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Jayne PE, Szucs LE, Lesesne CA, Grose RG, Johns MM. "I wouldn't have felt so alone": The sexual health education experiences of transgender and gender diverse youth living in the southeastern United States. PERSPECTIVES ON SEXUAL AND REPRODUCTIVE HEALTH 2024. [PMID: 38623631 DOI: 10.1111/psrh.12258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/17/2024]
Abstract
BACKGROUND Transgender and gender diverse youth experience multiple disproportionate adverse sexual health outcomes. Sexual health education teaches knowledge, attitudes, and skills for promoting sexual health, including reducing risk for sexually transmitted infection, HIV acquisition, and unintended pregnancy. Provision of sexual health education may be protective, but research remains scarce. METHODS We conducted a multi-stage thematic analysis of 33 in-depth interviews among transgender and gender diverse youth (ages 15-24) living in the southeastern United States on their sexual health education experiences. RESULTS Our study participants described school-based sexual health education as unhelpful due to a lack of relevant information, inadequately prepared teachers, and a perceived negative tone toward sexuality. They reported relying on online sources of sexual health information, finding relevant content and community despite some limitations. Participants desired content and pedagogy that expands beyond binary and white-centric presentations of sexuality and gender and sought resources that provide relevant, accurate, and judgment-free information while holding positive framing around sexuality and gender. CONCLUSION There is much work needed to improve the breadth, quality, and relevance of school-based sexual health education. Sexual health education can improve by strengthening critical media literacy skills of youth; raising staff cultural competency on gender, race, and sexual identity through training and supports; using culturally relevant and inclusive curricula; and partnering with community-based organizations. Transgender and gender diverse youth would benefit from sexual health education from multiple sources which is queer-friendly, affirms their existence, and provides information on gender, race, and sexuality in positive and expansive ways.
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Affiliation(s)
- Paula E Jayne
- U.S. Centers for Disease Control and Prevention's Division of Adolescent and School Health, Atlanta, Georgia, USA
| | - Leigh E Szucs
- U.S. Centers for Disease Control and Prevention's Division of Adolescent and School Health, Chamblee, Georgia, USA
| | | | - Rose Grace Grose
- Colorado School of Public Health, Community Health Education, University of Northern Colorado, Greeley, Colorado, USA
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Zhang Y, Liu J, Liang J, Lang J, Zhang L, Tang M, Chen X, Xie Y, Zhang J, Su L, Wang X. Online education isn't the best choice: evidence-based medical education in the post-epidemic era-a cross-sectional study. BMC MEDICAL EDUCATION 2023; 23:744. [PMID: 37817252 PMCID: PMC10563228 DOI: 10.1186/s12909-023-04746-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Accepted: 10/04/2023] [Indexed: 10/12/2023]
Abstract
BACKGROUND The COVID-19 pandemic led many educational institutions to shift to online courses, making blended education a significant trend in teaching. We examined the effectiveness of blended learning in an evidence-based medicine course. METHODS We compared the examination scores of a blended learning group, an online only group, and a traditional offline group and conducted a questionnaire survey on students' preferences for different learning modes and the reasons for their preferences. A total of 2100 undergraduate students in clinical medicine were included in this cross-sectional study. Examination results were collected, and questionnaires were administered to the study participants. We compared the mean scores and exam pass rates of the three teaching groups using ANOVA and c2test for multiple comparisons. RESULTS The blended group's exam scores and pass rate were significantly higher than those of the offline and online groups. Furthermore, 71.6% preferred the blended teaching mode. In the survey on " learning effectiveness", the majority of the students believed that blended education could better enhance the initiative of learning, the interest of the course, the pertinence of the learning content, the comprehension of evidence-based medical thinking, and the basic skills of evidence-based practice. Subsequently, in a questionnaire administered to a blended group of students, their foremost reason for liking online instruction was 'flexible in time and space' (99%), followed by 'can be viewed repeatedly, facilitating a better understanding of knowledge points' (98%). Their foremost reason for liking offline teaching was 'helps to create a good learning atmosphere' (97%), followed by 'teachers can control students' learning status in real time' (89%). CONCLUSIONS This study explored the effectiveness of learning in evidence-based medicine courses by comparing the learning outcomes and personal perceptions of three different teaching modes. This is the first cross-sectional study in which three different teaching models are compared and discussed in an evidence-based medicine course. We also elaborate on the specific instructional protocols for each model. This study shows that using a blended education approach in evidence-based medicine courses can improve students' learning motivation, autonomy, and satisfaction. It also enhances instructional efficiency, thereby improving students' understanding of the course content.
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Affiliation(s)
- Yi Zhang
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China.
