Standardizing Perinatal Mental Health Interventions: A Guide For The U.S., Maile Lauren Robles

Master's Projects and Capstones

The term perinatal individual refers to women and other individuals who are pregnant or who have been pregnant within the last 12 months. Every year, in the United States there are 700 pregnancy-related deaths and 10% are due to mental health causes including death by suicide. Mental health conditions including but not limited to anxiety, depression, substance use disorders, and post-traumatic stress disorder affect one in five perinatal individuals throughout the United States. This increases perinatal morbidity, hospitalization costs, and economic burden nationwide.

After 43 days postpartum, mental health conditions are the second leading cause of death. The United States …

How Can Single Mothers Care For Themselves And Their Children During The Covid-19 Pandemic?, Lisbeth Alexandra Pino Gavidia

Electronic Thesis and Dissertation Repository

This work investigates how single mothers maintain healthy behaviours for themselves and their children as they try to meet the evolving COVID-19 public recommendations. Everyone has had to adapt to changing public health rules. Single mothers may have unique challenges as they juggle to adapt to changing family responsibilities since they do not have another person helping in the home, and help outside the home may be restricted by public health rules. My research plan addressed these questions to learn more about the experiences of single mothers during the pandemic: 1) What are the changes in family responsibilities? 2) How …

Menstrual And Fertility Tracking Apps And The Post Roe V. Wade Era, Samantha T. Campanella

Undergraduate Student Research Internships Conference

In the first section of the paper, I will place current conversations about data privacy within the broader context of restrictions that have been placed on reproductive rights by examining historical trajectories. Emphasis will be placed on the historical trajectory of how past policies and ideologies have worked against Roe v. Wade, and how this trajectory contributes to a decrease in access to abortions. In addition, recent news stories have documented the overturning of Roe v. Wade in several jurisdictions within the United States, which confirms the criminalization of abortion. In light of this, experts have raised awareness about the …

The Global Network Socioeconomic Status Index As A Predictor Of Stillbirths, Perinatal Mortality, And Neonatal Mortality In Rural Communities In Low And Lower Middle Income Country Sites Of The Global Network For Women's And Children's Health Research, Archana B. Patel, Carla M. Bann, Cherryl S. Kolhe, Adrien Lokangaka, Antoinette Tshefu, Melissa Bauserman, Lester Figueroa, Nancy F. Krebs, Fabian Esamai, Sarah Saleem

Community Health Sciences

Background: Globally, socioeconomic status (SES) is an important health determinant across a range of health conditions and diseases. However, measuring SES within low- and middle-income countries (LMICs) can be particularly challenging given the variation and diversity of LMIC populations.
Objective: The current study investigates whether maternal SES as assessed by the newly developed Global Network-SES Index is associated with pregnancy outcomes (stillbirths, perinatal mortality, and neonatal mortality) in six LMICs: Democratic Republic of the Congo, Guatemala, India, Kenya, Pakistan, and Zambia.
Methods: The analysis included data from 87,923 women enrolled in the Maternal and Newborn Health Registry of the NICHD-funded …

Interventions To Support Teen Mothers In California And Reduce The Disparities Related To The Effects Of Teen Pregnancy, Shanelle Christine Sanchez

Master's Projects and Capstones

The US teen birth rate has slowly been declining; however, teenage pregnancy is still prevalent. In 2018 the US teen birth rate was 17.4 births per 1,000 girls aged 15-19 years, totaling 179,871 births (National Vital Statistic Report). California’s most recent birth rate was 13.6 births per 1,000 girls aged 15-19 years in 2020 (CDC, 2020). Few studies focus on teen mothers’ health, life needs, and outcomes as a result of adolescent pregnancy and subsequently, adolescent parenting. Additionally, few studies have looked at the cultural differences and views of adolescent pregnancy and parenting within the Hispanic population, which are greatly …

Behind Closed Doors: A Look Into Access To Supportive Resources And Women Experiencing Intimate Partner Violence (Ipv), Ashley Lauren Holloway

Master's Projects and Capstones

Introduction Intimate Partner Violence (IPV) is a preventable health disparity that remains an underrepresented health issue due to survivors' comfortability in reporting violence within their most intimate relationships; in addition to providers' comfortability in addressing intimate partner violence. The high prevalence of IPV-related incidents highlights the importance of early intervention to prevent victims from experiencing violence again and dying.

Methods A systematic review was conducted to look into intimate partner violence against women. Key words such as intimate partner violence or domestic violence, women, utilization of care services or services, socioecological model were searched through pubmed and other scholarly search …

The Child Care Crisis: Through The Social Ecological Lens, Jocelyne Saldana

Master's Projects and Capstones

Abstract

Objective - Working mothers face mental strain when returning to work due to the challenges of the current child care system. It is unclear how the instability of the child care sector impacts the mental health of working mothers.

