{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T16:49:17Z","timestamp":1786553357075,"version":"build-2736575974"},"reference-count":55,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["179437"],"award-info":[{"award-number":["179437"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001804","name":"Canada Research Chairs","doi-asserted-by":"publisher","award":["2019-00158"],"award-info":[{"award-number":["2019-00158"]}],"id":[{"id":"10.13039\/501100001804","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Womens Health (Lond Engl)"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The COVID-19 pandemic has had significant mental health impacts globally. However, prior studies have not examined the specific mental health effects of the COVID-19 pandemic on women and gender-diverse people with disabilities, particularly as they intersect with sexual and reproductive health (SRH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>Our objective was to examine the impacts of the COVID-19 pandemic on mental health and access to mental health care among women and gender-diverse people with disabilities, including how mental health intersected with SRH.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>We conducted a community-engaged concurrent mixed-methods study in Canada with women and gender-diverse people with physical, sensory, psychiatric, and cognitive disabilities recruited using convenience and purposeful sampling.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between May, 2022 and March, 2023, participants completed a survey (including identification of anxiety and depression symptoms using the Patient Health Questionnaire-4) and\/or in-depth semi-structured interviews. Quantitative data were analyzed using descriptive statistics, and qualitative data were analyzed using deductive and inductive coding following a constructivist approach.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>The study included 116 survey participants and 61 interview participants, with 50 participants completing both the survey and interview. Twenty-nine per cent of participants rated their mental health as poor during the pandemic (vs. 21.6% before), and 58.3% had symptoms of anxiety and\/or depression. Participants described social isolation, threat of infection, and ableism as contributing to poor mental health. Over half (54.2%) who sought mental health care reported barriers. Long wait times, inaccessible virtual care, restrictions on support persons at appointments, and economic insecurity impacted access. Mental health and SRH intersected, with pandemic-related psychological distress negatively affecting menstrual health, sexual wellbeing, perinatal health, and menopause. Delays accessing SRH care also contributed to poor mental health.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>These data show the need for integration of accessible mental health and SRH services and promotion of disability-affirming mental health care during public health emergencies and beyond.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/17455057261466290","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T17:07:21Z","timestamp":1786381641000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Intersections of mental health and sexual and reproductive health during the COVID-19 pandemic: A mixed-methods study of women and gender-diverse people with disabilities"],"prefix":"10.1177","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0009-0000-5036-816X","authenticated-orcid":false,"given":"Sidrah K.","family":"Zafar","sequence":"first","affiliation":[{"name":"University of Toronto Scarborough"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3310-380X","authenticated-orcid":false,"given":"Carmela Melina","family":"Albanese","sequence":"additional","affiliation":[{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meredith","family":"Evans","sequence":"additional","affiliation":[{"name":"University of Toronto Scarborough"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra","family":"Rego","sequence":"additional","affiliation":[{"name":"University of Toronto Scarborough"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Keat","family":"Welsh","sequence":"additional","affiliation":[{"name":"University of Toronto Scarborough"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nkem","family":"Ogbonna","sequence":"additional","affiliation":[{"name":"University of Toronto Scarborough"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy C.","family":"Barker","sequence":"additional","affiliation":[{"name":"Women\u2019s College Hospital Research Institute"},{"name":"Women\u2019s College Hospital"},{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne","family":"Berndl","sequence":"additional","affiliation":[{"name":"Sunnybrook Health Sciences Centre"},{"name":"University of Toronto"},{"name":"Sunnybrook Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Janice","family":"Du Mont","sequence":"additional","affiliation":[{"name":"University of Toronto"},{"name":"Women\u2019s College