Young Minority Women Research Articles

Pilot Randomized Controlled Trial of an Intervention to Promote HPV Uptake Among Young Women Who Attend Subsidized Clinics

ObjectiveTo evaluate the preliminary efficacy, acceptability, and feasibility of Step Up to Prevention, a technology-enhanced intervention to promote human papillomavirus (HPV) vaccination uptake among young minority and low-income women. DesignA pilot randomized controlled trial. SettingTwo federally supported outpatient clinics in a large city in the northeastern United States. ParticipantsWomen who were 18 to 26 years of age (N = 60). MethodsWe randomized participants into four groups: computer information, in-person tailored, combined, and usual care. We administered computer-assisted self-interview surveys before the intervention (baseline), immediately after the intervention (postintervention), and after their clinic visit (post–clinic visit). We conducted a descriptive analysis of participant characteristics. For preliminary efficacy, we used logistic regression–assessed HPV vaccine initiation uptake rates, and we used descriptive statistics to compare theoretical mediators. We used conventional content analysis to assess participant feedback about intervention acceptability. We assessed feasibility through recruitment and retention rates and our ability to deliver the intervention. ResultsWe observed significant differences in initial HPV vaccine uptake between the intervention groups and the usual care group. Participant feedback indicated that the intervention was acceptable, empowering, and informative. We met our recruitment target, maintained a high retention rate (98%), and delivered the complete intervention to all participants. ConclusionWe report the preliminary efficacy, acceptability, and feasibility of this intervention to promote HPV vaccine initiation among young women in federally subsided health care settings by advancing favorable views and improving knowledge about HPV vaccination.

Formation of Fear and Adaptive Behavior in Young Ethnic Minority Women Riding Public Transport

Young ethnic minority women face unique challenges when riding public transport. The present study contributes by providing a narrative-based examination of young ethnic minority women’s formation of fear and adaptive behavior when using public transport. Twenty-nine ethnic minority women, under the age of 30, participated in a semi-structured interview in Auckland, New Zealand. Findings show that adaptive behavior commonly includes pre-planning nighttime trips, relying on their phones to act confident and engage in communication with family en-route, and appearing disinterested to reduce unwanted attention. These measures are expressions of women’s agency and their capacity to prevent victimization and manage fear, particularly in places where they feel unsafe, such as empty stations and dark or enclosed environments. Their lived experiences highlight the level of anxiety they experience on a regular basis. Participants discussed how they are acutely aware of their ethnicity (and appearance) when using public transport at all times of the day. They remain near exits and are constantly on high alert. They also discussed how, from an early age, women are educated in a culture of “stranger-danger” which in the long term erodes their confidence to travel independently and safely. These findings show that the current design of public transport systems does not adequately meet the travel needs of certain groups of women. Public transport authorities are encouraged to gain deeper insights into these issues and develop design strategies which promote inclusiveness.

Breast cancer diagnosis in Inner-City African American and Hispanic women: The importance of early screening

PurposeTo evaluate the diagnosis of breast cancer in inner-city African-American and Hispanic women under age 50 to support the importance of screening in this population. MethodsThis retrospective chart review included women newly diagnosed with breast cancer from 1/1/2015 to 1/1/2019 in a city hospital mainly serving minority patients. Chi-square and Fisher's exact tests were used for analysis. ResultsIn this cohort of 108 newly diagnosed African-American (63%) and Hispanic (31%) women, 60/108 (56%) presented with a site of palpable concern for diagnostic workup, and the remaining were diagnosed via asymptomatic screening. Women ages 30–49 were significantly more likely to present with a site of palpable concern when compared to women ages 50–69 (68% vs. 44%, p = 0.045). Additionally, women ages 30–49 were more likely to have triple-negative breast cancer (TNBC) than women ages 50–69 (20% vs. 10%, p = 0.222). However, women ages 30–49 were less likely to have prior mammogram than women ages 50–69 (24% vs. 46%, p = 0.062). ConclusionAfrican-American and Hispanic women ages 30–49 were more likely to present with a site of palpable concern and TNBC than those ages 50–69. However, these young minority women ages 30–49 were less likely to have prior screening mammograms when compared to those ages 50–69. Our data highlights the importance of starting screening mammography no later than age 40 in African-American and Hispanic women. In addition, these women should have risk assessment for breast cancer no later than age 30 and be screened appropriately.

