Maternal and Child Health Commons^™

Effectiveness Of Breastfeeding Shift Champions On Exclusive Breastfeeding, Comfort Obi

Doctor of Nursing Practice (DNP) Translational and Clinical Research Projects

Purpose. This project evaluated the effect of breastfeeding support on breastfeeding and exclusive breastfeeding rates among postpartum mothers in immediate postpartum period. The breastfeeding support was provided by breastfeeding shift champions (BFSC) following childbirth.

Design. A convenience sample of BFSCs, aged between 18 and 44 years, was utilized.

Method. Pre-and post-intervention questionnaires were used to evaluate breastfeeding knowledge of BFSC. Breastfeeding and exclusive breastfeeding rates were extracted, pre- and post- intervention, from electronic medical records of newborns and their mothers.

Data analysis. Descriptive and inferential statistics were used for data analyses. Descriptive data were displayed using frequency …

When The Health System Fails You: Maternal Care Under Kenya’S 2017 Nurses' Strike, Tessa Coughtrey-Davenport

Independent Study Project (ISP) Collection

This study focuses on the 2017 nurses’ strike and how the crippling of the public health system impacted maternal care in Kisumu, Kenya. Kenya has one of the highest maternal mortality ratios in the world, and there have been many efforts to reduce this, such as delivery with a Skilled Birth Attendant and attending antenatal care visits, all of which are centered around a functioning health system. The research team used a combination of interviews with key populations and analysis of service delivery data at local health centers to evaluate the effects of the strike on maternal care. The study …

Modeling The Influence Of Early Skin-To-Skin Contact On Exclusive Breastfeeding In A Sample Of Hispanic Immigrant Women, Ana Maria Linares, Karen Wambach, Mary Kay Rayens, Amanda Wiggins, Elizabeth Coleman, Mark B. Dignan

Nursing Faculty Publications

Using data from a longitudinal study of breastfeeding in Hispanics, this study evaluated the influence of early skin-to-skin contact (SSC) on initiation and sustained exclusive breastfeeding (EBF) at 1 month postpartum. Two-thirds of the women in the sample participated in early SSC. At discharge, over half of the women were EBF; this proportion decreased to one-third at 1 month postpartum. Controlling for demographic and clinical variables in the model, participation in early SSC was associated with a greater than sevenfold increase in the odds of EBF at discharge (p = .005) but was not predictive of EBF at 1 …

A Delphi Study: Guidelines For Researchers Working With Teenage Mothers, Alison M. Chamberlain

Nursing Theses and Dissertations

Problem: It is difficult to get teenage mothers to participate in studies, yet some researchers have been successful. Researchers who understand the barriers to conducting studies with a vulnerable population and are guided in ways to overcome these barriers, will experience greater success when doing studies with this group. Improved study methods can lead to larger numbers of teenage mothers who participate in studies. Researchers who follow developmentally appropriate guidelines are more likely to conduct and replicate studies with this population. Access is essential to advance the science related to care for teenage mothers who are at risk for many …

Who's Hungry In San Diego, Alison M. Schurman, Kathy S. James

Doctor of Nursing Practice Final Manuscripts

Objective: Food insecurity (FI) is a lack of access to nutritious food. FI has been linked to multiple preventable diseases from behavioral disorders to asthma to obesity and its sequelae. In San Diego County, 14 percent of families are food insecure. The AAP recommends screening for FI at all well appointments using the two-question FI screening tool. The aim of this project was to implement this tool at a multi-clinic, low income population community health center where ninety-five percent of patients meet qualification for SNAP benefits.

Methods: Stakeholders chose one week to screen all patients presenting to clinic for FI …

Psychometric Evaluation Of The Nursing Child Assessment Teaching (Ncat) Scale In Two Samples Of Mothers And Children, Samantha H. Ransone

Theses and Dissertations (ETD)

The mother-child relationship (MCR) has received an increasing amount of attention over the last several decades regarding its effect on long-term child development. Because the quality and quantity of interactions in the MCR have been established as important predictors of the child’s development, early identification of areas in the relationship requiring support and intervention is essential for promoting positive child outcomes. Observational assessment of the mother and child is considered best practice in evaluating maternal-child interaction (MCI). The Nursing Child Assessment Teaching (NCAT) scale is an instrument that has been used to quantify the quality of interaction in the MCR …