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China.
| | - Jiarui Liu
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- School of Public Health, Guizhou Medical University, No. 6, Ankang Avenue, Machang Town, Guian New District, Zunyi, Guizhou Province, China
| | - Jun Liang
- School of Chemical Engineering and Light Industry, Guangdong Industry Polytechnic, Guangzhou, Guangdong, 510300, China
| | - Jie Lang
- Enrollment and Employment Office, Zunyi Medical University, Zunyi, Guizhou, 563099, China
| | - Lijia Zhang
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China
| | - Mingwen Tang
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China
| | - Xinyu Chen
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China
| | - Yan Xie
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China
| | - Jianlin Zhang
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China
| | - Liyu Su
- Department of Hygiene Toxicology, School of Public Health, Zunyi Medical University, Zunyi, Guizhou, 563000, China
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China
| | - Xin Wang
- Key Laboratory of Maternal & Child Health and Exposure Science of Guizhou Higher Education Institutes, Zunyi Medical University, Zunyi, Guizhou, 563000, China.
- Department of Orthopaedic Surgery, Affiliated Hospital of Zunyi Medical University, Zunyi, Guizhou, 563003, China.
- Guizhou Provincial Key Laboratory of Medicinal Biotechnology in Colleges and Universities, Zunyi Medical University, Zunyi, Guizhou, 563000, China.
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Niu Y, Xi H, Liu J, Sui X, Li F, Xu H, Zhao L, Li Y, Zhang S, Guo L. Effects of blended learning on undergraduate nursing students' knowledge, skills, critical thinking ability and mental health: A systematic review and meta-analysis. Nurse Educ Pract 2023; 72:103786. [PMID: 37793247 DOI: 10.1016/j.nepr.2023.103786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 09/03/2023] [Accepted: 09/20/2023] [Indexed: 10/06/2023]
Abstract
AIM This study aimed to evaluate the effects of blended learning on nursing students. The primary outcomes include knowledge and skills, and the secondary outcomes include critical thinking ability, mental health, blended learning design, and nursing students' attitudes toward blended learning. BACKGROUND Blended learning combines the advantages of online learning and traditional face-to-face learning, and makes up for the disadvantages of simple online learning or traditional learning. The effects of blended learning on the knowledge, skills, critical thinking ability, and mental health of nursing students were unknown. DESIGN Systematic review and meta-analysis. METHODS The present systematic review and meta-analysis was applied according to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement. Publications were searched in PubMed, Web of Science, EMBASE, ERIC, CINAHL and the Cochrane's Library before February 2023. Two researchers independently retrieved articles and evaluated quality. The meta-analysis was performed using Stata 12.0 software according to PRISMA guidelines. The risk of bias in the selected studies was evaluated using the Revised Cochrane risk-of-bias tool for randomized trials. Heterogeneity was assessed by I2 and P statistics. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were used as effective indicators. RESULTS A total of 26 studies involving 2823 nursing students were included in the present study. The results showed that blended learning courses were designed based on learning theory. Blended learning was more effective on the knowledge (SMD = 0.73, 95%CI [0.37, 1.09]) and skills (SMD = 0.86, 95% CI [0.35, 1.37]) compared with non-blended learning for nursing students. Critical thinking ability improved significantly through BL (SMD = 2.23, 95% CI [0.85, 3.61]). In addition, blended learning had a positive impact on nursing students' mental health. Nursing students were very satisfied with blended learning. CONCLUSIONS The results of this study indicated that blended learning had a positive impact on nursing students. In the future, the optimal ratio of online to offline learning in blended learning should also be explored.
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Affiliation(s)
- Yirou Niu
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Huihui Xi
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Jinshu Liu
- School of Pharmaceutcal Sciences, Jilin University, No. 1163, Xinmin Street, Chaoyang, Changchun, Jilin, China
| | - Xin Sui
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Feng Li
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Haiyan Xu
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Lijing Zhao
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Yuewei Li
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Shuang Zhang
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China
| | - Lirong Guo
- School of Nursing, Jilin University, No. 965, Xinjiang Street, Chaoyang, Changchun, Jilin, China.
