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1.
J Health Econ ; 95: 102876, 2024 May.
Artigo em Inglês | MEDLINE | ID: mdl-38763530

RESUMO

Prior research has found that a high level of residential racial segregation, or the degree to which racial/ethnic groups are isolated from one another, is associated with worsened infant health outcomes, particularly among non-Hispanic (NH) Black infant populations. However, because exposure to segregation is non-random, it is unclear whether and to what extent segregation is causally linked to infant health. To overcome this empirical limitation, we leverage exogenous variation in the placement of railroad tracks in the 19th century to predict contemporary segregation, an approach first introduced by Ananat (2011). In alignment with prior literature, we find that residential segregation has statistically significant associations with negative birth outcomes among Black infant populations in the area. Using OLS methods underestimates the negative impacts of segregation on infant health. We fail to detect comparable effects on health outcomes among NH White infant populations. Further, we identify several key mechanisms by which residential segregation could influence health outcomes among Black infant populations, including lower access to prenatal care during the first trimester, higher levels of anti-Black prejudice, greater transportation barriers, and increased food insecurity. Given that poor birth outcomes have adverse effects on adults' health and well-being, the findings suggest that in-utero exposure to residential segregation could have important implications for Black-White inequality over the life course.


Assuntos
Saúde do Lactente , Segregação Social , Humanos , Feminino , Lactente , Negro ou Afro-Americano/estatística & dados numéricos , Recém-Nascido , Gravidez , Estados Unidos , Masculino , Características de Residência , Adulto , Disparidades nos Níveis de Saúde
2.
J Immigr Minor Health ; 26(2): 341-350, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-37733168

RESUMO

This study examines the factors influencing physical health status, specifically focusing on the gender differences in risk and promotive factors affecting health outcomes among Somali refugee youth displaced in Nairobi, Kenya (n = 227). A survey was used to assess participants' physical health along with psychosocial factors, somatic symptoms, and demographic characteristics. The study shows that religious belief and somatic symptoms among the total sample were significant predictors in influencing the outcome of physical health. A moderated mediation analysis and logistic regression analyses also revealed gender differences in associated factors as well as health status; female participants reported higher somatic symptoms, associated with a decline in physical health, whereas the protective effect of social support and religious belief promote was found only among male counterparts. Future studies and interventions would be benefited from a gender-specific approach to health promotion and coping mechanisms in this population.


Assuntos
Sintomas Inexplicáveis , Refugiados , Humanos , Masculino , Feminino , Adolescente , Somália , Quênia , Apoio Social , Religião , Avaliação de Resultados em Cuidados de Saúde
3.
Sex Reprod Healthc ; 38: 100916, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37722252

RESUMO

OBJECTIVE: To document physicians' beliefs about abortion safety and the associations between these beliefs and physician support for, referral for, and participation in abortion care. METHODS: In a 2019 survey at the University of Wisconsin School of Medicine and Public Health, we assessed physicians' abortion attitudes, beliefs, and practices (N = 893). We conducted bivariate analyses followed by logistic regression to document relationships between physician beliefs about abortion safety and their support for, referral to, and participation in abortion care. RESULTS: Four-in-five physicians (78%, n = 690) believed that abortion is very or extremely safe. Medical specialty (Obstetrics-Gynecology vs. other; adjusted odds ratio [aOR] = 10.58, 95% CI: 1.41-79.56), educational exposure to abortion (aOR = 1.43, 95% CI: 1.02-2.01), and religiosity (aOR = 0.59, 95% CI: 0.41-0.85) were associated with physicians' beliefs about the safety of abortion. Providers who believed that abortion was very/extremely safe were more likely to support medication (aOR = 2.99, 95% CI: 1.93-4.65) and procedural abortion (aOR = 3.56, 95% CI: 2.31-5.50) and refer patients for abortion care (aOR = 3.14, 95% CI: 1.90-5.01). CONCLUSION: Although abortions are associated with extremely few adverse events, a sizable portion of surveyed physicians had incorrect perceptions of the safety of abortion. These beliefs were associated with decreased support and referrals for abortion care. Educational exposure to abortion is associated with more accurate assessments of abortion safety, underscoring the importance of training in this area. Considering the current abortion policy landscape, it is imperative for physicians to hold accurate knowledge about abortion so they can provide comprehensive counseling and, when indicated, referrals for safe and legal care.