Prevalence of Chronic Pelvic Pain by Sexual Orientation in a Large Cohort of Young Women in the United States

Sexual minority (lesbian, bisexual, mostly heterosexual) young women face many sexual and reproductive health disparities, but there is scant information on their experiences of chronic pelvic pain, including an absence of information on prevalence, treatment, and outcomes. The purpose of this study was to describe the characteristics of chronic pelvic pain experiences of young women by sexual orientation identity and gender of sexual partners. The analytical sample consisted of a nationwide sample of 6,150 U.S. young women (mean age=23 years) from the Growing Up Today Study who completed cross-sectional questionnaires from 1996 to 2007. Age-adjusted regression analyses were used to examine groups categorized by sexual orientation identity (completely heterosexual [ref.], mostly heterosexual, bisexual, lesbian) and gender of sexual partner (only men [ref.], no partners, both men, and women). We examined differences in lifetime and past-year chronic pelvic pain symptoms, diagnosis, treatment, and quality of life outcomes. Sensitivity analyses also examined the role of pelvic/gynecologic exam history and hormonal contraceptive use as potential effect modifiers. Around half of all women reported ever experiencing chronic pelvic pain, among whom nearly 90% had past-year chronic pelvic pain. Compared to completely heterosexual women, there was greater risk of lifetime chronic pelvic pain among mostly heterosexual (risk ratio [RR]=1.30, 95% confidence interval [CI]: 1.22-1.38), bisexual (RR=1.30, 95% CI: 1.10-1.52), and lesbian (RR=1.23, 95% CI: 1.00-1.52) young women. Additionally, compared to young women with only past male sexual partners, young women who had both men and women as past sexual partners were more likely to report chronic pelvic pain interfered with their social activities (b=0.63, 95% CI: 0.25-1.02), work/school (b=0.55, 95% CI: 0.17-0.93), and sex (b=0.53, 95% CI: 0.05-1.00). Healthcare providers, medical education, and field-wide standards of care should be attentive to the way sexual orientation-based healthcare disparities can manifest into differential prognosis and quality of life outcomes for women with chronic pelvic pain (particularly bisexual women). Our study is the first to examine a variety of chronic pelvic pain outcomes in a nationwide U.S. sample across different outcomes (ie, past-year and lifetime). Though limited by sample homogeneity in terms of age, race, ethnicity, and gender, findings from this article provide foundational insights about chronic pelvic pain experiences of sexual minority young women. Our key finding is that sexual minority women were commonly affected by chronic pelvic pain, and bisexual women face pain-related quality of life disparities. Tabaac AR, Chwa C, Sutter ME, etal. Prevalence of Chronic Pelvic Pain by Sexual Orientation in a Large Cohort of Young Women in the United States. J Sex Med 2022;19:1012-1023.

Gendered care, empathy and un/doing difference in the Danish welfare state: care managers approaching female caregivers of older immigrants

ABSTRACT This article explores how municipal care managers negotiate tensions in policy logics and state discourses in encounters with ethnic minority families in Denmark. It focuses on the “self-appointed helper arrangement”, an option in the Danish Social Service Act under which municipalities can employ family members to care for older citizen at home. Based on ethnographic fieldwork, I examine the consequences of this care arrangement from the perspective of care managers, focusing on gender dynamics and state-family divides in need assessments and care provision. I demonstrate how care managers slip in and out of their roles as administrators, health professionals and morally concerned citizens in encounters with different caregivers. While they focus mainly on equal access to care for all older citizens, sometimes they shift perspective and focus more on the wellbeing of the self-appointed helper in question. These shifts in moral registers are triggered by empathetic encounters with young ethnic minority women. However, care managers’ empathy is double-sided and ambivalent. Although striving to undo difference and include these women in a community of independent Danish female citizens, they also tend to place them and their families in a different category than the majority population and thus risk further marginalizing them.

