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A study of secret shoppers sheds light on barriers to opioid treatment in women

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After a 2020 study at Vanderbilt University Medical Center showed women had difficulty accessing treatment for opioid use disorder (OUD), researchers analyzed the comments from participants in the study. Other barriers to care have been exposed, including everything from long hold times. For difficult interactions with the clinic front desk during a phone call requesting a reservation. Credits: Vanderbilt University Medical Center

After a 2020 study at Vanderbilt University Medical Center showed women had difficulty accessing treatment for opioid use disorder (OUD), researchers analyzed the comments from participants in the study. Other barriers to care have been exposed, including everything from long hold times. For difficult interactions with the clinic reception during a phone call requesting a reservation.

A study of “Secret Shopper” published on the JAMA network in 2020 attempted to seek treatment from a trained actor in 10 states in the United States. Over 10,000 individual “patients” are randomly assigned during pregnancy or non-pregnancy and have private or Medicaid-based insurance to assess differences in access experience.

The results revealed many challenges in planning the first appointment for treatment for OUD, including finding a healthcare provider who would get insurance instead of cash. Access to treatment was even more difficult to receive treatment than women who are not pregnant.

Trained actors left around 18,000 comments explaining what happened during the call, and pregnant callers and those using Medicaid are the hardest to book. I recorded a problem. The qualitative survey is published in the following journals. Women’s health problems.

“These trained callers didn’t really have opioid use disorders and weren’t desperate for help for themselves or their babies, but they were still stigmatized during those calls. “I felt,” said lead author Dr. Julia Filippi. D., CNM, Midwife and Academic Director of the Midwifery Program at Vanderbilt University School of Nursing. “They were treated for better or worse, so emotions often overwhelmed them. That really speaks to something. “

Many callers did not welcome the answer from the person who answered the call and often stigmatized them. A secret buyer told the receptionist, “People don’t usually show up on promises because they want the last drink before they come.”

In many cases, the caller has repeatedly put on hold or transferred. One caller commented, “It’s strange how long it takes to speak to someone,” and another said, “I’m being treated for an addiction and I’m four months pregnant.” They put it on a typical instant stop. “

Not all interactions were negative. One caller reported that “everyone who spoke during the call, including the receptionist, was deeply compassionate, knowledgeable, and friendly”.

As the opioid crisis worsened in the United States, women became more and more affected. From 1999 to 2016, the drug-related death rate for women rose from 3.9 to 13.4 per 1,000, according to the National Center for Health Statistics.

Treatment with Opioid Use Disorder Drugs (MOUD) is very effective in reducing overdose deaths and improving quality of life. For pregnant women, MOUD improves pregnancy outcomes. Premature birth ..

“Overdose deaths have hit record levels in the United States that the COVID-19 pandemic may have made worse,” said Dr. Stephen Patrick, Director of the Center for Pediatrics Health Policy at Vanderbilt University School of Medicine and Associate Professor of Pediatrics. Is very expensive. “And a neonatologist at Health Policy and Vanderbilt University Medical Center. “We know that drugs used to treat opioid use disorders reduce the risk of death from maternal overdose and increase the chances of giving birth to a higher birth weight. We have easy access to treatment. You need to. It’s not difficult at all. “

The authors recommend interventions to improve access to OUD treatment for women of childbearing potential, including increasing the number of US clinics offering MOUD with or without pregnancy and insurance. More training for clinic phone responders. Address this problem nationwide through political reform.

Cumbersome access to opioid treatment for patients

For more informations:
Julia C. Phillippi et al., Experience of Women of Childbearing Potential Who Have Access to Treatment for Opioid Use Disorders: “We’re Not Doing It Here,” Women’s Health Problems (2021). DOI: 10.1016 / j.whi.2021.03.010

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Vanderbilt University Medical Center

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Women’s Health

Commit to self-care and schedule a well-woman exam

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“As black women, we must commit to total self-care, and one way to do that is to take care of our health inside and out,” says Ciara. “Through the Cerving Confidence Initiative, I want to improve conversations about health and address inequalities by giving black women the inspiration and information they need to take a Pap test to screen for cervical cancer.”

