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Diabetes

Public Health

2018

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Full-Text Articles in Medicine and Health Sciences

Video-Based Diabetes Education For A Culturally Diverse Population, Heather Harris Dec 2018

Video-Based Diabetes Education For A Culturally Diverse Population, Heather Harris

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Immigrants and refugees represent an underserved population in need of quality, accessible, and culturally appropriate healthcare and education. Diabetes is a chronic condition frequently seen in this population. The author utilized the Wagner Chronic Care Model (CCM) as a theoretical framework for planning diabetes education delivery in this diverse population. Studies report significant health disparities in diabetes care and subsequent poor diabetes quality indicators in refugees and immigrants. Research has found that culturally sensitive diabetes education can improve diabetes outcomes in ethnically diverse populations. The author implemented a translational project to develop and evaluate a video-based diabetes health education intervention …


The Impact Of Maternal Diabetes On Fetal And Infant Outcomes: A Secondary Analysis Of Peridata.Net® From 2013 To 2017, Christina Lynn Dzioba Dec 2018

The Impact Of Maternal Diabetes On Fetal And Infant Outcomes: A Secondary Analysis Of Peridata.Net® From 2013 To 2017, Christina Lynn Dzioba

Theses and Dissertations

ABSTRACT

THE IMPACT OF MATERNAL DIABETES ON FETAL AND INFANT OUTCOMES:

A SECONDARY ANALYSIS OF PERIDATA.NET® FROM 2013 TO 2017

Christina Dzioba, MS, ARNP, WHNP-BC, C-EFM

Background: Diabetes is a leading cause of morbidity and mortality for most of the developed world and is known to contribute to adverse maternal, fetal, and infant outcomes. The purpose of this study was to examine the relationship of maternal diabetes to fetal and infant outcomes for infants born in a small heterogeneous urban community with significant disparities in infant mortality using data in the PeriData.Net® database.

Methods: Women with diabetes were case matched …


Factors Associated With Medical And Dental Compliance For Adults With Diabetes Mellitus, Mahua Saha Dec 2018

Factors Associated With Medical And Dental Compliance For Adults With Diabetes Mellitus, Mahua Saha

Capstone Experience

Background: Over the few decades, diabetes has become one of the most common chronic conditions in the U.S and worldwide. With the increasing number of incidences of diabetes and the cost associated with the treatment, adherence to treatment regimens is one key factor, which immensely affects the success of the diabetes treatment. The American Diabetes Association recommends annual preventive care for diabetes in terms of self-care practices such as daily blood glucose check and daily foot check. An eye examination with pupil dilation and a dental checkup are also recommended as part of annual care for diabetic patients. Considering the …


Does A Vegan Diet Contribute To Prevention Or Maintenance Of Diseases?, Malia K. Burkholder, Danae A. Fields Nov 2018

Does A Vegan Diet Contribute To Prevention Or Maintenance Of Diseases?, Malia K. Burkholder, Danae A. Fields

Exercise Science Senior Research Projects

This literature review deals with the topic of, does a vegan diet contribute to prevention or maintenance of diseases? Our main focus was to look at what a vegan diet entailed, the history of veganism, and why people decide to adhere to this diet type. Multiple research studies were looked over on the topics of how a vegan diet effects the disease processes of cancer, diabetes, gastral intestinal issues, weight loss, and heart disease. The overall arching theme that was found in the research is that a vegan diet is beneficial in helping to lessen the risk or aid in …


Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu Aug 2018

Exploring H.Pylori Seropositivity As A Risk Factor For Type 2 Diabetes, Virginia Chaidez, Yumou Qiu

Journal of Health Disparities Research and Practice

Background: In the US, the percentage of adults with diagnosed diabetes are higher in members of racial and ethnic minority groups compared to non-Latino Whites. Understanding why such disparities exist has been less forthcoming.

Methods: Secondary data analysis was conducted using the National Health and Nutrition Examination Survey (NHANES) 1999-2000 cross-sectional data.

