A mixed methods study: Midlife African American women’s knowledge,beliefs, and barriers to well-woman visit,flu vaccine,and mammogram use

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.     

A study of physical-health and neuroticism among women engaged in the home-based production of chikan embroidery

The present study examined physical health and neuroticism among women (n=200) engaged in the unorganized home-based production of chikan embroidery. Physical health of women chikan workers was examined with the help of an abbreviated version of CMI, and neuroticism, with PGI Health Questionnaire N-2 in easy paced, face to face personal interviews. The results indicated that women chikan workers in general were facing some serious health problems. Significant variations were also obtained across groups of women associated with different centres of chikan production. The study points towards the stressful nature of environment in which these women chikan workers live and work.     

The Influence of the Built Environment and Other Factors on the Physical Activity of Older Women from Different Ethnic Communities

ABSTRACT

Inactivity has been identified as a major contributor to the burden of disease in older women. Study aims were: (a) to assess the personal, social, and environmental facilitators and impediments to physical activity in older women from ethnic communities; and (b) to determine the factors associated with physical activity participation. Older women (aged 60–84 years) were recruited from the local Italian (n = 20), Vietnamese (n = 26) and Anglo-Celtic (n = 26) communities. A survey questionnaire was administered in the participants' preferred language. The most common barriers were: “I am not in good health,” “I am self-conscious about my looks,” “I am too tired,” “I don't have time,” and “The weather is bad.” When comparing the ethnic groups, the Vietnamese women reported fewer barriers than the Italian women (2.6 vs. 5.9). While the Vietnamese women were much more likely to report being “self-conscious about my looks,” the Italian women more commonly reported poor health, being too tired, and not liking exercise as barriers. Overall, those living alone were more likely to be active and those who reported fear of injury, less active. Recognizing ethnospecific differences in the prevalence of barriers may be important when devising strategies to increase activity levels of older women.     

High Rates of Access to Health Care,Disclosure of Sexuality and Gender Identity to Providers Among House and Ball Community Members in New York City

The House and Ball community is an important cultural manifestation of resiliency for Black and Latino gay and bisexual men and transgender women. Participants at the August 2013 House of Latex Ball in New York City were surveyed about insurance coverage, health care access, experiences in health care, and housing instability. The sample (n = 367) was 58% Black/African American and 20% Hispanic/Latino, with a mean age of 31. Fifty-five percent were gay and bisexual men. Although only 6% identified as transgender, nearly one half were gender nonconforming. Strong majorities had health insurance, were in regular medical care, and were “out” to their providers. Some were unstably housed and had recently exchanged sex for shelter or money. High rates of health care access and disclosure indicate resiliency and agency. Unstable housing and income insecurity may be structural drivers of vulnerability for this population to HIV infection and other health risks.     

Pregnancy care and birth outcomes for women with moderate to super-extreme obesity

PurposeTo describe the health service utilisation and birth outcomes of pregnant women with moderate to super-extreme obesity.BackgroundMaternal obesity is increasingly recognised as a key risk factor for adverse outcomes for both women and their babies. Little is known about the service utilisation and perinatal outcomes of women with obesity beyond a body mass index of 40.MethodWomen with a self-reported pre-pregnancy BMI of 40 or more, who had received care and birthed a baby at the study site between 1 January 2009 and 31 December 2010. Clinical audit was used to identify the health service utilisation and birth outcomes of these women.Results153 women had a BMI of 40 or more. Women saw 6 different health professionals during pregnancy (1–16). Most of their visits were with a medical practitioner, often with limited experience, and almost all women only saw a midwife once at their booking visit (n = 150, 98.0%). While the majority of women experienced a normal pregnancy, free from any complications, almost half the women in this study experienced a caesarean section (n = 74, 48.4%).ConclusionClinical audit has been useful in providing additional information which suggests current maternity care provision is not meeting the needs of this group of women. The model of antenatal care provision may be a mediating factor in the birth outcomes experienced by obese women. The development of effective, targeted antenatal care, designed to meet the needs of these women is recommended.     

Differences in the Health Care Needs and Service Utilization of Women in Nursing Homes: Comparison by Race/Ethnicity

ABSTRACT

The purpose of this study is to describe health care needs and service utilization among institutionalized women of color. The sample was dichotomized by length of stay to determine how African American, Native American, Asian/Pacific Islander, and Hispanic/Latino women differed at two points in time. Data for this study came from the Current Resident Survey of the 1999 National Nursing Home Survey. The data were analyzed using GLM. The findings suggest that Native American women are the most impaired and Asian/Pacific Islander women are the least impaired. Additionally, very few women received mental health services despite their extensive need.     