Assuntos
Aborto Induzido , Médicos , Gravidez , Feminino , Humanos , Atitude do Pessoal de Saúde , Inquéritos e Questionários , Encaminhamento e Consulta
5.
Lancet Reg Health Am ; 21: 100489, 2023 May.
Artigo em Inglês | MEDLINE | ID: mdl-37179794

RESUMO

Background: Prior research provides evidence of implicit and explicit anti-Black prejudice among US physicians. However, we know little about whether racialized prejudice varies among physicians and non-physician healthcare workers relative to the general population. Methods: Using ordinary least squares models and data from Harvard's Project Implicit (2007-2019), we assessed the associations between self-reported occupational status (physician, non-physician healthcare worker) and implicit (N = 1,500,268) and explicit prejudice (N = 1,429,677) toward Black, Arab-Muslim, Asian, and Native American populations, net of demographic characteristics. We used STATA 17 for all statistical analyses. Findings: Physicians and non-physician healthcare workers exhibited more implicit and explicit anti-Black and anti-Arab-Muslim prejudice than the general population. After controlling for demographics, these differences became non-significant for physicians but remained for non-physician healthcare workers (ß = 0.027 and 0.030, p < 0.01). Demographic controls largely explained anti-Asian prejudice among both groups, and physicians and non-physician healthcare workers exhibited comparatively lower (ß = -0.124, p < 0.01) and similar levels of anti-Native implicit prejudice, respectively. Finally, white non-physician healthcare workers exhibited the highest levels of anti-Black prejudice. Interpretation: Demographic characteristics explained racialized prejudice among physicians, but not fully among non-physician healthcare workers. More research is needed to understand the causes and consequences of elevated levels of prejudice among non-physician healthcare workers. By acknowledging implicit and explicit prejudice as important reflections of systemic racism, this study highlights the need to understand the role of healthcare providers and systems in generating health disparities. Funding: UW-Madison Centennial Scholars Program, Society of Family Planning Research Fund, UW Center for Demography and Ecology, the County Health Rankings and Roadmaps Program and the National Institutes of Health (NIH).

6.
Health Serv Res ; 58(4): 772-780, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-37020244

RESUMO

OBJECTIVE: To investigate the frequency and impact of contraceptive coercion in the Appalachian region of the United States. DATA SOURCES AND STUDY SETTING: In fall 2019, we collected primary survey data with participants in the Appalachian region. STUDY DESIGN: We conducted an online survey including patient-centered measures of contraceptive care and behavior. DATA COLLECTION/EXTRACTION METHODS: We used social media advertisements to recruit Appalachians of reproductive age who were assigned female at birth (N = 622). After exploring the frequency of upward coercion (pressure to use contraception) and downward coercion (pressure not to use contraception), we ran chi-square and logistic regression analyses to explore the relationships between contraceptive coercion and preferred contraceptive use. PRINCIPAL FINDINGS: Approximately one in four (23%, n = 143) participants reported that they were not using their preferred contraceptive method. More than one-third of participants (37.0%, n = 230) reported ever experiencing coercion in their contraceptive care, with 15.8% reporting downward coercion and 29.6% reporting upward coercion. Chi-square tests indicated that downward (χ2 (1) = 23.337, p < 0.001) and upward coercion (χ2 (1) = 24.481, p < 0.001) were both associated with a decreased likelihood of using the preferred contraceptive method. These relationships remained significant when controlling for sociodemographic factors in a logistic regression model (downward coercion: Marginal effect = -0.169, p = 0.001; upward coercion: Marginal effect = -0.121, p = 0.002). CONCLUSIONS: This study utilized novel person-centered measures to investigate contraceptive coercion in the Appalachian region. Findings highlight the negative impact of contraceptive coercion on patients' reproductive autonomy. Promoting contraceptive access, in Appalachia and beyond, requires comprehensive and unbiased contraceptive care.


