Hormonal contraceptive use and women's well-being: links with body image, eating behavior, and sleep.

The goal of the current study was to examine associations between hormonal contraceptive use and indicators of well-being including body image, eating behavior, sleep and energy level. Drawing on a health protection framework, we expected that individuals who use hormonal contraceptives would be more attuned to health and report more positive health attitudes and behaviors on these dimensions. Undergraduate college women (N = 270; M = 19.39 years, SD = 2.43, range 18-39 years) from diverse racial/ethnic and sexual orientation groups completed a survey online. Measures included hormonal contraception use, body image, weight control behavior, breakfast consumption, sleep behavior, and daytime energy level. Nearly 1/3 (30.9%) of the sample reported current hormonal contraceptive use, with most users reporting use of birth control pills (74.7%). Women who used hormonal contraceptives reported significantly higher appearance orientation and body surveillance, lower average energy, more frequent night awakenings, and more naps. Longer duration of hormonal contraceptive use was significantly related to higher body surveillance, and engaging in more unhealthy weight control behavior. Hormonal contraceptive use is not related to indicators of greater well-being. Rather, hormonal contraceptive use is related to greater attention to appearance, lower daytime energy, and some indicators of poorer sleep quality. Clinicians who prescribe hormonal contraceptives should attend to body image, sleep and energy concerns among users.

Sexual and Reproductive Health Protective Factors among Adolescents with Child Welfare Involvement.

Youth with child welfare involvement experience disproportionate rates of sexual and reproductive health (SRH) risks and adverse outcomes. However, little is known about SRH protective factors among youth with child welfare involvement. This study examined whether birth control knowledge or SRH agency, norms, and expectancies differed by gender, age, race/ethnicity, or out-of-home care status among 245 youth, ages 12-15, with open child welfare cases due to maltreatment. Less than half of participants had received information on birth control or knew how to access birth control services; however, the majority reported high confidence in avoiding sex when not desired, strong peer norms for condoms, and few perceived benefits to unprotected sex. Males and younger adolescents had fewer protective attitudes and birth control knowledge, while Latinas had more protective attitudes. This study highlights the protective SRH attitudes already held by youth (ages 12-15) with child welfare involvement, as well as the need for early and gender-inclusive SRH education.

Body Appreciation and Health Care Avoidance: A Brief Report.

Research suggests that body image is related to health behaviors and health care use, but possible mechanisms for this relationship remain unclear. The current study examined the presence of a relationship between body appreciation and avoiding the doctor to avoid being weighed, using a diverse sample of women (N = 499). Controlling for body size and determinants of health care utilization, logistic regression results suggested that women with higher body appreciation were less likely to avoid health care to avoid being weighed (odds ratio = 0.38, p < .001). In addition, differences in avoiding the doctor to avoid being weighed were found for the covariates (that is, age, race, body mass index, and socioeconomic status). These results inform knowledge regarding barriers to health care use and the relationship between body image and health care use. The article concludes with a discussion of the implications for future research, social work interventions, and social work education to promote women's health and well-being.

Exploring Body Image, Contraceptive Use, and Sexual Health Outcomes Among an Ethnically Diverse Sample of Women.

This cross-sectional study examined the links between body appreciation, contraceptive use, and sexual health outcomes. Body appreciation has been shown to influence contraceptive use in homogenous samples of women. However, a common problem in body image literature is a lack of racial and ethnic diversity with regard to sample; this study was able to take steps toward overcoming that limitation. A sample of 499 women aged 18-56 (M = 26.24; SD = 6.15) was recruited via Reddit.com-White (29.3%, n = 120), Asian (19%, n = 78), Black (17.3%, n = 73), multiracial (13.9%, n = 57), and Latina (13.9%, n = 57). Covariates included race/ethnicity, body size as measured by body mass index, relationship status, age, sexual orientation, and education level. Results indicated that higher levels of body appreciation were related to a higher likelihood of using non-barrier contraception. Regarding the covariates, race, relationship status, age, and education were related to non-barrier contraceptive use and age was related to dual contraceptive use. Further exploration is needed to determine how body appreciation may affect contraceptive use and sexual health outcomes and how these differ by race/ethnicity.

