Diverse Young Women Research Articles

‘You made us feel at home’: towards Indigenous feminist methodologies with young wāhine in sport and exercise

ABSTRACT Decades of research on Indigenous and culturally diverse young women in sport and exercise has been underpinned by deficit models where these groups are portrayed as ‘lacking’, ‘at risk’, and/or ‘vulnerable’. Such approaches have been heavily critiqued for ignoring broader structural and systemic inequities that have produced such health disparities. These approaches also reproduce racialised ideologies of Indigenous and culturally diverse women where they are seen as a ‘problem group’ in sport, exercise and health research. Over recent years, a growing body of research is advancing culturally appropriate methodologies and methods that aim to prioritise the voices and lived experiences of Indigenous and culturally diverse women. This paper contributes to this literature by providing an example of research that used Indigenous methodologies (Mana Wahine and Masi Methodology) to engage young Māori and Pasifika wāhine in Aotearoa New Zealand. We start by positioning this paper in relevant literature, then detail the cultural underpinnings of the methodological approach we used. We then outline the research and offer some practical considerations in, i) recruiting young women within one’s community, ii) using methods such as wānanga (meetings), digital diaries and kai (food), and iii) weaving care and reciprocity. In so doing, we highlight the importance of using locally specific feminist methodologies throughout research with, by and for young Indigenous and culturally diverse young women.

Vaginal microbiota in ethnically diverse young women who did or did not develop pelvic inflammatory disease: community-based prospective study

ObjectivesA lactobacilli-dominated vaginal microbiome may protect against pelvic inflammatory disease (PID), but one dominated by Gardnerella species might increase susceptibility. Not all lactobacilli are equally protective. Recent research suggests that...

How Are They Different? An Exploration of Family and School Factors among Post-Adjudicated Young Women

This study explores the associations between family and school factors, and their relationship to criminal risk among post-adjudicated diverse young women. Cross-sectional data were collected through the Positive Achievement Change Tool using seven measures of family and school factors (n = 365). After controlling for age, this model (Family incarceration, Running away from home, School suspension or Expulsion, Abuse, Neglect and Special education need) emerged as significant predictors of criminal risk (p ≤ .001). However, only family incarceration and special education needs (learning, behavioral or ADHD/ADD) were predictive of higher levels of criminal risk for Black young women while running away from home was predictive for Hispanic young women. Interventions should be gender-specific and culturally responsive in addressing family and school factors that impact diverse young women.

Staying safe: how young women who trade sex in Toronto navigate risk and harm reduction.

Celling Sex was a community-based participatory research project that used a strengths-based approach to explore the agentic harm reduction practices employed by young women who trade sex and learn about their experience accessing health and social services. Fifteen racially diverse young women participated in interviews. They described how they tried to stay safe and advice for others. Each participant also individually made a brief digital video (cellphilm) to tell their story. Participants were invited to a private screening at which cellphilms were screened and common themes identified. The interviews and cellphilms were subsequently coded according to these themes. Participants identified a number of trading risks including: physical risks (unwanted pregnancy, STIs, and violence), social risks (racism and fetishisation), and mental health risks. To mitigate these concerns, participants detailed the harm reduction strategies they used which included use of technology, screening measures, boundary setting, and actively incorporating sexual health protections. Young women who trade sex are keenly aware of the risks inherent in transactional relationships and proactively negotiate and navigate harm reduction strategies in the context of deep systemic barriers. Further intervention may be necessary for them to actualise these strategies and access important forms of health and social support.

Invisible Young Women and Public Policy in Ontario

Scholars across research fields have pointed to the exclusion of young women from theories and studies of citizenship, political engagement, and public policy. Limited systematic attention has been paid to whether or how diverse young women's experiences are reflected in public policy. We ask (a) in which provincial policy areas in Ontario do diverse young women warrant unique attention and (b) how are their experiences reflected in these areas? Using intersectionality to guide our analysis, we find that diverse young women's unique experiences are largely invisible in Ontario public policies, despite Ontario's introduction of an Inclusion Lens in policy development and analysis in 2011. We argue for efforts to counter the dominance of neoliberalism, which serves to individualize responsibility, erase difference, and diminish young women's political agency.

