarities and some unique differences in the questions, topics and priorities across the regions. CONCLUSIONS These findings can be used to design and fund research addressing unanswered questions that matter most to women at high risk for preterm birth. Investigators and funders are strongly encouraged to incorporate women at the front lines of the preterm birth epidemic in research design and funding decisions, and more broadly, to advance methods to deepen healthcare research partnerships with affected communities.
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Affiliation(s)
- Linda S Franck
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA.
- Department of Family Health Care Nursing, University of California San Francisco, San Francisco, 2 Koret Way, N411F, Box 0606, San Francisco, CA, 94143, USA.
| | - Monica R McLemore
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| | - Shanell Williams
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| | - Kathryn Millar
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| | | | | | - Nakia Woods
- Oakland Best Babies Zone (formerly), San Francisco, CA, USA
| | | | | | - Artie Padilla
- Fresno Every Neighborhood Partnership, Fresno, CA, USA
| | - Fanta Nelson
- Fresno County Black Infant Health, Fresno, CA, USA
| | - Larry Rand
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
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13
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Franck LS, McLemore MR, Williams S, Millar K, Gordon AY, Williams S, Woods N, Edwards L, Pacheco T, Padilla A, Nelson F, Rand L. Research priorities of women at risk for preterm birth: findings and a call to action. BMC Pregnancy Childbirth 2020; 20:10. [PMID: 31928534 PMCID: PMC6956492 DOI: 10.1186/s12884-019-2664-1] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2019] [Accepted: 12/06/2019] [Indexed: 11/19/2022] Open
Abstract
Background Traditional hierarchical approaches to research give privilege to small groups with decision-making power, without direct input from those with lived experience of illness who bear the burden of disease. A Research Justice framework values the expertise of patients and communities as well as their power in creating knowledge and in decisions about what research is conducted. Preterm birth has persisted at epidemic levels in the United States for decades and disproportionately affects women of color, especially Black women. Women of color have not been included in setting the agenda regarding preterm birth research. Methods We used the Research Priorities of Affected Communities protocol to elicit and prioritize potential research questions and topics directly from women of color living in three communities that experience disproportionately high rates of preterm birth. Women participated in two focus group sessions, first describing their healthcare experiences and generating lists of uncertainties about their health and/or healthcare during pregnancy. Women then participated in consensus activities to achieve ‘top-priority’ research questions and topic lists. The priority research questions and topics produced by each group were examined within and across the three regions for similarities and differences. Results Fifty-four women participated in seven groups (14 sessions) and generated 375 researchable questions, clustered within 22 topics and four overarching themes: Maternal Health and Care Before, During, and After Pregnancy; Newborn Health and Care of the Preterm Baby; Understanding Stress and Interventions to Prevent or Reduce Stress; and Interpersonal and Structural Health Inequities. The questions and topics represent a wide range of research domains, from basic science, translational, clinical, health and social care delivery to policy and economic research. There were many similarities and some unique differences in the questions, topics and priorities across the regions. Conclusions These findings can be used to design and fund research addressing unanswered questions that matter most to women at high risk for preterm birth. Investigators and funders are strongly encouraged to incorporate women at the front lines of the preterm birth epidemic in research design and funding decisions, and more broadly, to advance methods to deepen healthcare research partnerships with affected communities.
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Affiliation(s)
- Linda S Franck
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA. .,Department of Family Health Care Nursing, University of California San Francisco, San Francisco, 2 Koret Way, N411F, Box 0606, San Francisco, CA, 94143, USA.
| | - Monica R McLemore
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| | - Shanell Williams
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| | - Kathryn Millar
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
| | | | | | - Nakia Woods
- Oakland Best Babies Zone (formerly), San Francisco, CA, USA
| | | | | | - Artie Padilla
- Fresno Every Neighborhood Partnership, Fresno, CA, USA
| | - Fanta Nelson
- Fresno County Black Infant Health, Fresno, CA, USA
| | - Larry Rand
- California Preterm Birth Initiative, University of California San Francisco, San Francisco, CA, USA
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14
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Abstract
PURPOSE OF REVIEW This paper reviews literature on perinatal depression prevalence, consequences, and screening among low-income women and women of color. We introduce the Warm Connections program's innovative perinatal depression screening protocol and explore perinatal depression patterns among WIC participants. RECENT FINDINGS Perinatal depression negatively impacts maternal and child outcomes. Research shows mixed findings of perinatal depression prevalence rates among low-income women and women of color. The Warm Connections program supports the ability of WIC staff to administer the EPDS to WIC participants. Perinatal depression rates appeared lower in the Warm Connections program than in studies using less specific perinatal depression screening instruments with similar samples. Future research should continue to explore perinatal depression patterns among low-income women and women of color. Partnering with community-based settings such as WIC provides innovative opportunities to provide screening, referral, and treatment for low income women and women of color.