Results: H.pylori seropositivity was highest in Mexican Americans (43.7%), lowest in non-Hispanic Whites (18.1%). Diabetes was highest in non-Hispanic Blacks (5.9%); lowest in non-Hispanic whites (4.3%). H.pylori seropositivity was associated with greater likelihood of having type 2 diabetes (1.927, 95% CI 1.142, 3.257) compared to H.pylori negative in …


The Indigenous Determinants Of Health As Predictors For Diabetes And Unmet Health Needs Among Urban Indigenous People: A Respondent-Driven Sampling Study In Toronto, Ontario, Stephanie Rachael Mcconkey Jun 2018

The Indigenous Determinants Of Health As Predictors For Diabetes And Unmet Health Needs Among Urban Indigenous People: A Respondent-Driven Sampling Study In Toronto, Ontario, Stephanie Rachael Mcconkey

Electronic Thesis and Dissertation Repository

National statistics commonly present Indigenous peoples as a falsely homogenous group of people experiencing disproportionate ill health when compared to non-Indigenous peoples. There are significant gaps in statistical information regarding the health services access barriers experienced by Indigenous people that disrupts the quality of care they receive or prevents them from accessing care altogether. Our Health Counts Toronto is a community-based study that employed respondent-driven sampling (RDS) methodologies to sample 917 urban Indigenous adults. Prevalence estimates and prevalence ratios were calculated using RDS-II weights and adjusting for clustering by shared recruiter in SAS 9.4 and SAS-callable SUDAAN 11.0 software. This …


Identifying Motivators And Barriers For Wellness Programs To Inform Recruitment And Retention Of Diabetes Prevention Programs (Dpps), Beenish Kamran, Kate Beatty, Leighanne Hurst, Deborah L. Slawson Apr 2018

Identifying Motivators And Barriers For Wellness Programs To Inform Recruitment And Retention Of Diabetes Prevention Programs (Dpps), Beenish Kamran, Kate Beatty, Leighanne Hurst, Deborah L. Slawson

Appalachian Student Research Forum

Obesity and type 2 diabetes (T2DM) has increased greatly in incidence in the United States over the past decade. Diagnosis of T2DM is typically preceded by insulin resistance, which is typically indicated by increases in fasting blood sugar and called pre-diabetes. The Diabetes Prevention Program (DPP) is a group-based program focused on improving diet and maintaining consistent exercise towards a lower body weight. It has been found that minimum weight loss and 150 minutes of moderate exercise is more effective at preventing T2DM than medication-based treatment. Therefore, the DPP has potential in preventing T2DM however currently faces obstacles concerning recruitment …


Abstracts From The 24th Annual Health Care Systems Research Network Conference, April 11–13, 2018, Minneapolis, Minnesota Apr 2018

Abstracts From The 24th Annual Health Care Systems Research Network Conference, April 11–13, 2018, Minneapolis, Minnesota

Journal of Patient-Centered Research and Reviews

Founded in 1994, the Health Care Systems Research Network (HCSRN) is a consortium of 18 research centers that are housed in community-based health systems. The organization's annual conference serves as a venue for research teams to disseminate scientific findings, stimulate new collaborations, and share insights about conducting research in real-world care-delivery settings. Abstracts accepted for presentation at HCSRN 2018 are published within this supplement of the Journal of Patient-Centered Research and Reviews.


Epid 7131 - Epidemiology Of Chronic Disease, Jian Zhang Apr 2018

Epid 7131 - Epidemiology Of Chronic Disease, Jian Zhang

Jiann-Ping Hsu College of Public Health Syllabi

This course is designed to introduce the student to the ever-expanding area of chronic disease epidemiology. Students will be introduced to the current status of chronic disease and control programs, methods used in chronic disease surveillance, intervention methods, and modifiable risk factors. Some of the major chronic diseases such as cancer, cardiovascular disease, chronic lung disease, diabetes and arthritis will be discussed in detail.


Pubh 3131 - Chronic Disease: A Modern Epidemic, Yelena N. Tarasenko Apr 2018

Pubh 3131 - Chronic Disease: A Modern Epidemic, Yelena N. Tarasenko

Jiann-Ping Hsu College of Public Health Syllabi

Chronic conditions (e.g. diabetes, cardiovascular disease, renal disease, obesity) are currently responsible for 60% of the global burden of disease and the World Health Organization predicts this to rise to 80% by the year 2020. This is one of the greatest challenges facing health care systems throughout the world and it places long-term health and economic demands on health care systems as the population ages. This course will provide students with the opportunity to study specific issues related to chronic disease epidemiology and management and their links to practice.


