To learn how to address health issues specific to Hispanic cultures in an effort to address health disparities, learning from cultural aspects that affect health from the countries of origin would be most useful. Community programs built on rigorous and systematic research prove to be more powerful than ad-hoc programs. Qualitative research techniques offer powerful alternatives for public health professionals to develop adequate and directed programs at the community level, especially among underserved communities and those represented by oral/spoken traditions. The study was conducted among 132 working class single and married Mestizo women between the ages of 20-40 living in Panama City, Panama. This group of women has the highest incidence of HPV in Panama so are at the highest risk of cervical cancer. Using social construction as the theoretical framework, this study uses four different qualitative research techniques: free listing, pile sorting, individual semi-structured, and group interviews. Key findings include the importance of religion and family, women's understandings of the relationship between sexuality and health, influence of media, other women, and husbands help construct screening knowledge among women in the study. Culturally relevant health education interventions and programs delivered in a group format at the community level in a participatory mode would be most effective in reaching women in Panama and other Hispanic populations. Future quantitative studies and influences of social networks are suggested.

The purpose of this research study was to test the effects of an education/behavioral intervention on knowledge, perceived risk, and self-efficacy for sexually transmitted infections (STIs) prevention in women. Additionally, the instruments that measured knowledge of sexually transmitted infections and perceived risk were tested for reliability. Instruments used to test the effects of the intervention at pretest and following the intervention included the Sexually Transmitted Infection Knowledge Survey (Johnson-Mallard, 2002); the Perceived Risk for Sexually Transmitted Infection Survey (Johnson-Mallard, 2002); and the Sexual Self-Efficacy Survey (Heather and Pinkerton, 1998). Participants included 89-women seeking family planning services, sexually transmitted infection services or prenatal care at three county health units. Participants were randomly assigned to a treatment (n = 47) or control (n = 42) group. The treatment group received the theory based STI education/behavioral intervention. A logic model and Banduras Social Cognitive Theory were used to test the effects of an education/behavioral intervention on decreasing individual exposure to sexually transmitted infections by increasing individual knowledge, perceived risk, and self-efficacy. Data were analyzed using Analysis of Variance. Significantly differences from pretest to posttest was obtained between the experimental and control group on knowledge of STIs F (1, 87) = 73.66, p [less than] .001. Test results for the effect of the education/behavioral intervention on sexual self-efficacy resulted in significance difference between groups at posttest on refusing sexual intercourse F (1, 87) = 50.18, p [less than] .001; questioning potential sex partners F (1, 87) = 15.48, p [less than] .001; and condom use F (1, 87) = 19.60 p [less than] .001; indicating the brief (30-minute) education/behavioral intervention had an effect on the experimental group. However, posttest on STI perceived risk for women receiving the education/behavioral intervention did not approach significance F (1, 87) = .02 p [less than] .901 indicating the education/behavioral intervention did not have a statistically significant effect on the experimental group. The findings of the study indicate the importance of healthcare providers reinforcing STI information during clinical encounters with women.

Polycystic Ovarian Syndrome (PCOS) is the most common endocrine disorder among females of childbearing age, affecting between 6-8% of the population. It is also the most common cause of infertility. Females with PCOS may have two or more of a constellation of symptoms that can potentially leave them at odds in terms of normative ideals of femininity. This study examines how feminist theory interrogates and analyzes knowledge about the body and PCOS, integrating the lived experiences of women to provide a deeper, more meaningful understanding of what it means to be a woman with PCOS.

Immigrant women often lack the social support and help from extended family and other social relationships, which is very significant during the pregnancy, delivery, and postnatal period. This research was conducted among Bangladeshi immigrant women living in the United States, in order to understand their experiences during pregnancy and childbirth: how they coped with the settings of a different country during that period, and how they felt about this situation. While there are several studies on immigrant women and maternal health issues in anthropology, to my knowledge, there have been none that focused specifically on the childbirth experiences of Bangladeshi immigrant women in the US. These women have very specific culturally-based perceptions about the US health care system around issues such as communication with service providers, dealing with the hospital system, the role of health insurance, and so on. This research was conducted among Bangladeshi women in Tampa, Florida, and sought to understand their experiences during pregnancy and childbirth and perceptions of access and quality in the health care system. Fifteen women were selected through purposive and snowball sampling. Data was collected using in-depth interviews. This study examines the experiences of these Bangladeshi immigrant women within their socioeconomic context and immigration status.

