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Janssen I, Powell LH, Dugan SA, Derby CA, Kravitz HM. Cardiovascular Health, Race, and Decline in Cognitive Function in Midlife Women: The Study of Women's Health Across the Nation. J Am Heart Assoc 2024; 13:e031619. [PMID: 38656121 DOI: 10.1161/jaha.123.031619] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 03/08/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Cognitive decline may progress for decades before dementia onset. Better cardiovascular health (CVH) has been related to less cognitive decline, but it is unclear whether this begins early, for all racial subgroups, and all domains of cognitive function. The purpose of this study was to determine the impact of CVH on decline in the 2 domains of cognition that decline first in White and Black women at midlife. METHODS AND RESULTS Subjects were 363 Black and 402 White women, similar in baseline age (mean±SD, 46.6±3.0 years) and education (15.7±2.0 years), from the Chicago site of the Study of Women's Health Across the Nation. Cognition, measured as processing speed and working memory, was assessed annually or biennially over a maximum of 20 years (mean±SD, 9.8±6.7 years). CVH was measured as Life's Essential 8 (blood pressure, body mass index, glucose, non-high-density lipoprotein cholesterol, smoking, physical activity, diet, sleep). Hierarchical linear mixed models identified predictors of cognitive decline with progressive levels of adjustment. There was a decline in processing speed that was explained by race, age, and the 3-way interaction of race, CVH, and time (F1,4308=8.8, P=0.003). CVH was unrelated to decline in White women but in Black women poorer CVH was associated with greater decline. Working memory did not decline in the total cohort, by race, or by CVH. CONCLUSIONS In midlife Black women, CVH promotion may be a target for preventing the beginnings of cognitive decline, thereby enhancing independent living with aging.
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Affiliation(s)
- Imke Janssen
- Department of Family and Preventive Medicine Rush University Medical Center Chicago IL USA
| | - Lynda H Powell
- Department of Family and Preventive Medicine Rush University Medical Center Chicago IL USA
- Department of Psychiatry and Behavioral Sciences Rush University Medical Center Chicago IL USA
- Department of Pharmacology Rush University Medical Center Chicago IL USA
| | - Sheila A Dugan
- Department of Family and Preventive Medicine Rush University Medical Center Chicago IL USA
- Department of Physical Medicine and Rehabilitation Rush University Medical Center Chicago IL USA
| | - Carol A Derby
- Department of Neurology and of Epidemiology and Population Health Albert Einstein College of Medicine Bronx NY USA
| | - Howard M Kravitz
- Department of Family and Preventive Medicine Rush University Medical Center Chicago IL USA
- Department of Psychiatry and Behavioral Sciences Rush University Medical Center Chicago IL USA
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Quesada O, Crousillat D, Rodriguez F, Bravo-Jaimes K, Briller J, Ogunniyi MO, Mattina DJ, Aggarwal NR, Rodriguez CJ, De Oliveira GMM, Velarde G. Cardiovascular Disease in Hispanic Women: JACC Review Topic of the Week. J Am Coll Cardiol 2024; 83:1702-1712. [PMID: 38658109 DOI: 10.1016/j.jacc.2024.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 01/29/2024] [Accepted: 02/05/2024] [Indexed: 04/26/2024]
Abstract
Cardiovascular disease affects 37% of Hispanic women and is the leading cause of death among Hispanic women in the United States. Hispanic women have a higher burden of cardiovascular risk factors, are disproportionally affected by social determinants of health, and face additional barriers related to immigration, such as discrimination, language proficiency, and acculturation. Despite this, Hispanic women show lower rates of cardiovascular disease and mortality compared with non-Hispanic White women. However, this "Hispanic paradox" is challenged by recent studies that account for the diversity in culture, race, genetic background, country of origin, and social determinants of health within Hispanic subpopulations. This review provides a comprehensive overview of the cardiovascular risk factors in Hispanic women, emphasizing the role of social determinants, and proposes a multipronged approach for equitable care.
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Affiliation(s)
- Odayme Quesada
- Women's Heart Center, The Christ Hospital Heart and Vascular Institute, Cincinnati, Ohio, USA; The Carl and Edyth Lindner Center for Research and Education, The Christ Hospital, Cincinnati, Ohio, USA.
| | - Daniela Crousillat
- Division of Cardiovascular Sciences, Department of Medicine, Department of Obstetrics and Gynecology, University of South Florida Morsani College of Medicine, Tampa, Florida, USA
| | - Fatima Rodriguez
- Division of Cardiovascular Medicine and the Cardiovascular Institute, Stanford University School of Medicine, Stanford, California, USA
| | - Katia Bravo-Jaimes
- Department of Cardiovascular Medicine, Mayo Clinic, Jacksonville, Florida, USA
| | - Joan Briller
- Division of Cardiology, Department of Medicine, University of Illinois Chicago, Chicago, Illinois, USA; Department of Obstetrics and Gynecology, University of Illinois Chicago, Chicago, Illinois, USA
| | - Modele O Ogunniyi
- Division of Cardiology, Department of Medicine, Emory University School of Medicine, Atlanta, Georgia, USA; Grady Health System, Atlanta, Georgia, USA
| | - Deirdre J Mattina
- Department of Cardiovascular Medicine, Cleveland Clinic, Beachwood, Ohio, USA
| | - Niti R Aggarwal
- Department of Cardiovascular Disease, Mayo Clinic, Rochester, Minnesota, USA
| | | | | | - Gladys Velarde
- Division of Cardiology, Department of Medicine, University of Florida College of Medicine, Jacksonville, Florida, USA
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Daniels KP, D Thomas M, Chae DH, Allen AM. Black Mothers' Concern for Their Children as a Measure of Vicarious Racism-Related Vigilance and Allostatic Load. J Health Soc Behav 2023; 64:520-536. [PMID: 37332176 DOI: 10.1177/00221465231175942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
This study investigates the relationship between allostatic load and a novel form of altruistic racism-related fear, or concern for how racism might harm another, which we term vicarious racism-related vigilance. Using a subsample of Black mothers from the African American Women's Heart & Health Study (N = 140), which includes detailed health and survey data on a community sample of Black women in the San Francisco Bay Area, this study investigates the relationship between Black mothers' experiences with racism-related vigilance as it relates to their children and allostatic load-a multisystem metric of underlying health across multiple biological systems. Findings indicate that vicarious racism-related vigilance was positively associated with allostatic load (i.e., worse health). Findings highlight the salience of vicarious racism-related vigilance for the health of Black mothers, underscoring how intersections between race, gender, and parenthood result in susceptibility to unique forms of health-harming stress.
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Chandler R, Guillaume D, Francis S, Xue E, Shah K, Parker A, Hernandez N. "I care about sex, I care about my health": A mixed-methods pre-test of a HIV prevention mobile health app for Black women in the southern United States. PLoS One 2023; 18:e0289884. [PMID: 37851669 PMCID: PMC10584133 DOI: 10.1371/journal.pone.0289884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 07/27/2023] [Indexed: 10/20/2023] Open
Abstract
BACKGROUND Black women experience higher rates of adverse sexual and reproductive health and HIV outcomes, however the use of mHealth to address these health disparities in this population has been inadequate. This study involved a one-month pre-test with Black women living in metro-Atlanta to evaluate the usability, acceptability, and engagement of an HIV prevention app SavvyHER. METHODS An explanatory mixed-methods design was employed in which quantitative data was collected through weekly cross-sectional surveys, and qualitative data was collected through semi-structured in-depth interviews. Descriptive and ANOVA analysis was conducted for the quantitative data using STATA software. Qualitative data was analyzed through qualitative descriptive methods on Atlas.ti. RESULTS Participants had high levels of acceptability towards the app and used SavvyHER moderately. The most frequently used features were live groups (2.96 ±0.22, 95% CI 2.51,3.41), viewing resources and educational information (2.77 ± 0.21, 95% CI 2.33,3.20), and mental health monitoring (2.73 ±0.21, 95% CI 2.29,3.12). The least used features were pregnancy symptom monitoring (1.92 ±0.27, 95% CI 1.38,2.47) and STI symptom monitoring (2.0 ±0.25, 95% CI 1.48,2.52). In qualitative interviews, several women discussed how the ability to engage in active discussions and join live sessions with other end-users was a favorable aspect of SavvyHER. Although the app's primary focus was on sexual and reproductive health and HIV prevention, women were more likely to access mental health monitoring and physical activity monitoring features. Women expressed their fondness of the app design and interface as it was reflective of the diversity of Black women. CONCLUSION Further research is needed to explore the efficacy in using SavvyHER and additional mHealth interventions to enhance Black women's sexual and reproductive health and overall wellness.
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Affiliation(s)
- Rasheeta Chandler
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States of America
| | - Dominique Guillaume
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, United States of America
- Center for Infectious Disease and Nursing Innovation, School of Nursing, Johns Hopkins University, Baltimore, MD, United States of America
| | - Sherilyn Francis
- School of Interactive Computing, College of Computing, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Eric Xue
- School of Interactive Computing, College of Computing, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Kewal Shah
- School of Interactive Computing, College of Computing, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Andrea Parker
- School of Interactive Computing, College of Computing, Georgia Institute of Technology, Atlanta, Georgia, United States of America
| | - Natalie Hernandez
- Center for Maternal Health Equity, Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia, United States of America
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Mosley DV. A biomythography introducing the Blafemme Healing framework. Am Psychol 2023; 78:678-694. [PMID: 37166845 DOI: 10.1037/amp0001146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Black feminism has so much to offer. Its philosophical, intellectual, and activist practice grounded in the experiences of Black women is a source of healing and liberation. Building on the Black feminist tradition, the current article introduces an intersectional and practical healing framework titled Blafemme Healing. The framework is designed to support individuals in exploring personal healing regardless of their social location while intentionally providing mechanisms for increasing the experience and outcome of wellness, equity, love, liberation, and survival for Black people. The framework includes eight areas, or chambers, that require people's attention if we are to achieve personal and collective wellness. The author, a Black queer cisgender woman pursuing personal and collective wellness and healing through and beyond the field of psychology, uses the biomythography method to introduce and describe Blafemme Healing. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Adames HY, Chavez-Dueñas NY, Jernigan MM. Dr. Janet E. Helms: Envisioning and creating a more humane psychological science, theory, and practice. Am Psychol 2023; 78:401-412. [PMID: 37384496 DOI: 10.1037/amp0001037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Dr. Janet E. Helms's use of psychological science to engage the field of psychology in radical progressive debates about race and identity is unprecedented. Her scholarship transformed prevailing paradigms in identity development theory and cognitive ability testing in psychology, to name a few. However, mainstream psychology often ignores, dismisses, and minimizes the importance of Dr. Helms's scientific contributions. Despite the numerous systemic barriers she encounters as a Black woman in psychology, Dr. Helms has persisted and made immeasurable contributions to the field and society. The intellectual gifts she has provided have shaped psychology for decades and will undoubtedly continue to do so for centuries to come. This article aims to provide an overview of Dr. Helms's lifetime contributions to psychology and the social sciences. To achieve this goal, we provide a brief narrative of Dr. Helms's life as a prelude to describing her foundational contributions to psychological science and practice in four domains, including (a) racial identity theories, (b) racially conscious and culturally responsive praxis, (c) womanist identity, and (d) racial biases in cognitive ability tests and measurement. The article concludes with a summary of Dr. Helms's legacy as an exceptional psychologist who offers the quintessential blueprint for envisioning and creating a more humane psychological science, theory, and practice anchored in liberation for all. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Hector Y Adames
- Department of Counseling Psychology, The Chicago School of Professional Psychology
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Lewis JA. Contributions of Black psychology scholars to models of racism and health: Applying intersectionality to center Black women. Am Psychol 2023; 78:576-588. [PMID: 37384509 DOI: 10.1037/amp0001141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023]
Abstract
Although theoretical and empirical research on the impact of racism on the mental and physical health of African Americans is well established in the literature, there is still a dearth of research that focuses on the role of the intersection of racism and sexism, or gendered racism, on the health of Black women. The purpose of this article is threefold: (a) to review the foundational contributions of Black psychologists to the study of racism and health, (b) to highlight the intellectual contributions of Black feminist scholars to the study of intersectionality in psychology, and (c) to apply an intersectionality framework to research on racism and health by introducing a conceptual Biopsychosocial Model of Gendered Racism to better understand the impact of gendered racism on Black women's health and well-being. This article ends with recommendations for future research, clinical practice, and social justice advocacy centered on Black women's health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Jioni A Lewis
- Department of Counseling, Higher Education, and Special Education, University of Maryland, College Park
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Gemmill A, Berger BO, Crane MA, Margerison CE. Mortality Rates Among U.S. Women of Reproductive Age, 1999-2019. Am J Prev Med 2022; 62:548-557. [PMID: 35135719 PMCID: PMC8940663 DOI: 10.1016/j.amepre.2021.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 09/21/2021] [Accepted: 10/03/2021] [Indexed: 11/01/2022]
Abstract
INTRODUCTION High and increasing levels of pregnancy-related mortality and morbidity in the U.S. indicate that the underlying health status of reproductive-aged women may be far from optimal, yet few studies have examined mortality trends and disparities exclusively among this population. METHODS All-cause and cause-specific mortality data for 1999-2019 were obtained from the Centers for Disease Control and Prevention WONDER Underlying Cause of Death database. Levels and trends in mortality between 1999 and 2019 for women aged 15-44 years stratified by age, race/ethnicity, and state were examined. Given the urgent need to address pregnancy-related health disparities, the correlation between all-cause and pregnancy-related mortality rates across states for the years 2015-2019 was also examined. RESULTS Age-adjusted, all-cause mortality rates among women aged 15-44 years improved between 2003 and 2011 but worsened between 2011 and 2019. The recent increase in mortality among this age group was not driven solely by increases in external causes of death. Patterns differed by age, race/ethnicity, and geography, with non-Hispanic American Indian and Alaskan Native women having 2.3 and non-Hispanic Black women having 1.4 times the risk of all-cause mortality in 2019 compared with that of non-Hispanic White women. Age-adjusted all-cause mortality rates and pregnancy-related mortality rates were strongly correlated at the state level (r=0.75). CONCLUSIONS Increasing mortality among reproductive-aged women has substantial implications for maternal, women's, and children's health. Given the high correlation between pregnancy-related mortality and all-cause mortality at the state level, addressing the structural factors that shape mortality risks may have the greatest likelihood of improving women's health outcomes across the life course.