Assuntos
Coerção , Anticoncepcionais , Recém-Nascido , Humanos , Feminino , Estados Unidos , Anticoncepção , Acessibilidade aos Serviços de Saúde , Região dos Apalaches
7.
Cult Health Sex ; 25(12): 1690-1706, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-36780368

RESUMO

Good quality patient care requires health care providers to respect the humanity and autonomy of their patients. However, this is not achieved in all settings. This study used cross-sectional survey data including open-ended text responses to explore negative experiences with health care providers among women in Appalachia. We used the Heath Stigma & Discrimination Framework (HSDF) to identify how stigma is created and perpetuated through interactions with health care providers. Survey data from 628 women collected through purposive sampling identified that two out of three participants had had a bad encounter with a provider that made them not want to return for care. One in six participants had a negative experience specifically while seeking contraception. Using the domains of the HSDF framework, qualitative answers to open-ended questions illuminated how health care providers, influenced by social and cultural norms related to religiosity, patriarchal views, poverty, poor health infrastructure, and the opioid crisis, created and perpetuated stigma through dehumanising treatment, low-quality care, and health care misogyny. Because stigma is a driver of health inequity, these findings highlight the important and sometimes problematic role that health care providers can play when they create a barrier to future care through poor treatment of patients.


Assuntos
Instalações de Saúde , Estigma Social , Humanos , Feminino , Estudos Transversais , Região dos Apalaches , Acessibilidade aos Serviços de Saúde
8.
J Interpers Violence ; 38(9-10): 6389-6406, 2023 05.
Artigo em Inglês | MEDLINE | ID: mdl-36310500

RESUMO

Reproductive coercion (RC) is a type of intimate partner violence (IPV) characterized by partner interference with contraception or reproductive decision-making. Despite sexual minority people's vulnerability to other forms of IPV, limited research has examined reproductive coercion in this population. Research on behavioral health impacts of reproductive coercion is also lacking, especially for sexual minorities. This study addressed these gaps by examining the occurrence and behavioral health impact of reproductive coercion among emerging adults, including both heterosexual and sexual minority people. In 2020, survey data were collected with emerging adults (aged 18-24 years) at a university in the southeastern United States (N = 387). We conducted bivariate analyses to explore associates of reproductive coercion and logistic regression to identify risk factors. We then conducted linear regression to investigate relationships between reproductive coercion and behavioral health outcomes, in the full sample and in separate models based on sexual attraction. One in 15 sampled students (6.3%) had experienced reproductive coercion. Sexual attraction was a significant risk factor for reproductive coercion, with increased rates among plurisexual (i.e., attracted to people of multiple genders) compared to monosexual students, in both bivariate (χ2(2) = 7.57, p = .023) and regression analyses (B = 1.25, p = .012). Reproductive coercion was associated with worse behavioral health outcomes in bivariate and regression analyses (anxiety: B = 3.77, p = .001; depression: B = 3.26, p = .010; alcohol use: B = 2.32, p < .001). In separate linear regression models based on sexual attraction, RC was significantly associated with behavioral health indicators for participants who were attracted only to men and those attracted to people of multiple genders but not for participants who were attracted only to women. Findings indicated increased RC risk for plurisexual students compared to monosexuals and showed significant associations between RC and behavioral health outcomes, with differential effects based on sexual attraction. These novel findings support the need for continued research on RC, inclusive of nuanced conceptualizations of sexuality.


Assuntos
Violência por Parceiro Íntimo , Minorias Sexuais e de Gênero , Adulto , Humanos , Feminino , Masculino , Heterossexualidade , Parceiros Sexuais , Coerção , Prevalência , Saúde Reprodutiva
10.
Health Soc Care Community ; 30(6): e6487-e6499, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-36317755

RESUMO

In the United States, about half of pregnancies are unintended, and most women of reproductive age are at risk of unintended pregnancy. Research has explored predictors of contraceptive use and unintended pregnancy, but there is a lack of research regarding access to preferred contraceptive method(s) and the complex pathways from sociodemographic factors to these family planning outcomes. This study applied Levesque et al.'s (2013) healthcare access framework to investigate pathways from sociodemographic factors and indicators of access to family planning outcomes using secondary data. Data were collected at four time points via an online survey between November 2012 and June 2014. Participants were US women of reproductive age who were seeking to avoid pregnancy (N = 1036; Mage  = 27.91, SD = 5.39; 6.9% Black, 13.6% Hispanic, 70.2% white, 9.4% other race/ethnicity). We conducted mediational path analysis, and results indicated that contraceptive knowledge (ß = 0.116, p = 0.004), insurance coverage (ß = 0.423, p < 0.001), and relational provider engagement (ß = 0.265, p = 0.011) were significant predictors of access to preferred contraceptive method. Access to preferred contraceptive method directly predicted use of more effective contraception (ß = 0.260, p < 0.001) and indirectly predicted decreased likelihood of experiencing unintended pregnancy via contraceptive method(s) effectiveness (ß = -0.014, 95% confidence interval: -0.041, -0.005). This study identifies pathways to and through access to preferred contraceptive methods that may be important in determining family planning outcomes such as contraceptive use and unintended pregnancy. This information can be used to improve access to contraception, ultimately increasing reproductive autonomy by helping family planning outcomes align with patients' needs and priorities.


