Navigating geographical disparities: access to obstetric hospitals in maternity care deserts and across the United States.

Background: Access to maternity care in the U.S. remains inequitable, impacting over two million women in maternity care "deserts.

Bias in Self-reported Prepregnancy Weight Across Maternal and Clinical Characteristics.

Objectives: Prepregnancy body mass index (BMI) and gestational weight gain (GWG) are known determinants of maternal and child health; calculating both requires an accurate measure of prepregnancy weight. We compared self-reported prepregnancy weight to measured weights to assess reporting bias by maternal and clinical characteristics.

Methods: We conducted a retrospective cohort study among pregnant women using electronic health records (EHR) data from Kaiser Permanente Northwest, a non-profit integrated health care system in Oregon and southwest Washington State.

Improving management of the genitourinary syndrome of menopause: evaluation of a health system-based, cluster-randomized intervention.

Background: Genitourinary symptoms are common in postmenopausal women and adversely affect the quality of life. National surveys and data collected from our healthcare system indicate that postmenopausal women with the genitourinary syndrome of menopause often fail to receive appropriate diagnosis or treatment.

Objective: To promote greater detection and treatment of the genitourinary syndrome of menopause, we created and tested a clinician-focused health system intervention that included clinician education sessions and a suite of evidence-based electronic health record tools.

Education and employment outcomes in clients of the Nurse-Family Partnership.

Objectives: Nurse-Family Partnership (NFP) is an evidence-based home visitation program designed for low-income, first-time mothers to support pregnancy, child development, and maternal self-sufficiency. This study examined educational and employment outcomes among NFP clients compared to a reference sample.

Design: Entropy balancing and a difference-in-difference design were used to compare the two samples of women from 2007 to 2016.

Correlates of Benzodiazepine Use and Adverse Outcomes Among Patients with Chronic Pain Prescribed Long-term Opioid Therapy.

Objective: To examine the correlates and odds of receiving overlapping benzodiazepine and opioid prescriptions and whether co-prescription was associated with greater odds of falling or visiting the emergency department.

Design: Cross-sectional study.

Setting: A large private integrated health system and a Veterans Health Administration integrated health system.

Clinician knowledge, attitudes, and barriers to management of vulvovaginal atrophy: variations in primary care and gynecology.

Objective: Vulvovaginal atrophy is a common, but under-recognized condition affecting postmenopausal women. To guide development of an intervention to boost its detection and treatment, we surveyed primary care and gynecology clinicians practicing in an integrated healthcare system.

Methods: We constructed a three-part survey that contained (1) eight multiple-choice knowledge questions; (2) three Likert-scale questions regarding clinicians' likelihood of assessing for vulvovaginal atrophy symptoms at a routine (well) visit, confidence in advising patients about symptoms and counseling about therapy; and (3) a 12-item check list of potential barriers to diagnosis and treatment.

Decrease in unnecessary vitamin D testing using clinical decision support tools: making it harder to do the wrong thing.

Objective: To evaluate the impact of clinical decision support (CDS) tools on rates of vitamin D testing. Screening for vitamin D deficiency has increased in recent years, spurred by studies suggesting vitamin D's clinical benefits. Such screening, however, is often unsupported by evidence and can incur unnecessary costs.