1
|
Sereika SM, Moore KR, Stotz S, Chalmers LJ, Garrow H, Gonzales K, O'Banion N, Powell J, Knoki-Wilson U, Charron-Prochownik D. The Associations Between Health-Related Knowledge and Health Beliefs Regarding Risk for Gestational Diabetes in American Indian and Alaska Native Female Adolescents and Young Adults at Risk for Gestational Diabetes and Their Female Caregivers: A Cross-Sectional Dyadic Analysis. J Midwifery Womens Health 2024; 69:383-393. [PMID: 38831486 DOI: 10.1111/jmwh.13643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 04/13/2024] [Indexed: 06/05/2024]
Abstract
INTRODUCTION Research on associations between knowledge and health beliefs for women at risk for gestational diabetes mellitus (GDM) has focused on adults at risk for or having GDM. Gaps also exist in examining interpersonal associations with family members or peers. We examined dyadic associations between knowledge and health beliefs about the risk for GDM between and within American Indian and Alaska Native (AIAN) female adolescents and young adults (FAYAs) at risk for GDM and their mothers or adult female caregivers (FCs). METHODS Grounded in the Expanded Health Belief Model, we employed a cross-sectional design using baseline data from 147 dyads of AIAN FAYAs at risk for GDM and their FCs who participated in the Stopping GDM in Daughters and Mothers trial. FAYAs were 12.0 to 24.5 years of age, and 89.1% were students. FCs had a mean (SD) age of 44.0 (9.3) years, 87.0% were AIAN, 44.9% were college educated, 19.7% had ever had GDM, and 81.0% were the FAYA's mother. FAYAs and FCs completed surveys about knowledge and health beliefs (benefits, barriers, severity, susceptibility) regarding GDM risk and prevention. Bivariate correlational analyses were performed to examine associations between and within dyad members. Dyadic associations were investigated using actor-partner interdependence modeling (APIM) assuming distinguishable dyad members. RESULTS Compared with their FCs, FAYAs had lower health-related knowledge and perceived benefits of GDM prevention and susceptibility regarding GDM risk. APIM revealed actor and partner effects of health-related knowledge on health beliefs for dyads. In particular, positive actor effects were found for FAYAs and FCs for GDM-related knowledge with perceived benefits (P < .001), and positive partner effects of GDM-related knowledge for FCs were related to perceived susceptibility and severity for FAYAs (P < .05). DISCUSSION As shown in these AIAN dyads, FAYAs and their FCs, as members of one another's social network, may influence each other's health beliefs regarding GDM risk and prevention.
Collapse
Affiliation(s)
- Susan M Sereika
- Department of Health and Community Systems, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Kelly R Moore
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado
| | - Sarah Stotz
- Department of Food Science and Human Nutrition, College of Health and Human Sciences, Colorado State University, Fort Collins, Colorado
| | - Laura J Chalmers
- Department of Pediatrics, School of Medicine, University of Oklahoma, Tulsa, Oklahoma
| | | | - Kelly Gonzales
- School of Public Health, Oregon Health Science University-Portland State University, Portland, Oregon
| | - Nancy O'Banion
- Indian Health Care Resource Center of Tulsa, Tulsa, Oklahoma
| | - Jeffrey Powell
- Northern Navajo Medical Center, Navajo Area Indian Health Service, Shiprock, New Mexico
| | | | - Denise Charron-Prochownik
- Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, Pittsburgh, Pennsylvania
| |
Collapse
|
2
|
Walker C, Begum T, Boyle JA, Ward J, Barzi F. Preconception Health of Indigenous Peoples in Australia, Canada, New Zealand, and the United States: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:345. [PMID: 38541344 PMCID: PMC10969840 DOI: 10.3390/ijerph21030345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/23/2024] [Accepted: 02/28/2024] [Indexed: 07/23/2024]
Abstract
BACKGROUND There is increasing recognition of the importance of the preconception period for addressing reproductive and intergenerational health inequities and supporting improved maternal and child health outcomes. This study aimed to understand the extent and type of evidence that exists in relation to preconception health for Indigenous peoples living in high-income countries with similar experiences of colonisation, namely, Australia, New Zealand, Canada, and the United States. METHODS This review was conducted as per the JBI methodology and PRISMA Extension for Scoping Reviews. A comprehensive search of PubMed, CINAHL [EBSCO], Ovid Embase, Scopus, and the Wiley Cochrane Library was conducted using keywords and index terms. We included research in English published between January 2010 and June 2023 on quantitative and qualitative primary studies. Data were extracted using a standardised tool, and the analysis included quantitative descriptions and qualitative content analysis. RESULTS We identified 360 potential studies and included 57 articles in the review. Most studies were from the United States (n = 36, 63.2%) and Australia (n = 13, 22.8%), and they commonly reported associations between preconception health risk factors and maternal or child health outcomes (n = 27, 48.2%) or described the development, implementation, or evaluation of preconception health interventions (n = 26, 46.4%). Common preconception health areas were pre-pregnancy body mass index or weight (n = 34), alcohol (n = 16), diet (n = 14), physical activity (n = 12), and diabetes (n = 11). Most studies focused exclusively on women (n = 46, 80.7%), and very few included men (n = 3, 5.3%). The study populations were mostly urban and rural (n = 25, 43.9%) or rural only (n = 14, 24.6%); however, the geographical remoteness was often unclear (n = 14, 24.6%). CONCLUSIONS While there was some research relating to the preconception health of Indigenous peoples, this review identified considerable research gaps. There is a need for dedicated research into preconception health risk factors and reproductive health outcomes, attitudes and awareness of preconception health, and preconception health interventions for Indigenous peoples.
