Conditions that influence coping mechanisms in Latina mothers affected by incarceration: A secondary analysis using the vulnerability framework.

The objective of this study is to assess women's vulnerability to becoming involved with the legal system as it relates to their exposure, sensitivity, and resiliency to specific experiences associated with incarceration before, during, and after their confinement using the vulnerability framework. We sampled 12 women who self-identified as Latina mothers from local jail annexes, probation department offices, and substance use treatment centers in South Central Texas. We conducted a qualitative, secondary analysis. Three overarching themes emerged: (1) "[The abuse] just kept happening;" (2) "[Incarceration] was an excessive interference;" and (3) "I wasn't there back then [for my children], but now I can be [there for them] in some way." We also identified subthemes. More research and culturally tailored programming are needed to bridge services across legal system sites (jails, prisons, probation) that interact with this population of women to provide supportive services. PUBLIC CONTRIBUTION: We would like to recognize community stakeholders who work in the local jail, probation, and medication treatment centers who helped with the distribution of fliers and participant recruitment along with the women who shared their experiences following incarceration for the original study's data used in this secondary analysis.

Assessing preferences for a university-based smoking cessation program in Lebanon: a discrete choice experiment.

INTRODUCTION: Smoking prevalence rates in Lebanon are among the highest in the Eastern Mediterranean region. Few smoking cessation programs are offered in Lebanon and little is known about the preferences of Lebanese smokers for cessation treatment programs. OBJECTIVE: To establish which attributes of smoking cessation programs are most important to Lebanese smokers. METHODS: Smokers at the American University of Beirut were surveyed to elicit their preferences for, and tradeoffs between the attributes of a hypothetical university-based smoking cessation program. Preferences for medication type/mechanism, risk of benign side effects, availability of support, distance traveled to obtain medication, and price of complete treatment were assessed using the discrete choice experiment method. RESULTS: The smokers' responses (N = 191) to changes in attributes were statistically significant. Smokers were willing to make trade-offs between attributes. On average, smokers were willing to pay LBP 103,000 (USD 69) for cessation support. Respondents were willing to give up LBP 105,000 (USD 70) to avoid an additional 10% risk of minor side effects and LBP 18,000 (USD 12) to avoid an addition kilometer of travel to the nearest pharmacy. Heavy smokers were the least responsive group and had the lowest demand elasticities. CONCLUSIONS: Student smokers were willing to participate in a relatively complex exercise that weighs the advantages and disadvantages of a hypothetical smoking cessation program. Overall they were less interested in the pill form of smoking cessation treatment, but they were willing to make tradeoffs to be smoke-free.

What is Known About Reproductive Autonomy Among Justice-Involved Black Women?: A Scoping Review.

OBJECTIVE: There are approximately 231,000 women detained daily within the nation's jail and prison systems with women of color making up nearly half of those experiencing incarceration. The purpose of this scoping review was to synthesize the literature on the reproductive autonomy of Black women influenced by incarceration, using the three tenets of reproductive justice. METHODS: We searched PubMed, CINAHL, SocINDEX, and PsycINFO for research related to reproductive justice written in English and published in the United States from 1980 to 2022. A review of 440 article titles and abstracts yielded 32 articles for full-text review; nine articles met inclusion. RESULTS: Eight addressed Tenet 1; five mentioned Tenet 2; none addressed Tenet 3. Recognition of the influence of incarceration on the reproductive autonomy of Black women is limited. CONCLUSION: The findings from this review suggest a need to address (a) reproductive choice, (b) support goals, and (c) support of justice-involved Black women.

Undoing Racism and Mitigating Bias Among Healthcare Professionals: Lessons Learned During a Systematic Review.

BACKGROUND: Research indicates that the implicit biases and racist attitudes of healthcare workers are fundamental contributing factors to race-based health inequities. However, few studies and reviews appear to have examined the provision and effects of anti-racist education and training on post-licensure healthcare workers. The purpose of this systematic literature review was to explore what research methods are being used to ascertain the training healthcare workers are receiving post-licensure and to identify the goals and outcomes of this training. METHODS: Using PubMed, CINAHL, and Google Scholar databases, peer-reviewed articles meeting inclusion criteria were identified and reviewed by the authors from March through October of 2020 in alignment with the renewed national focus on anti-racism and racial justice. Studies or initiatives involving students were excluded as were commentaries on studies and studies not specific to racism or anti-racism. RESULTS: Eleven articles were identified as meeting stipulated inclusion criteria. Few were outcome studies (n = 3), and many articles did not clearly delineate training methods, content, or outcomes assessed. Identified methods included group discussion, case studies, and online modules. Reported outcomes included increased self-awareness of implicit biases and racism. Only two studies focused specifically on nurses, with the majority of studies centering on physicians (n = 5). CONCLUSIONS: A considerable knowledge gap exists regarding effective methods, tools, and outcomes to use for undoing racism and mitigating bias in healthcare professionals. Nothing less than a seismic paradigm shift is called for, one in which an anti-racist perspective informs all healthcare education, research, and practice.

