Women's Health Research Research Articles

P1-S4.32 Recruiting via social networking sites for sexual health research (assessing chlamydia and HPV knowledge)

BackgroundRecruiting participants into population health studies has become increasingly challenging: traditional strategies have limitations including low participation rates and high costs. Social networking sites, commonly used for communication by young people, present an unique opportunity for innovative recruitment modalities.MethodThis is part of a larger feasibility study assessing use of Facebook to recruit subjects for a novel prospective health study, the Young Female Health Initiative (YFHI). Women aged 16 to 25 years, living in Victoria, Australia were eligible to participate. An advertisement was placed on Facebook between May—and October 2010 and was visible to a random sample of eligible women. Women clicking on the advertisement were redirected to our website (http://www.yfhi.org) and invited to provide their contact details. They were contacted by a researcher and asked to complete a survey at the YFHI study site, or to complete the questionnaire online. The survey contained demographic questions, plus sensitive questions about sexual history, experience and knowledge ofChlamydia trachomatis, human papillomavirus (HPV) and HPV vaccines.Results551 women responded to the advertisement (recruitment could be scaled up or down by changing the advertising frequency). We enrolled 426 respondents, of whom 278 completed the survey within the time available (50% at the study site, 50% online). Respondents' age and geographical distribution (urban, regional, rural) was representative of the target population; women over 18 years were 37% more likely to enrol and complete the survey than 16–17-year olds (p<0.05). Despite the sensitive nature of some questions, over 98% of participants found the survey not at all, or only slightly, embarrassing. Overall, 63% had heard of HPV: of these, 73% knew that HPV is sexually acquired and 94% knew that it causes cancer. 78% had heard of chlamydia: those who were sexually active were more likely to know of chlamydia than virgins (p<0.01), while 63% knew it could cause chronic pelvic pain, and 86% that it could cause infertility. This recruitment method also was cost-effective ($USD 20 per compliant participant).ConclusionsResults demonstrate excellent potential for such information and communication technologies (ICT) to engage young women in health research, including those from regional and rural communities, and support the use of ICT in future population-based studies, including sexual health research.

Factors Associated With Female Provider Preference Among African American Women, and Implications for Breast Cancer Screening

Globally, breast cancer incidence is increasing. Early detection remains important for addressing disparities, including among U.S. minorities. Seeing a female physician increases screening, but the effects of unmet provider gender preference among underserved populations remain unexplored. Among 576 urban African American women age 45–93, we examined predictors of gender preference and how met and unmet preference influenced screening. We conclude that provider gender is a “double-edged sword.” We saw a female provider screening benefit, but also that gender preference was associated with past disadvantage and attitudes inconsistent with health maintenance. Provider gender preference merits further consideration in women's health research.

Women's health research: progress, pitfalls, and promise

Women's health research: progress, pitfalls, and promise

Proceedings of the First Annual Conference of the International Working Group for Global Women's Health Research.

Proceedings of the First Annual Conference of the International Working Group for Global Women's Health Research.

For Women's Health Research, Results Mixed

For Women's Health Research, Results Mixed

Electronic information systems for women's health care, teaching and research: a plea for an higher involvement of health professionals?

A qualidade, a seguranca e a eficiencia do cuidado em saude dependem muito da tomada de decisoes corretas baseadas em informacao adequada e acessivel atempadamente. Na verdade, desde o inicio do seculo 20 e em parte motivados pelo relatorio Flexner de 1910, os servicos de saude comecaram, de modo gradual, a incorporar na sua pratica clinica o registro de dados e informacoes dos seus pacientes, surgindo ja a partir de 1960 os primeiros sistemas eletronicos de informacao hospitalar. Desde entao, a informatica medica, em paralelo a evolucao do conhecimento cientifico em saude, tem progredido rapidamente, ajudando a melhorar a pratica medica. Neste âmbito, os sistemas eletronicos de informacao – ao permitirem, de um modo mais agil e seguro que os tradicionais registros em papel, o armazenamento, compartilhamento e gerenciamento de dados clinicos – tem vindo a assumir um papel cada vez mais relevante no cuidado de saude. De fato, nao so a qualidade da documentacao informatizada pode aprimorar o cuidado ao paciente como, ao facilitar a utilizacao de protocolos clinicos e a pesquisa clinica, propiciar tambem a geracao de novos conhecimentos. Neste editorial, os autores propoem apresentar alguns conceitos basicos de sistemas eletronicos de informacao em saude (SEIS) como instrumentos de apoio a prestacao de servicos clinicos, ao ensino e a pesquisa. Serao ainda discutidas diversas questoes atuais que decorrem do uso destes sistemas, e abordados os principais desafios que se colocam ao uso mais frequente dos SEIS na melhoria do cuidado de saude da mulher. O registro eletronico em saude (Electronic Health Record – EHR), conhecido no Brasil como prontuario eletronico do paciente (PEP), e um repositorio de informacoes, mantidas eletronicamente, sobre o estado de saude e de cuidados de saude de um individuo durante toda sua vida, armazenado de modo a servir a multiplos usuarios legitimos. Os conteudos do PEP podem ser estruturados em funcao do tempo, ou seja, por ordem cronologica, semelhante aos prontuarios de papel, em funcao do tipo de problemas, doencas ou assuntos (por exemplo, asma ou gravidez), em funcao da fonte ou natureza da informacao (por exemplo, analises laboratoriais, exames radiologicos ou dados do ambulatorio) ou pela combinacao destes tres elementos. Ao serem adicionadas a eles ferramentas de gerenciamento de dados, tais como elementos de captacao, processamento e analise de dados e utilizando software especificamente desenhado e testado, os PEP podem ser integrados e organizados em SEIS, os quais tem vindo a tornar-se um componente cada vez mais importante no cuidado em saude. Em contraste com

