Public Health Commons^™

Metabolism During Pregnancy And Postpartum: How Does It Change And What Factors Influence It?, Kristin Yoho

Masters Theses & Specialist Projects

PURPOSE: Pregnancy is a physically impactful process in a woman’s life. During this time, a woman will gain weight and research has shown that many women will retain some extra weight after delivery. Because of this, recovery in the postpartum period is pivotal to avoiding the implications of weight retention. The postpartum period is vastly understudied in both the research and medical communities and this gap between pregnancy and postpartum research needs to be bridged. Therefore, the purpose of this study was to investigate metabolic changes from pregnancy to postpartum and to study how factors such as sleep and breastfeeding …

La Adherencia A Las Recomendaciones De Sueño Seguro Por Parte De Las Enfermeras En Unidades De Cuidado Intensiva Neonatal (Ucin) De Hospitales Públicos Y Privados En El Gran Buenos Aires / The Adherence To Safe Sleep Recommendations By Nurses In Neonatal Intensive Care Units (Nicus) Of Public And Private Hospitals In Grand Buenos Aires, Joelle M. Schauer

Independent Study Project (ISP) Collection

El Síndrome de Muerte Súbita de Lactante (SMSL) es “la muerte de un niño menor de 1 año que ocurre, aparentemente, durante el sueño y no puede ser explicada luego de una investigación exhaustiva, que incluye una autopsia completa, la investigación de las circunstancias de la muerte y la revisión de la historia clínica" (Jenik et al., 2015, p. 2). La Academia Americana de Pediatría (AAP) tiene recomendaciones sobre las prácticas del sueño seguro que pueden disminuir el riesgo de SMSL y otras Muertes Súbitas Inesperadas Infantiles (MSII).

El objetivo de esta investigación es analizar la adherencia a estas recomendaciones …

Is Breastfeeding Truly Best? Evolutionary, Physiological, & Cultural Factors That Shape Breastfeeding Practices, Emily J. Green 19

Honor Scholar Theses

No abstract provided.

Growing Healthy Together: Protocol For A Randomized Clinical Trial Using Parent Mentors For Early Childhood Obesity Intervention In A Latino Community, Byron A. Foster, Kelsey Weinstein, Jackilen Shannon

OHSU-PSU School of Public Health Faculty Publications and Presentations

Background: Latino children in the US experience high rates of obesity, increasing their risk of subsequent diabetes. There are few clinical trials among low-income, Latino families to test interventions that account for and address their unique situation.

Methods/design: This trial, conducted in a Head Start (early childhood education) setting, randomly assigns children 2–5 years of age who have obesity by CDC (Centers for Disease Control and Prevention) guidelines (at least 95th percentile body mass index) and their parents to one of three conditions: (1) control, (2) parent mentor with an experimental curriculum, or (3) parent mentor with a …

Factors Associated With Rapid Repeat Pregnancy Among Women In A Healthy Start Program In Kent County, Michigan, Sarah Jane Schmidt

Masters Theses

Strong Beginnings (SB) is a federal Healthy Start Program aiming to improve the health and well-being of black and Hispanic families by promoting racial equity and eliminating racial disparities in birth outcomes, including rapid repeat pregnancy (secondary pregnancy within 18 months of index birth). To better prevent the occurrence of rapid repeat pregnancy (RRP), this study explores individual, social, and environmental factors associated with RRP. De-identified data for this study included information from SB, the Maternal Infant Health Program, Medicaid claims, and birth certificates. The sample includes women enrolled in SB with an index birth between 2013 and 2015. Chi-square …

My Body, Their Choice: Childbearing Attitudes And Practices In Jamkhed, Maharashtra, Sienna Sewell

