Women's Health Commons^™

Understanding Maternity Care Coordination For Women Veterans Using An Integrated Care Model Approach, Kristin M. Mattocks, Aimee Kroll-Desrosiers, Rebecca L. Kinney, Sara Singer

Kristin M. Mattocks

BACKGROUND: An increasing number of women veterans are using VA maternity benefits for their pregnancies. However, because the VA does not offer obstetrical care, women must seek maternity care from non-VA providers. The growing number of women using non-VA care has increased the importance of understanding how this care is integrated with ongoing VA medical and mental health services and how perceptions of care integration impact healthcare utilization. Therefore, we sought to understand these relationships among a sample of postpartum veterans utilizing VA maternity benefits.

METHODS: We fielded a modified version of the Patient Perceptions of Integrated Care survey among …

Uncertainty And Competing Priorities In Shared Clinical Decision-Making, Dennis J. Baumgardner

Dennis J. Baumgardner, MD

In this issue introduction, the editor-in-chief of Journal of Patient-Centered Research and Reviews observes that a connecting thread among the articles published therein is an element of uncertainty among patients and clinicians. Competing priorities for the patient also may be present. Several approaches to overcoming these prevalent conflicts to delivery of better health care have been proposed, the most important of which may be clinicians embracing a will to practice shared decision-making.

Evening Snacking In Relation To Self-Reported Declines In Sleep Quality During Pregnancy: Preliminary Results From The Decision-Making, Eating, And Weight Gain During Pregnancy (Dew) Study, Wendy Mccallum, Bradley M. Appelhans, Tiffany A. Moore Simas, Rui Sherry Xiao, Shums Alikhan, Isabelle C. Pierre-Louis, Barbara C. Olendzki, Sherry L. Pagoto, Molly E. Waring

Tiffany A. Moore Simas

Background: Poor sleep in non-pregnant adults has been associated with increased evening snacking, which may contribute to weight gain. Sleep disturbances are common during pregnancy.

Objective: To examine the association between changes in sleep quality from pre-pregnancy and evening snacking.

Methods: In an ongoing prospective cohort study, pregnant women were recruited from UMMHC obstetric practices and the community. Participants are 18+ years, with singleton gestation <36 >weeks, pre-pregnancy BMI 18.5-40 kg/m2, English-speaking, and with plans to deliver at UMMHC. Participants were asked “compared to the three months before you became pregnant, how is your sleep quality now?”; we combined responses of …

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 …

Frequency Of Private Spiritual Activity And Cardiovascular Risk In Post-Menopausal Women: The Women's Health Initiative, Elena Salmoirago Blotcher, George Fitchett, Kathleen M. Hovey, Eliezer Schnall, Cynthia Thomson, Christopher A. Andrews, Sybil Crawford, Mary Jo O'Sullivan, Stephen Post, Rowan T. Chlebowski, Judith K. Ockene

Sybil L. Crawford

Purpose: Spirituality has been associated with better cardiac autonomic balance, but its association with cardiovascular risk is not well studied. We examined whether more frequent private spiritual activity was associated with reduced cardiovascular risk in postmenopausal women enrolled in the Women’s Health Initiative Observational Study. Methods: Frequency of private spiritual activity (prayer, Bible reading, and meditation) was selfreported at year 5 of follow-up. Cardiovascular outcomes were centrally adjudicated, and cardiovascular risk was estimated from proportional hazards models. Results: Final models included 43,708 women (mean age: 68.9±7.3; median follow-up: 7.0 years) free of cardiac disease through year 5 of follow-up. In …