Assuntos
Anticoncepção , Serviços de Planejamento Familiar , Gravidez , Humanos , Estados Unidos , Feminino , Adulto , Serviços de Planejamento Familiar/métodos , Anticoncepção/métodos , Gravidez não Planejada , Anticoncepcionais , Etnicidade
11.
Contraception ; 115: 22-26, 2022 11.
Artigo em Inglês | MEDLINE | ID: mdl-35940300

RESUMO

OBJECTIVE: This study assessed a broad array of socioeconomic barriers in relation to preferred contraceptive use during a time of exacerbated personal and social financial strain (the COVID-19 pandemic). STUDY DESIGN: Using statewide data collected in early 2021 through the Survey of the Health of Wisconsin, we conducted bivariate analyses exploring the relationship between socioeconomic resources and preferred contraceptive use among Wisconsin women. RESULTS: The survey garnered 1889 responses, with a response rate of 34%. The sample for the current study (N = 247) included only adult women of reproductive age who reported current contraceptive use. Nearly one-third (32.8%) of contraceptive users reported that they were not using their preferred method. We found that greater resource deprivation, including housing instability (had to relocate: p = 0.004; unable to pay rent and/or mortgage: p = 0.008), food insecurity (ran out of food: p = 0.003; worried about running out of food: p = 0.008), and greater financial stress (p < 0.001), were significantly associated with lowered likelihood of using one's preferred contraceptive method. CONCLUSIONS: Findings indicated that people lacking socioeconomic resources, including adequate food and housing, may be unable to access their preferred contraceptive method(s). Amidst competing demands on time and resources, the inability to obtain preferred contraceptive method(s) may represent system-wide barriers as well as people's lowered ability to prioritize and access care in light of socioeconomic struggles. IMPLICATIONS: Health care providers and health systems should work to address structural barriers to care and bolster community resources in ways that promote patients' reproductive autonomy. There is also a need for continued research on specific socioeconomic determinants of preferred contraceptive use and potential solutions that bolster community resources.


Assuntos
COVID-19 , Anticoncepcionais , Adulto , Anticoncepção/métodos , Feminino , Estresse Financeiro , Humanos , Pandemias , Wisconsin
12.
Glob Public Health ; 17(12): 3426-3439, 2022 12.
Artigo em Inglês | MEDLINE | ID: mdl-35923097

RESUMO

Urban refugees often face tremendous adversities during displacement that exacerbate mental health and psychosocial outcomes. Given the lack of research on how extended displacement affects mental health in urban refugee youth, this study examines the differential effects of country of birth on trauma exposure and psychosocial factors that influence mental health experiences among Somali refugee youth in urban Kenya (n = 303). Findings reveals that childhood trauma and impeded social functioning predicted mental health outcomes. Being born in Kenya was a significant predictor of poor mental health despite there being no significant difference in trauma exposures and psychosocial factors between Somali-born and Kenya-born youth. This difference can be attributed to prolonged displacement, disrupted development of cultural identity, and discrimination experienced in the host country. Given the widely devastating effects of childhood trauma and community violence, mental health interventions need to be two-prolonged: addressing and preventing intergenerational trauma sequelae through family-based interventions; and community-level programs and advocacy for safety and protection for the displaced. Our findings also emphasize that future interventions for urban refugee communities should be inclusive to all community members, considering shared vulnerability to community violence as well as intergenerational transmission of traumas through childhood adversities and lacking support.


Assuntos
Saúde Mental , Refugiados , Feminino , Gravidez , Humanos , Adolescente , Refugiados/psicologia , Somália , Parto , Violência
13.
Community Ment Health J ; 58(6): 1179-1190, 2022 08.
Artigo em Inglês | MEDLINE | ID: mdl-35013831

RESUMO

Somali refugee youth present with a heightened risk for common mental disorders (CMDs), and yet few studies have discussed factors influencing mental health outcomes after psychosocial interventions. This study aimed to identify key factors that contribute to the improvement of CMD symptoms among Somali youth displaced in urban Kenya. Logistic regression analyses revealed that trauma exposure and emotional coping predict overall symptom improvement, pointing to a differential intervention effect on those with differing levels of religious belief and attitudes toward violence. This study provides insights into how psychosocial factors likely contribute to positive intervention outcomes in Somali refugee youth.