The Effects Of Continuous Insulin Pump Therapy On Glycemic Control In Pregnant Type 1 Diabetics, Kimberly Kelsey

Scholarly and Creative Works Conference (2015 - 2021)

Type 1 Diabetes Mellitus accounts for approximately 5% of the diabetic population (CDC, 2015). Numerous complications must be avoided when a diabetic is insulin dependent. Women who are diabetic who are planning to conceive a family have special considerations. Little research has been focused into how to best manage Type 1 diabetics during pregnancy. Since Type 1 diabetes is predominantly diagnosed between birth and 30 years of age, many Type 1 diabetics have potential to become pregnant without knowing how to best manage their diabetes. Poor glycemic control in diabetics has been related to miscarriages, stillbirths, malformations, and macrosomia (Lapolla, …

The Benefits Of Breastfeeding, Annagrace E. Anderson

Senior Honors Theses

Breast milk is the gold standard for infant nutrition. In the past, infant formula was promoted as equal or superior to breast milk. However, research has shown that breastfeeding is the superior form of infant nutrition except in rare circumstances. Breast milk provides for all of a newborn’s caloric needs and has the correct balance of nutrients to promote proper development. In addition, breast milk provides protection against illnesses, supports an infant’s immune system, and promotes life-long health for the newborn. Mothers also experience personal benefits by breastfeeding such as decreased cancer risks, bonding with their babies, and faster postpartum …

The Effectiveness Of Combined Appointments And Influenza Immunization Rates In A Rural Wic Population, Lisa L. Sitler

Dissertations

Purpose: The purpose of this descriptive retrospective study was to examine predictors and barriers to influenza immunizations receipt in a low-income WIC population.

Method: A quality improvement project was conducted in October 2010 in which 129 caregivers of children having WIC appointments were randomly assigned to receive (a) influenza immunizations at the time of the WIC visit or (b) educational materials and a later immunization. Caregivers completed a survey about their perceptions of influenza immunizations. Tanahashi’s access to care model (1978) was used to identify predictors (acceptability, accessibility, availability, and effectiveness) of influenza immunizations.

Analysis: In analysis …

Goals Of Exclusive Breastfeeding And The Effectiveness Of Programs And Initiatives In Attaining Them, Natalie Scott

Senior Honors Theses

Over recent years, breastfeeding has gained renewed significance in research and practice. Both in the United States and around the world, especially in poor countries that do not have easy access to quality healthcare, breastfeeding has been shown to dramatically and positively affect the health and lifespan of infants. However, there is still a low prevalence of effective breastfeeding practices universally. Even with the presence of global programs and goals that are geared toward exclusive breastfeeding habits, global rates are lower than what is desired. There are various determinants of breastfeeding that factor into a woman’s decision and practice of …

A Systematic Review: The Prenatal And Postnatal Events Associated With Infant Mortality Rate (Imr), Ariel L. Thomas, Sarah A. Awwad, Briana E. Clark

Williams Honors College, Honors Research Projects

Infant mortality rate (IMR) is an indication of overall population health, maternal and child health, accessibility and quality of primary health care, and the availability of community resources. The current IMR in the United States is high despite advances made in the medical field. The purpose of our systematic review is to describe and critically appraise research about prenatal events, postnatal events, and increased infant mortality rate and to give nursing practice recommendations to help decrease the rate. We used CINAHL, Medline and PubMed to find 20 research articles. Overall, the research stated that going to prenatal visits had a …

Home Visiting Programs For Families Of Children Who Are Deaf Or Hard Of Hearing: A Systematic Review, Nannette Nicholson, Patti Martin, Abby Smith, Sheila Thomas, Ahmad A. Alanazi M.Aud.

