Assessing the effectiveness of menstrual health education in Japan: A non-randomized comparative study of adolescent girls with typical development and those with intellectual disabilities and high support needs.

This study elucidates the effectiveness of a menstrual education program with segmented MHM procedure on the MHM skills of girls with intellectual disabilities/HSN compared with those with typical development. Participants in a nonrandomized comparative study included nine adolescent girls with intellectual disabilities/HSN and ten with typical development. They practiced MHM on dolls three times: before, immediately after, and three months after participating in the educational program. Although the total MHM scores were significantly higher after both groups attended the program, the girls with intellectual disabilities/HSN had significantly lower total and mean scores on MHM items than girls with typical development. They still required instruction on the majority of the items after 3 months. Meanwhile, girls with intellectual disabilities/HSN showed a significant improvement in napkin changing skills and maintained post-course scores 3 months later, similar to those with typical development.

Twelve-month outcomes of a community-based, father-daughter physical activity program delivered by trained facilitators.

BACKGROUND: Dads and Daughters Exercising and Empowered (DADEE) is a program targeting fathers/father-figures to improve their daughters' physical activity and well-being. Previous randomised controlled efficacy and effectiveness trials of DADEE demonstrated meaningful improvements in a range of holistic outcomes for both fathers and daughters in the short-term. This study aims to assess the long-term impact (12-months) of the program when delivered in the community by trained facilitators. METHODS: Fathers/father-figures and their primary school-aged daughters were recruited from Newcastle, Australia into a single-arm, non-randomised, pre-post study with assessments at baseline, 10-weeks (post-intervention) and 12-months. The 9-session program included weekly 90-min educational and practical sessions, plus home-based tasks. The primary outcome was fathers' and daughters' days per week meeting national physical activity recommendations (≥ 30 min/day of MVPA for fathers, ≥ 60 min/day MVPA for daughters). Secondary outcomes included physical activity, screen time, self-esteem, father-daughter relationship, social-emotional well-being, parenting measures, and process outcomes (including recruitment, attendance, retention and program acceptability). RESULTS: Twelve programs were delivered with 257 fathers (40.0 ± 9.2 years) and 285 daughters (7.7 ± 1.9 years). Mixed effects regression models revealed significant intervention effects for the primary outcome, with fathers increasing the days/week meeting physical activity recommendations by 27% at 10-weeks (p < 0.001) and by 19% at 12-months (p < 0.001) compared with baseline. Likewise, for daughters there was a significant increase by 25% at 10-weeks (p < 0.001) and by 14% at 12-months (p = 0.02) when compared to baseline. After conducting a sensitivity analysis with participants unaffected by COVID-19 lockdowns (n = 175 fathers, n = 192 daughters), the primary outcome results strengthened at both time-points for fathers and at 12-months for daughters. Additionally, the sensitivity analysis revealed significant intervention effects at post-program and 12-months for all secondary outcomes in both fathers and daughters. Furthermore, the process outcomes for recruitment capability, attendance, retention and satisfaction levels were high. CONCLUSIONS: Findings provide support for a sustained effect of the DADEE program while delivered in a community setting by trained facilitators. Further investigation is required to identify optimised implementation processes and contextual factors to deliver the program at scale. TRIAL REGISTRATION: ACTRN12617001450303 . Date registered: 12/10/2017.

Sex and age-related patterns in pediatric primary headaches: observations from an outpatient headache clinic.

Background: Age reportedly affects headache prevalence differently in boys and girls. However, little empirical data exists regarding pediatric headache prevalence and headache-related burden in children and adolescents according to age and sex. In the present study, we considered age and sex while evaluating the distribution, characteristics, and impairment of primary headache disorders at a pediatric headache center in Germany. Methods: Medical records of children and adolescents attending the headache clinic of the Interdisciplinary Pain Center of the Carl Gustav Carus University Hospital in Dresden during the period 2015-2022 were retrospectively grouped and analyzed depending on age (< or ≥14 years) and sex. Results: The study population consisted of 652 children and adolescents, aged between 3 and 18 years. Almost two-thirds of the patients (≈60%) were females, and almost two-thirds of these females (58%) were ≥14 years of age. Generally, the most prevalent headache diagnoses as defined by the International Classification of Headache Disorders 3rd edition were episodic migraine without aura and the combination of tension-type headache and episodic migraine with or without aura i.e., mixed-type headache (each ≈27%). In the younger group (<14 years), the mixed-type headache was the most prevalent in girls (28.6%), whereas, for boys, episodic migraine without aura was the most prevalent headache diagnosis (47.4%). In the older group (≥14 years), the mixed-type headache continued to be the most prevalent for girls (30%), and it became the most prevalent for boys (26.3%). Before the age of 14, about 16% of children were severely affected by their headaches. After the age of 14, this proportion increased to roughly one-third (33%) of adolescents, driven mainly by teenage girls (26%) who were severely affected by their headaches. Furthermore, the prevalence of comorbidities was significantly higher among girls (67%), particularly in the adolescent group (74%). Conclusions: Our data shows that headache disorders in a specialized pediatric clinic impose a significant burden, especially among teenage girls indicating high therapy needs. Enhancing awareness of early diagnosis and preventive care is crucial to mitigate the development of chronic headaches, and mitigate their adverse effects on life quality and educational capability.

