MPH / Department of Public Health / See the attached abstract below

This thesis conveys the history of reproductive politics in Oregon through the life of Dr. Jessie Laird Brodie (1898-1990). Brodie was a key figure in this history from the 1930's until the 1970's, mainly through the establishment of family planning programs through social and medical channels in Oregon and throughout Latin America. Oregon's reproductive legislation walked a fine line between conservatism and progressivism, but in general supported reproductive healthcare as a whole in comparison to the rest of the United States and Latin America. The state passed controversial contraceptive legislation in 1935 that benefited public health, but also passed eugenic laws, specifically a 1938 marriage bill, that attempted to limit specific population's reproductive control. By the time family planning was solidly rooted in the national and international sociopolitical discourse in the 1960's, due to the advent of the "pill," population control rhetoric, and the Griswold v. Connecticut (1965) Supreme Court decision, eugenic laws were virtually obsolete. Portland's history suggests that leaders in local reproductive politics sought to appeal to a diverse clientele but were restricted to the confines of federal funding mandates, specifically the war on poverty, that were fueled by postwar liberalism in an increasingly global age. The first chapter concentrates on the history of women's health and reproduction in Oregon prior to the 1960's. Dr. Jessie Laird Brodie's experiences with families in poverty during medical school in the 1920's disheartened her and motivated her to seek ways for these women to efficiently and affordably access birth control information. In response to public health concerns, she helped get positive contraception legislation passed in Oregon in the 1930's that set guidelines and restrictions for manufacture of contraceptives. This law was the first of its kind in the country and set a precedent for other states to follow. Brodie also supported a marriage bill in the 1930's that mandated premarital syphilis and psychological testing, in the hopes that it would lead couples to seek contraceptive, or "hygienic," advice from their physicians as efforts to establish a birth control clinic had failed up to this point. The second chapter focuses on Brodie's continued involvement in Oregon in the 1940's and 1950's, a period marked by a high tide of pronatalism in the U.S., and how she took Oregon's vision for women to a national and international level. Locally, she was involved with the E.C. Brown Trust, an organization dedicated to sex education, and was the President for the Pacific Northwest Conference on Family Relations, a group focused on the postwar family adjustments of higher divorce rates and juvenile delinquency. In 1947, Brodie was one of the founding members of the Pan-American Medical Women's Alliance, an organization created to provide a professional arena for women physicians throughout the Americas to discuss problems specific to women and children. Involvement with these groups helped her gain recognition nationally and in the late 1950's she served as President, and then Executive Director, of the American Medical Women's Association. Lastly, the third chapter looks at the establishment and growth of Planned Parenthood Association of Oregon (PPAO) in the 1960's under Brodie's leadership and her foray into the international establishment of family planning programs through the Boston-based Pathfinder Fund, an organization whose mission involved bringing effective reproductive healthcare to developing countries. Brodie acted as Executive Director for PPAO, where she was able to use her medical expertise and connections to bring the new organization credibility and respect throughout Oregon that they lacked before her involvement because the board was mainly comprised of a younger generation on the brink of second-wave feminism and the sexual revolution. In her career with Pathfinder she assessed the needs for family planning in Latin American and Caribbean countries and facilitated the establishment of programs in the region, largely in cooperation with the U.S. federal government and the Population Council. The conclusion offers a brief history of Dr. Brodie's continued involvement in the local and international communities beyond 1975 and the awards she received highlighting her career in the battle for effective healthcare for all women. In short, this thesis argues that legal and rights-based contestations that were prevalent in other regions of the U.S. and throughout the world were not characteristic of Oregon, allowing Brodie and PPAO to bring birth control to the state with relatively limited opposition.

BACKGROUND: Contraception is an effective, preference-sensitive intervention that supports quality of life, management of health, and self-determination. Contraception is used by 99% of people assigned female at birth with an average of 3.4 methods used across their lifespan. Providers counsel patients on contraception and patients want to be counselled. Shared decision-making frameworks promote using decision aids (DA) during counseling as best practice. Existing DAs lack transparency in their development methodologies and evaluation results and may not facilitate patient-centered care. AIM: Create a contraception DA and accompanying contraception method information sheets (MIS) that are informed by patients’ values, align with international standards, meet health literacy and accessibility guidelines, and are evaluated by patients and providers to be acceptable, quality, and feasible to use during contraceptive counseling. METHODOLOGY: To create the DA/MIS, (1) literature was reviewed on contraceptive counseling frameworks, DAs, patients’ contraceptive preferences, health literacy, accessibility, user-centered design, and validated patient education material quality measures, (2) results were reviewed from a patient focus group and provider meeting where they defined user requirements, and (3) evidence-based contraceptive information was synthesized. Once created, an exploratory sequential mixed-methods study iteratively refined the DA/MIS after each data collection phase: (1) provider focus groups and survey, (2) patient focus groups and survey, (3) observed patient testing during counseling followed by an interview and survey, (4) expert patient and provider review, and (5) provider field testing in clinic followed by an interview and survey. DA/MIS readability levels were assessed. RESULTS: Quantitatively, the DA/MIS were acceptable, quality, and feasible to use during counseling. Qualitatively, the DA/MIS were preferred to verbal-only counseling and other DA/MIS, centered patients’ preferences, increased knowledge, focused on patient autonomy, challenged bias/coercion, improved counseling satisfaction and quality, offered a novel design, and were appealing, inclusive, and accessible. CONCLUSION: This DA/MIS had positive quantitative and qualitative results, offered a novel design aligned with international standards, and had a transparent, rigorous development process aligned with frameworks and validated tools. Initial results show this DA/MIS can support and improve patient-centered contraceptive counseling. / 2026-08-31T00:00:00Z