Assuntos
Transtornos Mentais , Refugiados , Adaptação Psicológica , Adolescente , Humanos , Quênia , Refugiados/psicologia , Somália
14.
Community Ment Health J ; 58(5): 917-929, 2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-34618270

RESUMO

This paper introduces culturally responsive and trauma-informed mental health training modules to build and enhance competences and partnerships among mental health professionals and refugee community leaders, while facilitating intercultural, mutual learning between participants from various cultural and professional backgrounds. Focus group interviews and participant self-reflections with the training participants (N = 54) were analyzed using thematic analysis. Findings revealed an enhanced understanding of culturally unique as well as universal trauma responses and coping in the refugee community, which led to the building and strengthening of a sense of community and an expansion of social networks and support systems. This study highlights the effectiveness of interactive learning and knowledge transference among participants with various cultural and professional backgrounds, showing that face-to-face interactions and mutual learning reportedly facilitated building relationships and trust among participants and especially those between refugee/immigrant community leaders and service providers.


Assuntos
Emigrantes e Imigrantes , Refugiados , Comparação Transcultural , Grupos Focais , Humanos , Aprendizagem , Refugiados/psicologia
15.
Reprod Health ; 18(1): 235, 2021 Nov 22.
Artigo em Inglês | MEDLINE | ID: mdl-34809673

RESUMO

BACKGROUND: Contraceptive access is influenced by policy decisions, which can expand and constrict the contraceptive options available. This study explored the impact of recent US federal policy on contraceptive access. METHODS: Federal policy changes impacting contraceptive access over the past decade were identified in grey literature. These policy changes were organized into a timeline and analyzed according to Levesque et al.'s (2013) five dimensions of healthcare access (approachability, acceptability, availability/accommodation, affordability, and appropriateness), noting the most salient healthcare dimension impacted by the policy change and analyzing whether, according to this framework, the policy created a theoretical increase or decrease in contraceptive access. RESULTS: Of those policy changes coded as increasing (n = 42) and decreasing (n = 28) contraceptive access, most were related to the affordability (increasing n = 13; decreasing n = 12), physical availability (increasing n = 10; decreasing n = 7), and appropriateness (increasing n = 12; decreasing n = 4) of contraceptive care. Policy changes largely followed partisan divides, with contraceptive access increasing in years with a Democratic president and decreasing when a Republican president was in office. Many policy changes were related to the Affordable Care Act (ACA) and Title X of the Public Health Services Act. The implementation of the ACA and subsequent updates to it have increased the affordability of contraception, whereas changes to Title X have decreased the availability and appropriateness of contraceptive care. CONCLUSIONS: This study highlights recent policy changes impacting contraceptive access, organizing them according to the five dimensions of healthcare access. It outlines specific policy barriers to contraceptive access and provides suggestions for policy and practice action that will improve contraceptive access and reproductive autonomy. Opportunities to ensure contraceptive access for all Americans include promoting comprehensive sex education, extending the Community Health Center Fund, increasing contraceptive care options for people with employers who are exempted from the ACA contraceptive mandate, addressing discrimination and building trust in contraceptive care, and amplifying outreach efforts to combat misinformation and confusion created by continuous changes to key family planning policies. Continued research on the role of policy in determining reproductive autonomy is warranted, and practice and policy action is needed to improve contraceptive access.


Legislation influences if, when, and how people access contraception. Healthcare access can be conceptualized across five dimensions: approachability, acceptability, availability/accommodation, affordability, and appropriateness. Applying this healthcare access framework can help understand barriers to and facilitators of contraceptive access. In this study, I conducted a systematic Google search to identify recent federal policy changes related to contraceptive access. I organized these policy changes into a timeline and analyzed them according to the healthcare access framework mentioned above. Through this analysis, I have highlighted specific policy barriers to contraceptive access and provided suggestions for policy and practice action that can improve contraceptive access and reproductive autonomy.Findings indicated that Levesque et al.'s (2013) dimensions of healthcare access are relevant to contraceptive care. Many recent US policy changes related to contraceptive access are described in this study, and the analysis showed that these policy changes have fluctuated with election cycles and according to partisan divides. Two key US policies related to contraceptive access, the Affordable Care Act and Title X of the Public Health Services Act, have sustained many changes across the past decade. These policies have increased contraceptive access in the United States by dedicating funding to family planning availability and affordability and increasing insurance coverage for contraceptive care. However, recent changes to these policies threaten contraceptive access and reproductive autonomy. There is a need for continued research regarding the ways that policy influences reproductive autonomy and a need for practice and policy action to improve contraceptive access.


