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  1. Article ; Online: First-trimester occupational exposures and hypertensive disorders of pregnancy among US nurses.

    Agarwal, I / Wang, S / Stuart, J / Strohmaier, S / Schernhammer, E / Rich-Edwards, J / Kang, J H

    Occupational medicine (Oxford, England)

    2023  Volume 73, Issue 7, Page(s) 419–426

    Abstract: Background: Limited and conflicting data exist regarding the impact of first-trimester nursing occupational exposures on hypertensive disorders of pregnancy (HDP).: Aims: To investigate whether first-trimester night shift work, work hours and work- ... ...

    Abstract Background: Limited and conflicting data exist regarding the impact of first-trimester nursing occupational exposures on hypertensive disorders of pregnancy (HDP).
    Aims: To investigate whether first-trimester night shift work, work hours and work-related activities are associated with HDP.
    Methods: We conducted a cross-sectional analysis of 6610 women within the Nurses' Health Study II. We used multiple logistic regression to estimate the odds ratios (ORs) and 95% confidence intervals (CIs) for the relation of occupational exposures to HDP.
    Results: Nine per cent of respondents reported an HDP in the index pregnancy (gestational hypertension: n = 354, 5%, preeclampsia: n = 222, 3%). First-trimester fixed or rotating night shift work was not significantly associated with gestational hypertension or preeclampsia compared to day shift work only. Compared to those working 21-40 h/week, working overtime (≥41 h/week) was not associated with gestational hypertension but was associated with 43% higher odds of preeclampsia (95% CI 1.02, 2.00). For part-time work (≤20 h/week), the OR was 0.76 (95% CI 0.56, 1.02) for gestational hypertension and 0.64 (95% CI 0.43, 0.97) for preeclampsia. The odds of preeclampsia were 3% higher per additional hour worked per week (95% CI 1.01-1.04). Compared to 0-4 h spent standing or walking per day, standing or walking ≥9 h daily was associated with 32% lower odds of gestational hypertension (95% CI 0.47, 0.99) but was not significantly associated with preeclampsia. Frequency of heavy lifting was not associated with either hypertensive disorder or pregnancy.
    Conclusions: Among nurses, working overtime was associated with higher odds of preeclampsia.
    MeSH term(s) Pregnancy ; Female ; Humans ; Pre-Eclampsia/epidemiology ; Pre-Eclampsia/etiology ; Hypertension, Pregnancy-Induced/epidemiology ; Hypertension, Pregnancy-Induced/etiology ; Pregnancy Trimester, First ; Cross-Sectional Studies ; Occupational Exposure/adverse effects
    Language English
    Publishing date 2023-08-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 1103950-4
    ISSN 1471-8405 ; 0962-7480
    ISSN (online) 1471-8405
    ISSN 0962-7480
    DOI 10.1093/occmed/kqad089
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  2. Article: Leveraging Artificial Intelligence to Predict Health Belief Model and COVID-19 Vaccine Uptake Using Survey Text from US Nurses.

    Omranian, Samaneh / Khoddam, Alireza / Campos-Castillo, Celeste / Fouladvand, Sajjad / McRoy, Susan / Rich-Edwards, Janet

    Behavioral sciences (Basel, Switzerland)

    2024  Volume 14, Issue 3

    Abstract: We investigated how artificial intelligence (AI) reveals factors shaping COVID-19 vaccine hesitancy among healthcare providers by examining their open-text comments. We conducted a longitudinal survey starting in Spring of 2020 with 38,788 current and ... ...