Hospital Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yona","family":"Lunsky","sequence":"additional","affiliation":[{"name":"University of Toronto"},{"name":"Centre for Addiction and Mental Health"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy C.","family":"McPherson","sequence":"additional","affiliation":[{"name":"University of Toronto"},{"name":"Holland Bloorview Kids Rehabilitation Hospital"},{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Rotenberg","sequence":"additional","affiliation":[{"name":"London School of Hygiene and Tropical Medicine"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lesley A.","family":"Tarasoff","sequence":"additional","affiliation":[{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Vandermorris","sequence":"additional","affiliation":[{"name":"The Hospital for Sick Children (SickKids)"},{"name":"University of Toronto"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8690-5841","authenticated-orcid":false,"given":"Hilary K.","family":"Brown","sequence":"additional","affiliation":[{"name":"University of Toronto Scarborough"},{"name":"University of Toronto"},{"name":"Women\u2019s College Hospital Research Institute"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,8,10]]},"reference":[{"key":"e_1_3_8_2_2","volume-title":"Mental health and COVID-19: Early evidence of the pandemic\u2019s impact","author":"World Health Organization","year":"2022","unstructured":"World Health Organization. Mental health and COVID-19: Early evidence of the pandemic\u2019s impact. World Health Organization, 2022. https:\/\/www.who.int\/publications\/i\/item\/WHO-2019-nCoV-Sci_Brief-Mental_health-2022.1"},{"key":"e_1_3_8_3_2","volume-title":"Policy brief: COVID-19 and the need for action on mental health","author":"United Nations","year":"2020","unstructured":"United Nations. Policy brief: COVID-19 and the need for action on mental health. UN, 2020. Accessed 20 December 2024 from.https:\/\/unsdg.un.org\/sites\/default\/files\/2020-05\/UN-Policy-Brief-COVID-19-and-mental-health.pdf"},{"key":"e_1_3_8_4_2","doi-asserted-by":"publisher","DOI":"10.7326\/M22-1507"},{"key":"e_1_3_8_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/pubmed\/fdab102"},{"key":"e_1_3_8_6_2","doi-asserted-by":"publisher","DOI":"10.1002\/pnp.708"},{"key":"e_1_3_8_7_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ps.20230181"},{"key":"e_1_3_8_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11126-021-09926-7"},{"key":"e_1_3_8_9_2","volume-title":"Disability","author":"World Health Organization","year":"2023","unstructured":"World Health Organization. Disability. World Health Organization, 2023."},{"issue":"34","key":"e_1_3_8_10_2","first-page":"1142","article-title":"Mental health and substance use among adults with disabilities during the COVID-19 pandemic \u2013 United States, February-March 2021","volume":"70","author":"Czeisler ME","year":"2021","unstructured":"Czeisler ME, Board A, Thierry JM, et al. Mental health and substance use among adults with disabilities during the COVID-19 pandemic \u2013 United States, February-March 2021. MMWR 2021; 70(34): 1142\u20131149. https:\/\/doi.org\/10.15585\/mmwr.mm7034a3","journal-title":"MMWR"},{"key":"e_1_3_8_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dhjo.2021.101085"},{"key":"e_1_3_8_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dhjo.2021.101110"},{"key":"e_1_3_8_13_2","first-page":"103985","article-title":"The impact of the COVID-19 pandemic on the health, wellbeing, and access to services of people with intellectual and developmental disabilities","volume":"114","author":"Rosencrans M","year":"2021","unstructured":"Rosencrans M, Arango P, Sabat C, et al. The impact of the COVID-19 pandemic on the health, wellbeing, and access to services of people with intellectual and developmental disabilities. Disabil Health J 2021; 114: 103985. https:\/\/doi.org\/10.1016\/j.ridd.2021.103985","journal-title":"Disabil Health J"},{"key":"e_1_3_8_14_2","doi-asserted-by":"publisher","DOI":"10.1080\/19315864.2021.1892890"},{"key":"e_1_3_8_15_2","doi-asserted-by":"publisher","DOI":"10.1037\/rep0000434"},{"key":"e_1_3_8_16_2","doi-asserted-by":"publisher","DOI":"10.1002\/smi.3091"},{"key":"e_1_3_8_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dhjo.2022.101359"},{"key":"e_1_3_8_18_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dhjo.2022.101271"},{"key":"e_1_3_8_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/07308884221129839"},{"key":"e_1_3_8_20_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dhjo.2021.101171"},{"key":"e_1_3_8_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.dhjo.2021.101212"},{"key":"e_1_3_8_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/S2468-2667(21)00069-4"},{"key":"e_1_3_8_23_2","doi-asserted-by":"publisher","DOI":"10.1177\/21568693221115347"},{"key":"e_1_3_8_24_2","doi-asserted-by":"publisher","DOI":"10.1177\/15248380231155529"},{"key":"e_1_3_8_25_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.8685"},{"key":"e_1_3_8_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2019.08.069"},{"key":"e_1_3_8_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.psychres.2020.112946"},{"key":"e_1_3_8_28_2","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2020.20020154"},{"key":"e_1_3_8_29_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00737-024-01506-5"},{"key":"e_1_3_8_30_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10389-024-02191-5"},{"key":"e_1_3_8_31_2","doi-asserted-by":"publisher","DOI":"10.1007\/s11195-023-09778-y"},{"key":"e_1_3_8_32_2","doi-asserted-by":"publisher","DOI":"10.1111\/jar.12977"},{"key":"e_1_3_8_33_2","volume-title":"The