Pediatric Type Ii Diabetes Mellitus: Examining The Upward Trend, Allison Foering Apr 2018

Pediatric Type Ii Diabetes Mellitus: Examining The Upward Trend, Allison Foering

Senior Honors Theses

In recent years, there has been a significant increase in pediatric onset of type II diabetes. This paper will examine elements contributing to this trend. Type II diabetes will be discussed, including related pathophysiology, manifestations, diagnosis, and complications, with differentiation between adult and pediatric onset. Possible prevention and treatment methods appropriate for pediatric patients will also be discussed, along with possible outcomes in pediatric patients that could result from this disease. Overall, this paper will provide insight on the causes of this growing trend, and ways to improve the risks imposed on pediatric patients.


Understanding Diabetes-Related Distress Characteristics And Psychosocial Support Preferences Of Urban African American Adults Living With Type 2 Diabetes: A Mixed-Methods Study, Sula Marie Hood, Amy Irby-Shasanmi, Mary De Groot, Elissabeth Martin, Andrew S. Lajoie Jan 2018

Understanding Diabetes-Related Distress Characteristics And Psychosocial Support Preferences Of Urban African American Adults Living With Type 2 Diabetes: A Mixed-Methods Study, Sula Marie Hood, Amy Irby-Shasanmi, Mary De Groot, Elissabeth Martin, Andrew S. Lajoie

Faculty Scholarship

Purpose

The purpose of this study is to understand diabetes-related distress (DRD) characteristics and identify psychosocial support preferences of urban African American adults living with type 2 diabetes (T2DM).

Methods

A 2-phase, mixed-methods sequential explanatory study design was used to gather data. In phase 1, a purposive sample of participants (N = 155) was recruited and asked to complete a written survey. The Diabetes Distress Scale (DDS17) was used to assess DRD, including subscales—emotional burden (EB), regimen distress (RD), interpersonal distress (ID), and physician distress (PD). In phase 2, a subset of phase 1 participants (N = 23) volunteered to …


The Lifestyle Initiative: An Innovative Coaching-Based Quality Improvement Study To Improve The Health Of Aurora Health Care Caregivers And Family Members, Tiffany A. Mullen, Jessica J.F. Kram, Dennis J. Baumgardner Jan 2018

The Lifestyle Initiative: An Innovative Coaching-Based Quality Improvement Study To Improve The Health Of Aurora Health Care Caregivers And Family Members, Tiffany A. Mullen, Jessica J.F. Kram, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

Background: Self-management support has been shown to improve clinical outcomes. Health coaching, one form of self-management support, empowers patients within the health care system by providing information and through collaboratively developed care plans.

Purpose: Assess the impact of The Lifestyle Initiative, a coaching-based health program utilized by Aurora Health Care caregivers or family members.

Methods: The Lifestyle Initiative is a coaching-based approach for Aurora caregivers or family members enrolled in Aurora’s health insurance network. Individuals were recruited from the care management database, and all participants had an Aurora primary care provider. Participation was limited to those ≥ 18 years of …


Fitting A Square Peg Into A Round Hole: Perceptions Of Appalachian Physicians On The Incorporation Of Chronic Disease Prevention Into Their Practice, Lauri Andress, Danny Scalise, Jessica G. Wright, Stephanie E. Moore Jan 2018

Fitting A Square Peg Into A Round Hole: Perceptions Of Appalachian Physicians On The Incorporation Of Chronic Disease Prevention Into Their Practice, Lauri Andress, Danny Scalise, Jessica G. Wright, Stephanie E. Moore

Faculty & Staff Scholarship

This study used a focus group in August 2017 (n = 9) to explore the perceptions of rural physicians to a state request to incorporate diabetes prevention screening into their West Virginia medical practice. Analysis of the data revealed that the participants did not think private physicians were equipped to incorporate diabetes prevention programming into their practice. Three categories emerged from the data analysis to explain the reasoning of the health practitioners on the incorporation of pre-diabetes screening and management into their practice.