    Abstract We investigated how artificial intelligence (AI) reveals factors shaping COVID-19 vaccine hesitancy among healthcare providers by examining their open-text comments. We conducted a longitudinal survey starting in Spring of 2020 with 38,788 current and former female nurses in three national cohorts to assess how the pandemic has affected their livelihood. In January and March-April 2021 surveys, participants were invited to contribute open-text comments and answer specific questions about COVID-19 vaccine uptake. A closed-ended question in the survey identified vaccine-hesitant (VH) participants who either had no intention or were unsure of receiving a COVID-19 vaccine. We collected 1970 comments from VH participants and trained two machine learning (ML) algorithms to identify behavioral factors related to VH. The first predictive model classified each comment into one of three health belief model (HBM) constructs (barriers, severity, and susceptibility) related to adopting disease prevention activities. The second predictive model used the words in January comments to predict the vaccine status of VH in March-April 2021; vaccine status was correctly predicted 89% of the time. Our results showed that 35% of VH participants cited barriers, 17% severity, and 7% susceptibility to receiving a COVID-19 vaccine. Out of the HBM constructs, the VH participants citing a barrier, such as allergic reactions and side effects, had the most associated change in vaccine status from VH to later receiving a vaccine.
    Language English
    Publishing date 2024-03-07
    Publishing country Switzerland
    Document type Journal Article
    ZDB-ID 2651997-5
    ISSN 2076-328X
    ISSN 2076-328X
    DOI 10.3390/bs14030217
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  3. Article ; Online: In their own words: a qualitative survey of healthcare providers' experiences with personal protective equipment during the COVID-19 pandemic.

    Becene, Iris / Shah, Aarushi / Nguyen, Katie / West, Madeline / Berrill, Jane / Stuart, Jennifer / Borba, Christina / Rich-Edwards, Janet

    Annals of work exposures and health

    2024  

    Abstract: Background: At the beginning of the coronavirus disease (COVID-19) pandemic, healthcare personnel (HCP) faced a dire shortage of personal protective equipment (PPE). This shortage has been identified as a major source of distress among HCP during the ... ...

    Abstract Background: At the beginning of the coronavirus disease (COVID-19) pandemic, healthcare personnel (HCP) faced a dire shortage of personal protective equipment (PPE). This shortage has been identified as a major source of distress among HCP during the early COVID-19 pandemic, though the specific consequences of this shortage have not been identified in the qualitative literature.
    Methods: We sought to fill this gap by conducting a qualitative analysis of PPE related free-text comments from online surveys completed by 923 HCP during Spring 2020.
    Results: We found that HCP used words such as "required" and "had" to describe how their use of non-standard PPE was imposed on them by their workplace, suggesting that they felt little control over their protection at work. HCP described cleaning PPE with novel methods, such as bleach, alcohol, hydrogen peroxide, and UV light, in addition to creating their own PPE out of materials such as garbage bags, sheets, and cloth. Furthermore, HCP expressed frustration with PPE policies at their workplaces, which continued throughout the early pandemic due to the rapidly changing guidelines and the inability to express their opinions to their institutions. The combination of these concerns left HCP scared of being infected with COVID-19 while at work and subsequently infecting their loved ones at home.
    Conclusion: It is critical that healthcare institutions understand HCP's experiences with and feelings towards PPE, as providing the proper protection is vital in ensuring an adequate HCP workforce.
    Language English
    Publishing date 2024-04-17
    Publishing country England
    Document type Journal Article
    ZDB-ID 2885096-8
    ISSN 2398-7316 ; 2398-7308
    ISSN (online) 2398-7316
    ISSN 2398-7308
    DOI 10.1093/annweh/wxae026
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  4. Article ; Online: Financial precarity, food insecurity, and psychological distress prospectively linked with use of potentially dangerous dietary supplements during the pandemic in the US.

    Austin, S Bryn / Beccia, Ariel L / Raffoul, Amanda / Jackson, Destiny A / Sarda, Vishnudas / Hart, Jaime E / Chavarro, Jorge E / Rich-Edwards, Janet

    Frontiers in public health

    2023  Volume 11, Page(s) 1120942

    Abstract: Introduction: Supplements sold with claims to promote weight loss, cleansing/detoxing, increased energy, or boosted immunity can be dangerous, and consumers experiencing extreme stressors may be especially vulnerable to deceptive claims. The purpose of ... ...

