Vama Jhumkhawala

Period poverty, defined as difficulty affording menstrual products, is increasingly recognized as a basic needs issue among students in the United States. However, evidence on the prevalence and awareness of this phenomenon among both undergraduate and graduate populations remains limited. Therefore, the aim of this descriptive cross-sectional study is to describe period poverty experiences and awareness levels among menstruating college students at a public university in South Florida. An online survey was administered to menstruating undergraduate and graduate students (n = 151). Period poverty was assessed using a past-year affordability question, while awareness of period poverty was measured descriptively through seven items derived from a previous study on period poverty in U.S. college students. Overall, 13.9% of respondents reported past-year period poverty. Awareness of period poverty was limited, despite high support for policies providing free menstrual products. Only 16.67% perceived period poverty to be highly prevalent in developed countries, and only 8% believed that it existed in their local area. Three fourths (75.00%) of the sample strongly supported policies to provide free menstrual products. Finally, over half of the respondents felt “not at all embarrassed” (55.07%) towards buying menstrual products, while just over one fourth reported being “fairly embarrassed” (28.26%). The discrepancy between the number of students experiencing period poverty and the levels of awareness of the issue shows a clear need for evidence-based educational interventions and menstrual resources on college campuses to improve overall menstrual well-being.

Endometrial cancer is the fourth most diagnosed cancer in U.S. women. Diabetes and obesity are established independent risk factors for EC, but their combined effect is less defined. This review investigates the literature on these comorbidities as risk factors and modifiers of EC. Multiple cohort and case–control investigations have shown an increased relative risk (RR) and odds ratio (OR) when diabetes and obesity coexist. In one prospective cohort, the RR of EC in diabetic women was 1.94 [95% CI, 1.23–3.08], but increased to 6.39 [95% CI, 3.28–12.06] with obesity; with low physical activity added, RR rose to 9.61 [95% CI, 4.66–19.83]. Case–control studies similarly show an OR of 1.4 [95% CI, 0.9–2.4] for diabetes alone, vs. 5.1 [95% CI, 3.0–8.7] with BMI > 30 and diabetes. Mechanistically, both conditions promote a pro-cancerous microenvironment through metabolic and inflammatory pathways. They also worsen treatment outcomes, with greater surgical complications, thromboembolic events (p < 0.01), prolonged hospitalizations 6.2 days versus 4.5 days (p < 0.03), and poorer survival with an elevated cancer-specific mortality (HR = 2.65, 95% CI 1.60–4.40). These findings underscore the urgent need for targeted interventions and translational research on how these comorbidities impact the pathophysiologic processes of EC.

Cardiovascular disease disproportionately affects women in the United States. CVD outcomes are closely tied to a multitude of factors including lifestyle habits and socioeconomic status which create a complex interweb of determinants of health that place certain age and racial groups at higher risk over others. Such inequities highlight the need for targeted prevention strategies to address the unique risks faced by different populations. In this study, a state-wide analysis examining the mortality rates among women aged 35 years or older in Florida from 2018 to 2023 was done in order to identify high risk groups to better inform evidence-based public heath interventions that are tailored to the population’s needs. Mortality rates were extracted from the CDC Wonder Database. Age-adjusted and crude mortality rates, per 100,000 women, were calculated and stratified by ten-year age groups, Hispanic origin, race, and major CVD subtypes based on various ICD-10 codes. From the ICD-10 113 Cause List, “The Diseases of the Heart” were the cause of the majority of the deaths; however, “Other Forms of Chronic Ischemic Heart Diseases” was the leading subtype. Crude rates for the “Ischemic Heart Diseases” decreased 110.9 per 100,000 women in 2018 to 101.5 per 100,000 women in 2023. Yet, the most common cause of CVD-related mortality remains ischemic heart disease. Across the study period, non-Hispanic women experienced more than twice the crude mortality rate of Hispanic women. Racial breakdowns showed that White women had the highest CVD mortality, followed by Black women, who had elevated rates of heart failure and heart attacks in comparison to other minority groups. Asian women had the lowest rates across all cardiovascular subtypes. These findings underscore the persistent age and racial differences in cardiovascular outcomes emphasize the urgent need for culturally informed, community-specific preventative interventions to improve cardiovascular care and reduce mortality within high-risk populations.