Cerving Confidence means women find the power to protect themselves and their cervical health. Building on the idea of ​​“serving” looks, Ciara plays the lead role in a new PSA video and tells it. She invites black women to join her in #CervingConfidence in their own life and urges her girlfriends to do the same. She talks about how cervical cancer affects women she knows, how easy it is to get tested – “Roll up. Pull up. Boom, bam, it’s done!” says Ciara – and the world she would like to create for her own daughter.

To participate in #CervingConfidence on social media, women can visit our photobooth on the Cerving Confidence website or search for the hashtag in the Giphy integration of Instagram Stories. Information on preparing for an annual health exam, including key questions to ask a doctor about cervical cancer prevention with Pap and HPV tests, is also available. Later that summer, Ciara is hosting a virtual summit on the importance of self-care and how black women can protect their own health. Free access to cervical cancer screening is also available at various health facilities across the country.

Exacerbation of racial differences in cervical cancer
The need for an initiative like Cerving Confidence to reach black women with life-saving information through a culturally relevant lens is more urgent than ever. There are still longstanding racial, ethnic, and socio-economic inequalities that aggravate the effects of cervical cancer on black women. Research shows that black women in the US are twice as likely to die from cervical cancer than white women1 and are more likely to be diagnosed with advanced cervical cancer than any other ethnic group, 2-3, which can lead to worse results. COVID-19 has likely exacerbated these inequalities as many women may have postponed their exams for healthy women due to the pandemic. Although more and more people are being vaccinated against COVID-19, many experts fear the delay in screenings will lead to more undiagnosed cancers – including cervical cancer. At a time when cervical cancer can be largely prevented, this is unacceptable.

“Cerving Confidence will help eradicate health inequalities for Black women by increasing awareness of the importance of preventing cervical cancer and providing access to health screenings that can protect them from unnecessary disease,” says Linda Goler Blount, MPH, President and CEO of BWHI. “Too many women die unnecessarily from cervical cancer and it could simply be prevented with regular checkups. Together with Ciara, we encourage black women to make themselves and their health a priority.”

Improving the health of black women through access to screening
Cerving Confidence is an extension of Project Health Equality, a collaboration that addresses the structural and cultural barriers that prevent black women in the United States from receiving quality health care. As part of Project Health Equality, communities in need are identified and clinical partners selected to provide health screening, including cervical cancer screenings, to women who might otherwise be without them.

“Our mission is to protect women’s health, and we do this by providing high-precision diagnostic tests for various types of female cancers and more,” says Michelle Garsha, Vice President, Women’s Health Diagnostics, Hologic. “Screening with Pap and HPV tests can detect cancer early when it’s easier to treat, and also detect abnormalities before they turn into cervical cancer, which can actually prevent disease. And for women in select cities who don’t have access, we will provide this important information. ” Demonstrations. “

Understanding cervical cancer and how to recognize it
Cervical cancer occurs in the cells of the cervix that connects the vagina (birth canal) to the upper part of the uterus.4 Routine screening with a Pap test alone is recommended for women aged 21 to 29.5 years old Age 30 to 65, certain studies show that screening with a Pap test combined with an HPV test (also known as Pap + HPV Together) is the best way to detect disease.6-7 The Pap test while the HPV test identifies abnormal cervical cells for the presence of the human papillomavirus (HPV). About eight in ten women will develop HPV at some point in their lives.8 Most of the time, HPV goes away on its own. Sometimes, however, it persists and develops into cervical cancer.9 Detected early, cervical and precancerous cancer is treatable and the lives of black women can be saved .

About the health imperative for black women
The Black Women’s Health Imperative (BWHI) is the only national not-for-profit organization dedicated to promoting health equity and social justice for black women across the lifespan through politics, advocacy, education, research, and leadership development. BWHI identifies the most pressing health problems affecting the country’s 22 million black women and girls and invests in the best strategies and organizations that achieve their goals.

