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Background: School nurses play a vital role in ensuring the health and well-being of their students, but little is known about menstrual products and resources available in schools. This study assessed period product resources and needs in Missouri schools from the perspective of school nurses and analyzed differences by district enrollment characteristics. Methods: An electronic survey was emailed to public, charter, private, and parochial school nurses in Missouri who served fourth grade or older. From January through March 2022, 976 self-administered surveys were completed (40% response rate). Logistic regressions examined the associations between student needs and district characteristics. Results: Among the sample, 70.7% knew students who could not afford period products, and 68.0% knew students who had missed school because of their period. When controlling for district size, race/ethnicity, and urban/rural classification, as the percentage free- or reduced-lunch (FRL) eligibility increases in a school, awareness of students struggling to afford products increases (AOR = 1.008, 95% confidence interval 1.000, 1.015). Implications for School Health Policy, Practice, and Equity: School nurses need the resources and educational materials to support students to help reduce menstruation-related absences. Conclusions: Issues of period poverty cut across districts of differing enrollment characteristics, yet FRL percentage is an important predictor.

Menstrual hygiene management (MHM) among female students is a neglected public health issue in the U.S. This study documented period product insecurity, school absenteeism, and use of school resources to obtain period products among high-school students in St. Louis, MO. Female students completed an anonymous, self-administered survey in English (n = 119). Descriptive statistics were used to determine the prevalence of period product need, resources used to obtain period products, and period-related absenteeism. The mean age of participants was 15.78 ± 1.28. Nearly two-thirds (64.4% (95% CI 55.1%-73.0%)) reported period product insecurity. Two-thirds (66.9% (95% CI 57.7%-75.3%)) reported using at least one of the school's resources to obtain period products. One-third of the participants (33.6% (95% CI 25.0%-43.1%)) reported missing school due to a lack of period products. School nurses need to be cognizant of how MHM affects their students' attendance at school and what measures they can take to help reduce menstruation-related absenteeism. [ABSTRACT FROM AUTHOR]

Background: Data documenting period product insecurity, or an inability to access products, in the United States have recently emerged. With multiple years of data now available, we assessed trends in period product insecurity among two nationally representative samples of U.S. adults. Materials and Methods: Data from nationally representative, cross-sectional online surveys conducted in January 2018 and April 2021 were used to run weighted logistic regressions. Those aged 18–49 years and who had menstruated in the past year (n = 922 in 2018; n = 1037 in 2021) were included. Results: In 2021, 59% experienced period product insecurity compared with 53% in 2018. In 2018 (adjusted odds ratio [aOR] 1.91, confidence interval [95% CI]: 1.29–2.83) and 2021 (aOR 1.53, 95% CI: 1.06–2.21), Hispanic respondents were more likely to find products unaffordable. Some college attainment was associated with finding products unaffordable in 2018 (aOR 1.53, 95% CI: 1.00–2.34) and 2021 (aOR 1.97, 95% CI: 1.35–2.88). Participants struggling to purchase products had higher odds of experiencing period product insecurity in 2018 (aOR 11.78, 95% CI: 8.07–17.20) and 2021 (aOR 7.71, 95% CI: 5.44–10.93). Conclusions: Hispanic ethnicity, lower educational attainment, and struggling to purchase period products were strong predictors of finding products unaffordable and experiencing product insecurity in both 2018 and 2021. Policies that improve access to or affordability of period products in the United States are needed to help those most vulnerable. [ABSTRACT FROM AUTHOR]

We evaluated the sustainability of CARE's Community Score Card© (CSC) social accountability approach in Ntcheu, Malawi, approximately 2.5 years after the end of formal intervention activities. Using a cross-sectional, exploratory design, we conducted 41 focus groups with members of Community Health Advisory Groups (CHAGs) and youth groups and 19 semi-structured interviews with local and district government officials, project staff, and national stakeholders to understand how and in what form CSC activities are continuing. Focus groups and interviews were audio-recorded, transcribed and translated into English. Thematic coding was done using Dedoose software. Most groups were continuing to meet and implement the CSC, although some made modifications. CHAGs, youth and local government officials all attributed their continued implementation to the value that they saw in the process that allows marginalized groups within the community, including women and youth, a safe space for sharing their ideas and issues and the initial results this generated. However, lack of access to resources for implementation and challenges in convening and facilitating the interface meeting phase created barriers to continued sustainability. The CSC is sustainable by communities 2.5 years after the end of formal intervention activities. For future interventions, health systems and non-governmental organizations should plan for a transition phase with periodic refresher trainings and a small fund to support implementation, such as refreshments and transportation, to increase the likelihood of community-driven sustainability. [ABSTRACT FROM AUTHOR]