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Affiliation(s)
- Susanne Klawetter
- Portland State University, School of Social Work, PO Box 751-SSW, Portland, OR, 97207, USA.
| | - Cassidy McNitt
- Department of Psychiatry, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Jill A Hoffman
- Portland State University, School of Social Work, PO Box 751-SSW, Portland, OR, 97207, USA
| | - Kelly Glaze
- Department of Psychiatry, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Ashley Sward
- Department of Psychiatry, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
| | - Karen Frankel
- Departments of Psychiatry and Pediatrics, University of Colorado School of Medicine, 13001 E 17th Pl, Aurora, CO, 80045, USA
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Thomas MP, Ammann G, Brazier E, Noyes P, Maybank A. Doula Services Within a Healthy Start Program: Increasing Access for an Underserved Population. Matern Child Health J 2017; 21:59-64. [PMID: 29198051 DOI: 10.1007/s10995-017-2402-0] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
PURPOSE Women of color in the United States, particularly in high-poverty neighborhoods, experience high rates of poor birth outcomes, including cesarean section, preterm birth, low birthweight, and infant mortality. Doula care has been linked to improvements in many perinatal outcomes, but women of color and low-income women often face barriers in accessing doula support. DESCRIPTION To address this issue, the New York City Department of Health and Mental Hygiene's Healthy Start Brooklyn introduced the By My Side Birth Support Program in 2010. The goal was to complement other maternal home-visiting programs by providing doula support during labor and birth, along with prenatal and postpartum visits. Between 2010 and 2015, 489 infants were born to women enrolled in the program. ASSESSMENT Data indicate that By My Side is a promising model of support for Healthy Start projects nationwide. Compared to the project area, program participants had lower rates of preterm birth (6.3 vs. 12.4%, p < 0.001) and low birthweight (6.5 vs. 11.1%, p = 0.001); however, rates of cesarean birth did not differ significantly (33.5 vs. 36.9%, p = 0.122). Further research is needed to explore possible reasons for this finding, and to examine the influence of doula support on birth outcomes among populations with high rates of chronic disease and stressors such as poverty, racism, and exposure to violence. However, feedback from participants indicates that doula support is highly valued and helps give women a voice in consequential childbirth decisions. CONCLUSION Available evidence suggests that doula services may be an important component of an effort to address birth inequities.
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16
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McLemore MR, Altman MR, Cooper N, Williams S, Rand L, Franck L. Health care experiences of pregnant, birthing and postnatal women of color at risk for preterm birth. Soc Sci Med 2018; 201:127-135. [PMID: 29494846 DOI: 10.1016/j.socscimed.2018.02.013] [Citation(s) in RCA: 184] [Impact Index Per Article: 30.7] [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: 09/23/2017] [Revised: 01/25/2018] [Accepted: 02/15/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Chronic stress is a known risk factor for preterm birth, yet little is known about how healthcare experiences add to or mitigate perceived stress. In this study, we described the pregnancy-related healthcare experiences of 54 women of color from Fresno, Oakland, and San Francisco, California, with social and/or medical risk factors for preterm birth. METHODS This study was a secondary analysis of focus group data generated as part of a larger project focused on patient and community involvement in preterm birth research. English and Spanish speaking women, age 18 or greater with social and/or medical risk factors for preterm birth participated in two focus groups, six weeks apart. Data from the first focus groups are included in this analysis. RESULTS Five themes emerged from thematic analysis of the transcripts. Participants described disrespect during healthcare encounters, including experiences of racism and discrimination; stressful interactions with all levels of staff; unmet information needs; and inconsistent social support. Despite these adverse experiences, women felt confidence in parenting and newborn care. Participant recommendations for healthcare systems improvement included: greater attention to birth plans, better communication among multiple healthcare providers, more careful listening to patients during clinical encounters, increased support for social programs such as California's Black Infant Health, and less reliance on past carceral history and/or child protective services involvement. DISCUSSION The women in this study perceived their prenatal healthcare as a largely disrespectful and stressful experience. Our findings add to the growing literature that women of color experience discrimination, racism and disrespect in healthcare encounters and that they believe this affects their health and that of their infants.
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Affiliation(s)
- Monica R McLemore
- Family Health Care Nursing Department, University of California, 2 Koret Way, N431H, San Francisco, CA, 94143, United States.
| | - Molly R Altman
- UCSF Preterm Birth Initiative, 3333 California Street, Suite 285, San Francisco, CA, 94118, United States.
| | - Norlissa Cooper
- Department of Social and Behavioral Sciences, Health Policy, University of California, 3333 California Street, San Francisco, CA, 94118, United States.
| | - Shanell Williams
- UCSF Preterm Birth Initiative, 3333 California Street, Suite 285, San Francisco, CA, 94118, United States.
| | - Larry Rand
- Marc and Lynne Benioff Endowed Chair in Maternal Fetal Medicine, Director of Perinatal Services, Fetal Treatment Center, University of California, Dept. of Ob/Gyn and Surgery, Divisions of Perinatology and Pediatric Surgery, 550 16th Street, Box #0132, San Francisco, CA, 94143-0132, United States.
| | - Linda Franck
- Department of Family Health Care Nursing, Jack and Elaine Koehn Endowed Chair in Pediatric Nursing, University of California, 2 Koret Way, N411F, Box 0606, San Francisco, CA, 94143, United States.
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