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Affiliation(s)
- Alison Gemmill
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
| | - Blair O Berger
- Department of Population, Family and Reproductive Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Matthew A Crane
- Johns Hopkins University School of Medicine, Baltimore, Maryland; USC Leonard D. Schaeffer Center for Health Policy & Economics, University of Southern California, Los Angeles, California; Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Claire E Margerison
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan
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Cauley JA, Greendale GA. RE: "Race/ethnic differences in trabecular bone score in mid-life women: the Study of Women's Health Across the Nation (SWAN)". Osteoporos Int 2022; 33:951. [PMID: 35083507 DOI: 10.1007/s00198-021-06269-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/09/2021] [Indexed: 10/19/2022]
Affiliation(s)
- J A Cauley
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
| | - G A Greendale
- David Geffen School of Medicine at UCL, Los Angeles, CA, USA
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Abstract
This article explores how intrapersonal and structural oppression may impact treatment and the recovery process of 23 self-identified African American women with histories of incarceration and substance use. Using a critical consciousness (CC) framework and content-based thematic analysis, researchers systematically coded and extracted themes and patterns from focus group data to evaluate how marginalizing processes-such as race-based discrimination-impact treatment, the therapeutic relationship, and service provision. Results indicate that participants' health and treatment were negatively impacted by oppressive factors, specifically the oppressive process of silencing. The authors discuss research and practice implications.
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Affiliation(s)
- Alexis Jemal
- Silberman School of Social Work at Hunter College, 2180 3 Ave, New York, NY 10035
| | - Alana Gunn
- Department of Criminology, Law, and Justice, University of Illinois at Chicago, 1007 W. Harrison ST, Chicago, IL 60607
| | - Christina Inyang
- Clarity Treatment Center, LLC, 262 State St., Perth Amboy, NJ 08861
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Shadyab AH, Manson JE, Luo J, Haring B, Saquib N, Snetselaar LG, Chen JC, Groessl EJ, Wassertheil-Smoller S, Sun Y, Hale L, LeBoff MS, LaCroix AZ. Associations of Coffee and Tea Consumption With Survival to Age 90 Years Among Older Women. J Am Geriatr Soc 2020; 68:1970-1978. [PMID: 32329900 PMCID: PMC8580285 DOI: 10.1111/jgs.16467] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2020] [Revised: 03/21/2020] [Accepted: 03/23/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND Coffee and tea are two of the most widely consumed beverages worldwide and have been associated with reduced risk of mortality in some studies. However, it is unknown whether consumption of these beverages is associated with survival to an advanced age. OBJECTIVE To examine associations of coffee and tea consumption with survival to age 90 years. DESIGN Prospective cohort study among participants from the Women's Health Initiative, recruited during 1993 to 1998 and followed up until March 31, 2018. SETTING The setting included 40 US clinical centers. PARTICIPANTS A racially and ethnically diverse cohort of 27,480 older women, aged 65 to 81 years at baseline. MEASUREMENTS Women were classified as having either survived to age 90 years or died before this age. Consumption of caffeinated and decaffeinated coffee and caffeinated tea was assessed at baseline and categorized as 0, 1, 2 to 3, or 4 or more cups/day. Associations of coffee and tea consumption with survival to age 90 years were examined using logistic regression models adjusted for sociodemographic characteristics, lifestyle behaviors, dietary quality, and chronic disease history. RESULTS A total of 14,659 (53.3%) women survived to age 90 years during follow-up. Caffeinated coffee, decaffeinated coffee, or caffeinated tea consumption was not significantly associated with survival to age 90 years after adjusting for confounders. Findings did not significantly vary by smoking, body mass index, or race/ethnicity. CONCLUSION No amount of coffee or tea consumption was associated with late-age survival among older women. These findings may be reassuring to older women who consume coffee and tea as part of their daily diets but do not support drinking these beverages to achieve longevity.
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Affiliation(s)
- Aladdin H. Shadyab
- Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA
| | - JoAnn E. Manson
- Department of Epidemiology, Harvard T.H. Chan School of Public Health and Division of Preventive Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN
| | - Bernhard Haring
- Department of Internal Medicine I, University of Würzburg, Würzburg, Germany
| | - Nazmus Saquib
- College of Medicine, Sulaiman AlRajhi University, Al Bukayriyah, Saudi Arabia
| | - Linda G. Snetselaar
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Jiu-Chiuan Chen
- Departments of Preventive Medicine and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Erik J. Groessl
- Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA
| | | | - Yangbo Sun
- Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, IA
| | - Lauren Hale
- Department of Family, Population and Preventive Medicine, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY
| | - Meryl S. LeBoff
- Division of Endocrinology, Diabetes, and Hypertension, Department of Medicine, Brigham and Woman's Hospital, Harvard Medical School, Boston, MA
| | - Andrea Z. LaCroix
- Department of Family Medicine and Public Health, University of California, San Diego School of Medicine, La Jolla, CA
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Brown A, Wilson DK, Sweeney AM, Van Horn ML. The Moderating Effects of Social Support and Stress on Physical Activity in African American Women. Ann Behav Med 2020; 55:376-382. [PMID: 32692356 DOI: 10.1093/abm/kaaa051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND African American women participate in less physical activity (PA), have higher rates of chronic disease, and report higher perceived stress relative to other race and sex demographic groups. PURPOSE Based on the stress-buffering hypothesis, this study tested the hypothesis that social support would buffer the negative effects of perceived stress on moderate-to-vigorous PA (MVPA) under high, but not low, perceived stress. METHODS Participants were 143 African American women (mean [M] age = 43.94, standard deviation [SD] = 8.62; M body mass index = 37.94, SD = 8.11) enrolled in the Families Improving Together (FIT) for Weight Loss Trial. Average daily minutes of MVPA were obtained via 7 day accelerometer estimates at baseline and 8 and 16 weeks. RESULTS A multilevel growth model demonstrated a significant three-way interaction between stress, social support, and time (B = -0.31, standard error [SE] = 0.14, p = .03). Simple slopes analyses revealed that, at baseline, among participants with high social support (+1 SD), stress was positively associated with greater MVPA (B = 0.49, SE = 0.18, p = .008), whereas among participants with low social support (-1 SD), stress was not significantly associated with MVPA (B = -0.04, SE = 0.14, p = .81). However, at 8 and 16 weeks, stress was not significantly associated with MVPA for either high or low support groups. CONCLUSIONS Findings highlight the importance of integrating constructs of stress and social support into future physical activity intervention programs for African American women and the need to evaluate changes in stress and social support longitudinally.
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Affiliation(s)
- Asia Brown
- Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC, USA
| | - Dawn K Wilson
- Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC, USA
| | - Allison M Sweeney
- Department of Psychology, Barnwell College, University of South Carolina, Columbia, SC, USA
| | - M Lee Van Horn
- Department of Educational Psychology, University of New Mexico, Albuquerque, NM, USA
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Springfield S, Qin F, Hedlin H, Eaton CB, Rosal MC, Taylor H, Staudinger UM, Stefanick ML. Resilience and CVD-protective Health Behaviors in Older Women: Examining Racial and Ethnic Differences in a Cross-Sectional Analysis of the Women's Health Initiative. Nutrients 2020; 12:E2107. [PMID: 32708626 PMCID: PMC7400950 DOI: 10.3390/nu12072107] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/02/2020] [Accepted: 07/09/2020] [Indexed: 11/09/2022] Open
Abstract
Little is known about the relationship between self-reported psychological resilience (resilience) and health behaviors shown to reduce the risk of cardiovascular disease (CVD). This study examines the associations between resilience and CVD-related risk factors, such as diet, smoking, physical activity, sleep, and alcohol consumption among older American women from diverse backgrounds. METHODS A cross-sectional secondary analysis was conducted on 77,395 women (mean age 77 years, Black (N = 4475, 5.8%), non-Hispanic white (N = 69,448, 89.7%), Latina (N = 1891, 2.4%), and Asian or Pacific Islander (N = 1581, 2.0%)) enrolled in the Women's Health Initiative Extension Study II. Resilience was measured using an abbreviated version of the brief resilience scale. Multivariable logistic regression models were used to evaluate the association between resilience and health behaviors associated with risk for CVD, while adjusting for stressful life events and sociodemographic information. To test whether these associations varied among racial/ethnic groups, an interaction term was added to the fully adjusted models between resilience and race/ethnicity. RESULTS High levels of resilience were associated with better diet quality (top 2 quintiles of the Healthy Eating Index 2015) (OR = 1.22 (95% Confidence Interval (1.15-1.30)), adhering to recommended physical activity (≥ 150 min per week) (1.56 (1.47, 1.66)), sleeping the recommended hours per night (7-9) (1.36 (1.28-1.44)), and moderate alcohol intake (consuming alcoholic drink(s) 1-7 days per week) (1.28 (1.20-1.37)). The observed association between resilience and sleep is modified by race/ethnicity (p = 0.03). CONCLUSION Irrespective of race/ethnicity, high resilience was associated with CVD-protective health behaviors. This warrants further investigation into whether interventions aimed at improving resilience could increase the effectiveness of lifestyle interventions.
