Public Health Commons^™

Advancing Objective Mobile Device Use Measurement Inchildren Ages 6–11 Through Built-In Device Sensors: A Proof-Of-Concept Study, Olivia L. Finnegan, Robert Glenn Weaver Med, Phd, Hongpeng Yang, James W. White, Srihari Nelakuditi, Zifei Zhong, Rahul Ghosal Ph.D., Yan Tong, Aliye B. Cepni, Elizabeth L. Adams, Sarah Burkart Mph, Ph.D., Michael W. Beets Med, Mph, Phd, Bridget Armstrong Ph.D.

Faculty Publications

Mobile devices (e.g., tablets and smartphones) have been rapidly integrated into the lives of children and have impacted howchildren engage with digital media. The portability of these devices allows for sporadic, on-demand interaction, reducing theaccuracy of self-report estimates of mobile device use. Passive sensing applications objectively monitor time spent on a givendevice but are unable to identify who is using the device, a significant limitation in child screen time research. Behavioralbiometric authentication, using embedded mobile device sensors to continuously authenticate users, could be applied toaddress this limitation. This study examined the preliminary accuracy of machine learning models trained on iPad …

Employing Digital Pcr For Enhanced Detection Of Perinatal Toxoplasma Gondii Infection: A Cross-Sectional Surveillance And Maternal-Infant Outcomes Study In El Salvador, Mary K. Lynn, Marvin Stanley Rodriguez Aquino, Pamela Michelle Cornejo Rivas, Xiomara Miranda, David F. Torres-Romero, Hanson Cowan, Madeleine M. Meyer, Willber D. Castro-Godoy, Mufaro Kanyangarara Ph.D., Stella Coker Watson Self Ph.D., Ms, Berry A. Campbell, Melissa Nolan Ph.D., Mph

Faculty Publications

Toxoplasma gondii is a parasitic infection that can be transmitted in utero, resulting in fetal chorioretinitis and other long-term neurological outcomes. If diagnosed early, pregnancy-safe chemotherapeutics can prevent vertical transmission. Unfortunately, diagnosis of acute, primary infection among pregnant women remains neglected, particularly in low-and-middle-income countries. Clinically actionable diagnosis is complex due to the commonality of infection during childhood and early adulthood which spawn long-last antibody titers and historically unreliable direct molecular diagnostics. The current study employed a cross-sectional T. gondii perinatal surveillance study using digital PCR, a next generation molecular diagnostic platform, and a maternal-fetal outcomes survey to ascertain …

Meeting Abstracts From The 5th National Big Data Health Science Conference, Bankole Olatosi, Miranda Nixon, Xiaoming Li

Publications

No abstract provided.

Novel Tetrazolium-Based Colorimetric Assay For Helicase Nsp13 In Sars-Cov-2, Triet M. Pham, Morgan G. Howard, Shane M. Carey, Lindsey R. Baker, Edward L. D'Antonio

Natural Sciences Faculty Publications

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is a human pathogenic virus that encodes for a helicase (SC2Hel) that is essential for viral replication. SC2Hel has the ability to unravel dsRNA or dsDNA in an NTP-dependent manner from the 5′ to 3′ directionality. The standard helicase assay from studies involving SARS-CoV and SARS-CoV-2 have relied on the concept of fluorescence resonance energy transfer. Adding to the collection of helicase assays, herein, we have developed a novel tetrazolium-based colorimetric assay system for the detection of ADP that is produced via SC2Hel activity. This SC2Hel assay combines three enzyme-coupled steps involving the …

Reducing Non-Communicable Diseases Among Palestinian Populations In Gaza: A Participatory Comparative And Cost-Effectiveness Modeling Assessment, Sanjay Basu, John S. Yudkin, Mohammed Jawad, Hala Ghattas Ph.D., Bassam Abu Hamad, Zeina Jamaluddine, Gloria Safadi, Marie Elizabeth Ragi, Raeda El Sayed Ahmad, Eszter P. Vamos, Christopher Millett

Faculty Publications

We sought to assess the effectiveness and cost-effectiveness of potential new public health and healthcare NCD risk reduction efforts among Palestinians in Gaza. We created a microsimulation model using: (i) a cross-sectional household survey of NCD risk factors among 4,576 Palestinian adults aged ≥40 years old in Gaza; (ii) a modified Delphi process among local public health experts to identify potentially feasible new interventions; and (iii) reviews of intervention cost and effectiveness, modified to the Gazan and refugee contexts. The survey revealed 28.6% tobacco smoking, a 40.4% prevalence of hypertension diagnosis (with a 95.6% medication treatment rate), a 25.6% prevalence …

