Browsing by Subject "Women"
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Item Adult Women and Coronary Heart Disease: Studies on Surgical Procedures and Perception(2010-12-01) Schlorke, Patricia; Bae, Sejong; Biswas, Swati; Chen, OliveSchlorke, Patricia J., Adult Women and Coronary Heart Disease: Studies on Surgical Procedures and Perception. Doctor of Public Health (Biostatistics), December 2010, 124 pp., 12 tables, 3 figures, bibliography, 95 titles. Coronary heart disease (CHD) was the number one cause of death in the United States. The main CHD symptom was a heart attack. The most common form of a heart attack was chest pain and shortness of breath, which occurred in men. However, women did not usually have chest pain, but other symptoms such as abdominal pain or indigestion. This could lead women to perceive or believe that they would not have heart disease or heart attacks. This thought could lead women to not obtaining health care, such as surgical procedures, for CHD. Health professionals knew the signs and symptoms of CHD in men, but they may be uncertain in their diagnosis in women. This could lead to women not asking their health care professional about heart attacks or other symptoms. The purpose of this dissertation analyzed CHD in two areas in all women 18 years and older. These two areas were: (a) comparing hospital length of stay between men and women who had either coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA); and (b) women’s perceptions about CHD. Data for the surgical procedures study came from the 2006 National Hospital Discharge Survey (NHDS) and for the perception study came from the 2007 Behavioral Risk Factor Surveillance System (BRFSS). The results showed for the surgical procedures men and women had increased hospital days of care (DOC) for all surgical procedures. The results for the perception study showed women varied by age, race-ethnicity, education, income, and other factors in heart attack symptom knowledge. These two studies had the following conclusions. The results for increased hospital DOC had implications, such as increased health utilization, for present and future hospitalizations. The results for heart attack symptom knowledge showed a need for more awareness and communication of heart attack symptoms among all women across the United States.Item ASSESSING REPRODUCTIVE INTERCONCEPTION CARE BEHAVIORS, BARRIERS, AND FACILITATORS AMONG WOMEN RECENTLY PREGNANT AND HOMELESS(2022-08) Galvin, Annalynn M.; Thompson, Erika; Lewis, Melissa; Walters, Scott T.Interconception care, care provided to mothers between pregnancies, reduces short birth interval risks such as prematurity and low birthweight. Women experiencing homelessness have higher rates of unintended pregnancy and may experience stronger benefits from reproductive interconception care through either unintended pregnancy reductions or healthy pregnancy promotion via family planning. It is critical to build on limited research on interconception care within this population to potentially reduce poverty and cyclical, intergenerational homelessness. By utilizing a sequential explanatory mixed-methods design, this proposed study aimed to first determine prevalence ratios of interconception behaviors such as attendance of maternal postpartum visits, birth spacing and family planning counseling, and postpartum contraception outcomes of women experiencing homelessness, then identify the most salient interconception barriers and facilitators related to interconception information (e.g., knowledge), motivation (e.g., personal attitudes), and behavioral skills (e.g., perceived self-efficacy) among postpartum women who experienced homelessness during pregnancy. Using the 2016-2019 Pregnancy Risk Assessment and Monitoring System, the prevalence of interconception care behaviors among women experiencing homelessness and the associations between housing status and interconception care behaviors were estimated. The sample (n=100,706) was primarily non-Hispanic White (59.4%), married (61.9%) women with private insurance (59.4%) and less than a 4-year degree (63.0%). Approximately 2.4% of participants experienced housing instability in the 12 months before their child was born. Perinatal housing instability was significantly associated with lower odds of attending a postpartum maternal visit (aOR=0.45, 95% CI 0.37, 0.56) and (aOR=1.30, 95% CI 1.07, 1.57) when compared to women who did not experience homelessness in the last 12 months from the time of the interview. Findings from aim 1 determined specific interconception care behavior deficits to further explore via one-hour semi-structured interviews with 12 women experiencing homelessness while pregnant who had given birth within the last four years. Eligible women were recruited through local agency partnerships using purposive sampling. Interviews were audio-recorded, coded to consensus, and analyzed for themes. Information-related themes included knowledge and misconceptions about perinatal processes (e.g., pregnancy, labor and delivery, becoming pregnant, preventing pregnancy) as well as information-seeking themes. Motivation-related themes included attitudes about recent interconception care experiences, perinatal social influences, perceived susceptibility to future pregnancy, and attitudes regarding reasons for not engaging in postpartum pregnancy prevention. Behavioral skill-related themes included objective ability to engage in perinatal behaviors during housing instability, as well as perceived self-efficacy related to barriers and facilitators to engaging in reproductive interconception pregnancies as well as ease of pregnancy. Macro-related themes included housing effects on perinatal period, how perinatal experiences affected seeking stable