Behavioral Health Integration on Inpatient Obstetric Units: Program Development, Strategies for Implementation, and Lessons Learned.

Perinatal mood and anxiety disorders and substance use disorders are the primary causes of maternal mortality in the postpartum period and represent major public health concerns. Despite this, these conditions remain undertreated. Behavioral health integration in outpatient obstetric settings is necessary but insufficient to meet the needs of all patients. Inpatient behavioral health integration represents a promising avenue for addressing gaps in care. Results from recent program development indicate that needs assessment, stakeholder backing, collaboration with existing programs, and adaptability are key factors in successful implementation.

Body Appreciation in Lesbian, Bisexual, and Queer Women: Examining a Model of Social Support, Resilience, and Self-Esteem.

Purpose: There is increasing research on positive body image, but no studies to date have examined these constructs in lesbian, bisexual, and queer (LBQ) women. However, LBQ women are at increased risk for mental health concerns and disordered eating, and there is evidence that body appreciation might be both adaptive and protective. This study examined factors that could uniquely relate to body appreciation in LBQ women. Method: Women identifying as LBQ (N=150) completed demographics and measures of social support, resilience, self-esteem, and body appreciation. We tested a hypothesized mediational model of social support leading indirectly to body appreciation through resilience and self-esteem, controlling for body mass index. Results: All direct effects, except social support to body appreciation (p=0.696), were significant (ps=0.017-0.001), reflecting a full multiple mediation. As hypothesized, the effect of social support on body appreciation was indirect (p=0.011), through resilience and self-esteem. Conclusion: This is the first study to investigate factors that might facilitate positive body image in LBQ women. Although preliminary, results suggest social support, resilience, and self-esteem might be important targets of body image interventions with LBQ women.

Are You Covered? Associations Between Patient Protection and Affordable Care Act Knowledge and Preventive Reproductive Service Use.

PURPOSE: Sexual and reproductive health conditions (eg, infections, cancers) represent public health concerns for American women. The present study examined how knowledge of the Patient Protection and Affordable Care Act (PPACA) relates to receipt of preventive reproductive health services among women. DESIGN: Cross-sectional online survey. SETTING: Online questionnaires were completed via Amazon Mechanical Turk, a crowdsourcing website where individuals complete web-based tasks for compensation. PARTICIPANTS: Cisgendered women aged 18 to 44 years (N = 1083) from across the United States. MEASURES: Participants completed online questionnaires assessing demographics, insurance status, preventive service use, and knowledge of PPACA provisions. ANALYSIS: Chi-squares showed that receipt of well-woman, pelvic, and breast examinations, as well as pap smears, was related to insurance coverage, with those not having coverage at all during the previous year having significantly lower rates of use. Hierarchical logistic regressions determined the independent relationship between PPACA knowledge and use of health services after controlling for demographic factors and insurance status. RESULTS: Knowledge of PPACA provisions was associated with receiving well-woman, pelvic, and breast examinations, human papillomavirus vaccination, and sexually transmitted infections testing, after controlling for these factors. Results indicate that expanding knowledge about health-care legislation may be beneficial in increasing preventive reproductive health service use among women. CONCLUSION: Current findings provide support for increasing resources for outreach and education of the general population about the provisions and benefits of health-care legislation, as well as personal health coverage plans.

"I don't need people to tell me I'm pretty on social media:" A qualitative study of social media and body image in early adolescent girls.

Social media appear to contribute to body dissatisfaction in adolescents, although few empirical studies exist. This study used six focus groups (total N=38) to explore relations between social media use and body image in early adolescent girls (ages 12-14). Thematic analysis identified patterns in the data. In this sample, social media use was high. Girls endorsed some appearance concerns and social comparison, particularly with peers. However, they displayed high media literacy, appreciation of differences, and confidence, strategies that appeared helpful in mitigating the potential negative association between social media exposure and body image. Girls reported these characteristics were nurtured by positive parental influence and a supportive school environment. Results support an ecological approach to the prevention of body dissatisfaction. Although peer influence strengthens throughout adolescence, current findings suggest that parents and the school environment are associated with girls' attitudes and behaviors regarding social media and body image.