How Livelihood Change Affects Food Choice Behaviors In Low- And Middle-Income Countries: A Scoping Review, Emma Kenney Mph-Pa, Krystal K. Rampalli, Sharraf Samin, Edward A. Frongillo Ph.D., Ligia I. Reyes, Shiva Bhandari, Morgan Boncyk, Stella Nordhagen, Helen Walls, Sigrid Wertheim-Heck, Amy Ickowitz, Solveig A. Cunningham, Ramya Ambikapathi, Beatrice Ekesa, Mirriam Matita, Christine E. Blake Ph.D., Rd

Faculty Publications

Livelihoods have changed dramatically over the past decade in low- and middle-income countries (LMIC). These shifts are happening in tandem with shifts in individual and household food choice behaviors. This scoping review aimed to identify and characterize mechanisms through which livelihood changes could affect food choice behaviors in LMIC, including behaviors relating to food production, acquisition, preparation, distribution, and consumption. A literature search was conducted using 4 databases: PubMed, PsycInfo, AGRICOLA, and Embase. The search was further enhanced by expert solicitations. Studies were included if they measured or focused on a livelihood change, described or assessed a change in ≥1 …

Employing Digital Pcr For Enhanced Detection Of Perinatal Toxoplasma Gondii Infection: A Cross-Sectional Surveillance And Maternalinfant Outcomes Study In El Salvador, Mary K. Lynn, Marvin Stanley Rodriguez Aquino, Pamela Michelle Cornejo Rivas, Xiomara Miranda, David F. Torres-Romero, Hanson Cowan, Madeleine M. Meyer, Willber D. Castro-Godoy, Mufaro Kanyangarara Ph.D., Stella C.W. Self Ph.D., Ms, Berry A. Campbell, Melissa S. Nolan Ph.D., Mph

Faculty Publications

Toxoplasma gondii is a parasitic infection that can be transmitted in utero, resulting in fetal chorioretinitis and other long-term neurological outcomes. If diagnosed early, pregnancysafe chemotherapeutics can prevent vertical transmission. Unfortunately, diagnosis of acute, primary infection among pregnant women remains neglected, particularly in low-andmiddle-income countries. Clinically actionable diagnosis is complex due to the commonality of infection during childhood and early adulthood which spawn long-last antibody titers and historically unreliable direct molecular diagnostics. The current study employed a cross-sectional T. gondii perinatal surveillance study using digital PCR, a next generation molecular diagnostic platform, and a maternal-fetal outcomes survey to ascertain the …

Maternal Care Utilization And Provision During The Covid-19 Pandemic: Voices From Minoritized Pregnant And Postpartum Women And Maternal Care Providers In Deep South, Ran Zhang, Tiffany Byrd, Shan Qiao Ph.D., Myriam E. Torres Phd, Msph, Xiaoming Li Ph.D., Jihong Liu Sc.D.

Faculty Publications

Background

The COVID-19 pandemic has significantly affected maternal care services especially for minoritized individuals, creating challenges for both service users (i.e., African American and Hispanic pregnant/postpartum women) and maternal care providers (MCPs). Guided by a socioecological framework, this study aims to investigate the experiences of African American and Hispanic pregnant and postpartum women, as well as MCPs, in accessing and providing maternal care services during the COVID-19 pandemic in the Deep South.

Methods

We conducted semi-structured interviews with 19 African American women, 20 Hispanic women, and 9 MCPs between January and August 2022. Participants were recruited from Obstetrics and Gynecology …

Systematic Review On The Impacts Of Agricultural Interventions On Food Security And Nutrition In Complex Humanitarian Emergency Settings, Melodie Al Daccache, Berthe Abi Zeid, Leila Hojeij, Ghassan Baliki, Tilman Brück, Hala Ghattas Ph.D.