The Association Between Perceived Spirituality, Religiosity, and Life Satisfaction: The Mediating Role of Self-Rated Health

This study examined the mediating role of self-perceived health between perceived spirituality, religiosity, and life satisfaction among a stratified, random sample of college students, while controlling for gender. Although both models displayed excellent fit criteria, the perceived spirituality and life satisfaction model was fully mediated by self-perceived health χ² (n=459, 4) = 1.64, p=0.80, CFI =0.99, TLI=0.99), and the perceived religiosity and life satisfaction model was partially mediated by self-perceived health χ² (n=459, 10) = 22.29, p=0.01 CFI = 0.99, TLI = 0.99). Both models were equal for men and women. Students who describe themselves as spiritual (or religious) are likely to report greater self-perceived health and greater self-perceived health likely influences life satisfaction for both men and women. Results preliminarily support the contention that life satisfaction is related to differing reported health status, whether physical or mental, and that life satisfaction may be influenced by religiosity and spirituality engagement. Implications for colleges and universities are discussed.     

Implementing innovative evidence-based perinatal mental health screening for women of refugee background

ProblemNational guidelines recommend repeated screening for depression and anxiety for all women in the perinatal period. Routine screening in pregnancy is limited due to service, community and individual barriers.BackgroundPerinatal depression and perinatal anxiety affect up to 20% of all women. Women of refugee background are at even greater risk for perinatal mental health conditions due to refugee experiences and resettlement stressors.AimTo evaluate the acceptability and feasibility of a perinatal mental health screening program for women of refugee background from the perspective of health professionals.MethodsA mixed methods design guided by the Normalization Process Theory was used. Data were collected at a dedicated refugee antenatal clinic in the south-eastern suburbs of Melbourne, Australia. An online survey (n = 38), focus groups (n = 2; 13 participants) and semi-structured interviews (n = 8; 11 participants) with health professionals were conducted.FindingsUnder the four constructs of the Normalization Process Theory, health professionals reported improvements in identifying and referring women with mental health issues, more open and in-depth conversations with women about mental health and valued using an evidenced-based measure. Key issues included professional development, language barriers and time constraints.DiscussionImplementing a perinatal mental health screening program has been positively received. Strategies for sustainability include professional development and the addition of audio versions of the measures.ConclusionThis perinatal mental health screening program is acceptable and a feasible option for health professionals. Health professionals value providing more holistic care and have more open discussion with women about mental health.     

A Proactive Approach to Aging Well for Women Over 45

ABSTRACT

This paper reports on an exploratory two-group, pre- and posttest design study, which employed data triangulation with a convenience sample (n = 120) of women over 45 years aged between 45 and 83 years, living and/or working within the South East Sydney and Illawarra areas of New South Wales. Sixty-nine women recorded the Health Check Log (HCL) (33 were health professionals) to assess and monitor their health over 12 months. The majority found the HCL greatly assisted in monitoring and maintaining their health, and the analyses of the SF-36 health survey suggest that women 45 years and over may benefit by regular use of the HCL.     

Factors Associated with Advance Care Planning Among Older Women in Southwest Florida

ABSTRACT

As the nation's population continues to age, many older women will face care needs that can be anticipated in advance. However, little is known about the advance care plans of older women and the characteristics of those who plan. This study utilized a stratified random sampling design to survey older women (n = 124) in the state of Florida regarding their attitudes toward future care and planning behavior in social-environmental, health, and financial domains. Regression analyses were conducted to determine factors most predictive of attitudes toward future care and planning behavior by domain. Results suggest that advanced age predicts greater planning behavior, while living alone is associated with less advance care planning behavior. Other factors associated with less planning by domains of care needs include income status, chronic health conditions, educational attainment, and religious status. Nonaccepting attitudes toward planning were associated with a decreased likelihood to have advance care planning documents.     