Parental Sexual Socialization, Sexual Subjectivity, and Emotional Responses to Sexual Experiences among Adolescent Girls.

This study explored girls' sexual subjectivity as a pathway through which parental socialization influenced their emotions about past sexual experiences. A national online survey of 397 adolescent girls (Mage = 16.8 years) from diverse racial/ethnic backgrounds (33.0% Black, 25.7% Latina, 28.0% non-Hispanic White) assessed (1) parental messaging emphasizing relational, sex-positive, gendered sex role, abstinence-only, and sex-is-taboo discourses; (2) girls' sexual subjectivity including sexual body esteem, entitlement to sexual pleasure, and perceived sexual control; and (3) positive and negative emotional reactions to sexual experiences. Sexual subjectivity fully mediated the positive effect of relational messaging on positive emotional reactions and the negative effect on negative emotional reactions. Additionally, sexual subjectivity partially mediated the positive effect of gendered sex role messaging on negative emotional reactions. This study draws critical attention to placing the psychological aspects of girls' sense of their own sexuality and the emotional components of their sexual experience at the forefront of understanding the influence of parental sexual socialization on the sexual experiences of adolescent girls.

Prevalence and associated risk factors for depression symptoms in adolescent girls with polycystic ovary syndrome: a hospital-based cross-sectional study.

Background: Depression symptoms are a growing concern for adolescent girls with PCOS around the world. However, relatively small samples have given varying reports of its prevalence and risk factors in previous studies. Therefore, there is an urgent need for further research on the prevalence and associated factors of depression among adolescent girls with PCOS. Methods: A cross-sectional study was performed from October 2021 to May 2022 using a questionnaire and examination of the medical records of a convenience sample of 335 adolescent girls with PCOS. The Chinese version of the Children's Depression Scale (CDI) was used to investigate depression symptoms. A multivariate logistic regression model was used to determine factors that were significantly associated with depression symptoms. Results: The prevalence of depression symptoms was 36.12% among adolescent girls with PCOS. A multivariate logistic regression model identified significant factors as perceived social support (95% CI: 0.921 ~ 0.965%, p = 0.000), sleep quality (95% CI: 1.134 ~ 1.324%, p = 0.000), belief illness (95% CI, 1.040 ~ 1.102%, p = 0.000), hirsutism (95% CI, 1.292 ~ 4.392%, p = 0.005), and LH/FSH ≥ 2 (95% CI, 1.939 ~ 6.369%, p = 0.000). Conclusion: Depression symptoms are an important problem among adolescent girls with PCOS in China. A comprehensive approach that encompasses social support, structured health education for the disease, and evaluation of the psychological status of PCOS girls with hirsutism (and) or LH/FSH ≥ 2 in time is important to minimize depression symptoms and improve psychological health among adolescent girls with PCOS.

Menstrual hygiene management practice and associated factors among secondary school girls in eastern Ethiopia: The influence of water, sanitation and hygiene facilities.

