Medicine and Health Sciences Commons^™

Multilevel Community Engagement To Inform A Randomized Clinical Trial, Kirby L. Wycoff, Jabina G. Coleman, Christine M. Santoro, Leah L. Zullig, Niesha Darden, Porsche M. Holland, Jane F. Cruice, Shukriyyah Mitchell, Michelle Smith, Saleemah J. Mcneil, Sharon J. Herring

Counseling and Behavioral Health Faculty Papers

OBJECTIVE: To explore how patients, community-based perinatal support professionals, and health system clinicians and staff perceived facilitators and barriers to implementation of a randomized clinical trial (RCT) designed to optimize Black maternal heart health.

METHODS: This article describes the formative work that we believed needed to occur before the start of the Change of H.E.A.R.T (Here for Equity, Advocacy, Reflection and Transformation) RCT. We used a qualitative, descriptive design and community-based, participatory approach, the latter of which allowed our team to intentionally focus on avoiding harm and equalizing power dynamics throughout the research process. Data were collected between November 2021 …

Mothers Get Really Exhausted!” The Lived Experience Of Pregnancy In Extreme Heat: Qualitative Findings From Kilifi, Kenya, Fiona Scorgie, Adelaide Lusambili, S. Luchters, Peter. Khaemba, Veronique Filippi, B. Nakstad, Jeremy Hess, Cathryn Birch, S. Kovats, M.F. Chersich

Institute for Human Development

Background: Palliative care (PC) can reduce symptom distress and improve quality of life for patients and their families experiencing life-threatening illness. While the need for PC in Kenya is high, PC service delivery and research is limited. Qualitative research is needed to explore potential areas for PC research and support needed to enable that research. This insight is critical for informing a national PC research agenda and mobilizing limited resources for conducting rigorous PC research in Kenya.

Objectives: To explore perceptions of priority areas for PC research and support needed to facilitate rigorous research from the perspective of Kenyan PC …

One Size Doesn’T Fit All: Attitudes Towards Work Modify The Relation Between Parental Leave Length And Postpartum Depression, Christine Y. Chang, Sabrina R. Liu, Laura M. Glynn

Psychology Faculty Articles and Research

The present study aimed to investigate the relationship between parental leave length and maternal depressive symptoms at six- and twelve-months postpartum and whether this relation was influenced by women’s attitudes towards leave, whether leave was paid or unpaid, and the reason they returned to work. The sample included 115 working women recruited during pregnancy as part of a larger longitudinal study. Analyses revealed that maternal attitudes toward leave influenced the association between leave length and depressive symptoms. Specifically, longer leaves were associated with increased depressive symptoms for women who missed their previous activities at work. Furthermore, women who missed work …

Can The Date Of Last Menstrual Period Be Trusted In The First Trimester? Comparisons Of Gestational Age Measures From A Prospective Cohort Study In Six Low-Income To Middle-Income Countries, Archana Patel, Carla M. Bann, Vanessa R. Thorsten, Sowmya R. Rao, Adrien Lokangaka, Antoinette Tshefu Kitoto, Melissa Bauserman, Lester Figueroa, Nancy F. Krebs, Fabian Esamai, Sherri Bucher, Sarah Saleem, Robert L. Goldenberg, Elwyn Chomba, Waldemar A. Carlo, Shivaprasad Goudar, Richard Derman, Marion Koso-Thomas, Elizabeth Mcclure, Patricia L. Hibberd

Global Health Articles

OBJECTIVES: We examined gestational age (GA) estimates for live and still births, and prematurity rates based on last menstrual period (LMP) compared with ultrasonography (USG) among pregnant women at seven sites in six low-resource countries.

