Recent Research Publications- January 2025

Social media provides support and education for pregnant people when healthcare does not.

Faro EZ, Santillan DA, Funk ML, Boeldt K, Santillan MK.

Front Glob Womens Health. 2024 Nov 28;5:1410831. doi: 10.3389/fgwh.2024.1410831. PMID: 39669112; PMCID: PMC11634836.

• The use of social media for health-related reasons is growing, but there is a dearth of research on the mechanisms of support provided. Understanding how social media groups work could improve communications between providers and patients. Preeclampsia (PreE) is a hypertensive disease of pregnancy that has short- and long-term physical and psychosocial effects. The Preeclampsia, Eclampsia & HELLP Syndrome Survivors Global Support Network (PEHSS) Facebook group is an online, international, moderated support group that provides evidence-based information and community support. Our study aimed to (1) characterize the forms of social support and types of information sought and provided from the perspective of the group moderators and members, and (2) describe group members' experiences of patient care. We triangulated interview and survey findings to identify gaps in care, ultimately to inform in improvements in care delivery.

• We began with 30-45-minute semi-structured interviews with PEHSS moderators exploring experiences and perceptions of membership; preliminary findings were member-checked with additional moderators. Interviews were analyzed using template and matrix analysis. Based on emergent themes, we conducted an online, validated patient experience survey with PEHSS members that was analyzed using descriptive statistics.

• Emotional and social support, mental health, resources and education, and personal health advocacy emerged as major themes in the 12 interviews. 1,148 PEHSS members responded to the survey. 68% of survey participants wanted to be more involved in the decisions about their care and treatment and over 30% felt they were not informed about danger signals post discharge while approximately half reported always feeling treated with respect and dignity while in the hospital. Geographic analysis showed differences in experiences of communication with providers within and outside the US.

Discussion: The triangulated results from interviews and surveys indicated a need for better communication with providers and the ability for patients to have more input on their care. The survey results indicate a global issue in providing support for people with hypertensive disorders of pregnancy during their hospitalization. The needs currently supported through communities on social media highlight opportunities to address critical gaps in care.

For a full text of the article, click here: https://www.frontiersin.org/journals/global-womens-health/articles/10.3389/fgwh.2024.1410831/full

A Multicenter Prospective Cohort Study of Antibiotics for OnabotulinumtoxinA.

Morocco E, Lua-Mailland L, Werth A, Carr D, Rabice S, Ashmore S, Duong V, Wilkes M, Nilsson W, Ferzandi T.

Urogynecology (Phila). 2024 Dec 13. doi: 10.1097/SPV.0000000000001621. Epub ahead of print. PMID: 39689227.

Importance: Urinary tract infection (UTI) is the most common complication of intradetrusor onabotulinumtoxinA (BTX-A) injection. Despite this, there are no evidence-based guidelines on antibiotic prophylaxis.

Objectives: Our primary aim was to determine whether antibiotic prophylaxis decreased symptomatic, culture-proven UTI rates within 6 weeks of intradetrusor BTX-A injection. Our secondary aims were to determine if there are differences between antibiotic regimens and to identify risk factors for developing a UTI.

Study design: This was a prospective, observational multicenter cohort study of female patients receiving BTX-A for idiopathic overactive bladder. We compared patients who received antibiotics (nitrofurantoin or trimethoprim-sulfamethoxazole) to those who did not. To detect a 15% difference in UTI rates between groups (80% power, alpha = 0.05), 270 participants were needed.

• : A total of 282 participants ultimately received BTX-A and were included in the analysis. One hundred eighty-one (62.6%) were in the antibiotic cohort and 101 (35.8%) were in the no-antibiotic cohort. The overall rate of symptomatic, culture-proven UTI was 12.1%, and there was no difference between the antibiotic and no-antibiotic cohort (10.6% vs 14.9%, respectively; P = 0.29). On multivariable logistic regression, UTI was associated with older age (adjusted odds ratio [aOR], 1.07; 95% CI, 1.02-1.11), BTX-A dose of 200 units (aOR, 4.24; 95% CI, 1.45-12.35), and self-catheterization (aOR, 26.0; 95% CI, 3.62-186.5). The odds of symptomatic UTI were lower among postmenopausal participants (aOR, 0.13; 95% CI, 0.02-0.68) and participants in the Northeast United States (aOR, 0.23; 95% CI, 0.08-0.72).

• Our study did not find a lower rate of symptomatic, culture-proven UTI among participants who took antibiotics compared with those who did not.