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Affiliation(s)
- Sparkle Springfield
- Parkinson School of Health Sciences and Public Health, Department of Public Health, Loyola University Chicago, 2160 S N 1st Ave, Maywood, IL 60153, USA
| | - FeiFei Qin
- Quantitative Sciences Unit, Stanford University, Alto, CA 94304, USA; (F.Q.); (H.H.)
| | - Haley Hedlin
- Quantitative Sciences Unit, Stanford University, Alto, CA 94304, USA; (F.Q.); (H.H.)
| | - Charles B. Eaton
- Warren Alpert Medical School, Department of Family Medicine School of Public Health Brown, Providence University, Providence, RI 02912, USA;
| | - Milagros C. Rosal
- Department of Population and Quantitative Health Sciences, Medical School of Massachusetts University, Massachusetts University, Worcester, MA 01605, USA;
| | - Herman Taylor
- Research Wing Room, Morehouse School of Medicine Cardiovascular Research Institute, Atlanta, GA 30310, USA;
| | - Ursula M. Staudinger
- Columbia Aging Center & Department of Socio medical Science, Mailman School of Public Health, Columbia University, New York, NY 10032, USA;
| | - Marcia L. Stefanick
- Stanford Prevention Research Center, Stanford University, Alto, CA 94304, USA;
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Simhi M, Yoselis A, Sarid O, Cwikel J. Hidden Figures: Are Ultra-Orthodox Jewish Women Really so Different When it Comes to Health Care? J Relig Health 2020; 59:1398-1420. [PMID: 31218549 DOI: 10.1007/s10943-019-00862-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Incorporating the needs of at-risk populations into national health care initiatives is essential. Israel has identified ultra-Orthodox Jewish, or Haredi, women, as at risk of increased morbidity and mortality, yet actual data on this insular community are lacking. We reviewed published research on Israeli Haredi women's health status, behaviors and health care access and examined methodologies. Of 273 articles identified, 14 publications and four government reports were included. More research is needed on this community, essential not only to Israeli health care policy, but to that of the USA and the UK, who share the largest percentages of Haredi Jews.
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Affiliation(s)
- Meital Simhi
- Spitzer Department of Social Work and the Center for Women's Health Studies and Promotion, Ben Gurion University of the Negev, POB 653, 84105, Beer Sheva, Israel.
| | - Aviva Yoselis
- Health Advize, POB 383, 90651, Mitzpe Yericho, Israel
| | - Orly Sarid
- Spitzer Department of Social Work and the Center for Women's Health Studies and Promotion, Ben Gurion University of the Negev, POB 653, 84105, Beer Sheva, Israel
| | - Julie Cwikel
- Spitzer Department of Social Work and the Center for Women's Health Studies and Promotion, Ben Gurion University of the Negev, POB 653, 84105, Beer Sheva, Israel
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Nagamatsu Y, Barroga E, Sakyo Y, Igarashi Y, Hirano O Y. Risks and perception of non-communicable diseases and health promotion behavior of middle-aged female immigrants in Japan: a qualitative exploratory study. BMC Womens Health 2020; 20:88. [PMID: 32357884 PMCID: PMC7195750 DOI: 10.1186/s12905-020-00955-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2019] [Accepted: 04/16/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Ensuring good health of immigrants is a serious issue across countries, including Japan. This study focused on the health of middle-aged female immigrants in Japan who experienced changes to their health as well as an increased risk of non-communicable diseases. Specifically, the study aimed to clarify the risks and perceptions of non-communicable diseases and health promotion behavior of middle-aged female immigrants in Japan. METHODS This investigation used an exploratory design. The participants were a purposive sample of 35 middle-aged female immigrants (age ≥ 40 years) living in urban and rural areas of Japan. Data were generated using mixed methods. A quantitative approach provided data of their risks of non-communicable diseases. Focus group discussions provided insights to identify their health promotion perceptions. RESULTS Blood pressure measurement revealed that 29% of the immigrants had hypertension, 29% had a body mass index of > 30, and 71% had an abdominal girth of > 80 cm. About 31% had a history of chronic disease and 34% had regular medication. There were 80% who received regular health check-up, 49% who received breast cancer screening, and 34% who received cervical cancer screening. The focus group discussions indicated that the middle-aged female immigrants recognized the threat of non-communicable diseases. However, they lacked knowledge about the prevention of non-communicable diseases, and they felt that non-communicable diseases were unavoidable. They also failed to understand the benefits of health promotion behavior. The study revealed that the monolingual Japanese health service prevented immigrant women from understanding their health check-up and cancer screening results, and how to utilize the health service system. CONCLUSIONS Middle-aged female immigrants in Japan had potential risks of non-communicable diseases, and recognized their threat. These settled immigrant women received health check-ups and cancer screenings with the support of their family, and consequently attained the same level of adherence as that of Japanese women. However, lack of knowledge about health promotion and its benefits and the absence of a culturally sensitive health service system for immigrants in Japan constrained their health-promotion behavior. Sociocultural multilingual-tailored interventions including interpretation services by care providers with cultural sensitivities must be developed.
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Affiliation(s)
- Yasuko Nagamatsu
- Graduate School of Nursing Science, St. Luke’s International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044 Japan
| | - Edward Barroga
- Graduate School of Nursing Science, St. Luke’s International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044 Japan
| | - Yumi Sakyo
- Graduate School of Nursing Science, St. Luke’s International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044 Japan
| | - Yukari Igarashi
- Graduate School of Nursing Science, St. Luke’s International University, 10-1 Akashi-cho, Chuo-ku, Tokyo, 104-0044 Japan
| | - Yuko Hirano O
- Institute of Biomedical Sciences, Nagasaki University, 1-7-1 Sakamoto, Nagasaki City, Nagasaki, 8528520 Japan
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16
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Henderson V, Madrigal JM, Handler A. A mixed methods study: Midlife African American women's knowledge, beliefs, and barriers to well-woman visit, flu vaccine, and mammogram use. J Women Aging 2020; 32:292-313. [PMID: 30466373 PMCID: PMC6531362 DOI: 10.1080/08952841.2018.1549433] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
African American women (AAW) are particularly at risk for deleterious health outcomes that might be mitigated through increased preventive care use. A mixed methods study that examined relationships between knowledge of, beliefs about, and barriers to well-woman visits, flu vaccines, and mammograms was conducted with midlife AAW who participated in an online survey (n = 124) and in-depth interviews (n = 19). Findings showed that greater knowledge of preventive service recommendations and positive patient-provider relationships were associated with greater preventive service use. Flu vaccines were significantly underused. Study implications inform strategies to increase preventive care utilization among AAW and increase capacities to improve health disparities.
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Affiliation(s)
- Vida Henderson
- University of Illinois Cancer Center, 818 S Wolcott Ave. MC 709,
Chicago, Illinois 60612
| | - Jessica M. Madrigal
- University of Illinois School of Public Health, 1603 W. Taylor St.,
Chicago, Illinois 60612,
| | - Arden Handler
- University of Illinois School of Public Health, 1603 W. Taylor
St,.Chicago, Illinois 60612,
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17
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Epstein A, Bendavid E, Nash D, Charlebois ED, Weiser SD. Drought and intimate partner violence towards women in 19 countries in sub-Saharan Africa during 2011-2018: A population-based study. PLoS Med 2020; 17:e1003064. [PMID: 32191701 PMCID: PMC7081984 DOI: 10.1371/journal.pmed.1003064] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 02/21/2020] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Drought has many known deleterious impacts on human health, but little is known about the relationship between drought and intimate partner violence (IPV). We aimed to evaluate this relationship and to assess effect heterogeneity between population subgroups among women in 19 sub-Saharan African countries. METHODS AND FINDINGS We used data from 19 Demographic and Health Surveys from 2011 to 2018 including 83,990 partnered women aged 15-49 years. Deviations in rainfall in the year before the survey date were measured relative to the 29 previous years using Climate Hazards Group InfraRed Precipitation with Station data, with recent drought classified as ordinal categorical variable (severe: ≤10th percentile; mild/moderate: >10th percentile to ≤30th percentile; none: >30th percentile). We considered 4 IPV-related outcomes: reporting a controlling partner (a risk factor for IPV) and experiencing emotional violence, physical violence, or sexual violence in the 12 months prior to survey. Logistic regression was used to estimate marginal risk differences (RDs). We evaluated the presence of effect heterogeneity by age group and employment status. Of the 83,990 women included in the analytic sample, 10.7% (9,019) experienced severe drought and 23.4% (19,639) experienced mild/moderate drought in the year prior to the survey, with substantial heterogeneity across countries. The mean age of respondents was 30.8 years (standard deviation 8.2). The majority of women lived in rural areas (66.3%) and were married (73.3%), while less than half (42.6%) were literate. Women living in severe drought had higher risk of reporting a controlling partner (marginal RD in percentage points = 3.0, 95% CI 1.3, 4.6; p < 0.001), experiencing physical violence (marginal RD = 0.8, 95% CI 0.1, 1.5; p = 0.019), and experiencing sexual violence (marginal RD = 1.2, 95% CI 0.4, 2.0; p = 0.001) compared with women not experiencing drought. Women living in mild/moderate drought had higher risk of reporting physical (marginal RD = 0.7, 95% CI 0.2, 1.1; p = 0.003) and sexual violence (marginal RD = 0.7, 95% CI 0.3, 1.2; p = 0.001) compared with those not living in drought. We did not find evidence for an association between drought and emotional violence. In analyses stratified by country, we found 3 settings where drought was protective for at least 1 measure of IPV: Namibia, Tanzania, and Uganda. We found evidence for effect heterogeneity (additive interaction) for the association between drought and younger age and between drought and employment status, with stronger associations between drought and IPV among adolescent girls and unemployed women. This study is limited by its lack of measured hypothesized mediating variables linking drought and IPV, prohibiting a formal mediation analysis. Additional limitations include the potential for bias due to residual confounding and potential non-differential misclassification of the outcome measures leading to an attenuation of observed associations. CONCLUSIONS Our findings indicate that drought was associated with measures of IPV towards women, with larger positive associations among adolescent girls and unemployed women. There was heterogeneity in these associations across countries. Weather shocks may exacerbate vulnerabilities among women in sub-Saharan Africa. Future work should further evaluate potential mechanisms driving these relationships.
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Affiliation(s)
- Adrienne Epstein
- Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, United States of America
- * E-mail:
| | - Eran Bendavid
- Department of Medicine, Stanford University, Stanford, California, United States of America
| | - Denis Nash
- Institute for Implementation Science in Population Health, City University of New York, New York, New York, United States of America
| | - Edwin D. Charlebois
- Department of Medicine, University of California, San Francisco, San Francisco, California, United States of America
| | - Sheri D. Weiser
- Department of Medicine, University of California, San Francisco, San Francisco, California, United States of America
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18
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Yu J, Saltus R, Jarvis P. Perceived inequalities in care and support for older women from Black and minority ethnic backgrounds in Wales: findings from a survey exploring dignity from service providers' perspectives. Ethn Health 2020; 25:222-242. [PMID: 29124965 DOI: 10.1080/13557858.2017.1399200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 10/26/2017] [Indexed: 06/07/2023]
Abstract
Objective: As part of a large mixed-method study aimed at capturing understandings of dignity, and care expectations of community dwelling older women from Black and minority ethnic (BME) backgrounds living in Wales, the aim of this paper is to compare service providers' perceptions of their care and support provided to older people in general, and to older women from BME backgrounds in particular, with a focus on two dignity indicators: care and support needs, and effective communication.Design: A survey design was used.Results: A total of 124 responses from service providers in Wales were received. Perceived inequalities in care and support were found. Although most respondents reported that care and support provision was generally acceptable, more respondents believed that compared to older people in general, older women from BME backgrounds were seldom or never offered opportunities and support to express their needs, were involved in their own care, were provided appropriate information, had their key needs especially less visible needs (psychological and religious needs) been taken into account, or were communicated with effectively (all p < 0.05). In some cases, respondents tended to report more positively in areas related to their own practice.Conclusion: We suggest that learning from the views and perceptions of service providers, as well as older people and their families, remains key to developing services for the UK's increasingly diverse and ageing population. A better understanding of how inequalities may occur, their impact on older people and their families, and how they may be minimised can inform the development of high quality care for older people regardless of their ethnic and cultural backgrounds in Wales, other parts of the UK and beyond.