BACKGROUND: Inadequate water supply, poor sanitation and hygiene (WASH) facilities in schools, insufficient puberty education and a lack of hygienic menstrual hygiene management (MHM) items (absorbents) cause girls in developing countries like Ethiopia to view menstruation as shameful and uncomfortable. However, there was little evidence of female MHM practice and associated factors among secondary school girls in eastern Ethiopia. OBJECTIVE: To assess MHM practice and associated factors among secondary school girls in eastern Ethiopia. DESIGN: Institutional-based cross-sectional study design was conducted. METHODS: A total of 473 secondary schoolgirls were selected using a stratified sampling technique. Data were collected using a self-administered structured questionnaire, double-entered to Epidata version 3.1 and exported to SPSS version 26 for analysis. Descriptive analysis was computed using frequency, percentage, mean and standard deviations. Multivariable logistic regression was applied to assess the association of the school water, sanitation and hygiene facilities with MHM. Adjusted odd ratio (AOR) with its 95% confidence interval was computed to show the strength of the association between dependent and independent variables. The goodness of fit of the model was tested by the Hosmer-Lemeshow goodness of fit test. RESULTS: Out of 473 study participants, 72.93% of them (95% CI: 68.74-76.76) reported good MHM practices. The study also found that availability of continuous water supply (AOR = 2.40, 95% CI: (1.42-4.01)); types of toilet (AOR = 2.01, 95% CI: (1.20-3.40)), confined space (AOR = 3.02, 95% CI: (1.49-4.76)) and having females' toilets alone inside in the school (AOR = 2.70, 95% CI: (1.20-4.40)) were significantly associated with female students' good MHM practice. CONCLUSION: The survey revealed that some of the secondary schoolgirls practiced poor menstrual hygiene management (MHM), which needs further improvement. The study also found that the availability of continuous water supply in the school, types of toilet facility in the school, availability of private space to manage periods at school, learning about MHM in schools and availability of female toilets kept locked inside were factors significantly associated with MHM practice of students, which require integration of Zonal Health and education bureau to jointly work towards the improvement of school WASH facilities.

Factors Associated with Usage of Oral-PrEP among Female Sex Workers in Nairobi, Kenya, Assessed by Self-Report and a Point-of-Care Urine Tenofovir Immunoassay.

Pre-exposure prophylaxis (PrEP) is highly effective at reducing HIV acquisition. We aimed to estimate usage of oral-PrEP, and factors associated with adherence among female sex workers (FSWs) in Nairobi, Kenya, using a novel point-of-care urine tenofovir lateral flow assay (LFA). The Maisha Fiti study randomly selected FSWs from Sex Worker Outreach Program clinics in Nairobi. Data were collected from 1003 FSWs from June-October 2019, including surveys on self-reported oral-PrEP adherence. Adherence was also measured using the LFA for HIV-negative FSWs currently taking oral-PrEP. Informed by a social-ecological theoretical framework, we used hierarchical multivariable logistic regression models to estimate associations between individual, interpersonal/community, and structural/institutional-level factors and either self-reported or LFA-assessed adherence. Overall, 746 HIV-negative FSWs aged 18-40 participated in the study, of whom 180 (24.1%) self-reported currently taking oral-PrEP. Of these, 56 (31.1%) were adherent to oral-PrEP as measured by LFA. In the multivariable analyses, associations with currently taking oral-PrEP included having completed secondary education, high alcohol/substance use, feeling empowered to use PrEP, current intimate partner, no recent intimate partner violence, having support from sex worker organisations, experiencing sex work-related stigma, and seeking healthcare services despite stigma. Associations with oral-PrEP LFA-measured adherence measured included having only primary education, experience of childhood emotional violence, belonging to a higher wealth tertile, and being nulliparous. Oral-PrEP adherence, measured by self-report or objectively, is low among FSWs in Nairobi. Programs to improve oral-PrEP usage among FSWs should work to mitigate social and structural barriers and involve collaboration between FSWs, healthcare providers and policymakers.

Influences of HPV disease perceptions, vaccine accessibility, and information exposure on social media on HPV vaccination uptake among 11,678 mothers with daughters aged 9-17 years in China: a cross-sectional study.

BACKGROUND: Mothers play a crucial role in influencing their daughters' HPV vaccination decisions. Addressing barriers to receiving HPV vaccination among mothers of girls may achieve two goals in one strike: increasing vaccination coverage among both mothers and their daughters. This study aims to examine the HPV vaccination uptake and its determinants among mothers of girls in China at both the individual and interpersonal levels. METHODS: From July to October 2023, a cross-sectional online study was conducted to investigate HPV vaccine refusal for daughters aged 9-17 years among 11,678 mothers in Shenzhen, China. A randomized selection method was employed, targeting 11 primary schools and 13 secondary schools in Shenzhen. The research team invited mothers of girls to participate in an anonymous online survey. Multilevel logistic regression models (level 1: schools; level 2: individual participants) were employed to analyze the data. RESULTS: Among 11,678 mothers, 41.1% self-reported receiving at least one dose of HPV vaccination. Through multilevel logistic regression analysis, eight items measuring illness representations of HPV, which refers to how people think about HPV, were associated with higher HPV vaccination uptake (AOR: 1.02-1.14). These items included identity (identifying symptoms of HPV), timeline (whether HPV is acute/chronic), negative consequences, personal and treatment control (whether HPV is under volitional control), concern, negative emotions, and coherence (overall understanding of HPV). In addition, participants refusing HPV vaccines for the index daughters (AOR: 0.82, 95%CI: 0.76, 0.89) had lower vaccine uptake. Perceived more difficulties in accessing the 9-valent vaccines (AOR: 1.06, 95%CI: 1.04, 1.08) and more satisfaction with vaccine-related promotional materials (AOR: 1.50, 95%CI: 1.46, 1.54) at the individual level were associated with higher vaccine uptake. At the interpersonal factors, higher frequency of exposure to testimonials given by others about HPV vaccination on social media (AOR: 1.19, 95%CI: 1.14, 1.25) and thoughtful consideration of the veracity of the information (AOR: 1.11, 95%CI: 1.07, 1.16) were correlated with higher HPV vaccination uptake. CONCLUSIONS: These findings offer essential implications for modifying HPV disease perceptions, addressing difficulties in accessing the 9-valent HPV vaccines, and enhancing health communication needs to improve HPV vaccine uptake among mothers of girls.