Assuntos
Política de Planejamento Familiar , Patient Protection and Affordable Care Act , Anticoncepção , Acessibilidade aos Serviços de Saúde , Humanos , Formulação de Políticas , Estados Unidos
16.
Behav Sci (Basel) ; 11(11)2021 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-34821616

RESUMO

Trauma-informed care (TIC) approaches have gained popularity in various contexts of human services over the past decades. However, relatively little has been explored about how it is applicable and built into services for refugee populations in resettlement programs. This study explores the current status of the application of TIC in refugee-serving agencies and identifies perceived and experienced challenges and opportunities for culturally responsive TIC in the United States. As designed as part of the evaluation of state-wide refugee health promotion programs, this study conducted individual interviews with 78 refugee service providers from five resettlement sites. Despite the burgeoning interest and attempt to embrace TIC, our findings show that there is clear inconsistency and inexperience in TIC adaptation in resettlement programs. This study highlights that TIC that is culturally responsive and relevant to refugee trauma and acculturation experiences is a vital way to address the chasms between refugee-specific programs and mainstream services including mental health care systems. This study also discusses community resources and opportunities to bridge the deep divide and substantial gaps between mental health services and refugee resettlement services and to address comprehensive needs around mental health and wellness in the refugee community.

17.
J Child Adolesc Trauma ; 14(3): 321-333, 2021 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-34471451

RESUMO

The purpose of this study was to explore exposure to trauma as well as demographic and psychosocial factors as predictors of mental health symptoms among Somali refugees in Kenya. Participants were recruited via snowball sampling to complete a survey and included 86 Somali refugee youth, aged 15 to 34 years, who were living in Eastleigh. We measured trauma using a total traumas experienced variable as well as four trauma types categories (pre-migration/migration trauma, post-migration trauma, family trauma, and individual trauma). We measured anxiety and depression symptoms using the Hopkins Symptom Checklist-25 (HSCL-25) and PTSD using the PTSD Check List - Civilian Version (PCL-C). We ran descriptive statistics followed by multiple linear regression models with trauma exposure, education, gender, and willingness to share problems as predictors of mental health symptoms. Out of 12 possible traumatic events, most participants (83.7%) reported experiencing at least one trauma, and participants reported experiencing an average of 3.76 total traumas. The regression models predicted between 11.5% and 35.5% of the variance of the mental health symptoms. Willingness to share problems was a significant predictor of decreased mental health symptoms in most models. These findings highlight the role of trauma exposure and psychosocial factors in predicting Somali refugee mental health and indicate that implementing programs to encourage problem sharing may help address Somali refugee mental health needs. Further research is needed to explore the differential impact of trauma exposure and various psychosocial factors on Somali refugee mental health.

18.
Contraception ; 104(3): 265-270, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-33930381

RESUMO

OBJECTIVE: The purpose of this study was to investigate the psychometric properties of the short-form Reproductive Coercion Scale among a sample of Appalachian women. STUDY DESIGN: We recruited a purposive sample of Appalachian women, using targeted Facebook ads to collect data via an online survey in fall 2019. We randomly split our sample into two independent samples and used exploratory factor analysis on sample 1 (N = 314) and confirmatory factor analysis on sample 2 (N = 314) in order to cross-validate our findings. RESULTS: Findings indicated that the short-form Reproductive Coercion Scale is a valid and reliable instrument to assess reproductive coercion among this sample of Appalachian women. Our findings indicated that, in this Appalachian sample, the reduced, five-item Reproductive Coercion Scale measured a unidimensional construct and was not comprised of the multiple dimensions of pregnancy coercion and condom manipulation. As expected, intimate partner violence and pregnancy fatalism were significantly and positively associated with reproductive coercion while religious affiliation and insurance status were not significantly associated with reproductive coercion. These findings help build construct validity for the short-form Reproductive Coercion Scale with this sample. CONCLUSION: While pregnancy coercion and condom manipulation are often considered independent reproductive coercion factors, the current study indicates that, in this Appalachian sample, the short-form Reproductive Coercion Scale measures a single latent reproductive coercion factor. IMPLICATIONS: While pregnancy coercion and condom manipulation are often considered independent reproductive coercion factors, the current study indicates that, in this Appalachian sample, the short-form Reproductive Coercion Scale measures a single latent reproductive coercion factor. Additional research may be needed to confirm the factor structure of the short-form Reproductive Coercion Scale across populations and geographic conditions.