Independent Study Project (ISP) Collection

Understanding the beliefs and practices of women and their families during pregnancy and childbirth is fundamental to the creation of successful public health interventions that target maternal and infant mortality. This study explores the childbearing practices of women in rural Jamkhed, as well as the social and economic factors that influence family planning, reproductive health-seeking, and delivery. Interviews and quantitative surveys were conducted with women in villages that have partnered with the Comprehensive Rural Health Project (CRHP) to examine how and why women access prenatal care during pregnancy. The influence of CRHP’s “Jamkhed Model” on healthcare access is considered in …

When Crayons Meet Tibetan Living Room Walls: Early Childhood In Exile, Emma Hart

Independent Study Project (ISP) Collection

This study aims to understand early childhood caregiving among Tibetan refugees living in Nepal. Due to the brain’s enormous developmental plasticity from ages zero to three, children’s experiences during this period are extremely important to explaining their future learnings in school, interactions with people, and engagements with their surroundings. Through interviews and observations, Tibetan parents shared their conceptions of early childhood, parent-child interaction norms, dreams for their children, and how their status as refugees in Nepal affects these. Research was conducted in two Pokhara district Tibetan settlements and one settlement in Mustang. Connected by the flow of children and adults …

Voices Unheard: Women And Their Children In Nepal’S Incarceration System, Aune Nuyttens, Mikayla Rose

Independent Study Project (ISP) Collection

This research project focused on women in Nepal’s incarceration system. Our goal was to hear and share their stories with the hopes of humanize and de-stigmatize perceptions of female prisoners in and outside of Nepal. A central component to these stories, as we learned, was also the story of prisoner’s children and the NGOs who provide assistance to this vulnerable group of women and their children. The researchers travelled to the east and west of Kathmandu to visit rural and urban prisons in Nepal, and visited various children homes, however the research was based out of Kathmandu, where many of …

An Investigation Into The Relationship Between Academic Pressure And Non-Medical Prescription Stimulant Use Among University Of South Carolina Undergraduate Students, Arslan Valimohamed

Senior Theses

One hundred and six undergraduate students of the University of South Carolina were surveyed to understand misuse of prescription stimulants and how perceived academic pressure may play a role in this behavior. Overall, the survey revealed that 33.0% of participants reported illicit use of prescription stimulants in the last 30 days, and 52.8% reported illicitly using prescription stimulants at least once during their time in college. Data from the survey responses indicated that students perceiving academic pressure were more likely to have misused prescription stimulants at least once during their time in college, but only if these students also reported …

A Comparison Of The United States And Costa Rican Health Care Systems And Their Influence On Immigrant Women's Maternal And Child Health Outcomes, Tamera R. Sullivan

Senior Theses

Health is a fundamental right for all humans, and every nation has a unique system for health care delivery. While the United States and Costa Rica follow two different welfare state models, there is still value in comparing the two countries. This project was inspired by my public health-based study abroad experience in Costa Rica in May 2018, which sparked a desire to learn more about the structures that form the health care system of each country. The United States has a more privatized and fragmented health care system, while Costa Rica has a public, universal health care system. Although …

Are Family Planning Vouchers Effective In Increasing Use, Improving Equity And Reaching The Underserved? An Evaluation Of A Voucher Program In Pakistan, Moazzam Ali, Syed Khurram Azmat, Hasan Bin Hamza, Md Mizanur Rahman, Waqas Hameed

Community Health Sciences

Background: Low modern contraceptive prevalence rate and high unmet need in Pakistan aggravates the vulnerabilities of unintended pregnancies and births contributing to maternal morbidity and mortality. This research aims to assess the effectiveness of a free, single-purpose voucher approach in increasing the uptake, use and better targeting of modern contraceptives among women from the lowest two wealth quintiles in rural and urban communities of Punjab province, Pakistan.
Methods: A quasi-interventional study with pre- and post-phases was implemented across an intervention (Chakwal) and a control district (Bhakkar) in Punjab province (August 2012-January 2015). To detect a 15% increase in modern contraceptive …

