Womens Health Issues最新文献

Introduction: This study explored relationships between aspects of flourishing and leadership trajectories of women leaders, and collected participants' suggestions for ways to recruit and retain women in executive leadership.

Method: Between November 2022 and February 2024, the authors conducted virtual semi-structured interviews with 24 women leaders (at and above department chair or equivalent staff level) from five academic medical centers. Interviews were recorded, transcribed, and analyzed using consensual qualitative research approaches to identify themes. Driven by participant responses, the authors interviewed two additional deans from the associated medical schools.

Results: When asked to describe flourishing, women leaders referred to elements such as new challenges, agency, support, success, aligned values, and meaningful domain integration (e.g., work-family). Elements of nonflourishing included barriers to positive flourishing plus health-related issues and toxic climates. A subset indicated that they were always flourishing-it was a state of mind. In describing decisions about advancing in leadership roles, participants emphasized the importance of new challenges and domain integration. Deans described successful recruitment and retention through leader-specific mentoring, values alignment, assertive recruitment, and being an authentic ally.

Discussion: Women leaders' concepts of flourishing elucidate and expand published flourishing perspectives. Participants gravitated toward leadership opportunities that promoted flourishing, indicating the importance of flourishing in choice making. Suggestions to help women succeed included early specific mentoring, building a critical mass of women, living one's values, and creating a proactively supportive environment. Search committees and leaders should be aware of these drivers as they recruit and work to retain women leaders.

Background: Cervical cancer screening rates are declining in the United States and below the Healthy People 2030 goal of 79.2%. Alternative screening methods to the Pap test (e.g., at-home human papilloma virus [HPV] testing) need to be explored to determine if they are feasible for those unscreened and underscreened. The purpose of this study was to determine the relative importance of Health Belief Model constructs on intention to use at-home HPV testing and explore possible moderation by a person's decision-making style.

Methods: A total of 300 women aged 30-65 in the United States were recruited via a survey panel, Prolific, to complete an online survey assessing their decision-making styles (analytic or intuitive), relative importance of various health beliefs, and intention to use at-home HPV testing, if such an option were available to them. Constructs of the Health Belief Model were included as predictors of intention in a regression model, with decision-making styles included as potential moderators of the relative importance.

Results: Participants' mean age was 40.9 ± 8.9; most were white (79.3%) and had graduated college (66.3%). The mean intention to use at-home HPV testing score was 3.9 (standard deviation = 1.1) out of 5, indicating generally positive agreement. Perceived general benefits, cues to action with family and friends, and self-efficacy related to the test were significantly positively associated with intention, whereas misunderstanding related to need for HPV testing was negatively associated with intention. Self-efficacy was the strongest predictor (β = .69, p < .001). Neither decision-making style was significantly associated with the outcome and there was no evidence of moderation.

Conclusions: As self-efficacy related to at-home HPV testing is the strongest predictor of intention to use it, effective messaging that ensures users' self-efficacy and confidence in their ability to correctly complete the test is needed.

Background: Although mental health screenings have increased during perinatal visits, perinatal mental health services are often inaccessible. Social workers may facilitate mental health referrals or increase access to integrated behavioral health services in perinatal health settings. The aim of this systematic review was to identify studies that described or evaluated perinatal social work interventions.

Methods: We comprehensively searched the literature from the following databases: PubMed, Web of Science, CINAHL, SocINDEX, and PsychInfo. The searches were performed between April and May of 2023 with updates in May of 2024. Inclusion criteria were pregnant and/or postpartum participants; a perinatal mental health and/or substance use intervention; inclusion of a social worker within the intervention; reporting at least one mental health outcome, which could be screening or referral; within a U.S. health care setting; English language; and published after 2008.

Results: A total of 32 studies were included and described with narrative synthesis. Social workers were embedded in various settings including obstetrics and gynecology offices (40%), other outpatient clinics like primary care (13%), hospitals (22%), and community settings like home visitation programs (25%). More than half of studies (n = 20) assessed the efficacy of a social work perinatal mental health intervention at reducing depression, anxiety, or another mental health outcome. Of these studies, almost all (n = 18) reported at least one significant improvement in a mental health outcome.

Discussion: Social workers are a key workforce to assessing and addressing perinatal mental health and implementing integrated behavioral health. Our findings suggest that interventions delivered by social workers may improve perinatal mental health outcomes.

Background: Women with blindness and low vision (WWBLV) experience significant health disparities, yet the relationships among eHealth literacy, physical activity engagement, and depressive symptoms in this population remain poorly understood.

Purpose: This study investigated the relationships among eHealth literacy, physical activity engagement, and depressive symptoms among WWBLV, with particular focus on whether eHealth literacy moderates the relationship between physical activity engagement and depressive symptoms.

Methods: A cross-sectional online survey was conducted with 1,668 WWBLV across the United States. Participants completed validated measures of eHealth literacy, physical activity engagement, and depressive symptoms. A hierarchical multiple linear regression analysis was conducted to estimate the moderating effect of eHealth literacy on physical activity engagement and depressive symptoms, adjusting for sociodemographic factors.

