Journal of women's health
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Objective: In the United States, there have been very few improvements in adverse birth outcomes, such as infant mortality, low birthweight, and preterm birth in recent years. Health promotion before pregnancy (e.g., preconception care) has been increasingly recognized as an important strategy by which to improve these reproductive outcomes. As of yet, no research has examined sexual orientation disparities in preconception health which has important implications for birth outcomes in the United States, since sexual minority women (SMW) are more likely to report stillbirths, low birthweight, and preterm infants than heterosexual women. ⋯ Results: Our findings suggest that, even after controlling for maternal characteristics, SMW are more likely to report adverse health conditions and behaviors before pregnancy relative to heterosexual women 1 year before the survey, including higher odds of binge drinking, other substance use, having a sexually transmitted infection diagnosis, and depression. Conclusions: Despite new public health policies aimed at improved preconception health, our findings suggest that SMW are even more vulnerable to poor preconception health than their heterosexual counterparts, which has important implications for maternal and child health. This study provides important evidence for the need to invest in the reproductive health of SMW, particularly in the context of pregnancy.
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Journal of women's health · Jun 2020
The Roles of Alcohol Use Severity and Posttraumatic Stress Disorder Symptoms as Risk Factors for Women's Intimate Partner Violence Experiences.
Background: To reduce women's risk for intimate partner violence (IPV), it is critical to elucidate malleable psychiatric and behavioral health risk factors. We aimed to identify if alcohol use problems moderate the associations between posttraumatic stress disorder (PTSD) symptoms and past-year IPV victimization experiences among female veterans, a population at high risk for IPV. Methods: Female veterans (N = 198) completed mail surveys assessing PTSD symptoms, alcohol use, and IPV at two time points between 2012 and 2013. ⋯ Although both PTSD symptoms and alcohol use were independent risk factors for past-year sexual and psychological IPV, no moderating effect was found for these IPV types. Conclusions: Findings can inform tailored IPV, psychiatric, and behavioral health screening and counseling. Such practices may reduce psychiatric distress and IPV risk.
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Journal of women's health · Jun 2020
Incorporating Sex as a Biological Variable into Clinical and Translational Research Training.
Incorporating sex as a biological variable (SABV) into basic and medical research requires a deliberate plan that weaves concepts of basic genetics, cellular and molecular physiology, and pharmacology into translational medicine. An R4 approach (Right content to the Right learner at the Right time with the Right modality) allows for content to be available in a variety of formats that reinforces the concepts at staged levels of integration. ⋯ In addition, the collaborative work among the BIRCWH and SCORE programs brings collective expertise from centers around the United States to individual programs through development of best practices and materials. These collective efforts assure that the next generation of basic, clinical, and translational scientists will bring the dimension of SABV into their research and clinical practice.
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Journal of women's health · Jun 2020
Historical ArticleFilling the Regulatory Gap: Potential Role of Institutional Review Boards in Promoting Consideration of Sex as a Biological Variable.
Consideration of sex differences in biomedical research is crucial to ensure the safety and effectiveness of drugs and devices for both sexes and to improve the rigor and reproducibility of scientific discoveries. Historically, women were underrepresented in clinical research and sex differences typically were not considered. The U. ⋯ As it is not appropriate for all studies to be reviewed by the FDA nor do all studies have NIH funding, this results in a regulatory gap. We propose that local institutional review boards (IRBs) and institutional animal care and use committees (IACUCs) provide greater oversight by encouraging researchers to consider sex as a biological variable (SABV) during protocol review. In this perspective article, we review how FDA and NIH policies have fostered change and highlight how IRBs and IACUCs could encourage investigators to consider SABV.
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Journal of women's health · Jun 2020
Provider Counseling and Women's Family Planning Decisions in the Postpartum Period.
Introduction: Provider counseling may influence women's postpartum family planning decisions. Materials and Methods: We conducted an anonymous Internet-based cross-sectional survey of postpartum women regarding multiple topics, including prenatal/postpartum care and family planning. We used multivariable logistic regression to determine associations between quantity of provider counseling (indexed as number of family planning topics discussed with a health care provider) and women's decisions regarding contraception and pregnancy spacing. ⋯ Women who received more counseling were more likely to use a highly effective contraceptive method (adjusted odds ratio [AOR] 1.33, confidence interval [95% CI] 1.09-1.62) but were not more likely to desire an IPI >2 years (AOR 0.96, 95% CI 0.81-1.14). Desired IPI modified the association between provider counseling and contraception (p = 0.06 for interaction): Among those desiring an IPI >2 years, more counseling was associated with use of a highly effective contraceptive method (AOR 1.58, 95% CI 1.23-2.03), but this was not observed among those desiring a shorter IPI (AOR 1.05, 95% CI 0.73-1.49). Conclusions: Contraceptive decisions depend on both provider counseling and patient goals.