Using a Pedagogical Approach to Integrate Evidence‐Based Teaching in an Undergraduate Women's Health Course

Evidence-based practice (EBP) is promoted as a foundation for nursing practice. However, the 2005 U.S. survey of nurses revealed that they do not have requisite skills for EBP. PURPOSE AND GOALS: To evaluate a pedagogical approach aimed at (1) fostering undergraduate nursing students EBP competencies, and (2) identifying gaps in the literature to direct future women's health research. A secondary analysis of data abstracted from required EBP clinical journals for an undergraduate women's health course in which students (n = 198) were asked to find evidence to answer their clinical questions. Content analysis was used to identify main themes of the topics of inquiry. Students identified 1,808 clinical questions and 30.3% (n = 547) of these could not be answered or supported by evidence in the literature. This assignment was an important teaching and assessment tool for EBP. Questions reflected critical thinking and quest for in-depth knowledge to support nursing practice. Some students lacked skills in searching databases and a significant number of knowledge gaps were identified that can direct women's health research.

Cultivating the power of partnerships in feminist participatory action research in women’s health

Feminist participatory action research integrates feminist theories and participatory action research methods, often with the explicit intention of building community-academic partnerships to create new forms of knowledge to inform women's health. Despite the current pro-partnership agenda in health research and policy settings, a lack of attention has been paid to how to cultivate effective partnerships given limited resources, competing agendas, and inherent power differences. Based on our 10+ years individually and collectively conducting women's health and feminist participatory action research, we suggest that it is imperative to intentionally develop power-with strategies in order to avoid replicating the power imbalances that such projects seek to redress. By drawing on examples from three of our recent feminist participatory action projects we reflect on some of the tensions and complexities of attempting to cultivate power-with research partnerships. We then offer skills and resources needed by academic researchers to effectively harness the collective resources, agendas, and knowledge that each partner brings to the table. We suggest that investing in the process of cultivating power-with research partnerships ultimately improves our collective ability to understand and address women's health issues.

IOM Identifies Gaps in Women's Health Research

IOM Identifies Gaps in Women's Health Research

Abstracts from the NIH Office of Research on Women's HealthSeventh Annual Interdisciplinary Women's Health Research Symposium November 9, 2010

Abstracts from the NIH Office of Research on Women's HealthSeventh Annual Interdisciplinary Women's Health Research Symposium November 9, 2010

Public Partnerships for a Vision for Women's Health Research in 2020

Public Partnerships for a Vision for Women's Health Research in 2020

Assesment of changes in uterine and subendometrial blood flows: the use of prediction outcome in IVF cycles

OBJECTIVE: The aim of this study is to evaluate the relationship between uterine Doppler flow and endometrial and subendometrial blood flows and uterine receptivity during IVF cycles. DESIGN: This is a prospective observational study which is conducted at Zekai Tahir Burak Women's Health Research and Education Hospital, Reproductive Endocrinology Clinic. MATERIALS AND METHODS: Sixty-eight patients from our infertility programme were recruited for this prospective observational study, after giving informed consent. Eight of them were excluded because of total fertilization failure (5 patients) and no sperm extraction in TESE (3 patients). A color Doppler ultrasound examination performed on the day of hCG injection and midluteal phase. Pulsatility and resistance indices of uterine vessels, and vascularization and flow endometrial and subendometrial region were assumed. No Doppler study was done on the endometrium in midluteal phase. RESULTS: There were no significant differences in the age of patients, BMI of patients, duration of infertility,cycle lenght or total number of embryos transferred between women who became pregnant (n =16) and those who did not (n = 44). There were no difference in mean endometrial thickness between the two groups on hCG day and 5-6days after embryo transfer. Mean uterine arterial resistance index (RI) and Pulsatility Index (PI) values were not significantly different in both group on hCG day but both indices were significantly lower in the pregnant than in the non-pregnant group in mudluteal phase (p=0.05 and 0.016, respectively). Also no significant differences were found between the two groups in subendometrial blood flow. CONCLUSION: Patients undergoing IVF-ICSI and embryo transfer, Doppler ultrasound examination of the uterine artery and subendometrial blood flow on hCG day do not discriminate between cycles resulting in conceived and non-conceived but especially low mean PI of uterine artery in 5-6 days after ET can predict pregnancy.