Oxytocin Receptor Gene (Oxtr) And Father Support Interact To Predict Depressive Symptoms Postpartum, Parambir Bhatti, Taylor Delaney, Michael Poulin, Jennifer Hahn-Holbrook

Psychology Faculty Articles and Research

Postpartum depression (PPD) is a debilitating mental illness affecting approximately 13% of mothers after birth. Both genetic and psychosocial factors contribute to PPD risk, but very little is known about how these factors interact. We tested whether the rs53576 polymorphism in the oxytocin receptor (OXTR) gene accounts for variation in the impact of low social support as a risk factor for depression among mothers during the perinatal period. New mothers (N = 220) provided saliva or blood DNA samples and completed surveys assessing PPD symptoms and perceived social support. In a significant interaction, social support from the …

Built Food Environment And Perinatal Depression: An Integrative Literature Review, Rachel N. Mileski

Grace Peterson Nursing Research Colloquium

Background: Built food environment contributes to food access and insecurity, which impactsmaternal health due to increased rates of perinatal depression.

Objectives: The purpose of this integrative literature review will be to (1) identify contributing factors of built food environments in communities that increase the rate of perinatal depression and (2) evaluate the current intervention programs and methods addressing these factors in order to provide recommendations for further research.

Method: An integrative literature review will be used, in accordance with the Ecological Model, to evaluate contributing factors and suggestions.

Results: Findings from this integrative literature review revealed a link that connects …

Factors Associated With Anemia Among Women Of The Reproductive Age Group In Thatta District: Study Protocol, Sumera Aziz Ali, Zahid Abbasi, Anam Feroz, K Michael Hambidge, Nancy F. Krebs, Jamie E. Westcott, Sarah Saleem

Community Health Sciences

Background: Maternal anemia is a leading public health issue placing pregnant women at higher risk of low birth weight, preterm birth, perinatal mortality, and neonatal mortality. Women in developing countries are at higher risk of anemia which could be either due to micronutrient deficiencies, hemoglobinopathies, infections or other socio-demographic factors. Thus, it is highly essential to explore the factors of anemia among women of the reproductive age group in order to design suitable interventions. The primary objective of this study is to assess the biological and socio-demographic factors that are associated with anemia among the women of the reproductive age …

Evaluating Quality Of Contraceptive Counseling: An Analysis Of The Method Information Index, Karen T. Chang, Mulenga Mukanu, Ben Bellows, Waqas Hameed, Amanda M. Kalamar, Karen A. Grépin, Xaher Gul, Nirali M. Chakraborty

Community Health Sciences

The Method Information Index (MII) is calculated from contraceptive users' responses to questions regarding counseling content-whether they were informed about methods other than the one they received, told about method-specific side effects, and advised what to do if they experienced side effects. The MII is increasingly reported in national surveys and used to track program performance, but little is known about its properties. Using additional questions, we assessed the consistency between responses and the method received in a prospective, multicountry study. We employed two definitions of consistency: (1) presence of any concordant response, and (2) absence of discordant responses. Consistency …

Unintentional Bathtub Drowning Deaths Among Those Aged 65 Years And Older In Australia, Amy E. Peden, Richard C. Franklin, John H. Pearn M.D., Alison J. Mahony

International Journal of Aquatic Research and Education

When compared with other age groups, fatal drowning rates among seniors have stayed static. This study identifies causal factors in unintentional bathtub drowning deaths among people aged 65 years and over. This study is a 10-year (2003-2012) total population retrospective survey of all unintentional bathtub (baths, spa baths and showers) drowning deaths afflicting people aged 65 years and over. Data were sourced from the Australian National Coronial Information System. Risk factors and circumstantial variables were analysed including sex, age, activity prior to drowning, alcohol, drugs, pre-existing medical conditions, living circumstances, time until found, and performance of cardio-pulmonary resuscitation (CPR). There …

Social Ecological Predictors Of Risky Sexual Behavior Among Young Adults, Maureen Muchimba