The Relationship between Country of Residence, Gender and the Quality of Life in Australian and Taiwanese Midlife Residents

A growing global aging population is presenting more opportunities for health professionals to interact with other cultures. The specific aims of this study were to: (1) compare the quality of life of midlife men and women in Australian and Taiwan; and (2) to explore the impact of country of residence and gender on quality of life. A cross-sectional survey was conducted using census data and a probability proportional sampling (PPS) strategy on a general population of men and women aged 40–59 years-old who live permanently in Taiwan and Australia. The sample consisted of 278 Australians and 398 Taiwanese men and women. Analysis showed that country of residence does have an impact on quality of life with significant differences seen between midlife Australian and Taiwanese men and women (F 4, 666 = 59.31, p < 0.001). The results suggest that midlife Australian men and women have a better quality of life than midlife Taiwanese men and women. The mean score for the four domains of quality of life by gender indicated that midlife women consider that they have a better quality of life than midlife men in both Australia and Taiwan. Midlife Australian men in this study reported they are more dissatisfied with their sleep and rest (χ ² = 10.57, df = 4, p = 0.03) and more dissatisfied with their sexual activities (χ ² = 9.42, df = 4, p = 0.05) in contrast to midlife Australian women. This study has addressed and contributed to the assessment of multi-cultural quality of life research and has important implications for both health providers and policy makers of both countries.     

“Whatsapping” the continuity of postpartum care in Switzerland: A socio-anthropological study

BackgroundDigital media such as Apps, Internet and social networks have become integral parts of the maternity experience for more than a decade. These media can support or undermine women’s experiences as has been shown in digital sociology research. Using Immediate Messaging Applications to provide information and support to women during the perinatal period is an emerging practice.AimThis article analyses how health and social care professionals – with a focus on community midwives – and women communicate between postpartum home visits through Immediate Message Applications in Switzerland.MethodsA socio-anthropological study that relied on qualitative methods including semi-directed interviews with midwives and health and social care professionals (n = 30) and immigrant women (n = 20).FindingsSince the introduction of Immediate Messaging Applications, women and their carer converse more regularly between post-partum home visits. Women send questions, pictures and videos to them, often allowing swift responses to their concerns. Midwives encounter difficulties answering women’s questions when they cannot be solved through quick communication (e.g. infant crying). To them, texting frequency forms a clinical clue to women’s mental health. Not all women contact their carer through digital messages; immigrant women are less likely to know and use this service.Discussion and conclusionImmediate Messaging Applications form a promising communication tool, complementary to home visits, and contribute to woman-centered care and continuity of care. As an emergent practice, it has not been framed by a guideline yet. Policy makers and practitioners should ensure that its use does not contribute to unequal access to care.     

The effectiveness of a group-based educational program on the self-efficacy and self-acceptance of menopausal women: A randomized controlled trial

This study aimed to assess the effectiveness of a group-based educational training on the self-efficacy and self-acceptance of Iranian menopausal women using the PRECEDE–PROCEED model. This Randomized Controlled Trial (RCT) was conducted on 80 menopausal women in the age range of 47–55 years residing in the northeast of Iran. The participants were divided randomly into a test group (n = 40) and a control group (n = 40). We found that designing and implementation of a group-based educational training according to the PRECEDE–PROCEED model can significantly enhance the knowledge and performance of the test group with regard to self-efficacy and self-acceptance.     

The Subjective Happiness Scale: Translation and Preliminary Psychometric Evaluation of a Spanish Version

The aim of the present study was to investigate the psychometric properties of the Spanish version of the Subjective Happiness Scale (Lyubomirsky and Lepper in Soc Indic Res 46:137–155, 1999) in a wide sample of 1,155 participants (448 men, 707 women) from three different groups (high school students, college students, and community adult participants). The participants completed the following measures: the Spanish version of SHS, the Satisfaction with Life Scale, the Beck Depression Inventory and the Spielberger Trait Anxiety Inventory. The results revealed preliminary evidence of adequate internal consistency, appropriate test–retest reliability and convergent validity for research purposes. Also, results from confirmatory factor analyses showed a clear one-factor structure, identical with the English version. No significant sex effects were evidenced, although differences between the high school student group and the undergraduate university group were found. In general, our findings add empirical evidence of the usefulness of such a brief measure for the assessment of subjective happiness in large-scale national and international studies with native Spanish-speaking populations. Finally, practical recommendations and future lines of research are suggested.     

The South Carolina LGBT Needs Assessment: A Descriptive Overview

Limited quantitative information exists about the demographics and needs of lesbian, gay, bisexual, and transgender (LGBT) persons in South Carolina, a predominately rural Southern state. Responses to a needs assessment survey (n = 715) were analyzed to understand the diversity and needs of members of the LGBT community in SC. The purpose was to inform future programming and guide the development of a more comprehensive portfolio of services to be offered by a local LGBT community center. Findings suggest that a diverse LGBT community exists in SC and needs include increased programming for community members as well as efforts to provide policy-level support and increased acceptability and understanding of LGBT persons in South Carolina.     