Sex and Sensitivity: The Continued Need for Sex-Based Biomedical Research and Implementation

The phrase 'women's health research' embraces women as part of the biomedical research engine while categorizing women as separate. Before personalized medicine can become a reality, we must first ensure that basic physiological differences between the sexes are clearly delineated. In this article we argue that research into sex differences should be encouraged at the most fundamental levels of the biomedical sciences. Moreover, appropriate representation of both sexes as participants in clinical studies is still critically needed. Academic and governmental organizations must continue to articulate strong policy in order to ensure inclusion and analysis of sex as a critical variable. Focused attention on sex as a contributing factor to health, disease and therapeutic activity will increase our fund of knowledge regarding our everyday health, increase the pace of clinical research and ensure a healthier population.

Progress and Priorities in the Health of Women and Girls: A Decade of Advances and Challenges

Following the initial wave of federal support to address women's health, there is a need to assess successes and determine the next priorities to advance the health of women. The objective of this study was to systematically collect expert opinion on the major advances in women's health in the past decade and priorities for women's health research and service in the coming decade. We utilized a Delphi method to query the leadership from academic and community Centers of Excellence in Women's Health, as designated by the Department of Health and Human Services. Leaders from 36 of the 48 centers responded to a series of questions about the major advances and critical indicators to evaluate future needs in women's health. We utilized a social ecology model framework to organize the responses to each question. The experts identified increased health education for women and increased empowerment of women across multiple spheres as the major advances positively impacting the health of women. The experts selected the following areas as the most important indicators to measure the status of the health of women in the future: health education and promotion, rates and impact of interpersonal violence against women, and access to healthcare. The major advances and measures of the health of women did not focus on specific changes to individual women in illness management, clinical care, or individual behavioral change. As we move to address health reform, we must be able to recognize and incorporate a broad perspective on public health and policy initiatives critical to the health and wellness of women and girls and, therefore, central to the well-being of the nation.

Kudos Corner

Dr Henry-Tillman was recently appointed as a member of the Advisory Committee on Research on Women's Health at the National Institutes of Health (NIH). This committee assists the Office of Research on Women's Health (ORWH) and the NIH in addressing scientific, legal, and ethical issues affecting the health of the nation's women through biomedical and behavioral research and related career opportunities. The ORWH was established in 1990 by the NIH and statutorily mandated by Congress in 1993 as a mechanism for eliciting advice and recommendations on priority issues affecting women's health research. Advisory committee members are expected to provide guidance in such areas as refinement of the NIH's women's health research agenda, exploration of questions regarding gender difference in clinical drug trials, development of methodologies that enhance research on health needs of women, and monitoring the inclusion of women in clinical trials funded by the NIH. The director of the Office of Research on Women's Health is Dr Vivian W. Pinn, former president of the National Medical Association.

The Illinois Women'S Health Registry: Advancing Women'S Health Research and Education in Illinois, USA

To achieve the goal of personalized medicine, we must first improve our understanding of the differences in health and illness between men and women. The purpose of the Illinois Women's Health Registry (USA) is to provide a research and education tool that advances scientific knowledge of sex- and gender-based differences in health and disease. Specifically, the Registry is a confidential 30-min health and lifestyle survey for female residents of Illinois over the age of 18 years. The survey includes questions regarding health, environment, health-related behaviors, symptoms and illnesses or conditions that a participant may have now or has had in the past. By enrolling in the Registry, women throughout the state are provided with information and access to clinical research studies that they may be eligible for, based on their self-reported health information. The Registry not only serves as a platform for recruitment into pivotal research studies, but also represents the beginning of a state-wide database that enables researchers to examine the collective de-identified health information provided by women living in Illinois. Ultimately, a cross-sectional and longitudinal analysis of these data will help to clarify the issues that women themselves identify as their main health concerns. In response to these concerns, specific research studies can be designed and launched, allowing us to eventually deliver tailored treatment and prevention options to women. Finally, by creating a reliable state-focused research tool, developed by staff that are trained in women's health research, we can compare health issues across the state and apply strategies for improvement where it is needed most. This article will provide examples of sex differences in disease, the lack of federal enforcement for inclusion of women in studies, researcher-perceived burdens and sex-based reasons as to why recruitment of women is considered to be more challenging. In addition, this article will discuss what a women's health registry is and why we need one in Illinois, how we have recruited women and our successes and challenges. Our goal is to inform the reader about the utility of a state-based tool and to provide a discussion regarding the lessons learned in order to aid other states in implementing this kind of program.