Results: Significant differences in eHealth literacy, physical activity, and depressive symptoms were found across visual impairment severity groups. Unexpectedly, both moderate low vision and blind groups demonstrated higher eHealth literacy than those with severe low vision. eHealth literacy was positively correlated with depressive symptoms (r = .15, p < .001) and negatively correlated with physical activity engagement (r = -.08, p < .001). A hierarchical multiple linear analysis revealed a significant interaction between eHealth literacy and physical activity (B = -.05, β = -.07, p = .002), indicating that higher eHealth literacy strengthened the protective relationship between physical activity and lower depressive symptoms.

Conclusions: The significant moderating effect of eHealth literacy suggests that integrated approaches addressing both eHealth literacy and physical activity may be particularly effective for improving mental health outcomes in this population.

Objective: This pilot study aimed to evaluate the feasibility of a randomized controlled trial comparing high-intensity focused electromagnetic therapy (HIFEM) combined with pelvic floor muscle training (PFMT) versus PFMT alone for improving urine leakage and quality of life in primiparous and multiparous women with stress urinary incontinence (SUI).

Methods: A single-blinded, pilot randomized controlled trial was conducted with primipara and multipara women aged 30 or older who were experiencing symptoms of SUI. Participants were divided into two groups: the experimental group received both HIFEM and PFMT, while the control group received sham HIFEM and PFMT. Treatments were administered weekly for 6 weeks. Feasibility was evaluated in terms of recruitment, retention, adherence, acceptability, safety, blinding integrity, and the practicality of data collection. Urine leakage/bladder health evaluations included the 1-hour pad test, the International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF), and sonography to measure the vertical movement of the bladder neck, conducted at baseline and after the intervention. One-way repeated measures analysis of covariance was used to compare outcomes between the two groups.

Results: Forty participants were randomly assigned to two groups (n = 20 each). This pilot confirmed the study's feasibility and operational robustness. There were no significant interaction effects between time and group for any measures. However, within-group analysis showed significant improvement in the 1-hour pad test in the experimental group (p = .049) and notable improvements in ICIQ-UI SF scores and sonographic measurements of bladder neck movement in both groups.

Conclusion: These findings support progression to a definitive trial: both interventions improved quality of life and bladder control, and the combination of HIFEM and PFMT significantly reduced urine leakage in the experimental group. Larger, longer-term studies are needed to confirm these results and assess durability. This study was retrospectively registered at ClinicalTrials.gov on 9 October 2024 (Registration ID: NCT06638489).

Objectives: Individuals who undergo abortion are up to three times more likely to have experienced prior traumatic events compared with the general reproductive age population, including sexual assault, interpersonal violence, or adverse childhood events. We sought to elicit and understand perceived facilitators and barriers to providing trauma-responsive abortion care among abortion providers.

Methods: We recruited providers from Chicago-area abortion clinics to participate in a 45-minute, semi-structured one-on-one phone or Zoom interview. We used thematic content analysis to analyze data, developing and refining our code directory with iterative readings of the text. We used ATLAS.ti to apply codes, calculate Cohen's kappa scores to ensure inter-rater reliability, and identify major themes in the data.

Results: We interviewed 20 abortion providers: 13 physicians and seven nurse midwives/advanced practice nurses. Half of the respondents expressed feeling confident in their ability to provide trauma-responsive care. Participants identified several facilitators to providing trauma-responsive abortion care at the individual level, including receipt of formal or informal training in trauma-responsive care and years of clinical experience, and at the structural level, accessible in-clinic behavioral health support and sedation. Barriers to providing trauma-responsive abortion care included perceived inadequate training, lack of clinical guidelines to standardize staff practices, and absence of screening protocols to identify individuals with a history of trauma.

Conclusion: Several provider and clinic-level factors influence providers' abilities to provide trauma-responsive abortion care. Greater provider training and standardization of trauma-responsive clinic practices and resources are warranted to enhance abortion care for all patients, including those with a history of trauma(s).

Background: Women veterans are the fastest-growing population of new users within the Department of Veterans Affairs (VA) health care delivery system. Building on the priorities established in the 2011 research agenda, and the research conducted in the intervening years, this paper describes the expert panel priority-setting process and reports on the national research priorities for women's health and health care research in VA.

Methods: We applied content analysis to documents from a conference brainstorming session and then facilitated an expert panel using a modified Delphi process to generate a ranked list of research priorities. Participants ranked each priority on a 5-point Likert scale (1 = not at all impactful; 5 = extremely impactful) and we calculated average descriptive statistics across panelists for each item.

Results: We identified 14 research priorities spanning mental health (4 items), access/rural health (3 items), primary care/prevention (2 items), reproductive health (2 items), other research topics (2 items), and complex chronic conditions, aging, and long-term care (1 item). The pertinence of a life course approach emerged across several research priorities.

Conclusion: Researchers, VA program leaders, other federal agency leaders, and women veterans collectively established updated VA women's health research priorities. The VA Office of Research & Development used the priorities to inform a women's health-focused notice of special interest setting funding priorities for women veterans' research, and the Women's Health Research Network will use them in strategic planning.