60 Background: Breast cancer survivors report ongoing information and self-management needs from diagnosis through treatment and survivorship. Commercial mHealth apps could support symptom management, decision-making, communication, and survivorship care planning, but it is unclear whether available apps consistently include these features. The purpose of our study was to characterize what breast cancer patients are likely to encounter in the current mHealth app marketplace by synthesizing evidence from published reviews that manually evaluated apps, rather than relying solely on descriptions in the literature. Methods: We conducted a systematic review following PRISMA reporting guidelines. We searched PubMed, Embase, and CINAHL from database inception through September 4, 2024, for studies that directly evaluated commercially available breast cancer mHealth apps and incorporated a patient perspective. Screening and study selection were managed in Covidence. We included studies assessing ≥2 apps, extracted reported app features, and summarized feature prevalence across included studies using descriptive statistics. Results: Informational content was more common than active support functions. Early detection and diagnosis content was variably present (e.g., self-exam 52%; tumor type 28%, stage 25%). Treatment support was limited (treatment management 23%; side effects 20%; medication management 9%; labs 7%; nutrition 6%). Evidence-aligned resources were inconsistent (referenced research 21%; clinical trials 6%). Connection features were scarce, especially patient–clinician communication (4%), general support (6%), and psychosocial support (18%). Survivorship functions were modest (lifestyle modification 29%; care management 23%; survivorship content 21%); end-of-life content was rare (1%). Conclusions: Breast cancer apps evaluated in published manual reviews frequently underdeliver on functions and content most relevant to patients during active treatment and survivorship, particularly communication, survivorship planning, medication support, psychosocial support, and clinical trial information. Multidisciplinary, evidence-aligned app development and evaluation should address these gaps, include explicit survivorship and treatment-transition workflows, and ensure transparent privacy, safety, and health literacy standards to support informed, values-concordant survivorship care decisions.

OBJECTIVES:This study aimed to assess patient experiences and preferences for counseling, addressing pain and anxiety, and provider support during placement of intrauterine devices (IUDs). STUDY DESIGN:This mixed-methods study included a survey and in-depth interviews of patients undergoing IUD placement. Participants reported pain, satisfaction, and importance of aspects of care during IUD placement. Ten provider behaviors measured on a Likert scale (1-5) sum to create a "provider support score" (range 10-50). We measured pain with categorical variables and a visual analog scale (0-10). We performed descriptive statistics, bivariate analysis, and multivariable analysis on survey data. Qualitative data analysis utilized inductive analytics with NVivo. RESULTS:Among 79 respondents, the three factors most frequently cited as "very important" included explaining steps before the procedure (74.7%), discussing pain concerns in advance (72.2%), and being attentive to comfort during the procedure (72.2%). The mean (SD) pain score was 5.7/10 (2.8). Most participants were satisfied (24.1%) or very satisfied (62%) with their IUD placement. The mean provider support score was 32.8/50. When controlling for pain score, higher provider support scores predicted satisfaction; with each unit increase in provider support score, the odds of satisfaction increased by 69% (adjusted odds ratio 1.69). Themes emerging from qualitative data included the importance of acknowledging rather than minimizing pain experiences, setting clear and realistic expectations, and both exploring and attending to individualized patient preferences around IUD placement. CONCLUSIONS:Answering the call for more patient-centered IUD placement requires not only addressing pain but also tailoring a range of supportive behaviors to each patient to improve satisfaction. IMPLICATIONS:In addition to addressing pain, clinicians need to focus on a range of other supportive behaviors related to IUD placement, including clear counseling, provider empathy, and forthcoming expectation setting to make the procedure more patient-centered and improve patient satisfaction.

Migrant and minority women in the United States face a high likelihood of experiencing poor reproductive health outcomes. Hispanic/Latina women are an especially high-risk population. Comprehensive and high-quality sexual and reproductive healthcare (SRHC) is desperately needed among this population, yet many Latina women face substantial barriers in accessing care. This study builds upon the three-delays model to better understand why Latina women experience delays in accessing quality SRHC in the state of South Carolina. Data for this study were drawn from semi-structed interviews with 14 adult women identifying as either Hispanic or Latina. Findings reveal that structural factors, including long distances to facilities, high costs of care, and difficulties navigating local healthcare and insurance systems, served as barriers to accessing quality SRHC. Socio-cultural factors, such as communication challenges and low cultural competency among healthcare providers, further inhibited access to care, even among women who spoke fluent English. These findings indicate a need for SRHC education and services to be more culturally-centered, by accounting for cultural knowledge and historical dynamics, and by giving patients more agency with respect to their care. Regarding the three-delays model, future applications should seek to better incorporate preventive services and consider that perceptions of quality SRHC are both individually- and contextually-mediated. This will be an important step toward developing policies and programs that are appropriately tailored to specific populations' cultural backgrounds and contextual needs.