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Sewak A, Yousef M, Deshpande S, Seydel T, Hashemi N. The effectiveness of digital sexual health interventions for young adults: a systematic literature review (2010-2020). Health Promot Int 2023; 38:7033126. [PMID: 36757346 DOI: 10.1093/heapro/daac104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023] Open
Abstract
There has been a proliferation of digital sexual health interventions targeting adolescents; however, limited evaluative reviews have compared the effectiveness of multiple digital tools for sexual health literacy and behaviour change. This study conducted a systematic literature review, screened 9881 records and analysed 61 studies. Findings suggest that websites and mobile phones dominate digital sexual health interventions, with a majority effectively delivering cognitive (e.g. awareness and attitudes about sexual and reproductive health) and behavioural outcomes (e.g. abstinence and use of contraception). The most popular sexual health promotion mechanisms were interactive websites, text messaging and phone calls, and online education programmes, followed by mobile applications-fewer studies in this review utilized social media, games and multimedia. Previous reviews focused on single outcome measures (e.g. sexually transmitted infection testing) to assess interventions' effectiveness. The current review moves beyond single outcome measures to cover a wider range of behavioural and non-behavioural sexual health issues and contexts covered in the literature. Four main categories were analysed as outcomes: cognitive perceptions, promoting sexual health-related behaviours, promoting sexual health-related products and services, and impact (viral load). Seventy-nine per cent of interventions focused on preventive sexual health behaviours and products (e.g. condoms) and services (e.g. HIV testing). Overall, 75% of studies effectively changed sexual health behaviour and cognitive perceptions. However, the digital-only tools did not vary from the blended formats, in influence outcomes, even after categorizing them into behavioural or non-behavioural outcomes. Compared to previous systematic reviews, more studies from the last decade used rigorous research design in the form of randomized controlled trials, non-randomized control trials, and quasi-experiments and lasted longer.
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Affiliation(s)
- Aarti Sewak
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Queensland 4111, Australia
| | - Murooj Yousef
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Queensland 4111, Australia
| | - Sameer Deshpande
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Queensland 4111, Australia
| | - Tori Seydel
- Social Marketing @ Griffith, Department of Marketing, Griffith University, 170 Kessels Road, Nathan, Queensland 4111, Australia
| | - Neda Hashemi
- School of Medicine, Griffith University, Gold Coast Campus, Building G01, Gold Coast, Queensland 4215, Australia
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Ashraf MA, Yang M, Zhang Y, Denden M, Tlili A, Liu J, Huang R, Burgos D. A Systematic Review of Systematic Reviews on Blended Learning: Trends, Gaps and Future Directions. Psychol Res Behav Manag 2021; 14:1525-1541. [PMID: 34629910 PMCID: PMC8493276 DOI: 10.2147/prbm.s331741] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Accepted: 09/18/2021] [Indexed: 11/23/2022] Open
Abstract
Blended Learning (BL) is one of the most used methods in education to promote active learning and enhance students' learning outcomes. Although BL has existed for over a decade, there are still several challenges associated with it. For instance, the teachers' and students' individual differences, such as their behaviors and attitudes, might impact their adoption of BL. These challenges are further exacerbated by the COVID-19 pandemic, as schools and universities had to combine both online and offline courses to keep up with health regulations. This study conducts a systematic review of systematic reviews on BL, based on PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines, to identify BL trends, gaps and future directions. The obtained findings highlight that BL was mostly investigated in higher education and targeted students in the first place. Additionally, most of the BL research is coming from developed countries, calling for cross-collaborations to facilitate BL adoption in developing countries in particular. Furthermore, a lack of ICT skills and infrastructure are the most encountered challenges by teachers, students and institutions. The findings of this study can create a roadmap to facilitate the adoption of BL. The findings of this study could facilitate the design and adoption of BL which is one of the possible solutions to face major health challenges, such as the COVID-19 pandemic.
