County (UMBC) ScholarWorks@UMBC digital repository on the Maryland Shared Open Access (MD-SOAR) platform.

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Purpose Prior research has found that poor receipt of cervical cancer screening is more prevalent among women with disabilities. However, there is a research gap regarding receipt of cervical cancer screening by types of disability. The purpose of this study was to examine the differences in the receipt of cervical cancer screening through self-reported Pap testing among women by types of disability. Methods This cross-sectional study analyzed data from the 2016, 2018 and 2020 Behavioral Risk Factor and Surveillance System (BRFSS) to estimate the prevalence of Pap testing by disability type among women ages 21-65 years of age. Modified Poisson regression with robust error variance was conducted to examine difference in Pap testing among women by disability type. Disability was defined as having any difficulty with vision, hearing, cognitive, mobility, self-care, or independent living. Multivariate analyses adjusted for risk factors associated with cervical cancer screening. Results A total of 307,142 women from across the U.S. were sampled. Women with multiple disabilities (aRR=0.91; 95% CI, 0.89 - 0.94) and women with ambulatory disability (aRR=0.94; 95% CI, 0.91 - 0.97) reported being less likely to receive Pap test than women with no disability. In every disability group, older women were significantly less likely to receive Pap test than their counterparts without disabilities. Conclusion Ambulatory disability and multiple disabilities are associated with a lower likelihood of screening with Pap test, raising the increased need to eliminate disability-specific disparities in Pap testing.

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Objective: Interventions currently recommended to control and prevent obesity have not been successful. Recent research has shifted toward the transgenerational cycle of obesity. We assessed the association between fetal macrosomia and early childhood body weight.Methods: We conducted a follow-back study to link birth certificate data to the Third National Health and Nutrition Examination Survey (1988-1994) of 2621 United States-born singletons aged 2-6 years. Birth weight and gestational age data were collected from birth certificates. Fetal macrosomia was defined as ≥90th percentile of gestational age-race-sex-parity specific body weight distribution in 1989 vital statistics.Results: With 12.7% (standard error = 0.85%) of participants born macrosomic, the prevalence of obesity and overweight (BMI percentiles ≥85th in the CDC growth chart) among children was 17.8% (1.17%). When the body weight was measured against age-sex-specific height (BMI percentiles), macrosomia was significantly associated with overweight and obesity (odds ratio [OR] = 1.64, 95% confidence interval = 1.07-2.50) adjusted for family income, maternal age and marital status, race, maternal smoking during pregnancy, and breastfeeding. The association became insignificant after adjusting for postnatal lifestyle and parental body mass index ]. When body weight was measured against age, children who were too heavy for their age were more likely to be born macrosomically ) than their peers with healthy age-specific body weight. Conclusion:Fetal macrosomia was significantly associated with a doubled risk of heavy body weight in children aged 2-6 years.