This descriptive study was conducted to identify barriers encountered by school systems, health departments, and other health care agencies while implementing pregnancy prevention projects in public school settings. The following questions were addressed in this study: 1. Do identifiable barriers exist that prevent the implementation of programs to serve adolescent parents in public schools? 2. Do common characteristics exist among school systems and health care agencies which implement pregnancy prevention projects? 3. Do school systems, community health care agencies, and health departments experience similar barriers during the implementation of pregnancy prevention programs? Eight sites were selected, four each from the categories of Delayed Implemented and Promptly Implemented Sites. Key persons involved with the initial project implementation were interviewed using a semistructured interview guide. Tape transcriptions and field notes from the interviews provided data for subsequent coding and classification around major themes. Three barriers were identified that were common to all Sites: access to contraceptives; access to abortions; and religious opposition to the project, or a specific project activity. Much of the religious opposition involved issues related to dispensing contraceptives, abortions, and the secular nature of the projects. An overwhelming majority of persons interviewed felt that pregnancy prevention and service delivery to adolescent parents were important issues for the school systems. A past working relationship appeared to be common to joint operated projects. An unstable funding cycle, staff recruitment, and staff retention were common barriers to project operators. Staff recruitment and staff retention were also impacted by the year-to-year funding cycle. There is also some indication that school system operated projects experienced fewer problems during implementation and enjoyed considerable support among the school staff and the community. / Ed. D.

This thesis investigates and interprets the origins and political discourses of the post World War II population movement in the United States. It argues that this movement, in part, was artificially created by members of the upper social class. Its most important representatives were the founder of the Population Council, John D. Rockefeller III and the owner of the Dixie Cup Company, Hugh Moore. Reasons for their interest in population control can be found in their concern for the national security of the United States which, they believed, was challenged by Communist expansion. Equally important was their attempt to perpetuate their upper-class privileges by ensuring the continuation of the existing political and social order in the United States. The ideology employed was "overpopulation." But while the image was overcrowding, it was not the industrialized, densely populated countries that were accused of being overpopulated but rather the poor, underdeveloped, often sparsely populated nations in the Third World. Or, similarly, the poor in the US were accused of being the main cause of all kinds of social ills. As poor countries had a higher population growth rate and as poor people tended to have more children than rich people, the poor were the main target of population control. This study, then, shows how pronatalism and antinatalism, the two variants of the population movement, capitalized on the political and social setting of their time in the United States. Although the antinatalists' apparent goal was population control in general, the poor were their main target while the wealthy population, as supporters of American values, did not have to be controlled in number. Similarly, the pronatalists seemingly desired to increase US birth rates, but mainly addressed the more privileged portions of the American population. The attitude toward the poor, and here explicitly toward the Third World, remained antinatalist. / Master of Arts

Reproductive health is very important as it shapes a woman's whole life. Currently there are a lot of obstacles which deny women their rights to reproductive health. The aim of this research was to find out what obstacles deny women the freedom to enjoy their reproductive health in order to establish a contribution which can be used by the Department of Health to improve their services. Descriptive research was conducted, using a survey approach. Convenience sampling was utilized. Participants were selected from a sample of people attending the reproductive health clinic at a hospital and a clinic in the Northern Province. The findings indicate that women are not enjoying reproductive health rights due to low educational level, cultural and societal constraints, low socio economic status and the negative attitude of the providers, of reproductive health services. / Contraceptives / Family planning / Health and gender / Health rights / Reproductive choice / Reproductive health / Reproductive rights / Reproductive health care / Women's rights / Rural women / Health Science / M.A.Cur.(Nursing Science)