This article centers the methods and materials of illegal abortion in South Carolina from criminalization (1883) to Roe v. Wade (1973) as they appeared in criminal trial records, coroners' reports, newspaper accounts, oral histories, and contemporary medical literature. The authors explore abortion techniques and technologies by analyzing the objects used in criminal abortion attempts. In particular, they focus on the common objects and substances that could be found in homes or local shops, such as herbs and emmenagogues, turpentine, and rubber tubing, which are medical technologies and obstetrical objects. The analysis of illegal abortions in pre-Roe South Carolina demonstrates that abortion providers, and especially Black laywomen providers, not only depended on but actively nurtured centuries of intergenerational knowledge of abortion techniques and tools. Furthermore, they innovated with everyday objects and professional instruments alike to provide abortions to Black and white women.

The COVID-19 pandemic resulted in substantially lower uptake of childhood vaccinations in the U.S. As vaccination rates struggle to rebound, childhood vaccine hesitancy continues to grow. Addressing vaccine disinformation and increasing catch-up vaccination is an urgent public health priority. The purpose of this study was to evaluate the effectiveness of "Jenny's First Sleepover," a darkly humorous satirical book about childhood vaccinations, to influence attitudes of vaccine hesitant parents. This study implemented a randomized pretest - posttest experimental design using a web-based survey with one intervention and one control. "Jenny's First Sleepover" improved attitudes toward vaccination among vaccine hesitant parents. Negative emotions were an important mediator of attitudes toward vaccinations. Findings identify mechanisms that increase effectiveness of satirical approaches, including the presentation of novel information about serious vaccine-preventable diseases with a dark narrative twist. Health communicators may consider a darkly humorous satirical approach to improve attitudes toward childhood vaccination among vaccine hesitant parents.

AbstractIntroductionChoosing the right contraception can be a daunting process and it is important that people feel in control of their bodies during this decision‐making process.Materials and MethodsThis study investigates who college‐aged students talk to about their hormonal contraceptive choice and how that impacts their feeling of control during their decision‐making process.ResultsThe study found participants spoke to a variety of sources about this decision, like their healthcare providers when they wanted a clinical point of view, their mothers when they wanted a more personal and caring point a view, their overall social networks when they wanted multiple point of views, and some participants ultimately felt the most control when just referring to themselves and their own feelings.ConclusionsMore research can be done on how specific beliefs among figures in college‐aged students' lives impact these contraceptive discussions, the choices they feel they can make, and how in control of themselves they feel.

High rates of sexually transmitted infections and unplanned pregnancy continue to plague young adults in the USA with low condom use a contributing factor. To better understand condom acquisition, errors, and breakage among US cisgender college students, a survey was conducted across six structurally diverse institutions of higher education in 2019–2020 prior to the COVID-19 pandemic. Students who had used external condoms in the last year (N = 1584) were asked about specific on- and off-campus locations of condom acquisition and practices related to condom use. Findings indicate that students most frequently acquired condoms off-campus with location differences between genders and relationship status. Condom errors were common, with no consistent patterns related to gender, but unpartnered students were more likely than those in relationships to experience condom errors. Multivariate logistic regression indicated that relationship status, applying condom on wrong side, adding condom after sex started, removing condom during sex, condom slipping off, and problems with fit were predictors for condom breakage. The study results provide guidance for healthcare and sexuality education professionals working with college students to better address the differing needs of college students regarding condom acquisition and correct condom use.

Young people account for over half of new STI cases and youth of color face increased sexual health disparities. In partnership with Fact Forward, researchers conducted qualitative formative audience research to develop a culture-centered health communication campaign to increase access to and use of sexual health services among youth of color in South Carolina. Grounded in a reproductive justice theoretical framework, this study employed innovative strategies, including training youth ambassadors to moderate peer-to-peer focus groups. A total of 134 participants were recruited for the study with 51 individuals participating in 9 focus groups and 83 respondents completing a web-based survey (ages 15-24). Qualitative data analyses used Nvivo 1.5.1. Statistical analyses used R Studio (R). Findings revealed barriers including lack of education about risks. Participants identified dimensions of inequity and the importance of intersectional messaging to address intimacy, sexuality, and trust. They emphasized normalizing conversations about sexual health and the need for important others "in your corner" to provide support. Participants suggested an empowering storytelling approach to reduce shame surrounding sexual health services. Social media emerged as an optimal communication channel. UNC Perceived Message Effectiveness (PME) Scale scores ranged from 4.42 to 4.57 (out of 5) indicating that messages were well received by participants. Sex-positive campaign messaging focused on self-love, empowerment, and taking control of sexual health. This study offers practical suggestions to develop effective communication strategies to reach youth of color to increase use of sexual health services, including contraceptive counseling, STI prevention, screening, and treatment.

