U.S. adolescent and adultwomen’s experiences accessing and using toilets in schools, workplaces, and public spaces: A multi-site focus group study to inform future research in bladder health

The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium 12

Research output: Contribution to journalArticle

Abstract

The World Health Organization recognizes access to clean and safe toilets as crucial for public health. This study explored U.S. adolescent and adult cisgender women’s lived experiences accessing toilets in schools, workplaces, and public spaces. As part of the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium, we conducted 44 focus groups with female participants (n = 360; ages 11-93). Focus groups were stratified by age (11-14, 15-17, 18-25, 26-44, 45-64, 65+) and conducted across 7 geographically diverse U.S. sites from July 2017-April 2018. Using a transdisciplinary approach, we conducted conventional qualitative coding informed by our PLUS conceptual framework and used content analysis processes to identify salient themes. Across settings, toilet access was restricted by “gatekeepers” (i.e., individuals who control access to toilets). In contrast, self-restricting toilet use (deciding not to use the toilet despite biologic need to urinate) was based on internalized norms to prioritize school and job responsibilities over urination. In public spaces, self-restricting use was largely in response to lack of cleanliness. Across the life course, participants perceived gender disparities in the ability to easily access public toilets. Further research is needed to determine if and how these factors impact bladder health across the life course.

Original languageEnglish (US)
Article number3338
JournalInternational journal of environmental research and public health
Volume16
Issue number18
DOIs
StatePublished - Sep 2019

Fingerprint

Lower Urinary Tract Symptoms
Focus Groups
Workplace
Urinary Bladder
Urination
Health
Research
Public Health

Keywords

  • Bladder health
  • Female
  • Focus groups
  • Qualitative research
  • Toilet

Cite this

@article{73a75837b90345dd8d62551fcd1531d4,
title = "U.S. adolescent and adultwomen’s experiences accessing and using toilets in schools, workplaces, and public spaces: A multi-site focus group study to inform future research in bladder health",
abstract = "The World Health Organization recognizes access to clean and safe toilets as crucial for public health. This study explored U.S. adolescent and adult cisgender women’s lived experiences accessing toilets in schools, workplaces, and public spaces. As part of the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium, we conducted 44 focus groups with female participants (n = 360; ages 11-93). Focus groups were stratified by age (11-14, 15-17, 18-25, 26-44, 45-64, 65+) and conducted across 7 geographically diverse U.S. sites from July 2017-April 2018. Using a transdisciplinary approach, we conducted conventional qualitative coding informed by our PLUS conceptual framework and used content analysis processes to identify salient themes. Across settings, toilet access was restricted by “gatekeepers” (i.e., individuals who control access to toilets). In contrast, self-restricting toilet use (deciding not to use the toilet despite biologic need to urinate) was based on internalized norms to prioritize school and job responsibilities over urination. In public spaces, self-restricting use was largely in response to lack of cleanliness. Across the life course, participants perceived gender disparities in the ability to easily access public toilets. Further research is needed to determine if and how these factors impact bladder health across the life course.",
keywords = "Bladder health, Female, Focus groups, Qualitative research, Toilet",
author = "{The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium 12} and Camenga, {Deepa R.} and Brady, {Sonya S.} and Hardacker, {Cecilia T.} and Williams, {Beverly R.} and Jeni Hebert-Beirne and James, {Aimee S.} and Kathryn Burgio and Jesse Nodora and Wyman, {Jean F.} and Amanda Berry and Low, {Lisa K.} and Linda Brubaker and Mueller, {Elizabeth R.} and Fitzgerald, {Colleen M.} and Missy Lavender and Shoham, {David A.} and Lewis, {Cora E.} and Alayne Markland and Gerald McGwin and Camille Vaughan and Lukacz, {Emily S.} and Sheila Gahagan and LaCoursiere, {D. Yvette} and Miller, {Janis M.} and An, {Lawrence Chin I.} and Harlow, {Bernard L.} and Rudser, {Kyle D.} and Haitao Chu and John Connett and Melissa Constantine and Cynthia Fok and Sarah Lindberg and Todd Rockwood and Newman, {Diane Kaschak} and Epperson, {C. Neill} and Schmitz, {Kathryn H.} and Smith, {Ariana L.} and Ann Stapleton and Siobhan Sutcliffe and Lowder, {Jerry L.} and Leslie Rickey and Cunningham, {Shayna D.} and Toby Chai and Lewis, {Jessica B.} and Palmer, {Mary H.} and Tamara Bavendam and Ziya Kirkali and Chris Mullins and Jenna Norton",
year = "2019",
month = "9",
doi = "10.3390/ijerph16183338",
language = "English (US)",
volume = "16",
journal = "International Journal of Environmental Research and Public Health",
issn = "1661-7827",
publisher = "Multidisciplinary Digital Publishing Institute (MDPI)",
number = "18",

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T1 - U.S. adolescent and adultwomen’s experiences accessing and using toilets in schools, workplaces, and public spaces

T2 - A multi-site focus group study to inform future research in bladder health

AU - The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium 12

AU - Camenga, Deepa R.