The practice of medicine

Prevention is a mismatch

Social determinants of health

In the …


Czech Republic: Diabetes, Alejandra Martinez Jan 2018

Czech Republic: Diabetes, Alejandra Martinez

Global Public Health

The prevalence of diabetes mellitus, a life-threatening disease, continues to grow annually in the Czech Republic and the accessibility of care is at stake. Most of the information and statistics compiled in this brief are derived from insurance companies in the Czech Republic, rather than governmental records, which reflects the need for mass data collection of diabetes accessibility and treatment. In order to understand the public health issue, the public must also be informed and encouraged to visit their doctor for checkups to prevent diabetes and its various complications. The healthcare system could better care for Czechs not only to …


Seychelles: Diabetes, Camille Myers Jan 2018

Seychelles: Diabetes, Camille Myers

Global Public Health

One of the major health problems in Seychelles, a cluster of islands off the coast of Eastern Africa, is diabetes. There are many different types of diabetes, but the most common type to this region is Type 2 diabetes. At this time Seychelles, and many other countries in Africa, have about half of the adult population diagnosed with Type 2 diabetes. Along with the diagnosis of diabetes being a problem, people in Seychelles often go undiagnosed for a while because they are ignorant to the risks and the symptoms of the disease. Only about 50% of the population with pre-diabetic …


Qatar: Diabetes, Diangelo Gonzalez Jan 2018

Qatar: Diabetes, Diangelo Gonzalez

Global Public Health

The State of Qatar is a developed nation that is located in the Middle East and borders the Persian Gulf and Saudi Arabia. The nation is a constitutional monarchy and is currently led by Amir Tamim bin Hamad Al Thani. The 2,300,000+ people of Qatar face many major challenges. Although it is one of the wealthiest nations in the Middle East, Qatar faces issues of human trafficking, migrants willing to work in poor conditions, and Middle Eastern Respiratory Syndrome (MERS). The most critical issue that plagues this county is diabetes, both I and II. Diabetes is a disease that is …


Food Insecurity: United States, Courtney Handzel Jan 2018

Food Insecurity: United States, Courtney Handzel

Global Issues in Public Health

Food insecurity is a global issue and has caused struggles to millions of people, specifically in the United States. This environmental issue involves not having the resources to obtain adequate food supply. The economic and social influences that affect food insecurity leave vulnerable populations, such as low-income families and minority races, at a greater disadvantage. This issue causes serious health complications to arise too, the most common being diabetes. The increased risk of diabetes due to food insecurity has been studied on several occasions and the results all show the correlation, lack of food security increases the risk of diabetes. …


Perceived Benefits And Barriers Of A Community-Based Diabetes Prevention And Management Program, Samantha Shawley-Brzoska, Ranjita Misra Jan 2018

Perceived Benefits And Barriers Of A Community-Based Diabetes Prevention And Management Program, Samantha Shawley-Brzoska, Ranjita Misra

Faculty & Staff Scholarship

This study examined the perceptions of benefits of and barriers to participating in a community-based diabetes program to improve program effectiveness. The Diabetes Prevention and Management (DPM) program was a twenty-two session, 1-year program, modeled after the evidence-based National Diabetes Prevention Program and AADE7 Self-Care Behaviors framework. Community-based participatory research approach was used to culturally tailor the curriculum. Participants included overweight or obese adults with dysglycemia. A benefits and barriers survey was developed to gather information on participants’ perception of the program, as well as information on demographics and health literacy levels. Eighty-nine adults participated in the DPM program (73% …


Perfluoroalkyl Substances And Kidney Function In Chronic Kidney Disease, Anemia, And Diabetes, Baqiyyah N. Conway, Ashley N. Badders, Tina Costacou, John M. Arthur, Kim E. Innes Jan 2018

Perfluoroalkyl Substances And Kidney Function In Chronic Kidney Disease, Anemia, And Diabetes, Baqiyyah N. Conway, Ashley N. Badders, Tina Costacou, John M. Arthur, Kim E. Innes

Faculty & Staff Scholarship

Background: Anemia often complicates chronic kidney disease (CKD), leading to insufficient tissue oxygenation and hypoxic injury, the factor thought to underlie progression from CKD to renal failure. Perfluorocarbons are potent oxygen transporters used in organ preservation and synthetic blood development. Data are scarce on their relationship with kidney function, especially in diabetes where anemia and hypoxia are more prevalent. We investigated the relationship of perfluoroalkyl acids (PFAS) with kidney function and variation by diabetes and anemia status.

