VIRTUAL POSTER PRESENTATIONS
POSTER 1
Sexual Assault Nurse Examiner Programs and Their Impact on Prosecutorial Outcomes in the United States
Presenter: Shannon Carey, BSN, RN, CEN, Clinical Nurse Coordinator, Sue & Bill Gross School of Nursing, UC Irvine
Background and Significance: Victims of sexual assault require a highly specialized type of support in the immediate hours following the violent crime that traditional emergency department settings do not provide. This support is found at the complicated intersection of healthcare, public health safety and the judicial system and is reflected in the multifaceted field of the sexual assault nurse examiner (SANE). Sexual assault nurse examiners (SANEs) are registered nurses with expert training in collecting forensic evidence, assessing, treating and compassionately caring for patients who have experienced sexual assault.
Methods: This paper reviews 3 robust quasi-experimentally designed studies on the effectiveness of SANE programs on prosecutorial outcomes. The reviewed studies support the statistically significant impact that SANEs have on the prosecutorial rate and improved case progression through the judicial system.
Findings & Implications for Women’s Health: The reviewed studies support the statistically significant impact that SANEs have on the prosecutorial rate and improved case progression through the judicial system. As registered nurses, advocacy for the highest quality of healthcare, especially in issues of human rights violations, is part of the ethical responsibilities of nurses. From this literature review it is clear more research is needed to improve methodologies in order to promote implementation of SANE programs nationally as the gold standard clinical practice for post-sexual assault victim care.
Contact: Shannon Carey at scarey@hs.uci.edu
POSTER 2
Structural Violence: A concept analysis
Presenter: Claire Gilpin, Nursing Student, Sue & Bill Gross School of Nursing, UC Irvine
Background and Significance: With roots often ascribed to the 1969 work of Johan Galtung, “Violence, Peace, and Peace Research,” the term structural violence can be thought of as violence perpetrated against individuals or groups where there is no direct “actor” committing the violence (Galtung, 1969). Explorations of structural violence help us understand how societal structures – social, political, economic, etc. and the intersections of social, cultural, and economic factors – create conditions that heighten individual’s or groups’ vulnerability to experiencing violence. Through research conducted by many scholars across disciplines, from the social sciences to the health sciences, it has become evident that exposure to the effects of structural violence should be thought of as a social determinant of health. The effects of structural violence are particularly damaging to women on a global stage, from heightened risk of exposure to intimate partner violence among women from lower socioeconomic castes in India, to higher rates of maternal and infant death among African American women in California, to barriers to accessing HIV-related care for lesbian, bisexual, transgender, and queer (LBTQ) women (California Health Care Foundation, 2019; Krishnan, 2005; Logie, James, Tharao, and Loutfy, 2012). Enhancing understanding of structural violence among women’s health care providers will be beneficial for patients, both in Orange County and beyond. We will present a brief concept analysis of structural violence in the context of women’s healthcare with the goal of enhancing understanding of this important concept for women’s healthcare providers in Orange County.
Methods: The concept analysis was conducted using methods from Walker and Avant (2019).
Findings: The effects of structural violence have an impact on women’s health and can be viewed as a social determinant of health.
Implications for Women's Health: Structural violence may create barriers to overall health and wellbeing and to accessing care for women.
Contact: Claire Gilpin at gilpinc@uci.edu
POSTER 3
Advancing Breast Health Equity for African American Women during the COVID-19 Pandemic
Presenter: Kristen Hobbs, MPH, Program Evaluation, Susan G. Komen Global Headquarters
Background and Significance: African American women in the Los Angeles and Orange County metropolitan area are 55% more likely to die of breast cancer and 22% more likely to be diagnosed at a later stage of breast cancer than their white counterparts. This is simply unacceptable to Susan G. Komen®. We have embarked on a landscape analysis to collect both quantitative and qualitative data to determine the systemic drivers of these disparities. Likewise, we understand that the same systemic drivers creating these breast cancer disparities are being perpetuated in the COVID-19 pandemic; a parallel and unfortunate truth.
Methods: The Komen African American Health Equity Initiative (AAHEI) team partnered with public health consultants from John Snow, Inc. (JSI) for this analysis. Secondary quantitative data were collected from publicly available public health sources. To compliment these data, the JSI team conducted six focus groups, including survivors, undiagnosed women and patient/community health navigators, two provider interviews and one patient/community navigator interviews, building a narrative to understand the systemic drivers of these disparities. Likewise, JSI conducted a thorough policy analysis of the local, state and federal policies at play that impact the systemic and social determinants of health.