Pubic hair and its removal: A practice beyond the personal

Pubic hair removal, now common among women in Anglo/western cultures, has been theorised as a disciplinary practice. As many other feminine bodily practices, it is characterised by removal or alteration of aspects of women's material body (i.e., pubic hair) considered unattractive but otherwise “natural.” Emerging against this theorisation is a discourse of personal agency and choice, wherein women assert autonomy and self-mastery of their own bodies and body practices. In this paper, we use a thematic analysis to examine the interview talk about pubic hair from 11 sexually and ethnically diverse young women in New Zealand. One overarching theme – pubic hair is undesirable; its removal is desirable – encapsulates four themes we discuss in depth, which illustrate the personal, interpersonal and sociocultural influences intersecting the practice: (a) pubic hair removal is a personal choice; (b) media promote pubic hair removal; (c) friends and family influence pubic hair removal; and (d) the (imagined) intimate influences pubic hair removal. Despite minor variations among queer women, a perceived norm of genital hairlessness was compelling among the participants. Despite the articulated freedom to practise pubic hair removal, any freedom from participating in this practice appeared limited, rendering the suggestion that it is just a “choice” problematic.

A qualitative exploration of supports and unmet needs of diverse young women with breast cancer.

Young women with breast cancer face different challenges than those faced by older women because of their age and life stage, yet few studies have focused on the different challenges faced by women from diverse populations. To explore existing supports that are important during diagnosis and treatment and the unmet needs for information and support in young women with breast cancer. We conducted 20 semistructured interviews in English with women aged 42 or younger who had been diagnosed with stage I-III invasive breast cancer within the previous 4 years. We recorded and transcribed the interviews and used collaborative group immersion/ crystallization to analyze data, identify emergent themes, and determine if there were differences by race/ethnicity. 20 participants, recruited from 9 US states and Canada, were interviewed, of whom 25% were Hispanic, 15% were black, 50% were white and non-Hispanic, and 10% were another race/ethnicity. Faith and/or spirituality and family were reported as important sources of support by many of the participants. Most of them lamented the inadequacy of their connections with other young survivors and also of supports for their family. Some recommended that young patients be provided with more information about: treatment-related physical and emotional changes; fertility and menopause; relationships after cancer; navigating work challenges; and transitioning into survivorship. None of these supports or recommendations was limited to a specific race/ethnicity or geographic region. Small sample size, exclusion of non-English speakers. Conclusions Key informant interviews of young breast cancer survivors identified similar needs for education and support across various races/ethnicities and geographies. Key informant interviews of young breast cancer survivors identified similar needs for education and support across various races/ethnicities and geographies.

Food neophiles: Profiling the adventurous eater

The study objective was to identify how food neophilia-having an adventurous eating style for new/different foods-may relate to body mass index (BMI). A nationwide online survey was conducted in 2012 with a group of 501 diverse young women (mean age = 26.8, mean BMI = 25.96). Items measured eating adventurousness, perceptions of novel foods, lifestyle and psychological characteristics, and BMI (dependent variable). Linear regressions were run to examine associations between eating adventurousness and weight-related outcomes. To examine mean differences between adventurous and non-adventurous eaters, a one-way ANOVA was run for variables on perceptions of novel foods, lifestyle, and psychology (significance level = P < 0.05). Food neophiles had lower BMIs (P < 0.01) and were more likely to cook to connect with their heritage, host friends for dinner, be physically active, and be concerned about the healthfulness of food, when compared to non-adventurous eaters (all P values < 0.05). Promoting adventurous eating in adults could help individuals lose/maintain weight without feeling as restricted. Given the lack of research on food neophiles, future studies should examine their characteristics and behaviors, as well as how food neophiles may intersect with others interested in food (e.g., foodies).