Journal of Social, Behavioral, and Health Sciences

Most studies on sexual behavior outcomes are restricted to adolescents. However, rates of sexually transmitted diseases (STDs) are highest among young adults. This study examined social–ecological predictors in adolescence that predict risky sexual behavior in young adulthood. Using longitudinal data, logistic regression was used to determine social–ecological factors that predict early sexual debut and a high number of lifetime sexual partners among 3,109 young adults. Risk-taking was associated with early sexual debut and a high number of lifetime sexual partners. Father–child connectedness decreased the odds of early sexual debut and a high number of lifetime sexual. School connectedness also decreased …

Health Care Seeking For Maternal And Newborn Illnesses In Low- And Middle-Income Countries: A Systematic Review Of Observational And Qualitative Studies, Zohra S. Lassi, Philippa Middleton, Zulfiqar Ahmed Bhutta, Caroline Crowther

Woman and Child Health

Background: In low- and middle-income countries, a large number of maternal and newborn deaths occur due to delays in health care seeking. These delays occur at three levels i.e. delay in making decision to seek care, delay in access to care, and delay in receiving care. Factors that cause delays are therefore need to be understand to prevent and avoid these delays to improve health and survival of mothers and babies.
Methods: A systematic review of observational and qualitative studies to identify factors and barriers associated with delays in health care seeking.
Results: A total of 159 observational and qualitative …

Marshallese Beliefs, Perceptions, And Practices Related To Child Feeding Among Marshallese In The United States: Implications For Childhood Obesity, Kelly Vowell Johnson, Allison L. Scott, Marilou Shreve, Britni L. Ayers, Victoria S. Seaton, Pearl A. Mcelfish

The Eleanor Mann School of Nursing Faculty Publications and Presentations

Obesity affects more than 40 million children globally. Efforts to promote proper nutrition in an attempt to reduce childhood obesity should consider maternal beliefs and cultural customs around food. Little is known regarding child feeding, including weaning practices and foods consumed in the first years of life among Marshallese children, a sub-group of Pacific Islanders, residing in the United States.

This study aims to explore the influences on introduction of complementary foods among Marshallese mothers and caregivers residing in the United States, to serve as the basis for promotion of improved nutrition. Focus groups and demographic surveys were conducted with …

A Qualitative Metasynthesis Of Published Research Exploring The Pregnancy And Resettlement Experience Among Refugee Women, Diana M. Kingsbury, Sheryl L. Chatfield

The Qualitative Report

The number of refugees and asylum seekers throughout the world continues to increase, leading to increasing challenges in meeting healthcare needs of these individuals. Women’s antenatal health is of particular concern due to their vulnerability to sexual violence and the substantial proportion of refugees consisting of women and girls of or nearing reproductive age. The purpose of this qualitative metasynthesis was to integrate and interpret findings from previously published research reports in which authors explored aspects of pregnancy among resettled refugee women. Following a systematic search process, we used Dedoose qualitative data analysis software to manage the process of extracting …

Intimate Partner Violence Among Expectant Adolescent Couples: Psychological And Relational Predictors And Sexual Risk, Jessica Lewis

Dissertations, Theses, and Capstone Projects

BACKGROUND/PURPOSE: Intimate partner violence (IPV) is prevalent and tends to be bilateral in adolescent relationships. Expectant adolescent couples are at even higher risk. Using the Actor-Partner Interdependence Model (APIM), this study sought to: (1) describe the patterns of physical/sexual and psychological IPV victimization of women and men in expectant adolescent couples from pregnancy through twelve months postpartum; (2) examine the associations between psychosocial and relational factors during pregnancy and postpartum IPV; and (3) investigate the relationship between IPV victimization and later sexual risk across the perinatal period.

