Medicine and Health Sciences Commons^™

Needs Assessment For Creating A Patient-Centered, Community-Engaged Health Program For Homeless Pregnant Women, Tegan Ake, Sabina Diehr, Leslie Ruffalo, Emily Farias, Ashton Fitzgerald, Samuel D. Good, Lindsay B. Howard, Stefan P. Kostelyna, Linda N. Meurer

Journal of Patient-Centered Research and Reviews

Purpose: Women who experience homelessness during pregnancy have poorer birth outcomes than the general population. This exploratory research describes the needs assessment of homeless women currently living at a shelter in Milwaukee, Wisconsin, to identify unmet needs related to maternal and infant perinatal health as the first step in designing a mutually beneficial patient-centered service-learning program for medical students to address these needs.

Methods: Two 1-hour focus groups were held at a shelter for women who are homeless and/or victims of domestic violence. A total of 13 women participated in each session; four medical students and a physician served as …

Contingency Management For Smoking Cessation In Pregnancy, Jacob Miller, Brady Reynolds, Courtney Crain, Hisham Keblawi, Lynne J. Goebel

Marshall Journal of Medicine

This pilot study examined the feasibility of applying Contingency Management (CM), where the woman receives financial compensation for abstinence from smoking. Eleven subjects were recruited from Marshall’s OB clinic for the program. CO levels were measured daily using online video recording. Quit rates were determined at the end of pregnancy. Birth outcomes were measured at delivery. 21 pregnant smokers from Marshall’s OB clinic were used as the control group. The results demonstrated a trend toward improved rates of smoking abstinence in CM participants as compared with the control group. Our study also showed a trend towards improved birth outcomes in …

E-Cigarettes And Smoking Cessation Among Pregnant Women: Insights From A Secondary Analysis Of A Randomized Controlled Trial, Shawn Chiang, Lorien Abroms

GW Research Days 2016 - 2020

Background: The use of electronic cigarettes is a rapidly expanding phenomenon. Currently, there is a scarcity of data to help guide decisions regarding the potential harm and benefits of e-cigarettes. This study examines whether pregnant smokers who used e-cigarettes are more likely to quit smoking than those who had never used e-cigarettes.

Methods: Data were drawn from the Quit4Baby study, a text-message-based smoking cessation randomized controlled trial. The sample was comprised of 481 participants with complete follow-up data at 1 month follow-up. Linear and logistics regression models to control for confounds were conducted to evaluate the association between e-cigarette use …

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’ …

Predictors Of Infant Age At Enrollment In Early Infant Diagnosis Services In Kenya., Kathy Goggin, Catherine Wexler, Niaman Nazir, Vincent S. Staggs, Brad Gautney, Vincent Okoth, Samoel A Khamadi, Andrea Ruff, Michael Sweat, An-Lin Cheng, Sarah Finocchario-Kessler

Manuscripts, Articles, Book Chapters and Other Papers

Despite the importance of early detection to signal lifesaving treatment initiation for HIV+ infants, early infant diagnosis (EID) services have received considerably less attention than other aspects of prevention of mother to child transmission care. This study draws on baseline data from an on-going cluster randomized study of an intervention to improve EID services at six government hospitals across Kenya. Two logistic regressions examined potential predictors of "on time" (infant ≤6 weeks of age) vs. "late" (≥7 weeks) and "on time" versus "very late" (≥12 weeks) EID engagement among 756 mother-infant pairs. A quarter of the infants failed to get …

Psychological And Sociocultural Influences Of Current And Historical Intimate Partner Violence In Pregnancy, Cindy D. Phillips

Electronic Theses and Dissertations

The Centers for Disease Control and Prevention (CDC) estimates that 1.5 million women are victims of intimate partner violence (IPV) each year, and 324,000 of these women are pregnant (2013). Research on the predictability of certain factors and their relationship to current and historical IPV is limited. In order to better understand IPV as it related to a sample of 1,016 Appalachian pregnant women selected for the Tennessee Interventions for Pregnant Smokers (TIPS), it was important to evaluate various influences that may predict the prevalence of IPV in this population when compared to the State of Tennessee and the U.S. …

Smoking Characteristics And Psychiatric Comorbidities Of Pregnant Smokers: An Analysis Of Quit4baby Randomized Controlled Trial, Shawn Chiang, Lorien C. Abroms, Jennifer M. Schindler-Ruwisch, Leah E. Leavitt

