Browsing by Author "Siddiqui, Nazema Y"
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Item Open Access Barriers to urinary incontinence care seeking in White, Black, and Latina women.(Female pelvic medicine & reconstructive surgery, 2015-03) Willis-Gray, Marcella G; Sandoval, Juan S; Maynor, Jean; Bosworth, Hayden B; Siddiqui, Nazema YObjective
We compared barriers to urinary incontinence (UI) healthcare seeking between white, black, and Latina women.Methods
This is a cross-sectional study using a convenience sample of white, black, and Latina women. Women completed the Barriers to Incontinence Care Seeking Questionnaire (BICS-Q), the Incontinence Quality of Life Instrument (I-QOL), the Questionnaire for Urinary Incontinence Diagnosis, and the Incontinence Severity Index (ISI). The primary objective was to assess barriers to UI care seeking among groups, as measured by the BICS-Q. Secondary objectives were to assess factors associated with barriers to incontinence care and to compare specific barriers using BICS-Q subscale scores. Regression analyses were used to further assess for differences among groups while adjusting for potential confounding variables.Results
We included a total of 93 subjects, including 30 white, 33 black, and 30 Latina women. Mean I-QOL, Questionnaire for Urinary Incontinence Diagnosis, and ISI scores were not significantly different among our 3 groups. Barriers, based on BICS-Q scores, were lowest in white women and higher in blacks and Latinas (2.9 vs 7.3 vs 10.9, respectively; P < 0.001). When adjusting for potential confounders such as age, income, education, presence of UI, ISI score, and I-QOL score, Latinas continued to demonstrate higher barriers compared with white or black women (β = 7.4; 95% CI, 2.2-12.7; P = 0.006). There were no significant differences between black women compared with other groups in the adjusted analyses.Conclusions
Latinas experience more barriers to UI healthcare seeking compared with white and black women.Item Open Access Risk of obstetric anal sphincter injuries at the time of admission for delivery: A clinical prediction model.(BJOG : an international journal of obstetrics and gynaecology, 2022-11) Luchristt, Douglas; Meekins, Ana Rebecca; Zhao, Congwen; Grotegut, Chad; Siddiqui, Nazema Y; Alhanti, Brooke; Jelovsek, John EricObjective
To develop and validate a model to predict obstetric anal sphincter injuries (OASIS) using only information available at the time of admission for labour.Design
A clinical predictive model using a retrospective cohort.Setting
A US health system containing one community and one tertiary hospital.Sample
A total of 22 873 pregnancy episodes with in-hospital delivery at or beyond 21 weeks of gestation.Methods
Thirty antepartum risk factors were identified as candidate variables, and a prediction model was built using logistic regression predicting OASIS versus no OASIS. Models were fit using the overall study population and separately using hospital-specific cohorts. Bootstrapping was used for internal validation and external cross-validation was performed between the two hospital cohorts.Main outcome measures
Model performance was estimated using the bias-corrected concordance index (c-index), calibration plots and decision curves.Results
Fifteen risk factors were retained in the final model. Decreasing parity, previous caesarean birth and cardiovascular disease increased risk of OASIS, whereas tobacco use and black race decreased risk. The final model from the total study population had good discrimination (c-index 0.77, 95% confidence interval [CI] 0.75-0.78) and was able to accurately predict risks between 0 and 35%, where average risk for OASIS was 3%. The site-specific model fit using patients only from the tertiary hospital had c-stat 0.74 (95% CI 0.72-0.77) on community hospital patients, and the community hospital model was 0.77 (95%CI 0.76-0.80) on the tertiary hospital patients.Conclusions
OASIS can be accurately predicted based on variables known at the time of admission for labour. These predictions could be useful for selectively implementing OASIS prevention strategies.Item Open Access Urinary Incontinence and Health-Seeking Behavior Among White, Black, and Latina Women.(Female pelvic medicine & reconstructive surgery, 2016-09) Siddiqui, Nazema Y; Ammarell, Natalie; Wu, Jennifer M; Wu, Jennifer M; Sandoval, Juan S; Bosworth, Hayden BObjective
Fewer than half of women with urinary incontinence (UI) seek care for their condition. Our objective was to qualitatively assess the themes surrounding treatment-seeking behaviors.Methods
We conducted 12 focus groups with women and, using purposive sampling, we stratified by racial or ethnic group (white, black, Latina) and by UI frequency. All sessions were transcribed and coded for common themes. Comparative thematic analysis was used to describe similarities and differences among groups.Results
In total, 113 (39 white, 41 black, and 33 Latina) community-dwelling women participated in focus groups. There were no differences in treatment-seeking themes between groups with different UI frequency. However, certain themes emerged when comparing racial/ethnic groups. Women from all groups shared experiences of embarrassment and isolation because of UI, which were impediments to care seeking. White and black women described discussions with close friends or family that led to normalization of symptoms and prevented care seeking. Latina women maintained more secrecy about UI and reported the longest delays in seeking care. Women articulated a higher likelihood of seeking care if they had knowledge of treatment options, but white women were more likely to seek UI-related knowledge compared with black or Latina women. Physician communication barriers were identified in all groups.Conclusions
Despite similar experiences, there are different perceptions about care seeking among white, black, and Latina women. Culturally relevant educational resources that focus on a range of treatment options may improve knowledge and thus improve care-seeking behaviors in women with UI.