Journal of women's health
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Journal of women's health · Dec 2019
Development and Uptake of Long-Acting Reversible Contraception Services in Rwanda, 2009-2016.
Background: Long-acting reversible contraception (LARC) is highly effective at preventing pregnancy. However, in sub-Saharan Africa, LARC education for clients is relatively limited and providers are often not skilled in their insertion. Before 2009, only 1% of family planning clients in Rwanda received an LARC. Materials and Methods: We trained Rwandan government clinic nurses to promote, insert, and remove copper intrauterine devices (IUDs) and hormonal implants. ⋯ Challenges included inconsistent funding, irregular supplies, and staff turnover. Rural and Catholic clinics performed as well as urban and non-Catholic clinics. Concerted efforts to improve IUD uptake are needed.
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Journal of women's health · Dec 2019
A Patient Portal Intervention for Menopause Knowledge and Shared Decision-Making.
Background: Menopause is a time often fraught with changes and symptoms, which may require difficult choices and decision-making. During this period, women would benefit from a better understanding and in-depth discussions with providers regarding menopause, associated conditions, and appropriate therapy. ⋯ After 6-months, all participants are surveyed on menopause knowledge, SDM, and satisfaction with the program. Conclusion: This study is among the first to assess the impact of an innovative patient portal intervention to improve knowledge and SDM between patients and providers regarding menopause. If successful, our program will add to the "meaningful use" of patient portals and offer a scalable and timely resource for SDM about menopause.
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Journal of women's health · Dec 2019
Neighborhood Income and Cesarean Section Rates at a Tertiary Care Center in Canada.
Background: With rising rates of cesarean sections (CSs) in Canada and worldwide, nonclinical factors for CS warrant consideration. Objective: To determine the association between a primigravid woman's neighborhood income and rates of CSs. Materials and Methods: A retrospective cohort study was conducted at an Ontario tertiary care center from January 2003 to December 2013. Rates of CSs were determined using data collected from the Discharge Abstract Database. Women with singleton live births were included. ⋯ Following adjustment for important confounders, there was no longer an association between the neighborhood income and CS rate (adjusted RR 1.00, 95% CI [0.99-1.01]). Women in the highest quintile were more likely to have greater maternal age (p < 0.01). Conclusions: Although differences in CS rates are seen by the neighborhood income quintile, they appear to be mediated through a combination of maternal age and other clinical factors. Neighborhood income does not appear to be an independent predictor of CS.
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Journal of women's health · Dec 2019
Factors Associated with Preventive Dental Visits Before and During Pregnancy.
Objective: Poor prenatal oral health has implications for maternal, fetal, and infant health. Studies have shown an association between periodontal disease and adverse pregnancy outcomes, such as preterm delivery, low birth weight, and pre-eclampsia. The objective of this study was to identify the factors associated with preventive dental visits before and during pregnancy and examine the relationship of dental insurance with those visits among Virginia women. Methods: The Virginia Pregnancy Risk Assessment Monitoring System (2012-2014) cross-sectional data were used to explore the use of dental cleaning visit among women. ⋯ Dental insurance (odds ratio [OR] = 3.5; 95% confidence interval [95% CI] = 2.17-5.67) and oral health knowledge (OR = 2.8; 95% CI = 1.42-5.48) were associated with before pregnancy dental visit. During pregnancy dental visit was strongly associated with dental insurance (OR = 5.8; 95% CI = 2.80-11.97), before pregnancy dental visit (OR = 20.72, 95% CI = 11.14-38.54), and oral health promotion by health provider (OR = 12.37, 95% CI = 7.31-20.93). Conclusions: Overall, the use of a preventive dental visit before and during pregnancy was low among Virginia women. Improving the use of routine dental visits before pregnancy, increasing access to dental insurance, and engaging health care providers to promote oral health can impact the use of dental care during pregnancy.
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Journal of women's health · Dec 2019
Sex and Gender Health Education Summit: Advancing Curricula Through a Multidisciplinary Lens.
Introduction: The Sex and Gender Health Education (SGHE) Summit was a national collaboration that engaged educational thought leaders from various health professions to advance curricula by integrating sex- and gender-based evidence into health education. Materials and Methods: The SGHE Summit was held over a 2.5-day period April 2018 at the University of Utah. Pre- and postsummit surveys assessed attitudinal and knowledge changes. Results: A total of 246 health care professionals and trainees from U. S. and International Institutions attended. ⋯ A teaching tool summarizes the initial questions to consider in SGHE. Conclusion: The SGHE Summit was the first multiprofessional large-scale national effort focused on the integration of sex and gender knowledge into the education of all health professionals. Summit participants now represent a national network of educators and clinicians who recognize the centrality of sex and gender to health professionals' knowledge and practice. These educational efforts will ultimately ensure a more personalized health care delivery.