Jennifer Hebert-Beirne

Knowledge and perceptions of pelvic floor disorders among african american and latina women.

Objective: The objective of this study was to explore knowledge, barriers to seeking sociocultural perceptions of pelvic floor disorders (PFDs) among African American (AA) and Latina (LA) community-dwelling women. Methods: Thirty-two women participated in 4 focus groups. The sample included AA and LA women aged 24 to 77 years. Focus groups were stratified by age and race/ethnicity. Discussion questions included knowledge of and related health needs and barriers to seeking care with respect to PFDs, urinary incontinence, and pelvic organ prolapse. Demographics and basic knowledge and experience with PFDs were also captured by survey. Results: Several significant themes emerged from the data. AA and LA women had general misconceptions about PFDs and were unaware of PFDs causes, symptoms, and available treatments. Women were eager to receive more information, particularly prevention information that could be shared with their daughters. A major barrier to seeking care was the pattern of placing family demands before their own health needs. Conclusions: Findings suggest that there is a gap in information on PFDs among AA and LA women, yet a demand for information exists. Sociocultural perspectives discerned from focus group with AA and LA women can be used to tailor educational information and materials on PFDs. Findings may increase health provider awareness of the unique sociocultural barriers to seeking care for AA and LA women and improve patient education on PFDs.

A Pelvic Floor Fitness Program for Older Women With Urinary Symptoms: A Feasibility Study

To determine the feasibility of an adapted pelvic fitness and educational program to control urinary incontinence (UI) and overactive bladder (OAB) symptoms in women older than 65 years.

A Qualitative Study to Understand Nativity Differences in Breastfeeding Behaviors Among Middle-Class African American and African-Born Women

Objective To explore nativity differences and the role of attitudes, social norms, and behavioral control perceptions surrounding breastfeeding initiation and duration among middle-class African-American (AA) and African-born (AB) mothers in the US. Methods Semi-structured individual interviews were conducted with 20 middle-class AA and AB mothers in central Ohio from December 2012 to February 2013. Interview questions were developed based on the Theory of Planned Behavior (TPB). Interviews were analyzed for salient themes by TPB constructs. Differences in themes were examined by nativity status. Results All study participants had initiated breastfeeding or bottle-feeding with expressed breast milk, noting the benefits it conferred as well as the persuasive encouragement they received from others. Persistent encouragement was often cited as a factor for sustaining breastfeeding. More AA mothers had discontinued breastfeeding by the time of the interview, which was often attributed to health, lactation, and work challenges. Inconsistent support from health providers, dissuasive remarks from others, ambivalent breastfeeding attitudes, and diminished family support led some mothers to begin formula supplementation. Analysis of maternal narratives revealed nativity differences across sources of encouragement. Specifically, important sources of encouragement were health providers for AA mothers and family, friends, partners and culture for AB mothers. Only AB mothers expressed concerns about difficulty they encountered with breastfeeding due to the lack of proximal family support. Conclusions Findings reveal that both groups of mothers may be susceptible to unsupportive breastfeeding norms in the US and also highlight the need for intervention in health care settings and workplaces to improve AA women’s breastfeeding rates.

Association of neighborhood crime with asthma and asthma morbidity among Mexican American children in Chicago, Illinois

BACKGROUND There is increasing evidence that neighborhood-level factors, in addition to individual-level factors, may contribute directly or indirectly to childhood asthma by affecting environmental and lifestyle factors. Exposure to neighborhood crime and violence has been associated with poor health outcomes, especially among underserved and minority populations, and its effect on respiratory health is an area of active research. OBJECTIVE To examine the association of residential neighborhood crime with asthma and asthma-related outcomes among Mexican American children. METHODS This cross-sectional study was conducted with parents of 2,023 Mexican American children. We derived measures of neighborhood (census tract) violent, property, and drug abuse crime and used multilevel generalized estimating equations to test associations of neighborhood crime counts with respiratory conditions. RESULTS In multiple regression models, a 1-SD increase in neighborhood property crimes significantly increased the odds of lifetime asthma, lifetime wheezing, lifetime emergency department (ED) visits attributable to asthma or wheezing, and lifetime hospitalization attributable to asthma or wheezing by 25%, 18%, 44%, and 62%, respectively. A 1-SD elevation in neighborhood violent crime was positively and significantly associated with 21% and 57% higher odds of lifetime wheezing and ED visits, respectively. We also observed 13% and 44% significantly increased odds of lifetime wheezing and ED visits, respectively, for a 1-SD increase in drug abuse crime. These findings were not explained or modified by individual- and neighborhood-level covariates. CONCLUSION Higher neighborhood crime was associated with greater odds of asthma and asthma morbidity in Mexican American children.

Partner development praxis: The use of transformative communication spaces in a community-academic participatory action research effort in a Mexican ethnic enclave in Chicago

Trusting, productive relationships between traditionally discordant stakeholders—community members and researchers—are critical for successful Community-Based Participatory Research. Practical guidance on processes allowing for partner trust-building and collaborative leadership development in Community-Based Participatory Research literature lacks specificity. In this paper, we introduce our praxis of Transformative Communication Spaces to facilitate purposeful, iterative discourse that occurs in, and fuels each research phase. We elaborate on the use of Transformative Communication Spaces through Pláticas de Salud, Oral History Listening Events, and Data Analysis Think Tanks within the framework of our Little Village Participatory Community Health Assessment. We believe the integrity and potential of Community-Based Participatory Research is contingent on the use of Transformative Communication Spaces strategies to foster trusting partnerships necessary for shared learning and co-leadership.

Oral Histories as Critical Qualitative Inquiry in Community Health Assessment

Qualitative methods such as focus groups and interviews are common methodologies employed in participatory approaches to community health assessment to develop effective community health improvement plans. Oral histories are a rarely used form of qualitative inquiry that can enhance community health assessment in multiple ways. Oral histories center residents’ lived experiences, which often reveal more complex social and health phenomena than conventional qualitative inquiry. This article examines an oral history research component of the Little Village Community Health Assessment, a collaborative research effort to promote health equity in an urban, Mexican ethnic enclave. We collected of 32 oral histories from residents to provide deeper, more grounded insight on community needs and assets. We initially used thematic data analysis. After analytic peer debriefings with the analysis team, we found the process inadvertently reductionist and instead opted for community listening events for participatory data analysis, knowledge translation, and dissemination of findings. Oral histories were most meaningful in their original audio form, adding to a holistic understanding of health by giving voice to complex problems while also naming and describing concepts that were culturally unique. Moreover, the oral histories collectively articulated a counternarrative that celebrated community cultural wealth and opposed the mainstream narrative of the community as deprived. We argue for the recognition and practice of oral histories as a more routine form of qualitative inquiry in community health assessment. In the pursuit of health equity and collaboratively working toward social justice, oral histories can push the boundaries of community health assessment research and practice.

Proximity to traffic and asthma among Mexican American children: Independent and interactive effects

Our results show deleterious effects of living closer to traffic on respiratory outcomes among Mexican American children. Some of these effects are exacerbated in children with parental history of asthma or allergies.