About Hologic’s Health Justice Project
Project Health Equality (PHE) is a multi-faceted, multi-year initiative by Hologic, Inc. that uniquely combines research, education, and access to overcome the structural and cultural barriers that prevent Black and Hispanic women from enjoying the same quality of health care how to get white women. The initiative seeks an immediate change in the way thousands of black and Hispanic women experience health care in cities across Europe The United States, and engages key partners like BWHI and RAD-AID to drive meaningful, sustainable change for these communities.

BWHI media contact:
Shana Davis
678.523.4364 (mobile)
[email protected]

Hologic media contact:
Jane Mazur
508.263.8764 (direct)
585.355.5978 (mobile)
[email protected]

References

  1. Beavis AL, Gravitt PE. Hysterectomy-corrected cervical cancer death rates show greater racial gaps in the United States. Cancer. 2017; 123 (6): 1044-1050.
  2. Olusola P, Banerjee HN, Philley JV, Dasgupta S. human Papillomavirus-Associated Cervical Cancer and Health Differences. Cells. 2019; 8 (6): 622. doi: 10.3390 / cells8060622.
  3. Arvizo C, Madhi H. Disparities in Cervical Cancer in African American Women: What General Practitioners Can Do. Clev-Klinik J Med. 2017; 84 (10): 788-794
  4. Centers for Disease Control and Prevention. Basic information about cervical cancer. https://www.cdc.gov/cancer/cervical/basic_info/index.htm. Accessed June 15, 2021
  5. American College of Obstetrician and Gynecologist. Women doctors in health care. https://www.acog.org/clinical/clinical-guidance/practice-advisory/articles/2021/04/updated-cervical-cancer-screening-guidelines. Released April 2021. Accessed June 18, 2021.
  6. Kaufmann H. et al. Contributions of liquid-based (Papanicolaou) cytology and human papillomavirus testing in Cotesting for the detection of cervical and precancerous cancer in The United States. Am J Clin Pathol. 2020: 154; 4: 510-516.
  7. Austin RM, et al. Improved detection of cervical and precancerous cancer through the use of liquid imaging cytology in routine cytology and HPV cotesting. At J Obstet Gynecol. 2018; 150 (5): 385-392.
  8. National Health Institute. Medline Plus magazine. HPV and Cervical Cancer: What You Need To Know. https://magazine.medlineplus.gov/article/hpv-and-cervical-cancer-what-you-need-to-know. Accessed June 15, 2021.
  9. Centers for Disease Control and Prevention. Genital HPV Infection – CDC Information Sheet. https://www.cdc.gov/std/hpv/hpv-Fs-Juli-2017.pdf. Accessed June 15, 2021.

SOURCE health imperative for black women; Hologics project health justice

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Women’s Health

How shame around women’s health led me to create a DEI policy for all | Analysis

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I am an oversharer. That’s why I have absolutely no qualms about talking to anyone who’ll listen to me about my period. Whether painful, difficult or just gross, I am not afraid to go into detail, even at work.

One of the reasons I love talking about my period is because it has been incredibly painful for the past four years. It’s almost impossible for me not to talk about it because once a month I have pain, squirm, can’t move or, in the worst case, pass out if I don’t get to the pain medication quickly enough. I really struggled with that because, as you’d expect from a production manager in a fast-paced advertising company, I don’t want to be held back by anything and it frustrates me that I have to take things slower or worse for a few days once a month, don’t show up once.

But when it first happened at Contented, I made a conscious effort to tell my bosses (all men) exactly why I would be late for work that day and to tell my colleagues why I was holding a hot water bottle on mine Desk sat. It was really important to me not to lie and just as important to see that they take it seriously. They never made me feel guilty, ashamed, or in trouble, which was a great relief.

But I seem to be in the minority because, according to a study by Bloody Good Period, “nine out of 10 of those who menstruate say they have menstrual anxiety at work”.. Your campaign with the title “No Shame Here” culminated in one incredible music video (Pictured above), which was released on Menstrual Health Day and aimed to reduce the shame associated with menstruation and get society to accept this natural biological process.

And it’s not just periods that we have a problem with. In her recent Channel 4 documentary Sex, Myths & the Menopause, Davina McCall stated that nine out of ten women thought menopause was having a negative impact on their working lives, but only one in 10 companies had a working menopausal policy.

