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Fournier V, Varet F. Conspiracy beliefs and intention to use conventional, complementary and alternative medicines: Two vignette studies. Br J Health Psychol 2024; 29:333-350. [PMID: 37880094 DOI: 10.1111/bjhp.12702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 09/08/2023] [Accepted: 10/05/2023] [Indexed: 10/27/2023]
Abstract
OBJECTIVE Conspiracy beliefs (CBs) can have substantial consequences on health behaviours by influencing both conventional and non-conventional medicine uptake. They can target powerful groups (i.e. upward CBs) or powerless groups (i.e. downward CBs). Considering their repercussions in oncology, it appears useful to understand how CBs are related to the intentions to use conventional, complementary and alternative medicines (CAM). DESIGN AND METHODS This paper includes two pre-registered online correlational studies on a general French population (Study 1 N = 248, recruited on social media Mage = 40.07, SDage = 14.78; 205 women, 41 men and 2 non-binaries; Study 2 N = 313, recruited on social media and Prolific, Mage = 28.91, SDage = 9.60; 154 women, 149 men and 10 non-binaries). We investigated the links between generic and chemotherapy-related CBs and intentions to use conventional, complementary and alternative medicines. Study 2 consisted of a conceptual replication of Study 1, considering the orientation of CBs. RESULTS Generic CBs and chemotherapy-related CBs appear strongly and positively correlated, negatively correlated with intentions to take conventional medicine and positively with intentions to take CAM. The link between generic CBs and medication intention is fully mediated by chemotherapy-related CBs. When distinguished, upward CBs are a stronger predictor of chemotherapy-related CBs than downward CBs. CONCLUSIONS The findings suggest that intentions to use medicine are strongly associated with CBs. This has several important implications for further research and practice, notably on the presence and effects of CBs on medication behaviours in cancer patients.
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Affiliation(s)
- Valentyn Fournier
- CNRS, UMR 9193 - SCALab - Sciences Cognitives et Sciences Affectives, Université de Lille, Lille, France
- ULR 4072 - PSITEC - Psychologie: Interactions, Temps, Emotions, Cognition, Université de Lille, Lille, France
| | - Florent Varet
- Anthropo-Lab, ETHICS EA7446, Lille Catholic University, Lille, France
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2
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Rocca CH, Muñoz I, Rao L, Levin S, Tzvieli O, Harper CC. Measuring a Critical Component of Contraceptive Decision Making: The Contraceptive Concerns and Beliefs Scale. Matern Child Health J 2024; 28:847-857. [PMID: 38194129 PMCID: PMC11001673 DOI: 10.1007/s10995-023-03856-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2023] [Indexed: 01/10/2024]
Abstract
INTRODUCTION Concerns about safety and side effects from contraceptives are widespread and related to reluctance to use them. Measuring these concerns is an essential component of understanding contraceptive decision-making and guiding contraceptive and interpregnancy clinical care. METHODS We used qualitative research and item response theory to develop and test a psychometric instrument to measure contraceptive concerns and beliefs. We developed 55 candidate scale items and tested them among 572 adolescents and adults across nine California healthcare facilities in 2019-2020. We derived a 6-item scale and assessed differences by age and social determinants of health with multivariable regression. RESULTS In qualitative data, participants voiced both concerns and positive beliefs about contraception. Quantitative survey respondents were aged 21 years on average, and 24% were parous. Over half (54%) worried contraception has dangerous side effects, and 39% worried it is unnatural. The mean Contraceptive Concerns score, increasing with higher concerns, was 1.85 (SD: 1.00, range 0-4, α = 0.81). Items fit a partial credit item response model and met prespecified criteria for internal structure validity. Contraceptive use declined with increasing Concerns score (adjusted prevalence ratio [aPR] = 0.81 [0.72-0.92]). Scores were elevated among Black (mean: 2.06; aβ = 0.34 [0.09, 0.59]) and Multiracial or other race (2.11; aβ = 0.34 [0.02, 0.66]) respondents vs. White (1.66), but not Latinx respondents (1.81; aβ = 0.11 [- 0.11, 0.33]). Scores were also elevated among participants with lower maternal education (high school/Associate's 1.89 versus college 1.60; aβ = 0.28 [0.04, 0.53]). DISCUSSION The psychometrically robust Concerns instrument can be used in research to measure autonomous contraceptive decision-making and to design person-centered care.
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Affiliation(s)
- Corinne H Rocca
- Advancing Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California, San Francisco, Oakland, CA, USA.
| | - Isabel Muñoz
- Advancing Standards in Reproductive Health (ANSIRH), Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California, San Francisco, Oakland, CA, USA
- Department of Epidemiology and Biostatistics, School of Public Health, University of California, Berkeley, Berkeley, CA, USA
| | - Lavanya Rao
- Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sara Levin
- Division of Public Health, Contra Costa Health, Martinez, CA, USA
| | - Ori Tzvieli
- Division of Public Health, Contra Costa Health, Martinez, CA, USA
| | - Cynthia C Harper
- Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology and Reproductive Sciences, School of Medicine, University of California, San Francisco, San Francisco, CA, USA
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Wang Y, Thier K, Ntiri SO, Quinn SC, Adebamowo C, Nan X. Beliefs in COVID-19 Vaccine Misinformation Among Unvaccinated Black Americans: Prevalence, Socio-Psychological Predictors, and Consequences. HEALTH COMMUNICATION 2024; 39:616-628. [PMID: 36794382 DOI: 10.1080/10410236.2023.2179711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/18/2023]
Abstract
Health-related misinformation is a major threat to public health and particularly worrisome for populations experiencing health disparities. This study sets out to examine the prevalence, socio-psychological predictors, and consequences of beliefs in COVID-19 vaccine misinformation among unvaccinated Black Americans. We conducted an online national survey with Black Americans who had not been vaccinated against COVID-19 (N = 800) between February and March 2021. Results showed that beliefs in COVID-19 vaccine misinformation were prevalent among unvaccinated Black Americans with 13-19% of participants agreeing or strongly agreeing with various false claims about COVID-19 vaccines and 35-55% unsure about the veracity of these claims. Conservative ideology, conspiracy thinking mind-set, religiosity, and racial consciousness in health care settings predicted greater beliefs in COVID-19 vaccine misinformation, which were associated with lower vaccine confidence and acceptance. Theoretical and practical implications of the findings are discussed.
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Affiliation(s)
- Yuan Wang
- Department of Communication, University of Maryland, College Park
| | - Kathryn Thier
- Department of Communication, University of Maryland, College Park
| | - Shana O Ntiri
- Department of Family & Community Medicine, University of Maryland, School of Medicine, Baltimore
| | - Sandra Crouse Quinn
- Department of Family Science, University of Maryland, School of Public Health, College Park
| | - Clement Adebamowo
- Department of Epidemiology and Public Health, University of Maryland, School of Medicine, Baltimore
| | - Xiaoli Nan
- Department of Communication, University of Maryland, College Park
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Ahmed S, McLoughlin Dymond A, Correa M, Willcox ML. Views and experiences of long-acting reversible contraception among ethnic minorities in high-income countries: a systematic review of qualitative studies. BMJ SEXUAL & REPRODUCTIVE HEALTH 2024; 50:53-66. [PMID: 37949640 DOI: 10.1136/bmjsrh-2023-201864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/12/2023] [Accepted: 09/30/2023] [Indexed: 11/12/2023]
Abstract
BackgroundEthnic minorities in high-income countries have higher rates of unintended pregnancies but are less likely to use highly efficacious long-acting reversible contraception (LARC). The reasons for this are unclear. AIM To understand the views and experiences of ethnic minorities within high-income countries about LARC. METHODOLOGY Medline, CINAHL, EMBASE and Sociological Abstracts were searched systematically to find qualitative articles about views on LARC. Titles and abstracts were screened to select qualitative studies about LARC whose participants were mainly from ethnic minorities in high-income countries. Quality assessment was conducted using the Critical Appraisal Skills Programme (CASP) tool. Thematic synthesis was conducted. RESULTS Seventeen studies (19 articles) met the inclusion criteria, 14 of which were from the USA (227 participants identified as Latina, 222 Black, 15 multiracial, 4 Asian). Two studies included 32 Chinese women in the UK and Australia and one included 20 Aboriginal women in Australia. Factors influencing uptake of LARC included side effects, convenience, and perceived efficacy of LARC compared with other methods; women's ideas, concerns and expectations; and external influences (partner, family/friends, health professionals and society). Convenience of LARC, control over reproductive decisions, and desire to prevent pregnancy were the main facilitators. Barriers included specific cultural concerns about irregular bleeding, concerns about racial discrimination, and family/friends having negative views on LARC. CONCLUSIONS Ethnic minority women often have additional needs and concerns about LARC compared with the White majority. Further research is needed to develop and evaluate customised respectful counselling on contraception options for ethnic minority women and their partners.
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Affiliation(s)
- Sumayyah Ahmed
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, UK
| | - Abigail McLoughlin Dymond
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, UK
| | - Michele Correa
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, UK
| | - Merlin L Willcox
- Primary Care Research Centre, School of Primary Care, Population Sciences and Medical Education, University of Southampton Faculty of Medicine, Southampton, UK
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Woolweaver AB, Drescher A, Medina C, Espelage DL. Leveraging Comprehensive Sexuality Education as a Tool for Knowledge, Equity, and Inclusion. THE JOURNAL OF SCHOOL HEALTH 2023; 93:340-348. [PMID: 36404494 DOI: 10.1111/josh.13276] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 09/21/2022] [Accepted: 11/02/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Sexual education programs in the United States are rooted in inequitable structures and are often inadequate at educating marginalized student groups such as students of color, Lesbian, Gay, Bisexual, Transgender, Queer (LGBTQ+), women, and disabled students. CONTRIBUTIONS TO THEORY Current sexual education is irregularly implemented and often excludes or misrepresents the experiences of students with marginalized identities. This theoretical paper specifically discusses ways that sexual education has been harmful or exclusionary for marginalized student groups and how a shift toward making sexual education inclusive and equitable will improve outcomes for students of all identities. IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY This paper discusses several recommendations on improving access to equitable sexual health education for all students including reviewing and improving sexual education curriculum and delivery, as well as the need for additional research focused on this topic. CONCLUSIONS This article provides an overview on the current sexual education system, its inadequacies, and how comprehensive sexuality education programs can be leveraged as a tool for equity for students of all backgrounds, but particularly those who are underrepresented in sexual education curricula.
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Affiliation(s)
- Ashley B Woolweaver
- School of Education, University of North Carolina at Chapel Hill, 100 East Cameron Avenue, Chapel Hill, NC 7514-3916, USA
| | - Anne Drescher
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Courtney Medina
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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Douglas KM, Sutton RM. What Are Conspiracy Theories? A Definitional Approach to Their Correlates, Consequences, and Communication. Annu Rev Psychol 2023; 74:271-298. [PMID: 36170672 DOI: 10.1146/annurev-psych-032420-031329] [Citation(s) in RCA: 12] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Conspiracy theories are abundant in social and political discourse, with serious consequences for individuals, groups, and societies. However, psychological scientists have started paying close attention to them only in the past 20 years. We review the spectacular progress that has since been made and some of the limitations of research so far, and we consider the prospects for further progress. To this end, we take a step back to analyze the defining features that make conspiracy theories different in kind from other beliefs and different in degree from each other. We consider how these features determine the adoption, consequences, and transmission of belief in conspiracy theories, even though their role as causal or moderating variables has seldom been examined. We therefore advocate for a research agenda in the study of conspiracy theories that starts-as is routine in fields such as virology and toxicology-with a robust descriptive analysis of the ontology of the entity at its center.