    Abstract Introduction: Supplements sold with claims to promote weight loss, cleansing/detoxing, increased energy, or boosted immunity can be dangerous, and consumers experiencing extreme stressors may be especially vulnerable to deceptive claims. The purpose of our study was to investigate associations of financial strain and psychological distress during the COVID-19 pandemic with use of supplements sold for weight loss, cleanse/detox, energy, or immunity.
    Methods: We used repeated-measures data gathered over five survey waves from April/May 2020-April 2021 from the COVID-19 Substudy (
    Results: At baseline in April/May 2020, soon after pandemic onset, current use of supplement types was: weight loss 2.7%; cleanse/detox 3.2%; energy 4.4%; immune 22.6%. By the end of the study period, cumulative incidence was: weight loss 3.5%; cleanse/detox 3.7%; energy 4.5%; immune 21.3%. In prevalent-use analyses, financial precarity, food insecurity, and psychological distress were associated with up to 2.4 times the risk of use of these types of supplements across the study period. Similarly, in incident-use analyses, financial precarity and psychological distress were associated with up to 2.1 times the risk of initiating use; whereas, high food insecurity was associated with nearly 1.8 times higher risk of onset of weight-loss supplements use but was not associated with onset of use of other types of supplements.
    Discussion: We found consistent evidence that during the first year of the pandemic, participants experiencing elevated financial strain and psychological distress were at heightened risk of initiating use of potentially dangerous types of supplements. Our findings raise concerns about deceptive claims about the safety and product effectiveness by manufacturers of these supplements to profit from vulnerable consumers during the pandemic.
    MeSH term(s) Humans ; COVID-19/epidemiology ; Pandemics ; Prospective Studies ; Psychological Distress ; Dietary Supplements ; Weight Loss
    Language English
    Publishing date 2023-03-02
    Publishing country Switzerland
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, P.H.S.
    ZDB-ID 2711781-9
    ISSN 2296-2565 ; 2296-2565
    ISSN (online) 2296-2565
    ISSN 2296-2565
    DOI 10.3389/fpubh.2023.1120942
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  5. Article ; Online: Unlocking the mechanisms of change in the MAMAACT intervention to reduce ethnic disparity in stillbirth and newborns' health: integration of evaluation findings.

    Villadsen, Sarah Fredsted / Johnsen, Helle / Damsted Rasmussen, Trine / Ekstrøm, Claus Thorn / Sørensen, Janne / Azria, Elie / Rich-Edwards, Janet / Essén, Birgitta / Christensen, Ulla / Smith Jervelund, Signe / Nybo Andersen, Anne-Marie

    Frontiers in health services

    2024  Volume 4, Page(s) 1233069

    Abstract: Ethnic disparities in stillbirth exist in Europe and suboptimal care due to miscommunication is one contributing cause. The MAMAACT intervention aimed to reduce ethnic disparity in stillbirth and newborns' health through improved management of pregnancy ... ...

    Abstract Ethnic disparities in stillbirth exist in Europe and suboptimal care due to miscommunication is one contributing cause. The MAMAACT intervention aimed to reduce ethnic disparity in stillbirth and newborns' health through improved management of pregnancy complications. The intervention encompassed training of antenatal care midwives in cultural competencies and intercultural communication combined with health education materials for the expecting parents about symptoms of pregnancy complications. The evaluation consisted of a qualitative in-depth implementation analysis and a process evaluation embedded in a cluster randomized trial including 19 of 20 maternity wards in Denmark. In this article, the findings from the different evaluation perspectives are integrated. The integration follows the principles of realist evaluation by analyzing to what extent the MAMAACT activities were generating mechanisms of change in interaction with the context. The integration analysis shows that the health education materials in the MAMAACT intervention contributed to heightened health literacy concerning pregnancy complications among pregnant women. Additionally, the training of midwives in cultural competency and intercultural communication raised awareness among midwives. Nonetheless, the exclusive emphasis on midwives and the inflexibility in care provision hindered them from changing their communication practices. To enhance the cultural competence in maternity care, it is essential to implement more comprehensive initiatives involving healthcare professionals in maternity care at all levels, from pregraduate to postgraduate. Adequate interpreter services and management support should also be ensured. Currently, the Danish antenatal care system faces challenges including inadequate information transfer between healthcare sectors, insufficient differentiation of care, and inflexibility in midwife scheduling. This results in a lack of responsiveness to the individual needs of women with immigrant backgrounds, potentially reproducing health inequities.
    Language English
    Publishing date 2024-02-16
    Publishing country Switzerland
    Document type Journal Article
    ISSN 2813-0146
    ISSN (online) 2813-0146
    DOI 10.3389/frhs.2024.1233069
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  6. Article ; Online: Association of age at menarche, reproductive lifespan and age at menopause with the risk of atrial fibrillation: The HUNT study.