This best practice article explains a Public Health Seminar course that represents an innovative approach to public health pedagogy with demonstrated learning impacts. Reflecting many of the new Council on Education for Public Health competencies, this required course introduces incoming MPH students to the field of public health using a series of classic and contemporary cases, critically analyzed in a small group discussion format. Other modalities include succinct weekly written reflection critiques, rotating faculty discussion leaders, and a final project using various media platforms to communicate case narratives. Key pedagogical elements support students' knowledge and skill acquisition: (1) small group discussion format, (2) case-based learning, (3) integration across MPH curriculum, and (4) communication skill building. The Public Health Seminar course offers the opportunity to motivate students early in a program, engaging them in relevant issues and providing insight into the importance of their MPH learning and public health professional practice. [ABSTRACT FROM AUTHOR]

Physically demanding work carried out during long workdays affects women's health. In rural and agrarian societies, women perform a variety of domestic and productive tasks, often from dawn to dusk, with little or no leisure time. This paper presents the results of a survey of indigenous women in six rural communities in the Ecuadorian highlands. It was conducted to measure the amount of time women spend on physically demanding work in the context of food security, parity outcomes, and access to prenatal health care. The findings demonstrate that these women work very long workdays and also experience food insecurity and poor access to prenatal health care. [ABSTRACT FROM AUTHOR]

Objective. To describe the relationship between exposure to physical and/or sexual intimate partner violence (IPV) and indicators of antenatal care (ANC) service utilization among Honduran women of reproductive age. Methods. Data from the 2011-2012 Honduras Demographic and Health Survey were analyzed to describe the relationship between self-reported exposure to IPV and two ANC outcomes: (1) sufficient ANC visits (defined by the Honduran Ministry of Health as five or more visits) and (2) early ANC initiation (within the first trimester). Multiple logistic regression was used to estimate effects of physical and sexual IPV on the outcomes, controlling for women's age, education, literacy, residence, household size, religion, parity, wealth, husband's age, and husband's education. Results. Of women who were married, had at least one living child 5 years or younger, and completed the IPV module (N = 6 629), 13.5% of them reported any physical IPV, and 4.1% reported both physical and sexual IPV. There was no significant association between IPV and early ANC; however, a significant relationship between IPV and sufficient ANC was found. Women who experienced any physical IPV (adjusted odds ratios (aOR) = 1.25; 95% confidence interval (CI): 1.00-1.56) or sexual IPV (aOR = 1.53; 95% CI: 1.08-2.16) were, respectively, 25% and 53% more likely to receive insufficient ANC. Conclusions. Honduras has one of highest rates of interpersonal violence of any nation in the world. In Honduras, IPV is a contributor to this broader category of interpersonal violence as well as a risk factor for insufficient ANC. Our findings suggest that universal IPV screening during ANC as well as future initiatives aimed at reducing IPV might improve ANC utilization in the country. [ABSTRACT FROM AUTHOR]

Background Few models of how community mobilisation works have been elaborated in the scientific literature, and evaluation of the impact of these programmes on HIV and other health outcomes is extremely limited. Avahan, the India AIDS Initiative, has been implementing community mobilisation as part of its prevention programming with groups of high-risk individuals across six states since 2005. Purpose To articulate a programme theory and evaluation framework for evaluation of Avahan's approach to community mobilisation among female sex workers in four southern states in India. Methods The authors use a goal-based evaluation approach to describe the programme goals and an underlying programme theory that specifies how the programme is expected to work. Using multilevel structural equation modelling with propensity score matching, the evaluation will compare what is observed in the data with the predicted relationships specified by the model. Results The Avahan model of community mobilisation posits that meaningful participation in high-risk group intervention, structural intervention and organisational development activities leads to identification, collectivisation and ownership, which in turn leads to improved programme outcomes. Strong community groups and an enabling environment reinforce social norm and behaviour change outcomes and lead to sustained impact. Discussion Specifying an explicit programme theory can aid in the evaluation of complex interventions, especially when the evaluation design is observational. In addition to articulating Avahan's community mobilisation approach in a model that can be tested, we recommend some specific measures and methods that could be used to improve evaluation efforts in the future. [ABSTRACT FROM AUTHOR]