Faculty Publications

Complex humanitarian emergencies are a main driver of food and nutritional insecurity. Agricultural interventions are key to improving nutrition and food security, and their positive impacts are well-documented in stable developing countries. However, it is unclear if their positive effects on food security hold in complex emergency settings, too. In this paper, we systematically review empirical articles that apply rigorous designs to assess the causal impacts of agricultural interventions on food security, nutrition, or health outcomes in complex humanitarian emergencies. We only find six articles matching these criteria, which have mixed results on dietary diversity and food security, and little …

Messaging About Very Low Nicotine Cigarettes (Vlncs) To Influence Policy Attitudes, Harm Perceptions And Smoking Motivations: A Discrete Choice Experiment, Reed M. Reynolds, Lucy Popova, David L. Ashley, Katherine C. Henderson, Charity A. Ntansah, Bo Yang, Emily E. Hackworth, James Hardin, Jim F. Thrasher Ph.D., Ma, Ms

Faculty Publications

Background To reduce smoking and the harms it causes, countries, including the USA, are considering policies to reduce nicotine in combustible tobacco to minimally addictive levels. Effective messages about very low nicotine cigarettes (VLNCs) and this policy are crucial in combating misperceptions threatening the policy’s effectiveness.

Data and methods A discrete choice experiment assessed messages about VLNCs. Participants were 590 adults who smoked exclusively, 379 adults who both smoked and used e-cigarettes, 443 adults who formerly smoked and 351 young adults who never smoked (total n=1763). Seven message attributes were varied systematically (source, harm, chemicals, nicotine, satisfaction, addictiveness and quitting …

Identifying Multilevel Predictors Of Behavioral Outcomes Like Park Use: A Comparison Of Conditional And Marginal Modeling Approaches, Marilyn E. Wende, S. Morgan Hughey, Alexander C. Mclain, Shirelle Hallum, J. Aaron Hipp, Jasper Schipperijn, Ellen W. Stowe, Andrew T. Kaczynski Ph.D.

Faculty Publications

This study compared marginal and conditional modeling approaches for identifying individual, park and neighborhood park use predictors. Data were derived from the ParkIndex study, which occurred in 128 block groups in Brooklyn (New York), Seattle (Washington), Raleigh (North Carolina), and Greenville (South Carolina). Survey respondents (n = 320) indicated parks within one half-mile of their block group used within the past month. Parks (n = 263) were audited using the Community Park Audit Tool. Measures were collected at the individual (park visitation, physical activity, sociodemographic characteristics), park (distance, quality, size), and block group (park count, population density, age structure, racial …

Hhp-3 Comparing Fitness Data Of Cadets In South Carolina To The General Population: A Pilot Study, Justen Chatman, Ming-Chi Sung, Matthew Brisebois

SC Upstate Research Symposium

BACKGROUND: To prepare for physically challenging environments, it is expected that military personnel achieve higher levels of physical fitness than the general population. The recent COVID-19 pandemic impacted physical activity levels among many of America’s youth, and thus, new recruits may be entering military service with lower fitness levels. It is also unknown how fitness levels of army cadets in upstate South Carolina compare to the general population. Therefore, the purpose of this pilot study was to compare anthropometric and fitness variables of army cadets from upstate South Carolina to data from the general population. METHODS: A sample of 22 …

Identifying A Group Of Factors Predicting Cognitive Impairment Among Older Adults, Longgang Zhao, Yuan Wang, Eric Mishio Bawa, Zichun Meng, Jingkai Wei, Sarah Newman-Norlund, Tushar Trivedi, Hatice Hasturk, Roger Newman-Norlund, Julius Fridriksson Ph.D., Anwar T. Nerchant

Faculty Publications

Background

Cognitive impairment has multiple risk factors spanning several domains, but few studies have evaluated risk factor clusters. We aimed to identify naturally occurring clusters of risk factors of poor cognition among middle-aged and older adults and evaluate associations between measures of cognition and these risk factor clusters.

Methods

We used data from the National Health and Nutrition Examination Survey (NHANES) III (training dataset, n = 4074) and the NHANES 2011–2014 (validation dataset, n = 2510). Risk factors were selected based on the literature. We used both traditional logistic models and support vector machine methods to construct a composite score …

Associations Between Sleep Duration, Sleep Disturbance And Cardiovascular Disease Biomarkers Among Adults In The United States, Prince Nii Ossah Addo, Paddington T. Mundagowa, Longgang Zhao, Mufaro Kanyangarara, Monique J. Brown Ph.D., Mph, Jihong Liu Sc.D.

Faculty Publications

Background

Sleep problems are associated with abnormal cardiovascular biomarkers and an increased risk of cardiovascular diseases (CVDs). However, studies investigating associations between sleep problems and CVD biomarkers have reported conflicting findings. This study examined the associations between sleep problems and CVD biomarkers in the United States.