METHODS: Data were collected from pregnant adolescents and their male partners (N=296) recruited …

A Multicountry Randomized Controlled Trial Of Comprehensive Maternal Nutrition Supplementation Initiated Before Conception: The Women First Trial., K. Michael Hambidge, Jamie E. Westcott, Ana Garcés, Lester Figueroa, Shivaprasad S. Goudar, Sangappa M. Dhaded, Omrana Pasha, Sumera A. Ali, Antoinette Tshefu, Adrien Lokangaka, Richard J. Derman, Robert L. Goldenberg, Carl L. Bose, Melissa Bauserman, Marion Koso-Thomas, Vanessa R. Thorsten, Amaanti Sridhar, Kristen Stolka, Abhik Das, Elizabeth M. Mcclure, Nancy F. Krebs

Global Health Articles

Background: Reported benefits of maternal nutrition supplements commenced during pregnancy in low-resource populations have typically been quite limited.

Objectives: This study tested the effects on newborn size, especially length, of commencing nutrition supplements for women in low-resource populations ≥3 mo before conception (Arm 1), compared with the same supplement commenced late in the first trimester of pregnancy (Arm 2) or not at all (control Arm 3).

Methods: Women First was a 3-arm individualized randomized controlled trial (RCT). The intervention was a lipid-based micronutrient supplement; a protein-energy supplement was also provided if maternal body mass index (kg/m2) was(DRC), Guatemala, India, and …

The Influence Of Unpredictable, Fragmented Parental Signals On The Developing Brain, Laura M. Glynn, Tallie Z. Baram

Psychology Faculty Articles and Research

Mental illnesses originate early in life, governed by environmental and genetic factors. Because parents are a dominant source of signals to the developing child, parental signals - beginning with maternal signals in utero - are primary contributors to children’s mental health. Existing literature on maternal signals has focused almost exclusively on their quality and valence (e.g. maternal depression, sensitivity). Here we identify a novel dimension of maternal signals: their patterns and especially their predictability/unpredictability, as an important determinant of children’s neurodevelopment. We find that unpredictable maternal mood and behavior presage risk for child and adolescent psychopathology. In experimental models, fragmented/unpredictable …

Racial Discrimination And Preterm Birth Among African American Women: The Important Role Of Posttraumatic Stress Disorder, Amelia Gavin, Nancy Grote, Kyaien Conner, Taurmini Fentress

Journal of Health Disparities Research and Practice

Among African American infants, preterm birth (PTB) is the most frequent cause of infant mortality. In the United States, there remains a stark African American-Non-Hispanic White difference in PTB (< 37 weeks of completed gestation). When compared to Non-Hispanic White infants, African American infants have greater than three times the risk of preterm-related mortality. Prior research studies have examined whether traditional prenatal risk factors explain the African American-Non-Hispanic White difference in PTB. However identification of these factors fails to explain the disparity. The lack of progress in addressing the African American - Non-Hispanic White difference in PTB suggests that exposures to risk factors across the life-course may be vital to addressing the African American-Non-Hispanic White difference in PTB. One potential life-course risk exposure is racial discrimination, which has been shown to influence the increased risk of PTB among African American women. However, research is needed to reveal the mechanisms that underlie the association between racial discrimination and PTB. Posttraumatic stress disorder (PTSD) may be one potential mechanism by which African American women's exposure to racial discrimination contributes to increased risk of PTB. This concept paper strives to advance our understanding of the increased risk of PTB among African American women. Recommendations are suggested to mitigate the impact of racial discrimination and PTSD on the PTB risk among African American women.

