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OBJECTIVE To assess knowledge of the human papillomavirus (HPV), cervical cancer, and HPV vaccination in African American women (AAW). STUDY DESIGN This study was a quantitative cross-sectional survey of English speaking, AAW, ages 18-70 recruited from a community fair in Chicago, IL. Surveys were distributed to a convenience sample to assess knowledge of HPV, cervical cancer, and the HPV vaccine. Cumulative knowledge scores were calculated for each participant and analysis was performed to identify factors associated with adequate knowledge scores. RESULTS 322 surveys were distributed, 242 surveys were collected, and 215 met inclusion criteria. Mean knowledge score was 12.3 ± 4.2 (mean ± SD) out of a maximum score of 28 (range 3-23); 73% of participants scored <65% on the knowledge portion of the survey. Education level (P=0.007), household income (P=0.010), and having a child that had been offered the HPV vaccine (P=0.041) were associated with adequate (≥65% accuracy) knowledge scores. CONCLUSION Knowledge of HPV, cervical cancer and HPV vaccination was low in this urban African American adult female population. Targeted educational health programs are needed in order to increase awareness among these women who have the highest rate of cervical cancer mortality in the United States. Such patient educational programs need to be developed by physicians and should address the cultural and literacy needs of this particular group of women. In addition, AAW exert influence on the health of their communities and are integral in health-related decision making, thus educating them through their healthcare providers will have far ranging impact.

Background: Uterine fibroids are benign tumors that are the leading cause of hysterectomy in the United States. Despite their high prevalence and associated morbidity, there are little qualitative data characterizing what drives women's treatment-seeking behavior for their fibroids. Methods: Women with symptomatic or recently treated uterine fibroids completed in-depth interviews and demographic surveys. Interviews were transcribed verbatim and uploaded to NVivo version 10 for data management and thematic coding. Coders identified major themes and subthemes that emerged from the interviews. Results: Sixty women (n = 60) completed the interviews. The kappa among coders was 0.94. The mean age of participants was 43.0 -6.8. 61.7% of participants self-identified as African American, 25.0% as Caucasian, 8.3% as Hispanic, and 5.0% as Asian. Many women reported obtaining a delayed diagnosis for their uterine fibroids despite experiencing severe symptoms. There were five subthemes that identified why women delayed seeking treatment, which included the perception that their symptoms were ''normal,'' they had a low knowledge of fibroids, they did not perceive themselves to be at risk for fibroids, they engaged in avoidancebased coping strategies, and/or they dissociated themselves from their fibroids. Conclusions: Many women with symptomatic fibroids live with this condition chronically without seeking care. It appears that for some, limited knowledge regarding fibroids and normal menstruation may lead to a distorted view of what is normal with regard to uterine bleeding, resulting in limited treatment seeking behavior. Others know their symptoms are abnormal but simply avoid the problem. There is a need for patient-centered and community-based education to improve women's knowledge of fibroids and symptoms and to promote treatment options.

Objective To assess self-reported prevalence, knowledge, and health literacy regarding heavy menstrual bleeding (HMB) among African American women. Methods A quantitative cross-sectional survey study was conducted. An original survey was developed and distributed to a convenience sample of African American women aged 18–60 years at a community fair in a large city in the Midwestern region of the USA. Results Of the 274 surveys distributed, 247 were returned, 193 of which met the inclusion criteria. Overall, 163 (84.5%) participants demonstrated adequate health literacy; however, 168 (87.0%) answered fewer than 8 of 15 knowledge questions correctly. Although 75 (38.9%) women reported seeing a clinician for HMB, 89 (46.1%) believed that there was nothing that they could do to prevent it from occurring. Conclusion The present study found that the proportion of HMB among participants was higher than the nationwide prevalence. However, a gap existed in knowledge of HMB among the women surveyed. The study findings indicate an opportunity for community-based education to raise awareness of HMB, its associated clinical presentations, and available treatment modalities.

BackgroundBoth iron deficiency and iron deficiency anemia are common in the United States with a prevalence amongst women of 12 % and 4 % respectively. These numbers are even higher in African-American women (AAW) and are often a result of heavy menstrual bleeding (HMB). The primary objective of this study was to determine if perceived assessment of menstrual bleeding was associated with objective and subjective measures of anemia in AAW.MethodsQuantitative cross-sectional pilot study with surveys and venipuncture.Results44 premenopausal AAW (mean age 37.9 years ± 9. 4) participated in the study. Iron deficiency was present in 68.2 % of the participants and 18.2 % were anemic. Almost half of the participants reported that their menses were heavy or very heavy, and there was a relationship between perceived heaviness of menstrual flow and anemia (P = 0.021). Of the individuals who reported that their menses were heavy or very heavy, 35.0 % were anemic. AAW who reported heavy or very heavy menses had significantly lower hemoglobin (P = 0.015), hematocrit (P = 0.003), and ferritin (P = 0.012) levels, as well as more general (P = 0.006) and menses-associated symptoms of anemia (P = 0.015) than those who reported normal or light menses.ConclusionsThis pilot study of premenopausal AAW found that a significant percentage of women who report HMB are not only iron deficient, but also anemic. AAW should be educated on the consequences of HMB and counseled to seek care with a women’s health provider when they perceive HMB. More importantly, providers should be aware that when AAW report HMB, evaluation for iron deficiency and anemia are essential.Electronic supplementary materialThe online version of this article (doi:10.1186/s12905-016-0329-z) contains supplementary material, which is available to authorized users.