Kristine Hopkins

The University of Texas at Austin

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Co-Authors

Daniel Grossman

Institute for Reproductive Health

Joseph E. Potter

University of Arizona

Kari White

Foundation for Reproductive Medicine

Jon Amastae

The University of Texas at Austin

Amanda Jean Stevenson

University of Colorado Boulder

Sarah E. Baum

Ibis Reproductive Health

Celia Hubert

Instituto Nacional de Salud Pública

Liza Fuentes

Boston Medical Center

JoNell Potter

University of Miami

Michele G. Shedlin

New York University

Cooperative Institutions

RELX Group (United States)

137

RELX Group (United Kingdom)

103

University of California, San Francisco

The University of Texas at Austin

Ibis Reproductive Health

Johns Hopkins University

Columbia University

Planned Parenthood

Oregon Health & Science University

Universidade Estadual de Campinas (UNICAMP)

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The Impact of Payment Source and Hospital Type on Rising Cesarean Section Rates in Brazil, 1998 to 2008

Birth (2014)

Kristine Hopkins Ernesto F. L. Amaral Aline Nogueira Menezes Mourão

Abstract Background High cesarean section rates in Brazilian public hospitals and higher rates in private hospitals are well established. Less is known about the relationship between payment source and cesarean section rates within public and private hospitals. Methods We analyzed the 1998, 2003, and 2008 rounds of a nationally representative household survey ( PNAD ), which includes type of delivery, where it took place, and who paid for it. We construct cesarean section rates for various categories, and perform logistic regression to determine the relative importance of independent variables on cesarean section rates for all births and first births only. Results Brazilian cesarean section rates were 42 percent in 1998 and 53 percent in 2008. Women who delivered publicly funded births in either public or private hospitals had lower cesarean section rates than those who delivered privately financed deliveries in public or private hospitals. Multivariate models suggest that older age, higher education, and living outside the Northeast region all positively affect the odds of delivering by cesarean section; effects are attenuated by the payment source–hospital type variable for all women and even more so among first births. Conclusions Cesarean section rates have risen substantially in Brazil. It is important to distinguish payment source for the delivery to have a better understanding of those rates.

Section (typography)

Cesarean delivery

Odds

10.1111/birt.12106

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Citations (37)

Accuracy of Self-Screening for Contraindications to Combined Oral Contraceptive Use

Obstetrics and Gynecology (2008)

Daniel Grossman Leticia Fernández Kristine Hopkins Jon Amastae Sandra G. García

In Brief OBJECTIVE: To estimate how well a convenience sample of women from the general population could self-screen for contraindications to combined oral contraceptives using a medical checklist. METHODS: Women 18–49 years old (N=1,271) were recruited at two shopping malls and a flea market in El Paso, Texas, and asked first whether they thought birth control pills were medically safe for them. They then used a checklist to determine the presence of level 3 or 4 contraindications to combined oral contraceptives according to the World Health Organization Medical Eligibility Criteria. The women then were interviewed by a blinded nurse practitioner, who also measured blood pressure. RESULTS: The sensitivity of the unaided self-screen to detect true contraindications was 56.2% (95% confidence interval [CI] 51.7–60.6%), and specificity was 57.6% (95% CI 54.0–61.1%). The sensitivity of the checklist to detect true contraindications was 83.2% (95% CI 79.5–86.3%), and specificity was 88.8% (95% CI 86.3–90.9%). Using the checklist, 6.6% (95% CI 5.2–8.0%) of women incorrectly thought they were eligible for use when, in fact, they were contraindicated, largely because of unrecognized hypertension. Seven percent (95% CI 5.4–8.2%) of women incorrectly thought they were contraindicated when they truly were not, primarily because of misclassification of migraine headaches. In regression analysis, younger women, more educated women, and Spanish speakers were significantly more likely to correctly self-screen (P<.05). CONCLUSION: Self-screening for contraindications to oral contraceptives using a medical checklist is relatively accurate. Unaided screening is inaccurate and reflects common misperceptions about the safety of oral contraceptives. Over-the-counter provision of this method likely would be safe, especially for younger women and if independent blood pressure screening were encouraged. LEVEL OF EVIDENCE: II Self-screening for contraindications to oral contraceptives using a medical checklist is accurate, especially for younger women with a low prevalence of contraindications.

10.1097/aog.0b013e31818345f0

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Citations (100)

Food Insecurity and Sugar-Sweetened Beverage Consumption Among Young Adults in Community College

Journal of Nutrition Education and Behavior (2023)

Irene Rossetto Jennifer Yarger Kristine Hopkins Hannah Hecht Audrey Sánchez

Odds

Consumption

Added sugar

10.1016/j.jneb.2023.05.045

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Citations (0)

Knowledge, opinion and experience related to abortion self-induction in Texas

Contraception (2015)

Daniel Grossman E. Hendrick Liza Fuentes Kari White Kristine Hopkins

10.1016/j.contraception.2015.06.036

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Citations (46)

Table of Contents

Contraception (2017)

Kari White Daniel Grossman Amanda Jean Stevenson Kristine Hopkins Joseph E. Potter

Table (database)

10.1016/s0010-7824(17)30486-9

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Citations (0)

Texas Family Planning Providers’ Difficulties Offering Adolescents Confidential Services Foreshadows Similar Problems Nationwide as New Title X Rules Go Into Effect

Kate Coleman‐Minahan Kristine Hopkins Kari White

Texas is one of 24 states that does not explicitly allow minor teens to consent for their own contraceptive care. The federal Title X family planning program historically has guaranteed confidential and low-cost SRH services for all patients, including minor teens. Recent changes to the Title X program guidelines may deter minor teens from getting confidential services, especially in states that require parental consent. Kate Coleman-Minahan, former PRC postdoctoral fellow and co-investigator with the Texas Policy Evaluation Project, along with PRC faculty research associates Kristine Hopkins and Kari White, use in-depth interview data to explore the impact of changing parental consent rules on minor teens’ access to contraceptive care after policy changes in Texas. They find that the availability of confidential services for teens declined after the 2011-2013 changes to publicly funded family planning programs in Texas.

