Matching Items (11)

126902-Thumbnail Image.png

Reproductive Health Equity: One Key Question© for Women in Recovery

Description

Women in recovery from substance use disorders (SUD) face significant barriers to achieving reproductive well-being (RWB) and disproportionately experience unintended pregnancy. Unintended pregnancy can have serious consequences in this population.

Women in recovery from substance use disorders (SUD) face significant barriers to achieving reproductive well-being (RWB) and disproportionately experience unintended pregnancy. Unintended pregnancy can have serious consequences in this population. Equity-informed approaches promote the integration of reproductive health care (RHC) with recovery programs to improve both access to and quality of RHC. Arizona’s largest SUD recovery program, Crossroads, Inc. recently opened an on-site, integrated primary clinic offering RHC. A one-month pilot demonstration of One Key Question (OKQ), a pregnancy desire screening tool, was implemented with fidelity at Crossroads to identify clients with RHC needs and offer care.

IRB exempt status was obtained through Arizona State University. All female-bodied clients aged 18-49 were screened following routine admission assessments. The Institute for Healthcare Improvement Triple Aim model based on Self-Determination Theory and Motivational Interviewing was used to prioritize client autonomy. The client experience of care was measured using an adapted Interpersonal Quality of Family Planning scale. The magnitude of needs and desires were summarized with descriptive statistics. Sixty-three clients were screened with OKQ. Needs were identified in 97% of clients. Of those clients, 98% accepted referrals. Ninety percent of items measuring the client experience of care were rated as “excellent.” OKQ provided an efficient structure for person-centered screening and referral conversations to integrate RHC in a large SUD recovery program with excellent care experiences reported by clients.

Contributors

Agent

Created

Date Created
  • 2020-05-05

134473-Thumbnail Image.png

The first in its class? The cognitive effects of the contraceptive hormone drospirenone when given with and without an estrogen

Description

Drospirenone (DRSP) is a novel, pharmacologically unique synthetic progestin with properties more similar to the endogenous progestogen, progesterone, than any other progestin currently on the market. While a significant amount

Drospirenone (DRSP) is a novel, pharmacologically unique synthetic progestin with properties more similar to the endogenous progestogen, progesterone, than any other progestin currently on the market. While a significant amount of research has been conducted on the risks associated with DRSP, the impact of DRSP on cognition, especially in reference to learning and memory, is not well understood. However, it is imperative to fully understand the cognitive effects of DRSP, both alone and in combination with EE (as taken in a combined oral contraceptive [COC]), so that women and their physicians can make a fully-informed decision when deciding to take a DRSP-containing COC. Study 1 examined the effects of three doses of DRSP in order to determine the optimal dose for combining with EE, and found that the medium dose of DRSP (30 µg/day) enhanced spatial working memory performance. In Study 2, the medium dose of DRSP from Study 1 was combined with low (0.125 µg/day) and high (0.3 µg/day) doses of EE to examine the effects of DRSP as taken with EE in a COC. The results from Study 2 indicated that when DRSP was combined with a low, but not high, dose of EE, spatial working memory impairments were seen at the highest working memory load. Anxiety-like behavior was evaluated using the OFT, and DRSP was shown to decrease measures of anxiety-like behavior. Additionally, while treatment with a high dose of EE decreased several measures of anxiety-like behavior, a low dose of EE did not, suggestive of a dose response. Taken together, the findings presented from both studies suggest that some of the cognitive effects of the combination of DRSP with EE are different than those of either hormone administered on its own. Further exploration in a preclinical, ovary-intact animal model is a next step to fully understand these effects in the translational context of a contraceptive, given that women taking an EE-DRSP combination are typically ovary-intact.

Contributors

Created

Date Created
  • 2017-05

134955-Thumbnail Image.png

Dismantling Legal Constraints to Contraception in the 1900s

Description

In the late nineteenth century, the Comstock Act of 1873 made the distribution of contraception illegal and classified contraception as an obscenity. Reflecting the predominant attitude towards contraception at the

In the late nineteenth century, the Comstock Act of 1873 made the distribution of contraception illegal and classified contraception as an obscenity. Reflecting the predominant attitude towards contraception at the time, the Comstock Act was the first federal anti-obscenity law that targeted contraception. However, social acceptance of birth control changed at the turn of the twentieth century. In this thesis, I analyzed legislation, advocates, and literature pertinent to that social change to report on the events leading up to the decriminalization of contraception. Because of the complexity of social history, I used legislation and court cases to track pivotal movements that reflected a change in the accessibility and acceptability of birth control. I focused on the efforts of two prominent birth control advocates, Margaret Sanger and Mary Dennett, and analyzed the impact of their efforts in that social movement. I learned that they incited court cases that questioned the validity of the Comstock Act and helped influence societal acceptance of birth control. Through my research, I discovered that the medicalization of contraception influenced its decriminalization and acceptance by society.