GW Research Days 2016 - 2020

Background: Text messaging or short message service (SMS) programs have been shown to be effective in helping adult smokers quit smoking (Abroms et al., 2014). However, to our knowledge, no prior research has examined psychiatric comorbidities associated with smoking in the text messaging context. The risk of smoking has been shown to increase as a function of the number of psychiatric illnesses with which a person is diagnosed (Aubin, Rollema, Svensson, & Winterer, 2012). The current study examined this association and other correlates of smoking-psychiatric comorbidity in a sample of U.S. pregnant smokers enrolled in Quit4Baby, a smoking cessation text …

Proyecto Mama: A Lifestyle Intervention In Overweight And Obese Hispanic Women: A Randomised Controlled Trial--Study Protocol, Lisa Chasan-Taber, Bess H. Marcus, Milagros C. Rosal, Katherine L. Tucker, Sheri J. Hartman, Penelope S. Pekow, Edward J. Stanek Iii, Barry Braun, Caren G. Solomon, Joanne Manson, Sarah L. Goff, Glenn Markenson

Sarah L. Goff MD

BACKGROUND: The proportion of women entering pregnancy overweight or obese has been rising and, in turn, is associated with adverse maternal and fetal outcomes. Gestational weight gain (GWG) exceeding Institute of Medicine (IOM) guidelines further increases health risks and has been independently associated with postpartum weight retention. Hispanic women are disproportionately affected by overweight and obesity, but have had limited access to interventions that promote healthy lifestyles due to cultural, socioeconomic, and language barriers. Therefore, the overall goal of this randomized controlled trial is to test the efficacy of a culturally and linguistically modified, individually-tailored lifestyle intervention to reduce excess …

Smoking Cessation During Pregnancy: An Evidence Based Practice Protocol, Katherine J. Ruhlman

Master of Science in Nursing Evidence-Based Practice Projects

Intrauterine exposure to nicotine is one of the largest modifiable risk factors for infant morbidity and mortality. Previous progress toward decreasing the number impacted by intrauterine nicotine exposure has recently plateaued. While guidelines for assisting pregnant women to stop smoking are available, few providers have a formalized protocol in place. This project will evaluate most current research evidence regarding smoking cessation during pregnancy in order to develop a formalized protocol for implementation in an obstetric clinic in Southwest Ohio. Reviewed literature was summarized and level of evidence was established. Recommendations were made and categorized as strong, moderate, and weak. The …

Maternal Obesity And Incidence Of Depression, Caroline A. Habjan

Honors Capstone Projects - All

Obesity is a national epidemic in the United States, which both directly and indirectly affects the social productivity of individuals, the American macro economy and individuals’ personal health and well being. Depression often interferes with an individual’s ability to work, sleep, study, eat, and enjoy life. A maternal state of both obesity and depression may cause serious adverse medical conditions in the mother’s child. Taking steps to treat depression and obesity are critical in the construct of modern medicine. This project yields results that have the potential to make treatment options better tailored, more efficient, effective and economically-sound for the …

Perspectives From Community-Based Doulas And Mothers: Neighborhood Context And Pregnancy, Dara D. Mendez, Jessica Burke, Jennifer Jones, Cynthia Salter

Journal of Health Disparities Research and Practice

Objectives: Limited research explores the potential pathways by which neighborhoods influence pregnancy or how community members conceptualize and interpret how neighborhood contexts and living environments influence pregnancy and birth.

Study Design: We applied participatory Concept Mapping and a series of focused discussions with community-based doulas and mothers.

Methods: We collaborated with a community-based doula program to investigate how mothers and community doulas perceived the neighborhood to influence reproductive health. We conducted a series of focused discussions including ‘Brainstorming’ to uncover key themes related to how neighborhood context influenced pregnancy, ‘Sorting and Rating’ of key themes in association with pregnancy and …

Are Maternal Child Health Outcomes Affected By Adequacy Of Prenatal Care In Montgomery County, Oh?, Amy Rouse

Master of Public Health Program Student Publications

Background: Prenatal Care has been recommended by the World Health Organization for all pregnant women in order to improve health outcomes of the mother and the child. However, recommendations for the number of visits required to provide adequate health care and improve outcomes continue to be debated. Understanding if adequate prenatal care is improving maternal child outcomes is essential before making these recommendations. This research aims to determine if in Montgomery County, OH the adequacy of prenatal care influenced gestational age at birth, birth weight, breastfeeding rate, rate of cesarean sections, and smoking cessation rates.

