Wednesday, April 18, 2018
If the future is female, then Virginia Commonwealth University students will be equipped to treat the next XX chromosome population with the advancements in scientific research and innovative medical treatment practices that they are making today.
At the 14th annual Women’s Health Research Day last week, about 50 VCU students and faculty participated in an interdisciplinary seminar that centered on women and substance use disorders.
“I hope you will take advantage of this opportunity to meet researchers from other schools and departments who are conducting women’s health research here and have similar research interests to yours,” Susan Kornstein, M.D., executive director of VCU Institute for Women’s Health, told the audience of students and faculty from disciplines including psychology, psychiatry and medicine. “One of our major goals as an institute is to build interdisciplinary research in women’s health. Creating these cross-campus connections and collaborations is an important step toward making that happen.”
At the event, which serves to celebrate and promote research activities in women’s health at VCU, faculty members presented on the role that gender plays in substance use disorders. Discussions included the use of e-cigarettes during pregnancy, opioid use during pregnancy, and post-traumatic stress disorder-related drinking.
“Sex is a basic variable that has been shown to influence every phase of addiction,” said Dace Svikis, Ph.D., deputy director of VCU Institute for Women’s Health. Svikis was quoting Marilyn Carroll, Ph.D., a professor in the Department of Psychiatry at the University of Minnesota who studies sex differences in addictive behavior. “There is a lot to be learned by studying sex differences,” Svikis said.
A holistic approach to substance use treatment
Faculty members at the symposium presented on the latest research investigating gender differences in diseases of addiction, with the common theme being that more research examining women’s experiences is needed.
“One of the problems with the substance use treatment system in general is that it has been traditionally designed around caring for male patients,” said Sebastian Tong, M.D., an assistant professor of family medicine and population health in the VCU School of Medicine. Tong presented on opioid use in pregnancy, discussed neonatal abstinence syndrome trends in Virginia and spoke about what VCU Health is doing to help pregnant women struggling with opioid use disorders.
“In thinking about treating opioid use disorder in the perinatal and postpartum period, you have to approach it holistically,” Tong said. He cited a weekly clinic at VCU Health’s outpatient addiction treatment center at which an interdisciplinary team of health care providers offers combined perinatal care and medication-assisted management, along with on-site ultrasound and laboratory services.
“Many addiction treatment programs do not offer child care services, or even allow women to bring their children with them to treatment,” Tong said, adding that VCU Health’s MOTIVATE Clinic allows women to bring their babies to treatment. “Every Wednesday afternoon, the clinic becomes this baby clinic with women changing diapers on the floors and babies screaming everywhere. Women have an opportunity to get social support from other women and realize that they are not alone in doing this.”
Perceptions in stress across the sexes
After the symposium, students received awards for best posters in basic, clinical and translational, and community and public health research. Students then presented their research at a poster session and reception.
Wanderimam Tuktur, a 30-year-old research assistant in the School of Medicine’s Division of Epidemiology, presented on the research she conducted at VCU while she was a master of public health student at Liberty University.
“My study was trying to assess the correlation between the most popularly used stress measure and our stress measure,” Tuktur said.
Tuktur worked with VCU’s interdisciplinary Group for Research on the Epidemiology of Mobility, Aging, and Psychiatry in the fall of 2017. Her research was related to the group’s Richmond Stress and Sugar Study, a longitudinal cohort study of the role of stress exposure and reactivity on health disparities, specifically as they relate to Type 2 diabetes. The study aims to examine how chronic stress exposure influences the risk of developing Type 2 diabetes.
“The challenge is that most of the stress measurement tools out there do not take social disparities of health into account,” Tuktur said. “If you have a measure to assess stress in college students, that measure might not be relevant for factory workers in West Virginia with less than a high school education. A measurement might be applicable to one social group, race or political agenda, but not another.”
Through her research, Tuktur sought to evaluate an alternative to the perceived stress scale, which is the most widely used psychological instrument for measuring the perception of stress. The modified stress scale that was developed by the study's principal investigator Briana Mezuk, Ph.D., added measurements of financial, employment, relationship and family stress, in addition to the general and social stress measurements included in the perceived stress scale.
“We saw significant variations across gender for relationship and family health stress,” Tuktur said. “The responses across gender were significant for relationship and family health stress, but not for other types of stress. That means that how males responded was very different from how females responded in these particular domains, but not for others. It shows that there is a difference in the way individuals of different sexes handle stress.”
The modified stress scale is currently being utilized in the Richmond Stress and Sugar Study, and Tuktur hopes to achieve widespread use of the scale in other studies that examine stress’ impact on health. “We are the first research group that has utilized this particular stress measure, so we want to popularize it,” Tuktur said. “We have proven that it is highly internally consistent.”
Masculine norms and reproductive rights
Doctoral psychology student Shelby Smout presented her research on how masculine norms and adhesion to traditional masculine and feminine gender ideologies influenced men’s attitudes toward women’s reproductive rights. The study sought to answer the question: To what extent does a man's adhesion to traditional masculine norms influence his opinions about a progressive woman’s reproductive health? The topic resulted from a conversation Smout had with her mother.
“I was talking to my mom about how frustrated I was with the fact that a lot of men in politics and the health care field were making impactful decisions about women’s reproductive rights,” Smout said.
The 22-year-old graduated from VCU with bachelor’s degrees in psychology and gender studies before enrolling in the university’s health psychology graduate program. “From my gender studies perspective, I saw the trend coming from men’s own conceptions about how people, based on their gender, should behave, but I wanted to measure that scientifically,” Smout said.
To answer her research question, Smout conducted a mediation model, which is a statistical model that seeks to explain the process that underlies an observed relationship between an independent variable and a dependent variable via the inclusion of a third hypothetical variable. "We looked at conformity to masculine norms,” she said. “We wanted to establish a connection to attitudes about reproductive health, which we did through a mediation with attitudes toward dating and sexual relationships.”
Via surveys, the research team asked study participants about their conformity to masculine norms. They then asked about their attitudes toward dating and heterosexual relationships, and how that connected to attitudes toward reproductive health.
“We found that, looking at the correlation between attitudes about dating and sexual relationships and attitudes about masculine norms, there is a relationship with attitudes about reproductive health,” Smout said. “It is not masculine norms themselves that correlate with reproductive health. It is how those masculine norms pertain to relationships with women and women’s sexual health that then creates a relationship with attitudes about reproductive health."
The study was Smout’s first experience conducting public health research, and she hopes to continue examining the topic during her doctoral program at VCU.
“I am interested in gender and sexual minority health, and how constructs of gender and attitudes about gender might influence how people are treated within health policies and practices,” Smout said. “I am particularly interested in studying the perspectives of the people making the policies and examining how we can make sure all people have access to quality care."