U.S. Adolescent and Adult Women’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

Deepa R. Camenga, Sonya S. Brady, Cecilia T. Hardacker, Beverly R. Williams, Jeni Hebert-Beirne, Aimee S. James, Kathryn Burgio, Jesse Nodora, Jean F. Wyman, Amanda Berry, Lisa K. Low and The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium
Additional contact information
Deepa R. Camenga: Department of Emergency Medicine, Yale School of Medicine, New Haven, CT 06519, USA
Sonya S. Brady: Division of Epidemiology & Community Health, University of Minnesota School of Public Health, Minneapolis, MN 55454, USA
Cecilia T. Hardacker: Department of Education, Center for Education, Research and Advocacy, Howard Brown Health, Chicago, IL 60613, USA
Beverly R. Williams: Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham, Birmingham, AL 35233, USA
Jeni Hebert-Beirne: Division of Community Health Sciences, School of Public Health, University of Illinois at Chicago, Chicago, IL 60612, USA
Aimee S. James: Division of Public Health Sciences, Department of Surgery, Washington University in St Louis School of Medicine, St Louis, MO 63110, USA
Kathryn Burgio: Department of Medicine, University of Alabama at Birmingham and Department of Veterans Affairs, Birmingham, AL 35233, USA
Jesse Nodora: Department of Family Medicine and Public Health, University of California San Diego School of Medicine & Moores Cancer Center, La Jolla, CA 92093, USA
Jean F. Wyman: School of Nursing, University of Minnesota, Minneapolis, MN 55455, USA
Amanda Berry: Children’s Hospital of Philadelphia, Philadelphia, PA 19104, USA
Lisa K. Low: Department of Health Behavior and Biological Sciences, School of Nursing, University of Michigan, Ann Arbor, MI 48109, USA
The Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium: Minneapolis, MN 55414, USA

IJERPH, 2019, vol. 16, issue 18, 1-16

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; toilet; qualitative research; focus groups (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2019
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