Breastfeeding suppresses ovarian cycles, resulting in some period of postpartum amenorrhea (PPA) in women. In some traditional societies, a strong bimodial pattern of PPA has been observed, but the behavioral or physiological mechanisms leading to this pattern are unclear. We investigate the relationship between early breastfeeding behavior and short duration (~3 months) or long duration (~15 months) PPA in a sample of rural Bangladeshi women. Data came from a prospective study in which the time to initiation of breastfeeding and the duration and frequency of breastfeeding were assessed by questionnaire within a month of delivery. The duration of PPA was observed for up to 10 months following delivery. We identified six participants who experienced PPA for less than 3 months and 50 participants who experienced PPA for greater than 4 months. Our analysis found that the self-reported time to initiation of breastfeeding and number of breastfeeding episodes were not significantly different between the two groups. The self-reported duration of feeding episodes did differ significantly between the two groups. Women who reported longer episodes per nursing episode at around 10 days postpartum experienced, on average, a significantly longer duration of PPA. This study suggests that the bimodial distribution of PPA arises, in part, from breastfeeding differences that arise shortly after parturition.

Throughout Washington, there is a lack of awareness about the Hanford nuclear site and its impacts on Native American tribes. Since 2015, teaching of Since Time Immemorial (STI) - a tribally developed curriculum covering Hanford and other issues - has been required throughout Washington schools.Yet, there is a lack of information on how this curriculum has been implemented and to what extent Hanford is being taught about. Thus, this research project aims to gather data on current teaching practices on the Hanford site as well as general tribal education throughout Washington schools. We also attempt to understand what measures can be taken to help teachers implement native centered curriculum, especially about Hanford. Initial research was conducted through semi structured interviews with stakeholders about current education practices and efforts to implement education about Hanford. This preliminary research was used to develop a survey for middle and high school teachers across Washington. The survey contained 15 multiple choice and short answer questions addressing the STI curriculum and education on Hanford. The survey also included an educational research guide for teachers who were interested in learning more about STI or Hanford. The survey was administered to 234 districts by emailing school administrators with the request that the survey be forwarded to teachers in their school; contact information for administrators was gathered through the WA OSPI website. Based on current data, it’s anticipated that there is very limited coverage of Hanford in schools due to time constraints, lack of interest, and omission from standard curriculums, suggesting a need to ensure that existing tribally developed curriculum is taught in classrooms. This is an urgent matter because lack of public awareness about the history and impacts of the Hanford Site on Native Americans allows for the harms to continue to be perpetrated. 

Vaccine hesitancy reflects concerns about the decision to vaccinate oneself or one's children. There is a broad range of factors contributing to vaccine hesitancy, including the compulsory nature of vaccines, their coincidental temporal relationships to adverse health outcomes, unfamiliarity with vaccine-preventable diseases, and lack of trust in corporations and public health agencies. In addition, the very success of vaccine programs has seemingly fueled increasing vaccine concern as vaccine-preventable diseases are no longer prevalent in the United States. This decrease in prevalence has led the attention of the public to shift from the necessity of vaccines to the safety of the vaccines themselves. In light of the current COVID-19 pandemic and the heavy economic and public health toll it has taken, it became clear that a vaccine may be the “magic bullet”. In the midst of a pandemic that is taking thousands of lives and has been devastating society, many people will find these uncertainties acceptable. While for others, as with many trade-offs, the benefit may have less emotional resonance than the possibility, no matter how small, of a potential risk. My research seeks to understand the risk perceptions of vaccination in an adult population in the Puget Sound region of Washington state. My hypothesis suggests that social proximity to COVID-19 will influence vaccine decision making & vaccine risk perception. I will be using the annual influenza shot as well as assessing smaller recent outbreaks to build a framework for my thesis. Understanding the factors that are influencing adults, when it comes to vaccine decision making, may help inform strategies for state and public health officials in their multifaceted roles of communicating effectively on the benefits and safety of vaccines to policy makers, media, and the public as a means to better support informed decision making.

Pre-health undergraduate (PHU) students are often encouraged by graduate and professional programs to shadow in healthcare settings. However, shadowing opportunities can be limited and disengaging for students. A potential avenue to improve shadowing experiences for PHU students, while providing mutual benefits to health professionals who they shadow, is the active and guided incorporation of students as observers into patient- and family-centered rounds (PFCR). For this pilot study, our hypothesis was that a structured PFCR shadowing and feedback process would be mutually beneficial for PHU students and interprofessional care teams. We tested our pilot process at Seattle Children’s Hospital. There were two cycles from January through November 2019. In the first cycle, a single PHU student was trained to use the High-Value Care Rounding Tool to collect quantitative and qualitative observational data about PFCR. The second cycle expanded the approach to a cohort of six additional students. Results were presented to a convenience sample of attending physicians who afterwards completed a brief survey about the value of this shadowing process for their own practice. Additionally, PHU students shared their own experiences via an interview and survey. For the analysis, we used descriptive statistics for quantitative data and thematic analysis for qualitative data from 53 PFCR episodes, 17 attending surveys, and 7 PHU student interviews and surveys. Five major themes emerged from these results including: (1) PHU students observed PFCR from a family-like perspective, (2) students felt they had a designated role in PFCR, (3) students provided tangible and actionable feedback on communication techniques for the interprofessional team, (4) students appreciated structured experiences for their future careers, and (5) feedback was valued by attendings. This pilot study offers a promising model for shadowing programs to provide an engaging experience for students, useful feedback for health professionals, and improve patient and family-centered communication.

Women's reproductive health continues to be one of the most neglected issues in healthcare globally. This is illustrated by morbidity and mortality rates related to childbirth. The U.S., for example, has one of the worst rates of maternal mortality when compared to other developed, high income countries. The purpose of this scoping review was to gain a better understanding of predisposing, enabling, and reinforcing factors that impact women's reproductive rights and perinatal health. Key interviews were also conducted with scholars and practitioners to gain global perspectives. Through application of intersectionality theory as well as the social ecological model, this presentation will highlight factors at the individual, interpersonal, organizational, and public policy levels that impact reproductive health and childbirth.

 Human biospecimens have undeniably paved the way for medical progress, but historically also surfaces problematic ethical considerations around consent, compensation, and privacy. Marginalized communities have been historically exploited as test subjects and sample sources; unknowingly or unwillingly playing a lead character role in scientific research. This results in a legacy of distrust in science and medicine as well as health disparities. Broadly, I hope to examine cultural impacts and health legacies that result from exploitive research practices, specifically examining biospecimen collection from the Rongelap people during Project 4. in the Marshall Islands during the 1950's and other examples, such as Henrietta Lacks, and the Tuskegee Syphilis Study. By comparing these case studies, I endeavor to interrogate historical discourse around biospecimen collection in research to inform the relationship between scientific exploitation and population health disparities in marginalized communities today. In doing so, I hope to broaden the space for amplifying Marshallese voices and incorporating the population health impact of Project 4.1 into current dialogue around issues in scientific research.