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Affiliation(s)
- Muhammad Azeem Ashraf
- Research Institute of Education Science, Hunan University, Changsha, People's Republic of China
| | - Meijia Yang
- Research Institute of Education Science, Hunan University, Changsha, People's Republic of China
| | - Yufeng Zhang
- Research Institute of Education Science, Hunan University, Changsha, People's Republic of China
| | - Mouna Denden
- Research Laboratory of Technologies of Information and Communication & Electrical Engineering (LaTICE), Tunis Higher School of Engineering (ENSIT), Tunis, Tunisia
| | - Ahmed Tlili
- Smart Learning Institute, Beijing Normal University, Beijing, People's Republic of China
| | - Jiayi Liu
- School of Professional Studies, Columbia University, New York City, NY, USA
| | - Ronghuai Huang
- Smart Learning Institute, Beijing Normal University, Beijing, People's Republic of China
| | - Daniel Burgos
- Research Institute for Innovation & Technology in Education (UNIR iTED), Universidad Internacional de La Rioja (UNIR), Logroño, 26006, Spain
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Lameiras-Fernández M, Martínez-Román R, Carrera-Fernández MV, Rodríguez-Castro Y. Sex Education in the Spotlight: What Is Working? Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:2555. [PMID: 33806507 PMCID: PMC7967369 DOI: 10.3390/ijerph18052555] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 12/14/2022]
Abstract
Adolescence, a period of physical, social, cognitive and emotional development, represents a target population for sexual health promotion and education when it comes to achieving the 2030 Agenda goals for sustainable and equitable societies. The aim of this study is to provide an overview of what is known about the dissemination and effectiveness of sex education programs and thereby to inform better public policy making in this area. Methodology: We carried out a systematic review based on international scientific literature, in which only peer-reviewed papers were included. To identify reviews, we carried out an electronic search of the Cochrane Database Reviews, ERIC, Web of Science, PubMed, Medline, Scopus and PsycINFO. This paper provides a narrative review of reviews of the literature from 2015 to 2020. Results: 20 reviews met the inclusion criteria (10 in school settings, 9 using digital platforms and 1 blended learning program): they focused mainly on reducing risk behaviors (e.g., VIH/STIs and unwanted pregnancies), whilst obviating themes such as desire and pleasure, which were not included in outcome evaluations. The reviews with the lowest risk of bias are those carried out in school settings and are the ones that most question the effectiveness of sex education programs. Whilst the reviews of digital platforms and blended learning show greater effectiveness in terms of promoting sexual and reproductive health in adolescents (ASRH), they nevertheless also include greater risks of bias. Conclusion: A more rigorous assessment of the effectiveness of sexual education programs is necessary, especially regarding the opportunities offered by new technologies, which may lead to more cost-effective interventions than with in-person programs. Moreover, blended learning programs offer a promising way forward, as they combine the best of face-to-face and digital interventions, and may provide an excellent tool in the new context of the COVID-19 pandemic.
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Affiliation(s)
- María Lameiras-Fernández
- Faculty of Education and Social Work, University of Vigo, 32004 Ourense, Spain; (R.M.-R.); (M.V.C.-F.); (Y.R.-C.)
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Decker MJ, Gutmann-Gonzalez A, Price M, Romero J, Sheoran B, Yarger J. Evaluating the Effectiveness of an Intervention Integrating Technology and In-Person Sexual Health Education for Adolescents (In the Know): Protocol for a Cluster Randomized Controlled Trial. JMIR Res Protoc 2020; 9:e18060. [PMID: 32763885 PMCID: PMC7442936 DOI: 10.2196/18060] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 05/04/2020] [Accepted: 05/12/2020] [Indexed: 11/23/2022] Open
Abstract
Background Access to a smartphone is nearly universal among American adolescents, and most of them have used the internet to seek health information. Integrating digital technologies into health program delivery may expand opportunities for youth to receive important health information, yet there are few rigorous studies assessing the effectiveness of this type of intervention. Objective The purpose of this study is to assess the effectiveness of In the Know (ITK), a program integrating in-person and technology-based sexual health education for underserved adolescents. Methods Youth were engaged in the development of the intervention, including the design of the digital technology and the curriculum content. The intervention focuses on 3 main areas: sexual health and contraceptive use, healthy relationships, and educational and career success. It includes an in-person, classroom component, along with a web-based component to complement and reinforce key content. A cluster randomized controlled trial is in progress among adolescents aged 13-19 years living in Fresno County, California. It is designed to examine the differences in self-reported health and behavioral outcomes among youth in the intervention and control groups at 3 and 9 months. Primary outcomes are condom and contraceptive use or no sex in the past 3 months and use of any clinical health services in the past 3 months. Secondary outcomes include the number of sexual partners in the past 3 months and knowledge of local clinical sexual health services. We will use mixed-effects linear and logistic regression models to assess differences between the intervention and control groups. Results Trial enrollment began in October 2017 and ended in March 2020 with a total of 1260 participants. The mean age of the participants is 15.73 (SD 1.83) years, and 69.98% (867/1239) of the participants report being Hispanic or Latino. Study results will be available in 2021. Conclusions ITK has the potential to improve contraceptive and clinic use among underserved youth. This trial will inform future youth-focused health interventions that are considering incorporating technology. International Registered Report Identifier (IRRID) DERR1-10.2196/18060
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Affiliation(s)
- Martha J Decker
- Department of Epidemiology and Biostatistics, Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States
| | - Abigail Gutmann-Gonzalez
- Philip R Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States
| | - Melisa Price
- Philip R Lee Institute for Health Policy Studies, University of California, San Francisco, San Francisco, CA, United States
| | - Julio Romero
- Fresno Economic Opportunities Commission, Fresno, CA, United States
| | | | - Jennifer Yarger
- Philip R Lee Institute for Health Policy Studies, Bixby Center for Global Reproductive Health, University of California, San Francisco, San Francisco, CA, United States
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