A brief instrument measuring the water, sanitation and hygiene domain of menstrual health among women who inject drugs.
<h4>Background</h4>Domains of adequate menstrual health (MH) include access to water, sanitation, and hygiene (WASH). People who menstruate with social disadvantages-such as homelessness or drug injection practices-often face barriers to WASH access. However, validated instruments to mea...
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Public Library of Science (PLoS)
2024-01-01
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| author | Alhelí Calderón-Villarreal Lourdes Johanna Avelar Portillo Daniela Abramovitz Shira Goldenberg Shawn Flanigan Penelope J E Quintana Alicia Harvey-Vera Carlos F Vera Gudelia Rangel Steffanie A Strathdee Georgia L Kayser |
| author_facet | Alhelí Calderón-Villarreal Lourdes Johanna Avelar Portillo Daniela Abramovitz Shira Goldenberg Shawn Flanigan Penelope J E Quintana Alicia Harvey-Vera Carlos F Vera Gudelia Rangel Steffanie A Strathdee Georgia L Kayser |
| author_sort | Alhelí Calderón-Villarreal |
| collection | DOAJ |
| description | <h4>Background</h4>Domains of adequate menstrual health (MH) include access to water, sanitation, and hygiene (WASH). People who menstruate with social disadvantages-such as homelessness or drug injection practices-often face barriers to WASH access. However, validated instruments to measure MH are limited among marginalized populations, and available instruments involve lengthy surveys. We developed and evaluated psychometric properties of a novel 'MH WASH Domain Scale-12' among people who menstruate and who inject drugs in the Tijuana-San Diego region and identified correlates of MH access using this scale.<h4>Methods</h4>We constructed a MH-scale based on access to twelve WASH-related items: (1) menstrual products, (2) body hygiene (bathing per week), (3) water sources for bathing, (4) improved, (5) non-shared, (6) available, (7) private, (8) nearby, (9) and safe sanitation facilities, (10) availability of soap, (11) water source for handwashing, and (12) handwashing facilities with soap/water. Variables were dichotomized and summed, with scores ranging from 0-12 points and higher scores indicating better MH access. We assessed the scale's reliability and construct and content validity using data from a binational cross-sectional study. The sample included people who inject drugs (PWID) who had ever menstruated in their lifetime and were 18+ during 2020-2021. MH-WASH items were described, and the scale was further used as an outcome variable to identify correlates.<h4>Results</h4>Among 125 (124 cis-female and 1 trans-male) PWID that reported menstruating, our 'MH WASH Domain Scale-12' was reliable (Cronbach's alpha = 0.81, McDonald's Omega total = 0.83) and valid. We identified two sub-domains: Factor-1 included items describing 'WASH availability' and Factor-2 contained items related to 'WASH security'-encompassing physical and biological safety. Scale scores were significantly lower among participants experiencing unsheltered homelessness compared to participants experiencing sheltered homelessness or living in permanent housing.<h4>Conclusion</h4>We constructed and validated a novel and reliable scale to measure MH-related WASH access that can be used to assess MH among marginalized populations in English- and Spanish-speaking contexts. Using this scale we identified disparities in MH-WASH access among PWID and who menstruate in the US-Mexico border region. |
| format | Article |
| id | doaj-art-89690f278bba41f4863f9a41da52e7e8 |
| institution | Kabale University |
| issn | 1932-6203 |
| language | English |
| publishDate | 2024-01-01 |
| publisher | Public Library of Science (PLoS) |
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| spelling | doaj-art-89690f278bba41f4863f9a41da52e7e82025-01-08T05:33:35ZengPublic Library of Science (PLoS)PLoS ONE1932-62032024-01-01195e030337810.1371/journal.pone.0303378A brief instrument measuring the water, sanitation and hygiene domain of menstrual health among women who inject drugs.Alhelí Calderón-VillarrealLourdes Johanna Avelar PortilloDaniela AbramovitzShira GoldenbergShawn FlaniganPenelope J E QuintanaAlicia Harvey-VeraCarlos F VeraGudelia RangelSteffanie A StrathdeeGeorgia L Kayser<h4>Background</h4>Domains of adequate menstrual health (MH) include access to water, sanitation, and hygiene (WASH). People who menstruate with social disadvantages-such as homelessness or drug injection practices-often face barriers to WASH access. However, validated instruments to measure MH are limited among marginalized populations, and available instruments involve lengthy surveys. We developed and evaluated psychometric properties of a novel 'MH WASH Domain Scale-12' among people who menstruate and who inject drugs in the Tijuana-San Diego region and identified correlates of MH access using this scale.<h4>Methods</h4>We constructed a MH-scale based on access to twelve WASH-related items: (1) menstrual products, (2) body hygiene (bathing per week), (3) water sources for bathing, (4) improved, (5) non-shared, (6) available, (7) private, (8) nearby, (9) and safe sanitation facilities, (10) availability of soap, (11) water source for handwashing, and (12) handwashing facilities with soap/water. Variables were dichotomized and summed, with scores ranging from 0-12 points and higher scores indicating better MH access. We assessed the scale's reliability and construct and content validity using data from a binational cross-sectional study. The sample included people who inject drugs (PWID) who had ever menstruated in their lifetime and were 18+ during 2020-2021. MH-WASH items were described, and the scale was further used as an outcome variable to identify correlates.<h4>Results</h4>Among 125 (124 cis-female and 1 trans-male) PWID that reported menstruating, our 'MH WASH Domain Scale-12' was reliable (Cronbach's alpha = 0.81, McDonald's Omega total = 0.83) and valid. We identified two sub-domains: Factor-1 included items describing 'WASH availability' and Factor-2 contained items related to 'WASH security'-encompassing physical and biological safety. Scale scores were significantly lower among participants experiencing unsheltered homelessness compared to participants experiencing sheltered homelessness or living in permanent housing.<h4>Conclusion</h4>We constructed and validated a novel and reliable scale to measure MH-related WASH access that can be used to assess MH among marginalized populations in English- and Spanish-speaking contexts. Using this scale we identified disparities in MH-WASH access among PWID and who menstruate in the US-Mexico border region.https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0303378&type=printable |
| spellingShingle | Alhelí Calderón-Villarreal Lourdes Johanna Avelar Portillo Daniela Abramovitz Shira Goldenberg Shawn Flanigan Penelope J E Quintana Alicia Harvey-Vera Carlos F Vera Gudelia Rangel Steffanie A Strathdee Georgia L Kayser A brief instrument measuring the water, sanitation and hygiene domain of menstrual health among women who inject drugs. PLoS ONE |
| title | A brief instrument measuring the water, sanitation and hygiene domain of menstrual health among women who inject drugs. |
| title_full | A brief instrument measuring the water, sanitation and hygiene domain of menstrual health among women who inject drugs. |
| title_fullStr | A brief instrument measuring the water, sanitation and hygiene domain of menstrual health among women who inject drugs. |
| title_full_unstemmed | A brief instrument measuring the water, sanitation and hygiene domain of menstrual health among women who inject drugs. |
| title_short | A brief instrument measuring the water, sanitation and hygiene domain of menstrual health among women who inject drugs. |
| title_sort | brief instrument measuring the water sanitation and hygiene domain of menstrual health among women who inject drugs |
| url | https://journals.plos.org/plosone/article/file?id=10.1371/journal.pone.0303378&type=printable |
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