Asian Women's Health Research Network (ASIA-WH)

Asian Women's Health Research Network (ASIA-WH)

Surrogate end points in women's health research: science, protoscience, and pseudoscience

A surrogate end point (e.g., a laboratory test or image) serves as a proxy for a clinical end point of importance (e.g., fracture, thrombosis, or death). Adoption and use of surrogate end points lacking validation, especially in cardiovascular medicine, have caused thousands of patients' deaths, a serious violation of the ethical principle of beneficence.

Building Translation Science With Interdisciplinary Research: Why a Special Issue on the Proceedings of a Research Conference?

In answer to the question posed for this editorial: a Special Issue on the Proceedings of a Research Conference: Building Translation Science with Interdisciplinary Research? The answer is simple. The presentations of the conference held April 15, 2009, were thoughtful and eloquent about two topics critical to nursing and to in today's world. They addressed complex issues and challenges facing health care providers and scientists. The ideas were captured in the articles collected for this special issue so that they might be shared with the nursing community as well as our interdisciplinary colleagues. It is exciting to read these articles and envision ways that nursing can provide leadership in improving the health of the nation. As we began our planning activities for the conference, we had multiple objectives. First, we aimed to highlight the interdisciplinary research and translational supported by the Michigan Center for Nursing Intervention (P30 NR0090000). Our other objectives were to establish an ongoing forum for scientific inquiry among the faculty and students at the School and to disseminate our research among our colleagues within the School and across the University in order to forge lines of inquiry. As the National Institutes of Health roadmap initiatives have unfolded, interdisciplinary and translational have been emphasized as necessary for developing knowledge to solve today's complex health problems. We believed that a focus on strengthening our interdisciplinary collaborations and methods for building translational would be of high interest to the faculty. Many faculty at the School are actively engaged in interdisciplinary research and as nurses, all are committed to developing knowledge for use in practice. We believed, too, that learning about interdisciplinary and translational would benefit our early career investigators and doctoral students as they prepared for future careers in science. Dr. Nancy Fugate Woods, Professor and Dean Emerita of the University of Washington School of Nursing, was identified as the keynote speaker because of her longstanding history of collaborative, interdisciplinary research. Dr. Woods served as an investigator for the Women's Health Initiative Study and as President of interdisciplinary organizations, including the North American Menopause Society and the Society for Menstrual Cycle Research. She has participated in setting research agendas as a member of the National Institutes of Health Women's Health Task Force and Office of Women's Health Research Advisory Council. We invited her to build on this experience and present a paper entitled Translational Research: Why Interdisciplinary Collaboration Is Essential. Dr. Woods has produced an article that acknowledges past contributions of nursing to translational and delineates challenges and opportunities. She describes how scientists of all disciplines are working to learn ways of doing science as well as transitioning to a new social contract for how one does science (Woods, this issue). In explaining transdisciplinarity, Dr. Woods gives the benefits of creating perspectives that can cross the traditional boundaries of disciplines in finding solutions. She lists the skill sets needed for working in this paradigm. Importantly, Dr. Woods gives us compelling reasons why nurses need to lead in interdisciplinary, translational research and examples of how we can lead. We invited two School of Nursing faculty and their interdisciplinary colleagues to present an overview of a research study and describe the necessity of having an interdisciplinary team. Dr. Bernadine Cimprich, Associate Professor of Nursing, and her colleague, Dr. Douglas Noll, Professor and Chairperson of Bioengineering and Co-Director, fMRI Laboratory, presented An Interdisciplinary Focus on Altered Brain Function in Chemotherapy for Breast Cancer. …

Women-specific mental disorders in DSM-V: are we failing again?

Despite a wealth of studies on differences regarding the biobehavioral and social-psychological bases of mental disorders in men and women and repeated calls for increased attention, women-specific issues have so far not been comprehensively addressed in past diagnostic classification systems of mental disorders. There is also increasing evidence that this situation will not change significantly in the upcoming revisions of ICD-11 and DSM-V. This paper explores reasons for this continued failure, highlighting three major barriers: the fragmentation of the field of women's mental health research, lack of emphasis on diagnostic classificatory issues beyond a few selected clinical conditions, and finally, the "current rules of game" used by the current DSM-V Task Forces in the revision process of DSM-V. The paper calls for concerted efforts of researchers, clinicians, and other stakeholders within a more coherent and comprehensive framework aiming at broader coverage of women-specific diagnostic classificatory issues in future diagnostic systems.