Why is there so much shame? And why are we so afraid to talk about women’s health in the workplace? Because traditionally, our jobs in this area have never really been safe places. We keep it quiet because we fear for our jobs (Just take a look at some of the Real stories on pregnant, then screwed). We keep silent because often there is no one in the industry to speak to without fear or embarrassment, and there are also HR policies that address our issues.

Now that I’ve come to a point in my career where I can make change happen, I’ve recognized the real need for workplace policies that fully embrace women’s health in an inclusive and empathic way. So I set out to write one.

In collaboration with Lucy Barker, a consultant from Human Nature HR, we talked a lot about Contented and its culture and how I wanted to translate the openness, empathy and support I experienced there into a workplace policy. It helped me realize that while I thought this was going to be a women’s health policy, it actually translated into a full D&I policy because we could apply the same mindset to all areas of life where work and home meet overlap.

Our policies therefore encompass everything from equal opportunities in hiring to flexible working, gender-neutral language in job descriptions, adoption and fertility treatments, sex reassignment, menstrual health and much more.

The directive goes into detail on how we can aim for a more diverse and gender equitable workplace, not only by empowering women but also by providing opportunities for men. Tangible things like improved motherhood and fatherhood are great, but it’s the intangible support you get from a supportive work culture that is really the backbone of our politics. No matter what you are going through, come and talk to us and we will work out something that suits your needs for this time. It’s not a blanket policy, because that’s not how life works, but it is the basis of a positive work culture.

I posted Contented’s policy on LinkedIn and immediately received a barrage of messages from people across the industry who all wanted tips and advice on how to create a policy in their own organization. Here are my top tips for creating an authentic D&I policy:

  • Be ready to listen. The main role of the directive is to give people permission to speak openly about things they need help with and find a way to assist them. If any of our employees dissuade them from reading the guidelines, I hope they know they can talk to either of us about what they’re going through.

  • Be authentic. Make sure it reflects your culture and your people, because a good D&I policy cannot cover up the cracks in a bad work culture.

  • It’s never perfect or finished. An inclusive D&I policy will always be in the works. I’m already working on the next level of our policy to include more about mental health, disability and neurodiversity.

  • Make it public. The hardest part of creating the policy was trying to figure out what the “industry standard” is – but many of the topics we cover don’t exist, so be brave to get your policy out: share it with your co-workers , Your network and the entire industry to inspire and inform others about what industry standards should look like.

You can find ours on our website at https://www.contentedgroup.com/our-policy

Anneka Vestey is Production Manager at Contented.

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Women’s Health

The WHO alcohol-pregnancy warning for childbearing women overlooks men, as usual

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The World Health Organization recommends that “women of childbearing age” be a focus of alcohol prevention efforts whether or not they know they are pregnant. The proposal was included in an early draft of the Organization’s Global Plan of Action on Alcohol, which argued that anti-alcohol campaigns should target women specifically because of the risks alcohol poses to a fetus’ health. Yes, even a fictional, non-existent fetus.

The burden, at least scientifically, doesn’t just lie with the women who choose to drink. But it does in the minds of WHO officials.

The recommendation was immediately rejected after its publication on June 15. “It is extremely worrying to see the World Health Organization jeopardizing the hard-won rights of women by trying to control their bodies and decisions in this way,” Clare Murphy, CEO of the UK pregnancy counseling service, said in a statement. Others shared pictures of their wine glasses and alcoholic beverages on Twitter. As one woman remarked, “I plan to have an alcoholic drink tonight for the fourth night in a row. I don’t usually do that, but as a woman of childbearing age I feel it is my duty. “

Although WHO responded to the outcry by stressing that it “does not recommend all women an age at which they could get pregnant,” it continued that “it is trying to raise awareness of the grave consequences that it is having caused by alcohol consumption during pregnancy, even if the pregnancy is not yet known. “

However, men who drink can also harm fetuses – known or unknown – but they are not mentioned in WHO guidelines. Unintentional as it may be, the message implied is that parenting is a woman’s inevitable purpose rather than a life choice; that our needs come second to the needs of a newborn baby and a family we may or may not have; and that women still do not enjoy the same physical autonomy as the men who can get us pregnant.