Meeting The Needs Of Orphans And Other Vulnerable Children: Learnings From Project Soar, Project Soar

HIV and AIDS

Orphans and other vulnerable children (OVC), including those living with HIV, often have a range of unmet needs, such as education, food security, psychosocial support, and access to health care. Project SOAR is documenting the unique vulnerabilities of OVC and their caregivers, and examining strategies to mitigate the impacts of HIV on them. This brief presents a summary of the SOAR portfolio, including a prospective cohort study of young people living with HIV in Zambia, an evaluation of an HIV risk screening tool among OVC in Tanzania, and a systematic review of promising interventions to support engagement and treatment adherence …

Autonomy, Intimate Partner Violence, And Maternal Health-Seeking Behavior: Findings From Mixed-Methods Analysis In Kenya, Charlotte E. Warren, Pooja Sripad, Charity Ndwiga

Reproductive Health

Gendered norms and discriminatory practices often limit women’s decision-making power, which over time can lead to social norms that systematically disadvantage women. Aspects of empowerment were explored in a global evaluation of Demographic and Health Survey data that measured how gendered social norms influenced maternal health-seeking behaviors. Analysis specifically explored associations of women’s autonomy and acceptability of intimate partner violence against women (IPVAW) on antenatal care use and facility delivery in 63 low- and middle-income countries. Service utilization is positively associated with increased autonomy and negatively associated with increased acceptability of IPVAW, but variability exists across countries and regions. In …

"I Don't Know If I Have The Courage" Reproductive Choices In Times Of Zika, Ana Rosa Linde, Grace Furtado, Elisa Tristán-Cheever, Carlos Eduardo Siqueira

Gastón Institute Publications

In this transnational study, we aimed at providing insights into women's views and attitudes towards their reproductive rights during the Zika epidemic. Women of distinct nationalities and ethnicities were recruited from various locations in Brazil, Puerto Rico, and the United States. We conducted semistructured interviews that suggest that participants reproductive decisions were intimately related to personal convictions and cultural beliefs, and their actions and thoughts were embedded in their sociocultural norms. The majority of women interviewed communicated that it takes courage to make the extreme, emotional, and overwhelming decision to have an abortion. The findings of this study suggest that …

Factors That Influence Maternal Feeding Decisions For Toddlers: Extending The Theory Of Planned Behavior, Elizabeth Lucas Combs

Theses and Dissertations--Kinesiology and Health Promotion

Establishing healthy eating behaviors is vital in the early years to help combat the development of obesity and other chronic diseases. Mothers play an invaluable role in shaping their children's eating habits through controlling what and when children eat as well as the overall food environment, which is why a better understanding of what influences mothers’ decisions about these behaviors is important.

The purpose of the dissertation was to gain a better understanding of what impacts maternal feeding decisions regarding toddler nutrition behaviors. This was a two-phased mixed methods study. The aim of the initial study was to explore, using …

The Impact Of Maternal Nutrition During Pregnancy On Inflammation And Birth Outcomes, Lori Ogden

Theses and Dissertations--Nursing

More than 85% of American adults do not consume recommended amounts of fruits or vegetables. Preterm birth and hypertensive disorders of pregnancy are common adverse conditions affecting pregnancy and are leading causes of maternal and fetal morbidity and mortality. Preterm birth affects nearly 10% of all births in the United States and is on the rise, as are hypertensive disorders, which have increased by 25% over the last two decades. Pregnancy is a state of controlled inflammation, and dysregulation has been linked to preterm birth and other adverse gestational outcomes. A healthy diet is recommended in pregnancy, but little is …

The Relationship Between Maternal Plasma Homocysteine In Early Pregnancy And Birth Weight, Shona Cawley, Eimer O'Malley, Rachel Kennedy, Ciara Reynolds, Anne Molloy, Michael Turner

Articles

Background: There is limited evidence that plasma homocysteine (Hcy) is increased in women with adverse pregnancy outcomes, such as low birth weight (LBW).

Objective: We examined the relationship between maternal Hcy at the first prenatal visit and birth weight.

Study design: In a prospective observational study, women were recruited during their first prenatal visit after sonographic confirmation of gestational age. Along with the standard tests, blood was also taken for the measurement of maternal serum and red blood cell (RBC) folate, vitamin B12, and Hcy. In addition to collecting standard clinical and sociodemographic details, a detailed questionnaire on vitamin supplementation …