Objectives: This scoping review aims to fill research gaps by exploring four guiding research questions. First, we aim to understand the major barriers encountered by U.S. menstruating college students in accessing menstrual health products at their educational institutions, households, and community. Second, we aim to identify social determinants of health (SDoH) that significantly influence and contribute to menstrual health inequities experienced by U.S. college students. Third, we aim to explore the measurement tools that have been used to assess menstrual health inequities experienced by U.S. menstruating college students. Lastly, we aim to determine the lessons learned and recommendations to improve overall menstrual health outcomes in U.S. menstruating college students. Study Design: This scoping review followed the Arksey and O’Malley framework (2005) and incorporated recommendations from the Joanna Briggs Institute (JBI) for the extraction, analysis, and presentation of results. Methods: The four databases searched were PubMed, Embase (Ovid), Web of Science, and Cochrane Library (Medline). Included articles were (1) published between 2000 and 2023, (2) focused on menstruating college students in the United States, (3) addressed menstrual health, menstrual equity, and period poverty in college campuses in the U.S., and/or (4) explored challenges encountered by menstruating college students in accessing menstrual health products. Results: A total of seven studies were retained for assessment. The most frequently cited Healthy People 2030 categories were economic stability (n = 5) and social and community context (n = 5). The most-cited barriers were sorted into the “Financial Constraints and Accessibility” (n = 13) theme category. Conclusions: Our study highlights practical applications and several recommendations for the future design, adoption, implementation, and evaluation of effective evidence-based interventions to address period poverty and subsequent barriers imposed by menstruating college students specific SDoH. More research is needed to further explore the health implications of menstrual health on mental, physical, and socioeconomic outcomes of menstruating individuals, particularly young adults experiencing different challenges as they venture into college and build their careers.

Background: The United States (US) continues to face a substantial burden of cervical cancer, which has been the focus of many policies and public health prevention agendas. Of the numerous risk factors associated with cervical cancer, human papillomavirus (HPV) infection remains the leading and most preventable cause of this chronic disease. Therefore, one major public health prevention strategy to decrease cervical cancer cases is HPV vaccination. Another screening tool that enables cervical cancer prevention and early intervention is the Pap smear, the primary method of screening for abnormal cervical cells. However, barriers such as social determinants of health and ineffective patient–provider communication hinder access to such critical preventive measures. The purpose of this study was to provide a comprehensive overview of the knowledge level of US female adults, aged 21–65 years, concerning HPV infection and cervical cancer prevention using the Health Information National Trends Survey (HINTS) database. Additionally, it assessed associations between patient–provider communication and the completion of Pap smear tests. Methods: Descriptive statistics were computed to explore the sociodemographic characteristics of female survey participants as well as to gather frequency and percentages of responses related to knowledge of HPV, awareness of the HPV vaccine, and history of Pap smear. Chi-squared tests were carried out to examine the associations between awareness of a cervical cancer vaccine or HPV shot and whether the participant has had a Pap smear, heard of the HPV vaccine, and knowledge of HPV’s association with cervical cancer. Next, binary logistic regression models were built to determine the size and direction of the association between patient–provider communication metrics and measures of (1) having had a Pap smear, (2) participant knowledge of HPV, (3) participant awareness of causality between HPV and cervical cancer, and (4) participant knowledge of HPV vaccine and cervical cancer prevention measures. Results: A substantial majority of participants (81.8%) reported having heard of HPV. Among them, 72.1% recognized that HPV could cause cervical cancer. Awareness of the HPV vaccine was reported by 88.1%, suggesting a relatively high reach of effective public health messaging. Regarding Pap tests, 43.3% of participants had undergone testing within the past year, but 12.6% had not been tested in over five years, and 3.6% have never been tested. Bivariate analysis using chi-squared tests revealed significant associations between participants’ history of Pap smears and their knowledge of HPV infection, its role in cervical cancer, and HPV vaccination as a prevention tool. Participants who had undergone a Pap test were more likely to have heard of HPV (p < 0.001), were knowledgeable of the HPV vaccine (p < 0.001), and were more aware of the HPV vaccine (p < 0.001). Participants reporting “never” for certain communication criteria significantly had an increased risk of having lower knowledge levels about the HPV vaccine and other cervical cancer prevention measures. They also had almost twice the risk of having lower knowledge levels about HPV prevention measures when reporting “never” (RR = 1.997, 95% CI (1.018–3.916) for “spending enough time with patients” compared to those selecting “always”. Additionally, participants responding “sometimes” (RR = 1.889, 95% CI (1.187–3.005) rather than “always” to feeling involved in healthcare decisions had a significantly higher risk of being unaware of the vaccine or other cervical cancer prevention measures. Conclusions: Strengthening provider communication and education skills not only encourages greater patient knowledge and adherence to preventative measures, such as HPV and cervical cancer screening, but also reduces disparities in healthcare stemming from limited health literacy.