Community engagement in the Aboriginal Families Study: Strategies to promote participation

Background

Aboriginal women and families are under-represented in Australian research on pregnancy and childbirth. The Aboriginal Families Study aimed to investigate the views and experiences of a representative sample of women giving birth to an Aboriginal baby in South Australia between July 2011 and June 2013, using methods designed to respect Aboriginal culture and communities.

Exercise Self-Regulation Among Older Women Participating in a Heart Disease-Management Intervention

Using behavioral self-regulation processes may facilitate exercise among older women with heart disease. Data from women in a heart disease-management program (n = 658, mean 73 years), was used to explore associations among exercise self-regulation components (i.e., choosing to improve exercise and observing, judging, and reacting to one's behavior) and exercise capacity. General linear models showed that choosing exercise predicted higher exercise self-regulation scores postprogram and 8 months later. In turn, these scores predicted greater improvements in exercise capacity concurrently and 8 months later. Interaction analyses revealed that the effect of self-regulation on exercise capacity was stronger among women who chose to work on exercise.     

Sleep Behaviors in Older African American Females Reporting Nonmalignant Chronic Pain: Understanding the Psychosocial Implications of General Sleep Disturbance

This study examined factors that influence sleep quality in older African American women (N = 181) reporting chronic pain. Participants completed a series of questions assessing demographic and behavioral characteristics, health status, pain intensity, and sleep disturbance. Findings indicated that younger participants and those experiencing poorer physical functioning reported more difficulty sleeping due to pain. Similarly, participants who reported being awakened from sleep due to pain were younger and experienced greater pain intensity. Understanding the relationship between sleep and pain in this group of women may be useful in promoting effective disease management and sleep awareness among patients, caregivers, and healthcare professionals.     

Gay Community Involvement: Its Interrelationships and Associations With Internet Use and HIV Risk Behaviors in Swedish Men Who Have Sex With Men

We measured aspects of “community involvement” chosen for men who have sex with men (MSM) in Sweden (gay places, media accessed, Internet, gay festivals, and social engagement, measured as proportion of gay friends) in two Swedish Internet-based samples from 2006 (n?=?3,202) and 2008 (n?=?4,715). Data showed low to moderate reliability with a moderate (0.57) alpha coefficient. While there is moderate internal consistency, as might be anticipated from measures of actual community involvement, they can be treated as scales. The Internet scale indicated the lowest reliability, perhaps due to respondents having Internet sites of primary choice, rather than a high level of usage across several sites. A hypothesized lack of correlation between traditional domains of the gay community and the Internet did not appear: correlations between the Internet measure and the other measures were positive and significant, but among the lowest correlations obtained between the community measures, ranging from 0.06 to 0.24. Those who use the Internet extensively are less likely to be involved in other aspects of the community. Sexual risk was associated with high social engagement at sexual meeting sites and with Internet use. Gay community involvement, including the Internet community, may be complex and associated with both increase in HIV sexual risk behaviors (by measuring use of sexual risk sites) and preventive measures (HIV testing).     

“You Have to Keep Yourself Hidden”: Perspectives From Malaysian Malay-Muslim Men Who Have Sex With Men on Policy,Network, Community,and Individual Influences on HIV Risk

ABSTRACT

Malay-Muslim men who have sex with men (MSM) are marginalized and hidden in Malaysia, a predominantly Muslim country in southeast Asia. We explored the policy, network, community, and individual factors related to HIV infection among Malay-Muslim MSM through 26 in-depth interviews and one focus group discussion (n = 5) conducted in Kuala Lumpur and Kota Bharu between October 2013 and January 2014. As religion plays an important role in their lives, participants viewed homosexuality as a sin. Low risk perception and misconceptions about HIV/AIDS were common, and most participants expressed reluctance to consult a doctor unless they had symptoms. Additionally, buying condoms was embarrassing and anxiety-producing. Fear of discrimination by health care providers and community hindered participants from disclosing sexual behaviors and accessing health services. Homophobic comments and policies by the government and religious leaders were concerns of participants. A safe and enabling environment is needed to reduce HIV risks among Malay-Muslim MSM.