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Affiliation(s)
- Karen M Douglas
- School of Psychology, University of Kent, Canterbury, United Kingdom; ,
| | - Robbie M Sutton
- School of Psychology, University of Kent, Canterbury, United Kingdom; ,
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Wilkinson TA, Hawryluk B, Moore C, Peipert JF, Carroll AE, Wiehe S, Fortenberry JD. A human-centered designed outreach strategy for a youth contraception navigator program. PEC INNOVATION 2022; 1:100093. [PMID: 36540664 PMCID: PMC9762731 DOI: 10.1016/j.pecinn.2022.100093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 10/17/2022] [Accepted: 10/17/2022] [Indexed: 06/17/2023]
Abstract
OBJECTIVE To identify key elements of an outreach strategy for a youth contraception navigator program designed to help young people overcome barriers to contraception access. METHODS A human-centered design approach was used to engage adolescents aged 15-17 in co-design sessions. Human-centered design techniques, such as affinity diagramming and model building were used to inform key elements of the communication model and the final outreach strategy messages. RESULTS Messages focused on the individual, normalizing talking about birth control, acknowledging the challenges to obtaining birth control, explaining how the navigator program works resonate with young people. Having images of diverse participants, offering information about birth control, and showing images of reputable sources will enhance trust. CONCLUSIONS A name (IN Control) and key elements of an outreach strategy were determined for the navigator program. It is important to work with key stakeholders and co-design the optimal strategy and messages to assure that the intended audience is reached, and the desired behavior change is achieved. INNOVATION Human-centered design techniques can be used to provide insight into programmatic outreach strategies for a contraception navigator program to increase their impact and ultimate success.
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Affiliation(s)
- Tracey A. Wilkinson
- Indiana University School of Medicine, Department of Pediatrics/Children's Health Services Research, 410 West 10 Street, HS 2000, Indianapolis, IN 46202, United States of America
| | - Bridget Hawryluk
- Indiana Clinical Translational Institute, Research Jam, 410 West 10 Street, HS 2000, Indianapolis, IN 46202, United States of America
| | - Courtney Moore
- Indiana Clinical Translational Institute, Research Jam, 410 West 10 Street, HS 2000, Indianapolis, IN 46202, United States of America
| | - Jeffrey F. Peipert
- Indiana University School of Medicine, Department of Obstetrics and Gynecology, UH 2440, Indianapolis, IN 46202, United States of America
| | - Aaron E. Carroll
- Indiana University School of Medicine, Department of Pediatrics/Center for Pediatric and Adolescent Comparative and Effective Research, 410 West 10 Street, HS 2000A, Indianapolis, IN 46202, United States of America
| | - Sarah Wiehe
- Indiana University School of Medicine, Department of Pediatrics/Children's Health Services Research, 410 West 10 Street, HS 2000, Indianapolis, IN 46202, United States of America
- Indiana Clinical Translational Institute, Research Jam, 410 West 10 Street, HS 2000, Indianapolis, IN 46202, United States of America
| | - J. Dennis Fortenberry
- Indiana University School of Medicine, Department of Pediatrics, Division of Adolescent Medicine, 410 West 10 Street, HS 1000, Indianapolis, IN 46202, United States of America
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8
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Callegari LS, Benson SK, Mahorter SS, Nelson KM, Arterburn DE, Hamilton AB, Taylor L, Hunter-Merrill R, Gawron LM, Dehlendorf C, Borrero S. Evaluating the MyPath web-based reproductive decision support tool in VA primary care: Protocol for a pragmatic cluster randomized trial. Contemp Clin Trials 2022; 122:106940. [PMID: 36179982 DOI: 10.1016/j.cct.2022.106940] [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: 04/13/2022] [Revised: 09/22/2022] [Accepted: 09/23/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Counseling to identify and support individuals' desires for family formation is a key component of preventive health care that is often absent in primary care visits. This study evaluates a novel, web-based, person-centered intervention to increase the frequency and quality of communication about reproductive goals and healthcare needs in Veterans Health Administration (VA) primary care. METHODS We describe a hybrid type 1 effectiveness-implementation cluster randomized controlled trial in seven VA healthcare systems testing a web-based reproductive health decision support tool (MyPath). VA primary care providers are enrolled and randomized to intervention or usual care arms. Veterans scheduled to see intervention-arm providers receive a text message inviting them to use MyPath ahead of their appointment; Veterans scheduled to see control-arm providers receive usual care. Target enrollment is 36 providers and 456 Veterans. Outcomes are assessed by Veteran self-report after the visit and at 3- and 6-months follow-up. The primary outcome is occurrence of reproductive health discussions involving shared decision making; secondary outcomes include measures of communication, knowledge, decision conflict, contraceptive utilization, and receipt of services related to prepregnancy health. Data on implementation barriers, facilitators and cost are collected. RESULTS The trial is ongoing with no results to report. We have enrolled 36 primary care providers across 7 VA healthcare systems and recruitment of Veterans is ongoing. CONCLUSIONS Results will inform efforts to increase the quality and person-centeredness of reproductive healthcare delivery in primary care and to operationalize and scale up use of digital decision support tools in clinical settings. TRIAL REGISTRATION http://ClinicalTrials.gov Identifier: NCT04584294 Trial Status: Recruiting.
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Affiliation(s)
- Lisa S Callegari
- Health Services Research and Development, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle, USA; Department of Obstetrics & Gynecology, University of Washington School of Medicine, Seattle, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, USA.
| | - Samantha K Benson
- Health Services Research and Development, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle, USA
| | - Siobhan S Mahorter
- Health Services Research and Development, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle, USA
| | - Karin M Nelson
- Health Services Research and Development, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle, USA; Department of Health Systems and Population Health, University of Washington School of Public Health, Seattle, USA; Department of Medicine, University of Washington School of Medicine, Seattle, USA
| | - David E Arterburn
- Kaiser Permanente Washington Health Research Institute, Seattle, USA
| | - Alison B Hamilton
- Health Services Research and Development, VA Greater Los Angeles Healthcare System, Los Angeles, USA; Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, USA
| | - Leslie Taylor
- Health Services Research and Development, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle, USA
| | - Rachel Hunter-Merrill
- Health Services Research and Development, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle, USA
| | - Lori M Gawron
- Health Services Research and Development, VA Salt Lake City Health Care System, Salt Lake City, USA; Department of Obstetrics & Gynecology, University of Utah School of Medicine, Salt Lake City, USA
| | - Christine Dehlendorf
- Department of Family and Community Medicine, University of California San Francisco School of Medicine, San Francisco, USA
| | - Sonya Borrero
- Center for Health Equity, Research, and Promotion, VA Pittsburgh Health Care System, Pittsburgh, USA; Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, USA
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Paltrow LM, Harris LH, Marshall MF. Beyond Abortion: The Consequences of Overturning Roe. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:3-15. [PMID: 35652910 DOI: 10.1080/15265161.2022.2075965] [Citation(s) in RCA: 46] [Impact Index Per Article: 23.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The upcoming U.S. Supreme Court decision in Dobbs v. Jackson Women's Health Organization has the potential to eliminate or severely restrict access to legal abortion care in the United States. We address the impact that the decision could have on abortion access and its consequences beyond abortion care. We posit that an abortion ban would, in effect, mean that anyone who becomes pregnant, including those who continue a pregnancy and give birth to healthy newborns and those with pregnancy complications or adverse pregnancy outcomes will become newly vulnerable to legal surveillance, civil detentions, forced interventions, and criminal prosecution. The harms imposed by banning or severely restricting abortion access will disproportionately affect persons of color and perpetuate structural racism. We caution that focusing on Roe as a decision that only protects ending a pregnancy ignores the protection that the decision also affords people who want to continue their pregnancies. It overlooks the ways in which overturning Roe will curtail fundamental rights for all those who become pregnant and will undermine their status as full persons meriting Constitutional protections. Such a singular focus inevitably obscures the common ground that people across the ideological spectrum might inhabit to ensure the safety, health, humanity, and rights of all people who experience pregnancy.
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10
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Watson K. The Ethics of Access: Reframing the Need for Abortion Care as a Health Disparity. THE AMERICAN JOURNAL OF BIOETHICS : AJOB 2022; 22:22-30. [PMID: 35621314 DOI: 10.1080/15265161.2022.2075976] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The majority of U.S. abortion patients are poor women, and Black and Hispanic women. Therefore, this article encourages bioethicists and equity advocates to consider whether the need for abortion care should be considered a health disparity, and if yes, whether framing it this way would increase the ability of poor women and women of color to get the medical care they need. In order to engage with these critical questions, bioethicists must avoid abortion exceptionalism and respect patients as moral agents. Centering the conscience of pregnant people shifts our analysis away from the ethics of the act of abortion, and toward the ethics of access to abortion care. Because the Supreme Court is on the brink of shifting the question of abortion's legality to state legislatures, this is the moment for all bioethicists to clarify and strengthen their thinking, writing, and teaching in abortion ethics.
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11
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Yates L, Birken S, Thompson TA, Stuart GS, Greene S, Hassmiller Lich K, Weinberger M. A qualitative analysis of Medicaid beneficiaries perceptions of prenatal and immediate postpartum contraception counseling. WOMEN'S HEALTH 2022. [PMCID: PMC9486062 DOI: 10.1177/17455057221124079] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objectives: In the United States, about four out of every ten births are financed by
Medicaid, making it a program that is key in addressing racial disparities
in maternal health. Many women covered by Medicaid have access to prenatal
and immediate postpartum contraception counseling that can aid them in their
postpartum contraception decision-making. However, existing inequities
within Medicaid and a history of reproductive harms targeting Black women
and women with low incomes may contribute to women with Medicaid having
different experiences of contraception counseling. This qualitative study
explores how Black women and White women insured by Medicaid perceive
prenatal and immediate postpartum contraception counseling and identifies
additional factors that shape their contraception decision-making. Methods: We conducted semi-structured interviews with 15 Medicaid beneficiaries who
delivered at a public teaching hospital in North Carolina. Interviews
focused on women’s beliefs about planning for pregnancy, experiences with
prenatal and immediate postpartum contraception counseling, and perceived
need for postpartum contraception. We used a priori and emergent codes to
analyze interviews. Results: Seven Black women and eight White women completed interviews 14–60 days
postpartum. All women reported receiving prenatal and immediate postpartum
counseling. Several women described receiving prenatal counseling,
reflective of patient-centered contraception counseling, that helped in
their postpartum contraception decision-making; one woman described
receiving immediate postpartum counseling that helped in her
decision-making. Some Black women reported receiving unsupportive/coercive
contraception counseling. In addition to contraception counseling, past
reproductive health experiences and future pregnancy intentions were salient
to women’s contraception decision-making. Conclusions: Prenatal and immediate postpartum contraception counseling can help some
Medicaid beneficiaries with their postpartum contraception decision, but
past reproductive health experiences and future pregnancy intentions are
also relevant. Counseling that does not consider these experiences may be
harmful, particularly to Black women, further contributing to racial
disparities in maternal postpartum health outcomes.