Reproductive health is very important as it shapes a woman's whole life. Currently there are a lot of obstacles which deny women their rights to reproductive health. The aim of this research was to find out what obstacles deny women the freedom to enjoy their reproductive health in order to establish a contribution which can be used by the Department of Health to improve their services. Descriptive research was conducted, using a survey approach. Convenience sampling was utilized. Participants were selected from a sample of people attending the reproductive health clinic at a hospital and a clinic in the Northern Province. The findings indicate that women are not enjoying reproductive health rights due to low educational level, cultural and societal constraints, low socio economic status and the negative attitude of the providers, of reproductive health services. / Contraceptives / Family planning / Health and gender / Health rights / Reproductive choice / Reproductive health / Reproductive rights / Reproductive health care / Women's rights / Rural women / Health Science / M.A.Cur.(Nursing Science)

Text in Afrikaans / Summaries in English and Afrikaans / In an exploratory study variables influencing the intention to use contraceptives and contraceptive use of teenagers and the association between these variables were determined.A random quota sample consisting of 231 and 224 school boys and girls (14 - 18 years) were selected and the final investigating group were 315 sexually active teenagers. According to loglinear analyses the following variables showed a significant relationship with the intention to use contraceptives: attitudes towards the use of contraceptives, perceptions of accessibility and locus of control. Variables that showed a significant relationship with actual contraceptive use were gender, knowledge about reproduction and contraceptives, beliefs and attitudes towards the use of contraceptives, traditional values such as proving fertility before marriage and family size, perceptions of social approval of contraceptive use as well as perceptions of accessibility to contraceptives. An important conclusion was that an urgent need exists for effective sex education programmes and better access to contraceptives. / In 'n verkennende veldstudie is faktore wat verband hou met swart tienderjariges se intensie om kontraseptiewes te gebruik en werklike kontraseptiewe gebruik ge'identifiseer en die verhoudings tussen die faktore is bepaal. 'n Ewekansige kwotasteekproef van 231 en 224 plattelandse skoolseuns en meisies ( 14 - 18 jaar) is betrek en die finale ondersoekgroep was 315 seksueel aktiewe tienderjariges. Volgens logitmodelontledings het die volgende veranderlikes 'n beduidende verband getoon met die intensie om van kontraseptiewes gebruik te maak: houding teenoor die gebruik van kontraseptiewes, persepsies van toeganklikheid tot kontraseptiewes en lokus van beheer. Veranderlikes wat 'n beduidende verband getoon het met werklike kontraseptiewe gebruik was geslag, kennis oor menslike reproduksie en kontraseptiewes, menings en houdings oor die gebruik daarvan, tradisionele waardeor'ientasies soos die bewys van fertiliteit voor die huwelik en gesinsgrootte, persepsies van sosiale ondersteuning vir kontraseptiewe gebruik asook persepsies van toeganklikheid tot kontraseptiewes. 'n Belangrike gevolgtrekking was dat daar 'n dringende behoefte bestaan na effektiewe seksuele voorligtingsprogramme en grater toeganklikheid tot kontraseptiewes. / Psychology / M.A.(Psychology)

In Ethiopia the number of young people going to college is steadily increasing. This predisposes them to risky sexual behaviour which leads to unwanted pregnancy, unsafe abortions and HIV. This study has aimed to determine the patterns of sexual practice and contraceptives use and risk behaviours among those students in central Ethiopia. A descriptive cross-sectional survey was employed. Data on sexual practice, knowledge and contraceptive use were collected from 327 college students. The data were cleaned, entered and analysed using SPSS version 20. The results revealed that despite their knowledge of the methods of safe sex, there are still considerable misconceptions regarding the effectiveness of contraceptives, their side effects and their proper use. In terms of the sexual practice reported by the respondents, 142 (43.4%) practised sex and 110 (77.5%) of respondents had used contraceptives at least once. The age of the respondents, the number of years for which they stayed in college and their fields of study were significantly associated with their sexual practice. In conclusion, a significant number of college students practised sex without using contraceptives to prevent pregnancy, and a considerable number of their partners disapproved of the use of contraceptives / Health Studies / M.A. (Public Health)

This study assessed the intentions with regard to fertility and use of contraception by women living with HIV/AIDS. The study was a quantitative cross-sectional study on a sample of 362 HIV-positive women in the ART follow-up unit in Adama Hospital Medical College. Large numbers of HIV-positive women with no income, housewives, illiterates and women in the age group of 28-32 years declared their intention to fall pregnant. The most prevalent family planning method among the HIV-positive women before their HIV diagnosis was injectables. After wards the most popular method of contraception was the condom. The results suggest that the counselling about condom use that is offered to HIV positive women yields results, as more women adopt this method of contraception. This is important in view of prevention of HIV infections and re-infections. / Health Studies / M. A. (Public Health)