Contributors

Agent

Created

Date Created
  • 2017-05

133955-Thumbnail Image.png

Pelvic Ultrasound to Evaluate Parameters that may Affect Intrauterine Device (IUD) Placement Failure and Success

Description

Intrauterine devices (IUDs) have become one of the most common types of contraception in the United States. In the last decade, the American College of Obstetricians and Gynecologists, the World

Intrauterine devices (IUDs) have become one of the most common types of contraception in the United States. In the last decade, the American College of Obstetricians and Gynecologists, the World Health Organization, and the Food and Drug Administration (FDA) updated IUD recommendations to include placement in younger populations and nulliparous women. Research has shown that younger, nulliparous women may have smaller uterine dimensions and it is possible that larger IUDs are not suitable for those populations. This study retrospectively evaluated follow-up pelvic ultrasounds showing uterine dimensions and IUD positions of 57 women who had IUDs placed in a clinic. The largest IUD, the Paragard, showed a significantly higher rate of malpositioning than the Kyleena, Liletta, and Mirena IUDs. There is concern that the Paragard IUD, which is most commonly malpositioned, is also the IUD most dependent on position for adequate contraception. There was no correlation between uterine dimensions and IUD position at the time of analysis, however. Further data collection will continue in hopes that a larger sample size will reveal a parameter which affects IUD placement. Should further data analysis show that uterine width plays an important role in IUD position, the design for a device which can measure the width of patient's uterus (without the need for pelvic ultrasound) has been included. The concept generation for this measurement device includes laser measurements of uterine cavity width at different known lengths from the fundal wall, which output to an LED screen for recording.

Contributors

Agent

Created

Date Created
  • 2018-05

147637-Thumbnail Image.png

The Impact of Cultural Perceptions on Contraceptive Use Among Young Mexican- American Women

Description

Existing knowledge of Latina sexual health disparities has been discussed through traditional barriers such as financial, language, or location. Contraceptive use is proven to greater economic, social, and health outcomes

Existing knowledge of Latina sexual health disparities has been discussed through traditional barriers such as financial, language, or location. Contraceptive use is proven to greater economic, social, and health outcomes across women of all racial and ethnic backgrounds. This study aims to explore another factor, specifically among young Mexican-American women – whether or not cultural perceptions on sexual health impact the decision to use contraception. In- depth qualitative interviews were conducted among first-generation Mexican-American women ages 18-25 residing in Arizona. The results show that while negative cultural perceptions faced additional barriers in seeking contraception, it was not a complete deterrent for any participant. If anything, this motivated participants to actively destigmatize sexual health in their communities by speaking more openly about their experiences with others.

Contributors

Created

Date Created
  • 2021-05

137374-Thumbnail Image.png

Natural Family Planning in Evidence Based Practice: Implementing a True Method of Family Planning in Client Education Programs.

Description

Family planning educational programs offer a list of artificial contraceptive methods to couples wishing to avoid a pregnancy; however, many of these methods have disadvantages: many lead to negative individual

Family planning educational programs offer a list of artificial contraceptive methods to couples wishing to avoid a pregnancy; however, many of these methods have disadvantages: many lead to negative individual and environmental health outcomes, do not promote a sense of fertility awareness in women and men, may be culturally incompatible with certain religious beliefs and worldviews, and do not take into account the full extent of family planning, which includes the ability to achieve as well as to avoid a pregnancy. Natural Family Planning (NFP) is a true method of family planning in that it offers to the couple the option to achieve as well as avoid a pregnancy. NFP methods holistically approach fertility by taking into account the woman's unique fertility cycle and patterns, the need for the couple to understand complex fertility issues, and the needs and family planning intentions of the couple as a whole. This thesis utilizes Evidence Based Practice in an effort to search the best literature regarding the effectiveness of Natural Family Planning methods to avoid a pregnancy, in comparison to the effectiveness of artificial contraceptive methods to avoid a pregnancy. If effectiveness rates are similar, it is reasonable for the health care profession to consider Natural Family Planning as a valid and reliable family planning method, to move towards further research on its effectiveness and benefits, and to implement a practice change by including it in family planning client education programs.

Contributors

Created

Date Created
  • 2013-12

137236-Thumbnail Image.png

Reproductive Health and Contraceptive Access in Post-Communist Romania

Description

When communist leader Ceaușescu was overthrown in the Romanian revolution of 1989, Romania reinstated reproductive freedoms that had been denied under communist policy. This study looks at reproductive health

When communist leader Ceaușescu was overthrown in the Romanian revolution of 1989, Romania reinstated reproductive freedoms that had been denied under communist policy. This study looks at reproductive health in Romania in 2013, examining the progress in reproductive healthcare made since 1989 while looking at lingering barriers to resources and education. Thirty-five pharmacists were surveyed to collect information on pricing and accessibility of contraceptives in pharmacies. In addition, interviews were conducted with the director of Societatea de Educatie Contraceptiva si Sexuala (SECS), a reproductive clinic healthcare provider, a professor of philosophy and feminism at Babeș-Bolyai University, and four young Romanian women.

