Browsing by Author "Asdell, Stephanie"

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    Implementing Scheduled Women’s Health Clinics at Free Student Outreach Clinic
    (2022-03-30) Gensel, Annie; Brown, Lucy; Asdell, Stephanie
    Introduction/Problem: Since 2009, Indiana University Student Outreach Clinic (IU-SOC) has served the underinsured and uninsured members of the Indianapolis community. Many barriers to care exist within this community, from low income to lack of documented immigration status. One of the most concerning vulnerable populations observed was pregnant patients. Five years ago, the IU-SOC addressed this via creation of Women’s Health days on Saturdays every other month and in 2020 by creating an as needed prenatal clinic. However, the need still existed for general, non-prenatal women’s health concerns, which led to the expansion to a twice monthly general women’s clinic staffed by a board-certified obstetrician-gynecologist (OB/GYN). Methods/Interventions: In April 2021, twice monthly scheduled clinics were implemented for two hours on Wednesday evenings staffed by OB/GYNs or obstetrics-trained family medicine physicians. Additionally, the team available on Wednesday clinics expanded to include a women’s health specific clinic manager, women’s health patient navigator to facilitate referrals, and women’s health education specialist to address low health literacy. Results: In 2021, 15 women’s health clinic days have been hosted since April,expanding beyond prenatal patients and resulting in increased volume of this clinic. There were a total of 36 patient encounters from 31 different patients including eight pregnant patients. Other chief concerns addressed at the clinic included: infertility/preconception counseling, abnormal uterine bleeding, pelvic pain/mass, vaginal itching, dyspareunia, and preventive women’s health visit. Six patients received pap smears and sexually transmitted infection (STI) screening. Low pap smear and STI screening rates at the women’s health clinic are attributed to the presence of women’s health fourth year student representatives at general clinic days ensuring most patients receive pap smears and STI screenings prior to referral. Conclusion: We implemented a twice-monthly, referral-based women’s health clinic in 2021 that has successfully provided care for 31 different patients including eight pregnant patients for a variety of chief concerns and preventive care encounters. The presence of a certified OB/GYN has ensured appropriate management of prenatal and primary care women’s health issues. Consistent provision of women’s health care services helps to mitigate the many barriers to women’s health care in our Indianapolis community.
  • Thumbnail Image
    Item
    Long-acting reversible contraception knowledge & intent to use among US university students.
    (European Society of Contraception and Reproductive Health, 2020-03) Asdell, Stephanie; Bennett, Rachel; Cordon, Sabrina; Zhao, Qiuhong; Peipert, Jeffrey
    OBJECTIVES: More than 50% of births to women in the United States in their early 20s are unintended, and unintended pregnancies have adverse consequences on students’ education.Long-acting reversible contraceptives (LARC) offer highly-effective, long-term prevention of pregnancy, yet are utilized at low rates. Thus, we sought to assess the level of students’ LARC knowledge and any association with intent to use LARC at a large, urban university in the Midwest United States. We hypothesized that students with higher levels of LARC knowledge would be more likely to intend to use LARC in the future. We also hypothesized that fewer students would use LARC compared to the US rate of 15.8% of all contraceptive users in 2017. Data on student knowledge and attitudes regarding LARC will be used to inform a campus LARC initiative. METHODS: We designed and administered a cross-sectional survey to 300 undergraduates, graduate students, and resident physicians that assessed sexual experiences, contraceptive use, LARC knowledge, and intent to use LARC. The survey was administered at the university’s student center and student health facility in Indianapolis, Indiana. Participants’ demographic characteristics and LARC knowledge were summarized using descriptive statistics. Awareness of different LARC methods was assessed using McNemar’s test. The association between students’ reported LARC knowledge and future intent to use a LARC method was calculated with Fisher’s exact test. RESULTS: Our preliminary analysis includes 126 students. The mean age was 20.2 years. Mean score on the 10-question LARC assessment was 5.2/10. Higher levels of LARC knowledge were positively associated with future intent to use LARC (P < 0.05). Only 7.9% of contraceptive users surveyed used LARC, compared to 15.8% of US contraceptive users in 2017. Differences in awareness of the copper IUD (61.1%), hormonal IUD (74.6%) and implant (88.9%) were statistically significant (P < 0.05). The most common reason cited for not considering LARC use was “need for more information.” Conclusions: University students surveyed displayed low LARC knowledge, low LARC use, and a need for more information on LARC. A positive association between LARC knowledge and future intent to use LARC amongst students at this university further supports need for a campus-wide contraceptive initiative that will empower students to make informed reproductive decisions. Understanding student use and knowledge of LARC could also provide a model for starting other university LARC initiatives across the United States, at which uptake of LARC has been historically low.
  • Thumbnail Image
    Item
    Treatment for Pelvic Floor Myalgia and Myofascial Pelvic Pain: A Systematic Review
    (2021-10-22) Higgins, Olivia M.; Asdell, Stephanie; Stumpff, Julia C.; Patanwala, Insiyyah
    Introduction Pelvic floor myalgia is characterized by muscular tension, tenderness and trigger points of the pelvic floor muscles and connective tissue. Its prevalence varies from 14-78%. Our aim was to review treatment interventions for adult women with pelvic floor myalgia Methods A systematic review of prospective trials was conducted in MEDLINE (Ovid/PubMed), EMBASE, Cochrane Library, Scopus, Web of Science, ClinicalTrials.gov. Studies published up until March 2020 were included. After duplicates were removed, 7,711 studies were screened and 992 full texts were reviewed for final inclusion of randomized control trials (RCT) only. To meet inclusion criteria, study participants needed to have pelvic floor myalgia, hypertonicity or pain determined by a physical exam. All interventions were included. Results After final data extraction, 18 studies met inclusion criteria, which included 1043 participants. Most studied interventions were pelvic floor physical therapy (4 studies, 218 participants) and pelvic floor botulinum A toxin injections (4 studies, 281 participants). Other interventions included vaginal diazepam (3 studies, 112 participants), oral desipramine/local lidocaine (1 study, 133 participants), cognitive behavioral therapy (1 study, 117 participants), hypnotherapy (1 study, 36 participants), local anesthetic trigger point injections (1 study, 29 participants), and oxytocin nasal spray (1 study, 21 participants). Conclusions Many studies showed a placebo effect possibly indicating that simple acknowledgement of pain symptoms with a treatment plan can improve pain. Physical therapy showed significant improvement in pain and sexual functioning compared to controls. Botulinum toxin A was not proven to be beneficial for pelvic floor myalgia and hypertonicity