Journal of Early Hearing Detection and Intervention

Prelingual hearing loss greatly restricts a child’s language development, hindering his or her behavioral, cognitive and social functioning. Although technology such as hearing aids and cochlear implants are an option for providing access to sound, they fail to teach the child how to listen or attend, how to process language (whether visual or spoken), or how to produce language and communicate. Home visiting is widely recognized as a cost-effective intervention service delivery model. Home visiting programs for promoting language development in children who are diagnosed as deaf or hard of hearing have been in existence for over 50 years, yet …

A Preliminary Study Of Intergenerational Differences In Masxha Regarding Practice And Attitudes Towards Zulu Traditions During Pregnancy And Birth, Momoko Oyama

Independent Study Project (ISP) Collection

In the Zulu culture, several traditions and rituals are practiced during a woman’s pregnancy and perinatal period. However, as urbanization spreads and western influences strengthen, these rituals risk being lost. This project aims to capture existing knowledge of these traditions and to assess the intergenerational changes in practice and attitudes towards practicing the rituals.

Information on Zulu traditions practiced during a woman’s pregnancy and perinatal period was collected through two interviews and a focus group consisting of three elderly women in Masxha, a Black township in KwaZulu-Natal. Following the interviews and focus group, 32 Masxha residents were recruited to complete …

Maternal Healthcare In Eastern Uganda: The Three Delays, Mothers Making Empowered Choices, And Combatting Maternal Mortality, Emma Gier

Independent Study Project (ISP) Collection

Maternal and child health has been noted as an international concern and issue. While access to maternal healthcare has improved in Uganda since 2000, maternal mortality rates have remained high in the country as of 2015. However, maternal and child healthcare are inherently important in promoting sustainable and positive development. For that reason, I have explored maternal healthcare in Uganda’s Eastern region, specifically in Mbale Town and surrounding rural areas including Kween and Manafwa districts. Specifically I have looked at what factors influence women’s decision to give birth in a health centre or hospital, versus at home. I have also …

The Influence Of Socioeconomic Status And Ethnicity On Body Mass Index In Children In Northwest Arkansas, Madison E. Davidson

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Body Mass Index (BMI) is a measure of body fat that is calculated based on the height, weight, age, and gender of a child. Body Mass Index (BMI) is an important indicator of potential health risks in children. Determining correlations between ethnicity, socioeconomic status, and BMI may assist in identifying children at risk for comorbidities associated with either an elevated or low BMI. An elevated BMI may lead to complications later in life such as hypertension, hyperlipidemia, type 2 diabetes, obesity in adulthood, and psychosocial issues (Geason & Dodd, 2009). On the other hand, a low BMI could lead to …

Breastfeeding Rates In Marshallese Mothers; A Needs Assessment, Olivia N. Pennington

The Eleanor Mann School of Nursing Undergraduate Honors Theses

ABSTRACT

Background. Multiple health disparities are associated with the Marshallese population in Northwest Arkansas. Childhood obesity, linked to a decrease in exclusive breastfeeding, is one of the predominant issues. Since their migration to the United States, exclusive breastfeeding rates of Marshallese mothers have steadily declined throughout the years. Little research has been conducted to help combat this growing health disparity. Due to the increased growth in this population in Northwest Arkansas, it is imperative that measures are taken to decrease these disparities to improve the overall health of the future generations.

Objective: To determine the relationship between maternal age, …

Doulas Could Improve Foreign-Born Women’S Perinatal And Postpartum Satisfaction And Increase Health Providers’ Cultural Competency In A Multicultural Urban Area Of The United States., Crystal Kazik

Sustainability and Social Justice

Doulas act as a cultural bridge between clients and providers through the support, advocacy, and education they provide. Unfortunately, migrant women may be at a disadvantage for accessing and benefiting from their services due to a variety of socioeconomic and cultural factors including predisposed ideas of care and structure based on experiences in native countries, language barriers, lower health literacy, and a lack of awareness and understanding from hospital/clinic staff.

A strategic multifaceted approach utilizing doulas, such as Boston Medical Center’s collaborative and culturally competent model, may greatly improve foreign-born women’s experience and satisfaction with healthcare when pregnant and giving …

Effects Of An Educational Intervention On Exclusive Breastfeeding Rates In Marshallese Mothers Residing In The U.S., Bentley S. Snider

The Eleanor Mann School of Nursing Undergraduate Honors Theses

Abstract

Background: The Marshallese are one of the fastest growing migrant populations in the U.S. They have considerable health disparities despite their increasing access to health care. The Marshallese women in this population prefer to breastfeed, but have encountered many cultural barriers that have deterred them from exclusively breastfeeding for a significant amount of time. Breastfeeding is linked to many protective benefits for children’s health, such as decreasing the likelihood of obesity, even into the adult years.