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Affiliation(s)
- Lindsey Yates
- Department of Maternal and Child Health, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sarah Birken
- Department of Implementation Science, Bowman Gray Center for Medical Education, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Gretchen S Stuart
- Department of Obstetrics and Gynecology, UNC School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Sandra Greene
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Kristen Hassmiller Lich
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Morris Weinberger
- Department of Health Policy and Management, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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12
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Oben AG, Walker ZW, Blanchard CT, Szychowski JM, Maier JG, Rajapreyar I, Cribbs MG, Tita A, Sinkey RG. Racial disparities in reliable contraceptive use in women with heart disease. EUR J CONTRACEP REPR 2021; 27:174-179. [PMID: 34870553 DOI: 10.1080/13625187.2021.2010042] [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: 10/19/2022]
Abstract
OBJECTIVE The aim of the study was to investigate the differences in reliable contraceptive use between black women and white women with maternal cardiac disease. METHODS The study comprised a retrospective cohort of women with maternal cardiac disease managed by the University of Alabama at Birmingham (UAB) Comprehensive Pregnancy and Heart Program (CPHP). Women were included if they had attended one or more prenatal visits at the UAB CPHP and delivered at the UAB hospital between March 2015 and June 2019. The primary outcome was reliable contraceptive use within 2 months postpartum, defined by receipt of long-acting reversible contraception (i.e., an intrauterine contraceptive device or an etonogestrel implant) or female sterilisation. All outcomes were compared based on self-reported race. RESULTS One hundred and forty-nine women met the inclusion criteria. Black women (n = 63) were more likely than white women (n = 86) to use reliable contraception (65% vs 43%; p = 0.008). Black women were less likely than white women to be undecided or decline contraception at the time of admission (13% vs 27%; p = 0.037). There was no difference in reliable contraceptive use between black women (n = 20, 63%) and white women (n = 23, 72%) with modified World Health Organisation (WHO) class III/IV lesions (p = 0.42). CONCLUSION Black women with maternal cardiac disease were more likely than white women to receive reliable contraception. Interventions to prevent unintended pregnancy in women with maternal cardiac disease should focus on improving reliable contraceptive use, especially for women with modified WHO class III/IV lesions.
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Affiliation(s)
- Ayamo G Oben
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Zachary W Walker
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Christina T Blanchard
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Jeff M Szychowski
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Julia G Maier
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Indranee Rajapreyar
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Marc G Cribbs
- Division of Cardiovascular Disease, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Alan Tita
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Rachel G Sinkey
- Center for Women's Reproductive Health, University of Alabama at Birmingham, Birmingham, AL, USA.,Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL, USA
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13
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Shushtari ZJ, Salimi Y, Ahmadi S, Rajabi-Gilan N, Shirazikhah M, Biglarian A, Almasi A, Gharehghani MAM. Social determinants of adherence to COVID-19 preventive guidelines: a comprehensive review. Osong Public Health Res Perspect 2021; 12:346-360. [PMID: 34965686 PMCID: PMC8721272 DOI: 10.24171/j.phrp.2021.0180] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 10/13/2021] [Accepted: 11/16/2021] [Indexed: 12/21/2022] Open
Abstract
Adherence to coronavirus disease 2019 (COVID-19) preventive guidelines (ACPG) is an important strategy to control the COVID-19 pandemic effectively. The present study aimed to identify and summarize the social determinants of ACPG among the general population. A comprehensive review was performed from December 2019 to February 2021 through searching electronic databases. Two independent reviewers assessed and selected relevant studies. Next, the characteristics and main findings of the included studies were summarized. Finally, the World Health Organization's conceptual framework of social determinants of health was used to synthesize the identified social determinants of ACPG. Forty-one of 453 retrieved articles met the inclusion criteria. The study results showed different patterns of ACPG among various communities. Furthermore, 84 social determinants were identified and categorized into structural and intermediary determinants. ACPG is a set of complex behaviors associated with different individual sociodemographic and behavioral characteristics; living and working conditions; COVID-19 knowledge, attitudes, and risk perceptions; exposure to sources and information level; leisure activities; social support; trust; social norms; psychosocial well-being; socio-economic position; and the socio-economic and political context. Interventions to promote ACPG among the general population should consider the identified social determinants of ACPG.
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Affiliation(s)
- Zahra Jorjoran Shushtari
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Yahya Salimi
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Sina Ahmadi
- Social Development & Health Promotion Research Center, Health Institute, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Nader Rajabi-Gilan
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Marzieh Shirazikhah
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Akbar Biglarian
- Social Determinants of Health Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ali Almasi
- Department of Social Welfare Management, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
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14
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Who Believes in Conspiracy Theories about the COVID-19 Pandemic in Romania? An Analysis of Conspiracy Theories Believers’ Profiles. SOCIETIES 2021. [DOI: 10.3390/soc11040138] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
The current COVID-19 pandemic has been accompanied by the circulation of an unprecedented amount of “polluted” information, especially in the social media environment, among which are false narratives and conspiracy theories about both the pandemic and vaccination against COVID-19. The effects of such questionable information primarily concern the lack of compliance with restrictive measures and a negative attitude towards vaccination campaigns, as well as more complex social effects, such as street protests or distrust in governments and authorities in general. Even though there is a lot of scholarly attention given to these narratives in many countries, research about the profile of people who are more prone to believe or spread them is rather scarce. In this context, we investigate the role of age, compared with other socio-demographic factors (such as education and religiosity), as well as the role of the media (the frequency of news consumption, the perceived usefulness of social media, and the perceived incidence of fake information about the virus in the media) and the critical thinking disposition of people who tend to believe such misleading narratives. To address these issues, we conducted a national survey (N = 945) in April 2021 in Romania. Using a hierarchical OLS regression model, we found that people who perceive higher incidence of fake news (ß = 0.33, p < 0.001), find social media platforms more useful (ß = 0.13, p < 0.001), have lower education (ß = −0.17, p < 0.001), and have higher levels of religiosity (ß = 0.08, p < 0.05) are more prone to believe COVID-19-related misleading narratives. At the same time, the frequency of news consumption (regardless of the type of media), critical thinking disposition, and age do not play a significant role in the profile of the believer in conspiracy theories about the COVID-19 pandemic. Somewhat surprisingly, age does not play a role in predicting belief in conspiracy theories, even though there are studies that suggest that older people are more prone to believe conspiracy narratives. As far as media is concerned, the frequency of news media consumption does not significantly differ for believers and non-believers. We discuss these results within the context of the COVID-19 pandemic.
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15
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Callegari LS, Nelson KM, Arterburn DE, Dehlendorf C, Magnusson SL, Benson SK, Schwarz EB, Borrero S. Development and Pilot Testing of a Patient-Centered Web-Based Reproductive Decision Support Tool for Primary Care. J Gen Intern Med 2021; 36:2989-2999. [PMID: 33538956 PMCID: PMC8481447 DOI: 10.1007/s11606-020-06506-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 12/17/2020] [Indexed: 11/26/2022]
Abstract
BACKGROUND Patient-centered counseling to help women achieve their reproductive goals is an essential yet often absent component of primary care. OBJECTIVE We developed and piloted MyPath, a novel web-based decision support tool integrating reproductive goals assessment, information about optimizing health before pregnancy, and contraceptive decision support, for use prior to primary care visits in the Veterans Administration (VA). DESIGN We created MyPath using best practices for decision tool development, including a conceptual framework informed by theory and user-centered design with input from patients, providers, and scientific experts. We conducted a non-randomized pilot in two VA Women's Health primary care clinics. A control group (n = 28) was recruited prior to and intervention group (n = 30) recruited after introduction of MyPath into clinics. PARTICIPANTS Women Veterans ages 18-44 with an upcoming visit scheduled with one of eight providers. INTERVENTIONS After recruitment of controls, providers and staff received a brief introduction to MyPath. Patients scheduled to see providers in the intervention phase used MyPath on an iPad in the waiting room prior to their visit. MAIN MEASURES Acceptability, feasibility, discussions about pregnancy and/or contraceptive needs, and contraceptive decision quality by a survey of participants and providers. KEY RESULTS Nearly all participants who used MyPath reported they learned new information (97%) and would recommend it to other Veterans (93%). No providers reported that MyPath significantly increased workload. A greater proportion of intervention participants reported having discussions about reproductive needs in their visit compared to controls (93% vs 68%; p = 0.02). Intervention participants also experienced greater increases in pre-/post-visit knowledge and communication self-efficacy and a trend towards greater reduction in contraceptive decision conflict compared to controls. CONCLUSIONS MyPath was highly acceptable to women, increased the proportion of primary care visits addressing reproductive needs, and improved decision quality without increasing providers' perceived workload. A larger randomized evaluation of effectiveness is warranted.
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Affiliation(s)
- Lisa S Callegari
- Health Services Research and Development, Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA, USA.
- Department of Obstetrics & Gynecology, University of Washington School of Medicine, Seattle, WA, USA.
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA.
| | - Karin M Nelson
- Health Services Research and Development, Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA, USA
- Department of Health Services, University of Washington School of Public Health, Seattle, WA, USA
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - David E Arterburn
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
| | - Christine Dehlendorf
- Department of Family Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - Sara L Magnusson
- Health Services Research and Development, Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA, USA
| | - Samantha K Benson
- Health Services Research and Development, Seattle-Denver Center of Innovation for Veteran-Centered and Value-Driven Care, Department of Veterans Affairs (VA) Puget Sound Health Care System, Seattle, WA, USA
| | - E Bimla Schwarz
- Department of Medicine, University of California, Davis, Davis, CA, USA
| | - Sonya Borrero
- Center for Health Equity, Research, and Promotion, VA Pittsburgh Health Care System, Pittsburgh, PA, USA
- Department of Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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16
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Masten M, Vega S, Hailemariam M, Kagotho N, Key K, Jefferson B, Muhammad J, Summers M, Spencer B, Sadler S, Robinson D, Richie F, Miller R, McCoy JW, Greer D, Johnson JE. The Flint women's study: community perspectives on contraception and family planning, sexuality education and barriers to reproductive health. CULTURE, HEALTH & SEXUALITY 2021; 23:961-975. [PMID: 32484423 DOI: 10.1080/13691058.2020.1746401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2019] [Accepted: 03/19/2020] [Indexed: 06/11/2023]
Abstract
Teenage pregnancy can have adverse social and health outcomes, and rates are high in Flint, Michigan as compared to the rest of the state and the USA. It is important to understand contributing factors to adolescent pregnancy to be able to better address this issue. This study examined qualitative data from interviews with 100 community members who participated in the Flint Women's Study, a study designed to better understand the hopes, dreams and needs of women in Flint, and their suggestions for how to address identified needs. Using a Community Based Participatory Approach, data were collected and analysed by a team of community members and academic researchers. The paper focuses on the theme of family planning among young women which included attitudes about contraception, sexuality education and bio-medical and structural barriers to accessing reproductive health. Community members emphasised the need for increased access to comprehensive contraception options, improved sexuality education in schools and from health care providers, and ultimately valuing young women.
