Andrea L. DeMaria

Prevalence and correlates of pubic hair grooming among low-income Hispanic, Black, and White women

The purpose of this paper was to describe pubic hair grooming behaviors (shaving, waxing, trimming or dyeing) and the extent to which grooming was related to demographic characteristics and sexual history among low-income Hispanic, Black, and White women. Data were collected from 1677 women aged 16-40 years between July 2010 and August 2011 as part of a larger study. Participants completed a cross-sectional written survey. Multivariable analyses were used to identify correlates of pubic hair grooming. Being a current groomer was associated with being White, a younger age, under or normal weight, having a yearly household income >

Association Between Body Mass Index, Sexually Transmitted Infections, and Contraceptive Compliance

30,000, and having 5 or more lifetime sexual partners. Overall, we discovered pubic hair grooming was extremely common among women of varying demographics. It is important for health and research professionals to understand pubic hair grooming practices so they can address behavioral and clinical concerns.

Integrating Pregnancy Ambivalence and Effectiveness in Contraceptive Choice

BACKGROUND Recent studies have examined the relationship between body mass index (BMI) and sexual behaviors, but little information exists on this relationship among racially diverse, low-income women using objectively measured clinical data. The purpose of this study was to examine the association between BMI and sexual behaviors, rates of sexually transmitted infections (STIs) and unintended pregnancy, and contraceptive adherence among adolescent and young adult women. METHODS As part of a larger study, 1,015 Hispanic (54.2%), Black (18.6%) and White (24.8%) women aged 16 to 24 years seeking family planning services at publicly funded reproductive health clinics provided data on their baseline sexual behaviors, and contraceptive use and pregnancy history over 12 months. Objective clinical data were available from medical records at baseline (i.e., height, weight, and Papanicolaou [Pap] smear results), and over a 12-month period (i.e., STI results). Multivariable analyses were used to compare sexual behaviors, STI rates, contraceptive compliance, and unintended pregnancy rates between obese, overweight, and normal weight participants after adjusting for age, race/ethnicity, and other confounders. RESULTS Overall, 423 (36.6%), 304 (26.3%), and 288 (24.9%) participants were classified as normal weight, overweight, and obese, respectively. No statistically significant association was observed between BMI and sexual behaviors, STI rates (overweight odds ratio [OR] 0.67; 95% confidence interval [95% CI] [0.4, 1.08]; obese OR 0.68; 95% CI [0.42, 1.10]); contraceptive compliance (overweight OR 0.89; 95% CI [0.69, 1.16]; obese OR 0.89; 95% CI 0.68, 1.16]), or unintended pregnancy (overweight OR 1.08 95% CI [0.73, 1.60]; obese OR 1.09; 95% CI [0.72, 1.63]). CONCLUSION STI history and contraceptive compliance did not vary by BMI. Therefore, all women should receive equal contraceptive counseling (including condoms) to reduce the risk of unplanned pregnancy and STIs.

Perceptions and correlates of pubic hair removal and grooming among college-aged women: a mixed methods approach

ABSTRACT Approximately 70% of pregnancies among young unmarried women living in the United States are unintended. Unintended pregnancy results in negative health and economic outcomes for infants, children, women, and families. Further research into the decision-making process of contraceptive selection is needed to meet young women’s contraceptive needs in the United States. Overall, 53 women ages 18–24 years completed in-depth qualitative interviews. Researchers used analytical techniques from grounded theory and HyperRESEARCH 3.5.2 qualitative data analysis software to identify emergent themes. Problematic integration theory provided a theoretical lens to identify young women’s probabilistic and evaluative orientations toward contraception. Researchers identified two profound values at stake to participants regarding their contraceptive decisions: avoiding pregnancy in the present, and protecting future fertility. Participants resisted long-acting reversible contraception (LARC) methods (e.g., the intrauterine device and the implant) due to concerns about safety and fears about infertility. Participants experienced ambivalence toward the idea of pregnancy, which complicated contraceptive decisions, especially regarding long-term methods. Uncertainty led participants to rationalize their use of less effective methods and reduced information seeking. Findings from this study offer practical suggestions for practitioners and health communication campaign planners. Contraceptive access campaigns should focus on the effectiveness, safety, and convenience of LARC methods. Messages should help young women make contraceptive choices that better fit their needs in order to reduce unintended pregnancy.

Protecting the Next Generation Elaborating the Health Belief Model to Increase HPV Vaccination Among College-Age Women

UNLABELLED Background Although much is known about behavioural indicators of pubic hair removal, current research lacks deeper cognitive reasoning and understanding through utilising quantitative and qualitative methodologies. The purpose of this study was to: (1) describe and understand pubic hair removal behaviours using a quantitative survey; and (2) examine the relationship between pubic hair removal, sexual behaviours and genital self-image using in-depth interviews. METHODS Data were collected from women aged 18-24 years living in the United States. Overall, 663 participants completed an online survey and 53 completed in-depth interviews. Questions asked related to pubic hair removal and sexual history. RESULTS Participants removed hair for hygiene, comfort and sensation purposes, which was a personal decision influenced by family, friends and the media. Race, pubic hair removal initiation age, genital image and sexual behaviours were significantly related to pubic hair removal. CONCLUSIONS Data from this study prove that further education regarding safe pubic hair removal methods is needed, especially for those who initiate pubic hair removal and sexual behaviours concurrently.