Adventurous Eating: Expand Your Palate, Not Your Waistline

To examine the relationship between adventurous eating and body mass index (BMI) and to describe differences between adventurous and non-adventurous eaters. Participants were 501 diverse young women (mean age= 26.8, mean BMI=25.96). Survey measures assessed participants' eating adventurousness, perceptions of novel foods, height/weight, lifestyle and psychological characteristics. Eating adventurousness was assessed by asking if participants had tried some novel foods (e.g., seitan, beef tongue, polenta) (range 0-16). Linear regressions were run to examine associations between eating adventurousness and BMI. To examine mean differences between adventurous and non-adventurous eaters, ANOVAs were run for each of the lifestyle and psychological variables, as well as perceptions of novel foods. Eating adventurousness was significantly associated with BMI, in that adventurous eaters had lower BMIs (B= -0.191, t(499)=-2.796, p<0.01). Adventurous eaters (n=135) had significantly higher means on cooking to connect with their heritage, hosting friends for dinner, how physically active they were, how particular they were about the healthfulness of food, and enjoyment of trying new things, as compared to non-adventurous eaters (n=366). Adventurous eaters had lower means on importance of new foods being those that celebrities eat, importance of a new food being inexpensive, importance of a food being nicely packaged, and the importance of a new food being easy to fix. Adventurous eating is associated with lower BMI. Identification of characteristics that differ between adventurous and non-adventurous eaters may illuminate target areas for weight management. Promoting adventurous eating may be a way to help individuals lose/maintain weight without feeling as restricted.

Awareness of Heart Disease Among Female College Students

Awareness of heart disease as the leading cause of death in women has increased over the past 10 years, but little is known about the awareness level of college students. This study evaluated the level of awareness and knowledge of heart disease in women among college students. Using a cross-sectional design, a sample of 320 women from a private university was queried. A 13-item survey assessed demographic information and awareness of cardiovascular disease (CVD). The mean age was 23 years; the majority were single and of Hispanic ethnicity. Almost one third believed breast cancer was the greatest problem facing women. One half recognized CVD as the leading cause of death among women. Students aged 18-24 years were significantly less likely to identify heart disease/heart attack as the leading cause of death in women compared with students aged 25-34 years. Significant ethnic differences in perceptions of risk were found. Family history and obesity were seen as major contributors to CVD; less than a fourth ever discussed CVD with their healthcare provider. Information was gained primarily from television, magazines, and the Internet. Exercise and maintenance of healthy blood pressure were viewed as priorities in prevention of CVD. Results add to the body of research on CVD risk and the need for intervention to increase awareness and knowledge of heart disease risk among younger and ethnically diverse young women and raises questions about the role of colleges and universities in promotion of student health. Colleges and universities may provide the last opportunity to reach youth as a group to affect lifestyle changes.

Generalized Equations for Estimating DXA Percent Fat of Diverse Young Women and Men

Popular generalized equations for estimating percent body fat (BF%) developed with cross-sectional data are biased when applied to racially/ethnically diverse populations. We developed accurate anthropometric models to estimate dual-energy x-ray absorptiometry BF% (DXA-BF%) that can be generalized to ethnically diverse young adults in both cross-sectional and longitudinal field settings. This longitudinal study enrolled 705 women and 428 men (aged 17-35 yr) for 30 wk of exercise training (3 d·wk(-1) for 30 min·d(-1) of 65%-85% predicted V˙O2max). The distribution of ethnicity was as follows: 37% non-Hispanic white, 29% Hispanic, and 34% African-American. DXA-BF%, skinfold thicknesses, and body mass index (BMI) were collected at baseline and after 15 and 30 wk. Skinfolds, BMI, and race/ethnicity were significant predictors of DXA-BF% in linear mixed model regression analysis. For comparable anthropometric measures (e.g., BMI), DXA-BF% was lower in African-American women and men but higher in Hispanic women compared with non-Hispanic white. Addition of BMI to the skinfold model improved the SEE for women (3.6% vs 4.0%), whereas BMI did not improve prediction accuracy of men (SEE = 3.1%). These equations provide accurate predictions of DXA-BF% for diverse young women and men in both cross-sectional and longitudinal settings. To our knowledge, these are the first published body composition equations with generalizability to multiple time points, and the SEE estimates are among the lowest published in the literature.

