Intergenerational Transfer of Knowledge Regarding Douching

1
Intergenerational Transfer of Knowledge Regarding
Douching

• Yameika Head-Carroll, MD
• Richard Rupp, MD
• Susan Rosenthal, PhD
• Mary Short, PhD

2
Love Quiz (1948) (Lysol Douche Ad)
3
Current Knowledge

• Douching is a health risk behavior and
  associated with increased incidence of
• STDs
• Bacterial vaginosis
• Ectopic pregnancies
• Many women continue to douche despite this -
  possibly due to cultural tradition
• Health care professionals (HCPs) may neglect to
  assess and educate

4
Purpose

• To characterize douching behavior among the
  mothers in our primary care clinic
• Patterns, family traditions, when, and why
• To describe their actual or potential discussions
  about douching with their daughters

5
Methods

• Recruitment Mothers of girls (11-21 years)
• Measure Self-administered questionnaire
• personal douching history
• beliefs about douching
• discussions or intended discussions with their
  daughters about douching

6
Sample

• 61 mothers completed the questionnaire
• Final sample size 57 mothers
• 2 with no history of ever douching
• 2 with incomplete questionnaires

7
Demographics (n 57)

• Mean age 40 years (range 30 to 68 years)
• Race/ethnicity
• 53 African American
• 28 Non-Hispanic white
• 17 Hispanic
• 2 Native American
• Educational Level
• 13 Elementary/middle school
• 69 High school or General Education Diploma
  (GED)
• 14 Associates degree
• 5 Bachelors degree

8
Mothers Douching Patterns

• Mean age of initiation 17.4 years (range of 10
  to 38 years)
• Of the 57 mothers, 46 (81) currently reported
  douching
• Of the 46 mothers who douche, 70 douche once or
  twice a month

9
Family Traditions
Who taught mother most about douching

• 58 of mothers reported other family members
  douche (i.e. aunts, cousins, etc.)

10
When Mothers Douche(n56)
11
Why Mothers Douche (n 56)
12
Problematic whys for douching (10/56)
13
Discussions with HCPs

• 10 women had spoken with a healthcare provider
• 5 reported their HCP discouraged douching
• 2 reported their HCP encouraged douching
• 3 were unsure about their HCPs opinions

14
Discussions with Daughters

• Discussions
• 31 had already discussed douching
• 25 planned to discuss douching
• 1 did not plan to discuss douching
• Significant Age Differences (F(1,54) 8.75, p lt
  .01).
• Discussion occurred
• (mean age of daughters 16 yrs)
• Discussion not occurred
• (mean age of daughters 14 yrs)

15
When Discussions Occurred or Would Occur

• Mothers had the conversation (or planned to)
• Menarche (76)
• Sexual activity (40)
• Daughters initiation of conversation(44)

16
What was discussed

• Positives
• Cleanliness/feminine hygiene 89
• It treats vaginal odor 43
• Is not reliable birth control 27

• Negatives
• Can cause vaginal irritation 36
• May cause vaginal infections 30
• Is unnecessary 24

17
Mothers Recommendations Regarding
Douching(n56)
18
Conclusions

• Mothers are important source of information
  about douching for girls
• Mothers may support douching even in the face
  of other evidence, and thus, often encourage this
  detrimental practice among their daughters
• Anticipatory guidance from HCPs prior to
  menstruation

19
Limitations

• Sample size was limited
• To those who douched
• To those who spoke English
• Too small to do subgroup analyses
• Not enough specific information about
  conversation, particularly about why they would
  encourage douching if they believed it had
  negative impact or was unnecessary

20
Implications/Future Research

• Greater understanding of womens resistance to
  discontinuing douching
• Understand why mothers continue to recommend
  douching to their daughters
• Determine best methods for providing anticipatory
  guidance to mothers and daughters about
  douching

21
Acknowledgement

• Special Thanks to Stephanie Ramos, MA for her
  assistance with all steps of the project
• And to
• D. Martin Stanberry for data entry
• Dr. Nigel Bourne for encouragement
• Rosenthal Research Team for listening to me
  practice
• Ryan Casey Joshua Hay for technical assistance