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Affiliation(s)
- Megan Masten
- College of Human Medicine, Michigan State University, Flint, MI, USA
- Department of Obstetrics and Gynecology, University of Colorado, Aurora, CO, USA
| | - Shayna Vega
- College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Maji Hailemariam
- College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Njeri Kagotho
- College of Social Work, Ohio State University, Columbus, OH, USA
| | - Kent Key
- College of Human Medicine, Michigan State University, Flint, MI, USA
- Flint Community, Flint, MI, USA
| | | | | | - Monicia Summers
- College of Human Medicine, Michigan State University, Flint, MI, USA
- Flint Community, Flint, MI, USA
| | | | | | | | - Fallon Richie
- College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Raven Miller
- College of Human Medicine, Michigan State University, Flint, MI, USA
| | - Jonne White McCoy
- College of Human Medicine, Michigan State University, Flint, MI, USA
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17
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Allington D, Duffy B, Wessely S, Dhavan N, Rubin J. Health-protective behaviour, social media usage and conspiracy belief during the COVID-19 public health emergency. Psychol Med 2021; 51:1763-1769. [PMID: 32513320 PMCID: PMC7298098 DOI: 10.1017/s003329172000224x] [Citation(s) in RCA: 329] [Impact Index Per Article: 109.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 06/05/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND Social media platforms have long been recognised as major disseminators of health misinformation. Many previous studies have found a negative association between health-protective behaviours and belief in the specific form of misinformation popularly known as 'conspiracy theory'. Concerns have arisen regarding the spread of COVID-19 conspiracy theories on social media. METHODS Three questionnaire surveys of social media use, conspiracy beliefs and health-protective behaviours with regard to COVID-19 among UK residents were carried out online, one using a self-selecting sample (N = 949) and two using stratified random samples from a recruited panel (N = 2250, N = 2254). RESULTS All three studies found a negative relationship between COVID-19 conspiracy beliefs and COVID-19 health-protective behaviours, and a positive relationship between COVID-19 conspiracy beliefs and use of social media as a source of information about COVID-19. Studies 2 and 3 also found a negative relationship between COVID-19 health-protective behaviours and use of social media as a source of information, and Study 3 found a positive relationship between health-protective behaviours and use of broadcast media as a source of information. CONCLUSIONS When used as an information source, unregulated social media may present a health risk that is partly but not wholly reducible to their role as disseminators of health-related conspiracy beliefs.
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Affiliation(s)
- Daniel Allington
- King's College London, Digital Humanities, Strand, London, WC2R 2LS, UK
| | - Bobby Duffy
- King's College London, Digital Humanities, Strand, London, WC2R 2LS, UK
| | - Simon Wessely
- King's College London, Digital Humanities, Strand, London, WC2R 2LS, UK
| | - Nayana Dhavan
- King's College London, Digital Humanities, Strand, London, WC2R 2LS, UK
| | - James Rubin
- King's College London, Digital Humanities, Strand, London, WC2R 2LS, UK
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18
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D'Angelo AB, Davis Ewart LN, Koken J, Bimbi D, Brown JT, Grov C. Barriers and Facilitators to Pre-exposure Prophylaxis Uptake Among Black Women: A Qualitative Analysis Guided by a Socioecological Model. J Assoc Nurses AIDS Care 2021; 32:481-494. [PMID: 34171885 DOI: 10.1097/jnc.0000000000000241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Black women experience disparities in HIV incidence. Pre-exposure prophylaxis (PrEP) is a once-daily pill that can prevent HIV transmission. To enhance PrEP uptake among Black women, it is essential to examine their perceptions of PrEP. In 2018, 33 Black women in New York City completed interviews about their attitudes, knowledge, and perceived barriers and facilitators to PrEP use. Emergent themes were organized using a socioecological model. Participants identified barriers at the sociocultural level, including stigma, medical mistrust, and health care avoidance. At the community level, health care access issues and limited community knowledge were reported. Partner-level barriers included trust in partners and meaning attributed to PrEP use within the context of monogamy. Individual-level barriers included low perceived risk and concerns about PrEP's safety and efficacy. Our findings can inform future PrEP research with Black women, as well as PrEP implementation efforts aimed at increasing uptake among this population.
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Affiliation(s)
- Alexa B D'Angelo
- Alexa B. D'Angelo, MPH, is a Project Coordinator and PhD Student, CUNY Institute for Implementation Science in Population Health, Graduate School of Public Health and Health Policy, New York, New York, USA. Leah N. Davis Ewart, MPH, CHES, is a PhD Student, Department of Public Health Sciences, Miller School of Medicine, University of Miami, Miami, Florida, USA. Juline Koken, PhD, is an Associate Professor, Department of Health Sciences, LaGuardia Community College of CUNY, Long Island City, New York, USA. David Bimbi, PhD, is a Professor, Department of Health Sciences, LaGuardia Community College of CUNY, Long Island City, New York, USA. Justin T. Brown, PhD, MPH, is an Assistant Professor and Executive Director, Department of Health Sciences, The Center for LGBTQ Studies (CLAGS), LaGuardia Community College of CUNY, Long Island City, New York, USA. Christian Grov, PhD, MPH, is a Professor, Department of Community Health and Social Sciences, CUNY Graduate School of Public Health and Health Policy, New York, New York, USA
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19
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Oleksy T, Wnuk A, Gambin M, Łyś A. Dynamic relationships between different types of conspiracy theories about COVID-19 and protective behaviour: A four-wave panel study in Poland. Soc Sci Med 2021; 280:114028. [PMID: 34023709 DOI: 10.1016/j.socscimed.2021.114028] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/08/2021] [Accepted: 05/08/2021] [Indexed: 10/21/2022]
Abstract
RATIONALE Conspiracy theories about COVID-19 pose a serious threat to public health by providing false information and undermining official health recommendations. However, existing studies rarely employed longitudinal designs, precluding the determination of the directionality between endorsement of conspiracy theories and its societal consequences. Also, relatively little research examined whether the association between protective health behaviour and the endorsement of conspiracy theories is affected by the content of a given theory. METHODS A four-wave longitudinal panel survey on the association between belief in a wide range of conspiracy theories about COVID-19 and protective behaviour was carried out on a representative sample of Polish citizens (T1 = 1130, T2 = 971, T3 = 818, T4 = 688). Analyses were performed using Random Intercept Cross-Lagged Panel Models. RESULTS The results showed a reciprocal, bidirectional association between conspiracy mentality and protective behaviour. The same effect was also observed between protective behaviour and threat of authoritarianism. We did not find evidence that specific COVID-19 related conspiracy theories directly (and differently) predict within-person changes in protective behaviour over time. CONCLUSIONS Our results showed that the association between various conspiracy-related variables and anti-pandemic COVID-19 variables differs at within- and between-person levels. Changes in the adherence to pro-health measures were negatively predicted by conspiracy mentality and a feeling of threat that the solutions introduced by the government may limit civil rights. Specific conspiracy beliefs were significantly related to protective behaviour only at the between-person level.
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Affiliation(s)
- Tomasz Oleksy
- Faculty of Psychology, University of Warsaw, ul. Stawki 5/7, 00-183, Warsaw, Poland.
| | - Anna Wnuk
- The Robert B. Zajonc Institute for Social Studies, University of Warsaw, ul. Stawki 5/7, 00-183, Warsaw, Poland
| | - Małgorzata Gambin
- Faculty of Psychology, University of Warsaw, ul. Stawki 5/7, 00-183, Warsaw, Poland
| | - Agnieszka Łyś
- Faculty of Psychology, University of Warsaw, ul. Stawki 5/7, 00-183, Warsaw, Poland
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20
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Abstract
In recent years, there has been an increasing interest in the consequences of conspiracy theories and the COVID-19 pandemic raised this interest to another level. In this article, I will outline what we know about the consequences of conspiracy theories for individuals, groups, and society, arguing that they are certainly not harmless. In particular, research suggests that conspiracy theories are associated with political apathy, support for non-normative political action, climate denial, vaccine refusal, prejudice, crime, violence, disengagement in the workplace, and reluctance to adhere to COVID-19 recommendations. In this article, I will also discuss the challenges of dealing with the negative consequences of conspiracy theories, which present some opportunities for future research.
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21
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Hornik R, Kikut A, Jesch E, Woko C, Siegel L, Kim K. Association of COVID-19 Misinformation with Face Mask Wearing and Social Distancing in a Nationally Representative US Sample. HEALTH COMMUNICATION 2021; 36:6-14. [PMID: 33225745 DOI: 10.1080/10410236.2020.1847437] [Citation(s) in RCA: 94] [Impact Index Per Article: 31.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Wide-spread misinformation about the COVID-19 pandemic has presented challenges for communicating public health recommendations. Should campaigns to promote protective behaviors focus on debunking misinformation or targeting behavior-specific beliefs? To address this question, we examine whether belief in COVID-19 misinformation is directly associated with two behaviors (face mask wearing and social distancing), and whether behavior-specific beliefs can account for this association and better predict behavior, consistent with behavior-change theory. We conducted a nationally representative two-wave survey of U.S. adults from 5/26/20-6/12/20 (n = 1074) and 7/15/20-7/21//20 (n = 889; follow-up response 83%). Scales were developed and validated for COVID-19 related misinformation beliefs, social distancing and face mask wearing, and beliefs about the consequences of both behaviors. Cross-lagged panel linear regression models assessed relationships among the variables. While belief in misinformation was negatively associated with both face mask wearing (B = -.27, SE =.06) and social-distancing behaviors (B = -.46, SE =.08) measured at the same time, misinformation did not predict concurrent or lagged behavior when the behavior-specific beliefs were incorporated in the models. Beliefs about behavioral outcomes accounted for face mask wearing and social distancing, both cross-sectionally (B =.43, SE =.05; B =.63, SE =.09) and lagged over time (B =.20, SE = 04; B =.30, SE =.08). In conclusion, belief in COVID-19-related misinformation is less relevant to protective behaviors, but beliefs about the consequences of these behaviors are important predictors. With regard to misinformation, we recommend health campaigns aimed at promoting protective behaviors emphasize the benefits of these behaviors, rather than debunking unrelated false claims.
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Affiliation(s)
- Robert Hornik
- Annenberg School for Communication, University of Pennsylvania
| | - Ava Kikut
- Annenberg School for Communication, University of Pennsylvania
| | - Emma Jesch
- Annenberg School for Communication, University of Pennsylvania
| | - Chioma Woko
- Annenberg School for Communication, University of Pennsylvania
| | - Leeann Siegel
- Annenberg School for Communication, University of Pennsylvania
| | - Kwanho Kim
- Annenberg School for Communication, University of Pennsylvania
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22
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Fuerst MF, George KE, Moore JE. Long-Acting Reversible Contraception in Medicaid: Where Do We Go From Here? Womens Health Issues 2020; 31:310-313. [PMID: 33376044 DOI: 10.1016/j.whi.2020.11.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Revised: 11/18/2020] [Accepted: 11/25/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Megan F Fuerst
- Institute for Medicaid Innovation, Washington, District of Columbia.
| | - Karen E George
- Institute for Medicaid Innovation, Washington, District of Columbia
| | - Jennifer E Moore
- Institute for Medicaid Innovation, Washington, District of Columbia
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23
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Teovanović P, Lukić P, Zupan Z, Lazić A, Ninković M, Žeželj I. Irrational beliefs differentially predict adherence to guidelines and pseudoscientific practices during the COVID-19 pandemic. APPLIED COGNITIVE PSYCHOLOGY 2020; 35:486-496. [PMID: 33362344 PMCID: PMC7753549 DOI: 10.1002/acp.3770] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Revised: 11/13/2020] [Accepted: 11/21/2020] [Indexed: 11/10/2022]
Abstract
In the coronavirus "infodemic," people are exposed to official recommendations but also to potentially dangerous pseudoscientific advice claimed to protect against COVID-19. We examined whether irrational beliefs predict adherence to COVID-19 guidelines as well as susceptibility to such misinformation. Irrational beliefs were indexed by belief in COVID-19 conspiracy theories, COVID-19 knowledge overestimation, type I error cognitive biases, and cognitive intuition. Participants (N = 407) reported (1) how often they followed guidelines (e.g., handwashing, physical distancing), (2) how often they engaged in pseudoscientific practices (e.g., consuming garlic, colloidal silver), and (3) their intention to receive a COVID-19 vaccine. Conspiratorial beliefs predicted all three outcomes in line with our expectations. Cognitive intuition and knowledge overestimation predicted lesser adherence to guidelines, while cognitive biases predicted greater adherence, but also greater use of pseudoscientific practices. Our results suggest an important relation between irrational beliefs and health behaviors, with conspiracy theories being the most detrimental.