housing, and how the interconnected nature of housing and other macro-level factors influenced reproductive interconception care. These findings establish a baseline understanding of interconception behaviors and the associated barriers and facilitators related to interconception care information, motivation, and behavioral skills among women experiencing homelessness. Findings may potentially strengthen current interconception practices and augment reductions in unintended pregnancy, short birth intervals, or adverse birth outcomes in future pregnancies, thus improving pregnancy outcomes and improving the health of women before, during, and after pregnancy.Item "IT HAPPENS OUT HERE" - THE VICTIMIZATION EXPERIENCES AND HEALTH CHALLENGES OF WOMEN WHO ARE HOMELESS(2014-03) Saks, Gabrianna E.; Spence-Almaguer, Emily; Chhetri, Shlesma; Crain, CindyThe Homeless Women’s Health and Victimization Study was a collaborative community-based research project that has filled a crucial gap in knowledge about the violence and abuse experienced by women utilizing emergency shelters in the East Lancaster area of Fort Worth, Texas. This study was also an invaluable learning experience for UNT Health Science Center graduate students. Participation in the study was offered as a service learning project and volunteer opportunity in the School of Public Health. Students were involved in every stage of the study and were able to experience lessons related to the practice of Behavioral and Community Health that simply cannot be taught in a classroom. Since the initial release of data to community stakeholders, there have been remarkable changes made by homeless service providers in response to our report. Presbyterian Night Shelter has made changes to their policies that allow more women to stay inside the shelter during the day. They have also made changes to the facility to provide more beds for women and keep the women’s area more secure. YWCA has reallocated their resources to increase their number of emergency beds in order to provide emergency shelter options outside of the East Lancaster area. The Fort Worth Police Department has also responded by implementing a night patrol and outreach program in the East Lancaster area. The findings of this study have also helped the Day Resource Center for the Homeless become the first homeless outreach program in Texas to receive funding from the Victims of Crime Act to address homeless women’s safety. This study has embodied what it means for a health science center to work together with our community to identify problems and find solutions. Purpose (a): The Homeless Women’s Health and Victimization Study was conducted in order to explore the unique experience of violence and victimization among homeless women and the effects these experiences have on physical and mental health. Methods (b): This study utilized non-random, purposive sampling of women utilizing emergency shelter services in the East Lancaster area of Fort Worth, Texas. A total of 150 face-to-face interviews were conducted with homeless women by trained volunteers from December 2012 to May 2013. The interview consisted of closed and open ended questions covering recent victimization, service utilization, mental and physical health, healthcare utilization, prior abuse, transactional sex, and personal safety and health strategies. Quantitative data analysis was performed using statistical software and a grounded theory approach was used for qualitative data analysis. Results (c): The majority (60.1%) of participants reported at least one form of physical or sexual violence, stalking, threats, or verbal abuse in the last 12 months. One in 6 women (17.3%) reported experiences that meet the legal definition of rape in Texas, 46% were physically or sexually attacked, 20.7% reported intimate partner violence. These attacks have had significant health consequences, with 23% of women reporting injuries incurred as a result of their attacks. In addition, 78% of women reporting recent abuse and 88.5% of women reporting recent rape met the threshold for psychiatric distress. There was a clear relationship between prior victimization and recent violence. Among those reporting physical or sexual violence in the past 12 months, the majority were abused as a child (62.5%) or abused by an intimate partner (65%). Conclusions (d): Violence and victimization is a painful reality for many of the women experiencing homelessness in our community. The homeless services delivery system and community stakeholders must work together to identify solutions that will improve the safety of women on East Lancaster, as well as help women leave the East Lancaster region.Item Menopause Clinical Education Aid(2008-01-01)Item SURVIVAL SEX ON THE STREETS: RESULTS FROM THE HOMELESS WOMEN'S HEALTH AND VICTIMIZATION STUDY(2014-03) Chhetri, Shlesma; Saks, Gabrianna E.; Spence-Almaguer, Emily; Crain, CindyIn order to meet the needs of homeless women in our community, we must first understand their experience. The Homeless Women’s Health and Victimization Study provides valuable insight about the frequency, types, correlates, and consequences of violence and victimization among homeless women in our community. Some of the most compelling results from this study were related to transactional sex. These findings contribute to an understanding of the role that “survival sex” plays in the complex experience of female homelessness. Survival sex can be defined simply as transactional sex acts that are performed to meet a person’s most basic and immediate needs. This behavior is an adaptation to survive in the hostile and predatory environment that many homeless women find themselves in. Some homeless women perceive survival sex as the “last resort”. Although these behaviors