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Do Interventions Targeting Women Impact Children's Health Behaviors?
Pub Date : 2023-01-01 Epub Date: 2023-11-19 DOI: 10.26054/0d-jacn-53wd
McKenzie Nava, Kaila Christini, Deanna Kepka, Jacqueline Kent-Marvick, Kathleen B Digre, Louisa A Stark, France A Davis, Doriena Lee, Valentine Mukundente, Eruera Ed Napia, Ana Sanchez-Birkhead, O Fahina Tavake-Pasi, Jeannette Villalta, Heather Brown, Sara Simonsen

Objectives: Women play an important role in promoting healthy eating and physical activity within their households, influencing the current and life-long health behaviors of children. The purpose of this study is to describe changes in fruit/vegetable consumption and physical activity among children living with racially and ethnically diverse women participating in a lifestyle-change intervention.

Methods: The study involves secondary analysis of data from a randomized trial of a wellness-coaching intervention led by Community Health Workers, called Community Wellness Coaches in this study. Study participants came from five diverse racial/ethnic communities. Participants received monthly vs. quarterly wellness coaching. Data on changes in the health behaviors of children at four months after enrollment were collected through interviews. Children's behavior changes were compared by study arm, demographics, and women's health behaviors.

Results: Overall, 71.9% of women reported increases in the fruit/vegetable intake of children living in their household and 59.4% reported increases in children's physical activity. There were no differences in children's fruit/vegetable intake or physical activity by study arm (p=0.88). Women who reported that their own fruit/vegetable intake increased were more likely to report an increase in children's consumption (aOR=2.55, 95%CI 1.05 - 6.21).

Conclusion and implications: Among women of color participating in a health-behavior change intervention, women's behavior changes were associated with improvements in child health behaviors. Interventions focused on improving women's health behaviors may also impact the behaviors of children and other household members. Emphasizing the role of women on the health of children in such interventions may magnify this impact.

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引用次数: 0
What Role Does Hispanic/Latina Ethnicity Play in the Relationship Between Maternal Mental Health and Preterm Birth? 西班牙裔/拉丁裔在母亲心理健康与早产之间的关系中扮演什么角色?
Pub Date : 2022-01-01 DOI: 10.26054/0d-dkas-c5qe
Michelle Seage, M. Petersen, Margaret Carlson, J. Vanderslice, Joseph B. Stanford, K. Schliep
Objective To investigate the association of prepregnancy and prenatal depression and/or anxiety on preterm birth (PTB), while also exploring Hispanic/Latina ethnicity as a potential effect modifier. Methods Study population included respondents of UT-PRAMS (2016-2019). Associations between prepregnancy and prenatal depression and/or anxiety and PTB were evaluated using Poisson regression models accounting for stratified survey sampling. Results Women with prepregnancy and prenatal depression and anxiety, compared to those without, had a 67 percent (95% CI: 19%, 134%) higher probability of experiencing PTB, after controlling for relevant sociodemographic, lifestyle, and reproductive history factors. Impact of depression on PTB was slightly higher than impact of anxiety. Hispanic/Latina ethnicity was found to protect against PTB for those with prepregnancy and prenatal depression alone (aPR: 0.53, 95% CI: 0.24, 1.21) or both depression and anxiety (aPR: 0.51, 95% CI: 0.18, 1.40) compared to being non-Hispanic/Latina (aPR: 1.79, 95% CI: 1.25, 2.55 for depression alone; aPR: 1.62, 95% CI: 1.18, 2.21 for depression and anxiety). Conclusions Overall, Utah women reporting prepregnancy and prenatal depression and anxiety were more likely to have a PTB. Being of Hispanic/Latina ethnicity was found to mitigate the risk of PTB among women with depression and anxiety. Implications Prepregnancy and prenatal mental health screenings and treatment are key to lessening the impacts of depression and anxiety on both mother and infant. Hispanic/Latina ethnicity may be protective against PTB among women experiencing mental distress. Whether this is through increased social support or through a different mechanism should be explored in future research.
目的探讨孕前和产前抑郁和/或焦虑与早产(PTB)的关系,同时探讨西班牙裔/拉丁裔种族作为潜在的影响调节因素。方法研究人群包括UT-PRAMS(2016-2019)的调查对象。采用分层调查抽样的泊松回归模型评估孕前和产前抑郁和/或焦虑与PTB之间的关系。结果:在控制相关的社会人口统计学、生活方式和生育史因素后,有孕前和产前抑郁和焦虑的妇女与没有抑郁和焦虑的妇女相比,患PTB的可能性高出67% (95% CI: 19%, 134%)。抑郁对肺结核的影响略高于焦虑的影响。与非西班牙裔/拉丁裔(aPR: 1.79, 95% CI: 1.25, 2.55)相比,西班牙裔/拉丁裔对孕前和产前单独抑郁(aPR: 0.53, 95% CI: 0.24, 1.21)或同时患有抑郁和焦虑(aPR: 0.51, 95% CI: 0.18, 1.40)的患者预防PTB有保护作用;抑郁和焦虑的aPR: 1.62, 95% CI: 1.18, 2.21)。总体而言,犹他州报告孕前和产前抑郁和焦虑的妇女更有可能患PTB。研究发现,西班牙裔/拉丁裔可以降低患有抑郁和焦虑的女性患肺结核的风险。孕前和产前心理健康筛查和治疗是减轻抑郁和焦虑对母亲和婴儿影响的关键。西班牙裔/拉丁裔可能对经历精神痛苦的妇女预防肺结核有保护作用。这是通过增加社会支持还是通过不同的机制,应该在未来的研究中探索。
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引用次数: 0
Association Between Pre-pregnancy and Pregnancy Physical Abuse, Partner-related Stress, and Post-partum Depression: Findings from the Utah Pregnancy Risk Assessment and Monitoring System (UT-PRAMS), 2016-2018. 孕前和孕期身体虐待、伴侣相关压力和产后抑郁之间的关系:来自犹他州妊娠风险评估和监测系统(UT-PRAMS)的调查结果,2016-2018
Pub Date : 2022-01-01 DOI: 10.26054/0d-0tbc-7vhj
K. Kah, Jennifer Dailey-Provost, J. Stanford, C. Rogers, K. Schliep
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引用次数: 0
The Baby-Friendly Hospital Initiative (BFHI): An Early Cross-Sectional Analysis of PRAMS Phase 8 Data on Hospital Practices and Breastfeeding Outcomes in Utah and Wyoming. 爱婴医院倡议(BFHI):对犹他州和怀俄明州医院实践和母乳喂养结果的PRAMS第8阶段数据的早期横断面分析。
Pub Date : 2020-01-01 Epub Date: 2020-09-16 DOI: 10.26054/0KMTC25CW0
Jesse C Bliss, Nana A Mensah, Charles R Rogers, Joseph B Stanford, James VanDerslice, Karen C Schliep