Methods

Data were from the National Health and Nutrition Examination Survey (NHANES) (2007–2018) and analyses were restricted to adults ≥ 20 years (n = 23,749). CVD biomarkers [C-reactive Protein (CRP), low-density lipoproteins, high-density lipoproteins (HDL), triglycerides, insulin, glycosylated hemoglobin (HbA1c), and fasting blood glucose] were categorized as abnormal or normal using standardized cut-off …

The Effect Of Dental Insurance Coverage And Economic Fluctuations On Oral Health Outcomes In The United States, Laura Singletary

Senior Theses

Proper oral health is imperative to overall health, but obstacles often persist in

receiving proper oral health care. Lack of dental insurance coverage and economic recessions are two main factors contributing to oral health outcomes. Extended time without cleanings or addressing current oral health concerns exacerbates oral health problems into more costly procedures for the patient that are conveniently not covered by many insurance plans. This thesis investigates the oral health outcomes associated with periods following economic downturns, specifically citing the time of the Great Recession from 2007-2009.

Decoding Implant-Related Sickness: Unraveling The Complexities Of Breast Implant Illness, Madison M. Stewart

Senior Theses

This thesis investigates the phenomenon of breast implant illness (BII), examining its potential correlation with individual factors such as obesity and poor lifestyle habits. BII, characterized by nonspecific symptoms, is often self-diagnosed by patients influenced by social media and internet sources, leading to requests for implant removal. Conducting a comprehensive meta-analysis, the study scrutinizes existing literature to evaluate the association between BII, obesity, and lifestyle choices. Employing inclusion criteria, peer-reviewed publications are analyzed through systematic review methodology to offer insights into the interplay between BII and adiposity, exploring inflammatory mechanisms and patient behaviors like exercise and smoking. The research aims …

"Fueling For A Healthy Life:" A Cooking Class For Adolescent And Young Adult Childhood Cancer Survivors, Hope Dominique

Senior Theses

Following cancer treatment, childhood cancer survivors (CCS) are at an increased risk of developing chronic diseases and face an increased risk of health-related death during adulthood. Recent literature demonstrates that modifying lifestyle factors such as nutrition can reduce the risk of late mortality in survivors, suggesting that interventions promoting a healthy lifestyle may improve quality and quantity of life for CCS. However, many adolescent and young adult (AYA) CCS do not adhere to national dietary guidelines and face both real and perceived barriers to adopting healthier eating habits while in a critical period for establishing behaviors that contribute to lifelong …

Exploratory Multiple Regression Analysis Of Predictive Factors On Pediatric Concussion Recovery, Jaimeen Shah

Senior Theses

This study ultimately aimed to find how different extra-clinical factors correlate with different aspects of concussion recovery. This study evaluated 8 different independent variables and their correlation to 4 different dependent variables (that are composed of 11 sub-dependent variables). It was hypothesized that these predictive variables will have a statistically significant impact on somatic, psychological, and cognitive outcomes. Additionally, it was hypothesized that the majority of these predictive factors will have the largest statistically significant impact on cognitive outcomes and that time to biological sex, age, prior concussion history, and household income (in that respective order) would have the strongest …

A Scoping Review On Racial Disparities In South Carolina’S Opioid Epidemic, Jake D'Alto

Senior Theses

This thesis examines racial disparities in opioid-related outcomes within South Carolina, highlighting the disproportionate impact of the opioid epidemic on minority communities. Using a comprehensive literature review methodology, the study analyzes the intersection of race, socioeconomic status, and systemic factors that contribute to heightened risks of opioid misuse and overdose among African American populations. The paper identifies key factors such as poverty, incarceration rates, and limited access to healthcare that exacerbate the opioid crisis in these communities. Additionally, it evaluates the effectiveness of current public health responses and legislative measures in addressing these disparities. The research proposes several actionable interventions, …

Motivations Behind The Rise And Success Of Homeopathy In India, Kavya Patchipulusu

Senior Theses

Homeopathy is a form of medicine that is incredibly controversial and is often labeled as a fraudulent, placebo effect drug, that can have potentially dangerous side effects. This is the picture that is painted of homeopathy in the United States and many other countries in which these medicines are banned in distribution or highly unregulated. In contrast, India has popularized and well-integrated homeopathy into their medical systems with government backing and consistent funding towards accredited homeopathic institutions and funding hospital systems. This paper will explore the circumstances and health care dynamics of India that allowed homeopathy to gain the level …

A Historical Analysis Of Health Institutions, Professionals, And Advocates In The Civil Rights Movement In Columbia, South Carolina, Anusha Ghosh

Senior Theses

From 1900 to 1970, widespread racism severely restricted healthcare access for Black citizens in the South, leading them to establish and staff alternative healthcare institutions to support their community.