DESIGN: Prospective cohort study SETTING AND PARTICIPANTS: This study included data from the Global Network's population-based Maternal and Newborn Health Registry which follows pregnant women in six low-income and middle-income countries (Democratic Republic of the Congo, Guatemala, India, Kenya, Pakistan and Zambia). Participants in this analysis were 42 803 women, including their 43 230 babies, who registered for the study in their first trimester based …

A Call To Action: Person-Centered Care Aligned With Reproductive Justice For Incarcerated Pregnant People With Substance Use Disorder, Essence Hairston, Aunchalee El Palmquist, Andrea K. Knittel, Kevin Mensah-Biney, Crystal M. Hayes, Amelia Mack, Hendrée E. Jones

School of Social Work Faculty Publications

Although research has proven that jails and prisons are ineffective in preventing or reducing substance use among pregnant people, the USA continues to rely heavily on the criminal legal system as its intervention. Pregnant people with an opioid use disorder are more likely to experience incarceration than pregnant people without an opioid use disorder. In some states, pregnant people are transported from jail to prison through the process of safekeeping in order to receive physical or mental health care that the jail does not provide, despite conviction status. When pregnant and postpartum safekeepers with an opioid use disorder experience incarceration, …

Pain That Only She Must Bear: On The Invisibility Of Women In Judicial Abortion Rhetoric, Francesca Laguardia

Department of Justice Studies Faculty Scholarship and Creative Works

The graphic and bodily facts of a legal question of rights are relevant to the courts, particularly in questions that directly implicate physical bodies and pain, such as right to die cases, or what level of search may be allowable and when. However, in the case of abortion, or more specifically the bodily ramifications of pregnancy and childbirth, this detail is conspicuously absent. This article, relying on a content analysis of over 220 legal opinions on abortion rights, documents this absence of rhetoric. Particularly in the context of other discussions of pain and physical health risks in these very same …

Reproductive Regrets Among A Population-Based Sample Of U.S. Women, Arthur L. Greil, Michele H. Lowry, Andrea R. Burch, Kathleen Slauson-Blevins, Nicholas Park, Julia Mcquillan

Sociology & Criminal Justice Faculty Publications

Women have many reproductive options, but little is known about their regrets regarding prior reproductive choices and outcomes. Guided by the life-course and stratified reproduction perspectives, this study draws on an open-ended question about reproductive regrets from wave I of the National Survey of Fertility Barriers, a representative telephone survey of reproductive aged U.S. women conducted from 2004 to 2006. The authors classified regrets into five broad categories: (1) none, (2) problematic fertility, (3) unfulfilled fertility desires, (4) family, and (5) pregnancy experiences. The authors conducted the analyses separately by motherhood status. Logistic regression analysis revealed that regardless of parental …

The Contribution Of Racism-Related Stress And Adversity To Disparities In Birth Outcomes: Evidence And Research Recommendations, Sabrina R. Liu, Laura M. Glynn

Psychology Faculty Articles and Research

Currently, racial and ethnic differences in adverse birth outcomes and infant mortality are some of the largest and most persistent health disparities in the United States. This narrative review article synthesizes existing literature to present a conceptual model of how racism-related stress and adversity are critical determinants of such disparities. We describe how historical and ongoing racism has created conditions wherein women of color are disproportionately exposed to chronic, multilayered stress and adversity and how the biological consequences of exposure to these stressors confers risk for adverse birth outcomes. Next, we identify important priorities and considerations for future research, including …

Preconceptional Health Behavior Change In Women With Overweight And Obesity: Prototype For Smart Strong Healthy Women Intervention, Frank T. Materia, Joshua M. Smyth, Kristin E. Heron, Marianne Hillemeier, Mark E. Feinberg, Patricia Fonzi, Danielle Symons

Psychology Faculty Publications

Background: The prevalence of maternal perinatal obesity is rising, and in turn, increases health risks and morbidity for both mother and child. Past evidence suggests the preconceptional Strong Healthy Women (SHW) intervention can reduce multiple biobehavioral risk factors for adverse perinatal health. The SHW intervention, however, was time- and resource-intensive to deliver. Mobile health (mHealth) technologies provide an opportunity to expand intervention reach while reducing implementation cost and burden. Previous research suggests that preconceptional women are broadly supportive of using smartphones for behavior change, yet few studies have elicited their specific preferences for a targeted mHealth intervention. The objective of …

Using Neonatal Skin To Study The Developmental Programming Of Aging, Leryn J. Reynolds, Brett J. Dickens, Benjamin B. Green, Carmen J. Marsit, Kevin J. Pearson