Longitudinal associations between peer factors and suicidal thoughts and behaviors among sexual minority women

ObjectiveSexual minority young women endorse higher rates of suicidal thoughts and behaviors than heterosexual women, but the reasons for these disparities remain unclear. One hypothesis is that the two groups of women share peer-related risk factors, but the magnitude of effect is stronger for sexual minority women. MethodWe utilized 6 years of data drawn from a community sample of women (N = 2078; 26% sexual minority) to examine rates of suicidality in early adulthood, adolescent peer influences on later suicidal ideation and behavior, and whether sexual minority status moderated the impact of peer influences on suicidality. ResultsAcross the study period, rates of suicidality were higher among sexual minority women compared to heterosexual women. In prospective analyses, peer victimization increased risk for future suicidality whereas peer connectedness attenuated risk for the entire sample. Additionally, sexual minority status moderated the magnitude of these relationships for suicidal ideation and behavior. Specifically, the effect of peer connectedness on suicidal ideation was stronger for heterosexual women than sexual minority women, whereas the effect of peer connectedness on suicidal attempts was stronger for sexual minority than for heterosexual women. In addition, peer victimization increased risk for suicide attempts among sexual minority women. ConclusionsThis study highlights the importance of peer experiences in late adolescence for suicidality during the transition to young adulthood, and how such relations vary by sexual minority status.

The ethnicised hustle: Narratives of enterprise and postfeminism among young migrant women

Discourses of hustling are ever-present in a global, capitalist society in which, among other reforms, notions of time are compressed and intensified and neoliberalism is operationalised as a form of affective self-governance. Global brand campaigns like Nike’s ‘Rise and Grind’ want consumers to believe that hard work and persistence produces individual exceptionalism. Young people working in technology, cultural and creative industries in urban cities ‘never stop hustling – one never exits a kind of work rapture, in which the chief purpose of exercising or attending a concert is to get inspiration that leads back to the desk’ . This is the latest iteration of a corporatised vision of the hustle that seeks to glamourise exploitative working conditions, creating a culture where overwork and an obsession with being productive is the norm. This article considers how these discourses come into contact with localised migrant understandings of ‘the hustle’: an orientation to work rooted in the legacy of ethnic entrepreneurship. Drawing on a qualitative study with creative and cultural workers of ethnic minority backgrounds in Australia, the article explores their motivations to pursue creative vocational pathways in spite of structural challenges. While creative and cultural workers are heralded as model entrepreneurial subjects for their highly autonomous and flexible work patterns, here I draw on narratives about work and creative expression to suggest that the experiences of racialised young women lead to new possibilities for a race critical analysis of postfeminist, neoliberal discourses of entrepreneurship. By exploring how precarity and work insecurity is negotiated in the context of racialised young women’s lives, I ask what the implications are for minority young women who buy into the neoliberal values of individual exceptionalism and the myths of meritocracy while remaining embedded in their local communities.

Vitamin D Knowledge, Attitudes, and Behaviors in Young Danish Women with a Non-Western Ethnic Minority Background-A Questionnaire Survey.

The prevalence of vitamin D deficiency in women with a non-Western ethnic minority background in Nordic countries is high. The aim of this study was to assess vitamin D knowledge, attitudes, and behaviors in women with a non-Western ethic minority background living in Denmark. A validated vitamin D knowledge, attitudes, and behaviors’ questionnaire was translated into Danish, piloted, and distributed via relevant Facebook groups. The responses were analyzed using parametric and non-parametric tests for descriptive and bivariate analyses. In total, 254 women who considered themselves having a non-Western ethnic minority background responded to the questionnaire. The median age (IQR) was 25 (23–33) years old; 32% had a professional bachelor’s, 28% had high school, and 22% had a master’s or higher university education. Participants scored higher on vitamin D general knowledge (scores above 80 on the scale 0–100) compared to vitamin D nutrition knowledge or vitamin D attitudes and behaviors (scores around 60 on the scale 0–100). In conclusion, the vitamin D knowledge among study participants—i.e., young well-educated non-Western ethnic minority women in Denmark—was pretty good. The further examination of vitamin D knowledge, attitudes, and behaviors should explore specifics related to nationality and religion and focus on less-educated non-Western ethnic minority women in Denmark and other Nordic countries.