Increasing utilisation of skilled attendants at birth in sub-Saharan Africa: A systematic review of interventions.

BACKGROUND: Maternal mortality is a critical global public health concern, especially in low- and middle-income countries in sub-Saharan Africa. Although maternal mortality rates have declined by approximately 39% in sub-Saharan Africa over the last decade, maternal deaths during pregnancy and in childbirth remain high. Interventions to improve mothers' use of skilled birth attendants may decrease maternal mortality in sub-Saharan African countries. OBJECTIVES: This systematic literature review examines components of and evaluates the effectiveness of interventions to increase use of skilled birth attendants in sub-Saharan Africa. METHODS: Guided by the PRISMA model for systematic reviews, the PubMed, Web of Science, and CIHNAL databases were searched for studies from years 2003 through June 2020. RESULTS: The 28 articles included in this review reported on interventions incorporating community health workers, phone or text messages, implementation of community-level initiatives, free health care, cash incentives, an international multi-disciplinary volunteer team, and a group home for pregnant women, which improved use of skilled birth attendants to varying degrees. Only one study reported improved outcomes with the use of community health workers. All of the interventions using text messages increased hospital utilization for births. CONCLUSIONS: Interventions implemented in sub-Saharan Africa hold promise for improving maternal health. Multi-level interventions that involve community members and local leaders can help address the multi-faceted issue of poor maternal health outcomes and mortality. Interventions should focus on capacity building and on training and mentoring of formally-trained health care providers and community health workers in order to expand access.

Episiotomy practice in the Middle East: A Lebanese teaching tertiary care centre experience.

PROBLEM: There is lack of data on the rate of episiotomy in Lebanon and the study's hospital. BACKGROUND: Only a few studies have addressed episiotomy practice in Lebanon and the Middle East and they show varying rates. AIM: To identify the rate, and change in rate, of episiotomy practice over the years at a teaching hospital in Lebanon and to assess whether maternal age, parity, fetal weight, woman's hospital admission class, and physician's gender were associated with episiotomy. We also tested the association between episiotomy and postpartum hemorrhage and/or high degree perineal tears. METHODS: A retrospective observational study was conducted on 1756 records for women having a normal vaginal birth at a single centre from January 2009 to January 2014. FINDINGS: The rate of episiotomy at the hospital was very high, with 97.4% of women receiving an episiotomy in 2009. A major decrease in the rate was identified with a decline from 97.4% in 2009 to 73.3% in January 2014. Episiotomy was found to be associated with parity, maternal age, and with high degree perineal tears. DISCUSSION: The episiotomy rate at this centre remains higher than the 10% rate recommended by the World Health Organization, although there has been a significant reduction after a call for restrictive rather than liberal use. CONCLUSION: Raising awareness among providers appeared to play a significant role in reducing this rate, although more efforts remain warranted. Other strategies - such as raising awareness of women about potential risks of episiotomy - are also worth exploring.

African American Women's Preparation for Childbirth From the Perspective of African American Health-Care Providers.

Preparation for birthing has focused primarily on Caucasian women. No studies have explored African American women's birth preparation. From the perceptions of 12 African American maternity health-care providers, this study elicited perceptions of the ways in which pregnant African American women prepare for childbirth. Focus group participants answered seven semistructured questions. Four themes emerged: connecting with nurturers, traversing an unresponsive system, the need to be strong, and childbirth classes not a priority. Recommendations for nurses and childbirth educators include: (a) self-awareness of attitudes toward African Americans, (b) empowering of clients for birthing, (c) recognition of the role that pregnant women's mothers play, (d) tailoring of childbirth classes for African American women, and (e) research on how racism influences pregnant African American women's preparation for birthing.