Exploring Diaphragm Use as a Potential HIV Prevention Strategy Among Women in the United States at Risk

Given the immediate need for physical cervical barrier methods like the diaphragm to protect against HIV/STIs, understanding what factors influence the acceptability of these products and how to overcome obstacles to their use is important. We explored perceptions of the diaphragm and factors that might enhance its acceptability in 25 focus groups with racially/ethnically diverse young women in the U.S. at risk for HIV/STIs (N = 140). Women believed the diaphragm has positive attributes, and most indicated they would be more likely to use the diaphragm if they were confident they could use it correctly and it protected against HIV. They also considered it messy to use and difficult to insert or remove. Findings suggest that the diaphragm could be a desirable option for pregnancy and disease prevention for some women at risk for HIV/STIs. Although disadvantages to diaphragm use were identified, many could be eliminated through changes in product design and provider intervention.

Bone Mineral Density and Leg Muscle Strength in Young Caucasian, Hispanic, and Asian Women

Differences in bone mineral density (BMD) of ethnically diverse populations are usually attributed to anthropometric characteristics, but may also be due to life style or diet. We studied healthy young sedentary women with Asian (ASN, n = 40), Hispanic (HIS, n = 39), or Caucasian (CAU, n = 36) backgrounds. Body composition and regional BMD were measured by dual-energy X-ray absorptiometry (Hologic) or PIXI (Lunar GE) for the heel and wrist). Leg strength was quantified with a leg press and dietary calcium was estimated with 3-d diet records. CAU were taller than HIS and ASN ( p < 0.01). ASN had lower body weights, fat mass, lean body mass, and leg strength than HIS or CAU ( p < 0.01). Differences in BMD among groups were not eliminated by adjusting for body weight and height at the arm, trochanter, femoral neck, and total hip where BMD values remained lower in the ASN than in HIS or CAU ( p < 0.01). Conversely, adjusted BMD at the wrist was 7.3% higher in ASN and 8.3% higher in HIS and at the heel, 7.3% higher in ASN and 7.0% higher in HIS than in CAU ( p < 0.05). Leg strength was a significant predictor of BMD in the hip in CAU ( R = 0.53, p = 0.004), in the hip with dietary calcium in ASN ( R = 0.65, p = 0.02), and in the heel with height in HIS ( R = 0.57, p = 0.03). We conclude that significant factors underlying BMD in ethnically diverse young women vary as a function of ethnicity and include leg strength and dietary calcium as well as anthropometric characteristics.

Bacterial vaginosis in sexually experienced and non–sexually experienced young women entering the military

Objective To estimate the prevalence of bacterial vaginosis by Nugent Gram stain criteria in a nonclinic national sample of young women entering recruit training; to examine clinical associations with bacterial vaginosis; and to evaluate the performance of a pH test card and Papanicolaou smear against Gram stain as screening tools for bacterial vaginosis. Methods A cross-sectional study of 1938 women was conducted. Self-collected vaginal swabs were applied to a colorimetric pH test card and a glass slide for Gram stain evaluation according to the Nugent criteria. Papanicolaou smears and samples for sexually transmitted diseases screening were collected during routine entry pelvic examinations. Results Bacterial vaginosis prevalence was 27%, with 28% in sexually experienced and 18% in non–sexually experienced women ( P = .001). Bacterial vaginosis prevalence was 11% in Asian/Pacific Islanders, which was lower than in other nonwhite ethnic groups ( P = .004). Clinically, bacterial vaginosis was directly related to multiple sexual partners ( P = .026), self-report of vaginal discharge ( P = .001), self-report of vaginal odor ( P < .001), and concurrent Chlamydia trachomatis infection ( P = .002), and inversely related to hormonal contraceptive use ( P = .013). Vaginal discharge did not achieve statistical significance in multivariate analysis. Compared with the Nugent criteria, the sensitivities and specificities for bacterial vaginosis diagnosis were as follows: colorimetric pH test: 72% and 67%; Papanicolaou smear: 72% and 79%, respectively. Conclusion Among these diverse young women, bacterial vaginosis occurs commonly in both sexually experienced and inexperienced young women and differs by race and ethnicity. The pH colorimetric test and Papanicolaou smear performed moderately well as screening tools for bacterial vaginosis. The inverse relationship of bacterial vaginosis with hormonal contraceptive use and its direct relationship with C trachomatis need further study.

