Papers by Christa Johnson
The Journal of Sexual Medicine, 2014
The Journal of Sexual Medicine, 2014
In recent decades, growing migration to the United States from countries where female genital mut... more In recent decades, growing migration to the United States from countries where female genital mutilation/cutting (FGM/C) is widely practiced has caused a rise in the number of women and girls in the United States who could have potentially experienced FGM/C. A scoping review was conducted to identify research and gaps in literature about FGM/C–related attitudes and experiences among individuals from FGM/C–practicing countries living in the United States. This scoping review identified 40 articles meeting inclusion criteria. The findings of this review suggest that both women and men from FGM/C–practicing countries living in the United States generally oppose FGM/C, and that women with FGM/C have significant physical and mental health needs and have found US healthcare providers to lack understanding of FGM/C. Future research can improve measurement of FGM/C by applying a health equity lens and taking into account the sociocultural influences on FGM/C–related attitudes and experiences.
Refugee Health Care, 2020
Health & social care in the community, 2022
In 2020, healthcare workers faced the COVID-19 pandemic amidst other salient sociopolitical stres... more In 2020, healthcare workers faced the COVID-19 pandemic amidst other salient sociopolitical stressors. This study, therefore, set out to examine associations between personal, work-related and contextual factors and three outcomes - stress, burnout and turnover intention - at a critical juncture in the pandemic. In December 2020, we recruited a broad array of healthcare workers (n = 985) in a public safety net healthcare system serving socially and economically marginalised communities in the Southwest region of the United States using a cross-sectional online survey. The results indicated that more health problems were associated with higher stress and burnout symptoms. While seeking emotional support and using drugs or alcohol to cope were associated with higher stress, a positive social outlook was associated with lower stress. Lower quality of work-life was associated with higher burnout symptoms and turnover intention. Negative effects of the pandemic on wellbeing and higher nu...
Journal of Racial and Ethnic Health Disparities, 2022
Introduction There is scant evidence on the health morbidities experienced by Somali women and gi... more Introduction There is scant evidence on the health morbidities experienced by Somali women and girls affected by female genital mutilation/cutting (FGM/C) and their resultant health-seeking behavior in the USA as compared to those who have not undergone the procedure. To fill this gap, we conducted a comprehensive examination of health morbidity among women and teenage girls with and without FGM/C in a Somali migrant community. Methods Using a comprehensive community-based participatory research approach, a cross-sectional survey was administered to 879 Somali women and teenage girls in Phoenix and Tucson, Arizona. We employed Chi-square and analysis of variance to disentangle health and healthcare use among those with and without FGM/C. Results The majority of respondents had undergone FGM/C (79%). Respondents with FGM/C experienced significantly more health concerns compared to uncut women and girls, with those possessing Type III FGM/C experiencing significantly more obstetric, g...
Copyright © 2013 Jalana N. Lazar et al.This is an open access article distributed under the Creat... more Copyright © 2013 Jalana N. Lazar et al.This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. This pilot study explored health care providers ’ perceptions of barriers to providing health care services to Somali refugee women. The specific aim was to obtain information about providers ’ experiences, training, practices and attitudes surrounding the prenatal care, delivery, andmanagement of womenwith Female Genital Cutting (FGC).Methods. Individual semi-structured interviews were conducted with 14 obstetricians/gynecologists and nurse midwives in Columbus, Ohio. Results. While providers did not perceive FGC as a significant barrier in itself, they noted considerable challenges in communicating with their Somali patients and the lack of formal training or protocols guiding the management of circumcised women. Provid...
Background. This pilot study explored health care providers' perceptions of barriers to prov... more Background. This pilot study explored health care providers' perceptions of barriers to providing health care services to Somali refugee women. The specific aim was to obtain information about providers' experiences, training, practices and attitudes surrounding the prenatal care, delivery, and management of women with Female Genital Cutting (FGC). Methods. Individual semistructured interviews were conducted with 14 obstetricians/gynecologists and nurse midwives in Columbus, Ohio. Results. While providers did not perceive FGC as a significant barrier in itself, they noted considerable challenges in communicating with their Somali patients and the lack of formal training or protocols guiding the management of circumcised women. Providers expressed frustration with what they perceived as Somali patients' resistance to obstetrical interventions and disappointment with a perception of mistrust from patients and their families. Conclusion. Improving the clinical encounter ...
ABSTRACTObjectiveAutomated and accurate identification of refugees in healthcare databases is a c... more ABSTRACTObjectiveAutomated and accurate identification of refugees in healthcare databases is a critical first step to investigate healthcare needs of this vulnerable population and improve health disparities. This study developed a machine-learning method, named refugee identification system (RIS) that uses features commonly collected in healthcare databases to classify refugees and non-refugees.Materials and MethodsWe compiled a curated data set consisting of 103 refugees and 930 non-refugees in Arizona. For each person in the curated data set, we collected age, primary language, and home address. We supplemented individual-level data with state-level refugee resettlement statistics and world language statistics, then performed feature engineering to convert primary language and home address into quantitative features. Finally, we built a random forest model to classify refugee status.ResultsEvaluated on holdout testing data, RIS achieved a high classification accuracy of 0.97, sp...