Such institutions faced debilitating issues such as chronic financial shortages and patient overflow. Despite these problems, oral histories, media, and primary written sources show that Black healthcare workers in alternative healthcare institutions demonstrated a greater ability to meet the health needs of Black patients due to cultural understanding and external community involvement.

Dr. Matilda Evans was an African-American woman physician who became a leader in medicine, public health, and education in …

The Role Of Sport For Adolescents: The Effect Of Sport Participation As A Unique Form Of Physical Activity On Mental Health And Overall Subjective Well-Being During Adolescence, Caleb M. Rogers

Senior Theses

Well-being is an extremely multifaceted domain, as there are numerous factors that contribute to one’s way of life. Objective well-being focuses primarily on material factors such as access to food, housing, and a steady household income. Although these factors play a large role, it is important to analyze well-being from the perspective of the individual. Subjective well-being focuses on how one perceives one's own well-being. Physical activity has been well established as one factor associated with improvements within this domain for adolescents. This project investigates the role of one specific form of physical activity during adolescence: sport. The general assumption …

Association Between Direct Access Laws And Physical Therapy Use And The Effect Of Change In Physical Therapy Use On Subsequent Healthcare Spending, Utilization, And Opioid Use, Dakshu Jindal

Theses and Dissertations

Background

Physical therapy (PT) has been recommended as the first-line treatment for patients with incident musculoskeletal conditions without severe trauma. Initial or early use of PT may help address some of the nation’s most pressing health policy challenges, including escalating healthcare spending and an ongoing opioid epidemic, by encouraging the use of physical therapy as a substitute for expensive surgeries and the use of opioids. Yet, state scope of practice laws have historically restricted the diagnosis and treatment of medical conditions to physicians. Traditionally, patients seeking care from a physical therapist had to obtain a referral from a physician first. …

Covid-19 Vaccine Effectiveness Among People Living With And Without Hiv In South Carolina, Usa: Protocol Of A Population-Based Cohort Study, Xueying Yang, Jiajia Zhang Ph.D., Bankole Olatosi, Sharon Weissman, Xiaoming Li Ph.D.

Faculty Publications

Introduction Despite the effectiveness of COVID-19 vaccines in preventing severe COVID-19 outcomes, a small percentage of fully vaccinated persons will develop symptomatic or asymptomatic infections with SARSCoV-2, which is referred to as ‘breakthrough COVID-19’. People living with HIV (PLWH) appear to have an elevated risk of severe COVID-19 outcomes, yet the effectiveness of the COVID-19 vaccine in this population remains unclear due to the limited research efforts in this population in the real world. This study aims to characterise and compare the breakthrough COVID-19 (eg, prevalence and disease severity) between PLWH and non-PLWH and then examine whether HIV markers play …

Comparison Of Raw Accelerometry Data From Actigraph, Apple Watch, Garmin, And Fitbit Using A Mechanical Shaker Table, James W. White Iii, Olivia L. Finnegan, Nick Tindall, Srihari Nelakuditi, David E. Brown Iii, Russell R. Pate Ph.D., Gregory J. Welk, Massimiliano De Zambotti, Rahul Ghosal, Yuan Wang, Sarah Burkart, Elizabeth L. Adams, Mvs Chandrashekhar, Bridget Armstrong, Michael W. Beets, Robert Weaver Med, Phd

Faculty Publications

The purpose of this study was to evaluate the reliability and validity of the raw accelerometry output from research-grade and consumer wearable devices compared to accelerations produced by a mechanical shaker table. Raw accelerometry data from a total of 40 devices (i.e., n = 10 ActiGraph wGT3X-BT, n = 10 Apple Watch Series 7, n = 10 Garmin Vivoactive 4S, and n = 10 Fitbit Sense) were compared to reference accelerations produced by an orbital shaker table at speeds ranging from 0.6 Hz (4.4 milligravity-mg) to 3.2 Hz (124.7mg). Two-way random effects absolute intraclass correlation coefficients (ICC) tested inter-device reliability. …

Waning Effectiveness Of Mrna Covid-19 Vaccines Against Inpatient And Emergency Department Encounters, Theodoros V. Giannouchos, Nicole L. Hair Ph.D., Bankole Olatosi Ph.D., Xiaoming Li Ph.D.