Objectives: The purpose of this study was to explore contraceptive awareness among college women in the Southeast United States. This study sheds light on the gaps in contraceptive use found in college women and can be used to improve educational interventions on college campuses. Participants: College-age women ages 18-25 completed in-depth qualitative interviews over Zoom. Methods: Interviews examined levels of awareness by asking participants to list the contraceptive methods they were aware of, followed by probes that assessed their understanding of different contraceptive methods. Results: Prominent themes (n = 44) included high awareness of condoms, the pill and IUD, positive attitudes toward contraceptive options, fear and emotional anxiety from hormonal contraceptives and inability to explain how contraceptives work in the body. Conclusion: Results from this study will inform future contraceptive education campaigns for college women.

PURPOSE:The purpose of this study was to evaluate the effectiveness of the WISE (Women in the South-East) Telehealth Network. DESIGN:A follow-up survey design was used to determine the impact of the program on access to healthcare. SETTING:WISE provided preventive care to women and gender expansive people at local libraries and the Mobile Library in the rural South Carolina Lowcountry. SUBJECTS:In 1 year (February 2021-2022), WISE reached 523 individuals with 151 agreeing to participate in the study. Most participants identified as white (66%) or Black (22%). INTERVENTION:A Community Health Worker provided health education, connection to telehealth services, referrals, and connected individuals with community and social services. MEASURES:The Telehealth Usability Questionnaire (TUQ), changes in knowledge, satisfaction with WISE, Acceptability of Intervention measure (AIM), and sociodemographic characteristics. RESULTS:Participants with a high telehealth usability score were significantly more likely to be under the age of 35 (OR 4.60 [95% CI 1.21-17.52]), married (OR 10.00 [95% CI 2.19-45.64]), or white (OR 4.00 [95% CI 1.06-15.08]). The intervention earned a high acceptability score 4.46 (± .61)/5.0 by helping participants obtain necessary medical care and resources, as well as meeting their educational needs. CONCLUSION:This study offers practical suggestions to expand the use of telehealth initiatives to improve health outcomes by engaging libraries in rural communities.

Abstract Catching Fire: Women’s Health Activism in Ireland and the Global Movement for Reproductive Justice investigates women’s reproductive health activism in Ireland. It focuses on attempts by Irish healthcare reformers and activists to implement reproductive justice and improve Irish women’s access to essential healthcare services. Irish activists, it demonstrates, employed a strategy of making women’s narratives and stories the central focus of their movement and engaged with a variety of media outlets, particularly social media, to spread their messages. Feminist digital activism challenged high-tech myth systems to redefine women’s health and reproduction, making them central concerns in Irish society and government. The approach of empowering ordinary women to tell their own stories has resulted in widespread compassion and solidarity. This strategy has personalized reproductive justice and established the Republic of Ireland as a model for future intersectional activist movements. Catching Fire also links Irish developments to American advocacy and global movements and places recent activist campaigns in an essential, yet often overlooked, historical context. By valuing women’s embodied experience, activists reimagined the use of technology, disrupted the nature/culture dualism, and empowered women to tell their stories.

Courting Contraceptives is a first person, “dating-sim” style digital game designed by a team of researchers in computer science as well as communications and public health. The game aims to educate women and people who menstruate between the ages of 18 and 30 about a variety of methods of contraceptives available to them.

Abstract Chapter 1 analyzes the cervical cancer prevention scandals of the early 2000s. In 2015, Ireland saw a misinformation campaign about the human papillomavirus (HPV) vaccine that led to a sharp decline in Irish vaccination levels. Just three years later, Ireland’s CervicalCheck screening program came under scrutiny once it was revealed that it gave hundreds of women incorrect negative screening results, leading to several preventable cancer deaths. However, women and public health advocates publicized and problematized these scandals, forcing a government response and demonstrating the power of truth-telling and ethical communication. They exposed systemic and endemic problems involved in women’s healthcare in Ireland, including overinflating the authority of male doctors and the medical establishment’s history of ignoring women’s experiences and voices.