Associations Between Body Appreciation and Comfort Communicating About Sex: A Brief Report.

Communicating about sex with potential or current sex partners can lead to many positive outcomes, including fewer unplanned pregnancies and sexually transmitted infections. Although body image is related to many sexual health behaviors, the association between positive body image and comfort communicating about sex is underexplored. The purpose of the current study is to better understand this relationship among a sample of 399 18- to 25-year-old college women. Results suggest that positive body image, measured by body appreciation, is related to greater comfort communicating about sex with a current sex partner, even after accounting for body mass index (BMI).

Body Image Assessment Among Community Mental Health Providers.

Although research suggests an association between body image and mental health, with poor body image related to several mental illnesses, there is no research exploring mental health clinicians' body image screening practices. This study aims to fill this gap among a sample of community mental health providers (N = 216). Using a cross-sectional design, clinicians in Community Health Centers were recruited through email using purposeful and snowball sampling in a Midwest state. The majority of participants identified as women (88.4%) and White (88.4%). Additionally, the mean age of the sample was 36.66 years and participants reported working an average of 8.44 years as a mental health provider. We ran descriptive and Chi square analyses. Results suggest a relationship between viewing body image screening as important and level of preparedness as well as level of preparedness and actual assessment. Training and assessment tools may be warranted to increase clinician's preparedness. Additional clinical and policy recommendations are discussed.

MSW student perceptions of sexual health as relevant to the profession: Do social work educational experiences matter?

Many social work clients are at an increased risk for negative outcomes related to sexual behavior, including unwanted pregnancies and sexually transmitted infections (STIs). However, there is a dearth of literature on social work student experiences with these topics in social work classrooms and their perceptions about the topic's relevance to their practice. The purpose of this study is to explore relationships between experiences with STIs and contraception as topics in social work education and practica experiences on student perceptions toward sexual health as a relevant topic for social work. Among a national sample of MSW students (N = 443), experiences with STIs and contraception as topics in practica was significantly related to perceptions toward sexual health's relevance to social work. Findings and implications are discussed.

Transition, Adjustment, and Healthcare Avoidance: African Immigrant Women's Experiences and Perceptions of Navigating Primary Healthcare in the USA.

This study explores the transition and adjustment of African immigrant women, particularly Ethiopian immigrant women (EIW), as they navigate the U.S. healthcare system and their ability to access and utilize healthcare services. A qualitative cross-sectional design with a mix of purposive and snowball sampling techniques was utilized to recruit EIW (N = 21, ≥18 years) who arrived in the U.S. within the last five years. One-on-one in-depth interviews were conducted to collect data. The interviews were audio-recorded, transcribed verbatim, and analyzed thematically using Nvivo12 software. The thematic analysis revealed three major themes: (1) settling into new life in the U.S. delays EIWs' ability to access primary healthcare; (2) adjusting to the U.S. healthcare system: confusions and mixed perceptions; and (3) avoidance of care: EIW's reasons for PHC visits changed in the U.S. Participants avoided healthcare, except for life-threatening conditions, general check-ups, and maternal healthcare services. Transitional support for legal, residential, employment, and health information could help tackle the challenges of accessing primary healthcare for EIW. Future research should analyze access to healthcare in relation to the everyday struggles of immigrant women, as well as legal and complex structural issues beyond acculturative issues.

The Sociostructural-Intersectional Body Image (SIBI) framework: Understanding the impact of white supremacy in body image research and practice.