AU - Brady, Sonya S.

AU - Hardacker, Cecilia T.

AU - Williams, Beverly R.

AU - Hebert-Beirne, Jeni

AU - James, Aimee S.

AU - Burgio, Kathryn

AU - Nodora, Jesse

AU - Wyman, Jean F.

AU - Berry, Amanda

AU - Low, Lisa K.

AU - Brubaker, Linda

AU - Mueller, Elizabeth R.

AU - Fitzgerald, Colleen M.

AU - Lavender, Missy

AU - Shoham, David A.

AU - Lewis, Cora E.

AU - Markland, Alayne

AU - McGwin, Gerald

AU - Vaughan, Camille

AU - Lukacz, Emily S.

AU - Gahagan, Sheila

AU - LaCoursiere, D. Yvette

AU - Miller, Janis M.

AU - An, Lawrence Chin I.

AU - Harlow, Bernard L.

AU - Rudser, Kyle D.

AU - Chu, Haitao

AU - Connett, John

AU - Constantine, Melissa

AU - Fok, Cynthia

AU - Lindberg, Sarah

AU - Rockwood, Todd

AU - Newman, Diane Kaschak

AU - Epperson, C. Neill

AU - Schmitz, Kathryn H.

AU - Smith, Ariana L.

AU - Stapleton, Ann

AU - Sutcliffe, Siobhan

AU - Lowder, Jerry L.

AU - Rickey, Leslie

AU - Cunningham, Shayna D.

AU - Chai, Toby

AU - Lewis, Jessica B.

AU - Palmer, Mary H.

AU - Bavendam, Tamara

AU - Kirkali, Ziya

AU - Mullins, Chris

AU - Norton, Jenna

PY - 2019/9

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N2 - The World Health Organization recognizes access to clean and safe toilets as crucial for public health. This study explored U.S. adolescent and adult cisgender women’s lived experiences accessing toilets in schools, workplaces, and public spaces. As part of the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium, we conducted 44 focus groups with female participants (n = 360; ages 11-93). Focus groups were stratified by age (11-14, 15-17, 18-25, 26-44, 45-64, 65+) and conducted across 7 geographically diverse U.S. sites from July 2017-April 2018. Using a transdisciplinary approach, we conducted conventional qualitative coding informed by our PLUS conceptual framework and used content analysis processes to identify salient themes. Across settings, toilet access was restricted by “gatekeepers” (i.e., individuals who control access to toilets). In contrast, self-restricting toilet use (deciding not to use the toilet despite biologic need to urinate) was based on internalized norms to prioritize school and job responsibilities over urination. In public spaces, self-restricting use was largely in response to lack of cleanliness. Across the life course, participants perceived gender disparities in the ability to easily access public toilets. Further research is needed to determine if and how these factors impact bladder health across the life course.

AB - The World Health Organization recognizes access to clean and safe toilets as crucial for public health. This study explored U.S. adolescent and adult cisgender women’s lived experiences accessing toilets in schools, workplaces, and public spaces. As part of the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium, we conducted 44 focus groups with female participants (n = 360; ages 11-93). Focus groups were stratified by age (11-14, 15-17, 18-25, 26-44, 45-64, 65+) and conducted across 7 geographically diverse U.S. sites from July 2017-April 2018. Using a transdisciplinary approach, we conducted conventional qualitative coding informed by our PLUS conceptual framework and used content analysis processes to identify salient themes. Across settings, toilet access was restricted by “gatekeepers” (i.e., individuals who control access to toilets). In contrast, self-restricting toilet use (deciding not to use the toilet despite biologic need to urinate) was based on internalized norms to prioritize school and job responsibilities over urination. In public spaces, self-restricting use was largely in response to lack of cleanliness. Across the life course, participants perceived gender disparities in the ability to easily access public toilets. Further research is needed to determine if and how these factors impact bladder health across the life course.

KW - Bladder health

KW - Female

KW - Focus groups

KW - Qualitative research

KW - Toilet

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