Methods - The systematic review of literature was conducted to identify existing evidence to determine the influence access to quality, dependable, and affordable child care has on maternal mental health outcomes in working mothers. Multiple databases were used including PubMed and Scopus.

Results - Subsidized programs help reduce the cost of child care, however, income eligibility criteria makes it difficult …

No One Should Have To Give Birth Alone: An Analysis Of The Efficacy Of Community-Based Doula Programs Serving Ethnic Minorities In San Francisco, Maria Margaret Nelson

Master's Projects and Capstones

Adverse birth outcomes for both the parent and the child disproportionately affect people of color. Evidence demonstrates that one of the ways to mitigate these negative consequences is through the utilization of a doula, a trained birth companion that is not a medical provider but whose role it is to physically and emotionally support the patient through pregnancy, birth, and postpartum. Community-based doula programs, where the doula is of the same cultural background as the client, are particularly effective in improving birth outcomes in communities of color by providing culturally competent care and helping to navigate a healthcare system that …

The Impact Of Psychosocial Stress On Maternal Health Outcomes: A Multi-State Prams 8 (2016-2018) Analysis, Blessing Chidiuto Lawrence, Anna Kheyfets, Keri Carvalho, Shubhecchha Dhaurali, Marwah Kiani, Alison Moky, Ndidiamaka Amutah-Onukagha

Journal of Health Disparities Research and Practice

Introduction: Significant racial disparities persist in maternal morbidity rates, disproportionately affecting Black women. Experiencing high levels of stress during pregnancy is associated with increased risk for preterm birth, infant mortality, and preeclampsia. This study investigates the impact of psychosocial life stressors on maternal morbidity and racial disparities utilizing the Pregnancy Risk Assessment Monitoring System (PRAMS) dataset.

Methods: Participants (N=24,209) included were from Phase 8 (2016-2018) of the PRAMS survey across five states. Stressors were grouped into traumatic, partner-related, financial, or emotional. Maternal outcomes included gestational diabetes, hypertensive disorders of pregnancy, prenatal depression, and postpartum depression. The association between life stressors …

From A Place Of Love: The Experiences Of Birthing In A Black-Owned Culturally-Centered Community Birth Center, J'Mag Karbeah, Rachel Hardeman, Numi Katz, Dimpho Orionzi, Katy Kozhimannil

Journal of Health Disparities Research and Practice

Introduction: Racial and ethnic disparities in perinatal health outcomes are among the greatest threats to population health in the United States. Black birthing communities are most impacted by these inequities due to structural racism throughout society and within health care settings. Although multiple studies have shown that structural racism and the disrespect associated with this system of inequity are the root causes of observed perinatal inequities, little scholarship has centered the needs of Black birthing communities to create alternative care models. Leaning on reproductive justice and critical race theoretical frameworks, this study explores good birth experiences as described by Black …

Moving Towards Justice: Reducing Encounters Of Preeclampsia In Adolescent Maternal Health, Shaunesse' Jacobs Plaisimond, George Hodulik, Molly Wilde

Journal of Health Disparities Research and Practice

Using data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-to-Be (nuMoM2b), several relationships were explored between nutrition and diet, likely attributed to education, culture, training, and habits around food. While these factors remain relevant and worth pursuing, data analysis implied that the most significant issue remaining is access to healthcare. Across race, age, and nutrition consumption, if pregnant people make higher incomes—inferring better access to healthcare and higher-quality nutrients, then their risk of preeclampsia is reduced. Accordingly, this paper performs an extensive literature review of the intersection of extreme maternal age and nutrient intake as a significant factor for preeclampsia. …

Defining Birth Equity In Kansas, Oluoma Obi, Michelle L. Redmond, Joi Wickliffe, Sapphire Garcia-Lies, Sharla Smith

Journal of Health Disparities Research and Practice

Background: While some health outcomes improve in the United States, racial and ethnic disparities in pregnancy-related outcomes persist. In the United States and Kansas, Black women are three times more likely to die from a pregnancy-related complication than white women.

Description: The Kansas Birth Equity Network (KBEN), is an initiative developed to address racial disparities in maternal and child health outcomes. We used a community-centered approach to collect stakeholder perceptions of birth equity and develop a case definition of birth equity.

Methods: An open-ended online survey was designed to collect stakeholders’ definition of birth equity, their organization’s birth equity missions, …

Birth Justice Philly: Equitable Community Engagement In Action, Simone N. Snead, Imani Davis, Samantha Shuster, Elizabeth Guman, Cynthia Estremera Gauthier, Aasta D. Mehta

Journal of Health Disparities Research and Practice

This article describes how a multi-sector coalition focusing on carrying out recommendations of the Philadelphia Maternal Mortality Review Committee (MMRC) engages community participation through the development of equitable strategies that culminate in the implementation of actionable methods to improve perinatal outcomes.