    Morooka, Hikaru / Haug, Eirin B / Malmo, Vegard / Loennechen, Jan Pål / Mukamal, Kenneth J / Rich-Edwards, Janet / Sen, Abhijit / Janszky, Imre / Horn, Julie

    Maturitas

    2024  Volume 185, Page(s) 107979

    Abstract: Background: Age at menarche, reproductive lifespan, and age at menopause are associated with several cardiovascular diseases, but their relationship with atrial fibrillation (AF) is uncertain.: Methods: We linked information on all women who ... ...

    Abstract Background: Age at menarche, reproductive lifespan, and age at menopause are associated with several cardiovascular diseases, but their relationship with atrial fibrillation (AF) is uncertain.
    Methods: We linked information on all women who participated in the third survey of the population-based, longitudinal HUNT study in Norway with medical records from all local hospitals. A total of 14,632 women aged 60 or more were followed for validated incident AF. We retrieved age at menarche and age at menopause from the HUNT questionnaires. Reproductive lifespan was defined as the difference between age at menarche and age at menopause. We used Cox proportional hazards regression models to assess associations between AF and age at menarche, reproductive lifespan, and age at menopause.
    Results: During a median follow-up of 8.17 years (136,494 person-years), 1217 (8.3 %) participants developed AF. In multivariable-adjusted analyses, we observed no associations between early or late age at menarche and AF (hazard ratios (HRs): <12 years: 0.85 [95 % confidence interval (CI), 0.65-1.12]; ≥16 years: 0.99 [95 % CI, 0.80-1.24] compared to those who attained menarche at 13-14 years). The HR for a reproductive lifespan shorter than 30 years was 0.91 [95 % CI, 0.72-1.15] compared to 34-37 years. Likewise, there was no clear association between premature or early age at menopause and AF (HRs: <40 years: 1.21 [95 % CI, 0.83-1.75]; 40-44 years: 0.97 [95 % CI, 0.77-1.22] compared to 50-54 years).
    Conclusions: In this population of women aged 60 years and over, the risk of AF was not associated with age at menarche, reproductive lifespan, or age at menopause.
    Language English
    Publishing date 2024-03-26
    Publishing country Ireland
    Document type Journal Article
    ZDB-ID 80460-5
    ISSN 1873-4111 ; 0378-5122
    ISSN (online) 1873-4111
    ISSN 0378-5122
    DOI 10.1016/j.maturitas.2024.107979
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  7. Article ; Online: Nurses' use of 'wellness' supplements during the COVID-19 pandemic in the United States.

    Turner, Samantha L / Beccia, Ariel / Feeny, Gwenneth / Raffoul, Amanda / Jackson, Destiny / Sarda, Vishnudas / Rich-Edwards, Janet / Chavarro, Jorge / Hart, Jaime E / Austin, S Bryn

    Journal of advanced nursing

    2024  

    Abstract: Aim: Quantify disparities and identify correlates and predictors of 'wellness' supplement use among nurses during the first year of the pandemic.: Design: Longitudinal secondary analysis of Nurses' Health Studies 2 and 3 and Growing Up Today Study ... ...

