Publications by authors named "Heidi Roeber-Rice"

5 Publications

  • Page 1 of 1

Fertility goal-based counseling increases contraceptive implant and IUD use in HIV-discordant couples in Rwanda and Zambia.

Contraception 2013 Jul 12;88(1):74-82. Epub 2012 Nov 12.

Rwanda Zambia HIV Research Group, Department of Pathology and Laboratory Medicine, School of Medicine, Emory University, Atlanta, GA 30322, USA.

Background: HIV-discordant heterosexual couples are faced with the dual challenge of preventing sexual HIV transmission and unplanned pregnancies with the attendant risk of perinatal HIV transmission. Our aim was to examine uptake of two long-acting reversible contraceptive (LARC) methods--intrauterine devices (IUD) and hormonal implants--among HIV-discordant couples in Rwanda and Zambia.

Study Design: Women were interviewed alone or with their partner during routine cohort study follow-up visits to ascertain fertility goals; those not pregnant, not infertile, not already using LARC, and wishing to limit or delay fertility for ≥3 years were counseled on LARC methods and offered an IUD or implant on-site.

Results: Among 409 fertile HIV-discordant Rwandan women interviewed (126 alone, 283 with partners), 365 (89%) were counseled about LARC methods, and 130 (36%) adopted a method (100 implant, 30 IUD). Of 787 fertile Zambian women interviewed (457 alone, 330 with partners), 528 (67%) received LARC counseling, of whom 177 (34%) adopted a method (139 implant, 38 IUD). In both countries, a woman's younger age was predictive of LARC uptake. LARC users reported fewer episodes of unprotected sex than couples using only condoms.

Conclusions: Integrated fertility goal-based family planning counseling and access to LARC methods with reinforcement of dual-method use prompted uptake of IUDs and implants and reduced unprotected sex among HIV-discordant couples in two African capital cities.
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July 2013

What immunizations should I offer to my patients? A primer on adult immunizations.

J Assoc Physicians India 2011 Sep;59:568-72

HIV Project, Emory University, USA.

Despite the cost-effectiveness and widespread availability of vaccines, vaccine-preventable diseases remain an important cause of morbidity and mortality worldwide. We present the indications, contraindications and administration of adult vaccinations, as well as the strategies for improving the rate of outpatient adult vaccination as an effective means of disease prevention. Although immunizations have altered the course of many infectious diseases worldwide, there is a significant chasm in what we know is best for our patients versus what reaches our patients. A greater emphasis is needed for vaccination of adults, especially in primary care and public health settings as well as in special populations such as the pregnant, elderly or immunosuppressed.
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September 2011

A longitudinal analysis of total workload and women's health after childbirth.

J Occup Environ Med 2011 May;53(5):497-505

Division of Environmental Sciences, School of Public Health, University of Minnesota, Minneapolis, MN 55455, USA.

Objectives: To examine the association of women's postpartum health with total workload (TWL), work and personal factors in the year after childbirth.

Methods: Employed women from Minneapolis and St Paul, Minnesota, were recruited while hospitalized for childbirth. Longitudinal analyses, using fixed effects regression models, estimated the associations of TWL, job satisfaction and stress, social support, perceived control, breastfeeding and infant characteristics with women's health at 5 weeks, 11 weeks, 6 months, and 12 months postpartum.

Results: Increased TWL over time was associated with significantly poorer mental health and increased symptoms.

Conclusions: High TWL--including reduced time for rest, recovery, and sleep--is a risk factor for women's mental health and symptoms 12 months after childbirth. Women's postpartum health was positively associated with social support, which may help to decrease the negative effects of excess work.
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May 2011

Occupational medicine residency graduate survey: assessment of training programs and core competencies.

J Occup Environ Med 2007 Dec;49(12):1325-38

Occupational and Environmental Medicine (Dr Baker), HealthPartners, St. Paul, Minneapolis, MN 55455, USA.

Objective: This study provides insight into Occupational Medicine (OM) residency graduates and how residency programs are meeting their education goals.

Methods: A survey of graduates from nine OM residency program was performed to evaluate the effectiveness of OM residency training in the United States and Canada.

Results: Eighty percent of the OM residency graduates were currently practicing OM. Three-quarters worked in clinical practice for a mean of 20 hr/wk. Other activities varied and included management, teaching and consulting. Ninety-five percent were satisfied with their OM residency training. The competencies acquired were mostly ranked highly as practice requisites, although preparation in clinical OM might be better emphasized in training. Recent OM residency graduates were more likely to be board-certified in OM than other American College of Occupational and Environmental Medicine physician members (73% vs 41%).

Conclusions: OM residency graduates over the past 10 years were highly satisfied with OM residency training, with the training generally meeting practice needs.
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December 2007

Workplace hazards to women's reproductive health.

Minn Med 2007 Sep;90(9):44-7

Department of Occupational and Environmental Medicine, HealthPartners, USA.

Women make up nearly half of Minnesota's workforce. Thus, many women, including those of reproductive age, are exposed to workplace hazards. These hazards may be chemical-toxicants such as heavy metals, pesticides, and endocrine disruptors; physical--the result of activities or proximity to something in the environment; or biological-infectious agents. And they are of growing concern among scientists and the public. Although data on the effect of these hazards on the reproductive health of women is limited, there is evidence indicating they ought to be of concern to women and the physicians who treat them. Clinicians are encouraged to assess women for exposure to workplace hazards and to communicate with them about whether such exposure might increase their risk for problems such as infertility, miscarriage, and preterm birth. This article highlights selected job-related hazards and offers suggestions for caring for working women of reproductive age.
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September 2007