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Affiliation(s)
- Predrag Teovanović
- Faculty for Special Education and Rehabilitation University of Belgrade Belgrade Serbia.,Laboratory for Research of Individual Differences, Department of Psychology, Faculty of Philosophy University of Belgrade Belgrade Serbia
| | - Petar Lukić
- Laboratory for Research of Individual Differences, Department of Psychology, Faculty of Philosophy University of Belgrade Belgrade Serbia
| | - Zorana Zupan
- Laboratory for Research of Individual Differences, Department of Psychology, Faculty of Philosophy University of Belgrade Belgrade Serbia.,Institute of Psychology, Faculty of Philosophy University of Belgrade Belgrade Serbia
| | - Aleksandra Lazić
- Laboratory for Research of Individual Differences, Department of Psychology, Faculty of Philosophy University of Belgrade Belgrade Serbia
| | - Milica Ninković
- Laboratory for Research of Individual Differences, Department of Psychology, Faculty of Philosophy University of Belgrade Belgrade Serbia
| | - Iris Žeželj
- Laboratory for Research of Individual Differences, Department of Psychology, Faculty of Philosophy University of Belgrade Belgrade Serbia.,Institute of Psychology, Faculty of Philosophy University of Belgrade Belgrade Serbia
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24
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Zimmerman RK, South-Paul JE, Poland GA. Rationing of Civilian Coronavirus Disease 2019 Vaccines While Supplies Are Limited. J Infect Dis 2020; 222:1776-1779. [PMID: 32894861 PMCID: PMC7499655 DOI: 10.1093/infdis/jiaa569] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2020] [Accepted: 09/02/2020] [Indexed: 11/14/2022] Open
Affiliation(s)
- Richard K Zimmerman
- Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA.,Department of Behavioral and Community Health Sciences, Graduate School of Public Health, Pittsburgh, Pennsylvania, USA
| | - Jeannette E South-Paul
- Department of Family Medicine, University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania, USA
| | - Gregory A Poland
- Mayo Vaccine Research Group, Mayo Clinic, Rochester, Minnesota, USA
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25
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Andrade G. Medical conspiracy theories: cognitive science and implications for ethics. MEDICINE, HEALTH CARE, AND PHILOSOPHY 2020; 23:505-518. [PMID: 32301040 PMCID: PMC7161434 DOI: 10.1007/s11019-020-09951-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Although recent trends in politics and media make it appear that conspiracy theories are on the rise, in fact they have always been present, probably because they are sustained by natural dispositions of the human brain. This is also the case with medical conspiracy theories. This article reviews some of the most notorious health-related conspiracy theories. It then approaches the reasons why people believe these theories, using concepts from cognitive science. On the basis of that knowledge, the article makes normative proposals for public health officials and health workers as a whole, to deal with conspiracy theories, in order to preserve some of the fundamental principles of medical ethics.
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26
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Julian Z, Robles D, Whetstone S, Perritt JB, Jackson AV, Hardeman RR, Scott KA. Community-informed models of perinatal and reproductive health services provision: A justice-centered paradigm toward equity among Black birthing communities. Semin Perinatol 2020; 44:151267. [PMID: 32684310 DOI: 10.1016/j.semperi.2020.151267] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Perinatal health outcomes in the United States continue to worsen, with the greatest burden of inequity falling on Black birthing communities. Despite transdisciplinary literature citing structural racism as a root cause of inequity, interventions continue to be mostly physician-centered models of perinatal and reproductive healthcare (PRH). These models prioritize individual, biomedical risk identification and stratification as solutions to achieving equity, without adequately addressing the social and structural determinants of health. The objective of this review is to: (1) examine the association between the impact of structural and obstetric racism and patient-centered access to PRH, (2) define and apply reproductive justice (RJ) as a framework to combat structural and obstetric racism in PRH, and (3) describe and demonstrate how to use an RJ lens to critically analyze physician-led and community-informed PRH models. We conclude with recommendations for building a PRH workforce whose capacity is aligned with racial equity. Institutional alignment with a RJ praxis creates opportunities for advancing PRH workforce diversification and development and improving PRH experiences and outcomes for our patients, communities, and workforce.
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Affiliation(s)
- Zoë Julian
- Department of Obstetrics and Gynecology and Department of Medicine, University of Alabama at Birmingham School of Medicine, Birmingham, AL.
| | - Diana Robles
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco School of Medicine, San Francisco, CA
| | - Sara Whetstone
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco School of Medicine, San Francisco, CA
| | - Jamila B Perritt
- Independent Reproductive Health and Family Planning Specialist, Washington, DC, United States
| | - Andrea V Jackson
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco School of Medicine, San Francisco, CA
| | - Rachel R Hardeman
- Division of Health Policy and Management, University of Minnesota School of Public Health, Minneapolis, MN
| | - Karen A Scott
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco School of Medicine, San Francisco, CA
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Racial Disparities in Reproductive Healthcare among Parous and Nulliparous Women in Mississippi. J Racial Ethn Health Disparities 2020; 8:304-314. [PMID: 32495305 DOI: 10.1007/s40615-020-00783-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 05/16/2020] [Accepted: 05/22/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Long-standing racial disparities exist in reproductive healthcare and have been associated with negative health outcomes among minority women. This study aimed to analyze the racial disparities in reproductive healthcare among Mississippi women, particularly as it related to contraception access, usage, setting, provider type, and payer. METHODS A two-stage stratified probability design was employed - 95 of the 1500 licensed childcare facilities across the state were randomly selected, and then two to three classrooms were randomly selected within each facility. The children were the means to obtaining a weighted sample of parous women of childbearing age (15-44). Once a parous woman completed the study, she could invite a nulliparous friend of similar age, race, and socioeconomic background to also participate in the study. RESULTS Racial disparities were found in the reproductive healthcare of both the parous and nulliparous groups. Overall, black women were less likely to receive services from an obstetrics and gynecology. Parous and nulliparous black women were more likely to receive their reproductive healthcare at the health department and less likely to use the most effective methods of contraception. CONCLUSION Low use of the most effective methods of contraception, despite high levels of general contraceptive use and high insurance coverage, hints at additional barriers to full access for black women in Mississippi. More equitable access to effective family planning counseling and contraception can have meaningful impact on the lives of black women in our state.
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Gomez AM, Arteaga S, Aronson N, Goodkind M, Houston L, West E. No Perfect Method: Exploring How Past Contraceptive Methods Influence Current Attitudes Toward Intrauterine Devices. ARCHIVES OF SEXUAL BEHAVIOR 2020; 49:1367-1378. [PMID: 31429033 DOI: 10.1007/s10508-019-1424-7] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/02/2018] [Revised: 02/06/2019] [Accepted: 02/09/2019] [Indexed: 05/22/2023]
Abstract
Little research on contraceptive decision-making takes a holistic perspective to understand women's contraceptive journeys throughout the reproductive life course. This analysis investigated how Black and Latina women's past experiences with contraceptive use and acquisition impact their feelings and attitudes toward future use of intrauterine devices (IUDs). We utilized data from in-depth interviews that explored contraceptive decision-making and knowledge of, interest in, and attitudes toward IUDs among 38 young Black and Latina women collected in 2013 in the San Francisco Bay Area. Here, we focused on the IUD decision-making process among a subsample of 32 women who were not using or had not previously used an IUD. Overall, we found a strong link between past contraceptive experiences and attitudes regarding future use of IUDs. Notably, participants often referenced experiences of side effects with previous methods when explaining their interest-or lack thereof-in IUD use, as well as made links between contraceptive attributes they had experienced positively and attributes of the IUD. A minority of participants described being satisfied with their current method, resulting in a lack of interest in considering IUD use. More than half of participants described distrust, either in healthcare providers owing to previous negative interactions and contraceptive failures of provider-recommended methods or owing to family members' and friends' negative experiences with IUDs. This distrust undergirded their lack of interest in the IUD. These findings highlight the importance of locating contraceptive decision-making in the broader context of reproductive journeys.
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Affiliation(s)
- Anu Manchikanti Gomez
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, 110 Haviland Hall MC 7400, Berkeley, CA, 94720-7400, USA.
| | - Stephanie Arteaga
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, 110 Haviland Hall MC 7400, Berkeley, CA, 94720-7400, USA
| | - Natasha Aronson
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, 110 Haviland Hall MC 7400, Berkeley, CA, 94720-7400, USA
| | - Molly Goodkind
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, 110 Haviland Hall MC 7400, Berkeley, CA, 94720-7400, USA
| | - Livia Houston
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, 110 Haviland Hall MC 7400, Berkeley, CA, 94720-7400, USA
| | - Erica West
- Sexual Health and Reproductive Equity Program, School of Social Welfare, University of California, Berkeley, 110 Haviland Hall MC 7400, Berkeley, CA, 94720-7400, USA
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29
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Blackwell S, Louis JM, Norton ME, Lappen JR, Pettker CM, Kaimal A, Landy U, Edelman A, Teal S, Landis R. Reproductive services for women at high risk for maternal mortality: a report of the workshop of the Society for Maternal-Fetal Medicine, the American College of Obstetricians and Gynecologists, the Fellowship in Family Planning, and the Society of Family Planning. Am J Obstet Gynecol 2020; 222:B2-B18. [PMID: 32252942 DOI: 10.1016/j.ajog.2019.12.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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30
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Rosenthal L, Lobel M. Gendered racism and the sexual and reproductive health of Black and Latina Women. ETHNICITY & HEALTH 2020; 25:367-392. [PMID: 29447448 DOI: 10.1080/13557858.2018.1439896] [Citation(s) in RCA: 82] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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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31
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Nguyen BT, Violette C, Li HZ, Jensen JT. Expectations for Sex without Birth Control among Young Men: Risk Factors from the USA National Survey of Reproductive and Contraceptive Knowledge. World J Mens Health 2019; 38:573-581. [PMID: 31749339 PMCID: PMC7502322 DOI: 10.5534/wjmh.190098] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 09/16/2019] [Accepted: 09/30/2019] [Indexed: 11/15/2022] Open
Abstract
Purpose Male partner engagement in family planning can influence women's contraceptive behaviors and risk of unintended pregnancy. We identified factors associated with self-reported expectations for future contraceptive use among a nationally-representative sample of young men. Materials and Methods The National Survey of Reproductive and Contraceptive Knowledge asked unmarried, sexually active men (ages, 18–29 y), who were neither involved in nor trying for a pregnancy, about their likelihood of having sex without contraception in the following three months. Demographics, social factors, and contraceptive awareness and attitudes were examined for potential associations using weighted analyses. Results Of 903 men surveyed, nearly 600 were sexually active and expected to have sex in the following 3 months; nearly half (43%) reported at least some likelihood (23% slightly, 7% very, 13% extreme likely) that they would have sex without any contraception. Factors independently associated with sex without contraception included: not completing high school, not being in school full-time, not receiving sex education, limited awareness of contraceptive methods, multiple sexual partners, and friends with unintended pregnancies. Conclusions Despite not wanting a pregnancy, many young men report they will have sex without contraception. While comprehensive sex education may increase contraceptive use, interpersonal and social factors also influence men's expected use of contraception.