Pharmacology and Nutritional Sciences Faculty Publications

Numerous studies have examined how both negative and positive maternal exposures (environmental contaminants, nutrition, exercise, etc.) impact offspring risk for age-associated diseases such as obesity, type 2 diabetes, hypertension, and others. The purpose of this study was to introduce the foreskin as a novel model to examine developmental programming in human neonates, particularly in regard to adipogenesis and insulin receptor signaling, major contributors to age-associated diseases such as obesity and diabetes. Neonatal foreskin was collected following circumcision and primary dermal fibroblasts were isolated to perform adipocyte differentiation and insulin stimulation experiments. Human neonatal foreskin primary fibroblasts take up lipid when …

Challenges And Successes Of Adolescent Reproductive Healthcare And Education In Cachoeira, Bahia, Brazil, Elana Margosis

Independent Study Project (ISP) Collection

In this project, I discuss the impact of social, medical, and political factors on the reproductive healthcare of adolescents in Cachoeira, Bahia, Brazil. I collected qualitative data through formal interviews with public health professionals in the Sistema Única de Saúde (SUS), the Brazilian public health system, and through observations of clinic and home visits. Due to ethical concerns, I did not conduct formal interviews with the patients, were not of legal age. I focused on prevention of pregnancy and STI transmission of adolescents as metrics with which to measure sexual health. I gathered information with the intention to understand SUS’ …

Important Strategies For Effective Family Planning Counseling, Savera Aziz Ali, Minaz Mawani, Gulshan Bano, Sumera Aziz Ali

School of Nursing & Midwifery

No abstract provided.

The Relationship Between Religiosity And Health-Promoting Behaviors In Pregnant Women At Pregnancy Resource Centers, Natalie Cyphers, Andrea D. Clements, Jody L. Ralph

ETSU Faculty Works

Abstract available through the Annals of Behavioral Medicine.

Sexual And Reproductive Health And Rights Of Aymara Women In The Intercultural Health System In Chile / Salud Y Derechos Sexuales Y Reproductivos De Las Mujeres Aymara En El Sistema De Salud Intercultural De Chile, Ariela Schnyer

Independent Study Project (ISP) Collection

This investigation seeks to understand how Aymara women navigate their sexual and reproductive health and rights (SRHR) in Chile’s intercultural health care model. Indigenous communities have their own practices that complicate the provision of sexual and reproductive health by requiring health care providers to be aware of two different worldviews and how they may conflict, as well as what is necessary to provide respectful care. However, an ethnically and culturally pertinent framework is vital to actually assuring successful SRHR provision, whose tenants include autonomous choice and care free of discrimination, coercion or violence. These interactions were investigated through semi-structured interviews …

Depression Is More Prevalent Throughout Pregnancy And The First Six Months Postpartum In Women Low In Religious Commitment And Social Support, Andrea D. Clements, Tifani A. Fletcher, Beth A. Bailey

ETSU Faculty Works

Abstract available through the Annals of Behavioral Medicine.

Laboring To Mother In The Context Of Past Trauma: The Transition To Motherhood, Berman Helene, Robin Mason, Jodi Hall, Susan Rodger, Catherine C. Classen, Marilyn K. Evans, Lori E. Ross, Gloria Alvernaz Mulcahy, Leonarda Carranza, Fatmeh Al-Zoubi

Journal Articles

The occurrence of interpersonal trauma is a reality for many women, with effects that often persist long after the traumatic events end. The purpose of this feminist grounded theory study was to examine how past trauma shaped the lives of women as they became new mothers. We recruited a purposive sample of 32 women from two Canadian communities and conducted semistructured, dialogic interviews during the second trimester of pregnancy. We analyzed data using thematic content analytic methods, including open coding whereby we read transcripts line by line and applied codes to portions of text that illustrated concepts or themes. The …

Religious Commitment And Depression During Pregnancy, Tifani R. Fletcher, Andrea D. Clements, Lana Mcgrady, Beth A. Bailey

ETSU Faculty Works

Abstract available through the Annals of Behavioral Medicine.