    Abstract Aim: Quantify disparities and identify correlates and predictors of 'wellness' supplement use among nurses during the first year of the pandemic.
    Design: Longitudinal secondary analysis of Nurses' Health Studies 2 and 3 and Growing Up Today Study data.
    Methods: Sample included 36,518 total participants, 12,044 of which were nurses, who completed surveys during the first year of the COVID-19 pandemic (April 2020 to April 2021). Analyses were conducted in March 2023. Modified Poisson models were used to estimate disparities in 'wellness' supplement use between nurses and non-healthcare workers and, among nurses only, to quantify associations with workplace-related predictors (occupational discrimination, PPE access, workplace setting) and psychosocial predictors (depression/anxiety, county-level COVID-19 mortality). Models included race/ethnicity, gender identity, age and cohort as covariates.
    Results: Nurses were significantly more likely to use all types of supplements than non-healthcare workers. Lacking personal protective equipment and experiencing occupational discrimination were significantly associated with new immune supplement use. Depression increased the risk of using weight loss, energy and immune supplements.
    Conclusion: Nurses' disproportionate use of 'wellness' supplements during the COVID-19 pandemic may be related to workplace and psychosocial stressors. Given well-documented risks of harm from the use of 'wellness' supplements, the use of these products by nurses is of concern.
    Impact: 'Wellness' supplements promoting weight loss, increased energy, boosted immunity and cleansing of organs are omnipresent in today's health-focused culture, though their use has been associated with harm. This is of added concern among nurses given their risk of COVID-19 infection at work. Our study highlighted the risk factors associated with use of these products (lacking PPE and experiencing occupational discrimination). Findings support prior research suggesting a need for greater public health policy and education around the use of 'wellness' supplements.
    Reporting method: STROBE guidelines were followed throughout manuscript.
    Patient or public contribution: No patient or public contribution was involved.
    Language English
    Publishing date 2024-03-21
    Publishing country England
    Document type Journal Article
    ZDB-ID 197634-5
    ISSN 1365-2648 ; 0309-2402
    ISSN (online) 1365-2648
    ISSN 0309-2402
    DOI 10.1111/jan.16162
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  8. Article ; Online: Ten-Year Cardiovascular Disease Risk Trajectories by Obstetric History: A Longitudinal Study in the Norwegian HUNT Study.

    Fraser, Abigail / Markovitz, Amanda R / Haug, Eirin B / Horn, Julie / Romundstad, Pål Richard / Dalen, Håvard / Rich-Edwards, Janet / Åsvold, Bjørn Olav

    Journal of the American Heart Association

    2022  Volume 11, Issue 2, Page(s) e021733

    Abstract: Background Women with a history of obstetric complications are at increased risk of cardiovascular disease, but whether they should be specifically targeted for cardiovascular disease (CVD) risk screening is unknown. Methods and Results We used linked ... ...

    Abstract Background Women with a history of obstetric complications are at increased risk of cardiovascular disease, but whether they should be specifically targeted for cardiovascular disease (CVD) risk screening is unknown. Methods and Results We used linked data from the Norwegian HUNT (Trøndelag Health) Study and the Medical Birth Registry of Norway to create a population-based, prospective cohort of parous women. Using an established CVD risk prediction model (A Norwegian risk model for cardiovascular disease), we predicted 10-year risk of CVD (nonfatal myocardial infarction, fatal coronary heart disease, and nonfatal or fatal stroke) based on established risk factors (age, systolic blood pressure, total and high-density lipoprotein cholesterol, smoking, antihypertensive use, and family history of myocardial infarction). Predicted 10-year CVD risk scores in women aged between 40 and 60 years were consistently higher in those with a history of obstetric complications. For example, when aged 40 years, women with a history of preeclampsia had a 0.06 percentage point higher mean risk score than women with all normotensive deliveries, and when aged 60 years this difference was 0.86. However, the differences in the proportion of women crossing established clinical thresholds for counseling and treatment in women with and without a complication were modest. Conclusions Findings do not support targeting parous women with a history of pregnancy complications for CVD screening. However, pregnancy complications identify women who would benefit from primordial and primary prevention efforts such as encouraging and supporting behavioral changes to reduce CVD risk in later life.
    MeSH term(s) Adult ; Cardiovascular Diseases/epidemiology ; Female ; Humans ; Longitudinal Studies ; Middle Aged ; Myocardial Infarction ; Pregnancy ; Pregnancy Complications ; Prospective Studies ; Risk Factors
    Language English
    Publishing date 2022-01-11
    Publishing country England
    Document type Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
    ZDB-ID 2653953-6
    ISSN 2047-9980 ; 2047-9980
    ISSN (online) 2047-9980
    ISSN 2047-9980
    DOI 10.1161/JAHA.121.021733
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  9. Article ; Online: Feasibility of a Postpartum Web- and Phone-Based Lifestyle Program for Women with a History of Preeclampsia or Gestational Diabetes: A Pilot Intervention Study.

