Women & Health

Moreira, Mayle Andrade; Vafaei, Afshin; da Câmara, Saionara Maria Aires; Nascimento, Rafaela Andrade do; de Morais, Maria do Socorro Medeiros; Almeida, Maria das Graças; Maciel, Álvaro Campos Cavalcanti

doi: 10.1080/03630242.2019.1688445pmid: 31726939

We determined the prevalence of Metabolic Syndrome (MetS) and associated factors in 419 women (aged 40 to 65 years) in Northeast Brazil in a cross-sectional study conducted from April to November 2013. We defined MetS using the National Cholesterol Education Program Adult Treatment Panel III (NCEP-ATP III) criteria. Socio-demographic variables, reproductive factors, lifestyle factors, anthropometrics, body composition, quality of life, and physical performance were assessed for their associations. We constructed multivariate Poisson regression models to estimate prevalence rate ratios (PRR) and 95% confidence intervals (CI). We identified 275 (65.6%) cases of MetS. The three most prevalent indicators were obesity (73.5%), reduced high-density lipoprotein level (63.0%), and elevated blood pressure (60.9%). In the final adjusted model, black race (PR 1.30, 95% CI: 1.07–1.57), lower grip strength/body mass index (PR 1.31, 95% CI: 1.15–1.50), and low estradiol levels (PR 1.17, 95% CI: 1.00–1.35) were associated with MetS. MetS is a long-term threat to the health of middle-aged women and a potential public health burden. These results may help in developing health promotion strategies to prevent morbidity and mortality associated with MetS in this vulnerable population.

Corr, Méabh; McMullen, Jaimie; Morgan, Philip J.; Barnes, Alyce; Murtagh, Elaine M.

doi: 10.1080/03630242.2019.1688446pmid: 31709910

This study aimed to examine the feasibility of the Supporting Our Lifelong Engagement; Mothers and Teens Exercising (SOLE MATES) program. SOLE MATES, a single-arm six-week feasibility trial, comprised six face-to-face sessions. Participants were mothers (n = 27) with daughters (n = 31) aged 12–16 years. Data were collected in Ireland between January 2018 and March 2018. Feasibility benchmarks examined recruitment, data collection, acceptability, resources and participant responses. The primary outcome was daughters’ step counts, measured via sealed pedometer for seven consecutive days at baseline and six weeks. Secondary outcomes included mothers’ step counts, measures of communication, co-participation in activity, health-related quality of life and parenting practices. Feasibility benchmarks were reached or exceeded, except for retention. Eligibility rates were 93.4%, and baseline activity levels were low. Program content, measures and facilitators were acceptable, demonstrated through a mean score of 4.14 (SD 0.3) on a 5-point Likert Scale. Daily steps increased in mothers (2,875 increase, p = .009) and daughters (1,393 increase, p = .007). Positive feasibility metrics demonstrated the program’s appeal. Participant responses for outcome measures also indicated program success. However, the relatively homogenous sample and relatively poor initial participation rate were study limitations. The intervention should be evaluated in a randomized controlled trial.

Im, Hyojin; Swan, Laura E. T.; Heaton, Lindsay

doi: 10.1080/03630242.2019.1689543pmid: 31711407

Female genital mutilation or circumcision (FGM/C) is a perilous social and cultural practice that affects the physical, mental, and psychological health of affected women. It is widespread around the world, affecting 200 million women and girls. This study aimed to explore the relation of FGM/C to mental and physical conditions in Somali refugees displaced in a low-resource setting, applying the concept of poly-victimization to reveal multifaceted trauma sequelae. Data for this cross-sectional study with 143 female Somali youth living in Eastleigh, Kenya were collected between April and May in 2013. FGM/C was strongly associated with negative physical and mental health outcomes, including post-traumatic stress disorder and depressive, anxiety, and somatic symptoms. Logistic regression analysis revealed that separation from a parent and poly-victimization experiences were significantly associated with FGM/C experience. The results also showed that FGM/C and other traumas did not occur singly but were indicative of cumulative adversities, especially for women who were socially vulnerable and marginalized. The results of this study highlight the practice of FGM/C in the context of other adverse living conditions of refugees and the importance of attending to other co-occurring risk factors that prevail with FGM/C practice in the ecological system of refugee forced migration.

Fuensalida-Novo, Stella; Parás-Bravo, Paula; Jiménez-Antona, Carmen; Castaldo, Matteo; Wang, Kelun; Benito-González, Elena; Arendt-Nielsen, Lars; Fernández-De-Las-Peñas, César

doi: 10.1080/03630242.2019.1696440pmid: 31795922

Cao, Wangnan; Wong, Hai Ming; Yang, Xueying; Wagley, Neelima; Wong, Jack; Chang, Chun

doi: 10.1080/03630242.2019.1697790pmid: 31770499

This study explored the impact of serostatus disclosure on the spousal relationship between wives and their HIV-positive husbands who have had sex with men. A qualitative study using semi-structured interviews was conducted in Sichuan, China in 2017 with wives (n = 31) who had known their husbands’ HIV-positive status. Participants were identified by local governmental and non-governmental organizations that provide routine services for people living with HIV and their family members. Qualitative data underwent a detailed content analysis. Both positive and negative impacts on the spousal relationship were expressed by wives. Six themes were identified: (1) reduced sexual activities; (2) changes in intimacy; (3) limited communication on HIV-related issues but improved communication on other topics; (4) increased instrumental support but decreased emotional support; (5) improved resilience in the spousal relationship; and (6) shared privacy management rules regarding HIV-positive status. Moreover, the acknowledgment of the husband’s homosexual behavior hurt the spousal relationship more seriously than the disclosure of the husband’s HIV-positive status, and irremediable marriages were observed among wives who knew both. Disclosure of HIV-positive status had a great impact on the spousal relationship, though such impact varied across individuals.