Bacterial Vaginosis in Sexually Experienced and Non–Sexually Experienced Young Women Entering the Military

In Brief OBJECTIVE To estimate the prevalence of bacterial vaginosis by Nugent Gram stain criteria in a nonclinic national sample of young women entering recruit training; to examine clinical associations with bacterial vaginosis; and to evaluate the performance of a pH test card and Papanicolaou smear against Gram stain as screening tools for bacterial vaginosis. METHODS A cross-sectional study of 1938 women was conducted. Self-collected vaginal swabs were applied to a colorimetric pH test card and a glass slide for Gram stain evaluation according to the Nugent criteria. Papanicolaou smears and samples for sexually transmitted diseases screening were collected during routine entry pelvic examinations. RESULTS Bacterial vaginosis prevalence was 27%, with 28% in sexually experienced and 18% in non–sexually experienced women (P = .001). Bacterial vaginosis prevalence was 11% in Asian/Pacific Islanders, which was lower than in other nonwhite ethnic groups (P = .004). Clinically, bacterial vaginosis was directly related to multiple sexual partners (P = .026), self-report of vaginal discharge (P = .001), self-report of vaginal odor (P < .001), and concurrent Chlamydia trachomatis infection (P = .002), and inversely related to hormonal contraceptive use (P = .013). Vaginal discharge did not achieve statistical significance in multivariate analysis. Compared with the Nugent criteria, the sensitivities and specificities for bacterial vaginosis diagnosis were as follows: colorimetric pH test: 72% and 67%; Papanicolaou smear: 72% and 79%, respectively. CONCLUSION Among these diverse young women, bacterial vaginosis occurs commonly in both sexually experienced and inexperienced young women and differs by race and ethnicity. The pH colorimetric test and Papanicolaou smear performed moderately well as screening tools for bacterial vaginosis. The inverse relationship of bacterial vaginosis with hormonal contraceptive use and its direct relationship with C trachomatis need further study. Bacterial vaginosis occurs commonly in the sexually experienced and inexperienced, is related to concurrent Chlamydia trachomatis, and is inversely related to hormonal contraceptive use.

HIV/AIDS knowledge, attitudes, and risk-behaviors among African-American and Caribbean college women

The HIV/AIDS knowledge, attitudes, and sexualrisk-taking behaviors of a sample ofAfrican-American and Caribbean college wereinvestigated. The study also explored therelationship between the women's self-esteem,self-efficacy, sexual communication, andreligiosity and their HIV knowledge, attitudes,and risk behaviors. Findings revealed thatwhile both groups of women were fairlyknowledgeable about HIV/AIDS transmission andprevention, their sexual risk-taking behaviorswere still relatively high. TheAfrican-American women were more knowledgeableabout HIV/AIDS than were the Caribbean women. Also, the African-American women engaged insignificantly fewer sexual risk-takingbehaviors than their Caribbean femalecounterparts. No significant cultural groupdifferences emerged on attitudes towardHIV/AIDS as a disease, HIV infected persons,and AIDS-related issues. A number ofsignificant correlations were found. The studyconcludes that HIV/AIDS counseling andprevention approaches that are ethnic,cultural, and gender appropriate are vital forincreasing both cognitive and behavioralchanges in culturally diverse young women.