Faculty Publications

In the United States, most real-world estimates of COVID-19 vaccine effectiveness are based on data drawn from large health systems or sentinel populations. More data is needed to understand how the benefits of vaccination may vary across US populations with disparate risk profiles and policy contexts. We aimed to provide estimates of mRNA COVID-19 vaccine effectiveness against moderate and severe outcomes of COVID-19 based on state population-level data sources. Using statewide integrated administrative and clinical data and a test-negative case-control study design, we assessed mRNA COVID-19 vaccine effectiveness against SARS-CoV-2-related hospitalizations and emergency department visits among adults in South Carolina. …

Predictors Of Prior Hiv Testing And Acceptance Of A Community-Based Hiv Test Offer Among Male Bar Patrons In Northern Tanzania, Deng B. Madut, Preeti Manavalan, Antipas Mtalo, Timothy Peter, Jan Ostermann, Bernard Njau, Nathan M. Thielman

Faculty Publications

Community-based HIV testing offers an alternative approach to encourage HIV testing among men in sub-Saharan Africa. In this study, we evaluated a community-based HIV testing strategy targeting male bar patrons in northern Tanzania to assess factors predictive of prior HIV testing and factors predictive of accepting a real-time HIV test offer. Participants completed a detailed survey and were offered HIV testing upon survey completion. Poisson regression was used to identify prevalence ratios for the association between potential predictors and prior HIV testing or real-time testing uptake. Of 359 participants analyzed, the median age was 41 (range 19–82) years, 257 (71.6%) …

Food Systems Under Shock: The Evolution Of Food Security Status Of Karantina Residents After The Beirut Explosion, Mariana Makoukji, Nour El Houda Amhez, Abed Al Kareem Yehya, Hala Ghattas Ph.D., Yaser Abunnasr, Rami Zurayk

Faculty Publications

Robust food systems are crucial for ensuring access to affordable and nutritious food, particularly in times of crisis. Economic instability, currency devaluation, and political turmoil can disrupt food systems, leading to higher food prices, compromised nutrition, and increased vulnerability. Lebanon is a stark example of this, where a catastrophic explosion in Beirut’s Port in 2020 worsened an existing economic and humanitarian crisis. The depreciation of the Lebanese currency led to soaring food prices, impacting people’s ability to buy food, and pushing many into poverty, illustrating the significant impact of the state food systems during crises (FAO, 2021). In times of …

Sexual Orientation And Gender Identity Measures And Viral Suppression For People Living With Hiv: A Protocol For A Population-Based Cohort Study, Xueying Yang, Bankole Olatosi Ph.D., Sharon Weissman, Xiaoming Li Ph.D., Jiajia Zhang Ph.D.

Faculty Publications

Introduction The measure of sexual orientation and gender identity (SOGI) data in electronic health records (EHR) has been critical for addressing health disparities and inequalities, especially for HIV care. Given that gender and sexual minorities (eg, transgender, men who have sex with men and intersex) are key groups in people living with HIV (PLWH), SOGI data can facilitate a more accurate understanding about the HIV outcomes (eg, viral suppression) among this key group and then lead to tailored therapeutic services. The two-step SOGI collection method as an emerging gender measurement can be used to measure SOGI status in medical settings. …

The Effect Of Centering Pregnancy Group Antenatal Care On Maternal, Birth, And Neonatal Outcomes Among Low-Risk Women In The Netherlands: A Stepped-Wedge Cluster Randomized Trial, Mary-Ann Wagijo, Mathilde Crone, Birgit Bruinsma-Van Zwich, Jan Van Lith, Deborah Lynn Billings Phd, Marlies Rijnders

Publications

Introduction

This study was carried out to assess the effects of participating in CenteringPregnancy (CP) on maternal, birth, and neonatal outcomes among low-risk pregnant women in the Netherlands.

Methods

A total of 2124 pregnant women in primary care were included in the study. Data were derived from the Dutch national database, Perined, complemented with data from questionnaires completed by pregnant women. A stepwise-wedge design was employed; multilevel intention-to-treat analyses and propensity score matching were the main analytic approaches. Propensity score matching resulted in sample sizes of 305 nulliparous women in both the individual care (IC) and the matched control group …