White supremacy and racial inequities have long pervaded psychological research, including body image scholarship and practice. The experiences of white, heterosexual, able-bodied, cisgender (predominantly college) women from wealthy, Westernized nations have been centered throughout body image research and practice, thereby perpetuating myths of invulnerability among racialized groups and casting white ideals and experiences as the standard by which marginalized bodies are compared. Body image is shaped by multiple axes of oppression that exist within systemic and structural systems, ultimately privileging certain bodies above others. In this position paper, we highlight how white supremacy has shaped body image research and practice. In doing so, we first review the history of body image research and explain how participant sampling, measurement, interpretive frameworks, and dissemination of research have upheld and reinforced white supremacy. Next, grounded in inclusivity and intersectionality, we advance the Sociostructural-Intersectional Body Image (SIBI) framework to more fully understand the body image experiences of those with racialized and minoritized bodies, while challenging and seeking to upend white supremacy in body image research and practice. We encourage other scholars to utilize the SIBI framework to better understand body inequities and the body image experiences of all people, in all bodies.

Sexual health behaviors in a random sample of students at a Mid-Atlantic university: 2010-2011.

College students represent a unique population of interest to researchers, college health clinic and wellness program directors, as well as policy makers who are interested in promoting sexual health and well-being in young adults. In order to better understand the needs of this population, a large public, Land-grant University in the Mid-Atlantic region participated in the National College Health Assessment survey during 2010 and 2011. A stratified random sample of full-time undergraduate and graduate students was invited to participate in an online survey. The final sample included 2,304 students. Descriptive statistics using Chi-square highlight the relationships between student sexual practices, sexual health screening and prevention practices, and receipt of sexual health education at the university. Regression analysis was conducted to examine the factors associated with receipt of sexual health education. Implications for college health and wellness stakeholders are discussed.

Relationships between experiencing anti-fat microaggressions, body appreciation, and perceived physical and mental health.

This study examined whether body appreciation mediates the relationships between anti-fat microaggression experiences and perceived physical and mental health. Using a cross-sectional survey design, our study included 384 adult cisgender women in the United States. We found that anti-fat microaggression experiences had a negative association with body appreciation, and perceived physical and mental health. Body appreciation had a positive relationship to perceived physical and mental health. Our study further suggests that body appreciation is an important modifiable factor that mediates the relationships between anti-fat microaggression experiences and perceived mental and physical health. Implications for practice and research are discussed.

Sexual and reproductive health cancer screening avoidance: The role of body image.

The current study examines the relationship of female genital self-image, weight-related cancer screening avoidance, and internalized weight stigma among cisgender women that can provide knowledge about avoidance of life-saving preventative healthcare. This cross-sectional survey included a convenience sample of 384 U.S. cisgender women who were 18+. The sample was primarily white (n = 260, 67.7 %) with a mean age of 33.18 years. 28.4 % reported avoiding a pap smear, 27.1 % avoided a clinical breast exam, and 29.4 % avoided a mammogram. Using multivariate logistic regressions, our results show high internalized weight stigma moderates the relationship of positive genital self-image on weight-related genital and breast cancer screening avoidance. Thus, the odds of avoiding screenings are positive, where the odds of avoidance slightly decreases from the interaction term as female genital body image increases. Interventions to improve female genital body image among cisgender women may lessen the effects of internalized weight stigma on avoiding reproductive cancer screenings. BMI was only a predictor for avoiding pap tests. Further examination is warranted because BMI and sexual health behaviors are not usually associated in body image research. Clinical workforce training is needed to educate providers about the harm of weight stigma and its relationship with healthcare avoidance.

Women's refusal to be weighed during healthcare visits: Links to body image.

The purpose of this mixed methods study was to assess the relationship between body image and refusal to be weighed by a healthcare provider among women in the United States, including examination of their reasons for refusal. Between January 15 to February 1, 2021, an online mixed-methods cross-sectional survey assessing body image and healthcare behaviors was administered to adult cis-gender women. Of the 384 respondents, 32.3 % reported refusing to be weighed by a healthcare provider. After controlling for SES, race, age, and BMI in multivariate logistical regression, the odds of refusing to be weighed were 40 % lower for every unit increase in body image score (positive body appreciation). The most common reasons for refusing to be weighed were having a negative impact on emotions, self-esteem, or mental health (52.4 %). Higher body appreciation decreased the odds of refusing to be weighed among women. Reasons for refusing to be weighed ranged from shame and embarrassment to lack of provider trust, personal autonomy, and concerns about discrimination. Identifying interventions and alternatives such as telehealth to provide healthcare services that are weight-inclusive may mediate these negative experiences.