Assuntos
Coerção , Violência por Parceiro Íntimo , Preservativos , Feminino , Humanos , Gravidez , Gravidez não Planejada , Psicometria , Parceiros Sexuais
19.
J Interpers Violence ; 36(15-16): NP8520-NP8537, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-31014171

RESUMO

Lesbian, gay, bisexual, and transgender (LGBT) individuals experience intimate partner violence (IPV) at high rates, even bidirectionally, yet no studies to date have investigated IPV among LGBT individuals in Latin America. Thus, this study explored discrimination and IPV victimization and perpetration among LGBT individuals in Latin America. Participants (N = 99) were recruited for this online, cross-sectional survey via convenience sampling and completed measures of LGBT discrimination and lifetime IPV victimization and perpetration. Results indicated that 60.61% of the sample reported at least one form of IPV victimization at some point in their life, and 56.57% reported at least one form of perpetration. Psychological aggression was the most common type of IPV victimization and perpetration. Physical assault victimization was positively correlated with work/school heterosexism. Perpetration and victimization of physical assault, psychological aggression, and sexual coercion were correlated with the "other" heterosexism subscale. Cluster analysis revealed a three-cluster solution: participants in Cluster 1 were high in IPV victimization and perpetration; Cluster 2 participants were low in IPV victimization and perpetration; and Cluster 3 participants were moderate on psychological aggression perpetration and victimization, but low on the other three forms of IPV. Cluster 1 participants had a higher score for the "other" heterosexism subscale than Cluster 2. This study highlights the need to address certain aspects of IPV, such as bidirectionality, in clinical encounters such as safety planning. Future research should examine the role of Latinx identity in LGBT individuals' experiences of discrimination and IPV.


Assuntos
Vítimas de Crime , Homossexualidade Feminina , Violência por Parceiro Íntimo , Minorias Sexuais e de Gênero , Pessoas Transgênero , Estudos Transversais , Feminino , Humanos , América Latina
20.
J Interpers Violence ; 36(23-24): 11281-11303, 2021 12.
Artigo em Inglês | MEDLINE | ID: mdl-31920154

RESUMO

Reproductive coercion is behavior, typically perpetrated by a partner, that interferes with autonomous reproductive decision making, often through pregnancy coercion and/or contraceptive interference. Existing literature suggests that reproductive coercion is associated with intimate partner violence in the general population and among college women. However, there is limited research regarding the prevalence and correlates of reproductive coercion in college populations, especially regarding interpersonal violence victimization other than intimate partner violence. To fill this gap in knowledge, this study investigated the relationship between reproductive coercion and multiple forms of interpersonal violence victimization (sexual harassment, sexual abuse, physical partner abuse, psychological partner abuse, stalking, bullying, and polyvictimization). We conducted a secondary analysis of anonymous survey data, which were collected in fall 2015 with college students at a large public university in the southeast United States. The analysis sample was limited to cisgender college students endorsing at least one sexual partner in the past year (N = 431). Most (67.05%) participants indicated that they had experienced at least one form of interpersonal violence victimization, and 39.91% indicated that they had experienced polyvictimization. About 11% of the sample indicated that they had experienced reproductive coercion. Logistic regression analyses showed that reproductive coercion was associated with an increased likelihood of experiencing polyvictimization and all interpersonal violence victimization experiences except for physical partner abuse while controlling for demographic factors. Health providers, especially those working with college populations, could consider screening for reproductive coercion, to meet students' reproductive health needs and uncover associated interpersonal violence victimization experiences.


Assuntos
Bullying , Vítimas de Crime , Violência por Parceiro Íntimo , Coerção , Feminino , Humanos , Gravidez , Parceiros Sexuais , Estudantes , Estados Unidos
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