Adolescent girls' perceptions regarding the use of contraceptives in Ekurhuleni District, Gauteng.

Background: Unintended pregnancies pose various challenges for adolescent girls and can be prevented through contraceptive use. However, contraceptive use among adolescents is lower compared to among older women. Aim: To describe adolescent girls' perceptions of the use of contraceptives. Setting: Two high schools in Tembisa were selected as the study setting. Methods: Purposive sampling was used to select adolescent girls who had reached menarche and were willing to participate. Data collection involved narrative writing for girls under 16 and interviews for older adolescents. Braun and Clark's six-step method was used for data analysis. Results: A total of 35 adolescent girls were identified, and the final sample size was N = 33 adolescent girls whose ages ranged from 13 to 18 years. Two main themes emerged. Theme 1 was positive perceptions of contraceptives. Theme 1 was supported by two subthemes: the first was the influence of the male partner; the second was financial constraints in families. The second theme was negative perceptions of contraceptives. Four subthemes supported the second main theme, which were: myths and misconceptions, influence of parents, healthcare worker attitudes and negative attitudes of community members. Conclusion: Addressing the low contraceptive uptake among adolescent girls requires understanding their perceptions to tailor interventions accordingly. Contribution: The study contributes by highlighting the negative perceptions of contraceptive use, including family financial constraints and the influence of male partners. These findings can inform reproductive health initiatives aimed at increasing contraceptive use among adolescents.

Sexual gender-based violence among adolescent girls and young women during COVID-19 pandemic, Mid-Eastern Uganda.

Introduction: global studies indicate that sexual gender-based violence (SGBV) may increase during pandemics including COVID-19. The Mid-Eastern region in Uganda was of concern due to the high prevalence of intimate partner sexual violence among adolescent girls and young women (AGYW). Due to limited data, we investigated factors associated with SGBV among AGYW during the COVID-19 pandemic in Eastern Uganda, in April 2022. Methods: we listed all AGYW 10-24 years who obtained SGBV services at 10 high-volume health facilities from March 2020 to December 2021, the main COVID-19 period in Uganda. We conducted a case-control study among these AGYW. A case was ≥1 SGBV episode experienced by an AGYW aged 10-24 years residing in the Tororo and Busia districts. For every randomly selected case from the health facility line list, we identified two neighbourhood-matched AGYW controls who reported no SGBV. We interviewed 108 and 216 controls on socio-demographics, socio-economics, and SGBV experiences during COVID-19. We conducted logistic regression to identify associated factors. Results: among 389 SGBV cases, the mean age was 16.4 (SD± 1.6: range 10-24) years, and 350 (90%) were aged 15-19 years. Among 108 cases interviewed, 79 (73%) reported forced sex. Most (n=73; 68%) knew the perpetrator. In multivariate analysis, self-reported SGBV before the COVID-19 period [aOR=5.8, 95%CI: 2.8-12] and having older siblings [aOR=1.9, 95%: CI 1.1-3.4] were associated with SGBV during the period. Living with a family that provided all the basic needs was protective [aOR=0.42, 95%: CI 0.23-0.78]. Conclusion: previous SGBV experiences and family dynamics, such as having older siblings, increased the odds of SGBV during the COVID-19 pandemic in Uganda. Conversely, a supportive family environment was protective. Identifying, supporting, and enacting protective interventions for SGBV victims and socioeconomically vulnerable AGYW could reduce the burden of SGBV during similar events.

Factors that influence the uptake of human papillomavirus vaccine among preadolescent girls in South Africa: A Scoping Review.