College students support campus condom distribution programs, report high self-efficacy for correct condom use, and are more embarrassed about acquiring condoms than negotiating use or actual condom use. BackgroundCondom distribution programs are a structural-level intervention implemented on college campuses to reduce sexually transmitted infections and unplanned pregnancies. Understanding students' beliefs about these programs and attitudes that can affect condom use is critical.MethodsStudents at 6 different universities (n = 2809) completed items related to beliefs about campus condom distribution programs and their personal condom embarrassment and condom self-efficacy levels. Surveys were completed both in classroom and online. T Tests and analysis of variance were used to examine differences based on demographics. Logistic regression was used to examine predictors of condom use.ResultsCollege students support the distribution of condoms on campus (97.4%) but express moderate levels of embarrassment in condom acquisition and possession (mean, 19.37). Lower rates of embarrassment were reported for condom negotiation (mean, 9.13) and actual condom use (mean, 8.48). Lower overall rates of embarrassment were reported by condom users, men and individuals in relationships compared with noncondom users, women, and single individuals. Heterosexual students were more embarrassed than bisexual students about acquiring condoms and negotiating condom use. Condom users, men, and individuals in relationships had higher rates of condom self-efficacy compared with nonusers, women, and single students. There were no differences in self-efficacy based on sexual orientation. Embarrassment about acquiring and actual use of condoms, condom self-efficacy and demographics were all significant predictors of condom use.ConclusionsCampus condom distribution programs are supported by college students. Interventions to address embarrassment and increase condom self-efficacy need to be tailored to different students based on gender, experience with condoms, and relationship status.

OBJECTIVE:Do you want a period? empowers people who menstruate to better understand their reproductive health and contraceptive choices through informed patient-centered contraceptive decision-making. METHODS:Researchers partnered with the WISE (Women in the South-East) Telehealth Network to design, implement and evaluate the Do you want a period? brief educational intervention. Participants completed a longitudinal research study, including a web-based survey at baseline and a mobile-optimized text-based survey up to 6 weeks following baseline. RESULTS:Do you want a period? was believable (93%, n = 79), informative (89%, n = 76), and helpful (85%, n = 72). Participants who reported that the intervention was helpful were significantly more likely to be satisfied with the usefulness of information provided (OR 5.61 [95% CI 1.65-19.12]), the overall quality of services (OR 3.39 [95% CI 1.04-11.08)], and obtaining necessary medical care (OR 2.40 [95% CI 1.08-5.33)]. At longitudinal follow-up, participants who received contraceptive services reported high acceptability of intervention (4.51 (±0.53) out of 5). CONCLUSIONS:Do you want a period? envisions a new dialogue between women and clinicians, family, and friends. This brief educational intervention supports people who menstruate to determine if a safe and effective tailored contraceptive regimen is right for them.

Abstract Chapter 6 interrogates two case studies: the forced hysterectomy scandal at Our Lady of Lourdes Hospital during the 1990s and the symphysiotomy scandal that became public in the early 2000s. In the second half of the twentieth century, thousands of Irish women endured these harmful procedures at the hands of physicians empowered to abuse women’s bodies. This chapter examines these incidents as examples of obstetric violence. These practices testify to the pervasiveness of religious, national, and biomedical power in Ireland, past and present. The chapter argues that to achieve reproductive justice in Ireland, we must confront obstetric violence, following the lead of survivors who have spoken out and told truths about their embodied realities and the harms they have suffered in Ireland’s medicalized reproductive healthcare system.

Condom sabotage is a form of sexual assault that violates bodily autonomy, increasing the risk of unintended pregnancy and sexually transmitted infections (STI). The current study explored associations between reports of condom sabotage and sexual risk indicators among college students. College students (N = 466) completed a web-based cross-sectional survey. Students who reported experiencing condom sabotage were significantly more likely to describe themselves as single in comparison to students who described themselves as partnered (p = .002). After adjusting for relationship status, condom sabotage was significantly associated with reporting having multiple sexual partners (adjusted OR [aOR], 2.27; 95% CI, 2.22-42.28; p = .003), and being treated in the past 12 months for an STI (adjusted OR [aOR], 1,84; 95% CI, 1.82-21.98; p = . 004). The manuscript offers practical recommendations to develop health communication campaigns and public health interventions to prevent sexual assault, including condom sabotage, among college students.

Abstract Despite the nuances of gender and gender identity today, “women's health” is a broad area of health communication that is increasingly receiving scholarly attention and global application. Health communication specific to women occurs at four primary sites and depends on context, ranging from women's personal needs to medical/healthcare clinicians' approaches to treating women's bodies. These contexts tell different stories about the state of women's health, and communication – as an occupational discipline and rhetorical and cultural maintenance strategy – has an important role in each context. Gaps in women's health communication occur at four primary settings, which are embodied , or intrapersonal communication, contexts; political , or societal/systematic communication, contexts; rhetorical/representational , or cultural communication, contexts; and clinical , or interpersonal communication, contexts. Several enduring analytical lenses define modern women's health, specifically those of intersecting identities , the life‐course perspective , and technological innovations as ways research and science have conceptualized problems and opportunities in health communication. Health issues and the concept of gender specific to women are also addressed.