”Little girl, where do you think you go with this method?”: shame and use of emergency contraception

Abstract Background In England in 2018, 45% of pregnancies were unplanned at the time of conception. In 2017, there were 192,900 abortions carried out for women residing in England and Wales, with the highest rate of abortion being for women aged 20-24 (28.2 per 1000 resident women). Aim To understand social and cultural influences which affect ethnic minority young women's utilization and experience of emergency contraception in the United Kingdom. Methods Qualitative in-depth interviews following an interview topic guide were conducted with seven young women currently living in the UK, whose parents were born outside the UK. Interviews were recorded, transcribed and input into NVivo version 11.4.3. Transcriptions were coded to identify themes and these themes were then analyzed to identify commonalities and establish connections to understand perceptions and experiences of the participants. The themes coded were “Knowledge of emergency contraception”, “relationships” “concerns about obtaining and using EC”, “balancing risks” and “religion and culture”. Results Participants were often not open with their parents about sexual health related topics. Cultural taboos still persist towards sex before marriage which could translate into guilt and shame about using EC. When asked about concerns surrounding EC, participants mentioned concerns relating to obtaining EC, generally involving privacy embarrassment or shame. Stigma and concern about what others may think was a fairly frequent theme throughout the interviews, with participants being worried about what friends, family or service providers would think about them. Conclusions cultural awareness in healthcare reiterate the need for interventions which take into consideration sociocultural contexts. This is essential to ensure that young women have access to emergency contraception in order to prevent unwanted pregnancy. Key messages Despite availability of emergency contraception, young women still face the risk of going through an unwanted pregnancy becuase of embarrasment and shame. Cultural taboos towards sex before marriage still persists and this is translated into guilt and shame about using emergency contraception.

Diet Quality among Women with Previous Gestational Diabetes Mellitus in Rural Areas of Hunan Province.

Diet quality is critical for postpartum type 2 diabetes mellitus (T2DM) progression among women with a history of gestational diabetes mellitus (GDM). The Chinese Healthy Eating Index (CHEI) is a dietary index developed according to the latest Chinese Dietary Guidelines (CDG-2016). Our study aimed to assess the diet quality of women with previous GDM in rural areas of Hunan Province by applying the CHEI. Women with previous GDM in two counties of Hunan were enrolled. Their food intake data, which were used to calculate their CHEI scores, were collected by a 24-h dietary recall. The association of CHEI with sociodemographic and anthropometric variables was evaluated via linear regression models. 404 women were included in the final analysis. The mean score of the total CHEI was 54.9 (SD 7.9). The components of whole grains and mixed beans, seeds and nuts, tubers, dairy, and poultry scored extremely low. Ethnic minority groups and women younger than 30 years had lower CHEI scores. Our study observed an unsatisfactory diet quality among women with previous GDM in rural areas of Hunan Province. Future dietary education focusing on the CDG is needed to improve their diet quality and help in T2DM prevention among this population, especially young and ethnic minority women.

289. Adolescent Relationship Abuse, Gender Equitable Attitudes and Sexual Health Among Minority Young Women

289. Adolescent Relationship Abuse, Gender Equitable Attitudes and Sexual Health Among Minority Young Women

Sexual risk behavior and substance use among young, diverse women seeking care at a reproductive health clinic

BackgroundTo describe sexual risk behavior, alcohol (and other substance) use, and perceived health promotion needs among young adult women seeking care from an urban reproductive health care clinic in the Northeastern United States, and to examine if these needs differ by race and ethnicity.MethodsWomen 18–29 years old presenting for a routine medical visit were invited to participate. Of 486 eligible women, 466 (96%) agreed to participate and completed a brief survey on a tablet computer. Most of the sample (53%) identified as non-Hispanic White. One-quarter (25%) identified as Hispanic/Latina. A smaller proportion of women identified as African American (19%).ResultsOne-third (31%) of women reported a history of sexually transmitted infection (STI), and women reported infrequent condom use with recent sexual partners. Regarding behavioral health needs, nearly three-quarters of women (72%) reported regular alcohol use, approximately one-third had used marijuana (37%) or tobacco (33%) in the last month, and 19% reported clinically significant depressive symptoms in the last two weeks. Women reported moderate-to-strong interest in receiving information about relationships and sexual health; however, the majority were not interested in information about their substance use. Hispanic and African-American women were more likely to report STI history despite reporting fewer sexual partners than non-Hispanic White women. Minority women also reported significantly less alcohol and cigarette use, but more water pipe tobacco use, and reported significantly greater interest in interventions to promote sexual health. Hispanic women also evidenced significantly elevated rates of depressive symptoms, with 26% of Hispanic women reporting a clinically significant level of depressive symptoms.ConclusionsReproductive health centers are opportune settings to address a broad range of healthcare needs, including sexual health, substance use, and mental health. These centers engage a diverse group of women, which is important given observed disparities in health outcomes based on race/ethnicity. Young women, particularly racial and ethnic minority women, report the most interest in services addressing sexual and relationship health.

