ScholarWorks@UMassAmherst

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Recent Submissions

Risk factors associated with postpartum depression in immigrants in the U.S.: A systematic scoping review
(2025-05-18) Ayisi, Michaela
Background Meta analysis has shown that immigrant women are twice as likely to display postpartum depression (PPD) symptoms than non-immigrant women yet, the reason behind this increased risk is unknown. This review sets out to synthesize existing research on PPD in immigrant women and illuminate gaps for future research. The research question guiding this review is: what are the factors that impact postpartum depression (PPD) risk among immigrant women in the U.S.? Methods APA PsychInfo was searched on 24 February 2025 for studies assessing the risk factors of PPD in immigrant women in the U.S at any time. Only primary, observational studies were included. Results were narratively synthesized, grouped by risk factor type and further divided by specific risk factor. Results Five studies were included, representing 506 participants. The mean age of participants ranged from 29-33.4 and the mean years living in the U.S. ranged from 5.56-10. All included studies focused on immigrant populations originating from Asian and Middle Eastern countries. All studies utilized validated PPD measurements. Two of five studies reported on acculturation; one reported that lower levels of acculturation related to higher levels of PPD symptoms, whereas the other found no significant correlation. Two of the five included studies reported on social support and all found that lower levels of social support were associated with higher levels of PPD symptoms, suggesting social support may be an important risk factor to consider. Two studies reported on family dynamic descriptors including marital relationship, in-law relationship, arranged marriage, and child’s gender. Only marital relationship scores had significant associations with PPD scores. Two studies reported on mother’s mental health and confidence. One study found antenatal anxiety, antenatal depression, life stress, and maternity blues all increase PPD symptoms; while the other study found that low maternal self-efficacy was related to higher PPD symptoms. Conclusion The literature examining risk factors for PPD in immigrant women living in the U.S. is minimal. Data suggests strong associations between low social support and increased PPD symptoms. More research should be conducted to assess the impact of acculturation of PPD, as results are conflicting. Finally, future research should be done in immigrant populations from various countries of origin as current research heavily focuses on Asian and Middle Eastern countries.
The impacts of private equity hospital ownership on patient health outcomes and quality of care: a systematic scoping review
(2025-05) Khalaj, Andrew
Background Private equity (PE) acquisitions of acute care hospitals in the United States have fueled concerns about the effects of profit-driven management practices on care delivery. This review aimed to investigate the impacts of PE hospital ownership on patient health outcomes and quality of care. Methods PubMed was searched on 2 March 2025 for observational and quasi-experimental studies comparing patient outcomes in PE hospitals to those in non-PE hospitals or to outcomes before PE acquisition. Eligible studies reported at least one outcome related to mortality, readmissions, hospital-acquired conditions, or care access/quality. Results were narratively synthesized, grouped by outcome and by comparator. Results Six studies were included, encompassing 1,036 PE-owned and 6,718 non-PE hospitals. Study sizes ranged from 9,462 to 21,091,222 patients, with periods of analysis spanning from 2001 through 2020. All studies that reported it were conducted in majority white populations, with mean age ranging from 72.9 to 79.45. Two studies comparing pre- and post-acquisition outcomes found either modest declines or no differences in mortality at PE hospitals. Two other studies reported higher 30-day mortality rates among surgical patients at PE hospitals compared to non-PE hospitals. Readmission rates were largely similar across hospital types. One study found increased rates of hospital-acquired conditions, including falls and infections, at PE hospitals following acquisition. Two additional studies reported higher surgical complication rates at PE hospitals, with one also identifying elevated incidence of failure-to-rescue. Regarding care access/quality, one study found decreases in patient-reported experience ratings at PE hospitals post-acquisition, while another reported improved process quality scores for select conditions. Findings on length of stay and discharge status varied, with some studies noting longer admissions or increased transfers from PE hospitals after acquisition. Discussion Evidence on the effects of PE hospital ownership on patient outcomes is limited and mixed. Some findings suggest potential harms, including increased mortality among surgical patients, higher rates of hospital-acquired conditions, and declines in patient- reported experiences. Future research should include more diverse populations, clearly defined acquisition timelines, and stronger adjustments for confounders. Greater transparency and regulatory oversight are recommended to ensure that operational strategies of PE-owned hospitals prioritize patient safety and equitable care delivery.
The Impact of the COVID-19 Pandemic on Access to Contraceptives: A Systematic Scoping Review
(2025-05) Wilson, Madeleine