Introduction: Breastfeeding has immediate and long-term benefits for both maternal and child health. This study examines the association between Baby-Friendly Hospital Initiative (BFHI) experiences and breastfeeding outcomes in the Mountain West region.

Methods: A cross-sectional (retrospective secondary data analysis) was performed using the 2016 Pregnancy Risk Assessment Monitoring System (PRAMS) data. The participants were derived from a stratified random sample of 2,013 women living in Utah and Wyoming who recently had a live birth and who were surveyed on BFHI practices. The association between BFHI experiences and breastfeeding duration were assessed using crude and adjusted Poisson regression models, controlling for other BHFI experiences and maternal age, pre-pregnancy BMI, household income, smoking, alcohol, delivery method, and number of days spent in the hospital post delivery.

Results: 82.4% and 82.3% of women from Utah and Wyoming, respectively, reported breastfeeding for 2 months or longer. After controlling for other BFHI experiences and potential confounders, the one shared BFHI experience that was associated with breastfeeding for 2 months or longer vs less than 2 months was starting breastfeeding in the hospital (adjusted prevalence ratio [aPR]=1.49, 95% CI (1.12, 1.98) in Utah and aPR=2.03, 95% CI (1.13, 3.64) in Wyoming. Among women in Utah and Wyoming, only 5 of 7 BFHI steps were significant for breastfeeding duration in at least one state.

Conclusion: There is substantial epidemiological support for health benefits to both mother and infant for exclusive breastfeeding to 6 months and prolonged breastfeeding until at least 1-year. Our findings suggest that women who initiate breastfeeding in the hospital may be more likely to breastfeed for a longer duration.