Methods: Data on 53,650 adults (5,210 with diabetes) were obtained from the C8 Health Project. CKD was defined as an estimated glomerular filtration …


Association Between Type Of Diabetes Education And Health Status, Limitations, And Healthcare, Starr Michelle Seip Jan 2018

Association Between Type Of Diabetes Education And Health Status, Limitations, And Healthcare, Starr Michelle Seip

Walden Dissertations and Doctoral Studies

Diabetes is an epidemic that has started to capture political attention in the United States because of the devastating health care costs associated with the disease. Researchers in other studies have concluded that additional education face-to-face (FTF) and FTF with alternative forms of diabetes communication (FTF plus) have been beneficial. However, there is very little information on the comparison of the two groups as mentioned above when comparing chronic limitations, self-perception, health status, and healthcare satisfaction as circumscribed by specific demographic population. This study was an investigation of the above variables and explored how specific demographic characteristics (age, gender, educational …


Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner Jan 2018

Oral Glucose Insulin Secretion Test For Identifying Patients With Insulin Resistance, David Kershner

Walden Dissertations and Doctoral Studies

Insulin resistance is an increasing public health issue with the current literature, suggesting reduced sensitivity of insulin leads to adult onset diabetes and associated downstream pathologies that reduce life expectancy. The main objectives of this study were to evaluate the ability of the Oral Glucose Insulin Secretion Test (OGIST) to identify insulin resistance and examine differences in the insulin sensitivity based on gender, age, and ethnicity. This study was supported by the insulin resistance theory which focuses on the reduced ability of insulin to bind to the cellular insulin receptor, reducing the sensitivity of insulin. The OGIST lab results of …


A Qualitative Exploration Of Experiences And Motivations For Diabetes Self-Management In African American Men Between The Ages Of 40-85 With Type 2 Diabetes, Anthony Q. Walker Jan 2018

A Qualitative Exploration Of Experiences And Motivations For Diabetes Self-Management In African American Men Between The Ages Of 40-85 With Type 2 Diabetes, Anthony Q. Walker

Theses and Dissertations

Diabetes is a devastating disease that can affect an individual’s health and quality of life, but if managed properly, individuals with diabetes can have a good quality of life. Diabetes strikes African American men at a high rate. This study used a qualitative design to explore African American men between the ages of 40-85 with type 2 diabetes (T2DM) and their definition of diabetes and motivation, their experience of living with diabetes, their self-management behaviors, their motivations for managing diabetes, and what they and healthcare providers believe motivates them to self-manage diabetes and to attend diabetes self-management education (DSME) programs. …


Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston Jan 2018

Implementation Of A Diabetic Resource Toolkit In A Veterans Administration Emergency Department, Caroline Hairston

Walden Dissertations and Doctoral Studies

Diabetes is the 7th leading cause of death in the United States. Uncontrolled diabetes and lack of self-care knowledge leads to increased emergency department (ED) visits, utilizing limited health care resources. The practice-focused question asked whether a patient-focused diabetic self-care toolkit could decrease the number of diabetes-related ED visits. The purpose of this project was to reduce the number of diabetes-related ED visits and was supported by the social cognitive theory. The sources of evidence included the facility's ED Information System (EDIS) data and a patient survey developed by the project lead. There were 149 participants (135 males and 14 …


Improving Glycemic Control In Adult With Type 2 Diabetes, Basirat Romoke Triplett Jan 2018

Improving Glycemic Control In Adult With Type 2 Diabetes, Basirat Romoke Triplett

Walden Dissertations and Doctoral Studies

Ninety percent of people with diabetes have Type 2 diabetes mellitus (T2DM). T2DM is a complex disease that affects every organ in the body, which makes effective management of the disease imperative. The American Association of Clinical Endocrinologist (AACE) and American College of Endocrinology (ACE) strongly recommended early treatment initiation among the target population to delay disease progression and complications. The purpose of this evidence-based project was to examine the impact of using the T2DM management algorithm for effective management of adults with T2DM over a 3-month period. The shared experience decision-making model and the chronic care model were used …


Does Insulin Therapy Matter? Determinants Of Diabetes Care Outcomes, Jennifer A. Andersen, Larry Gibbs Jan 2018

Does Insulin Therapy Matter? Determinants Of Diabetes Care Outcomes, Jennifer A. Andersen, Larry Gibbs

Department of Sociology: Faculty Publications

Objective: To evaluate adherence to care standards for people with diabetes (PWDs) on insulin therapy versus PWDs who are not on insulin therapy, controlling for social determinants.