Young Muslim Women Living with Asthma in Denmark: A Link between Religion and Self-Efficacy

Asthma is a chronic respiratory disease that can be controlled with appropriate medicinal treatment. Adherence to pharmacological treatment is therefore critical. Self-efficacy plays a key role in adherence to medicine in chronic diseases, including asthma. Additionally, ethnic minorities have poor adherence to medicines. However, the impact of religion on self-efficacy and adherence is understudied. Therefore, the aim of this study was to explore the role of self-efficacy in adherence to asthma medicine treatment and the influence of religion on self-efficacy among young, Muslim minority women. A focus group and individual interviews with 10 Muslim minority women (14–24 years of age) living in Denmark were conducted. Data analysis was deductive using Bandura’s theory of self-efficacy and modes of agency. Overall, religion was shown to affect self-efficacy. The women reported changes in self-perceived self-efficacy during the holy month of Ramadan. In addition, praying was used as an alternative to medicine for controlling asthma symptoms. However, the women did not perceive religion and treating asthma with medicine as mutually exclusive, but rather as coexisting for the shared goal of controlling asthma symptoms. It is important for healthcare professionals (HCPs) to be aware of the link between self-efficacy, religion and adherence to asthma medicine treatment. This awareness can aid HCPs in giving advice regarding adherence to asthma treatment, and when monitoring treatment to improve the quality of asthma care for young Muslim minority women.

Sexual Health Risk Behavior Disparities Among Male and Female Adolescents Using Identity and Behavior Indicators of Sexual Orientation.

Sexual minority adolescent sexual risk behavior studies often overlook young women, do not consider behavior- and identity-based sexual orientation indicators in combination, and focus mainly on condomless sex. We examined multiple risk behaviors in a large sample of adolescent young men and women using combined behavior- and identity-based indices. The 2015 Dane County Youth Assessment data included 4734 students in 22 high schools who had ever voluntarily engaged in sexual contact (51.7% male; 76.0% White, non-Hispanic). Items assessed having sex with unfamiliar partners, sex while using substances, using protection, and STI testing. Logistic regressions tested for disparities based on combined identity- and behavior-based sexual orientation indicators. For both young men and women, youth who reported heterosexual or questioning identities-but who had sex with same-sex partners-were at consistently greater risk than heterosexual youth with only different-sex partners. Also, for both young men and women, bisexuals with partners of both sexes more consistently reported higher risk than heterosexual youth than did bisexuals with only different-sex partners. Risk behavior for gay young men who had sex only with men mirrored those in extant literature. Risk levels differed for specific groups of sexual minority young women, thus deserving further attention. Findings underscore the need for sexual health research to consider sexual orientation in a more multidimensional manner.

An Assessment of the HIV Prevention Needs of Young Minority Women

ABSTRACTThis study tested the reliability of nine scales assessing psychosocial mediators of HIV-risk and protective behaviors of young minority women in New York City. Sixty-nine age-eligible women were approached during clinical sessions, 90% (n = 62) agreed to participate, and 83% (n = 57) completed a web-based survey. With one exception, scale measures were reliable. The exception was the scale assessing frequency of sexual communication with partners. This scale did not demonstrate adequate interitem reliability for Black women. Findings provide program planners with a reliable set of measures that may be useful for preintervention needs assessments of young minority women at-risk of acquiring HIV.