Research in the Sociology of Health Care, 2018
Abstract Purpose To determine the health status of women before, during, and after the war, and t... more Abstract Purpose To determine the health status of women before, during, and after the war, and to explore women’s perceived health needs and current access to healthcare. Methodology/approach Individual interviews and focus groups were conducted in urban and rural areas. A total of 52 women participated in the study (N = 52; Individual Interviews, n = 12; Focus Group Participants, n = 40). Findings Women’s health concerns and healthcare needs overlap between the rural and urban communities. The women reported the needs for empowerment in the forms of social support groups for health, specialists for women’s health, education, resources, prevention, financial support to look for medical services, and mental health issues. Research limitations/implications Since these focus groups and interviews were conducted, the women have continued to meet. The strength of these meetings is represented in the forms of preparing a meal, eating, and socializing in unity. The social support experienced in these gatherings allows the women to openly express their issues, fears, concerns, joys, and successes. The CBPR approach is an important necessity when working with vulnerable populations. There were some inherent limitations due to economic issues to support the gatherings, transportation, and health-related complications that may have prevented women from attending. Originality/value Disparate health outcomes and biologic–environmental interactions are represented in female survivors of war. Their issues began or were exacerbated during war and continue today. In the future, we seek to identify and establish a culturally and gender-specific intervention for health access, prevention, maintenance, and improvements.
Female Sexual Pain Disorders, 2020
Journal of Immigrant and Minority Health, 2014
American Muslims have low rates of mammography utilization, and research suggests that religious ... more American Muslims have low rates of mammography utilization, and research suggests that religious values influence their health-seeking behaviors. We assessed associations between religion-related factors and breast cancer screening in this population. A diverse group of Muslim women were recruited from mosques and Muslim organization sites in Greater Chicago to selfadminister a survey incorporating measures of fatalism, religiosity, discrimination, and Islamic modesty. 254 surveys were collected of which 240 met age inclusion criteria (40 years of age or
Journal of Immigrant and Minority Health, 2014
As container traffic is increasing, the introduction of mega-vessel has had a significant impact ... more As container traffic is increasing, the introduction of mega-vessel has had a significant impact on the ports and terminals business. This movement of container shipping has led to intensely competitive environment among ports, so substantial pressures to develop new container ports or to expand existing ones, have been grown. However, it requires a huge investment, especially cost and time, to overcome environmental, geographical and financial restrictions generated from developing a port. This study addressed the Mobile Harbor, the new concept of marine logistics system as an alternative strategy. We performed an economic analysis on the introduction of the Mobile Harbor in coastal transport sector and also a sensitivity analysis to examine the effects of changing factors related on the economic evaluation. We have examined the value and application of Mobile Harbor as a preliminary study, which may contribute to further studies on the Mobile Harbor.
Ethnicity & Health, 2013
Somali women are at increased risk of adverse pregnancy outcomes. Anxiety and perceived stigmatiz... more Somali women are at increased risk of adverse pregnancy outcomes. Anxiety and perceived stigmatization toward female genital cutting (FGC) further fuels an atmosphere of miscommunication and distrust, contributing to poorer health outcomes. While the attitudes and experiences of Somali refugee women toward healthcare are widely known, the views of Somali refugee men are largely unknown. This study examines the perspectives of Somali men toward FGC and women's childbirth experiences in one refugee community in the USA. Community-based participatory research partnerships with key stakeholders within the Somali refugee community incorporated qualitative methods comprising semi-structured focus groups and individual interviews to elicit male participants' perspectives on FGC, experiences during childbirth, and the perception of increased cesarean deliveries among Somali women. Qualitative analyses involved a framework and team-based approach using grounded theory and conventional content analysis. Acculturation influenced changes in traditional gender roles fostering new dynamics in shared decision-making within the household and during childbirth. Participants were aware of FGC-related morbidity, ongoing matriarchal support for FGC, and were generally not supportive of FGC. They perceived health-care providers as being unfamiliar with caring for women with FGC fueling profound aversion to cesarean deliveries, miscommunication, and distrust of the health-care system. Our work yields new insights into Somali reproductive healthcare through Somali men, namely: strong matriarchal support of FGC, discomfort in men's presence during delivery, and a strong aversion to cesarean delivery. Our findings support the need for advocacy to engage Somali women, their partners/spouses, and health-care providers in facilitating greater continuity of care, building greater trust as men become engaged throughout the spectrum of care in the decision-making process while respecting traditional norms. Cultural health navigators should bridge communication and support between providers and patients. Our work provides foundational knowledge to inform culturally appropriate health interventions within a Somali refugee community.