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Affiliation(s)
- Juping Yu
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Roiyah Saltus
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
| | - Paul Jarvis
- Faculty of Life Sciences and Education, University of South Wales, Pontypridd, UK
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19
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Ward LM, Jerald M, Avery L, Cole ER. Following Their Lead? Connecting Mainstream Media Use to Black Women's Gender Beliefs and Sexual Agency. J Sex Res 2020; 57:200-212. [PMID: 30624966 DOI: 10.1080/00224499.2018.1554741] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Although media exposure has emerged as a significant predictor of consumers' sexual decision making, less is known about the mechanisms involved and about the dynamics of these relations for adults, in general, and for African American adults, in particular. To address these gaps, we used structural equation modeling (SEM) to test whether heterosexual Black women's endorsement of traditional gender and sexual roles mediates connections between their consumption of four mainstream media (music videos, reality TV programming, movies, and women's magazines) and three dimensions of their sexual well-being (sexual assertiveness, sexual inhibition, and sexual deception). We surveyed 594 heterosexual Black women aged 17 to 55 who were undergraduate and graduate students at two universities (one historically Black university and one predominantly White institution). Results confirmed expectations, such that greater media consumption was associated with greater support of traditional gender and sexual roles; in turn, endorsing these roles predicted lower levels of sexual assertiveness, greater sexual inhibition, and more frequent use of sexual dishonesty to retain a partner. We discuss implications of these findings for psychology and sexuality research and also for Black women's sexual relationships.
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Affiliation(s)
| | | | - Lanice Avery
- Departments of Psychology and Women, Gender, and Sexuality, University of Virginia
| | - Elizabeth R Cole
- Departments of Psychology and Women's Studies, University of Michigan
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20
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Cressman AE, Howe CJ, Nunn AS, Adimora AA, Williams DR, Kempf MC, Chandran A, Wentz EL, Blackstock OJ, Kassaye SG, Cohen J, Cohen MH, Wingood GM, Metsch LR, Wilson TE. The Relationship Between Discrimination and Missed HIV Care Appointments Among Women Living with HIV. AIDS Behav 2020; 24:151-164. [PMID: 31049811 DOI: 10.1007/s10461-019-02522-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Receiving regular HIV care is crucial for maintaining good health among persons with HIV. However, racial and gender disparities in HIV care receipt exist. Discrimination and its impact may vary by race/ethnicity and gender, contributing to disparities. Data from 1578 women in the Women's Interagency HIV Study ascertained from 10/1/2012 to 9/30/2016 were used to: (1) estimate the relationship between discrimination and missing any scheduled HIV care appointments and (2) assess whether this relationship is effect measure modified by race/ethnicity. Self-reported measures captured discrimination and the primary outcome of missing any HIV care appointments in the last 6 months. Log-binomial models accounting for measured sources of confounding and selection bias were fit. For the primary outcome analyses, women experiencing discrimination typically had a higher prevalence of missing an HIV care appointment. Moreover, there was no statistically significant evidence for effect measure modification by race/ethnicity. Interventions to minimize discrimination or its impact may improve HIV care engagement among women.
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Affiliation(s)
- Andrew E Cressman
- Department of Epidemiology, Centers for Epidemiology and Environmental Health, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02912, USA
| | - Chanelle J Howe
- Department of Epidemiology, Centers for Epidemiology and Environmental Health, Brown University School of Public Health, 121 South Main Street, Providence, RI, 02912, USA.
| | - Amy S Nunn
- Department of Behavioral and Social Sciences, Center for Health Equity Research, Brown University School of Public Health, Providence, RI, USA
| | - Adaora A Adimora
- School of Medicine and UNC Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapelhill, NC, USA
| | - David R Williams
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Department of African and African American Studies, Harvard University, Cambridge, MA, USA
| | - Mirjam-Colette Kempf
- Schools of Nursing, Public Health, Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Aruna Chandran
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Eryka L Wentz
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Oni J Blackstock
- Montefiore and Albert Einstein College of Medicine, Bronx, NY, USA
| | - Seble G Kassaye
- Department of Medicine, Georgetown University, Washington, DC, USA
| | - Jennifer Cohen
- Department of Clinical Pharmacy, University of California, San Francisco, San Francisco, CA, USA
| | - Mardge H Cohen
- Departments of Medicine, Stroger Hospital and Rush University, Chicago, IL, USA
| | - Gina M Wingood
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
- Lerner Center for Public Health Promotion, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Lisa R Metsch
- Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Tracey E Wilson
- Department of Community Health Sciences, School of Public Health, State University of New York Downstate Medical Center, Brooklyn, NY, USA
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21
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Bourgette-Henry SJ, Davis A, Flood J, Choi SY, Bourgette A. The Wahine Heart Wellness Program: A Community Approach to Reducing Women's Cardiovascular Disease Risk. Hawaii J Health Soc Welf 2019; 78:341-348. [PMID: 31723942 PMCID: PMC6848000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Cardiovascular disease remains the leading cause of death for women in the United States. Although Hawai'i has relatively low rates of death from heart disease and stroke, Native Hawaiians and Other Pacific Islanders (NHOPI) are plagued with disproportionately higher rates of the chronic diseases that contribute to these deaths. This study follows a Practice Inquiry Project framework and aims to improve identification of cardiovascular disease (CVD) risk and promote health literacy of the disease in Asian, Native Hawaiians and Other Pacific Islander women on O'ahu. The study addresses: (a) assessment of current level of awareness of CVD as the leading cause of death for this population; (b) implementation of a CVD risk reduction program; and (c) an evaluation of that program's effectiveness in decreasing CVD risk. The study design used a mixed methods approach. The methods included a cardiovascular awareness questionnaire (pre-test and post-test), a screening process using the American Heart Association's Life's Simple 7 matrix, and 6 educational sessions. With these research methods, the participants' knowledge levels, health perceptions, and behaviors were evaluated. A convenience sample of 20 predominantly Asian, Native Hawaiian, and Pacific Islander women were recruited. At the conclusion of the project, participants showed increased awareness of CVD and improved behaviors to reduce the risk of CVD. The project also demonstrated that collaboration and partnerships between local schools of nursing and community organizations, community-based integrated approaches, incorporating health literacy, and infusing cultural knowledge into practice are important in creating successful and innovative solutions when working with Asian, Native Hawaiian, and Other Pacific Islander women.
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Affiliation(s)
| | - Alice Davis
- University of Hawai'i at Hilo, Hilo, HI (AD)
| | - Jeanie Flood
- New Mexico Highlands University, Rociada, NM (JF)
| | - So Yung Choi
- John A. Burns School of Medicine, University of Hawai'i, Honolulu, HI (SYC)
| | - Alika Bourgette
- Center for the Study of the Pacific Northwest, University of Washington, Seattle, WA (AB)
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22
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Cahn MA, Harvey SM, Gonzales K. Use of sexual health services among American Indian and Alaska Native Women. Women Health 2019; 59:953-966. [PMID: 30821644 DOI: 10.1080/03630242.2019.1584144] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Revised: 01/22/2019] [Accepted: 01/24/2019] [Indexed: 10/27/2022]
Abstract
Because use of sexual health services among American Indian/Alaska Native women is understudied we: (1) examined disparities in use of sexual health services between American Indian/Alaska Native and non-Hispanic white women and (2) identified factors associated with service use among American Indian/Alaska Native women. We used data from the National Survey of Family Growth regarding the use of sexual health services collected between 2006 and 2010 from women aged 15-44 years who self-identified as American Indian/Alaska Native (n = 819) and white (n = 6,196). Weighted logistic regression models estimated the likelihood of reporting the use of sexual health services by race and factors associated with use in the American Indian/Alaska Native sample. Compared to whites, American Indian/Alaska Native women were less likely to use birth control services and more likely to use services for sexually transmitted diseases and HIV. Among American Indian/Alaska Natives, younger women were more likely to use birth control services, and women who had a higher number of sexual partners were more likely to use services for sexually transmitted diseases and HIV. Our results provide a national baseline against which to assess disparities and changes in the use of sexual health services among American Indian/Alaska Native women over time.
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Affiliation(s)
- Megan A Cahn
- College of Public Health and Human Sciences, Oregon State University , Corvallis , OR , USA
| | - S Marie Harvey
- College of Public Health and Human Sciences, Oregon State University , Corvallis , OR , USA
| | - Kelly Gonzales
- School of Public Health, Oregon Health & Science University-Portland State University , Portland , OR , USA
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23
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Alvarez C, Perrin N, Lameiras-Fernandez M, Rodriguez R, Glass N. Adverse childhood experiences among Latina women and its association with mastery of stress and health. Child Abuse Negl 2019; 93:139-148. [PMID: 31103836 DOI: 10.1016/j.chiabu.2019.05.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Revised: 04/11/2019] [Accepted: 05/05/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Adverse childhood experience (ACE) and intimate partner violence (IPV) have sustained, deleterious effects on physical and mental health. Few studies have examined how to help Latina survivors of ACEs and/or IPV regain control of their health. OBJECTIVE To inform interventions for this population, we examined whether mastery of stress and patient activation mediate the relationship between a history of ACE and/or IPV and mental and physical health. PARTICIPANTS AND SETTING We recruited 235 Latina women (M age = 29.6, SD = 5.75) from primary care clinics. METHOD For this cross-sectional study, we used linear regressions to examine the association between ACEs, history of IPV, and health, and the sobel's test to determine whether patient activation and mastery of stress mediated the relationships between ACEs, IPV, and health. RESULTS Most women reported at least one ACE (61.7%, n = 137) and 22.2% (n = 55) reported a history of IPV. Mastery of stress mediated the relationship between ACE and physical health (b= -3.16 p = .002) and mental health (b= -3.83, p < .001). Mastery of stress also mediated the relationship between history of IPV and physical health (b= -2.62, p = .008) and mental health (b= -2.74, p = .006). Patient activation was not associated with a history of trauma or mental health. CONCLUSION While past experiences of trauma cannot be changed, results from this study suggest that improving an individual's mastery of stress may be a point of intervention for improving mental and physical health among survivors of ACEs and IPV.
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Affiliation(s)
- Carmen Alvarez
- Johns Hopkins University School of Nursing, 525 N. Wolfe St, Baltimore, MD, 21205, United States.
| | - Nancy Perrin
- Johns Hopkins University School of Nursing, 525 N. Wolfe St, Baltimore, MD, 21205, United States
| | | | - Rebecca Rodriguez
- Casa de Esperanza: National Latin@ Network, P.O. Box 40115, St. Paul, MN, 55104, United States
| | - Nancy Glass
- Johns Hopkins University School of Nursing, 525 N. Wolfe St, Baltimore, MD, 21205, United States
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Van der Helm JJ, Schim van der Loeff MF, de Vries E, van der Veer C, Grünberg AW, Mans D, de Vries HJC. Vaginal herb use and Chlamydia trachomatis infection: cross-sectional study among women of various ethnic groups in Suriname. BMJ Open 2019; 9:e025417. [PMID: 31101696 PMCID: PMC6530446 DOI: 10.1136/bmjopen-2018-025417] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
OBJECTIVE Vaginal steam baths with herb leaves (herb use) is practised by some Surinamese women. We assessed herb use among women from the five most prevalent ethnic groups, and if herb use is associated with Chlamydia trachomatis infection. SETTING Participants were recruited at a sexually transmitted infection (STI) clinic and a family planning clinic (FP) in Paramaribo, Suriname. PARTICIPANTS 1040 women were included subsequently, comprising the following ethnic groups: Creole (26.7%), Hindustani (24.6%), Javanese (15.7%), Maroon (13.3%) and mixed descent (19.7%). METHODS Nurses collected a questionnaire and vaginal swabs for nucleic acid amplification C. trachomatis testing. PRIMARY OUTCOMES Determinants of vaginal herb use and C. trachomatis infection via univariable and multivariable logistic regression. RESULTS Herb use was most common among Maroon (68.8%) and Creole women (25.2%). In multivariable analysis including only Maroon and Creole women, determinants significantly associated with vaginal herb use were (OR; 95% CI): Maroon ethnic descent (5.33; 3.26 to 8.71 vs Creole), recruitment at the STI clinic (2.04; 1.24 to 3.36 vs FP), lower education levels (3.80; 1.68 to 8.57 lower vs higher, and 2.02; 0.90 to 4.51 middle vs higher). Lower age and recruitment at the STI clinic were associated with C. trachomatis infection, but not vaginal herb use. CONCLUSION In Suriname, vaginal herb use is common among Maroon and Creole women. Education, ethnic group and recruitment site were determinants for herb use. Vaginal herb use was not a determinant of C. trachomatis infection. Future research should focus on the effect of herb use on the vaginal microbiome and mucosal barrier.