Research design and methods: Utilizing the United States 2015 Behavioral Risk Factor Surveillance System Survey, this study used logistic regression analyses to estimate differences in self-care behaviors, healthcare provider quality of care, and diabetic complications for individuals on insulin therapy and individuals not on insulin therapy.

Results: PWDs on insulin therapy are more likely to adhere to self-care measures (self-glucose checks [OR: 7.57], self-foot checks [OR: 1.27], diabetes class participation [OR: 1.96]), adherence …


Impediments Of Self-Managed Type 2 Diabetes In Mgbidi Women, Nigeria, Augustina Oha Jan 2018

Impediments Of Self-Managed Type 2 Diabetes In Mgbidi Women, Nigeria, Augustina Oha

Walden Dissertations and Doctoral Studies

Type 2 diabetes is a complex metabolic disorder characterized by hypoglycemia or hyperglycemia that affects fat, protein, and carbohydrate metabolism. Researchers have identified that for individuals with Type 2 diabetes, staying on interventions for diabetes self-management is sometimes difficult and challenging. It is an increasing public health concern, especially in certain minority populations and in many developing and developed nations. This is especially true for the population of women 40 years and older in Mgbidi, Nigeria. In the Enugu State of Nigeria, women bear most of the burden of Type 2 diabetes when compared to the males in the state. …


Inpatient Rehabilitation, Diabetes, And The Risk Of Clostridium Difficile Infection, Kerry A. Flint Jan 2018

Inpatient Rehabilitation, Diabetes, And The Risk Of Clostridium Difficile Infection, Kerry A. Flint

Walden Dissertations and Doctoral Studies

Clostridium difficile is a frequent cause of healthcare-associated infections (HAI) and is associated with increased risk of morbidity and mortality. Studies suggest environmental and host characteristics increase patient's susceptibility to C. difficile infection (CDI). However, few studies have examined the risk of CDI among those with diabetes or patients in the acute rehabilitation (AR) setting. A case-control study, using secondary data (n = 473), evaluated the relationship between CDI and diabetes and identified modifiable environmental exposures. An ecosocial framework was used to examine the relationship between these two complex diseases among hospitalized patients in an AR setting. Results of the …


Association Between Body Mass Index And Depression On Hbaic Control Among Veterans, Opokua Osei-Yeboah Jan 2018

Association Between Body Mass Index And Depression On Hbaic Control Among Veterans, Opokua Osei-Yeboah

Walden Dissertations and Doctoral Studies

The study investigated the association between body mass index (BMI) and depression based upon glycated hemoglobin levels (HBA1C) among United States veterans. Based on Bandura's social cognitive theory, a cross-sectional analysis examined the association between BMI and depression on HBA1C regulation, and if the interaction between BMI and depression affects HBAIC regulation among veterans. Multiple regression analysis was used to test the multivariate associations between depression and BMI on the outcome variable of HBA1C. Linearity, normality, and homoscedasticity were assessed using normal probability plots and residual analysis. Durbin-Watson statistics were used to test for autocorrelations, and variance inflation factor was …


Physical And Psychological Health Outcomes Of Pregnancy-Related Intimate Partner Violence, Darrlyn Waynette Cornelius-Averhart Jan 2018

Physical And Psychological Health Outcomes Of Pregnancy-Related Intimate Partner Violence, Darrlyn Waynette Cornelius-Averhart

Walden Dissertations and Doctoral Studies

Intimate partner violence (IPV) is a public health issue that transcends cultures and nationalities. Women and men have been impacted by sexual violence through rape and other types of IPV. Each year, women experience IPV before and during pregnancies and are impacted by physical and psychological outcomes as a result. The purpose of the study was to examine the impact of IPV on the health outcomes of diabetes (Types 1, 2, and gestational), high blood pressure before pregnancy, and depression/anxiety among adult women before and during pregnancy. The social ecological model provided the framework for this quantitative cross-sectional study that …