Carol R Underwood
Biographic Data
| ID | 759209 |
|---|---|
| NAME | Carol R Underwood |
| GIVEN NAMES | Carol R |
| FAMILY NAME | Underwood |
| SIGNATURE | UNDERWOOD C R |
| AFFILIATIONS | Johns Hopkins University |
| ORCID | 0000-0003-1602-3066 |
| VERIFIED | Yes |
| TOTAL WORKS | 15 |
| TOTAL CITATIONS | 23 |
| AUTHOR COUNT | 15 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2011 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 3 |
Re-aligning social and behavior change to address structural determinants of health and improve health equity
While social and behavior change (SBC) programs have a history of addressing multiple social determinants of health (SDH), those interventions have sought primarily to influence the behaviors of individuals, groups, and communities, often overlooking underlying social and political causes of health inequities and the multiple ways SBC could address them. The SDH include (i) ‘structural mechanisms,’ or the social and political contexts that produc…
Mental health and HIV risk differs by co-occurring structural vulnerabilities among women who sell sex
Female sex workers (FSW) experience many structural vulnerabilities (SV; e.g., violence, economic insecurity) which contribute to increased risk of HIV and mental distress. However, little research has examined how SV co-occur to shape HIV risk, and none have studied mental distress. Among FSW (n = 385) in Baltimore, Maryland, latent class analysis of five binary indicators (housing insecurity; financial dependence on others; client-perpetrated p…
Residence in urban and rural areas over the life course and depression among Ghanaian and South African older adults
Intimate Communication across Borders: Spousal Labor Migration and Recent Partner Communication about Family Planning in Nepal
Amid widespread labor migration in Nepal, spousal separation may affect partner communication about intimate topics like family planning. We examined the association between spousal migration experience and partner communication about family planning using survey responses from 1,793 married Nepali women (ages 18–49 years) with a child under 5 years. More than 60% of women had recently migrating spouses. Forty-seven percent reported recent partne…
Concordance, communication, and shared decision-making about family planning among couples in Nepal: A qualitative and quantitative investigation
Couple communication and joint decision-making are widely recommended in the family planning and reproductive health literature as vital aspects of fertility management. Yet, most studies continue to rely on women's reports to measure couple concordance. Moreover, the association between communication and decision-making is often assumed and very rarely studied. Arguably, associations between dyadic communication and shared decision-making consti…
The (re)productive work of labour migration: The reproductive lives of women with an absent spouse in the central hill region of Nepal
Limited attention has been given to the effects of labour migration on the reproductive lives of women 'left behind' as their partners travel for work. Drawing on two rounds of qualitative interviews with 20 women in the central hill region of Nepal, this paper examines how global economic processes that lead Nepali men to travel for work also affect women's reproductive work, including childrearing and reproductive decision-making. Women underst…
Adapting the Risk Environment Framework to Understand Substance Use, Gender-Based Violence, and HIV Risk Behaviors Among Female Sex Workers in Tanzania
Talking about reproduction with a migrating spouse: Women’s experiences in Dhading, Nepal
Communication between Nepali women and their migrating spouses affects the transregional or transnational social fields of women "left behind" and may have implications for their reproductive health. We explored women's interactions with their absent spouses using data gathered from qualitative interviews. Conversations with migrant husbands were frequent, organized around husbands' schedules, and focused on children's needs and expenses. Couple …
You already drank my beer, I can decide anything’: Using structuration theory to explore the dynamics of alcohol use, gender-based violence and HIV risk among female sex workers in Tanzania
Female sex workers experience high rates of gender-based violence and HIV. Alcohol has been shown to facilitate women's risk of both gender-based violence and HIV; however, little research has explored how aspects of the sex work environment shape this risk. Drawing on structuration theory, this study explored how social conduct is patterned across time and space within the sex work environment to influence alcohol consumption, gender-based viole…
Suaahara in Nepal: An at‐scale, multi‐sectoral nutrition program influences knowledge and practices while enhancing equity