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Affiliation(s)
- Jannie J Van der Helm
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | | | - Esther de Vries
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Charlotte van der Veer
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
| | - Antoon W Grünberg
- Department of Public Health, Ministry of Health, Paramaribo, Suriname
| | - Dennis Mans
- Department of Pharmacology, Faculty of Medical Sciences, Anton de Kom University of Suriname, Paramaribo, Suriname
| | - Henry J C de Vries
- Department of Infectious Diseases, Public Health Service Amsterdam, Amsterdam, The Netherlands
- Department of Dermatology, Amsterdam UMC location Academic Medical Centre, Amsterdam Institute for Infection and Immunity (AI&II), Amsterdam, The Netherlands
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25
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Matthews KA, Hall MH, Lee L, Kravitz HM, Chang Y, Appelhans BM, Swanson LM, Neal-Perry GS, Joffe H. Racial/ethnic disparities in women's sleep duration, continuity, and quality, and their statistical mediators: Study of Women's Health Across the Nation. Sleep 2019; 42:zsz042. [PMID: 30778560 PMCID: PMC6519910 DOI: 10.1093/sleep/zsz042] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Revised: 01/09/2019] [Accepted: 02/08/2019] [Indexed: 11/15/2022] Open
Abstract
STUDY OBJECTIVES To describe racial/ethnic differences in sleep duration, continuity, and perceived sleep quality in postmenopausal women and to identify statistical mediators of differences in sleep characteristics. METHODS Recruited from the observational Study of Women's Health Across the Nation (SWAN), 1,203 (548 white, 303 black, 147 Chinese, 132 Japanese, and 73 Hispanic; mean age 65 years, 97% postmenopausal) women participated in a week-long actigraphy and daily diary study in 2013-2015. Actigraphic measures of sleep duration and wake after sleep onset (WASO), and diary-rated sleep quality were averaged across the week. Candidate mediators included health-related variables; stress; and emotional well-being assessed up to 13 times across 18 years from baseline to sleep study. RESULTS Whites slept longer than other groups; the significant mediators were concurrent financial hardship and increasing number of stressors for Hispanics or Japanese versus whites. Whites had less WASO than blacks and Hispanics; significant mediators were concurrent number of health problems, physical inactivity, waist circumference, vasomotor symptoms, number of life stressors, and financial hardship, and increasing number of health problems from baseline to sleep study. Whites reported better sleep quality than blacks, Chinese, and Japanese; significant mediators were concurrent physical inactivity, vasomotor symptoms, positive affect, and depressive symptoms. CONCLUSIONS Sleep differences between blacks or Hispanics versus whites were mediated by health problems, number of stressors, and financial hardship, whereas sleep differences between Chinese or Japanese versus whites were mediated by emotional well-being. This is the first study using formal mediational approaches.
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Affiliation(s)
- Karen A Matthews
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Martica H Hall
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Laisze Lee
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Howard M Kravitz
- Department of Psychiatry, Rush University Medical Center, Chicago, IL
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL
| | - Yuefang Chang
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, PA
| | | | | | | | - Hadine Joffe
- Connors Center for Women’s Health and Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA
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Variations in reproductive events across life: a pooled analysis of data from 505 147 women across 10 countries. Hum Reprod 2019; 34:881-893. [PMID: 30835788 PMCID: PMC7571491 DOI: 10.1093/humrep/dez015] [Citation(s) in RCA: 63] [Impact Index Per Article: 12.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 01/07/2019] [Accepted: 02/05/2019] [Indexed: 01/06/2023] Open
Abstract
STUDY QUESTION How has the timing of women's reproductive events (including ages at menarche, first birth, and natural menopause, and the number of children) changed across birth years, racial/ethnic groups and educational levels? SUMMARY ANSWER Women who were born in recent generations (1970-84 vs before 1930) or those who with higher education levels had menarche a year earlier, experienced a higher prevalence of nulliparity and had their first child at a later age. WHAT IS KNOWN ALREADY The timing of key reproductive events, such as menarche and menopause, is not only indicative of current health status but is linked to the risk of adverse hormone-related health outcomes in later life. Variations of reproductive indices across different birth years, race/ethnicity and socioeconomic positions have not been described comprehensively. STUDY DESIGN, SIZE, DURATION Individual-level data from 23 observational studies that contributed to the International Collaboration for a Life Course Approach to Reproductive Health and Chronic Disease Events (InterLACE) consortium were included. PARTICIPANTS/MATERIALS, SETTING, METHODS Altogether 505 147 women were included. Overall estimates for reproductive indices were obtained using a two-stage process: individual-level data from each study were analysed separately using generalised linear models. These estimates were then combined using random-effects meta-analyses. MAIN RESULTS AND THE ROLE OF CHANCE Mean ages were 12.9 years at menarche, 25.7 years at first birth, and 50.5 years at natural menopause, with significant between-study heterogeneity (I2 > 99%). A linear trend was observed across birth year for mean age at menarche, with women born from 1970 to 1984 having menarche one year earlier (12.6 years) than women born before 1930 (13.5 years) (P for trend = 0.0014). The prevalence of nulliparity rose progressively from 14% of women born from 1940-49 to 22% of women born 1970-84 (P = 0.003); similarly, the mean age at first birth rose from 24.8 to 27.3 years (P = 0.0016). Women with higher education levels had fewer children, later first birth, and later menopause than women with lower education levels. After adjusting for birth year and education level, substantial variation was present for all reproductive events across racial/ethnic/regional groups (all P values < 0.005). LIMITATIONS, REASONS FOR CAUTION Variations of study design, data collection methods, and sample selection across studies, as well as retrospectively reported age at menarche, age at first birth may cause some bias. WIDER IMPLICATIONS OF THE FINDINGS This global consortium study found robust evidence on variations in reproductive indices for women born in the 20th century that appear to have both biological and social origins. STUDY FUNDING/COMPETING INTEREST(S) InterLACE project is funded by the Australian National Health and Medical Research Council project grant (APP1027196). GDM is supported by the Australian National Health and Medical Research Council Principal Research Fellowship (APP1121844).
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Affiliation(s)
- InterLACE Study Team
- School of Public Health, University of Queensland, Brisbane, Queensland, Australia
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Abstract
This article explores how six Pakistani Muslim women interpret cultural concepts of izzat (honor and self-respect); what role, if any, it has in their lives; and whether there is interplay between upholding izzat and the participants' help-seeking strategies for mental health and well-being. Semistructured interviews were conducted and analyzed with an interpretative phenomenological analytic framework. Three themes were identified: (a) "the rules of izzat," (b) "negotiating tensions," and (c) "speaking out/breaking the 'rules.'" Findings highlighted new insights into the understanding of izzat and the implications these cultural concepts have for strategies in managing or silencing of psychological distress. Interviews illustrated tensions the participants experience when considering izzat, how these are negotiated to enable them to self-manage or seek help, and possible life experiences that might lead to self-harm and attempted suicide. Notably, cultural codes, in particular izzat, appear to vary over the life course and are influenced by migration.
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Affiliation(s)
| | | | - Jane Lawrence
- 2 University of East Anglia, Norwich, United Kingdom
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Rahbari L. Vaginal hygiene practices and the formation of sexuality. Cult Health Sex 2019; 21:360-371. [PMID: 29847221 DOI: 10.1080/13691058.2018.1468925] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Accepted: 04/20/2018] [Indexed: 06/08/2023]
Abstract
Although different forms of vaginal cleansing practices are common throughout the world, studies relating to Iranian women's experiences are scarce. This study uses the life-story method to give a thick description of one Iranian woman's experience of vaginal practices, and the role nurturing plays in shaping attitudes towards the female genitalia and sexual formation. The study addresses how gendered ideas about femininity, hygiene and the moral body are interconnected. Vaginal practices such as external washing, intravaginal cleaning or douching, the application and insertion of substances and hair removal are discussed. The interviewee draws on religious and cultural frameworks as well as hygiene discourses to explain vaginal cleansing regimes. The narrative reveals the importance of practices not only in the formation of sexuality, but also in self-perceptions of the body, femininity and sexual behaviour.
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Affiliation(s)
- Ladan Rahbari
- a Centre for Research on Culture and Gender , Ghent University , Ghent , Belgium
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Yellow Horse AJ, Santos-Lozada AR. Foreign-Born Hispanic Women's Health Patterns in Allostatic Load Converge to U.S.-Born Hispanic Women at a Slower Tempo Compared With Men. Womens Health Issues 2019; 29:222-230. [PMID: 30755363 DOI: 10.1016/j.whi.2019.01.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2017] [Revised: 01/03/2019] [Accepted: 01/04/2019] [Indexed: 01/12/2023]
Abstract
OBJECTIVES We investigated the patterns of foreign-born Hispanic health convergence to U.S.-born Hispanics using an allostatic load index, a subjective biological risk health profile, and we explored whether the health convergence patterns differ by sex. METHODS The analytic sample consisted of 3,347 Hispanics from the pooled 2005-2010 National Health and Nutrition Examination Survey. We used negative binomial regression models to investigate the association between duration in the United States and the allostatic load index, while controlling for potential covariates. RESULTS Foreign-born Hispanics who had lived in the United States for 0-9 years and 10-19 years had lower levels of allostatic load than U.S.-born Hispanics; however, those who had lived in the United States for 20 or more years had a level of allostatic load similar to their U.S.-born counterparts. The pattern of immigrant health convergence shows a clear sex difference. In the sex-stratified models, we found that foreign-born Hispanic men converged to the level of allostatic load of U.S.-born Hispanic men after having lived in the United States for approximately 10 years. The health convergence pattern qualitatively differed for foreign-born Hispanic women, who remained healthier than U.S.-born Hispanic women regardless of duration in the United States. CONCLUSIONS Foreign-born Hispanics are healthier than their U.S.-born counterparts, providing support for the healthy migrant hypothesis. This relatively better health of foreign-born Hispanics disappears with a longer duration in the United States, providing support for the health convergence hypothesis, but is most noticeable for men. Foreign-born Hispanic women converge to U.S.-born Hispanic women's health status at a slower tempo, compared with foreign-born Hispanic men.