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Affiliation(s)
- Brian T Nguyen
- Section of Family Planning, Department of Obstetrics and Gynecology, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.,Department of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland, OR, USA.
| | | | - Hong Z Li
- Department of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland, OR, USA
| | - Jeffrey T Jensen
- Department of Obstetrics and Gynecology, Oregon Health & Sciences University, Portland, OR, USA
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32
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Ataullahjan A, Mumtaz Z, Vallianatos H. Family planning in Pakistan: A site of resistance. Soc Sci Med 2019; 230:158-165. [PMID: 31015107 DOI: 10.1016/j.socscimed.2019.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 10/27/2022]
Abstract
As the population of Pakistan has increased beyond 200 million, it is evident that the country's family planning program has been unable to sufficiently expand contraceptive use. To understand the obstacles, researchers have tended to focus on service delivery failures, 'cultural' barriers and varying political support. However, a small body of literature documents citizen's suspicions of an ulterior motive underlying Pakistan's family planning program. Often dismissed as unfounded conspiracies, a gap in our knowledge is the role these beliefs might be playing in the failure of the program. Using a critical ethnographic approach, we conduced 242 observations of daily life, 109 informal and 197 in-depth interviews with 41 women and 35 men living in a village in Khyber Pakhtunkhwa. Data were collected between September 2013 and April 2015 and analysed using latent content analysis. Our respondents viewed Western support for family planning as confirmation of their suspicions of the program's hidden agenda. Western military intervention in the region complicated their beliefs about the potential altruistic nature of foreign support for the family planning program. Awareness of rampant corruption among Pakistani government officials had fractured their trust in the state while contributing to the notion that the government was complicit with foreign interference. These considerations coupled with the fact that the priorities of Pakistani Family Planning program did not align with the reality of their lives contributed to the skepticism of family planning. For our respondents, resisting family planning and its ideology was a means to resist the perceived violence inflicted by the West and the complicity of the Pakistani government. These findings signal how geopolitics influence the use of family planning services. By demonstrating the importance of embedding perceptions of family planning programs in their local and global contexts, these findings suggest potential areas for future research in the field.
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Affiliation(s)
| | - Zubia Mumtaz
- School of Public Health, University of Alberta, Canada.
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33
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Hawks RM, McGinn AP, Bernstein PS, Tobin JN. Exploring Preconception Care: Insurance Status, Race/Ethnicity, and Health in the Pre-pregnancy Period. Matern Child Health J 2019; 22:1103-1110. [PMID: 29464549 DOI: 10.1007/s10995-018-2494-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Objective To measure the association of preconception health insurance status with preconception health among women in New York City, and examine whether this association is modified by race/ethnicity. Methods Using data from the New York City Pregnancy Risk Assessment Monitoring System 2009-2011 (n = 3929), we created a "Preconception Health Score" (PHS) capturing modifiable behaviors, healthcare services utilization, pregnancy intention, and timely entry into prenatal care. We then built multivariable logistic regression models to measure the association of PHS with health insurance status and race/ethnicity. Results We found PHS to be higher among women with private insurance (7.3 ± 0.07) or public insurance (6.3 ± 0.08) before pregnancy than no insurance (5.9 ± 0.09) (p < .001). However, when stratified by race/ethnicity, the positive association of PHS with insurance was absent in the non-white population. Conclusions for Practice Having health insurance during the pre-pregnancy period is associated with greater health among white women, but not among black or Hispanic women in NYC.
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Affiliation(s)
- Rebecca Mahn Hawks
- Department of Obstetrics & Gynecology, NYU Langone Medical Center, 550 First Ave, New York, NY, 10016, USA.
| | - Aileen P McGinn
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, USA
| | - Peter S Bernstein
- Department of Obstetrics & Gynecology and Women's Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, USA
| | - Jonathan N Tobin
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, USA.,Center for Clinical and Translational Science, The Rockefeller University, New York, USA
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34
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van Prooijen J, Douglas KM. Belief in conspiracy theories: Basic principles of an emerging research domain. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2018; 48:897-908. [PMID: 30555188 PMCID: PMC6282974 DOI: 10.1002/ejsp.2530] [Citation(s) in RCA: 118] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 07/31/2018] [Indexed: 11/14/2022]
Abstract
In this introduction to the EJSP Special Issue on conspiracy theories as a social psychological phenomenon, we describe how this emerging research domain has developed over the past decade and distill four basic principles that characterize belief in conspiracy theories. Specifically, conspiracy theories are consequential as they have a real impact on people's health, relationships, and safety; they are universal in that belief in them is widespread across times, cultures, and social settings; they are emotional given that negative emotions and not rational deliberations cause conspiracy beliefs; and they are social as conspiracy beliefs are closely associated with psychological motivations underlying intergroup conflict. We then discuss future research and possible policy interventions in this growing area of enquiry.
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Affiliation(s)
- Jan‐Willem van Prooijen
- VU AmsterdamAmsterdamThe Netherlands
- The Netherlands Institute for the Study of Crime and Law Enforcement (NSCR)AmsterdamThe Netherlands
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35
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Prather C, Fuller TR, Jeffries WL, Marshall KJ, Howell AV, Belyue-Umole A, King W. Racism, African American Women, and Their Sexual and Reproductive Health: A Review of Historical and Contemporary Evidence and Implications for Health Equity. Health Equity 2018; 2:249-259. [PMID: 30283874 PMCID: PMC6167003 DOI: 10.1089/heq.2017.0045] [Citation(s) in RCA: 179] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023] Open
Abstract
Background: The sexual and reproductive health of African American women has been compromised due to multiple experiences of racism, including discriminatory healthcare practices from slavery through the post-Civil Rights era. However, studies rarely consider how the historical underpinnings of racism negatively influence the present-day health outcomes of African American women. Although some improvements to ensure equitable healthcare have been made, these historical influences provide an unexplored context for illuminating present-day epidemiology of sexual and reproductive health disparities among African American women. Methods: To account for the unique healthcare experiences influenced by racism, including healthcare provision, we searched online databases for peer-reviewed sources and books published in English only. We explored the link between historical and current experiences of racism and sexual and reproductive health outcomes. Results: The legacy of medical experimentation and inadequate healthcare coupled with social determinants has exacerbated African American women's complex relationship with healthcare systems. The social determinants of health associated with institutionalized and interpersonal racism, including poverty, unemployment, and residential segregation, may make African American women more vulnerable to disparate sexual and reproductive health outcomes. Conclusions: The development of innovative models and strategies to improve the health of African American women may be informed by an understanding of the historical and enduring legacy of racism in the United States. Addressing sexual and reproductive health through a historical lens and ensuring the implementation of culturally appropriate programs, research, and treatment efforts will likely move public health toward achieving health equity. Furthermore, it is necessary to develop interventions that address the intersection of the social determinants of health that contribute to sexual and reproductive health inequities.
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Affiliation(s)
- Cynthia Prather
- Division of HIV/AIDS Prevention, National Center for HIV, 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
| | - William L. Jeffries
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, 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
| | - A. Vyann Howell
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Angela Belyue-Umole
- Division of HIV/AIDS Prevention, National Center for HIV, Hepatitis, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Winifred King
- Division of Global HIV and TB, Center for Global Health, Centers for Disease Control and Prevention, Atlanta, Georgia
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36
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van Prooijen JW, van Vugt M. Conspiracy Theories: Evolved Functions and Psychological Mechanisms. PERSPECTIVES ON PSYCHOLOGICAL SCIENCE 2018; 13:770-788. [PMID: 30231213 PMCID: PMC6238178 DOI: 10.1177/1745691618774270] [Citation(s) in RCA: 120] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Belief in conspiracy theories—such as that the 9/11 terrorist attacks were an inside job or that the pharmaceutical industry deliberately spreads diseases—is a widespread and culturally universal phenomenon. Why do so many people around the globe believe conspiracy theories, and why are they so influential? Previous research focused on the proximate mechanisms underlying conspiracy beliefs but ignored the distal, evolutionary origins and functions. We review evidence pertaining to two competing evolutionary hypotheses: (a) conspiracy beliefs are a by-product of a suite of psychological mechanisms (e.g., pattern recognition, agency detection, threat management, alliance detection) that evolved for different reasons, or (b) conspiracy beliefs are part of an evolved psychological mechanism specifically aimed at detecting dangerous coalitions. This latter perspective assumes that conspiracy theories are activated after specific coalition cues, which produce functional counterstrategies to cope with suspected conspiracies. Insights from social, cultural and evolutionary psychology provide tentative support for six propositions that follow from the adaptation hypothesis. We propose that people possess a functionally integrated mental system to detect conspiracies that in all likelihood has been shaped in an ancestral human environment in which hostile coalitions—that is, conspiracies that truly existed—were a frequent cause of misery, death, and reproductive loss.