Findings: Preliminary quantitative findings for the Los Angeles and Orange County metropolitan area show a markedly contrasting difference in both late-stage diagnosis and mortality rates among black and white women in the metropolitan area. Black women in Los Angeles county have an age-adjusted, per 100,000 late stage diagnosis rate of 48.6 as compared to that of white women at 42.1. Black women in Los Angeles county are also more likely to die of breast cancer at an age-adjusted rate of 30.9, as compared to the mortality rate of white women Los Angeles county at 20.4. Likewise, the age-adjusted late-stage diagnosis rate for black women in Orange county is 46.2, while the late-stage diagnosis rate for white women is 43.2. And lastly, which enumerates the most stark disparity, black women in Orange county die from breast cancer at a rate of 28.9, while white women die from breast cancer at a rate of 19. This glaring disparities underscore the need to advance breast health equity for African American women in the Los Angeles and Orange County metropolitan area.
Implications for Women’s Health: This landscape analysis will support and inform the direction of community-led breast health equity interventions in the Los Angeles and Orange County metropolitan area.
Contact: Kristin Hobbs at KHobbs@komen.org
POSTER 4
Negative Expectancy Violation in NICU Mothers
Presenter: Sarah Rodrigues, BSN, RN, PhD student and Clinical Nurse II, Sue & Bill Gross School of Nursing, UC Irvine
Background and Significance: NICU mothers are at increased risk for psychological distress (Treyvaud, 2019), which can negatively affect overall family functioning, mother–infant bonding, and lead to adverse infant and childhood developmental outcomes (Woodward et al., 2014). However, predicting which mothers are at greatest risk for experiencing high levels of distress during infant NICU hospitalization remains challenging. Negative expectancy violation (NEV) is a construct offering broad predictive potential in this population. Applying NEV to the NICU setting, mothers may be tasked with the sudden need to revise prenatal expectations of the infant and parenting to match the postpartum reality, resulting in arousal and cognitive appraisals of violation (Flykt, 2014). NEV is congruent with the literature reporting NICU-related maternal distress across a range of domains and has the potential to encompass NICU maternal experiences broadly.
Methods: The objective of this study is to construct a retrospective measure which captures the construct of NEV in NICU mothers. Qualitative interviews will be conducted with mothers of infants post-NICU discharge. Maternal narratives will be coded to elucidate themes of negative EV in this population, which will be used to inform development of a preliminary retrospective measure of NEV. This measure will subsequently undergo evaluation and rating by experts and pilot testing in a sample of NICU mothers.
Implications for Women’s Health: Reconceptualizing NICU-related maternal distress through the lens of NEV may offer a pragmatic path forward in identifying mothers at risk for experiencing a more stressful trajectory during infant NICU hospitalization, ultimately improving long-term family and child outcomes in this population.
Contact: Sarah Rodrigues at sarahmr@uci.edu
POSTER 5
Surveillance of Vaccine Adverse Events in Pregnant Women reported to the Vaccine Adverse Events Reporting System (2010-2019)
Presenter: Salena Marie Preciado, MS, PhD Student, Social Administrative Sciences, Chapman University School of Pharmacy
Background and Significance: Vaccination during pregnancy has the potential to protect the mother and infant against vaccine-preventable diseases. This study assesses the safety of vaccines administered to pregnant women by analyzing reports to the Vaccine Adverse Events Reporting System (VAERS) in the US from 2010-2019.
Methods: We conducted a review to identify pregnancy reports for women 12-44 years using text string searching for “preg” in the Medical Dictionary for Regulatory Activities (MedDRA) terms. Pregnancy-related AEs were categorized as serious and non-serious. We assessed reporting rates to characterize AEs by vaccine type and severity status. Proportional reporting ratios (PRR) were calculated for reported preferred terms to assess for disproportionately higher reporting of AEs. Signal criteria for disproportionality was set at PRR≥2, number of reports≥3.