Human papillomavirus (HPV) infection is a sexually transmitted infection which causes cancer, especially cervical cancer. HPV infection and cervical cancer are a public health concern in South Africa. Primary prevention interventions, such as vaccination against cervical cancer, have been rolled out in the country. However, the uptake of the vaccine faces challenges due to various factors. The aim of the review was to identify factors which influence the uptake of the vaccine. A six-step framework developed by Levac, Colquhon and O'Brien was adopted to guide this scoping review. The articles were searched in the following databases: EBSCOhost, PubMed, CINAHL and Google scholar. The search, conducted from May to July 2023 was limited to articles published in English between 2008-2023 and those conducted in Africa. The results showed that most studies were conducted in sub-Saharan Africa, with majority of the studies being from Nigeria. Subthemes were extracted from the articles and categorised under the four themes of the Social Ecological Model. The four themes used from the Social Ecological Model were individual factors; interpersonal factors; community and societal factors, and organisational factors and public policy. The subthemes were socioeconomic and sociodemographic of parents, knowledge, fear and mistrust, family structure and proximity to cancer/STI, misinformation from social media, religion, culture and tradition, free vaccination programme and lack of engagement. The identified gap in literature was a lack of studies of factors which influence HPV vaccination uptake in South Africa and qualitative studies that explore and provide the factors influencing uptake. We conclude that in designing effective interventions for the uptake of HPV vaccines, it is important to consider influential factors that are tailor-made for specific demographics.

L'infection par le virus du papillome humain (VPH) est une infection sexuellement transmissible qui provoque le cancer, notamment le cancer du col de l'utérus. L'infection au VPH et le cancer du col de l'utérus constituent un problème de santé publique en Afrique du Sud. Des interventions de prévention primaire, telles que la vaccination contre le cancer du col de l'utérus, ont été déployées dans le pays. Cependant, l'adoption du vaccin se heurte à des difficultés dues à divers facteurs. Le but de l'examen était d'identifier les facteurs qui influencent l'adoption du vaccin. Un cadre en six étapes élaboré par Levac, Colquhon et O'Brien a été adopté pour guider cet examen de la portée. Les articles ont été recherchés dans les bases de données suivantes : EBSCOhost, PubMed, CINAHL et Google Scholar. La recherche, menée de mai à juillet 2023, s'est limitée aux articles publiés en anglais entre 2008-2023 et à ceux menés en Afrique. Les résultats ont montré que la plupart des études ont été menées en Afrique subsaharienne, la majorité des études provenant du Nigeria. Les sous-thèmes ont été extraits des articles et classés sous les quatre thèmes du modèle socio-écologique. Les quatre thèmes utilisés dans le modèle socio-écologique étaient des facteurs individuels ; facteurs interpersonnels; les facteurs communautaires et sociétaux, ainsi que les facteurs organisationnels et les politiques publiques. Les sous-thèmes étaient socio-économiques et sociodémographiques des parents, connaissances, peur et méfiance, structure familiale et proximité du cancer/IST, désinformation provenant des médias sociaux, religion, culture et tradition, programme de vaccination gratuit et manque d'engagement. La lacune identifiée dans la littérature était le manque d'études sur les facteurs qui influencent le recours à la vaccination contre le VPH en Afrique du Sud et d'études qualitatives qui explorent et fournissent les facteurs qui influencent le recours à la vaccination. Nous concluons que lors de la conception d'interventions efficaces pour l'adoption des vaccins contre le VPH, il est important de prendre en compte les facteurs influents adaptés à des données démographiques spécifiques.

Intra- and inter-examiner Reproducibility of the menstrual hygiene management skills' rating by prepubescent girls in Japan.

Prepubescent girls with intellectual disabilities and high support needs encounter difficulties with menstrual hygiene management (MHM) and require individualized education. However, no clear methodology exists for assessing the reliability and validity of premenstrual MHM skills. We developed a 17-item MHM assessment tool to determine the intra- and inter-examiner reproducibility of MHM skills. Prepubescents-9 with intellectual disabilities and 10 with typical development-were educated on menstruation and assessed by three examiners. The intra-class correlation coefficient (ICC) showed high reproducibility, with intra-examiner reproducibility (ICC [1.1]) ranging from 0.87 to 0.99, regardless of disability. Conversely, inter-examiner reproducibilities were ICC (2.1) = 0.69-0.92 and 0.50-0.94 and Kappa coefficients were 0.54-0.81 and 0.37-1.00 for girls with intellectual disability and others, respectively. Items such as lowering underwear and wrapping napkins were less reproducible despite disability. Ability did not affect reproducibility and was useful for identifying MHM changes pre- and post-menstrual education.

Exploring the barriers, facilitators, and opportunities to enhance uptake of sexual and reproductive health, HIV and GBV services among adolescent girls and young women in Zambia: a qualitative study.

