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Open Access Publications from the University of California

Scholarly Works (66 results)

  • Article
  • Peer Reviewed
UC San Francisco Previously Published Works (2019)
    Cover page: Establishing an Evidence Base for Meeting the Reproductive Health Needs of Immigrants
    • Thesis
    • Peer Reviewed
    UC San Francisco Electronic Theses and Dissertations (2018)

    Purpose: To explore pregnant women’s acceptability of alcohol, tobacco, and drug use screening and willingness to disclose their use in prenatal care. This research explores seeks to center the voices of pregnant women who are directly impacted by the adverse consequences of screening as central to informing the policies and practices that directly impact them, their health and wellbeing, the care they receive, and the formation of their families.

    Methods: This thesis is a secondary analysis of self-administered iPad surveys and in-clinic structured interviews with 589 pregnant women aged 18 and older, recruited at their first prenatal care visit from four university-affiliated prenatal care facilities in Baltimore, Maryland and Southern Louisiana. Data were analyzed for associations between outcome variables (acceptability of screening and willingness to disclose use) and predictor variables (substance use, previous CPS involvement, and participant characteristics) using Pearson’s chi-squared tests and Fisher’s exact tests.

    Results: A substantial majority of pregnant women found screening acceptable for alcohol (97%), tobacco (98%), and drug use (97%) during prenatal care. Screening for alcohol use was more unacceptable among women who did not report risky alcohol use compared to women who did report risky alcohol use (P = 0.08). Tobacco use, drug use, and previous CPS involvement were not associated with acceptability of screening. A substantial majority of pregnant women reported they are willing to honestly disclose alcohol (99%), tobacco (99%), and drug use (98%). Alcohol, tobacco, and drug use and prior CPS involvement were not associated with the willingness to disclose substance use.

    Conclusion: Pregnant women, including those who reported substance use or prior CPS involvement, found substance use screening in prenatal care acceptable and were willing to honestly disclose their use. In general, women with historical and cultural privilege (white, older, with self- or employment-based insurance) were less willing to honestly disclose their alcohol, tobacco, and drug use. These findings are significant as they challenge widely held perceptions of pregnant women who use drugs, and suggest that verbal screening is acceptable as a means of assessing substance use in prenatal care.

      Cover page: Pregnant Women’s Acceptability of Substance Use Screening and Willingness to Disclose Use in Prenatal Care
      • Article
      • Peer Reviewed
      UC San Francisco Previously Published Works (2022)
        Cover page: The Problem with “Justifying” Abortion: Why Real Reproductive Justice Cannot Be Achieved by Theorizing the Legitimacy of Abortion
        • Article
        • Peer Reviewed
        UC San Francisco Previously Published Works (2019)
          Cover page: The right decisions need the right voices
          • Article
          • Peer Reviewed
          UC San Francisco Previously Published Works (2021)
          It took a white police officer's knee on George Floyd's neck before white people began to reckon with 400 years of slavery and its aftermath, the effects of which Black people have endured for generations. Monuments are being taken down, flags are being redesigned, and institutions that honored those who denied the humanity of Black people are being renamed. Unfortunately for Sandra Bland, Breonna Taylor, Sha-Asia Washington and countless other Black transgender people including those with capacity for pregnancy, there was no justice even prior to the global pandemic of SARS-Cov-2 or coronavirus; namely racism, violence, and the Black Maternal Health crisis that makes it less likely that Black women will survive pregnancy and childbirth. The purpose of this article is to situate the state of Black people with the capacity for pregnancy in the context of these existing crises to illuminate the myths that racism has perpetuated through science, health services provision and policy. The greatest of these is the myth of a default human that can serve as a standard for the rest of the population. This racist ideal underpins education, provision of care, research, policies, and public health praxis. Demolishing the myth starts with acknowledging that Black people are not the architects of their own destruction: the default standard of whiteness is. The article begins with a historical background on how this myth came to be and elucidates the development and perpetuations of the myth of the default human. Next, we present an evidence based scoping review of the literature to summarize current thinking with specific focus on the Black maternal health crisis, we make policy recommendations and retrofits of upstream public health approaches for existing programs toward health equity. We also situate Black maternal health as part of a reproductive justice frame that centers Black women and birthing people's autonomy and agency. In other words, we use the scoping review to end with reimagining public health policy and provide an actionable roadmap to specifically disrupt the myth of the default human and dismantle racism in education, provision of care, research, policies, and public health praxis.
            Cover page: Demolishing the Myth of the Default Human That Is Killing Black Mothers
            • Article
            • Peer Reviewed
            UC San Francisco Previously Published Works (2017)
            Purpose The purpose of this paper is to make a case for novel and innovative reentry programs focused on women of color and to describe policy recommendations that are necessary to support the sustainability of these programs and in turn the success of the women who participate in them. Design/methodology/approach A review and analysis of the literature that described job-training opportunities specifically targeted to women exiting jail and the impact on recidivism provided limited information. The authors developed, implemented, and evaluated doula training program for low-income and women of color to determine if birth work could provide stable income and decrease recidivism. Findings Training low-income formerly incarcerated women to become birth doulas is an innovative strategy to solve employment barriers faced by women reentering communities from jail. Realigning women within communities via birth support to other women also provides culturally relevant and appropriate members of the healthcare team for traditionally vulnerable populations. Doulas are important members of the healthcare workforce and can improve birth outcomes. The authors' work testing doula training, as a reentry vocational program has been successful in producing 16 culturally relevant and appropriate doulas of color that experienced no re-arrests and to date no program participant has experienced recidivism. Originality/value To be successful, the intersections of race, gender, and poverty, for women of color should be considered in the design of reentry programs for individuals exiting jail. The authors' work provided formerly incarcerated and low-income women of color with vocational skills that provide consistent income, serve as a gateway to the health professions, and increase the numbers of well-trained people of color who serve as providers of care.
              Cover page: Making the case for innovative reentry employment programs: previously incarcerated women as birth doulas – a case study
              • Article
              • Peer Reviewed
              UC San Francisco Previously Published Works (2017)