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Affiliation(s)
- Aggie J Yellow Horse
- School of Social Transformation, Arizona State University, Tempe, Arizona; Population Research Institute, Pennsylvania State University, University Park, Pennsylvania.
| | - Alexis R Santos-Lozada
- Population Research Institute, Pennsylvania State University, University Park, Pennsylvania; Department of Sociology, Pennsylvania State University, University Park, Pennsylvania
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Maxwell AE, Young S, Moe E, Bastani R, Wentzell E. Understanding Factors that Influence Health Care Utilization Among Mixtec and Zapotec Women in a Farmworker Community in California. J Community Health 2019; 43:356-365. [PMID: 28975501 DOI: 10.1007/s10900-017-0430-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
This paper examines health care utilization among indigenous immigrants from Oaxaca, Mexico, who have settled in a farmworker community in southern California. In 2016, two trained Spanish-Mixteco and Spanish-Zapoteco bi-lingual interviewers conducted in-depth interviews with 44 indigenous women residing in Oxnard, California on issues that affect health care utilization. Interviews were conducted in Mixteco, Zapoteco and Spanish and were coded to identify structural, cultural, and provider-related barriers to health care utilization. Five bi-lingual Spanish-Mixteco indigenous interpreters employed at local clinics were also interviewed. Many women reported lack of health insurance, inability to pay, language barriers, long waiting times, rushed encounters with providers, and seeking western medical care only after home remedies did not work. However, several women were able to access routine health care services, often with support from indigenous interpreters employed at clinics. Interviews with five interpreters found that they provided assistance with interpretation during medical encounters and appointment making. They also educated patients about upcoming exams, identified low-cost services and insurance programs available to patients, assisted with paperwork and occasionally educated physicians on behalf of their patients. In addition to addressing barriers to health care access our findings suggest the importance of identifying and leveraging community assets, such as indigenous navigators, when developing programs for such underserved communities. Our findings can inform best practice in settings that provide health care to indigenous populations and may also apply to settings that provide health care to other immigrant communities that have very limited familiarity and contact with western health care.
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Affiliation(s)
- Annette E Maxwell
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA.
| | - Sandra Young
- Mixteco/Indigena Community Organizing Project, PO Box 20543, Oxnard, CA, 93034, USA
| | - Emily Moe
- Department of Anthropology, University of Iowa, Iowa City, IA, USA
| | - Roshan Bastani
- Fielding School of Public Health and Jonsson Comprehensive Cancer Center, UCLA Kaiser Permanente Center for Health Equity, University of California Los Angeles, 650 Charles Young Drive South, A2-125 CHS, Box 956900, Los Angeles, CA, 90095-6900, USA
| | - Emily Wentzell
- Department of Anthropology, University of Iowa, Iowa City, IA, USA
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Zick CD, Buder I, Waitzman NJ, Simonsen S, Digre K. The nexus between health and time use among racially and ethnically diverse women. Ethn Health 2019; 24:147-167. [PMID: 28406041 DOI: 10.1080/13557858.2017.1315529] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 03/10/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Ethnic and racial health disparities have been well-documented in the scholarly literature. In recent years, evidence about time spent in physical (in)activity and its relationship to physical and mental health has also emerged. This study assesses if observed ethnic/racial health differences were associated with differences in time use. DESIGN Our analyses utilized baseline data from 510 Utah women who enrolled in one of two community-based, participatory research intervention studies between 2012 and 2015. The distinct racial/ethnic groups included African immigrants, African Americans, Latinas, Native Hawaiians/Pacific Islanders, American Indians/Alaskan Natives, and rural White, Non-Latina women. In the baseline survey, respondents reported the typical time they spent in paid employment, television/movie viewing, physical activity, food preparation/clean-up, and sleep. Cluster analysis was used to identify seven distinct patterns of time use within these five activities. We related these time use patterns along with race/ethnicity, socio-demographics, and other potentially contributing health-related factors (e.g. smoking status) to two health outcomes: (1) self-reported health status, and (2) depression. RESULTS Our time use clusters revealed heterogeneity by racial/ethnic groups, suggesting that some of the health effects that may have been previously ascribed to group membership should instead be attributed to (un)healthy patterns of time use. In particular, spending too much time in sedentary activities such as watching television/movies and too little time sleeping both linked to poor physical and mental health, independently of racial/ethnic group membership. CONCLUSIONS Researchers and policy makers designing culturally sensitive physical activity health-related interventions should consider patterns of time use that are associated with poor health. Programs designed to improve sleep time and reduce sedentary television-viewing time may be as important as interventions designed to increase physical activity time. These broader patterns of time use mediated the relationships between race/ethnicity and physical and mental health for the women in our study.
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Affiliation(s)
- Cathleen D Zick
- a Department of Family and Consumer Studies , University of Utah , Salt Lake City , USA
| | - Iris Buder
- b Economics Department , Idaho State University
| | | | - Sara Simonsen
- d College of Nursing , University of Utah , Salt Lake City , USA
| | - Kathleen Digre
- e Department of Neurology , University of Utah , Salt Lake City , USA
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Saleh M, Friesen P, Ades V. On Female Genital Cutting: Factors to be Considered When Confronted With a Request to Re-infibulate. J Bioeth Inq 2018; 15:549-555. [PMID: 30117063 DOI: 10.1007/s11673-018-9875-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 03/02/2018] [Indexed: 06/08/2023]
Abstract
According to the World Health Organization, female genital cutting affects millions of girls and women worldwide, particularly on the African continent and in the Middle East. This paper presents a plausible, albeit hypothetical, clinical vignette and then explores the legal landscape as well as the ethical landscape physicians should use to evaluate the adult patient who requests re-infibulation. The principles of non-maleficence, beneficence, justice, and autonomy are considered for guidance, and physician conscientious objection to this procedure is discussed as well. Analyses of law and predominant principles of bioethics fail to yield a clear answer regarding performing female genital cutting or re-infibulation on an adult in the United States. Physicians should consider the patient's physical, mental, and social health when thinking about female genital cutting and should understand the deep-rooted cultural significance of the practice.
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Affiliation(s)
- Mona Saleh
- New York University School of Medicine, 550 First Avenue, NBV 9E2, New York, NY, 10016, USA.
| | - Phoebe Friesen
- New York University Medical Center, 227 East 30th Street, New York, NY, 10016, USA
| | - Veronica Ades
- New York University Medical Center, 423 East 23rd Street, 11066-AS, New York, NY, 10010, USA
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Hawkey AJ, Ussher JM, Perz J. Regulation and Resistance: Negotiation of Premarital Sexuality in the Context of Migrant and Refugee Women. J Sex Res 2018; 55:1116-1133. [PMID: 28682121 DOI: 10.1080/00224499.2017.1336745] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Constructions of normative sexuality shape the sexual scripts that women are permitted to adopt and the manner in which such sexuality can be expressed. We explored experiences and constructions of premarital sexuality among migrant and refugee women recently resettled in Sydney, Australia, and Vancouver, Canada. A total of 78 semistructured individual interviews and 15 focus groups composed of 82 participants were undertaken with women who had migrated from Afghanistan, Iraq, Somalia, South Sudan, Sudan, Sri Lanka, and South America. We analyzed the data using thematic decomposition. Across all cultural groups, women's premarital sexuality was regulated through cultural and religious discourse and material practice. Such regulation occurred across three main facets of women's lives, shaping the themes presented in this article: (1) regulating premarital sex-the virginity imperative; (2) regulation of relationships with men; and (3) regulation of the sexual body. These themes capture women's reproduction of dominant discourses of premarital sexuality, as well as women's resistance and negotiation of such discourses, both prior to and following migration. Identifying migrant and refugee women's experiences and constructions of premarital sexuality is essential for culturally safe sexual health practice, health promotion, and health education.
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Affiliation(s)
- Alexandra J Hawkey
- a Translational Research Institute (THRI), School of Medicine, Western Sydney University
| | - Jane M Ussher
- a Translational Research Institute (THRI), School of Medicine, Western Sydney University
| | - Janette Perz
- a Translational Research Institute (THRI), School of Medicine, Western Sydney University
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Herrick KA, Perrine CG, Aoki Y, Caldwell KL. Iodine Status and Consumption of Key Iodine Sources in the U.S. Population with Special Attention to Reproductive Age Women. Nutrients 2018; 10:E874. [PMID: 29986412 PMCID: PMC6073695 DOI: 10.3390/nu10070874] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Revised: 06/28/2018] [Accepted: 07/02/2018] [Indexed: 11/19/2022] Open
Abstract
We estimated iodine status (median urinary iodine concentration (mUIC (µg/L))) for the US population (6 years and over; n = 4613) and women of reproductive age (WRA) (15⁻44 years; n = 901). We estimated mean intake of key iodine sources by race and Hispanic origin. We present the first national estimates of mUIC for non-Hispanic Asian persons and examine the intake of soy products, a potential source of goitrogens. One-third of National Health and Nutrition Examination Survey (NHANES) participants in 2011⁻2014 provided casual urine samples; UIC was measured in these samples. We assessed dietary intake with one 24-h recall and created food groups using the USDA’s food/beverage coding scheme. For WRA, mUIC was 110 µg/L. For both non-Hispanic white (106 µg/L) and non-Hispanic Asian (81 µg/L) WRA mUIC was significantly lower than mUIC among Hispanic WRA (133 µg/L). Non-Hispanic black WRA had a mUIC of 124 µg/L. Dairy consumption was significantly higher among non-Hispanic white (162 g) compared to non-Hispanic black WRA (113 g). Soy consumption was also higher among non-Hispanic Asian WRA (18 g compared to non-Hispanic black WRA (1 g). Differences in the consumption pattern of key sources of iodine and goitrogens may put subgroups of individuals at risk of mild iodine deficiency. Continued monitoring of iodine status and variations in consumption patterns is needed.
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Affiliation(s)
- Kirsten A Herrick
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), Hyattsville, MD 20782, USA.
| | - Cria G Perrine
- Division of Nutrition, Physical Activity, and Obesity, CDC, Atlanta, GA 30341, USA.
| | - Yutaka Aoki
- Division of Health and Nutrition Examination Surveys, National Center for Health Statistics, Centers for Disease Control and Prevention (CDC), Hyattsville, MD 20782, USA.
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Seo JY, Li J, Li K. Cervical Cancer Screening Experiences Among Chinese American Immigrant Women in the United States. J Obstet Gynecol Neonatal Nurs 2018; 47:52-63. [PMID: 29144960 PMCID: PMC6260927 DOI: 10.1016/j.jogn.2017.10.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/01/2017] [Indexed: 11/23/2022] Open
Abstract
OBJECTIVE To understand the experiences and perceptions of having cervical cancer screening tests and to explore the extant barriers to having the tests among first-generation Chinese American women in the United States. DESIGN Qualitative, descriptive, phenomenological research. SETTING Los Angeles, California. PARTICIPANTS Snowball and purposive sampling of 12 Chinese American immigrant women ages 20 to 65 years. METHODS Individual face-to-face, in-depth, semistructured interviews in which participants were asked about their experiences and perceptions about cervical cancer screening. Interviews were audiotaped, transcribed, and translated into English. Data analysis included comparing and distinguishing, collecting and counting, and presupposing and inferring. RESULTS Through the analysis process, we identified four major themes that reflected the experiences, perceptions, and barriers to having cervical cancer screening among Chinese American women: Belief in a Healthy Lifestyle, Maintaining Privacy for Female Health Problems, Fear of Losing Control, and Feeling Vulnerable in an Unfamiliar Health Care System. These themes indicated that Chinese immigrant women in the United States face challenges to their cultural health beliefs and practices with regard to decision-making and health-seeking behaviors related to cervical cancer screening. They felt more vulnerable as immigrants because of systematic barriers to navigation of the unfamiliar health care system and limited resources. CONCLUSION Women's health care providers should be aware of and give consideration to cultural differences through the provision of more educational information and comfort to Chinese immigrant women who seek cervical cancer screening. Ultimately, the development of culturally appropriate and affordable cancer prevention programs with effective strategies is important to ease Chinese American women's senses of vulnerability.