Congenital CMV (cCMV) is the leading cause of hearing loss and neurodevelopmental disabilities in children, affecting 15–18% of births in the United States (U.S.). Despite its strong presence, the lack of routine prenatal screening limits its detection and prevention, especially in low-resource communities. The aim of this scoping review is to describe the scope of the CMV interventions and the policies on CMV screening in the United States, identify successful strategies for the implementation of improved CMV screening rates, and make recommendations for future efforts aimed at improving CMV screening in U.S. healthcare settings. The Joanna Briggs Institute recommendations for scoping reviews and the Arksey and O’Malley (2005) York methodology guided the different review steps. These included (1) identifying research questions; (2) searching for relevant studies; (3) selecting studies relevant to the research questions; (4) charting the data; (5) collating, summarizing, and reporting results. A total of six studies were retained for analysis. A common barrier reported across studies was the lack of generalizability of findings due to small sample size. Challenges encountered by patients often centered around awareness, emotional resistance, and cultural norms. Providers also faced significant barriers, particularly related to time constraints, knowledge gaps, and the prioritization of CMV education in prenatal care. Furthermore, a recurrent theme across included studies was the critical role of education in increasing awareness and reducing CMV transmission risks. Findings will contribute to the advancement of CMV prevention through the identification of gaps in education, policy, and practice, thus assuring better health outcomes for mothers and infants.

Background: Patient-centered communication is a critical process in high-quality healthcare that emphasizes the reciprocal sharing of information between providers and patients to ensure care aligns with the patient’s needs, preferences, and personal values. A significant challenge arises from the healthcare provider’s time constraints during clinical encounters and the lack of adequate training on how to adopt a patient-centered communication style that addresses patient concerns, making it difficult to foster an environment conducive to shared decision making. These issues are further exacerbated by cultural and language barriers, along with low levels of health literacy and social determinants of health (SDoHs), which complicate efforts to deliver patient-centered care. Objective: This study examined quality criteria for patient–provider communication (PPC) and their associations with sociodemographic characteristics and SDoHs on housing, transportation, and food insecurity. Methods: This retrospective cross-sectional study analyzed data from the 2022 Health Information National Trends Survey (HINTS-6) national dataset. Associations between PPC and sociodemographic variables were tested using the chi-squared test. Binary logistic regression was carried out to examine the association between three PPC criteria and each of the sociodemographic characteristics and patient comfort in disclosing information on SDoHs. Results: Bivariate analyses showed statistically significant associations for age, occupation status, marital status, Hispanic origin, and race across all three PPC criteria. Significant associations were reported for education and income for the two criteria related to being given the chance to ask questions and being involved in healthcare decisions. Finally, significant associations were reported for all PPC criteria and patient comfort levels in discussing SDoHs. Conclusions: Findings from this paper provide insight for enhancing the quality of PCC in underserved populations, particularly when it comes to informing the design of evidence-based cervical cancer screening interventions which are culturally centered around the patients’ needs and that integrate PPC as a foundational component.

Background: This study examines nationwide prevalence of US childhood behavioral, mental, and developmental problems in the 6–11 age group category between 2019 and 2022, and several key metrics related to caregiver social determinants of health. Methods: We used NSCH data for 6–11-year-old children for the years 2019–2022. Summary statistics for the selected sample were generated and binary logistic regressions were conducted for each severity level binary variable for each study year with caregiver mental or emotional health as a covariate. Results: Our study found significant associations between severe childhood anxiety and “fair” or “poor” caregiver rankings of mental and emotional health for both the 2020 and 2022 survey years. Our study also found that caregiver mental and emotional health may play a role in childhood ADD and ADHD prevalence rates as caregivers who ranked their mental health as “fair” or “good” had significantly higher odds of having a child with severe ADD or ADHD than caregivers who reported “excellent” mental and emotional health. Conclusion: These findings support prospects of an increase in the need for developmental health services, thus necessitating efforts towards effective allocation and focus of developmental treatment programs tailored to children and pediatric population groups.

Background: This systematic review has the following aims: (1) to identify measurement tools used globally by healthcare providers to diagnose PCOS in women at elevated risk; (2) to assess the comprehensiveness of these tools regarding mental health and chronic pain; (3) to list strategies for validating, disseminating, and implementing these tools; and (4) to provide future recommendations for experts in healthcare settings. Methods: This review utilized the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and the Arksey and O’Malley York methodology. Studies were sourced from the PubMed, Embase, and Cochrane Library databases, with inclusion criteria focusing on peer-reviewed articles addressing PCOS diagnosis and associated comorbidities. Data extraction and analysis followed the Joanna Briggs Institute (JBI) recommendations. Results: A total of 63 studies met the inclusion criteria. Findings indicate that current screening tools for PCOS often lack comprehensive integration of mental health and chronic pain assessments. Tools like the PCOSQ and its updated version, PCOSQ-50, inadequately address pain-related symptoms, highlighting a gap in holistic patient evaluation. This review identified significant associations between PCOS and mental health disorders, including anxiety and depression, emphasizing the need for mental health screenings as part of PCOS management. Conclusions: There is a critical need for validated PCOS screening tools that encompass both physical and psychological aspects of the condition. Educating healthcare providers on the cultural and social determinants influencing PCOS can improve diagnosis and patient outcomes. Future research should focus on developing holistic screening tools and culturally relevant educational resources, aiming to enhance the overall quality of life for women with PCOS.