The burden of undernutrition in South Asia is greater than anywhere else. Policies and programmatic efforts increasingly address health and non-health determinants of undernutrition. In Nepal, one large-scale integrated nutrition program, Suaahara, aimed to reduce undernutrition among women and children in the 1,000-day period, while simultaneously addressing inequities. In this study, we use household-level process evaluation data (N = 480) to a…
Assessing girls’ HIV vulnerability: Evidence from Botswana, Malawi and Mozambique
Past research documents multiple factors associated with girls' susceptibility to human immunodeficiency virus transmission; yet a literature review found no systematic approach to measure vulnerability. This study characterized, developed and tested a set of indicators to measure girls' vulnerability, resulting in the vulnerable girls index (VGI). A quasi- experimental, separate-sample pre-/post-test design was used to test the index. Adolescent…
Engaging school personnel in making schools safe for girls in Botswana, Malawi, and Mozambique
Transitions to adulthood: Examining the influence of initiation rites on the HIV risk of adolescent girls in Mangochi and Thyolo districts of Malawi
Although some cultural practices have been identified as a determinant of HIV transmission, research investigating how specific practices affect HIV risk is lacking. In Malawi, initiation rites, in which young people attend ceremonies around the time of puberty, have received little attention. In this qualitative study, we explored whether communities in southern Malawi perceive initiation rites to be an HIV risk factor for girls. Twelve focus gr…
Reconstructing Gender Norms Through Ritual Communication: A Study of African Transformation
African Transformation (AT) is a community development program informed by James Carey's notion of ritual communication and Paulo Freire's theory of critical pedagogy. AT features video portraits of ordinary people in Tanzania, Uganda, and Zambia who have overcome gender-based obstacles to better their lives. In Uganda, women and men gathered to interrogate common beliefs and explore actions they could take in light of the real-life stories portr…
Structural determinants of adolescent girls' vulnerability to HIV: Views from community members in Botswana, Malawi, and Mozambique
Structural determinants of adolescent girls' vulnerability to HIV: Views from community members in Botswana, Malawi, and Mozambique
Residence in urban and rural areas over the life course and depression among Ghanaian and South African older adults
Concordance, communication, and shared decision-making about family planning among couples in Nepal: A qualitative and quantitative investigation
Couple communication and joint decision-making are widely recommended in the family planning and reproductive health literature as vital aspects of fertility management. Yet, most studies continue to rely on women's reports to measure couple concordance. Moreover, the association between communication and decision-making is often assumed and very rarely studied. Arguably, associations between dyadic communication and shared decision-making consti…
Engaging school personnel in making schools safe for girls in Botswana, Malawi, and Mozambique
Reconstructing Gender Norms Through Ritual Communication: A Study of African Transformation
African Transformation (AT) is a community development program informed by James Carey's notion of ritual communication and Paulo Freire's theory of critical pedagogy. AT features video portraits of ordinary people in Tanzania, Uganda, and Zambia who have overcome gender-based obstacles to better their lives. In Uganda, women and men gathered to interrogate common beliefs and explore actions they could take in light of the real-life stories portr…
Structural determinants of adolescent girls' vulnerability to HIV: Views from community members in Botswana, Malawi, and Mozambique
Transitions to adulthood: Examining the influence of initiation rites on the HIV risk of adolescent girls in Mangochi and Thyolo districts of Malawi
Although some cultural practices have been identified as a determinant of HIV transmission, research investigating how specific practices affect HIV risk is lacking. In Malawi, initiation rites, in which young people attend ceremonies around the time of puberty, have received little attention. In this qualitative study, we explored whether communities in southern Malawi perceive initiation rites to be an HIV risk factor for girls. Twelve focus gr…
Engaging school personnel in making schools safe for girls in Botswana, Malawi, and Mozambique
Assessing girls’ HIV vulnerability: Evidence from Botswana, Malawi and Mozambique
Past research documents multiple factors associated with girls' susceptibility to human immunodeficiency virus transmission; yet a literature review found no systematic approach to measure vulnerability. This study characterized, developed and tested a set of indicators to measure girls' vulnerability, resulting in the vulnerable girls index (VGI). A quasi- experimental, separate-sample pre-/post-test design was used to test the index. Adolescent…
Suaahara in Nepal: An at‐scale, multi‐sectoral nutrition program influences knowledge and practices while enhancing equity
