Our body, Our health Quantitative Metadata

The National Pain Strategy notes the importance of addressing pain in minority populations to reduce health disparities. One such population is female refugees who have been victim to female genital cutting (FGC) --- which is known to cause sexual pain. The objective of the proposed research is to collect empirical data to (1) inform the conceptualization of sexual pain and other outcomes among Somali women living in Minnesota who have experienced FGC, (2) promote healthcare practices that minimize sexual pain, and (3) develop decision- making tool(s) and education seminars driven by study findings. The majority of Somali girls undergo infibulation when originally cut, which involves stitching the vaginal opening shut. Deinfibulation (i.e. opening the circumcision/infibulation scar) may decrease pain and is necessary before vaginal birth. It is recommended before labor and delivery; however, many patients wait until labor and delivery to undergo deinfibulation – thus increasing a risk in tears. Little is known about how sexual pain and sexual function are impacted by the timing of deinfibulation. To better understand sexual pain in relation to FGC, this study relied upon conceptual models that utilize a biopsychosocial approach, integrating biological, psychological, and cultural considerations. These models include fear-avoidance, endurance, and resilience. We partnered with a community-based organization (SoLaHmo) to conduct 75 qualitative interviews of Somali-American married women 18-45 years who have experienced FGC to accomplish the following aims: Aim 1: Qualitatively investigate sexual pain characteristics and meaning ascribed to sexual pain. Aim 2: Establish reference levels using descriptive statistics to quantify sexual pain characteristics (presence, frequency, intensity), sexual function, pain responses (fear avoidance, endurance, resilience), and moderator variables (acculturation and shared decision making) in this population. Aim 3: Among women who have vaginally delivered one or more babies, determine if sexual pain characteristics and sexual function are associated with the timing of deinfibulation with first child. Aim 4: Among women reporting sexual pain in Aim 3, determine if pain responses (fear avoidance, endurance, resilience) are associated with sexual pain and sexual function, and whether these associations are modified by degree of acculturation --- while adjusting for timing of deinfibulation. Study 2 Quantitative Questionnaires: 300 Somali women completed a survey on a touchscreen laptop computer using NOVA Research Company (QDS v5.0) Audio-Computer-Assisted Self-Interviewing (ACASI). Participants completed the survey at a location of their choice (home, clinic, office). Participants were recruited in the community or at Smiley's Family Medicine and Community-University Health Care Center (CUHCC). 203 (67%) interviews were completed in Somali. Data collected was on circumcision, genital history, pain, sexual, psychological, and sociodemographic variables. This record contains supporting metadata files: study protocol, quantitative data dictionary and coding tree, survey instrument, recruitment processes, and interview processes. Due to the sensitive nature of the study and informed consent process, the transcripts cannot be released for any reason. The raw data is stored at the Institute for Sexual and Gender Health at the University of Minnesota Medical School.