Women who live in Vancouver’s Downtown Eastside experience some of the most devastating health problems among residents of British Columbia. While crack cocaine use has been associated with many of these problems, we lack an understanding of how women who use crack cocaine experience these health problems and what they do to manage them. Informed by tenets of intersectionality and social geography, a critical ethnographic approach was used to examine the scope of health concerns experienced by women who are street-involved and use crack cocaine, the strategies they used to manage their health, and the social, economic, political, personal, and historical contexts that influenced these experiences. Data were collected over a seventeen month period and included a cross sectional survey (n=126), participant observations, and interviews (n=53). The women described experiencing poor physical and mental health throughout their lives; many of which were preventable. Respiratory problems, anxiety, sadness and insomnia were the most frequent concerns reported. They endured severe economic deprivation, unstable and unsanitary housing, and relentless violence and public scrutiny across a variety of contexts including their homes and on the street. These experiences were further influenced by structural and interpersonal relations of power operating within the health care, legal, and welfare systems. The women engaged in a several strategies to mitigate the harmful effects of factors that influenced their health including: (a) managing limited financial resources; (b) negotiating the health care system; (c) managing substance use; and (d) managing on your own. These strategies were influenced by the types of concerns experienced, perceptions of their most pressing concern, the nature of interpersonal relations with health care providers, and the limited social and economic resources available. Changes in the organizational policies and practices of the welfare, legal, and health care systems are needed to improve women’s health. Possible strategies include increased access to welfare and safe, affordable housing, safer alternatives to income, and improved collaboration between illness prevention and law enforcement programming. New approaches are required that build on women’s considerable strengths and are sensitive to ways in which gender, race, and class can disrupt opportunities to access services.

<p>Even though women make up over half the population in the United States, medical advancements in areas of women's health have typically lagged behind the rest of the medical field. Specifically, two major threats to women's reproductive health include human immunodeficiency virus (HIV), and cervical cancer with accompanying human papillomavirus (HPV) infection. This dissertation presents the development and application of two novel optical imaging technologies aimed at improving these aspects of women's reproductive health.</p><p>The presented work details the instrumentation development of a probe-based, dual-modality optical imaging instrument, which uses simultaneous imaging of fluorimetry and multiplexed low coherence interferometry (mLCI) to measure in vivo microbicide gel thickness distributions. The study explores the optical performance of the device and provides proof of concept measurements on a calibration socket, tissue phantom, and in vivo human data. Once the instrument is fully characterized, it is applied in a clinical trial in which in vivo human vaginal gel thickness distributions. The gel distribution data obtained by the modalities are compared in order to assess the ability of mLCI making accurate in vivo measurements. Differences between the fluorimetry and mLCI modalities are then exploited in order to show a methodology for calculating the extent of microbicide gel dilution with the dual-modality instrument data.</p><p>Limitations in cervical cancer screening are then addressed as angle-resolved low coherence interferometry (a/LCI) is used in an ex vivo pilot study to assess the feasibility of a/LCI in identifying dysplasia in cervical tissues. The study found that the average nuclear diameter found by a/LCI in the basal layer of ectocervical epithelium showed a statistically significant increase in size in dysplastic tissue. These results indicate that a/LCI is capable of identifying cervical dysplasia in ectocervical epithelium. The results of the work presented in this dissertation show that dual-modality optical imaging with fluorimetry and mLCI, and the a/LCI technique show promise in advancing technologies that are used in the field of women's reproductive health.</p> / Dissertation

Introduction: The primary purpose of this research was to determine whether women with stress urinary incontinence (SUI) demonstrate pelvic floor muscle (PFM) strength or endurance deficits and/or changes in the motor control patterns used during maximum voluntary PFM contractions (PFM MVCs) and coughing. A secondary purpose was to determine the effect of age on these parameters. Methods: After first validating the use of vaginal pressure to study the functional output of the PFMs, three studies were carried out to address these objectives. In two studies vaginal pressure and PFM and abdominal muscle electromyography (EMG) data were recorded simultaneously during PFM MVCs and maximum effort coughs in continent women, women with mild SUI and women with moderate to severe SUI in both supine and standing. In the final study, the effect of continence status and age on PFM strength and endurance was measured with vaginal pressure. Results: Changes in vaginal pressure induced by PFM MVCs and coughing were found to reflect changes in urethral pressure. The women with SUI and the continent women were found to be equally able to produce peak PFM EMG and vaginal pressure amplitudes during PFM MVCs and coughs. Compared to the continent women, the women with SUI delayed activating their abdominal muscles during the PFM MVCs. During coughing, vaginal pressure and PFM EMG peaked simultaneously in the continent women, while in the women with SUI vaginal pressure peaked after PFM EMG. During both the PFM MVCs and the coughs, the EMG activity in all of the muscles tested was higher at the onset of vaginal pressure generation in the women with SUI compared to the continent women. No difference was found in PFM endurance between the women with and without SUI. The ability to generate peak vaginal pressure during coughing decreased with age. Conclusions: PFM weakness does not appear to play a significant role in SUI. Rather, the results of this research suggest that a combination of motor control deficits and delays in pressure transmission are associated with SUI in women. / Thesis (Ph.D, Rehabilitation Science) -- Queen's University, 2009-09-21 09:37:12.923