Does Breastfeeding Offer Protection Against Maternal Depressive Symptomatology? A Prospective Study From Pregnancy To 2 Years After Birth, Jennifer Hahn-Holbrook, Martie G. Haselton, Christine Dunkel Schetter, Laura M. Glynn

Psychology Faculty Articles and Research

Depression is the leading cause of disability in women (Nobel 2005) and is the most prevalent of all childbearing-related illnesses, affecting approximately 13% of women worldwide within the first 12 [...] Mothers who breastfeed typically exhibit lower levels of depressive symptomatology than mothers who do not. However, very few studies have investigated the directionality of this relationship. Of the prospective studies published, all but one focus exclusively on whether maternal depression reduces rates of subsequent breastfeeding. This study again examines this relationship, but also the reverse--that breastfeeding might predict lower levels of later depression. Using multilevel modeling, we investigated the …

Communalism Predicts Prenatal Affect, Stress, And Physiology Better Than Ethnicity And Socioeconomic Status, Cleopatra M. Abdou, Christine Dunkel Schetter, Belinda Campos, Clayton J. Hilmert, Tyan Parker Dominguez, Calvin J. Hobel, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

The authors examined the relevance of communalism, operationalized as a cultural orientation emphasizing interdependence, to maternal prenatal emotional health and physiology and distinguished its effects from those of ethnicity and childhood and adult socioeconomic status (SES). African American and European American women (N = 297) were recruited early in pregnancy and followed through 32 weeks gestation using interviews and medical chart review. Overall, African American women and women of lower socioeconomic backgrounds had higher levels of negative affect, stress, and blood pressure, but these ethnic and socioeconomic disparities were not observed among women higher in communalism. Hierarchical multivariate regression analyses …

Familialism, Social Support, And Stress: Positive Implications For Pregnant Latinas, Belinda Campos, Christine Dunkel Schetter, Cleopatra M. Abdou, Calvin J. Hobel, Laura M. Glynn, Curt A. Sandman

Psychology Faculty Articles and Research

This study examined the association of familialism, a cultural value that emphasizes close family relationships, with social Support, stress, pregnancy anxiety, and infant birth weight. Foreign-born Latina (n = 31), U.S.-born Latina (n = 68), and European American (n = 166) women living in the United States participated in a prospective study of pregnancy in which they completed measures of familialism, social support, stress, and pregnancy anxiety during their second trimester. As expected, Latinas scored higher on familialism than European Americans. Familialism was positively correlated with social support and negatively correlated with stress and pregnancy anxiety in the overall sample. …

Pregnant Teenager Involvement In Sexual Activity And The Social Context, Maria José Carvalho Sant'anna, Júlia Kerr Catunda, Kepler Alencar Mendes Carvalho, Verônica Coates, Hatim A. Omar

Pediatrics Faculty Publications

Pregnancy during adolescence represents a challenge to society as a whole. Its incidence is increasing and brings about social and medical consequences to both the teen mothers and their children. The purpose of this study was to evaluate pregnant teenager involvement in sexual activity and the social context. The group studied comprised 152 pregnant teenagers attending the Department of Pediatrics, Santa Casa de Sao Paulo (SCSP) General Hospital. All information was analyzed. The age at first intercourse was 14.2 years and the average period between first intercourse and pregnancy was 1.4 years. Most pregnancies (75%) were neither planned nor wanted, …

Physical Violence During Pregnancy: Maternal Complications And Birth Outcomes, Vilma E. Cokkinides, Ann L. Coker, Maureen Sanderson, Cheryl Addy, Lesa Bethea

CRVAW Faculty Journal Articles

Objective: To assess the association between physical violence during the 12 months before delivery and maternal complications and birth outcomes.

Methods: We used population-based data from 6143 women who delivered live-born infants between 1993 and 1995 in South Carolina. Data on women's physical violence during pregnancy were based on self-reports of partner-inflicted physical hurt and being involved in a physical fight. Outcome data included maternal antenatal hospitalizations, labor and delivery complications, low birth weights, and preterm births. Odds ratios and 95% confidence intervals were calculated to measure the associations between physical violence, maternal morbidity, and birth outcomes.

Results: The prevalence …

Experiencing Physical Violence During Pregnancy: Prevalence And Correlates, Vilma E. Cokkinides, Ann L. Coker

CRVAW Faculty Journal Articles

Violence during pregnancy directly impacts the mental and physical health of pregnant women. We assessed the prevalence and correlates of physical violence around the time of pregnancy in a representative sample of 6,718 women in South Carolina. Physical violence, defined as "being physically hurt by husband or partner" or "being involved in a physical fight" was reported by 10.9% of recently pregnant women. These were correlates of violence: experiencing increased numbers of stressful life events, being unmarried, having increased parity, being on Medicaid, and having an unwanted pregnancy. Screening to identify violence in pregnancy in health care settings is vital …