Blackman Carr, Loneke T.; Samuel-Hodge, Carmen D.; Ward, Dianne S.; Evenson, Kelly R.; Bangdiwala, Shrikant I.; Tate, Deborah F.

doi: 10.1080/03630242.2019.1700585pmid: 31814531

Black women typically lose small amounts of weight in behavioral weight loss interventions, partially due to low engagement in physical activity. Culturally relevant enhancement of the physical activity component may improve weight loss. This study compared the effectiveness of a culturally-relevant, physical activity-enhanced behavioral weight loss intervention to a standard behavioral weight loss intervention in Black women (n = 85) over 6 months. The study was conducted in two cohorts from March 2016 to February 2017 at the University of North Carolina at Chapel Hill. Participants had an average age of 48.30 ± 11.02 years with an average body mass index of 36.46 ± 4.50 kg/m2. Standard and enhanced groups’ weight change (−2.83 kg and −2.08 kg, respectively) and change in physical activity (43.93 min/ week and 15.29 min/week, respectively) did not differ between groups. Significantly more standard group participants lost 5% of baseline weight compared to enhanced group participants. This study produced typical weight loss results in Black women. Behavioral weight loss treatment remains moderately effective for Black women. Strategies to increase attendance and self-monitoring, and the inclusion of cultural contexts to weight-related behaviors are needed to improve outcomes.

Radey, Melissa; McWey, Lenore; Cui, Ming

doi: 10.1080/03630242.2019.1700586pmid: 31814538

Poverty is linked with a host of negative outcomes. Approximately one-third of unmarried mothers and their children live in poverty in the United States. Public and private supports have the potential to mitigate the adverse effects of poverty; however, these supports may be unstable over time. The purpose of this study was to determine public and private safety net configurations of low-income mothers longitudinally and test linkages between safety net configurations and maternal psychological distress. Using longitudinal data from the Welfare, Children, Families project conducted in 1999, 2001, and 2005 (n = 1,987), results of multilevel models of change indicated that less than one-half of low-income mothers used public assistance and had private support at any one point. Safety net configurations and psychological distress levels changed over time with deterioration occurring more than improvement, and private safety net availability offered protection from psychological distress. These findings can be used to inform family support services and highlight the need to augment public assistance programs with services aimed to also address maternal psychological well-being and social support. Doing so can be a means of improving the public and private safety nets and outcomes of vulnerable families.

Tosun Güleroğlu, Funda; Mucuk, Salime; Özgürlük, İzzet

doi: 10.1080/03630242.2019.1707747pmid: 31878845

Evidence has been limited on the effect of mother-infant skin-to-skin contact on the involution process and maternal postpartum fatigue. This study aimed to determine such effects in a randomized controlled trial conducted in a hospital in Sivas, Turkey. Seventy-five women were randomized into one of two groups. The Mother-Infant Information Form, Involution Process Evaluation Form and Visual Analogue Scale for Fatigue were used to collect data between October 1, 2015 and May 1, 2016. Repeated Measures ANOVAs were used for data analyzes. In the intervention group, routine care and mother-to-infant skin-to-skin contact were provided for 30 minutes in first postnatal hour. In the control group, routine care was provided. At the postnatal second, fourth and 24th hours, fundus heights were 13.4 ± 0.3, 12.9 ± 0.3 and 11.8 ± 0.3 cm, respectively, in the intervention group, and 14.4 ± 0.4, 13.8 ± 0.3 and 12.9 ± 0.3 cm in the control group (p < .05). At the 24th hour, women in the intervention group had higher mean energy levels (29.8 ± 10.1) than the control group (25.1 ± 10.0) (p < .05), and fatigue score, amount of lochia and number of pads were statistically similar between the groups (p > .05). Mothers expressed satisfaction with skin-to-skin practice. Thus, mother-to-infant skin-to-skin contact can be used as a care practice in the postpartum period.

Mann, Emily S.; White, Ashley L.; Beavin, Cynthia; Dys, Gabrielle

doi: 10.1080/03630242.2019.1710891pmid: 31914864

Long-acting reversible contraceptives (LARC) are now recommended for use among nulliparous young women to prevent unintended pregnancy. While research has explored LARC knowledge, attitudes, and use among young women in the United States, college women’s feelings about LARC have received limited attention. This article reports findings from a focus group study conducted with a convenience sample of 45 women, ages 18–25 years, enrolled in a large public university in the southeastern USA in April 2017. Focus groups combined LARC users and non-users and elicited a range of positive and negative affective responses to LARC. Some participants had an aversion to LARC because they perceived them to be unnatural, while others felt a sense of security because of their long-term effectiveness. Feelings about the location and mode of insertion for the intrauterine device (IUD) versus the implant played a significant role in the decision to use a specific LARC method: some found being able to feel the implant in their arm reassuring, while others found it disturbing and preferred the IUD. College-going LARC users also appear to be effective advocates for LARC use among their peers.