Interdisciplinary, Inclusive, and Innovative: Promoting a Paradigmatic Shift in Cancer Research Among Transgender and Gender Diverse Adolescents and Young Adults.

Transgender and gender diverse (TGD) adolescents and young adults (AYA) face heightened risks of cancer due to cissexism and transphobia in healthcare, low cancer screening rates, limited knowledge and awareness of cancer risk and screenings, poor healthcare experiences, and exposure to sexually transmitted infections (STIs). Despite this, TGD AYA cancer risk is relatively unexamined in oncology research. To intervene early and mitigate risk, we require holistic understandings of cancer risk among TGD AYA. This research brief engages with an interdisciplinary knowledge base to identify gaps and limitations warranting critical attention by TGD AYA and cancer scholars. The current literature on TGD AYA risks for cancer are explored with specific attention to the social environment and its impact on cancer risk. The brief ends with a call to action for a paradigmatic shift to promote inclusive, innovative, and interdisciplinary cancer research with TGD AYA.

Rethink My Drink: study protocol for a 12-month randomised controlled trial comparing a brief internet-delivered intervention to an online patient information booklet in reducing risky alcohol consumption among older adults in Australia.

BACKGROUND AND AIMS: Alcohol consumption is increasing among older adults. Rethink My Drink is a brief internet-delivered intervention to reduce alcohol consumption and related harms, adapted specifically for older adults. This protocol for a large-scale randomised controlled trial will evaluate whether Rethink My Drink is effective in reducing alcohol consumption and cognitive decline in a sample of older risky drinkers, compared with an active control. DESIGN: 1:1 parallel group, randomised controlled trial. SETTING: Online trial in Australia. PARTICIPANTS: Hazardous or harmful drinkers (defined as those scoring ≥5 on the Alcohol Use Disorders Identification Test [AUDIT]) age 60 to 75 years old (n = 842). Participants will be recruited from August 2021 to August 2022 through online social media advertisements and community networks. INTERVENTION AND COMPARATOR: Participants will be randomly allocated to receive access to Rethink My Drink (intervention) or Alcohol: The Facts (comparator), an online patient information booklet provided by New South Wales (NSW) Health. MEASUREMENTS: Primary outcomes include (i) average weekly standard drinks and (ii) rate of cognitive decline. Secondary outcomes include (i) typical quantity of drinks per drinking day; (ii) heavy episodic drinking; (iii) age-specific risky drinking; (iv) alcohol-related harms; (v) subjective cognitive complaints; and (vi) quality of life. All primary and secondary outcomes will be assessed at baseline, post-intervention (4 weeks) and 12 months. Effectiveness will be evaluated using multilevel linear regression, adjusting for baseline demographic differences. Bonferroni adjustments will be used to control for multiple comparisons. Multiple imputation, regression weighting and sensitivity analyses will assess the effect of attrition. COMMENTS: This will be the first large-scale trial, internationally, to examine whether a brief internet-delivered intervention is effective in reducing alcohol consumption and cognitive decline among older adults. If successful, the intervention will provide an accessible and highly scalable treatment to reduce risky alcohol consumption in older adulthood.

"It really presents a struggle for females, especially my little girl": Exploring fathers' experiences discussing body image with their young daughters.