An April study of over 520,000 couples found a 35 percent increase in the risk of birth defects if a father drank alcohol regularly up to six months before conception. As the researchers wrote in JAMA, “Our results suggest that future fathers should be encouraged to change their alcohol consumption before conception to reduce fetal risk,” and found that this “significantly increases the risk of birth defects” .

The burden, at least scientifically, doesn’t just lie with the women who choose to drink. However, it does so in the minds of WHO officials, who continue to put all the burden – and guilt – of childbirth on women by highlighting their behavior.

Not only are there similar scientific findings or questions about the effects of fathers’ alcohol consumption on the fetus as that of mothers, there is also much less awareness about it. If WHO really wanted to stimulate thought about the link between alcohol and births, this would be an important point to highlight.

Alcohol can also negatively affect sperm and eggs, but how much publicity and messaging is devoted to the male side of the equation? A 2014 study of 1,221 men ages 18-28 found that even “modest habitual alcohol consumption” had “adverse effects on semen quality” and was linked to changes in men’s testosterone levels. And 15 cross-sectional studies of over 16,000 men in 2016 found that “Alcohol intake has an adverse effect on semen volume,” although it was found that daily alcohol users experienced a greater change in semen health than casual drinkers or those who abstain, suggesting this “Moderate consumption”, which is not done every day, could be safe.

“It’s hard to say because there are certainly other factors that contribute to egg and sperm health,” Dr. Jennifer Butt, an obstetrician and gynecologist practicing in New York City. “So I think it’s difficult to really attribute it to that one habit – drinking. Similar to women, light to moderate drinking is unlikely to affect sperm health. “

Less difficult to determine is how this proposed directive – like rules and regulations aimed at restricting access to birth control, abortion, and other family planning services that affirm a pregnant person’s innate autonomy – women trying to be pregnant and becoming mothers It will hurt just as much as it puts those who don’t.

“Our culture is fantastic at punishing women simply for making choices,” said Dr. Pooja Lakshmin, a state-certified psychiatrist who specializes in women’s psychiatry and perinatal psychiatry. “A devastating effect of these messages – whether it is about alcohol, medication or exercise – is that they lead women to question themselves even more and to internalize misogyny.”

This self-doubt can be most intense when it comes to pregnancy. This country already has a deep misconception about what causes miscarriage and infertility – for example, chromosomal abnormalities cause at least 60 percent of miscarriages, but a 2015 study of 1,084 adults found that 75 percent of participants believed a miscarriage was the result a stressful one, while 64 percent accused a woman of lifting something heavy and 22 percent thought it was the result of lifestyle choices such as smoking and drinking.

While studies have shown that alcohol can increase the risk of miscarriage, infections, hormonal irregularities, problems with contraceptive implants, and increased caffeine consumption can also increase the risk of miscarriage. However, the WHO has not yet issued a statement on the harm that overcaffeinated, potentially pregnant women can do to fetuses.

“When someone is faced with a miscarriage or infertility, it feels almost natural to reflect on yourself and see what might have ‘gone wrong’,” noted Butt. But she warned, “There really are a variety of factors and sometimes there may or may not be an explanation.” However, treating any woman who drinks as a potential incubator that could harm a fetus, possibly existing or non-existent, without including her male sexual partners in the conversation, means blaming women for a reproductive outcome that was not in a live birth.

And “women of childbearing age” are not pre-pregnancy women. We are women. Women who want to get pregnant but can’t get pregnant, or get pregnant and unable to carry that pregnancy to term, or simply don’t want to get pregnant, are not failures to experience the consequences of their actions. They are simply women who experience a variety of reproductive outcomes, all of which are common and often unpredictable.

“One of the central psychological questions that arises in pregnancy and motherhood is, ‘Can I satisfy my own needs when I am responsible for the needs of another person?'” Said Lakshmin. Men should ask this question too.

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