导言:母乳喂养对孕产妇和儿童健康都有直接和长期的好处。本研究探讨了西部山区爱婴医院倡议(BFHI)经验与母乳喂养结果之间的关系。方法:采用2016年妊娠风险评估监测系统(PRAMS)数据进行横断面(回顾性二次资料分析)分析。参与者来自2013名居住在犹他州和怀俄明州的妇女,她们最近活产,并接受了BFHI实践的调查。在控制其他BHFI经历与母亲年龄、孕前BMI、家庭收入、吸烟、酒精、分娩方式和分娩后住院天数的情况下,使用粗泊松回归模型和调整后的泊松回归模型评估bffi经历与母乳喂养持续时间之间的关系。结果:犹他州和怀俄明州分别有82.4%和82.3%的妇女报告母乳喂养2个月或更长时间。在控制了其他BFHI经历和潜在混杂因素后,与母乳喂养2个月或更长时间或少于2个月相关的共享BFHI经历的是在医院开始母乳喂养(调整患病率[aPR]=1.49, 95% CI(1.12, 1.98))在犹他州,aPR=2.03, 95% CI(1.13, 3.64)在怀俄明州。在犹他州和怀俄明州的妇女中,至少在一个州,7个BFHI步骤中只有5个对母乳喂养时间有显著影响。结论:纯母乳喂养至6个月和延长母乳喂养至至少1岁对母婴健康都有好处,这一观点得到了大量流行病学支持。我们的研究结果表明,在医院开始母乳喂养的妇女可能更有可能母乳喂养更长时间。
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引用次数: 0
The association between preconception body mass index and subfertility among Hispanic and non-Hispanic women: A cross-sectional study from Utah's Pregnancy Risk Assessment Monitoring System survey (2012-2015). 西班牙裔和非西班牙裔女性孕前体重指数与生育能力低下之间的关系:来自犹他州妊娠风险评估监测系统调查的横断面研究(2012-2015)。
Pub Date : 2020-01-01 Epub Date: 2020-07-31
Qingqing Hu, Jihyun Lee, Jeannette Nelson, Marci Harris, Rebekah H Ess, Charles R Rogers, Jessica Sanders, James VanDerslice, Joseph B Stanford, Karen C Schliep

Objective: To investigate the association between pre-pregnancy body mass index (BMI) and subfertility within a population-based cohort, exploring Hispanic ethnicity as a potential effect modifier.

Methods: We used cross-sectional study data from the Utah Pregnancy Risk Assessment Monitoring System from 2012-2015. Relationships between maternal pre-pregnancy BMI and subfertility were evaluated via Poisson regression models with robust error variance, accounting for the stratified survey sampling. Preconception BMI was analyzed continuously and categorically. Women's subfertility was defined via self-report in two ways: 1) time trying to achieve pregnancy; and 2) report of using fertility-related drugs/medical procedures.

Results: The median age was 27.0; 18.8% were obese, and 15.9% were Hispanic. Women with preconception obesity (BMI>30kg/m2), compared to normal weight women (18.4kg/ m22) had a 1.85 (95% CI 1.43, 2.38) higher adjusted prevalence ratio (aPR) for having subfertility defined by time trying and a 1.73 (95% CI 1.20, 2.32) higher aPR for receiving fertility-enhancing drugs/medical procedures. Continuous models indicated a linear relationship between BMI and subfertility (aPR 1.04, 95% CI 1.03, 1.06 for time trying; and 1.06, 95% CI 1.03, 1.10 for receiving fertility-enhancing drugs/medical procedures).

Conclusions: Obese women, but not underweight or overweight women, reported higher subfertility than normal-weight women. Findings among this cohort of at-risk new mothers, oversampled on low education and birth weight and comprised of higher than the national average of Hispanics, indicated a dose-response relationship between obesity and subfertility.

Implications: Our findings highlight the importance of population-oriented obesity prevention for at-risk women with intentions to conceive.

目的:在以人群为基础的队列中,研究孕前体重指数(BMI)与低生育能力之间的关系,探索西班牙裔作为潜在影响因素的可能性。方法:采用2012-2015年犹他州妊娠风险评估监测系统的横断面研究数据。孕妇孕前BMI与低生育能力之间的关系通过泊松回归模型进行评估,具有稳健误差方差,考虑分层调查抽样。对孕前BMI进行连续分类分析。女性的低生育能力是通过两种方式自我报告来定义的:1)尝试怀孕的时间;2)使用与生育有关的药物/医疗程序的报告。结果:中位年龄27.0岁;18.8%为肥胖,15.9%为西班牙裔。孕前肥胖妇女(BMI>30kg/m2)与正常体重妇女(18.4kg/ m22)相比,经时间尝试定义的生育能力低下的调整患病率(aPR)高1.85 (95% CI 1.43, 2.38),接受生育能力增强药物/医疗程序的调整患病率(aPR)高1.73 (95% CI 1.20, 2.32)。连续模型显示BMI与低生育能力呈线性关系(时间尝试的aPR为1.04,95% CI为1.03,1.06;接受提高生育能力药物/医疗程序的比率为1.06,95%可信区间为1.03,1.10)。结论:肥胖女性,而不是体重过轻或超重的女性,报告的生育能力低下率高于正常体重的女性。在这组有风险的新妈妈中,受教育程度低、出生体重低、西班牙裔美国人比例高于全国平均水平的研究结果表明,肥胖和生育能力低下之间存在剂量反应关系。启示:我们的研究结果强调了以人群为导向的肥胖预防对有意怀孕的高危女性的重要性。
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引用次数: 0
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The Utah women's health review
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