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Affiliation(s)
- Jan-Willem van Prooijen
- 1 Department of Experimental and Applied Psychology, VU Amsterdam.,2 The Netherlands Institute for the Study of Crime and Law Enforcement (NSCR)
| | - Mark van Vugt
- 1 Department of Experimental and Applied Psychology, VU Amsterdam.,3 Department of Politics and International Relations, University of Oxford
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37
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van Prooijen JW, Staman J, Krouwel AP. Increased conspiracy beliefs among ethnic and Muslim minorities. APPLIED COGNITIVE PSYCHOLOGY 2018. [DOI: 10.1002/acp.3442] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Jan-Willem van Prooijen
- Department of Experimental and Applied Psychology; VU Amsterdam; Amsterdam The Netherlands
- The Netherlands Institute for the Study of Crime and Law Enforcement (NSCR); Amsterdam The Netherlands
| | - Jaap Staman
- Department of Communication Science; VU Amsterdam; Amsterdam The Netherlands
| | - André P.M. Krouwel
- Department of Communication Science; VU Amsterdam; Amsterdam The Netherlands
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38
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Upadhyay UD, Johns NE, Cartwright AF, Franklin TE. Sociodemographic Characteristics of Women Able to Obtain Medication Abortion Before and After Ohio's Law Requiring Use of the Food and Drug Administration Protocol. Health Equity 2018; 2:122-130. [PMID: 30283858 PMCID: PMC6071907 DOI: 10.1089/heq.2018.0002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Purpose: In 2011, a law went into effect in Ohio that regulates how abortion care providers can offer medication abortion to their patients. We sought to evaluate changes in sociodemographic characteristics of Ohio medication abortion patients before and after the implementation of this law. Methods: We used a retrospective cohort design, comparing characteristics of women obtaining a medication abortion at four abortion facilities before and after the law. We used chart data from January 2010 to January 2011 and February 2011 to October 2014. For any significant changes in sociodemographics found before and after the law, we used stratified cross-tabulations to disentangle whether they were likely related to the restricted gestational limit imposed by the law (lowered from 9 to 7 weeks gestation), or whether they were likely related to other burdens brought on by the law, such as increased costs and visits. Results: Women obtaining a medication abortion after the law were more likely to be older (p=0.01), have higher levels of education (p<0.001), be of white race (p<0.001), have private insurance (p=0.001), have no children (p=0.002), and reside in a higher income zip code (p=0.03). Both the reduced gestational limit and the increased costs and visits likely contributed to declines among black women and women with lower levels of education. The reduced gestational limit for medication abortion likely contributed to a decline among younger women and Medicaid recipient groups. The increased costs and visits imposed by the law likely contributed to the decline in medication abortion among women with no insurance and women with children. Conclusion: The lower gestational limit, higher cost, and time and travel burdens exacted by Ohio's medication abortion law were associated with disproportionate reductions in medication abortion among the most disadvantaged groups. The law was associated with reduced access among women who were younger, of black race, less educated, and in lower socioeconomic groups.
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Affiliation(s)
- Ushma D. Upadhyay
- Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Oakland, California
| | - Nicole E. Johns
- Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Oakland, California
| | - Alice F. Cartwright
- Advancing New Standards in Reproductive Health (ANSIRH), Bixby Center for Global Reproductive Health, Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California, San Francisco, Oakland, California
| | - Tanya E. Franklin
- Department of Obstetrics, Gynecology, and Women's Health, University of Louisville School of Medicine, Louisville, Kentucky
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van der Wal RC, Sutton RM, Lange J, Braga JPN. Suspicious binds: Conspiracy thinking and tenuous perceptions of causal connections between co-occurring and spuriously correlated events. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2018; 48:970-989. [PMID: 30555189 PMCID: PMC6282862 DOI: 10.1002/ejsp.2507] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2017] [Accepted: 05/07/2018] [Indexed: 11/27/2022]
Abstract
Previous research indicates that conspiracy thinking is informed by the psychological imposition of order and meaning on the environment, including the perception of causal relations between random events. Four studies indicate that conspiracy belief is driven by readiness to draw implausible causal connections even when events are not random, but instead conform to an objective pattern. Study 1 (N = 195) showed that conspiracy belief was related to the causal interpretation of real‐life, spurious correlations (e.g., between chocolate consumption and Nobel prizes). In Study 2 (N = 216), this effect held adjusting for correlates including magical and non‐analytical thinking. Study 3 (N = 214) showed that preference for conspiracy explanations was associated with the perception that a focal event (e.g., the death of a journalist) was causally connected to similar, recent events. Study 4 (N = 211) showed that conspiracy explanations for human tragedies were favored when they comprised part of a cluster of similar events (vs. occurring in isolation); crucially, they were independently increased by a manipulation of causal perception. We discuss the implications of these findings for previous, mixed findings in the literature and for the relation between conspiracy thinking and other cognitive processes.
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Affiliation(s)
| | | | - Jens Lange
- University of Amsterdam Amsterdam The Netherlands
| | - João P N Braga
- Católica Lisbon School of Business and Economics UCP Lisbon Portugal
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40
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Akinola M, Hebert LE, Hill BJ, Quinn M, Holl JL, Whitaker AK, Gilliam ML. Development of a Mobile App on Contraceptive Options for Young African American and Latina Women. HEALTH EDUCATION & BEHAVIOR 2018; 46:89-96. [PMID: 29896969 DOI: 10.1177/1090198118775476] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Young African American and Latina women aged 15 to 24 are more likely to adopt short-acting forms of contraception over long-acting reversible contraception. Mobile applications and other forms of digital media may be useful for providing adolescents with information about sexual and reproductive health both inside and outside of the health care setting. The miPlan app was designed in accordance with principles of user experience design, and its content was informed by the theory of planned behavior and the transtheoretical model of behavior change. A university-based design team engaged young African American and Latina women to inform app development and provide input on app design, conducting multiple rounds of usability testing. Researchers then evaluated the acceptability of the miPlan app in family planning clinics among African American and Latina women aged 15 to 24. Participants rated the app highly acceptable, finding it both easy to use and highly informative. We demonstrate that mobile applications designed in conjunction with user populations may be effective at providing health information due to users' ability to identify with them and their accessibility.
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Kramer RD, Higgins JA, Godecker AL, Ehrenthal DB. Racial and ethnic differences in patterns of long-acting reversible contraceptive use in the United States, 2011-2015. Contraception 2018; 97:399-404. [PMID: 29355492 PMCID: PMC5965256 DOI: 10.1016/j.contraception.2018.01.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 01/10/2018] [Accepted: 01/11/2018] [Indexed: 10/18/2022]
Abstract
OBJECTIVE To investigate whether demographic, socioeconomic, and reproductive health characteristics affect long-acting reversible contraceptive (LARC) use differently by race-ethnicity. Results may inform the dialogue on racial pressure and bias in LARC promotion. STUDY DESIGN Data derived from the 2011-2013 and 2013-2015 National Surveys of Family Growth (NSFG). Our study sample included 9321 women aged 15-44. Logistic regression analyses predicted current LARC use (yes vs. no). We tested interaction terms between race-ethnicity (non-Hispanic White, non-Hispanic Black, Hispanic) and covariates (for example, education, parity, poverty level) to explore whether their effects on LARC use vary by race-ethnicity. RESULTS In the race-interactions model, data did not show that low income and education predict LARC use more strongly among Black and Hispanic women than among White women. There was just one statistically significant race-interaction: experience of unintended pregnancy (p=.014). Among Whites and Hispanics, women who reported ever experiencing an unintended pregnancy had a higher predicted probability of LARC use than those who did not. On the other hand, among Black women, the experience of unintended pregnancy was not associated with a higher predicted probability of LARC use. CONCLUSIONS With the exception of the experience of unintended pregnancy, findings from this large, nationally representative sample of women suggest similar patterns in LARC use by race-ethnicity. IMPLICATIONS Results from this analysis of NSFG data do not provide evidence that observed differences in LARC use by race-ethnicity represent socioeconomic disparities, and may assuage some concerns about reproductive coercion among women of color. Nevertheless, it is absolutely critical that providers use patient-centered approaches for contraceptive counseling that promote women's autonomy in their reproductive health care decision-making.
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Affiliation(s)
- Renee D Kramer
- Department of Population Health, School of Medicine and Public Health, University of Wisconsin-Madison, WARF Office Building Room 675, 610 Walnut Street, Madison, WI 53726, USA.
| | - Jenny A Higgins
- Department of Gender and Women's Studies, University of Wisconsin-Madison, Sterling Hall Room 3309, 475 North Charter Street, Madison, WI 53706, USA.
| | - Amy L Godecker
- Population Health Institute, School of Medicine and Public Health, University of Wisconsin-Madison, WARF Office Building Room 656, 610 Walnut Street, Madison, WI 53726, USA.
| | - Deborah B Ehrenthal
- Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, WARF Office Building Room 658, 610 Walnut St., Madison, WI 53726, USA.
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Jackson AV, Wang LF, Morse J. Racial and ethnic differences in contraception use and obstetric outcomes: A review. Semin Perinatol 2017; 41:273-277. [PMID: 28651792 DOI: 10.1053/j.semperi.2017.04.003] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In the United States, racial and ethnic minority women experience higher rates of contraceptive non-use, failure, unintended pregnancy, and lower use of long-acting reversible contraception (LARC), compared to whites. Simultaneously researchers have found that unintended pregnancy is associated with poor pregnancy outcomes and pregnancy behaviors, including pre-term birth and late initiation of prenatal care, respectively. Due to the association of pregnancy intention and obstetrical outcomes, public health efforts have focused on the increase in contraception use among these populations as a way to decrease poor pregnancy outcomes. In this review, we present the current literature on unintended pregnancy and contraception use by racial and ethnic minorities in the United States and the association of pregnancy intention and obstetrical outcomes and place these associations within the social and historical context in which these patients live and make their reproductive choices.
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Affiliation(s)
- Andrea V Jackson
- Department of Obstetrics, Gynecology, and Reproductive Sciences, University of California San Francisco, 2356 Sutter St, San Francisco, CA 94115.
| | - Lin-Fan Wang
- Department of Family and Community Medicine, Thomas Jefferson University Hospitals, Mazzoni Center, Philadelphia, PA
| | - Jessica Morse
- Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, NC
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Callegari LS, Zhao X, Schwarz EB, Rosenfeld E, Mor MK, Borrero S. Racial/ethnic differences in contraceptive preferences, beliefs, and self-efficacy among women veterans. Am J Obstet Gynecol 2017; 216:504.e1-504.e10. [PMID: 28063910 DOI: 10.1016/j.ajog.2016.12.178] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Revised: 12/01/2016] [Accepted: 12/29/2016] [Indexed: 11/26/2022]
Abstract
BACKGROUND Significant racial/ethnic disparities in unintended pregnancy persist in the United States, with the highest rates observed among low-income black and Hispanic women. Differences in contraceptive preferences, beliefs, and self-efficacy may be instrumental in understanding contraceptive behaviors that underlie higher rates of unintended pregnancy among racial/ethnic minorities. OBJECTIVES Our objective was to understand how contraceptive preferences, beliefs, and self-efficacy vary by race and ethnicity among women veterans. STUDY DESIGN We analyzed data from the Examining Contraceptive Use and Unmet Need Study, a national telephone survey of women veterans aged 18-44 years who had received primary care at the Veterans Administration in the prior 12 months. Participants rated the importance of various contraceptive characteristics and described their level of agreement with contraceptive beliefs using Likert scales. Contraceptive self-efficacy was assessed by asking participants to rate their certainty that they could use contraception consistently and as indicated over time using a Likert scale. Multivariable logistic regression was used to examine associations between race/ethnicity and contraceptive attitudes, controlling for age, marital status, education, income, religion, parity, deployment history, and history of medical and mental health conditions. RESULTS Among the 2302 women veterans who completed a survey, 52% were non-Hispanic white, 29% were non-Hispanic black, and 12% were Hispanic. In adjusted analyses, compared with whites, blacks had lower odds of considering contraceptive effectiveness extremely important (adjusted odds ratio; 0.55, 95% confidence interval, 0.40-0.74) and higher odds of considering the categories of does not contain any hormones and prevents sexually transmitted infections extremely important (adjusted odds ratio, 1.94, 95% confidence interval, 1.56-2.41, and adjusted odds ratio; 1.99, 95% confidence interval, 1.57-2.51, respectively). Hispanics also had higher odds than whites of considering the category of does not contain any hormones and prevents sexually transmitted infections extremely important (adjusted odds ratio, 1.72, 95% confidence interval, 1.29-2.28, and adjusted odds ratio, 1.63; 95% confidence interval, 1.21-2.19, respectively). Compared with whites, blacks and Hispanics had higher odds of expressing fatalistic beliefs about pregnancy (adjusted odds ratio, 1.79, 95% confidence interval, 1.35-2.39, and adjusted odds ratio, 1.48, 95% confidence interval, 1.01-2.17, respectively); higher odds of viewing contraception as primarily a woman's responsibility (adjusted odds ratio, 1.92, 95% confidence interval, 1.45-2.55, and adjusted odds ratio, 1.77; 95% confidence interval, 1.23-2.54, respectively); and lower odds of being very sure that they could use a contraceptive method as indicated over the course of a year (adjusted odds ratio, 0.73, 95% confidence interval, 0.54-0.98, and adjusted odds ratio, 0.66, 95% confidence interval, 0.46-0.96, respectively). CONCLUSION Women veterans' contraceptive preferences, beliefs, and self-efficacy varied by race/ethnicity, which may help explain observed racial/ethnic disparities in contraceptive use and unintended pregnancy. These differences underscore the need to elicit women's individual values and preferences when providing patient-centered contraceptive counseling.