INTRODUCTION: Adolescents and young women in low-middle-income countries face obstacles to accessing HIV, Sexual and Reproductive Health (SRH), and related Gender-Based Violence (GBV) services. This paper presents facilitators, opportunities, and barriers to enhance uptake of HIV, GBV, and SRH services among Adolescent Girls and Young Women (AGYW) in selected districts in Zambia. METHODS: This study was conducted in Chongwe, Mazabuka, and Mongu Districts among adolescent girls and young women in Zambia. Key informants (n = 29) and in and out-of-school adolescents and young people (n = 25) were interviewed. Purposive sampling was used to select and recruit the study participants. Interviews were transcribed verbatim, and a content analysis approach was used for analysis. RESULTS: The facilitators that were used to enhance the uptake of services included having access to health education information on comprehensive adolescent HIV and gender-based violence services. Non-governmental organisations (NGOs) were the main source of this information. The opportunities bordered on the availability of integrated approaches to service delivery and strengthened community and health center linkages with referrals for specialised services. However, the researchers noted some barriers at individual, community, and health system levels. Refusal or delay to seek the services, fear of side effects associated with contraceptives, and long distance to the health facility affected the uptake of services. Social stigma and cultural beliefs also influenced the understanding and use of the available services in the community. Health systems barriers were; inadequate infrastructure, low staffing levels, limited capacity of staff to provide all the services, age and gender of providers, and lack of commodities and specialised services. CONCLUSION: The researchers acknowledge facilitators and opportunities that enhance the uptake of HIV, GBV, and SRH services. However, failure to address barriers at the individual and health systems level always negatively impacts the uptake of known and effective interventions. They propose that programme managers exploit the identified opportunities to enhance uptake of these services for the young population.

Associations of mothers' decisional conflicts and satisfaction with governmental health promotion materials with their daughters' HPV vaccination uptake in China: A cross-sectional survey.

Background: China started to implement the HPV vaccination program for females in 2016. This study investigated associations between mothers' decisional conflicts, satisfaction with governmental health promotion materials, and their daughters' HPV vaccination uptake. Methods: A cross-sectional online survey was conducted between July and October 2023 among mothers of girls aged 9-17 years in Shenzhen, China. Participants were mothers having a daughter aged 9-17 years at the survey date and a smartphone with internet access. About 3 % of all primary and secondary schools in Shenzhen were randomly selected by the research team (11 primary schools and 13 secondary schools). Teachers at the selected schools invited mothers of female students aged 9-17 years to complete an anonymous online questionnaire. Multivariate logistic regression was fitted. Results: Among 11,728 mothers who completed the survey, 18.9% of their index daughters received at least one dose of HPV vaccination. In multivariate analysis, less decisional conflict about the choice of HPV vaccines for their daughters (AOR: 1.07, 95%CI: 1.05, 1.10), more satisfaction with the government's health promotional materials related to HPV vaccines (AOR: 1.15, 95%CI: 1.12, 1.19), receiving more cue to action from significant others (AOR: 1.23, 95%CI: 1.19, 1.27), and perceived higher self-efficacy related to HPV vaccines (AOR: 1.79, 95%CI: 1.67, 1.92) were associated with a higher uptake of HPV vaccines. Perceived susceptibility to HPV (AOR: 0.79, 95%CI: 0.74, 0.85), perceived barriers to having the index daughter receive HPV vaccines (AOR: 0.82, 95%CI: 0.80, 0.84), and mothers who were hesitant to receive HPV vaccination (AOR: 0.75, 95%CI: 0.68, 0.84) were associated with a lower uptake. Conclusion: HPV vaccination uptake was low among girls in China. Future health promotion should address mothers' decisional conflicts about the choice of HPV vaccines for their daughters and improve the health promotional materials. School-based HPV vaccination programs might be useful.

Driving improvement of diagnosis and awareness of heavy menstrual bleeding in women among physicians.