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Mishori R, Warren N, Reingold R. Female Genital Mutilation or Cutting. Am Fam Physician 2018; 97:49-52. [PMID: 29365235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Ranit Mishori
- Georgetown University School of Medicine, Washington, DC, USA
| | | | - Rebecca Reingold
- O'Neill Institute for National and Global Health Law, Georgetown University, Washington, DC, USA
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Seay JS, Mandigo M, Kish J, Menard J, Marsh S, Kobetz E. Intravaginal practices are associated with greater odds of high-risk HPV infection in Haitian women. Ethn Health 2017; 22:257-265. [PMID: 27774794 DOI: 10.1080/13557858.2016.1246423] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Haitian women have the highest incidence of cervical cancer within the Western hemisphere. Intravaginal hygiene practices have been linked with human papilloma virus (HPV) infection and cervical dysplasia. These practices, known as 'twalet deba' in Haitian Creole, are common among Haitian women and are performed with various natural and synthetic agents. As part of a community-based participatory research initiative aimed at reducing cervical cancer disparities in rural Haiti, we explored the use of intravaginal agents and their associations with high-risk HPV infection. DESIGN Community Health Workers recruited 416 women for cervical self-sampling from two neighborhoods within Thomonde, Haiti. Participants were interviewed regarding intravaginal hygiene practices and completed a cervical self-sampling procedure. Cervical samples were analyzed for the presence of high-risk HPV infection. Associations between each intravaginal agent and high-risk HPV infection were examined via univariate logistic regression analyses, as well as via multivariate analyses controlling for sociodemographic factors and concurrent agent use. RESULTS Nearly all women (97.1%) performed twalet deba, using a variety of herbal and commercially produced intravaginal agents. Approximately 11% of the participants tested positive for high-risk HPV. Pigeon pea and lime juice were the only agents found to be associated with high-risk HPV in the univariate analyses, with women who used these agents being approximately twice as likely to have high-risk HPV as those who did not. Only pigeon pea remained significantly associated with high-risk HPV after controlling for sociodemographic factors and concurrent agent use. CONCLUSION Two agents, pigeon pea and lime juice, may contribute to risk for HPV infection in this population. Results suggest that in addition to cervical cancer screening interventions, future preventive initiatives should focus on minimizing risk by advocating for the use of less-toxic twalet deba alternatives.
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Affiliation(s)
- Julia S Seay
- a Miller School of Medicine , University of Miami , Miami , FL , USA
| | - Morgan Mandigo
- a Miller School of Medicine , University of Miami , Miami , FL , USA
- b Department of Gynecology and Obstetrics , Johns Hopkins University School of Medicine , Baltimore , MD , USA
| | | | - Janelle Menard
- d Center for Multicultural Wellness & Prevention, Inc. , Orlando , FL , USA
| | | | - Erin Kobetz
- a Miller School of Medicine , University of Miami , Miami , FL , USA
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Robillard A, Padi A, Lewis K, Julious C, Troutman J. Advice for prevention from HIV-positive African-American women: 'My story is not just a story'. Cult Health Sex 2017; 19:630-642. [PMID: 27796161 DOI: 10.1080/13691058.2016.1243732] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Large disparities in HIV incidence, prevalence and mortality exist for African-American women, especially in the southern region of the USA. Based on the culture-centric health promotion model, HIV-positive African American women can use their stories to support primary prevention. The purpose of this study was to document advice from HIV-positive African-American women (n = 25) to young African-American women, as described in their own cultural narratives collected through qualitative interviews. Content analysis of women's advice identified five common themes revolving broadly around: (1) advice for prevention, (2) support systems for prevention, (3) education, (4) empowerment/self-care and (5) potential barriers to prevention. Advice reflected recommendations based on personal experience and highlighted social determinants linked to HIV, such as stigma, access to education and healthcare, social support, and gender and power dynamics. Women also offered advice for coping with an HIV-positive diagnosis. Communication with parents, family and friends regarding education and social support emerged as an important interpersonal factor for participants, as were interactions with sexual/romantic partners. Stigma, at the community level, was consistently discussed as a hindrance to prevention. Narratives of HIV-positive women as community health agents of change can enhance the effectiveness of HIV prevention interventions for young US African-American women.
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Affiliation(s)
- Alyssa Robillard
- a Health Promotion, Education, and Behavior , University of South Carolina, Arnold School of Public Health , Columbia , USA
| | - Akhila Padi
- a Health Promotion, Education, and Behavior , University of South Carolina, Arnold School of Public Health , Columbia , USA
| | - Kaleea Lewis
- a Health Promotion, Education, and Behavior , University of South Carolina, Arnold School of Public Health , Columbia , USA
| | - Carmen Julious
- b Palmetto AIDS Life Support Services Inc , Columbia , USA
| | - Jamie Troutman
- a Health Promotion, Education, and Behavior , University of South Carolina, Arnold School of Public Health , Columbia , USA
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Vardeman-Winter J. The Framing of Women and Health Disparities: A Critical Look at Race, Gender, and Class from the Perspectives of Grassroots Health Communicators. Health Commun 2017; 32:629-638. [PMID: 27367141 DOI: 10.1080/10410236.2016.1160318] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
As women's health has received significant political and media attention recently, I proposed an expanded structural theory of women's communication about health. Women's health communication and critical race and systemic racism research framed this study. I interviewed 15 communicators and community health workers from grass-roots organizations focused on women's health to learn of their challenges of communicating with women from communities experiencing health disparities. Findings suggest that communicators face difficulties in developing meaningful messaging for publics because of disjunctures between medical and community frames, issues in searching for health among women's many priorities, Whiteness discourses imposed on publics' experiences, and practices of correcting for power differentials. A structural theory of women's health communication, then, consists of tenets around geographic, research/funding, academic/industry, and social hierarchies. Six frames suggesting racial biases about women and health disparities are also defined. This study also includes practical solutions in education, publishing, and policy change for addressing structural challenges.
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Turner C, Pol S, Suon K, Neou L, Day NPJ, Parker M, Kingori P. Beliefs and practices during pregnancy, post-partum and in the first days of an infant's life in rural Cambodia. BMC Pregnancy Childbirth 2017; 17:116. [PMID: 28403813 PMCID: PMC5389162 DOI: 10.1186/s12884-017-1305-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 04/07/2017] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The aim of this study was to record the beliefs, practices during pregnancy, post-partum and in the first few days of an infant's life, held by a cross section of the community in rural Cambodia to determine beneficial community interventions to improve early neonatal health. METHODS Qualitative study design with data generated from semi structured interviews (SSI) and focus group discussions (FGD). Data were analysed by thematic content analysis, with an a priori coding structure developed using available relevant literature. Further reading of the transcripts permitted additional coding to be performed in vivo. This study was conducted in two locations, firstly the Angkor Hospital for Children and secondarily in five villages in Sotnikum, Siem Reap Province, Cambodia. RESULTS A total of 20 participants underwent a SSIs (15 in hospital and five in the community) and six (three in hospital and three in the community; a total of 58 participants) FGDs were conducted. Harmful practices that occurred in the past (for example: discarding colostrum and putting mud on the umbilical stump) were not described as being practiced. Village elders did not enforce traditional views. Parents could describe signs of illness and felt responsible to seek care for their child even if other family members disagreed, however participants were unaware of the signs or danger of neonatal jaundice. Cost of transportation was the major barrier to healthcare that was identified. CONCLUSIONS In the population examined, traditional practices in late pregnancy and the post-partum period were no longer commonly performed. However, jaundice, a potentially serious neonatal condition, was not recognised. Community neonatal interventions should be tailored to the populations existing practice and knowledge.
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Affiliation(s)
- Claudia Turner
- Cambodia Oxford Medical Research Unit, Siem Reap, Cambodia
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
- Angkor Hospital for Children, PO Box 50, Siem Reap, Cambodia
| | - Sreymom Pol
- Cambodia Oxford Medical Research Unit, Siem Reap, Cambodia
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Kamsan Suon
- Cambodia Oxford Medical Research Unit, Siem Reap, Cambodia
| | - Leakhena Neou
- Angkor Hospital for Children, PO Box 50, Siem Reap, Cambodia
| | - Nicholas P. J. Day
- Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
- Centre for Tropical Medicine and Global Health, Nuffield Department of Clinical Medicine, University of Oxford, Oxford, UK
| | - Michael Parker
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Patricia Kingori
- Ethox Centre, Nuffield Department of Population Health, University of Oxford, Oxford, UK
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Biyikli Gültekin E. Difficulties in health care for female Turkish immigrants with type 2 diabetes: a qualitative study in Vienna. Wien Klin Wochenschr 2017; 129:337-344. [PMID: 28382526 DOI: 10.1007/s00508-017-1190-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 03/13/2017] [Indexed: 11/28/2022]
Abstract
According to studies, type 2 diabetes mellitus (DMT2) is more commonly encountered among Turkish immigrants than resident populations in Europe and Turkish people living in Turkey. Within this context this study focused on female Turkish immigrants with DMT2 who are living in Vienna. The purpose of this study was to determine the needs, expectations, special conditions and cultural characteristics of Turkish women with DMT2 by gathering information about their own perceptions about DMT2, difficulties encountered during the diagnosis, treatment and their experiences living with the disease. A qualitative phenomenological design was utilized with a sample of 13 participants recruited from the Turkish mosques in Vienna. The interview guide, which included semi-structured questions, was based on previous studies conducted on DMT2 and immigration. Interviews were transcribed verbally from tape recordings, translated into German and each statement paraphrased for further analysis. The interviews indicated participants' degree of knowledge about DMT2 and was the most significant factor affecting approaches to the disease. The most important difficulty for the participants was the re-organization of nutritional habits to DMT2 because of the Turkish cuisine culture. The results of this study can be utilized by the health care providers to gain an understanding of Turkish immigrants and DMT2. Thus, it will enable them to adapt their health care and education to meet the needs of this population better.
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Affiliation(s)
- Elif Biyikli Gültekin
- The Department of Medical History and Ethic, Cerrahpasa Faculty of Medicine, University of Istanbul, Kocamustafapaşa Cd. No: 53 Cerrahpaşa, 34098, Fatih/İstanbul, Turkey.
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Gea-Sánchez M, Gastaldo D, Molina-Luque F, Otero-García L. Access and utilisation of social and health services as a social determinant of health: the case of undocumented Latin American immigrant women working in Lleida (Catalonia, Spain). Health Soc Care Community 2017; 25:424-434. [PMID: 26732249 DOI: 10.1111/hsc.12322] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/23/2015] [Indexed: 06/05/2023]
Abstract
Although Spain has social and healthcare systems based on universal coverage, little is known about how undocumented immigrant women access and utilise them. This is particularly true in the case of Latin Americans who are overrepresented in the informal labour market, taking on traditionally female roles of caregivers and cleaners in private homes. This study describes access and utilisation of social and healthcare services by undocumented Latin American women working and living in rural and urban areas, and the barriers these women may face. An exploratory qualitative study was designed with 12 in-depth interviews with Latin American women living and working in three different settings: an urban city, a rural city and rural villages in the Pyrenees. Interviews were recorded, transcribed and analysed, yielding four key themes: health is a tool for work which worsens due to precarious working conditions; lack of legal status traps Latin American women in precarious jobs; lack of access to and use of social services; and limited access to and use of healthcare services. While residing and working in different areas of the province impacted the utilisation of services, working conditions was the main barrier experienced by the participants. In conclusion, decent working conditions are the key to ensuring undocumented immigrant women's right to social and healthcare. To create a pathway to immigrant women's health promotion, the 'trap of illegality' should be challenged and the impact of being considered 'illegal' should be considered as a social determinant of health, even where the right to access services is legal.