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Kusunoki Y, Barber JS, Ela EJ, Bucek A. Black-White Differences in Sex and Contraceptive Use Among Young Women. Demography 2016; 53:1399-1428. [PMID: 27624320 PMCID: PMC5050155 DOI: 10.1007/s13524-016-0507-5] [Citation(s) in RCA: 35] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
This study examines black-white and other sociodemographic differences in young women's sexual and contraceptive behaviors, using new longitudinal data from a weekly journal-based study of 1,003 18- to 19-year-old women spanning 2.5 years. We investigate hypotheses about dynamic processes in these behaviors during early adulthood in order to shed light on persisting racial differences in rates of unintended pregnancies in the United States. We find that net of other sociodemographic characteristics and adolescent experiences with sex and pregnancy, black women spent less time in relationships and had sex less frequently in their relationships than white women, but did not differ in the number of relationships they formed or in their frequency or consistency of contraceptive use within relationships. Black women were more likely to use less effective methods for pregnancy prevention (e.g., condoms) than white women, who tended to use more effective methods (e.g., oral contraceptives). And although the most effective method for pregnancy prevention-long-acting reversible contraception (LARC)-was used more often by black women than white women, LARC use was low in both groups. In addition, black women did not differ from white women in their number of discontinuations or different methods used and had fewer contraceptive method switches. Further, we find that net of race and adolescent experiences with sex and pregnancy, women from more-disadvantaged backgrounds had fewer and longer (and thus potentially more serious) relationships, used contraception less frequently (but not less consistently), and used less effective methods (condoms) than women from more-advantaged backgrounds.
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Affiliation(s)
- Yasamin Kusunoki
- Department of Systems, Populations and Leadership, School of Nursing, University of Michigan, 400 North Ingalls Street, Room 4156, Ann Arbor, MI, 48109, USA.
- Population Studies Center, Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48104, USA.
| | - Jennifer S Barber
- Population Studies Center, Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48104, USA
- Department of Sociology, University of Michigan, 500 S. State Street, Ann Arbor, MI, 48109, USA
| | - Elizabeth J Ela
- Population Studies Center, Institute for Social Research, University of Michigan, 426 Thompson St, Ann Arbor, MI, 48104, USA
- Department of Sociology, University of Michigan, 500 S. State Street, Ann Arbor, MI, 48109, USA
| | - Amelia Bucek
- HIV Center for Clinical and Behavioral Studies, New York State Psychiatric Institute and Columbia University, 1051 Riverside Drive, Unit 15, New York, NY, 10032, USA
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Mental Health Service Use Among Young Adults: A Communication Framework for Program Development. ADMINISTRATION AND POLICY IN MENTAL HEALTH AND MENTAL HEALTH SERVICES RESEARCH 2016; 45:62-80. [DOI: 10.1007/s10488-016-0765-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
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Manze MG, McCloskey L, Bokhour BG, Paasche-Orlow MK, Parker VA. The perceived role of clinicians in pregnancy prevention among young Black women. SEXUAL & REPRODUCTIVE HEALTHCARE 2016; 8:19-24. [PMID: 27179373 DOI: 10.1016/j.srhc.2016.01.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2015] [Revised: 12/14/2015] [Accepted: 01/31/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The purpose of this study is to identify young Black women's attitudes toward clinicians and understand how they affect contraceptive behavior. STUDY DESIGN AND MAIN OUTCOME MEASURES We conducted semi-structured qualitative interviews with women aged 18-23 who self-identified as Black or African-American and analyzed data using techniques informed by grounded theory. Initial codes were grouped thematically, and these themes into larger concepts. RESULTS Participants discussed two salient concepts related to pregnancy prevention: (1) sexual responsibility and self-efficacy and (2) the perceived limited role of health care clinicians. Women portrayed themselves as in control of their contraceptive decision-making and practices. Many viewed their life plan, to finish school and gain financial stability, as crucial to their resolve to use contraception. Participants gathered information from various sources to make their own independent decision about which method, if any, was most appropriate for their needs. Most had limited expectations of clinicians and considered in-depth conversations about details of contraceptive use to be irrelevant and unnecessary. CONCLUSION These findings help understand factors contributing to contraceptive decision-making. The patient-clinician interaction is a necessary focus of future research to improve sexual health discussions and understand if and what aspects of this interaction can influence behavior.
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Affiliation(s)
- Meredith G Manze
- CUNY Graduate School of Public Health & Health Policy, New York, NY, USA.
| | - Lois McCloskey
- Boston University School of Public Health, Boston, MA, USA
| | - Barbara G Bokhour
- Boston University School of Public Health, Boston, MA, USA; Center for Healthcare Organization and Implementation Research, ENRM Veterans Affairs Medical Center, Bedford, MA, USA
| | - Michael K Paasche-Orlow
- Section of General Internal Medicine, Boston Medical Center, Boston University School of Medicine, Boston, MA, USA
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Patient-Centered Contraceptive Counseling: Evidence to Inform Practice. CURRENT OBSTETRICS AND GYNECOLOGY REPORTS 2016. [DOI: 10.1007/s13669-016-0139-1] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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van Prooijen JW, de Vries RE. Organizational Conspiracy Beliefs: Implications for Leadership Styles and Employee Outcomes. JOURNAL OF BUSINESS AND PSYCHOLOGY 2016; 31:479-491. [PMID: 27881900 PMCID: PMC5102939 DOI: 10.1007/s10869-015-9428-3] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
PURPOSE Belief in conspiracy theories about societal events is widespread among citizens. The extent to which conspiracy beliefs about managers and supervisors matter in the micro-level setting of organizations has not yet been examined, however. We investigated if leadership styles predict conspiracy beliefs among employees in the context of organizations. Furthermore, we examined if such organizational conspiracy beliefs have implications for organizational commitment and turnover intentions. DESIGN/METHODOLOGY/APPROACH We conducted a survey among a random sample of the US working population (N = 193). FINDINGS Despotic, laissez-faire, and participative leadership styles predicted organizational conspiracy beliefs, and the relations of despotic and laissez-faire leadership with conspiracy beliefs were mediated by feelings of job insecurity. Furthermore, organizational conspiracy beliefs predicted, via decreased organizational commitment, increased turnover intentions. IMPLICATIONS Organizational conspiracy beliefs matter for how employees perceive their leaders, how they feel about their organization, and whether or not they plan to quit their jobs. A practical implication, therefore, is that it would be a mistake for managers to dismiss organizational conspiracy beliefs as innocent rumors that are harmless to the organization. ORIGINALITY/VALUE Three novel conclusions emerge from this study. First, organizational conspiracy beliefs occur frequently among employees. Second, participative leadership predicts decreased organizational conspiracy beliefs; despotic and laissez-faire leadership predict increased organizational conspiracy beliefs due to the contribution of these destructive leadership styles to an insecure work environment. Third, organizational conspiracy beliefs harm organizations by influencing employee commitment and, indirectly, turnover intentions.
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Affiliation(s)
- Jan-Willem van Prooijen
- Department of Social and Organizational Psychology, VU Amsterdam, van der Boechorststraat 1, 1081BT Amsterdam, The Netherlands
- The Netherlands Institute for the Study of Crime and Law Enforcement (NSCR), Amsterdam, The Netherlands
| | - Reinout E. de Vries
- Department of Social and Organizational Psychology, VU Amsterdam, van der Boechorststraat 1, 1081BT Amsterdam, The Netherlands
- University of Twente, Enschede, The Netherlands
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van Prooijen JW. Sometimes inclusion breeds suspicion: Self-uncertainty and belongingness predict belief in conspiracy theories. EUROPEAN JOURNAL OF SOCIAL PSYCHOLOGY 2015. [DOI: 10.1002/ejsp.2157] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Jan-Willem van Prooijen
- Department of Experimental and Applied Psychology; VU University Amsterdam; Amsterdam The Netherlands
- The Netherlands Institute for the Study of Crime and Law Enforcement (NSCR); The Netherlands
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Schonberg D, Bennett AH, Sufrin C, Karasz A, Gold M. What Women Want: A Qualitative Study of Contraception in Jail. Am J Public Health 2015; 105:2269-74. [PMID: 26378832 DOI: 10.2105/ajph.2015.302765] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We undertook this study to understand women's perceptions of receiving contraception at Rikers Island Jail. METHODS We conducted semi-structured in-depth interviews in 2011 to 2012 with 32 women incarcerated at Rikers Island Jail. We analyzed the data using standard qualitative techniques. RESULTS Almost all participants believed that contraception should be provided at the jail. However, many said they would hesitate to use these services themselves. Reservations were caused in part by women's negative views of health care services at the jail. Fears about the safety of birth control, difficulties associated with follow-up in the community, and desire for pregnancy were other factors that influenced interest in accepting contraception. CONCLUSIONS Contraception at the jail must be provided by trusted medical providers delivering high quality care with the goal of allowing women to control their own fertility; this would ensure that women could access birth control and cease using birth control when desired.
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Affiliation(s)
- Dana Schonberg
- Dana Schonberg and Marji Gold are with the Department of Family and Social Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY. Ariana H. Bennett and Alison Karasz are with the Department of Family and Social Medicine, Albert Einstein College of Medicine. Carolyn Sufrin is with the Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Ariana H Bennett
- Dana Schonberg and Marji Gold are with the Department of Family and Social Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY. Ariana H. Bennett and Alison Karasz are with the Department of Family and Social Medicine, Albert Einstein College of Medicine. Carolyn Sufrin is with the Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Carolyn Sufrin
- Dana Schonberg and Marji Gold are with the Department of Family and Social Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY. Ariana H. Bennett and Alison Karasz are with the Department of Family and Social Medicine, Albert Einstein College of Medicine. Carolyn Sufrin is with the Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Alison Karasz
- Dana Schonberg and Marji Gold are with the Department of Family and Social Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY. Ariana H. Bennett and Alison Karasz are with the Department of Family and Social Medicine, Albert Einstein College of Medicine. Carolyn Sufrin is with the Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD
| | - Marji Gold
- Dana Schonberg and Marji Gold are with the Department of Family and Social Medicine, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, NY. Ariana H. Bennett and Alison Karasz are with the Department of Family and Social Medicine, Albert Einstein College of Medicine. Carolyn Sufrin is with the Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD
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