For a full text of the article, click here: https://oce.ovid.com/article/02273501-990000000-00313/PDF \

Embryoscopy with hysteroscopy for a more full-scope assessment and management of early miscarriage.

Salari S, Lindheim SR.

Fertil Steril. 2024 Nov 28:S0015-0282(24)02402-6. doi: 10.1016/j.fertnstert.2024.11.022. Epub ahead of print. PMID: 39615643.

For a full text of the article, click here: https://www.sciencedirect.com/science/article/pii/S0015028224024026?via%3Dihub

​Cervical Cancer 2010-2019: An Upper Midwest Catchment of 40,000 Square Miles.

Ulmer KK, Wilson PL, Petereit MA, Sargent M, Cina K, Kroboth L, Petereit DG, Harper DM.

J Low Genit Tract Dis. 2024 Dec 3. doi: 10.1097/LGT.0000000000000853. Epub ahead of print. PMID: 39626082.

• American Indian (AI) women have a higher incidence and mortality from cervical cancer than non-Hispanic White (NHW) women in the US. Our purpose is to detail the clinical events in the cervical cancer prevention continuum among the AI and White women with cervical cancer on the US frontier.

Materials and methods: A cancer center with a nearly 40,000 square-mile catchment area maintained a detailed cancer registry connected to the clinic records of all cervical cancer patients between 2010-2019. This catchment area provided records of both an AI and a White population. Descriptive and inferential statistics and modeling predictions detailed the prevention continuum.

• Among the 126 with cervical cancer, 20% were AI, and 78% were White. Sixty percent did not participate in cervical cancer screening within the 5 years before their diagnosis, and on average, 9.2 years passed since the last cervical cancer screening. 91% presented with symptoms, and most women presented with 2 or more symptoms. Thirteen percent underwent a colposcopic diagnostic step, significantly delaying the time to diagnosis compared to other diagnostic steps. Sixty-nine percent of the histopathologic diagnoses were squamous cell carcinoma, and 27% were adenocarcinoma. Forty-nine percent presented at stage I regardless of histopathology. Chemotherapy and radiation therapy were most commonly combined. Sixty-three percent of the population survived, and 42% survived at least 3 years from diagnosis. Younger age and earlier stages at diagnosis were the significant adjusted predictors of survival.

Conclusions: Our detailed cervical cancer prevention continuum events provide new data questioning the use of colposcopy for women symptomatic at presentation.

For a full text of the article, click here: https://journals.lww.com/jlgtd/fulltext/9900/cervical_cancer_2010_2019__an_upper_midwest.154.aspx

The use of a nursing implementation framework to enhance the uptake of an evidence-based intervention.

Karim K, Trower S, Segre LS.

Worldviews Evid Based Nurs. 2024 Nov 17. doi: 10.1111/wvn.12755. Epub ahead of print. PMID: 39552104.

• Evidence-based practices (EBPs) are instrumental in improving patient outcomes and ensuring high-quality nursing care, yet their implementation often encounters substantial barriers. The Iowa Implementation for Sustainability Framework and the Precision Implementation Approach© offer systematic strategies for overcoming barriers and enhancing EBP implementation and sustainability in health care settings.

• : This project aimed to use the Iowa Implementation for Sustainability Framework and the Precision Implementation Approach© to support the use of an evidence-based maternal depression intervention within Iowa's Title V Maternal Health Program that serves mothers of young children living in poverty.

Methods: This practice-based implementation was accomplished in three steps: (1) hold intervention-focused staff meetings, (2) identify barriers to using the intervention, and (3) identify and deliver implementation strategies. Collected data included barriers identified, selected implementation strategies, and evaluation of meeting attendance and impact on confidence.

Results: Four of the monthly virtual staff meetings focused on Listening Visits (LV) use. The 7 strategies comprising our approach to supporting LV use addressed three categories of identified barriers: lack of confidence, logistical issues, and not understanding intervention procedures. In the LV-focused meetings, representation of the 14 maternal health clinics was high, although attendance by individual staff was inconsistent. Post-meeting polls indicated that 40% to 65% of attendees felt more confident using intervention skills.

Linking evidence to action: This practical nursing-implementation framework facilitated EBP adoption, and our well-structured targeted strategies effectively increased staff confidence. Nursing managers and educators should consider using this framework to enhance their organizations' capacity to implement EBPs sustainably.

• community care; evidence‐based practice; implementation science; intervention focused staff meetings; listening visits; maternal health; nursing framework; sustainability.

For a full text of the article, click here: https://sigmapubs.onlinelibrary.wiley.com/doi/10.1111/wvn.12755