A Randomized Comparison of Medication and Cognitive Behavioral Therapy for Treating Depression in Low-Income Young Minority Women

BackgroundLongitudinal data arise frequently in biomedical science and health studies where each subject is repeatedly measured over time. We compared the effectiveness of medication and cognitive behavioral therapy on depression in predominantly low-income young minority women.Material/MethodsThe treatment effects on patients with low-level depression may differ from the treatment effects on patients with high-level depression. We used a quantile regression model for longitudinal data analysis to determine which treatment is most beneficial for patients at different stress levels over time.ResultsThe results confirm that both treatments are effective in reducing the depression score over time, regardless of the depression level.ConclusionsCompared to cognitive behavioral therapy, treatment with medication more often effective, although the size of the effect differs. Thus, no matter how severe a patient’s depression symptoms are, antidepressant medication is effective in decreasing depression symptoms.

Sexual partners among sexual minority young women: female, male and none

Sexual partners among sexual minority young women: female, male and none

Pelvic inflammatory disease: improving awareness, prevention, and treatment.

PurposePelvic inflammatory disease (PID) is a common disorder of the reproductive tract that is frequently misdiagnosed and inadequately treated. PID and its complications, such as infertility, ectopic pregnancy, and chronic pelvic pain, are preventable by screening asymptomatic patients for sexually transmitted infections (STIs) and promptly treating individuals with STIs and PID.Recent findingsThe rates of adverse outcomes in women with PID are high and disproportionately affect young minority women. There are key opportunities for prevention including improving provider adherence with national screening guidelines for STIs and PID treatment recommendations and patient medication adherence. Nearly half of all eligible women are not screened for STIs according to national quality standards, which may increase the risk of both acute and subclinical PID. Moreover, in clinical practice, providers poorly adhere to the Centers for Disease Control and Prevention recommendations for treatment of PID. Additionally, patients with PID struggle to adhere to the current management strategies in the outpatient setting.ConclusionNovel evidence-based clinical and public health interventions to further reduce the rates of PID and to improve outcomes for affected women are warranted. We propose potential cost-effective approaches that could be employed in real-world settings.

Black Adolescent Females’ Perceptions of Racial Discrimination When Accessing Reproductive and General Health Care

Adolescents, like adults, frequently experience discrimination, which can be particularly salient in the context of reproductive health care. We examined urban Black adolescent females’ perceived experiences of racial discrimination during reproductive health care encounters. Structured face-to-face interviews were conducted with female African American patients, from age 13 through 20, who obtained reproductive health care services at a single site. Twenty-four participants were enrolled. All were in or graduated from high school, with a mean age of 16.8 years. These young Black women reported infrequent race-based discrimination in the health care setting; however, many reported commonly experiencing discrimination in other places. An awareness of the discrimination that minority young women experience in non–health care settings can help providers demonstrate cultural humility when addressing such concerns with their patients. With this information, providers can provide anticipatory guidance and the tools necessary to navigate complex social systems.

Anxiety and Related Disorders and Concealment in Sexual Minority Young Adults

Sexual minorities face greater exposure to discrimination and rejection than heterosexuals. Given these threats, sexual minorities may engage in sexual orientation concealment in order to avoid danger. This social stigma and minority stress places sexual minorities at risk for anxiety and related disorders. Given that three fourths of anxiety disorder onset occurs before the age of 24, the current study investigated the symptoms of generalized anxiety disorder, social phobia, panic disorder, posttraumatic stress disorder, and depression in sexual minority young adults relative to their heterosexual peers. Secondarily, the study investigated sexual orientation concealment as a predictor of anxiety and related disorders. A sample of 157 sexual minority and 157 heterosexual young adults matched on age and gender completed self-report measures of the aforementioned disorders, and indicated their level of sexual orientation concealment. Results revealed that sexual minority young adults reported greater symptoms relative to heterosexuals across all outcome measures. There were no interactions between sexual minority status and gender, however, women had higher symptoms across all disorders. Sexual minority young women appeared to be at the most risk for clinical levels of anxiety and related disorders. In addition, concealment of sexual orientation significantly predicted symptoms of social phobia. Implications are offered for the cognitive and behavioral treatment of anxiety and related disorders in this population.