Methods: De-indentified birth data was …

A Descriptive Study Of Undergraduate Contraceptive Attitudes Among Students At The University Of New Hampshire, Katrina Heisler, Danielle M. Van Eron

Honors Theses and Capstones

PURPOSE: The purpose of this study was to examine and to understand undergraduate students’ contraceptive attitudes and its effects on contraceptive use to further enhance the education regarding unwanted pregnancies and sexually transmitted diseases (STDs). DESIGN AND METHODS: A descriptive study to understand contraceptive attitudes while exploring demographics and sexual behaviors as well as the incorporation of the Contraceptive Attitude Scale (CAS). The researchers utilized an online survey system to distribute surveys electronically. RESULTS: Most students had a positive attitude regarding contraception. IMPLICATIONS: Nurses at college health facilities can focus on educating the college population since their age group is …

Pregnancy Management Strategies And Childbirth Experiences Of Internally Displaced Women In Barranquilla, Colombia, Bre Bolivar

Master of Public Health Program Student Publications

This ethnographic study aims to illuminate the experiences of pregnant and new mothers in poor areas of Colombia with respect to pregnancy and childbirth. Ethnographic observations including key informant qualitative interviews were performed by the primary investigator in four different neighborhoods in and around the city of Barranquilla, Colombia, over the course of 3 months. A total of 24 women were interviewed, and additional interviews were held with Colombian medical students, religious workers and not-for-profit healthcare leaders. I seek to better understand the perspectives of these internally displaced women in terms of contraception use including the sense of necessity of …

The Efficacy Of Abstinence Only Education, Jennie Watt Mcadams

Master of Public Health Program Student Publications

Chlamydia, Gonorrhea and unplanned teen pregnancies cost the United States billions of dollars every year in various forms of government aid. Why are the numbers of teenage incidences of these health indicators higher than almost every other industrialized nation? Why are the youth in the United States so far behind their peers in sexual health? This paper proposes that one cause is that government funding goes to abstinence only education curriculum which is taught in many schools across the nation. These curricula many times do not teach youth about sexual protection or health and other times contain false information. If …

Trends In Maternal And Infant Health: An Analysis Of Births In Montgomery County, Ohio, 2000-2010, Abby Burns

Master of Public Health Program Student Publications

The demographic characteristics of women who give birth are continually changing. Age, education, use of assisted reproductive technology, BMI before pregnancy, and weight gain during pregnancy are maternal factors that play a role in maternal and fetal health. Other factors including induction, route of delivery, calculated gestational age, and birthweight help determine and identify complications of pregnancy. The purpose of this study is to analyze trends of maternal demographics, risk factors, and birth outcomes associated with poor health outcomes. This research is a secondary analysis of Ohio Natality Statistical Files collected by the Ohio Department of Health, Center for Vital …

Improving Prenatal Education In A Health Center: A Pilot Study, Marcy Keddy Boucher, Hugh Silk, Judith A. Savageau, Katharine C. Barnard, Mary Flynn

Judith A. Savageau

Background: Currently, the timing and variety of health education topics that are covered during prenatal visits are decided upon by the individual physician caring for the patient. Consequently, some patients do not gain exposure to important subject matter that could potentially improve their satisfaction and pregnancy outcomes. Previously reported studies have found evidence that improved patient education may increase rates of breastfeeding (as well as duration), seat belt use during pregnancy, and decrease preterm low birth weight infants. In addition, one study has shown that when prenatal visits are targeted to specific objectives, the number of prenatal visits can …

Smoking During Pregnancy: Its Effects On The Prevalence Of Low Birth Weight Infants, Lynda M. Colussi

Master of Public Health Program Student Publications

Objective: The purpose of this research was to determine what impact demographic characteristics and the smoking status of mothers had on the prevalence and risk for LBW births. Methods: Birth certificate data from Montgomery County, Ohio from 2006-2009 was analyzed. Among the information collected were the infant's birth weight, the mother's age, marital status, education level, race, payer status at time of delivery, WIC status, and smoking status. The impact demographic characteristics and smoking status had on the prevalence of LBW births was determined by a logistic regression model. The effect of when women smoked during pregnancy had on the …

Evidence-Based Public Health Practices For Screening For Postpartum Depression, Roula Hilli

Master of Public Health Program Student Publications

Background: Five to 20 percent of the women worldwide suffer from Post Partum depression (PPD) which has serious negative impacts on the mother and her newborn. Although PPD is a preventive disease thorough screening using different tools, half of its cases are left undetected.

Purpose of the study: Is to find the best practice for PPD screening, which includes the best screening tool, best setting for screening, best administration period and the best cut-off score.

Methods: It is an Evidence-based Public Health (EBPH) review through a comparative study of 82 studies since 2005 that screened women for PPD in the …

The Effect Of Prenatal Care And Other Factors On Preterm Births In Montgomery County 2007-2009, Leslie A. Schmieder

Master of Public Health Program Student Publications

Introduction Preterm birth is defined as a baby who is born before 37 weeks of pregnancy. Problems with preterm birth include an increased risk for health complications throughout life as well as having significantly more medical expenses compared to a full term infant. Prenatal care has shown to decrease the risk for preterm birth nationally. The objective of this project was to analyze prenatal care and other risk and demographic factors to determine their association with preterm birth in Montgomery County.