It’s Not My Place: Formative Evaluation Research to Design a Bystander Intervention Campaign:

This study guides social marketing campaigns to increase human papillomavirus (HPV) vaccination among young women by elaborating the health belief model (HBM). A self-administered, anonymous, web-based questionnaire was e-mailed to all entering female college students at a large, public university in the mid-Atlantic region of the United States. Findings elaborate the HBM constructs of perceived threat, benefits, barriers, and cues to action. Almost all participants had heard about the HPV vaccine and the majority of first-year students had received at least one shot in the vaccination series. Results expand understandings of perceived threat in relation to the HPV vaccine by explicating misinformation and knowledge gaps. Participants indicated that parents and physicians were their most trusted sources of vaccine information. Television and Internet cues to action were negatively associated with HPV vaccination among these women. Structural equation modeling results affirmed the HBM’s fit (comparative fit index = 0.935, normative fit index = 0.921, and root mean square error of approximation = 0.077). This finding suggests the importance of multimodal sources of information, expanding the dichotomous internal and external cues to action. Perceptions of vaccine safety remained a significant barrier to the uptake of HPV vaccination among participants. Racial disparities between White and non-White students could have a considerable impact on the established inequality in HPV vaccination rates in the United States. Results inform future social marketing campaign messages and strategies based on the HBM.

‘Everyone wants a community’: a qualitative investigation of the challenges and service needs among college students in recovery

Sexual misconduct remains a problem on college campuses despite years of documentation and research, and program development and implementation. The purpose of this study was to conduct systematic theory-based formative audience research to understand how college women and men make meaning of sexual assault and bystander intervention. A total of 69 men and women aged 18 to 24 years participated in eight gender-specific focus group discussions. A grounded theory approach was used to identify patterns and themes across the data. Themes emerging from the data included the following: (a) female participants’ experiences of sexism and misogyny, (b) the myth that rape is falsely reported, (c) complex understandings of consent and entitlement, (d) the reluctance to stop someone from having a “good time,” (e) the role of alcohol as a moderating factor in sexual misconduct and bystander intervention, and (f) preference for direct and impactful messaging. This study informs researchers and practitioners about college students’ perceptions of, and experiences with, bystander intervention and sexual assault. Practitioners can use this information to develop effective mixed media, campus-wide social marketing campaigns.

“It Makes You Rethink Your Choice of the Pill”: Theory-Based Formative Research to Design a Contraceptive Choice Campaign

Abstract Background: Problem drinking and illicit drug use is prevalent among college students, which can pose challenges for students in recovery from substance use disorders (SUDs). Collegiate recovery programs (CRPs) are emerging across the U.S. in order to provide support services for these students. Yet the population of college students in recovery still remains understudied. The objectives of this research were to explore (1) perceived service needs, and (2) opinions about the logistics of a CRP among a sample of college students in recovery. Methods: Semi-structured interviews were conducted with 13 students who self-identified as being in recovery from SUDs. Interviews were transcribed and coded using content analysis. Results: The sample of students was slightly older than traditional college students (M= 25 years). Due to age and lifestyle differences, such as sobriety, these students often felt isolated and unable to relate to the wider student body. Students also felt limited in their options for recovery support services and they expressed the desire for a formalized on-campus community, such as a CRP. Most stressed that a CRP should have flexibility in program acceptance and maintenance in order to serve all students in need. Conclusions: The results suggest the need to for college campuses, both in the US and abroad, to conduct assessments of the perceived need for recovery support services among students. While substance abuse services may be available, students may not feel they are adequate to support their unique needs as both as a student and in recovery from SUDs.

A qualitative analysis of postpartum contraceptive choice

Half of all pregnancies in the United States remain unplanned despite improved access to highly effective long-acting reversible contraception, including the intrauterine device and the implant. This study conducted theory-based formative research to develop a contraceptive choice campaign aimed at increasing long-acting reversible contraception uptake by women ages 18–44 years in Charleston, South Carolina, an urban area in the southeastern United States. Researchers developed and tested message concepts and designs. Six focus groups and 18 interviews were conducted among reproductive-age women (n = 79). Qualitative data analysis revealed messages and designs that resonated with these women. Emphasizing long-acting reversible contraception as the healthy option, highlighting long-acting reversible contraception effectiveness, including relatable and trustworthy characters, and using language of control emerged as themes. Women reported a preference for statistics illustrating effectiveness combined with empowering messages of control over contraceptive decision making. Findings from this study offer practical recommendations for developing contraceptive choice campaigns targeting long-acting reversible contraception use and further the goal of reducing unintended pregnancy among women.

It’s Your Place: Development and Evaluation of an Evidence-Based Bystander Intervention Campaign

ABSTRACT Background: The World Health Organization recommends a minimum 24-month birth-to-pregnancy interval to improve maternal and child health. Postpartum contraception is a mechanism to achieve optimal birth spacing and prevent unintended pregnancy, which may reduce health disparities and inequalities in health status among new mothers and their children. This study investigated women’s communication channel preferences, as well as patient engagement and shared decision making about contraceptive method choice and use in the postpartum period. Method: Researchers conducted six focus groups with 47 women receiving postpartum care at an outpatient clinic. A semi-structured focus group protocol was created and tested. A constant comparative approach provided an inductive method of analysis. HyperRESEARCH 3.5.2 qualitative data analysis software facilitated coding based on the health belief model. Results: Participants included women 18–39 years of age with an average of 1.7 children. The majority of participants utilized Medicaid (53%) and self-identified as Black (49%) or White (43%). Participants discussed interpersonal, mass media, and new media channels featuring messages about contraception, including long-acting reversible contraception (LARC). These women negotiated complex social norms, including preferring the Internet as a primary source of information and avoiding mass media. Participants balanced messages from social networks, including physician counseling and the power of personal experiences of friends and family in contraceptive decision making. Conclusions: This study demonstrated women perceive the voices of lay experts online as the most influential source of information and prefer to receive contraceptive information online and in-person during the prenatal and postpartum period.