INTRODUCTION: A number of barriers in care exist for women/girls with bleeding disorders. Little progress has been made to overcome them, particularly regarding levels of awareness of healthcare professionals (HCPs) and women/girls. AIM: To evaluate awareness and perception of heavy menstrual bleeding (HMB) and bleeding disorders among HCPs and women/girls. METHODS: A three-part qualitative study was conducted, including HCPs and women/girls from over seven countries. Part 1 included eleven 60-min interviews with experts discussing HMB diagnostic barriers, which were further assessed in surveys among 6099 women/girls, 353 general practitioners (GPs), and 426 obstetricians and gynaecologists (OB/GYNs) during Part 2. Part 3 included three 1.5-2-h workshops with 20 clinicians and patient representatives covering HMB knowledge, criteria defining HMB and HCP resourcing for diagnosis. RESULTS: Many HCPs do not conduct certain investigations for women/girls presenting with HMB, and 22% of GPs lack confidence in the management of HMB. Only 8% of GPs use screening tools to evaluate menstrual blood loss, and 13% of GPs and 15% of OB/GYNs assess underlying bleeding disorders. Seventy-six percent of menstruating women/girls believed they could recognise HMB symptoms 'well'. However, 23% of these women/girls would not seek medical advice for abnormal/prolonged menstruation disrupting their lives. Disruptions were reported in 34% of women/girls from the general population and 61% of women with at-risk symptoms of HMB. CONCLUSION: Many women/girls and HCPs have limited awareness of important HMB indicators. There is a need for standardized clinical criteria to promote efficient diagnoses and management.

Remote physical activity intervention to promote physical activity and health in adolescent girls (the HERizon project): a multi-arm, pilot randomised trial.

BACKGROUND: Engaging in physical activity (PA) during adolescence is beneficial for health and positive development. However, most adolescent girls have low PA levels, and there is a need for interventions outside of school hours. This pilot randomised controlled trial aimed to explore the preliminary effectiveness of three different remote PA interventions in increasing adolescent girls' moderate-to- vigorous PA (MVPA), fitness and psychosocial outcomes. METHODS: Girls living in the UK or Ireland, aged between 13 and 16 years old, who wished to increase their activity levels, were eligible for the study. Using a random number generator, participants (n = 153; 14.8y ± 1.4) were randomised into one of three 12-week intervention groups (i) PA programme, (ii) Behaviour change support, or (iii) Combined PA programme and Behaviour change support, or (iv) a Comparison group. Outcome measures included accelerometer and self-reported PA, physical fitness (cardiorespiratory fitness; 20 m shuttle run, muscular endurance; push up, muscular strength; long jump), and psychosocial assessments (perceived competence; body appreciation; self-esteem; behavioural regulation). Linear mixed models were used to analyse differences between each intervention arm and the comparison group immediately postintervention (12 weeks) and at follow up (3-months post-intervention), while adjusting for potential confounders. RESULTS: Participation in the PA programme group was associated with higher perceived competence (0.6, 95% CI 0.1 to 1.2), identified regulation (0.7, 95% CI 0.2 to 1.1) and intrinsic motivation (0.9, 95% CI 0.2 to 1.6) at post-intervention. Participation in the Behaviour change group was associated with higher perceived competence at post-intervention (0.6, 95% CI 0.1 to 1.2), and higher push-up scores at the 3-month follow-up (4.0, 95% CI 0.0 to 7.0). Participation in the Combined group was also associated with higher perceived competence at post-intervention (0.8, 95% CI 0.2 to 1.4), and higher push-up scores at the 3-month follow-up (5.0, 95% CI 1.0 to 8.0). No other significant differences were found between the intervention arms and the comparison group. CONCLUSION: Results suggest perceived competence increased across all intervention arms, while the PA programme group enhanced autonomous motivation in the short term. Intervention arms with behaviour change support appear most promising in improving muscular endurance. However, a larger scale trial is needed for a better understanding of between-group differences and the impact of intervention arms on MVPA and fitness, given the small sample size and short-term follow-up.

"I will find the best method that will work for me": navigating contraceptive journeys amongst South African adolescent girls and young women.

BACKGROUND: Given that South Africa has one of the highest rates of pregnancy amongst adolescent girls and young women (AGYW) globally, the provision of contraceptives to this group has been a key focus in recent years. Pregnancy prevention involves an on-going continuum of decision-making around contraceptive method choice, uptake, use, experience, continuation, and discontinuation. METHODS: This paper presents analysis of data from a cross-sectional survey with 2376 AGYW, as well as qualitative in-depth interviews (IDIs) with 54 AGYW, inclusive of contraceptive journey narratives. We examine the preferences, valued characteristics, choices, beliefs, understandings and experiences of choosing and using contraceptives amongst AGYW in two South African communities characterised by high rates of pregnancy. RESULTS: These findings shed light on the preferences towards, beliefs about, and experiences of choosing, using and discontinuing contraceptive methods amongst this population, with survey data suggesting that the most popular methods were the injection, followed by the implant, and then the oral pill. Findings illustrate the complexity and dynamic nature of contraceptive decision-making and the varied embodied and lived experiences of contraceptive use, and how these are impacted by contraception service provision. CONCLUSIONS: Our findings show that contraception experiences of each individual are cumulative, and comprise a continuum of method initiation, use, discontinuation, method switching and on-going circular decision-making influenced by multiple social, structural, contextual and interpersonal factors, combined with shifting preferences, values and needs. To maximise the use of contraceptives amongst South African AGYW, it is necessary to provide responsive contraception service provision to reflect the changing contexts and preferences of users, in order to ensure that pregnancy prevention needs are catered for throughout their reproductive life course.