The burden of undernutrition in South Asia is greater than anywhere else. Policies and programmatic efforts increasingly address health and non-health determinants of undernutrition. In Nepal, one large-scale integrated nutrition program, Suaahara, aimed to reduce undernutrition among women and children in the 1,000-day period, while simultaneously addressing inequities. In this study, we use household-level process evaluation data (N = 480) to a…
Adapting the Risk Environment Framework to Understand Substance Use, Gender-Based Violence, and HIV Risk Behaviors Among Female Sex Workers in Tanzania
Talking about reproduction with a migrating spouse: Women’s experiences in Dhading, Nepal
Communication between Nepali women and their migrating spouses affects the transregional or transnational social fields of women "left behind" and may have implications for their reproductive health. We explored women's interactions with their absent spouses using data gathered from qualitative interviews. Conversations with migrant husbands were frequent, organized around husbands' schedules, and focused on children's needs and expenses. Couple …
You already drank my beer, I can decide anything’: Using structuration theory to explore the dynamics of alcohol use, gender-based violence and HIV risk among female sex workers in Tanzania
Female sex workers experience high rates of gender-based violence and HIV. Alcohol has been shown to facilitate women's risk of both gender-based violence and HIV; however, little research has explored how aspects of the sex work environment shape this risk. Drawing on structuration theory, this study explored how social conduct is patterned across time and space within the sex work environment to influence alcohol consumption, gender-based viole…
The (re)productive work of labour migration: The reproductive lives of women with an absent spouse in the central hill region of Nepal
Limited attention has been given to the effects of labour migration on the reproductive lives of women 'left behind' as their partners travel for work. Drawing on two rounds of qualitative interviews with 20 women in the central hill region of Nepal, this paper examines how global economic processes that lead Nepali men to travel for work also affect women's reproductive work, including childrearing and reproductive decision-making. Women underst…
Residence in urban and rural areas over the life course and depression among Ghanaian and South African older adults
Intimate Communication across Borders: Spousal Labor Migration and Recent Partner Communication about Family Planning in Nepal
Amid widespread labor migration in Nepal, spousal separation may affect partner communication about intimate topics like family planning. We examined the association between spousal migration experience and partner communication about family planning using survey responses from 1,793 married Nepali women (ages 18–49 years) with a child under 5 years. More than 60% of women had recently migrating spouses. Forty-seven percent reported recent partne…
Concordance, communication, and shared decision-making about family planning among couples in Nepal: A qualitative and quantitative investigation
Couple communication and joint decision-making are widely recommended in the family planning and reproductive health literature as vital aspects of fertility management. Yet, most studies continue to rely on women's reports to measure couple concordance. Moreover, the association between communication and decision-making is often assumed and very rarely studied. Arguably, associations between dyadic communication and shared decision-making consti…
Mental health and HIV risk differs by co-occurring structural vulnerabilities among women who sell sex
Female sex workers (FSW) experience many structural vulnerabilities (SV; e.g., violence, economic insecurity) which contribute to increased risk of HIV and mental distress. However, little research has examined how SV co-occur to shape HIV risk, and none have studied mental distress. Among FSW (n = 385) in Baltimore, Maryland, latent class analysis of five binary indicators (housing insecurity; financial dependence on others; client-perpetrated p…
Re-aligning social and behavior change to address structural determinants of health and improve health equity
While social and behavior change (SBC) programs have a history of addressing multiple social determinants of health (SDH), those interventions have sought primarily to influence the behaviors of individuals, groups, and communities, often overlooking underlying social and political causes of health inequities and the multiple ways SBC could address them. The SDH include (i) ‘structural mechanisms,’ or the social and political contexts that produc…
Sociology (12 works) · Medicine (11 works) · Psychology (10 works) · Demography (9 works) · Population (7 works) · Adolescent Sexual and Reproductive Health (6 works) · Demography (6 works) · Environmental health (6 works) · Psychological intervention (6 works) · Geography (5 works)