    Horn, Julie / Kolberg, Marit / Rangul, Vegar / Magnussen, Elisabeth B / Åsvold, Bjørn Olav / Henriksen, Hege B / Blomhoff, Rune / Seely, Ellen W / Rich-Edwards, Janet

    Women's health reports (New Rochelle, N.Y.)

    2023  Volume 4, Issue 1, Page(s) 345–357

    Abstract: Background: Women with a history of preeclampsia (PE) or gestational diabetes mellitus (GDM) are at increased risk of diabetes and cardiovascular disease (CVD) later in life. Increased awareness of pregnancy complications as early warning signs for CVD ... ...

    Abstract Background: Women with a history of preeclampsia (PE) or gestational diabetes mellitus (GDM) are at increased risk of diabetes and cardiovascular disease (CVD) later in life. Increased awareness of pregnancy complications as early warning signs for CVD has called for postpartum primordial prevention strategies. The aim of this study was to evaluate the feasibility of a postpartum web- and phone-based lifestyle program promoting healthy lifestyle behaviors to women after a pregnancy complicated by PE or GDM.
    Materials and methods: Women with a validated history of PE or GDM were invited to participate in a nonrandomized pilot intervention study 3-12 months after delivery. The intervention was delivered over 6 months. All participants received tailored lifestyle counseling by a registered dietitian and access to information material on healthy lifestyle behaviors on the study's website. After inclusion, participants were invited to three study visits at baseline, 3 months, and 6 months. Feasibility outcomes included assessment of recruitment, retention, and acceptability. Secondary outcomes were changes in lifestyle behaviors and cardiovascular risk factors.
    Results: Of the 207 women invited, 44 were enrolled in the feasibility study and 40 women completed the intervention, corresponding to a recruitment rate of 21% and a retention rate of 91%. At the 3-month study visit, 94.6% of participants reported they had used the website. A total of 41.7% of the participants reported that they had achieved their personal goals during the intervention period.
    Conclusions: This study suggested the feasibility and potential acceptability of a web- and phone-based lifestyle intervention for mothers with recent PE or GDM.
    Clinical trial registration: clinicaltrials.gov, www.clinicaltrials.gov, no. NCT03993145.
    Language English
    Publishing date 2023-07-18
    Publishing country United States
    Document type Journal Article
    ISSN 2688-4844
    ISSN (online) 2688-4844
    DOI 10.1089/whr.2023.0039
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  10. Article ; Online: A long and resilient life: the role of coping strategies and variability in their use in lifespan among women.

    Trudel-Fitzgerald, Claudia / Lee, Lewina O / Guimond, Anne-Josée / Chen, Ruijia / James, Peter / Koga, Hayami K / Lee, Harold H / Okuzono, Sakurako S / Grodstein, Francine / Rich-Edwards, Janet / Kubzansky, Laura D

    Anxiety, stress, and coping

    2023  , Page(s) 1–14

    Abstract: Objectives: Associations of stress-related coping strategies with lifespan among the general population are understudied. Coping strategies are characterized as being either adaptive or maladaptive, but it is unknown the degree to which variability in ... ...

    Abstract Objectives: Associations of stress-related coping strategies with lifespan among the general population are understudied. Coping strategies are characterized as being either adaptive or maladaptive, but it is unknown the degree to which variability in tailoring their implementation to different contexts may influence lifespan.
    Method: Women (N = 54,353; M
    Results: In multivariable models, most adaptive and maladaptive strategies were associated with longer and shorter lifespans, respectively (e.g., per 1-SD increase: Active Coping = 4.09%, 95%CI = 1.83%, 6.41%; Behavioral Disengagement = -6.56%, 95%CI = -8.37%, -4.72%). Moderate and greater (versus lower) variability levels were similarly and significantly related to 8-10% longer lifespans. Associations were similar across age, racial/ethnic, residential income, and marital status subgroups.
    Conclusions: Findings confirm the adaptive and maladaptive nature of specific coping strategies, and further suggest benefits from both moderate and greater variability in their use for lifespan among women.
    Language English
    Publishing date 2023-11-29
    Publishing country England
    Document type Journal Article
    ZDB-ID 1115932-7
    ISSN 1477-2205 ; 1061-5806
    ISSN (online) 1477-2205
    ISSN 1061-5806
    DOI 10.1080/10615806.2023.2288333
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