The U.S. maternal mortality crisis continues to impact countless families and communities. Despite having some of the finest academic medical centers in the nation and a functioning county-level maternal mortality review committee, the maternal mortality rate in Philadelphia, Pennsylvania is far above the national average. Vital statistics show that Philadelphia’s rate of pregnancy-related deaths from 2012 to 2018 was …

Addressing Racial Disparities In Maternal Health: The Case For An Equity Birth Plan, Alice Trye, Damali Campbell Oparaji, Natalie Roche, Lisa Gittens Williams

Journal of Health Disparities Research and Practice

Birth equity can be defined as “The assurance of the conditions of optimal births for all people with a willingness to address racial and social inequities in a sustained effort.” (Birth Equity |California Maternal Quality Care Collaborative, n.d.). Complex explanations exist for adverse maternal outcomes, but unequal health care, socioeconomic and racial inequalities pose risks to women and their babies (“Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care,” 2003). The data is clear: Maternal death rates have increased and are 3 to 4 times higher for black women than white women (Zaharatos et al., 2018). These …

Editor's Notes, Nekeshia Jones, Sharla Smith, Melva Thompson-Robinson

Journal of Health Disparities Research and Practice

These Editors' Notes introduce the first special issue of the Journal of Health Disparities Research and Practice based on the work the National Maternal Health Research Network.

Hellp Syndrome: Hemolysis, Elevated Liver Enzymes, Low Platelets, Kimberly Roman

Nursing Student Class Projects (Formerly MSN)

The research provided was to understand a rare, life-threatening condition that occurs in pregnant women or recently postpartum women. The topic searched was HELLP Syndrome, an acronym for Hemolysis, Elevated Liver Enzymes, and Low Platelets. This syndrome is named this due to the underlying conditions in women who experience this disorder. Women can recover from HELLP Syndrome if detected early and treated appropriately, but symptoms are vague and difficult to diagnose. The best way to understand and detect this disorder is by promoting awareness and understanding the mechanisms and treatment involved. A search was conducted about the topic through research …

Provider Attitude Towards Postpartum Sexual Health, Katie Shearer, Pallavi Khanna

Longitudinal Scholar's Project

Background: The prevalence of female sexual dysfunction (FSD) worldwide is estimated to be 41%. FSD is even more prevalent in postpartum patients. There are significant barriers to addressing FSD in a busy clinic, and the use of a standardized screening questionnaire could be used to improve outcomes during postpartum appointments.

Methodology: Providers that care for postpartum patients at Regional One Health in Memphis, TN, were asked to complete an anonymous survey online. General knowledge and practices of providers were assessed.

Results: 79% of respondents answered that they felt very comfortable assessing for postpartum sexual health, and 88% …

“I Feel Like It’S One Of Those Things That Everyone Feels The Same Way About, No One Wants To Discuss It”: A Qualitative Examination Of Female College Students’ Pap Smear Experience, Ny'nika T. Mcfadden, Amanda H. Wilkerson, Heather J. Carmack

Health Behavior Research

The purpose of this study was to examine female college students’ Pap smear experience and communication with their provider before, during, and after the exam. In fall 2019, 158 female college students completed an online survey with closed and open-ended questions. Open-ended responses from participants reporting a previous Pap smear (n=36) were qualitatively analyzed to generate themes to explain female college students’ Pap smear experience and communication behavior with their provider before, during, and after the exam. The main themes identified included: Uncomfortable, Low Patient Engagement, Provider Support, and Provider Trust. Female college students overwhelmingly reported discomfort around …

Postpartum And Pediatric Education Program For Mothers, Lacie T. Ellithorpe

Department of Occupational Therapy Entry-Level Capstone Projects

My capstone experience included the focus area(s) of Clinical Practice Skills and Education. The aim of this capstone project was to create an ergonomic education program to address new motherhood and their occupations of health management and maintenance, sleep and rest, breastfeeding and other baby care, community mobility, and leisure. My Capstone Mentor was Dr. Kari Rasmussen, OTD, OTR/L. Becoming a new mother is considered a major life event, due to significant role changes that impact a mother’s everyday occupations. The population I served was new and expectant mothers in order to provide ergonomic education as they relate to the …

Development And Modification Of A Culturally Tailored Education Program To Prevent Breast Cancer In Korean Immigrant Women In New York City, Jin Young Seo, So-Hyun Park, Sung-Eun Choi, Minkyung Lee, Shiela M. Strauss

Publications and Research

Breast cancer (BC) is the most common cancer in Korean American (KA) women. In view of its high prevalence in these women, their low screening rates, and the cultural influence of BC risk factors in their lifestyles, we developed a community-based culturally tailored BC prevention program, the Korean Breast Cancer Risk Reduction Program (KBCRRP). Guided by the PRECEDE-PROCEDE and health belief models, the KBCRRP was developed to achieve four goals: (1) healthy weight, (2) physically active lifestyle, (3) healthy diet, and (4) BC screening and adherence. KBCRRP combines effective multicomponent strategies for BC screening and a group-based lifestyle intervention incorporating …