are often grossly underreported due to stigma, our study participants were graciously honest about their experiences. From their responses, it is clear that not only is survival sex happening in our homeless communities, but that it is happening at much higher rates than previously estimated. This finding is even more alarming when considered alongside the mental and physical health implications of these practices. Additionally this study highlights the correlation between survival sex and history of prior victimization among these women, broadening the conceptualization of transactional sex. This study has given a voice to women in our community that are often overlooked and these results highlight the significance of a practice that most would prefer to ignore. A problem cannot be addressed if nobody knows it exists. Purpose (a): The Homeless Women’s Health and Victimization Study was conducted in order to explore the unique experience of violence and victimization among homeless women and the effects these experiences have on physical and mental health. This poster will focus on the results related to transactional sex. Methods (b): This study utilized non-random, purposive sampling of women utilizing emergency shelter services in the East Lancaster area of Fort Worth, Texas. A total of 150 face-to-face interviews were conducted with homeless women by trained volunteers from December 2012 to May 2013. The interview consisted of closed and open ended questions covering recent victimization, service utilization, mental and physical health, healthcare utilization, prior abuse, and transactional sex. Quantitative data analysis was performed using statistical software and a grounded theory approach was used for qualitative data analysis. Results (c): One in every 4 participants reported that they had engaged in survival sex, or transactional sex acts intended to meet subsistence needs or substance dependencies. Many of those who had traded sex did so to meet their most basic needs. One in every 6 women had exchanged sex for a safe place to stay and 13% had traded sex for something to eat. Women who had engaged in survival sex activities were significantly more likely to report victimization in the past 12 months (p=.001), prior intimate partner violence (p=.03), and childhood physical and sexual abuse (p=.007). Sexual or physical victimization during childhood appeared to have an influential role: 75% of those who engaged in sex trade reported childhood victimization compared to 38% of women who reported no engagement in sex trade. Those engaged in survival sex were also significantly more likely to show signs of psychiatric distress (p=.004) and other health indicators. Conclusions (d): These findings contribute to a comprehensive understanding of the complex experience of homelessness and give new insight into the prevalence, context, and correlates of survival sex among women who are homeless. The results indicate that victimization may play a role as both a precursor and product of engaging in survival sex. The increased risk for psychiatric distress and other health conditions emphasize the serious health implications of transactional sex among homeless women.Item WOMEN'S HEALTH: OSTEOPOROSIS(2013-04-12) Chandrasekera, LalanicaPurpose: Osteoporosis is associated with changes in bone remodeling, characterized by decreased bone mass and structural deterioration. A major feature of osteoporosis, fractures, can have an enormous impact on a patient's morbidity and mortality, leading to increased need of social services and adding to the cost of health care. As there is no cure for osteoporosis, the importance of wellness and prevention becomes paramount. Here, we will review various osteoporosis resources available to the Terrant County community as well as on a national level. Methods: Daily calcium supplements along with Vitamin D improve bone density and maintain overall bone health, while weight bearing, strengthening, and balance exercises prevent further bone loss. Hormone replacement therapy is targeted to prevent rapid bone loss in post-menopausal women, and medications such as Actonel, Boniva, and Fosamax can be used to treat and prevent osteoporosis. Results: Locally, the Division of Chronic Disease Prevention at the Tarrant County Public Health Department offers free classes focusing on methods to delay the onset of osteoporosis. Services targeted to women's health and aging are the center of focus at "A Woman's View," a multidisciplinary clinic in Dallas, Texas. On a broader spectrum, the National Osteoporosis Foundation offers educational resources aimed at raising awareness of this disease and keeping physicians up-to-date with novel treatment options. Lastly, online services as well as consultation with Endocrinologists provide a rich resource to maintaining bone health and delaying age-associated osteoporosis. Conclusions: As it stands, the burden of osteoporosis lies mainly on elderly women, but remains underdiagnosed in men and those with risk factors predisposing to poor bone health. The Division of Chronic Disease Prevention at the Tarrant County Public Health Department, the National Osteoporosis Foundation, and other local multidisciplinary centers are resources discovered in this study whose purpose is to promote methods of prevention and wellness, including access to education. While these resources have proven to be a boon to the community, in order to alleviate the impact of osteoporosis on health care costs and improving overall public health, greater measures should be taken to target resources to more appropriate at-risk populations. For example, the adolescent female population is at risk for inadequate calcium intake and may be a beneficial group for osteoporosis awareness.