Objective: The purpose was to evaluate the impact on breastfeeding rates through implementation of a culturally significant educational intervention for the …

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. …

Breastfeeding Education For Fathers: An Intervention To Increase Breastfeeding Rates, Jill Marie Frisz

Evidence-Based Practice Project Reports

If every infant were breastfed within an hour of birth, exclusively breastfed until six months, and given breastmilk up to two years, almost 800,000 lives would be saved annually (who, 2014). Nationally, breastfeeding rates drop significantly from three to six months. A search of literature yielded significant evidence as fathers for facilitators to increase breastfeeding rates. The purpose of this evidence based practice (EBP) project was to determine the effects of best practice measures to educate fathers about breastfeeding to increase anytime breastfeeding rates. The social support theory and ACE Star model guided the literature search and implementation of this …

The Presence Of Stem Cells In Human Breast Milk And Research Implications, Melody (Brooke) Peterson

Senior Honors Theses

Stem cell therapy research is an expanding area of study as stem cell therapy is believed to have the potential to provide treatment options for numerous disease processes. Currently, embryonic stem cell research is the method of choice to evaluate the potential for stem cell therapy. The use of human embryos for stem cell research raises moral and ethical controversies. Stem cells are found in a variety of mediums, but until the recent discovery of stem cells in human breast milk, the most versatile stem cells have been those found in the human embryo. Human breast milk stem cells could …

Validity Of Home-Based Sonographic Diagnosis Of Obstetric Risk Factors By Auxiliary Nurse Midwives In Rural Nepal, Naoko Kozuki, Luke C. Mullany, Subarna K. Khatry, Ram Ghimire, Sharma Paudel, James M. Tielsch, +5 Additional Authors

Global Health Faculty Publications

Background

Approximately 2·3 million fetal, neonatal, or maternal deaths occur annually during the intrapartum period or on the day of birth. Several risk factors for intrapartum-related complications require ultrasonography for accurate diagnosis, but sonographic services are scarce in low-resource settings. In this study, we aimed to assess the feasibility of community-based ultrasonography conducted by auxiliary nurse midwives to identify basic obstetric risk factors, in rural Sarlahi District, Nepal. We aimed to assess the validity at which these health workers can detect noncephalic position, multiple gestation, and placenta previa and to explore whether sonographic diagnosis could improve outcomes for women with …

The Changing Roles And Reputations Of Dais In Rural Uttarakhand: An Investigation Into The Maternal Health Services Of Villages In Okhalkanda Block In Nainital, Jenna Davis

Independent Study Project (ISP) Collection

The dai, once a prominent figure in Indian maternal health, now faces marginalization as the government of India adopts the goal of universal institutional delivery. Under pressure from international discourse that Skilled Birth Attendants (SBAs) were more effective at lowering Maternal Mortality Rate (MMR) than Traditional Birth Attendants (TBAs) like dais (World Health Organization), dai training was discontinued and left in the hands of NGOs, while concurrently women and ASHAs were monetarily incentivized for every institutional birth (Park, 419). Yet in rural, isolated, or hilly areas like Okhalakanda block in Uttarakhand, institutional delivery is a long way from universal—only …

Maternal Anxiety Associated With Newborn Hearing Screening, Stephen J. Tueller, Karl R. White

Journal of Early Hearing Detection and Intervention

The purpose of this study was to determine if newborn hearing screening increases maternal anxiety. Mothers whose infants were screened for hearing were asked how worried they were prior to hospital discharge and again six weeks later. They were also asked if they were more concerned about their baby’s hearing than they were about other aspects of the infant’s health and behavior.