Body dissatisfaction in children, particularly young girls, is a growing concern around the world. The home environment can have a strong influence on children's well-being, and parents may contribute to their children's positive or negative body image development. Nearly all research on parent influence on body image has focused on mothers, leaving fathers' attitudes and experiences poorly-understood. To address this gap in the literature, we interviewed 30 fathers (Mage = 40.30; SD = 7.48) of girls between the ages of 5 and 10 about the conversations they have with their daughters regarding body image. Through thematic analysis, we identified three primary themes: barriers to effective communication, combatting negative influences, and strategies for discussing body image. Fathers recognized the importance of talking about body image with their daughters, yet many did not feel confident or competent to do so effectively. They engaged in a variety of strategies to combat adverse cultural influences and encourage self-expression, character development, and mental and physical health in their daughters. However, messages about health were sometimes conflated with messages about thinness or food restriction. Implications for families and future research are discussed.

Body Appreciation and Discontinuing Contraceptive Use Due to Concern About Weight Gain: A Brief Report.

Objective: This study explored the relationship between body appreciation and discontinuing contraception due to concern about weight gain. Methods: A racially and ethnically diverse sample of women, from the United States, (n = 494) was recruited online. Binomial logistic regression was used for analysis. Results: Participants with higher body appreciation were less likely to stop taking birth control due to concern about weight gain (OR = 0.56, p = .002). These results suggest body appreciation may be a defense against concern about weight gain associated with contraceptive use. Conclusions: Interventions aimed at increasing women's body appreciation, body positivity, as well as decreasing weight stigma could improve contraception use.

Body Image and Sexual Behavior Among Adult Men Who "Hook Up".

Understanding the psychosocial variables associated with sexual behavior is critical, particularly among high-risk individuals such as those who hook-up. It is possible body image is one of these variables. The current study aimed to examine the relationship between body appreciation and body image self-consciousness and three sexual health-related behaviors: 1) condom usage, 2) HIV screening, and 3) STI screening among a sample of adult men who have hooked up at least once in the past month (n = 243). We found that higher levels of body appreciation were related to being less likely to use condoms and higher levels of body image self-consciousness were related to being less likely to be screened for HIV and STIs. The conflicting results suggest additional research is warranted.

Sexual function in hook-up culture: The role of body image.

Hook-up mobile apps are increasing in popularity and research suggests sexual function may be lower among those who hook-up compared to those who have sex in a longer-term relationship. Sexual function is an important predictor of well-being; however, we know little about the psychosocial antecedents of sexual function, such as body image, among those who use hook-up apps. The current study aims to examine two measures of positive body image and one measure of body image self-consciousness during intimate activity among a sample of adult women and men who have hooked up in the previous month using a hook-up mobile app (N = 243). Our results suggest that higher body image self-consciousness during intimate activity was related to lower sexual function composite score and several specific domains (i.e., pain, arousal, orgasm, and lubrication) among women. Higher body appreciation was related to higher sexual satisfaction among women. Higher body image self-consciousness during intimate activity was related to higher erection difficulty, but not ejaculation difficulty, among men. These findings highlight the nuanced nature of body image and sexual function and provide further evidence that interventions for women and men aiming to improve some body image constructs may improve sexual function as well.

"On a Journey to Appreciate What My Body Does for Me": Qualitative Results from a Positive Body Image Pilot Intervention Study.

Research suggests body appreciation is related to mental, physical, and sexual health behaviors and outcomes that are relevant to social workers and public health clinicians. As such, it is imperative to develop and test interventions that aim to improve body appreciation. The current study is part of a larger pilot intervention study that utilized 3D scanning technology. During the intervention, 18-25-year-old women digitally "painted" their avatar on a computer based on a series of prompts from the researcher. The purpose of this study is to qualitatively explore how a small subsample of the participants (n = 18) experienced this innovative intervention and how they view themselves differently post-intervention. Using thematic analysis, we uncovered three themes: 1) ways of defining body image, 2) importance of body function over aesthetics, and 3) body acceptance and appreciation. This study provides support for the use of one-time individual-level interventions focused on body appreciation and functionality over appearance. Implications are discussed.