Findings: VAERS received 3,846 reports for pregnant women. 1,042 (27%) mentioned a serious AE and 1,012 (26%) mentioned a pregnancy-related serious AE. Frequent reports of AEs were for human papillomavirus (n=955), tetanus toxoid, diphtheria toxoid and acellular pertussis (n=589), and varivax-varicella virus (n=467) vaccines. Pregnancy-related serious AEs included 862 spontaneous abortions, 292 miscarriages, 63 stillbirths, 51 preterm deliveries, 11 preterm labors, and 8 birth defects. Outcomes of serious AEs included 5 (0.1%) deaths, 36 (0.9%) life threatening, 892 (23%) emergency room visits, 223 (5.8%) hospitalization, and 42 (1.1%) disability. PRR screening criteria were met for a Tdap vaccine and preterm labor (PRR 3.1; 95%CI 1.7-5.8). No direct link of adverse events and vaccines were found for pregnant women.
Implications for Women’s Health: Confounding variables such as prior medical conditions, reporting biases, and spontaneous reporting may be contributing to the reported vaccine adverse events and no vaccine safety concerns were found among pregnant women. This review of VAERS reports confirms the safety of vaccination during pregnancy.
Contact: Salena Marie Preciado at spreciado@chapman.edu
POSTER 6
Understanding the Acculturation of South Asian Immigrant Women in the United States
Presenter: Payal Sawhney, MSW, MHA, LISW-S, LCSW, President, SAAHAS For Cause
Background & Significance: The United States has the largest immigrant population in the world with over 61.6 million immigrants (Center for Immigration Studies). There are now over 5 million South Asians who call the U.S. home. Women comprise a large portion of the immigrated South Asian population in the U.S. The disparity between the South Asian and American culture creates the need to acculturate upon migration to the U.S. Acculturation is defined as a process of social, financial, psychological, and cultural change that stems from the balancing of two cultures (home country and host country) while adapting to the prevailing culture of the society. South Asian women Immigrants have been seen to be most affected by the acculturation process as they have additional responsibility, compared to south Asian men, of being primary transmitters of culture, values, and traditions to their families and have the hardest time adapting to the host county’s cultural values (Pew Research Center). Therefore, the major focus of this study is understanding the acculturation of first-generation South Asians immigrant women in light of the Berry’ bidimensional model and to explore various socioeconomic and demographic correlates of the sample. We are interested in seeing what portion of the population has had an easy or difficult time acculturating into the American culture. Common acculturation indicators include attitudes about the practice of common South Asian traditions in the U.S., types of food eaten at home and in restaurants, and ethnic composition of one’s social network. This study will be administered through the Clinicians, trained professionals, and interning students. We understand that there have been surveys looking at immigrants acculturating to the U.S., however very few have been performed directly looking at first-generation South Asians immigrant women.
Methods: Data will be collected using a web-based acculturation survey which comprises a socio-demographic form and an 18-question acculturation survey. The sample will be recruited through various web portals that serve the South Asian women population. Since this study aims at understanding specific research questions, purposive sampling will be used as the criteria for the selection of respondents are being a first-generation South Asian woman living in the U.S. and ages above 18. Berry’s Model of Acculturation that describes the acculturation process in 4 different ways: Assimilation, Integration, Separation, and Marginalization will be used to understand the acculturation strategies. Additionally, we will study the key factors contributing to the integration strategy of the South Asian immigrant women. The results will be analyzed and discussed using descriptive statistics and latent class analysis.
Findings: In our study we surveyed 67 women and noticed that 91% of the respondents were married, with 46% unemployed and 41% employed. The most common age range of participants was between 40 and 50 years old. In addition, most of the participants (46%) migrated to the United States at the youngest age, between 18-25 years old. Through Latent Class Analysis we found that only separation, integration, and assimilation strategies were used by the participants, while marginalization was not statistically significant. 30% of the participants adopted the separation strategy, 25 % adopted the Assimilation strategy. The most common acculturation strategy used was integration at 44.% of the time. Married women who are educated are most likely to adopt the integration strategy of acculturation. Acculturated women who felt very comfortable visiting their physician for physical or mental health needs mostly fell under the integration strategy. Additionally women with an education level greater than a master’s degree appear to be well integrated. Participants living with spouses and kids appear to be better integrated (N=35) and are more likely to seek professional help. Results will continue to be discussed in the light of women’s marital, educational, visa, and employment status, along with the acculturative strategy most adopted by them.
Implications for Women’s Health: This research is a part of a long-term project which is intended to lay the groundwork for future research on acculturation and mental health among South Asian immigrants in the U.S. The findings of this research will help develop a framework and conceptual model for women's mental health and domestic violence prevention program.
Contact: Payal Shawney at mrskohlimha@gmail.com