              Objective

              To evaluate the provision of procedural sedation during abortion by expert nurses and to describe the factors that are associated with time to discharge for women who receive this sedation.

              Design

              Retrospective chart review.

              Methods

              Descriptive statistics were generated to describe a retrospective cohort of women presenting for abortion under procedural sedation. Analysis of variance was used to determine significant characteristics that influenced time to discharge.

              Setting

              A single clinical site that employs seven expert nurses.

              Participants

              A total of 194 medical records were available for this analysis.

              Results

              All women were discharged home with accompaniment, and no incidents of respiratory distress or other adverse complications occurred. Most women (n = 136) received at least 150 μg fentanyl and 3 mg midazolam, and 71% of women in the first trimester and 83% of women in the second trimester entered the recovery area with no pain. Variables significantly associated with time spent in the recovery area were gestational age at time of abortion (t = -2.68, p = .008), pain at entry to recovery area (t = -0.254, p = .008), and pain at 15 minutes (t = 0.25, p = .038).

              Conclusion

              Expert nurses can administer procedural sedation for pain control associated with abortion and are capable of monitoring women and helping them return to baseline status after the procedure.
                Cover page: Retrospective Evaluation of the Procedural Sedation Practices of Expert Nurses During Abortion Care
                • Article
                • Peer Reviewed
                UC San Francisco Previously Published Works (2017)
                How African American men and women respond to and manage living with coronary heart disease (CHD) is not well understood despite the well-documented disproportionate burden of CHD and its complications among African Americans in the United States. Through a critical interactionist perspective, we explore illness experiences of African Americans living with CHD and describe a broad range of micro-, meso-, and macro-contextual factors that influence their illness experiences. For participants in this study, CHD has become a "Black disease" wherein certain bodies have become historically and racially marked; a conceptualization maintained and passed on by African Americans themselves. Such findings highlight that CHD is more than a "lifestyle disease" where high-risk behaviors and lack of healthy choices are ultimate culprits. Rather, CHD is perceived by African Americans who have it as yet another product of ongoing racial and socio-structural dynamics through which their health burdens are created, sustained, and reproduced.
                  Cover page: Illness Narratives of African Americans Living With Coronary Heart Disease
                  • Article
                  • Peer Reviewed
                  UC San Francisco Previously Published Works (2020)
                  The philanthropic-industrial complex fosters the belief that the most marginalized communities lack an existing repository of historical and contemporary knowledge to address social and health inequities. In so doing, philanthropy has contributed to the diminishing political power, legitimacy, and effectiveness of community voices and leadership in reproductive equity through research injustice, cultural arrogance, philanthropic redlining, and community harm. Black Feminism and Reproductive Justice, as mutually aligned theories and praxes, are described as new ethical standards for philanthropic accountability. Funders must embody the equity they aspire to see and build through the operationalization of cultural rigor to advance structural equity and racial justice and to sustain community engagement in research.
                    • Article
                    • Peer Reviewed
                    UC San Francisco Previously Published Works (2017)
                    Thoughtful, unbiased, evidence-based content in nursing education is crucial for the development of confident and competent nurses who provide care in every setting. The purpose of this article is twofold: to provide evidence to show that comprehensive sexual and reproductive health care by nurses is informed by educational exposure to content and to provide recommendations for change at the individual, institutional, and structural levels to improve and expand sexual and reproductive health services.
                      Cover page: Expanding Access to Sexual and Reproductive Health Services Through Nursing Education
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