Method Data used included the 2007-2009 Montgomery County Birth Certificate Data for mothers who had singleton births. The Kessner …

Maternal Characteristics And Infant Birth Weight In Dayton, Ohio, Matthew Pellerite

Master of Public Health Program Student Publications

Objective: To better understand and identify modifiable maternal risk factors that are driving the increased incidence of low birth weight (LBW) in Montgomery County.

Background Information: LBW has lifelong effects on growth and development. These medical and social implications are coupled with an enormous economic burden. In the US, over 5.8 billion dollars are spent annually to care for LBW babies. Despite the recognition of these medical and economic challenges and the implementation of public campaigns to decrease rates, LBW trends have continued to increase. Between 1995 and 2005 the LBW rates in the US incrementally increased from 7.3% to …

The Relationship Of Maternal Age, Trimester Of Entry Into Prenatal Care, Maternal Postpartum Depression, And Race With Birth Weight Of Infants Born In Cincinnati, Ohio, Kelli Kohake

Master of Public Health Program Student Publications

Healthcare, resources, and technology in the United States (U.S.) has improved, yet the U.S. ranks 29th in the world for the highest infant mortality rates – behind other less developed countries. Within the U.S., Ohio (and Hamilton County in particular) has high rates of infant mortality. Low birth weight and preterm births are a major cause of infant mortality. Data analysis was done consisting of descriptive statistics and Analysis of Variance of the prenatal patients served at the Cincinnati Health Department health centers who delivered in 2009, with dependent variables of birth weight and postpartum depression. Independent variables included maternal …

Preterm Birth Rates In Pregnant Women With Sexually Transmitted Infections: Cincinnati Public Health Centers 2005 And 2006 Deliveries, Elizabeth Singhoffer

Master of Public Health Program Student Publications

Objective: To evaluate the differences in prenatal maternal infections in women served by the City of Cincinnati health centers that have or have not had a preterm birth.

Methods: A retrospective and observational study of medical records of 738 patients seen at the City of Cincinnati health centers, who delivered in the years of 2005 and 2006. The usable data resulted in 668 total subjects. Data collected included types of health care visits prior to index pregnancy, if preconception/ reproductive health care was discussed, demographics, gestational age at first prenatal visit and at delivery, insurance at first prenatal visit and …

Retrospective Comparative Analysis Of The Socio-Demographic Characteristics Of Pregnant Abortion-Minded Clients Versus Pregnant Non-Abortion-Minded Clients In A Crisis Pregnancy Center In Montgomery County, Ohio, Betsy Liliana Cote

Master of Public Health Program Student Publications

Purpose: The purpose of this study is to compare socio-demographic characteristics of pregnant abortion-minded women versus pregnant non-abortion minded women who had consulted a crisis pregnancy center in Montgomery County, Ohio. The findings will be used to help develop public health prevention programs for unintended pregnancies.

Methods: A database sample of 581 records collected by a crisis pregnancy center in t Montgomery County was used for this study. Criteria for inclusion were women obtaining a positive pregnancy test, whose pregnancy intentions were assessed as being either abortion-minded or non-abortion-minded. Socio-demographic characteristics such as age, marital status, household income, education, religious …

Is Number Of Pregnancies A Risk Factor For Heart Attack In Women?, Pavan Kumar Irukulla

Theses and Dissertations

Background: Studies regarding number of pregnancies and coronary heart disease have shown inconsistent results. In the present study, we assessed the association between number of pregnancies and heart attack (HA) in women.Methods: Using data from NHANES III a cross sectional data analysis of 10634 women aged 17 and above was conducted. We considered socio-demographic factors and other potential risk factors including physical activity, smoking, alcohol, diabetes, hypertension, hypercholesterolemia, BMI, age, and family history of heart attack. We conducted Bivariate analysis to determine prevalence and crude odds ratios. Multivariate logistic regression analysis was used to adjust for confounding variables using SPSS. …

Decreasing Barriers For Teens: Evaluation Of A New Teenage Pregnancy Prevention Strategy In School-Based Clinics, Abbey C. Sidebottom, Amanda Birnbaum, Sarah S. Nafstad

Department of Public Health Scholarship and Creative Works

Sidebottom et al seek to evaluate the effects of the change in distribution systems on students' receipt of requested contraceptives and demand for contraceptive school-based clinics (SBC). The result of the study reveals that the average number of requests per student was higher under the voucher system, possibly as a consequence of expires vouchers resulting in repeated requests. The findings also suggest that SBCs could go a step further in reducing adolescents' barriers to accessing contraceptives by adopting an on-site direct delivery system..