Journal of women's health
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Journal of women's health · Sep 2021
Opportunities to Improve Women's Health: Engaging Racial/Ethnic Diverse Women to Provide Biospecimens for Research.
Objective: Inclusion of women in biomedical cancer research have the potential to close gaps in cancer health disparities and improve adjuvant therapies for women; yet samples needed to advance this area of science are lacking. We developed low-cost educational recruitment strategies to increase our collection of biospecimens from women. Materials and Methods: Women diagnosed with hormone receptor positive (HR+) breast cancer that initiated hormonal therapy were recruited from three integrated health systems. ⋯ Receipt of brief informational print materials inclusive of personalized messages enhanced our outreach strategies and increased our overall biospecimen provision rate by 17%. The inclusion of messages with a focus on spirituality and other cultural messages may further increase biospecimen provision in racial/ethnic diverse groups of women; however, further study is needed to support this claim. Clinical Trail Registration Number: NCT02992730.
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Journal of women's health · Sep 2021
Perceived Financial Barriers to Cervical Cancer Screening and Associated Cost Burden Among Low-Income, Under-Screened Women.
Background: Despite screening's effectiveness in reducing cervical cancer incidence and mortality, disparities in cervical cancer screening uptake remain, with lower rates documented among uninsured and low-income individuals. We examined perceived financial barriers to, and the perceived cost burden of, cervical cancer screening. Materials and Methods: We surveyed 702 low-income, uninsured or publicly insured women ages 25-64 years in North Carolina, U. ⋯ Conclusions: The majority of our sample of low-income women perceived substantial financial barriers to screening, particularly related to screening appointment costs and potential follow-up/future treatment costs. Providing greater cost transparency and access to financial assistance may reduce perceived financial barriers to screening, potentially increasing screening uptake among this underserved population. Clinicaltrials.gov registration number NCT02651883.
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Journal of women's health · Sep 2021
Increasing Access to Contraception in the United States: Assessing Achievement and Sustainability.
Background: During October 2016 through May 2018, a learning community was convened to focus on policies and programs to increase access to the full range of contraceptive options for women of reproductive age. The Increasing Access to Contraception (IAC) Learning Community included 27 jurisdictions, with teams from each jurisdiction consisting of state health department leaders, program staff, and provider champions. At the kick-off meeting, teams from each jurisdiction created action plans that outlined their goals. ⋯ At the time of the post-assessment 1 year later, jurisdictions were sustaining efforts for 69 (87%) of the total goals. In every jurisdiction, work on at least one goal that originated in the learning community was sustained. Conclusions: The jurisdictions that participated in the IAC Learning Community continued the work of their action plan goals 1 year after the formal closure of the learning community, indicating sustainability of the learning community activities, beyond what jurisdictions accomplished during formal participation.
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Journal of women's health · Sep 2021
Factors Predicting Type II Histology in Endometrial Biopsies Among Postmenopausal Minority Women at a Safety-Net Hospital.
Background: Rates of type II endometrial cancers (EC) are increasing in the United States, especially in minority women. The purpose of this project was to examine a primarily minority and low socioeconomic status patient population in a public hospital to identify risk factors associated with the finding of type II histology in endometrial biopsies (EMBs). Materials and Methods: A retrospective chart review was performed of patients who underwent an EMB between 2010 and 2016. ⋯ Caucasian) race (OR 8.75 [CI 0.86-88.70], p = 0.066), obesity (OR 0.39 [0.15-0.98], p = 0.044), and number of years since menopause (OR 1.06 [CI 1.01-1.12], p = 0.027), although none remained independently predictive in the multivariable analysis. Conclusion: This minority population of postmenopausal women with EC had a greater prevalence of type II histologies. Understanding this pattern may be helpful in expediting the workup for abnormal symptoms in these women and prompt a higher level of suspicion for EC.
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Journal of women's health · Sep 2021
Heterogeneous Effects of Affordable Care Act Medicaid Expansions Among Women with Dependent Children by State-Level Pre-Expansion Eligibility.
Objectives: This study explores the heterogeneity in effects of the 2014 Affordable Care Act (ACA) Medicaid expansions on insurance coverage, health care access, and health status of low-income women with dependent children by pre-expansion state-level income eligibility. Materials and Methods: We employ a quasiexperimental difference-in-differences design comparing outcome changes in Medicaid expansion states to nonexpansion states. We estimate effects separately for three groups of expansion states based on pre-expansion (2013) parent income eligibility: low pre-expansion eligibility (<90% of federal poverty level [FPL]), high eligibility (90% to <138% FPL), and full eligibility (≥138% FPL). ⋯ Changes in access largely mirror those in coverage. There are no significant changes in health status regardless of pre-expansion eligibility. Conclusions: The ACA Medicaid expansions increased coverage and access for low-income women with dependent children primarily in states with low pre-expansion parent eligibility, and therefore, reduced differences in these outcomes between expansion states.