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Affiliation(s)
- Montserrat Gea-Sánchez
- Nursing Department, GESEC, Lleida University, Spain
- Health Care Research Group (GRECS), IRB Lleida, Spain
| | - Denise Gastaldo
- Lawrence S. Bloomberg Faculty of Nursing, University of Toronto, Canada
| | | | - Laura Otero-García
- Nursing Department, GESEC, Lleida University, Spain
- National School of Public Health, Institute of Health Carlos III, Spain
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Chapuma C. They are people too (an Ob-Gyn intern's perspective). Malawi Med J 2017; 29:77. [PMID: 28567208 PMCID: PMC5442503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023] Open
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Paul M, Essén B, Sariola S, Iyengar S, Soni S, Klingberg Allvin M. Negotiating Collective and Individual Agency: A Qualitative Study of Young Women's Reproductive Health in Rural India. Qual Health Res 2017; 27:311-324. [PMID: 26531879 PMCID: PMC5302084 DOI: 10.1177/1049732315613038] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
The societal changes in India and the available variety of reproductive health services call for evidence to inform health systems how to satisfy young women's reproductive health needs. Inspired by Foucault's power idiom and Bandura's agency framework, we explore young women's opportunities to practice reproductive agency in the context of collective social expectations. We carried out in-depth interviews with 19 young women in rural Rajasthan. Our findings highlight how changes in notions of agency across generations enable young women's reproductive intentions and desires, and call for effective means of reproductive control. However, the taboo around sex without the intention to reproduce made contraceptive use unfeasible. Instead, abortions were the preferred method for reproductive control. In conclusion, safe abortion is key, along with the need to address the taboo around sex to enable use of "modern" contraception. This approach could prevent unintended pregnancies and expand young women's agency.
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Affiliation(s)
- Mandira Paul
- Uppsala University, Uppsala, Sweden
- Mandira Paul, Department of Women’s and Children’s health/IMCH, Uppsala University, Akademiska Sjukhuset, SE-751 85 Uppsala, Sweden.
| | | | | | - Sharad Iyengar
- Action Research & Training for Health, Udaipur, Rajasthan, India
| | - Sunita Soni
- Action Research & Training for Health, Udaipur, Rajasthan, India
| | - Marie Klingberg Allvin
- Karolinska Institutet/Karolinska University Hospital, WHO collaborating Centre, Stockholm, Sweden
- Dalarna University, Falun, Sweden
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Dills AK, Grecu AM. Effects of state contraceptive insurance mandates. Econ Hum Biol 2017; 24:30-42. [PMID: 27889633 DOI: 10.1016/j.ehb.2016.11.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Revised: 11/14/2016] [Accepted: 11/15/2016] [Indexed: 06/06/2023]
Abstract
Using U.S. Natality data for 1996 through 2009 and an event analysis specification, we investigate the dynamics of the effects of state insurance contraceptive mandates on births and measures of parental investment: prenatal visits, non-marital childbearing, and risky behaviors during pregnancy. We analyze outcomes separately by age, race, and ethnicity. Among young Hispanic women, we find a 4% decline in the birth rate. There is evidence of a decrease in births to single mothers, consistent with increased wantedness. We also find evidence of selection into motherhood, which could explain the lack of a significant effect on birth outcomes.
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Affiliation(s)
- Angela K Dills
- Western Carolina University, Forsyth 224A, Cullowhee, NC 28723, United States.
| | - Anca M Grecu
- Seton Hall University, JH 621 Department of Economics and Legal Studies, Stillman School of Business, Seton Hall University, 400 South Orange Ave, South Orange, NJ, 07079, United States.
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Mama SK, Song J, Ortiz A, Tirado-Gomez M, Palacios C, Hughes DC, Basen-Engquist K. Longitudinal social cognitive influences on physical activity and sedentary time in Hispanic breast cancer survivors. Psychooncology 2017; 26:214-221. [PMID: 26602701 PMCID: PMC4879102 DOI: 10.1002/pon.4026] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2015] [Revised: 09/30/2015] [Accepted: 10/16/2015] [Indexed: 12/30/2022]
Abstract
OBJECTIVE This study evaluated the effect of two home-based exercise interventions (one culturally adapted and one standard) on changes in social cognitive theory (SCT) variables, physical activity (PA), and sedentary time (ST), and determined the association between changes in SCT variables and changes in PA and ST in Hispanic breast cancer survivors. METHOD Project VIVA! was a 16-week randomized controlled pilot study to test the effectiveness and feasibility of a culturally adapted exercise intervention for Mexican American and Puerto Rican breast cancer survivors in Houston, Texas and San Juan, Puerto Rico, respectively. Women (N = 89) completed questionnaires on SCT variables, PA, and ST and were then randomized to a 16-week culturally adapted exercise program, a non-culturally adapted standard exercise intervention or a wait-list control group. Multiple regression models were used to determine associations between changes in SCT variables and changes in PA and ST. RESULTS Participants were in their late 50s (58.5 ± 9.2 years) and obese (31.0 ± 6.5 kg/m2 ). Women reported doing roughly 34.5 min/day of PA and spending over 11 h/day in sedentary activities. Across groups, women reported significant increases in exercise self-efficacy and moderate-intensity, vigorous-intensity, and total PA from baseline to follow-up (p < 0.05). Increased social support from family was associated with increases in vigorous-intensity PA. Increases in social modeling were associated with increases in moderate-intensity and total PA and with decreases in ST from baseline to follow-up (p < 0.05). CONCLUSIONS Hispanic cancer survivors benefit from PA interventions that focus on increasing social support from family and friends and social modeling. Copyright © 2015 John Wiley & Sons, Ltd.
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Affiliation(s)
| | - Jaejoon Song
- Department of Biostatistics, The University of Texas MD Anderson Cancer Center
| | - Alexis Ortiz
- School of Physical Therapy, Texas Woman’s University
| | - Maribel Tirado-Gomez
- Comprehensive Center for Cancer, Medical Sciences Campus, University of Puerto Rico
| | - Cristina Palacios
- Nutrition Program, Graduate School of Public Health, Medical Sciences Campus, University of Puerto Rico
| | - Daniel C. Hughes
- Institute for Health Promotion Research, The University of Texas Health Science Center - San Antonio
| | - Karen Basen-Engquist
- Center for Energy Balance in Cancer Prevention and Survivorship and Department of Behavioral Science, The University of Texas MD Anderson Cancer Center
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Whitt MC, DuBose KD, Ainsworth BE, Tudor-Locke C. Walking Patterns in a Sample of African American, Native American, and Caucasian Women: The Cross-Cultural Activity Participation Study. Health Educ Behav 2016; 31:45S-56S. [PMID: 15296691 DOI: 10.1177/1090198104266034] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This analysis describes walking patterns among African American, Native American, and Caucasian women from South Carolina and New Mexico. Walking was assessed using pedometer and physical activity (PA) record data based on 4 consecutive days on either three (Study Phase 1) or two (Study Phase 2) occasions. Participants walked 5,429 +/- 2,959 steps per day and recorded 159 +/- 59 minutes per day of total walking in the PA record. Most daily walking was accumulated during household (46%), transportation (26%), occupation (16%), and exercise-related (10%) walking. There was a modest correlation between steps per day and minutes per day. Steps per day were higher with education and household size, and lower with increasing age and body mass index. These findings have implications for developing PA surveys and for planning interventions related to walking patterns among women.
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Affiliation(s)
- Melicia C Whitt
- PHS-Epidemiology, Wake Forest University Health Sciences, Winston-Salem, North Carolina27157-1063, USA.
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Davies SL, DiClemente RJ, Wingood GM, Person SD, Crosby RA, Harrington KF, Dix ES. Relationship Characteristics and Sexual Practices of African American Adolescent Girls Who Desire Pregnancy. Health Educ Behav 2016; 31:85S-96S. [PMID: 15296694 DOI: 10.1177/1090198104266037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This study examined associations between African American adolescent girls' desire to become pregnant and their sexual and relationship practices. Odds ratios and 95% confidence intervals were used to detect significant associations between pregnancy desire and the assessed correlates. Of 522 participants (14 to 18 years old), 67 (12.8%) were pregnant and were thus excluded from this analysis. Of the remaining 455 adolescents, 107 (23.6%) expressed some desire to be pregnant at the time of assessment. Adolescents who desired pregnancy were significantly more likely to report having had sex with a casual partner and to use contraception inconsistently. Factors involving an adolescent girl's relationship with her partner (e.g., being in a relationship, length of relationship, time spent with boyfriend, or satisfaction with boyfriend) were not significantly associated with the desire for pregnancy. Effective pregnancy and sexually transmitted disease prevention programs for female adolescents should address their level of pregnancy desire.
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Affiliation(s)
- Susan L Davies
- Center for Health Promotion, Department of Health Behavior, University of Alabama at Birmingham, School of Public Health, 227 Ryals Building, Birmingham, AL 35294, USA.
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Zamanian M, Baneshi MR, Haghdoost A, Zolala F. Estimating the visibility rate of abortion: a case study of Kerman, Iran. BMJ Open 2016; 6:e012761. [PMID: 27737886 PMCID: PMC5073643 DOI: 10.1136/bmjopen-2016-012761] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 08/18/2016] [Accepted: 09/14/2016] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Abortion is a sensitive issue; many cultures disapprove of it, which leads to under-reporting. This study sought to estimate the rate of abortion visibility in the city of Kerman, Iran-that is, the percentage of acquaintances who knew about a particular abortion. For estimating the visibility rate, it is crucial to use the network scale-up method, which is a new, indirect method of estimating sensitive behaviours more accurately. MATERIALS AND METHODS This cross-sectional study was conducted in Kerman, Iran using various methods to ensure the cooperation of clinicians and women. A total of 222 women who had had an abortion within the previous year (74 elective, 74 medical and 74 spontaneous abortions) were recruited. Participants were asked how many of their acquaintances were aware of their abortion. Abortion visibility was estimated by abortion type. 95% CIs were calculated by a bootstrap procedure. A zero-inflated negative binomial regression analysis was conducted to assess the variables related to visibility. RESULTS The visibility (95% CI) of elective, medical and spontaneous abortion was 8% (6% to 10%), 60% (54% to 66%) and 50% (43% to 57%), respectively. Women and consanguineal family were more likely to be aware of the abortion than men and affinal family. Non-family members had a low probability of knowing about the abortion, except in elective cases. Abortion type, marital status, sex of the acquaintance and closeness of the relationship were the most important determinants of abortion visibility in the final multifactorial model. CONCLUSIONS This study shows the visibility rate to be low, but it does differ among social network members and by the type of abortion in question. This difference might be explained through social and cultural norms as well as stigma surrounding abortion. The low visibility rate might explain the low estimates of abortion rates found in other studies.
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Affiliation(s)
- Maryam Zamanian
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Reza Baneshi
- Modeling in Health Research Center, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - AliAkbar Haghdoost
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
| | - Farzaneh Zolala
- HIV/STI Surveillance Research Center, and WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
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Abstract
Black African women in rural South Africa have a very low incidence rate of breast cancer, 5-10 per 100,000. The rate, however, is rising in the considerably increasing urban population. During the period 1994 to 1999 in Durban, enquiries revealed an average of 57 urban patients admitted to hospital each year, from a population of about 600,000 African women, indicating an age-adjusted annual incidence rate of 15.1 per 100,000. This incidence rate is very low in comparison with those in developed populations, which range from 40 to 89 per 100,000. In the African patients studied, the mean age on admission was relatively young, 54.1±10.9 years, almost a decade earlier than patients of developed populations. Moreover, the disease was very far advanced; 21.1% were at Stage III and 63.1% at Stage IV. As to exposure to risk factors, African women in general are characterised by certain protective factors. These factors, which closely resemble those of importance in patients in developed populations are, late menarche, early age at birth of first child, high parity (with usually prolonged lactation), and being physically active. However, with ongoing changes in the lifestyle of urban African women, the protective factors are decreasing in their intensity. Changes in these respects have been associated with rises in the disease’s incidence rate. Clearly, because of the late stage of the disease at the time of the patients’ admission to hospital, and hence their poor survival rate, intensive efforts should be made to educate women to seek help at an early stage of their disease. For its avoidance, feasible protective or restraining measures are primarily to adopt a ‘prudent’ lifestyle, in respect of both dietary and non-dietary components. However, the chances of these measures being meaningfully adopted in African urban communities, unfortunately, are negligible. In consequence, further increases in incidence rate would seem inevitable.
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Affiliation(s)
- Alexander R Walker
- Human Biochemistry, Research Unit, School of Pathology, University of the Witwatersrand, National Health Laboratory Service, PO Box 1038, Johannesburg 2000, South Africa.
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