Results showed that mothers worried as much or more about many other aspects of their infants’ health and behavior as about hearing. Mothers whose infants had a false positive screening result were initially more worried about hearing than …

Bone Health Promotion For Youth: A Primary Care Intervention, Kay G. Wilson

Doctor of Nursing Practice Projects

Obese youth have high rates of vitamin D and calcium deficiencies and are at risk for developing osteoporosis. Clinical guidelines are needed in primary pediatric care services to promote bone-healthy behaviors. The aim of this project was to: a) implement the infrastructure and processes for physiological monitoring, consistent parameter-based vitamin D & calcium supplementation, family education, and coaching, and b) evaluate the impact of bone promotion changes on patients and parents and the primary care delivery system. The project outcomes included modest gains in bone health awareness among staff, patients, and families. In addition, modifications to clinical pathways and related …

An Evaluation Of The Screening And Management Of Childhood Overweight And Obesity In The Primary Care Setting, Diane L. Crutcher

DNP Projects

Background: Worldwide, the World Health Organization (2016) estimates that forty-two million children from two to five years of age are overweight or obese. In the United States, Kentucky ranks sixth for the highest rate of overweight youth in the nation (Partnership for Fit Kentucky, 2009). The long term consequences of overweight and obesity are early onset of adult chronic diseases as well as social and psychological issues in childhood and adulthood.

Purpose: The objective of this gap analysis was to assess BMI screening and weight management of children ages two to five who presented for a well-child check …

Nutritional Status And Tuberculosis Risk In Adult And Pediatric Household Contacts, Omowunmi Aibana, Xeno Acharya, Chuan-Chin Huang, Mercedes C Becerra, Jerome T Galea, Silvia S Chiang, Carmen Contreras, Roger Calderon, Rosa Yataco, Gustavo E Velásquez, Karen Tintaya, Judith Jimenez, Leonid Lecca, Megan B Murray

Faculty, Staff and Student Publications

BACKGROUND: Studies show obesity decreases risk of tuberculosis (TB) disease. There is limited evidence on whether high body mass index also protects against TB infection; how very high body mass indices influence TB risk; or whether nutritional status predicts this risk in children. We assessed the impact of body mass index on incident TB infection and disease among adults and children.

METHODS AND FINDINGS: We conducted a prospective cohort study among household contacts of pulmonary TB cases in Lima, Peru. We determined body mass index at baseline and followed participants for one year for TB infection and disease. We used …

Educated Birth: Beliefs Vs. Outcomes, Lauren Presley

Human Nutrition and Hospitality Management Undergraduate Honors Theses

“Our infant mortality rate is a national embarrassment.”¹ The words seem shocking and harsh across the headline of a 2014 Washington Post article. The thought of America not only not being the best at something, but falling upsettingly behind, is a foreign concept to many who view America as a nation inferior to none. However, the statistics on infant mortality rate tell the stark truth that of 26 “wealthy” countries, the U.S. ranks last, with a sobering 6.1 deaths per 1,000 live infant births.²

Part of the Healthy People 2020 Objectives is to reduce the rate of infant …

What Can Pakistan Do To Address Maternal And Child Health Over The Next Decade?, Zulfiqar Ahmed Bhutta, Assad Hafeez

Department of Paediatrics and Child Health

Pakistan faces huge challenges in meeting its international obligations and agreed Millennium Development Goal targets for reducing maternal and child mortality. While there have been reductions in maternal and under-5 child mortality, overall rates are barely above secular trends and neonatal mortality has not reduced much. Progress in addressing basic determinants, such as poverty, undernutrition, safe water, and sound sanitary conditions as well as female education, is unsatisfactory and, not surprisingly, population growth hampers economic growth and development across the country. The devolution of health to the provinces has created challenges as well as opportunities for action. This paper presents …

Perinatal Health Education Intervention For Adolescent And Young Adult Pregnant Homeless Women Living In Transitional Housing, And Best Practice Teaching Intervention Program For Staff Responsible For Care Of The Mother-Baby Dyad, Colleen Carrington

Seton Hall University DNP Final Projects

Purpose: A population at great risk is pregnant homeless adolescents and young adult women. Research shows that about 20% of homeless young women become pregnant (Bender, & Thompson, 2007). These pregnant young women are at an increased risk for low birth weight infants and a high infant mortality due to inadequate health care, poor dietary habits, and a knowledge deficit related to maintaining good health during pregnancy and to care of the infant and growing child. A transitional shelter may offer many psychosocial services to assist the women in becoming independent; however, a significant gap exists regarding the medical …