Contributors

Agent

Created

Date Created
  • 2014-05

575-Thumbnail Image.png

Improving Postpartum Follow-Up Through Enhanced Prenatal Education and Concurrent Scheduling with a One-Month Well Baby Visit

Description

Stress of transitioning to parenthood, hormonal fluctuations as well as physical changes, and complications during postpartum could be addressed at the routine postpartum follow-up visit to avoid long-term adverse effects.

Stress of transitioning to parenthood, hormonal fluctuations as well as physical changes, and complications during postpartum could be addressed at the routine postpartum follow-up visit to avoid long-term adverse effects. While emphasis on preconception and prenatal care has increased nationwide, attendance at this important visit is on the decline. The purpose of this project was to investigate how enhanced prenatal education and concurrent scheduling of a well-baby visit at four weeks, instead of the traditional six weeks, could increase adherence to recommended follow-up care at a federally qualified health clinic in the Southwestern United States.

The Theory of Reasoned Action guided the intervention while Rosswurum and Larrabee’s evidence-based practice model was used to develop the project. The pre-existing weekly prenatal education program was enhanced with information regarding the importance of a four-week postpartum follow-up visit. Front desk schedulers were educated to offer same day appointments for the postpartum care visit and one-month well-baby appointment. Data collection took place for three months after implementation of the project and was compared to adherence rates during the three months prior to the intervention. Providers and scheduling staff members participated in a short post-intervention interview. Prenatal education and convenience of concurrent scheduling increased the percentage of adherence to follow-up visits over a three-month period. Providers and clinic staff recommend continuing with the process changes to increase patient’s access to family centered care.

Contributors

Agent

Created

Date Created
  • 2017-05-01

133052-Thumbnail Image.png

An Evaluation of the Levonorgestrel-Releasing Intrauterine Device and its Impact on Cognitive Function in a Rat Model

Description

The aim of this study was to determine whether IUD administration, with and without the presence of Levo, and with and without the presence of the ovaries, impacts cognition in

The aim of this study was to determine whether IUD administration, with and without the presence of Levo, and with and without the presence of the ovaries, impacts cognition in a rat model. Rats received either Sham or Ovariectomy (Ovx) surgery (removal of the ovaries), plus either no IUD, a Blank IUD (without Levo), or a Levo-releasing IUD (Levo IUD), enabling us to evaluate the effects of Ovx and the effects of IUD administration on cognition. Two weeks after surgery, all treatment groups were tested on the water radial arm maze, Morris water maze, and visible platform task to evaluate cognition. At sacrifice, upon investigation of the uteri, it was determined that some of the IUDs were no longer present in animals from these groups: Sham\u2014Blank IUD, Ovx\u2014Blank IUD, and Sham\u2014Levo IUD. Results from the remaining three groups showed that compared to Sham animals with no IUDs, Ovx animals with no IUDs had marginally impaired working memory performance, and that Ovx animals with Levo IUDs as compared to Ovx animals with no IUDs had marginally enhanced memory performance, not specific to a particular memory type. Results also showed that Ovx animals with Levo IUDs had qualitatively more cells in their vaginal smears and increased uterine horn weight compared to Ovx animals with no IUDs, suggesting local stimulation of the Levo IUDs to the uterine horns. Overall, these results provide alternative evidence to the hypothesis that the Levo IUD administers Levo in solely a localized manner, and suggests that the possibility for the Levo IUD to affect reproductive cyclicity in ovary-intact animals is not rejected. The potential for the Levo IUD to exert effects on cognition suggests that either the hormone does in fact systemically circulate, or that the Levo IUD administration affects cognition by altering an as yet undetermined hormonal or other feedback between the uterus and the brain.

Contributors

Agent

Created

Date Created
  • 2018-12

155130-Thumbnail Image.png

Encounters with the state: a study of pathways to pregnancy prevention and termination in Phoenix, Arizona

Description

This research project analyzes women’s dynamic pathways to pregnancy prevention and termination in Arizona. Two levels of analysis guide the study: The first is a cultural analysis of the socio-legal

This research project analyzes women’s dynamic pathways to pregnancy prevention and termination in Arizona. Two levels of analysis guide the study: The first is a cultural analysis of the socio-legal conditions that shape the channels to birth control and abortion. During this historical moment, I analyze the fight over increasing (and calls for more) legal constraints against contraception and abortion, coupled with decreasing individual access to reproductive health care information and services. This dissertation includes an examination of the struggle over reproductive health on the ground and in the legal arena, and real pushbacks against these constraints as well. The second is an analysis of how women seek out contraception or abortion within the US socio-legal landscape. The study qualitatively examines narratives from 33 women in the greater Phoenix, Arizona area, a region emblematic of the political contest over the legal regulation of women’s reproductive health currently unfolding nationally. Ultimately, the state is implicated in the various resources and barriers—people, places, processes and policies—that inform women’s pregnancy prevention. These experiences can illuminate the ways that reproductive health care is shaped by intersecting and sometimes competing ideologies, and how women encounter them in their daily lives. The study theorizes the embodiment of women’s local encounters with the state within a cultural context of contested law and policy reform.

Contributors

Agent

Created

Date Created
  • 2016