Minor (academic)

Parental consent

10.26153/tsw/7108

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Citations (0)

The impact of payment source and hospital type on rising cesarean section rates in Brazil, 1998 to 2008

Kristine Hopkins Ernesto F. L. Amaral Aline Nogueira Menezes Mourão

Background: High cesarean section rates in Brazilian public hospitals and higher rates in private hospitals are well established. Less is known about the relationship between payment source and cesarean section rates within public and private hospitals. Methods: We analyzed the 1998, 2003, and 2008 rounds of a nationally representative household survey (PNAD), which includes type of delivery, where it took place, and who paid for it. We construct cesarean section rates for various categories, and perform logistic regression to determine the relative importance of independent variables on cesarean section rates for all births and first births only. Results: Brazilian cesarean section rates were 42% in 1998 and 53% in 2008. Women who delivered publicly funded births in either public or private hospitals had lower cesarean section rates than those who delivered privately financed deliveries in public or private hospitals. Multivariate models suggest that older age, higher education, and living outside the Northeast region all positively affect the odds of delivering by cesarean section; effects are attenuated by the payment source-hospital type variable for all women and even more so among first births. Conclusions: Cesarean section rates have risen substantially in Brazil. It is important to distinguish payment source for the delivery in order to have a better understanding of those rates.

Section (typography)

Cesarean delivery

Odds

10.31219/osf.io/qfhxe

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Citations (7)

Contraindications to Combined Oral Contraceptives Among Over-the-Counter Compared With Prescription Users

Obstetrics and Gynecology (2011)

Daniel Grossman Kari White Kristine Hopkins Jon Amastae Michele G. Shedlin

In Brief OBJECTIVE: To compare the estimated proportion of contraindications to combined oral contraceptives between women who obtained combined oral contraceptives in U.S. public clinics compared with women who obtained combined oral contraceptives over the counter (OTC) in Mexican pharmacies. METHODS: We recruited a cohort of 501 women who were residents of El Paso, Texas, who obtained OTC combined oral contraceptives in Mexico and 514 women who obtained combined oral contraceptives from family planning clinics in El Paso. Based on self-report of World Health Organization category 3 and 4 contraindications and interviewer-measured blood pressure, we estimated the proportion of contraindications and, using multivariable-adjusted logistic regression, identified possible predictors of contraindications. RESULTS: The estimated proportion of any category 3 or 4 contraindication was 18%. Relative contraindications (category 3) were more common among OTC users (13% compared with 9% among clinic users, P=.006). Absolute contraindications (category 4) were not different between the groups (5% for clinic users compared with 7% for OTC users, P=.162). Hypertension was the most prevalent contraindication (5.6% of clinic users and 9.8% of OTC users). After multivariable adjustment, OTC users had higher odds of having contraindications compared with clinic users (odds ratio [OR] 1.59, 95% confidence interval [CI] 1.11–2.29). Women aged 35 years or older (OR 5.30, 95% CI 3.59–7.81) and those with body mass index 30.0 or more (OR 2.24, 95% CI 1.40–3.56) also had higher odds of having contraindications. CONCLUSION: Relative combined oral contraceptive contraindications are more common among OTC users in this setting. Progestin-only pills might be a better candidate for the first OTC product given their fewer contraindications. LEVEL OF EVIDENCE: II Prevalence of relative, but not absolute, contraindications to combined oral contraceptive use is higher in women obtaining pills over the counter compared with by prescription.

Contraindication

10.1097/aog.0b013e31820b0244

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Citations (72)

Does information about abortion safety affect Texas voters' opinions about restrictive laws? A randomized study

Contraception (2017)

Kari White Daniel Grossman Amanda Jean Stevenson Kristine Hopkins Joseph E. Potter

SAFER

Affect

10.1016/j.contraception.2017.08.007

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Citations (9)

Perspectives on self-managed abortion among providers in hospitals along the Texas–Mexico border

BMC Women s Health (2021)

Sarah Raifman Sarah E. Baum Kari White Kristine Hopkins Tony Ogburn

Following self-managed abortion (SMA), or a pregnancy termination attempt outside of the formal health system, some patients may seek care in an emergency department. Information about provider experiences treating these patients in hospital settings on the Texas-Mexico border is lacking.The study team conducted semi-structured interviews with physicians, advanced practice clinicians, and nurses who had experience with patients presenting with early pregnancy complications in emergency and/or labor and delivery departments in five hospitals near the Texas-Mexico border. Interview questions focused on respondents' roles at the hospital, knowledge of abortion services and laws, perspectives on SMA trends, experiences treating patients presenting after SMA, and potential gaps in training related to abortion. Researchers conducted interviews in person between October 2017 and January 2018, and analyzed transcripts using a thematic analysis approach.Most of the 54 participants interviewed said that the care provided to SMA patients was, and should be, the same as for patients presenting after miscarriage. The majority had treated a patient they suspected or confirmed had attempted SMA; typically, these cases required only expectant management and confirmation of pregnancy termination, or treatment for incomplete abortion. In rare cases, further clinical intervention was required. Many providers lacked clinical and legal knowledge about abortion, including local resources available.Treatment provided to SMA patients is similar to that provided to patients presenting after early pregnancy loss. Lack of provider knowledge about abortion and SMA, despite their involvement with SMA patients, highlights a need for improved training.

Thematic Analysis

10.1186/s12905-021-01281-w

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Citations (6)