impact of COVID-19 on women with disabilities","author":"United Nations Population Fund and Women Enabled International","year":"2021","unstructured":"United Nations Population Fund and Women Enabled International. The impact of COVID-19 on women with disabilities. UN, 2021."},{"key":"e_1_3_8_34_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-075665"},{"key":"e_1_3_8_35_2","doi-asserted-by":"publisher","DOI":"10.1177\/1558689810382916"},{"key":"e_1_3_8_36_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/kwac115"},{"key":"e_1_3_8_37_2","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzm042"},{"key":"e_1_3_8_38_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pgph.0001452"},{"key":"e_1_3_8_39_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1468-3148.1998.tb00035.x"},{"issue":"1","key":"e_1_3_8_40_2","first-page":"142","article-title":"Research Electronic Data Capture (REDCap)","volume":"106","author":"Patridge EF","year":"2018","unstructured":"Patridge EF, Bardyn TP. Research Electronic Data Capture (REDCap). J Med Library Assoc 2018; 106(1): 142\u2013144. https:\/\/doi.org\/10.5195\/jmla.2018.319","journal-title":"J Med Library Assoc"},{"key":"e_1_3_8_41_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jbi.2008.08.010"},{"key":"e_1_3_8_42_2","doi-asserted-by":"publisher","DOI":"10.1017\/S1368980017000180"},{"key":"e_1_3_8_43_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jad.2009.06.019"},{"key":"e_1_3_8_44_2","doi-asserted-by":"publisher","DOI":"10.12968\/ijop.2014.5.4.139"},{"key":"e_1_3_8_45_2","doi-asserted-by":"publisher","DOI":"10.1080\/09638288.2026.2649665"},{"key":"e_1_3_8_46_2","volume-title":"Constructing grounded theory","author":"Charmaz K","year":"2006","unstructured":"Charmaz K. Constructing grounded theory. Sage Publications, 2006."},{"issue":"5","key":"e_1_3_8_47_2","first-page":"1189","article-title":"Enhancing the quality and credibility of qualitative analysis","volume":"34","author":"Patton MQ","year":"1999","unstructured":"Patton MQ. Enhancing the quality and credibility of qualitative analysis. Health Serv Res 1999; 34(5 Pt 2): 1189\u20131208.","journal-title":"Health Serv Res"},{"key":"e_1_3_8_48_2","doi-asserted-by":"publisher","DOI":"10.1080\/14780887.2016.1219435"},{"key":"e_1_3_8_49_2","doi-asserted-by":"publisher","DOI":"10.1002\/jgf2.600"},{"key":"e_1_3_8_50_2","first-page":"1","article-title":"To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample size rationales","volume":"13","author":"Braun V","year":"2019","unstructured":"Braun V, Clarke V. To saturate or not to saturate? Questioning data saturation as a useful concept for thematic analysis and sample size rationales. Qual Res Sport Exercise Health 2019; 13: 1\u201316. https:\/\/doi.org\/10.1080\/2159676x.2019.1704846","journal-title":"Qual Res Sport Exercise Health"},{"key":"e_1_3_8_51_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2023.44877"},{"key":"e_1_3_8_52_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0260435"},{"issue":"2","key":"e_1_3_8_53_2","first-page":"1242","article-title":"The access of women with disabilities to reproductive health services during the COVID-19 pandemic: A Qualitative Study","volume":"15","author":"Gul S","year":"2022","unstructured":"Gul S, Yagmur Y. The access of women with disabilities to reproductive health services during the COVID-19 pandemic: A Qualitative Study. Int J Caring Sci 2022; 15(2): 1242\u20131249.","journal-title":"Int J Caring Sci"},{"key":"e_1_3_8_54_2","doi-asserted-by":"publisher","DOI":"10.1080\/26410397.2024.2441027"},{"key":"e_1_3_8_55_2","doi-asserted-by":"publisher","DOI":"10.1521\/bumc.2023.87.2.105"},{"key":"e_1_3_8_56_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40596-020-01197-x"}],"container-title":["Women's Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17455057261466290","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/17455057261466290","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/17455057261466290","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T16:17:46Z","timestamp":1786551466000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/17455057261466290"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":55,"alternative-id":["10.1177\/17455057261466290"],"URL":"https:\/\/doi.org\/10.1177\/17455057261466290","relation":{},"ISSN":["1745-5057","1745-5065"],"issn-type":[{"value":"1745-5057","type":"print"},{"value":"1745-5065","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]},"article-number":"17455057261466290"}}