Program Description As a part of the community education branch of the Feminist Women’s Health Center (FWHC), there is a leadership & advocacy training program for young women called the Young Women’s Leadership Program. This project was developed in 1999 at the FWHC as a way to connect young women from all walks of life to different communities and prepare them for reproductive justice activism, advocacy, and organizational leadership. Through this program, young women will have the opportunity to develop invaluable skills that include: how to advocate for social justice and women’s rights, how to plan events and recruit new activists, and empowerment through volunteering. The Young Women’s Leadership Program has expanded to the Latina community of Atlanta as well as the African American community. Since inception, over 2,200 young women have graduated from the YWLP program (“Young Women’s Leadership Project”, n.d.). The end result of the YWLP is for the participants to take on leadership roles and to participate actively in the community as well as operate as a board member on a committee at the FWHC. Evaluation Questions Three main questions were posed in order to perform an outcome evaluation of the Young Women’s Leadership Program. These questions coincided with the agenda of the Program Coordinator because the current goal is to regain external funding for the program. Proof of the success of the program through the outcome evaluation would be helpful in meeting that goal. Through the activities of the program, did participants feel that their knowledge of reproductive rights and justice was increased? i. Was volunteer orientation valuable in increasing participant’s knowledge of reproductive health, rights, and justice for women? Did the participants find the advocacy activities of the program valuable in increasing their advocacy skills? Did the participants find the leadership activities of the program valuable in developing their leadership skills? i. Did any of the program participant’s progress to Tier III leadership roles within the Feminist Women’s Health Center? If so, in what capacity? Summary of Results To summarize the findings of the evaluation results, a majority of the program participants did have the perception that five of the Young Women’s Leadership Program activities did increase their knowledge of reproductive health, rights, and justice. Specifically, volunteer orientation and FOCUS: Reproductive Justice Advocacy workshop seemed to have the largest response rates and were favorable towards participants agreeing that their knowledge had increased as a result of the activity. Also, a majority of the participants did agree that 5 out of 6 activities were valuable in increasing their advocacy skills as well as their leadership skills. The evaluation question, “Did any of the program participant’s progress to Tier III leadership roles within the Feminist Women’s Health Center?” returned positive results as there were some 7 participants who moved to Tier III leadership out of 24 participants who responded. In summary, the participants of the Young Women’s Leadership Program, did have a positive perception of the program on increasing the leadership and advocacy skills as well as the knowledge of reproductive health, rights, and justice of the participants surveyed.

This study investigated links between childhood victimization, adult attachment style, and adult physical health outcomes among women. Existing research has found that female survivors of childhood abuse are more likely than non-abused women to experience a host of negative long-term sequelae, particularly in terms of mental and physical health concerns. Examining the attachment security of abuse survivors may facilitate our understanding of the relationship between early victimization and later health. Attachment theory posits that the security of childhood relationships with caregivers influences the quality of later interpersonal relationships. As a consequence of childhood abuse, normal attachment patterns are thought to be disrupted. Furthermore, insecure adult attachment has been linked to poorer physical health in community samples. Using structural equation modeling (SEM), adult attachment insecurity was found to partially mediate health outcomes among female survivors of childhood victimization in an undergraduate sample. Findings suggest that the experience of childhood maltreatment is tied to an increase in women's physical health concerns in a holistic manner, where victimization affects later perceptions of symptoms, functional impairment, and illness behaviour. Furthermore, adult attachment and relational behaviour appears to be a pathway through which this association is formed. Implications for health practitioners, clinicians and researchers are discussed. / Graduate

The purpose of this study was to determine the role of acculturation in the food consumption patterns of low income Hispanic women living in Texas and enrolled in the Women, Infants, and Children (WIC) Program by testing the following hypotheses: a) There are significant differences in consumption of fruit and vegetables by selected socio-demographic variables; and, b) less healthy food consumption patterns are associated with higher levels of acculturation in health-related research involving low-income Hispanic women living in Texas. A secondary-data analysis of the responses to the Texas Food & Nutrition (TEXFAN) questionnaire was performed. TEXFAN is a 122-item survey designed to measure WIC participants' consumption behaviors and to assess the impact of new food packages in Texas' WIC program. A total of 3,336 adult, non-pregnant women self-identified as having Hispanic ethnic background of all races were considered for this study. Analysis of Variance and Kruskal-Wallis tests showed significant differences in nutritional practices among Hispanic women for age, educational attainment, employment status, race, area of residence, and acculturation. Logistic Regression analysis confirmed the hypothesis that lower levels of acculturation are associated with healthier food consumption patterns. The majority of respondents (70.7%, N=2,358) did not consume the recommended five servings of fruits and vegetables a day; therefore, do not have healthy patterns of food consumption. Consequently, the majority of respondents (70.0%, N= 1,709) has a weight statuses above normal and at a higher proportion than women in the State of Texas and the nation. Acculturation continues to interest social and behavioral researchers but variations on conceptualization, definition, operationalization, and measurement negatively impact generalizability and applicability of results. Interventions not considering acculturation are not likely to be successful. Research has to include community, ecological, cultural and contextual factors (e.g., machismo, accessibility to sidewalks, availability of fresh healthy foods, etc.). Development of effective intervention programs should be aimed to increase consumption of healthy food and an adherence to the recommendations of the "Healthy Plate" and the "Dietary Guidelines for Americans 2010" among Hispanics. Also, interventions should generate necessary skills among Hispanics for empowering them to sustain proper nutritional behaviors and overcome barriers.