AJOG Global Reports, 2021
Background The COVID-19 pandemic has exposed disproportionate health inequities among underserved... more Background The COVID-19 pandemic has exposed disproportionate health inequities among underserved populations, including refugees. Public safety net health care systems play a critical role in facilitating access to care for refugees, and informing coordinated public health prevention and mitigation efforts during a pandemic crisis. Objective To evaluate the prevalence of SARS-CoV-2 among refugee women admitted for delivery relative to non-refugee parturient patients. We suspect the burden of infection is disproportionately distributed across refugee communities which may act as sentinels for community outbreaks. Study Design A cross-sectional study was performed examining parturient women admitted to the maternity unit between May 6 and July 22, 2020, when universal testing for SARS-CoV-2 was first employed. Risk factors for SARS-CoV-2 positivity were ascertained, disaggregated by refugee status, and other clinical and socio-demographic variables examined. Prevalence ratios (PR) we...
Journal of Refugee Studies
This study reviewed social support research with refugees in resettlement by assessing the scope ... more This study reviewed social support research with refugees in resettlement by assessing the scope of scholarship and examining methodological approaches, definitions, theoretical frameworks, domains, and sources of support. The scoping review followed a systematic approach that retained 41 articles for analysis. The findings indicate that refugee resettlement studies seldom conceptualizes social support as a central focus, defines the concept, draws from related theory, or examines multifaceted components of the construct. The review nevertheless yielded promising findings for future conceptual and empirical research. The analysis identified a wide range of relevant domains and sources of social support, laying the foundation for a socio-ecological model of social support specific to refugee experiences in resettlement. The findings also indicate an imperative to examine and theorize social support vis-à-vis diverse groups as a main outcome of interest, in connection to a range of re...
Aesthetic Surgery Journal
BackgroundCOVID-19 poses a life-threatening endangerment to individuals with chronic diseases. Ho... more BackgroundCOVID-19 poses a life-threatening endangerment to individuals with chronic diseases. However, not all comorbidities affect COVID-19 prognosis equally. Some increase the risk of COVID-19 related death by more than six folds while others show little to no impact. To prevent severe outcomes, it is critical that we comprehend pre-existing molecular abnormalities in common health conditions that predispose patients to poor prognoses. In this study, we aim to discover some of these molecular risk factors by associating gene expression dysregulations in common health conditions with COVID-19 mortality rates in different cohorts.MethodsWe focused on fourteen pre-existing health conditions, for which age-and-sex-adjusted hazard ratios of COVID-19 mortality have been documented. For each health condition, we analyzed existing transcriptomics data to identify differentially expressed genes (DEGs) between affected individuals and unaffected individuals. We then tested if fold changes ...
Journal of Racial and Ethnic Health Disparities
The current national COVID-19 mortality rate for Black Americans is 2.1 times higher than that of... more The current national COVID-19 mortality rate for Black Americans is 2.1 times higher than that of Whites. In this commentary, we provide historical context on how structural racism undergirds multi-sector policies which contribute to racial health inequities such as those highlighted by the COVID-19 pandemic. We offer a concrete, actionable path forward to address structural racism and advance health equity for Black Americans through anti-racism, implicit bias, and cultural competency training; capacity building; community-based participatory research (CBPR) initiatives; validated metrics for longitudinal monitoring of efforts to address health disparities and the evaluation of those interventions; and advocacy for and empowerment of vulnerable communities. This necessitates a multi-pronged, coordinated approach led by clinicians; public health professionals; researchers; social scientists; policy-makers at all governmental levels; and local community leaders and stakeholders across the education, legal, social service, and economic sectors to proactively and systematically advance health equity for Black Americans across the USA.
Archives of Sexual Behavior
Video featuring male performance artist, Makode Aj Linde, whose blackfaced, minstrel caricature e... more Video featuring male performance artist, Makode Aj Linde, whose blackfaced, minstrel caricature echoes the racialized stereotypes of the post-Civil War era in United States history wherein African-Americans were dehumanized and demeaned in the public media and entertainment with exaggerated facial features, language, movement, character and deportment; codifying blackness as primitive, hypersexual, and comedic. https ://www. youtu be.com/watch ?v=z8zLM _hIw7Y (accessed 2/6/20). 2 Jezebel's Erin Gloria Ryan. 4/17/12. "Swedish Official Gleefully Cuts Racist Black Lady Cake, Delights Onlookers." https ://jezeb el.com/swedi sh-offic ial-gleef ully-cuts-racis t-black-lady-cake-59026 72 (accessed 2/6/20). 3 Ebony magazine's Jonathan Pitts-Wiley. 4/18/12. "Taking the 'Painful Cake': Reconsidering the Swedish Ministry Art Nightmare" http:// www.ebony.com/news-views/the-swedish-ministry-art-nightmare#. UyOhZrlOXVi (accessed 2/6/2020).
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Papers by Christa Johnson