Background The COVID-19 pandemic was a disaster that had far reaching effects on healthcare services, one of which being sexual and reproductive health. By disrupting the majority of in-person healthcare services, as well as the function of many supply chains, people across the globe faced difficulties in accessing the goods and services they relied on. This review is attempting to answer the question, what were the impacts of the COVID-19 pandemic on women’s access to contraceptives? Methods Web of Science was searched on February 26, 2025 for studies reporting on participants’ ability to access contraceptives during the COVID-19 pandemic, compared to before and/or after. Studies must have been conducted exclusively in people who identify as women, and who were engaged with contraceptives at the start of the pandemic. Data were narratively synthesized and grouped based on changes in use of contraceptives attributed to pandemic, and unintended pregnancies. Results This review includes 7 included studies which represent 9 countries and 84,562 people. Women’s ages range from 12-50 years. Study size ranges from about 200 to over 70,000. Available data suggests that the COVID-19 pandemic had deleterious effects on reproductive health. Fear of becoming infected prevented many women from accessing contraceptives as they were able to pre-pandemic. COVID-19 related economic losses have also been linked to changes in fertility intentions, in turn changing contraceptives and family planning for some women. There was a reduction in dispensing of pharmaceutical contraceptives, such as the hormonal pill. There was an increase in unintended pregnancies. However, widespread use of long-acting reversible contraceptives (LARCs) eliminated some risks that arise from disruptions in services. Conclusion The current structure of the health care delivery system does not support equitable access to contraceptives. COVID-19 is one of many factors that can exacerbate this. Globally, interventions to address gaps in sexual education have the potential to improve access to and knowledge of contraception; this may be particularly critical during disruptions such as COVID-19 which can impact supply chains and access to healthcare providers.
The Impact of Child Access Prevention (CAP) Laws on Pediatric Firearm Injuries: A Systematic Scoping Review
(2025-05-18) Miller, Bridget
Background Firearm-related deaths and injuries are a significant public health concern in the United States, surpassing motor vehicle accidents, drug overdoses, and cancer as the leading cause of death among adolescents. Child Access Prevention (CAP) laws are designed to mitigate this problem by holding gun owners legally accountable for safely storing firearms and/or for recklessly or knowingly providing firearms to children. This review seeks to understand the impacts of state CAP laws on pediatric firearm injury. Methods PubMed was searched on February 12, 2025, for studies examining the relationship between CAP laws and pediatric firearm injuries. To ensure relevance to current policy discussions and research advancements, results were restricted to studies including data from 2016 or later. Results were narratively synthesized and grouped by comparator. Results A total of 11 studies were included in this review, covering various research designs and time periods. All studies were conducted within the United States, with a national geographic scope. The studies utilized observational, cross-sectional, longitudinal, and cohort methodologies to assess the impact of CAP laws on pediatric firearm injuries. Evidence from this review shows that CAP laws are generally associated with a reduction in pediatric firearm-related deaths and injuries, though the level of effectiveness is closely tied to the stringency of the specific legislation. States with any CAP law in place have shown a decrease in firearm injuries, but ‘strong' CAP laws, particularly those based on negligence, if a child could access a firearm, demonstrated a significant reduction. Moreover, CAP firearm storage laws correlate with significant reductions in youth firearm suicide mortality. While some studies suggest CAP laws can reduce firearm homicide, others found no significant impact. However, restrictive combinations of gun policies that include CAP laws have a high probability of reducing total firearm deaths. Discussion The main limitation of this literature is the challenge of isolating the specific effect of CAP laws from other coexisting state-level factors and the complexities of the policy landscape. Several studies acknowledge that other state firearm regulations could potentially affect the relationship between CAP laws and pediatric firearm injuries while others point out that state policies might reflect underlying gun culture, which can lead to both measurable and unmeasurable confounding factors. This makes it challenging to definitively base observed changes solely on the presence or specific characteristics of CAP legislation.
Lightning Talks: It Could Be Wonderful: OER Collaboration with Students
(2025) Hardy, Carter
OER textbooks already offer many advantages for our moral emotions. By removing cost and offering greater accessibility, they alleviate anxiety. By encouraging authors to create open resources for students in need, they foster empathy and sympathy, while reducing fear and anger over stolen intellectual property. This talk will address another step that can further promote the moral emotions of care and wonder: collaboration with students. These emotions are essential for keeping students engaged in their own learning, but often OER textbooks fall short in these areas. Care can be fostered by inviting students into the process of creating content for textbooks, such as student artists who could offer their works to liven up otherwise monotonous pages. Wonder is likewise fostered by challenging students to act as knowledge makers and content creators, while simultaneously offering perspectives that more directly inspire their generational peers.

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