Learning from a gender transformative intervention among faith-leaders in Woliso, Ethiopia: A qualitative study.

Violence against women and girls (VAWG) continues to be a pervasive issue globally, and in Ethiopia, that harms women and challenges progress towards a more gender-equal society. Many interrelated social, economic, and cultural factors impact VAWG. Religion is a complex factor that can contribute to and act as a preventative measure against VAWG. Thus, faith-leaders have been identified as key actors in VAWG prevention. This study examines Ethiopian Evangelical faith-leaders transformative knowledge change following a Channels of Hope for Gender training intervention. Focus group discussions were conducted with faith-leaders from five different Evangelical Church groups. The results show that the faith-leaders' experience of the Channels of Hope training challenged their gender norms and allowed them to enact relationship and community-level changes. Additionally, they demonstrated efforts and interest in generating change at the level of the Church. However, barriers remained to fully addressing VAWG and implement gender transformative learning more widely. Thus, we conclude that the Channels for Hope training is useful in generating mindset changes and improving relationship-level interactions, but that it requires a longer implementation timeframe and further support from other structures and interventions to achieve sustainable change to prevent VAWG.

Minipuberty in Daughters of Women with Hypothyroidism during Pregnancy.

Minipuberty is a term describing transient postnatal activation of the hypothalamic-pituitary-gonadal axis, likely playing an important role in the postnatal growth of female genital organs and breasts. Unlike infant boys, there are no data concerning the impact of gestational hypothyroidism on the course of minipuberty in infant girls. Therefore, the aim of the current study was to investigate the reproductive axis and genital organs in daughters of women with thyroid hypofunction during pregnancy. The study population included three matched groups of infant girls: offspring of women with thyroid hypofunction non-substituted or inadequately treated during gestation (group 1), descendants of women adequately substituted throughout pregnancy (group 2), and daughters of healthy women (group 3). Salivary concentrations of estradiol, progesterone, 17-hydroxyprogesterone, and androgens (testosterone, androstenedione, and dehydroepiandrosterone sulfate) and urine levels of gonadotropins were measured monthly from month 1 to month 6, once every two months between postnatal months 6 and 12, and once every three months between postnatal months 12 and 18. During each visit, we also determined ovarian volume, uterine length, and breast diameter. Concentrations of FSH, LH, and estradiol were lowest in group 1, and this group was also characterized by the shortest detection period for gonadotropins and estradiol. These differences were paralleled by differences in ovarian volume, uterine length, and breast diameter. There were no differences between groups 2 and 3 in levels of both hormones and in the size of the measured structures. The obtained results seem to indicate that non-substituted or inadequately substituted hypothyroidism during pregnancy may impair the course of minipuberty in the female offspring.

Level of Self-Objectification among Adolescent Girls from Co-educational Schools and All-Girls Schools: A Comparative Study.

Background: Indian females have been objectified since time immemorial. The ancient Indian texts and architecture have numerous instances of sexual objectification of females. In the present time, self-objectification in girls is evident from the increasing popularity of apps like Photoshop, the rise in the makeup industry, plastic and cosmetic surgeries, and so on. This is especially relevant for females across the globe and leads to huge negative effects on women's identities. Purpose: The aim of the present study is to assess and compare the levels of body surveillance (self-objectification), body shaming, and control beliefs in adolescent girls from co-educational schools and all-girls schools. Methods: Four hundred adolescent girls from Convent schools in different cities in Uttar Pradesh were included in the study using purposive (homogeneous) sampling based on the inclusion criteria. The Objectified Body Consciousness Scale (OBCS) was used to assess body surveillance (self-objectification), body shaming, and control beliefs. Results: The results of the study revealed that the level of body surveillance (self-objectification) was significantly high among Indian adolescent girls. It was found that all-girls schools had a higher level of body surveillance (self-objectification), body shaming, and control beliefs as compared to adolescent girls from co-educational schools. Conclusion: It can be concluded that the phenomenon of self-objectification has numerous implications for the physical and mental well-being of girls, particularly during their formative years. Healthy behaviors and positive thoughts are the best ways to respect and honor one's body. The research suggests the need for meditation, awareness workshops, and school-level counseling for adolescent girls, especially in all-girls schools.