Objective: To describe the relationship between exposure to physical and/or sexual intimate partner violence (IPV) and indicators of antenatal care (ANC) service utilization among Honduran women of reproductive age., Methods: Data from the 2011-2012 Honduras Demographic and Health Survey were analyzed to describe the relationship between self-reported exposure to IPV and two ANC outcomes: (1) sufficient ANC visits (defined by the Honduran Ministry of Health as five or more visits) and (2) early ANC initiation (within the first trimester). Multiple logistic regression was used to estimate effects of physical and sexual IPV on the outcomes, controlling for women's age, education, literacy, residence, household size, religion, parity, wealth, husband's age, and husband's education., Results: Of women who were married, had at least one living child 5 years or younger, and completed the IPV module (N = 6 629), 13.5% of them reported any physical IPV, and 4.1% reported both physical and sexual IPV. There was no significant association between IPV and early ANC; however, a significant relationship between IPV and sufficient ANC was found. Women who experienced any physical IPV (adjusted odds ratios (aOR) = 1.25; 95% confidence interval (CI): 1.00-1.56) or sexual IPV (aOR = 1.53; 95% CI: 1.08-2.16) were, respectively, 25% and 53% more likely to receive insufficient ANC., Conclusions: Honduras has one of highest rates of interpersonal violence of any nation in the world. In Honduras, IPV is a contributor to this broader category of interpersonal violence as well as a risk factor for insufficient ANC. Our findings suggest that universal IPV screening during ANC as well as future initiatives aimed at reducing IPV might improve ANC utilization in the country.

Purpose: The purpose of this study is to review the effectiveness of commonly used program modifications classified under cultural adaptation and program translational strategies for the Diabetes Prevention Program (DPP) in terms of risk reduction for type 2 diabetes., Methods: Authors extracted data about weight, body mass index (BMI), and 5 areas of program modification strategies from 28 interventions and analyzed them in SPSS software. Bivariate analyses examined the odds of achieving a significant reduction in outcomes by each modification of the DPP and by presence of a maintenance component, as well as the mean reduction of weight and BMI by more versus fewer modifications and by the presence of a maintenance component., Results: There were no statistically significant differences in achieving a significant reduction in weight or BMI by any type of modification or by the presence of a maintenance component. Programs with fewer modifications reported significantly greater reduction in mean weight at 12 months postintervention and the furthest time point extracted. Programs with a maintenance component achieved significantly greater reduction in mean weight measured at the furthest time point extracted., Conclusions: The DPP appears to be programmatically robust to a variety of cultural adaptation and translational strategies. Potentially cost-saving modifications do not seem to reduce effectiveness, which should encourage implementation on a broader scale. Program planners should, however, make efforts to include maintenance components because they appear to significantly reduce risk for acquiring type 2 diabetes., Competing Interests: All authors have no conflicts of interest to disclose., (© 2016 The Author(s).)

Entertainment-education programs promote health and development goals throughout the world. This study looks specifically at a radio serial drama designed to provide behavioral role models for HIV prevention and reproductive health in Botswana as part of the behavior-change strategy, Modeling and Reinforcement to Combat HIV/AIDS (MARCH). The purpose of this qualitative study is to elucidate regular listeners' involvement and identification with three different types of fictional characters in the drama. Regular listeners were interviewed using a semi-structured guide; 31 interviews were analyzed to assess respondents' reactions to three female characters. The findings suggest that characters designed to be "negative," "positive," and "transitional" (i.e., moving from negative to positive) role models were generally perceived as such and that the type of behavior modeled influenced whether a character was perceived to be transitional or positive. Audience members discussed the implications of specific behaviors by contrasting the different character types. Although characters modeled behaviors within distinct but interrelated storylines, the respondents spontaneously compared characters' ways of confronting similar dilemmas across storylines, suggesting that listeners perceived the drama as a unified whole rather than as a series of parallel stories. The use of more than one transitional character for each behavioral objective might be beneficial for improving audience identification with agents of behavior change by providing several models to which the audience can relate.