Collapse
Affiliation(s)
- Clara Walker
- UQ Poche Centre for Indigenous Health, The University of Queensland, Toowong, QLD 4066, Australia
- Centre for Health Research, University of Southern Queensland, Toowoomba, QLD 4350, Australia
| | - Tahmina Begum
- UQ Poche Centre for Indigenous Health, The University of Queensland, Toowong, QLD 4066, Australia
| | - Jacqueline A Boyle
- Eastern Health Clinical School, Monash University, Box Hill, VIC 3128, Australia
| | - James Ward
- UQ Poche Centre for Indigenous Health, The University of Queensland, Toowong, QLD 4066, Australia
| | - Federica Barzi
- UQ Poche Centre for Indigenous Health, The University of Queensland, Toowong, QLD 4066, Australia
| |
Collapse
|
3
|
Haakenstad MK, Butcher MB, Noonan CJ, Fyfe-Johnson AL. Outdoor Time in Childhood: A Mixed Methods Approach to Identify Barriers and Opportunities for Intervention in a Racially and Ethnically Mixed Population. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:7149. [PMID: 38131701 PMCID: PMC10743276 DOI: 10.3390/ijerph20247149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 10/25/2023] [Accepted: 11/20/2023] [Indexed: 12/23/2023]
Abstract
A growing body of literature suggests that outdoor time is beneficial for physical and mental health in childhood. Profound disparities exist in access to outdoor spaces (and the health benefits thereof) for children in communities of color. The objectives of this research were to: (1) identify challenges and solutions to outdoor time for children; (2) assess the importance of outdoor time for children; and (3) evaluate results stratified by race/ethnicity. Using a convergent mixed methods approach, we conducted a thematic analysis from 14 focus groups (n = 50) with outdoor educators, parents with children attending outdoor preschools, and community members with children. In addition, 49 participants completed a survey to identify challenges and solutions, perceived importance, and culturally relevant perspectives of outdoor time. The main challenges identified for outdoor time were safety concerns, inclement weather, lack of access to outdoor spaces, and parent work schedules. The primary proposed solution was integrating outdoor time into the school day. Nearly all participants, independent of racial identity, reported that outdoor time improved physical and mental health. Overall outdoor time was lower in participants from communities of color (~8 h/week) compared to their White counterparts (~10 h/week). While 50% of people of color (POC) reported that outdoor time was an important cultural value, only 18% reported that people in their respective culture spent time outside. This work contributes to accumulating knowledge that unique barriers to outdoor time exist for communities of color, and the children that live, learn, and play in these communities. Increasing outdoor time in school settings offers a potential solution to reduce identified barriers and to promote health equity in childhood.
Collapse
Affiliation(s)
- Magdalena K. Haakenstad
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
| | - Maria B. Butcher
- Elson S. Floyd College of Medicine, Washington State University, Spokane, WA 99202, USA;
| | - Carolyn J. Noonan
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
| | - Amber L. Fyfe-Johnson
- Institute for Research and Education to Advance Community Health, Elson S. Floyd College of Medicine, Washington State University, Seattle, WA 98101, USA; (M.K.H.); (C.J.N.)
| |
Collapse
|
4
|
Moore KR, Stotz SA, Terry MA, Seely EW, Gonzales K, Marshall G, Nadeau KJ, Akers A, Garcia-Reyes Y, Charron-Prochownik D. Respecting tribal voices in the development of a gestational diabetes risk reduction preconception counseling program for American Indian/Alaska Native adolescent females: a qualitative study. BMC Pregnancy Childbirth 2023; 23:552. [PMID: 37528363 PMCID: PMC10392008 DOI: 10.1186/s12884-023-05850-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Accepted: 07/12/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND American Indians and Alaska Natives (AI/AN) are disproportionately affected by adolescent obesity, adolescent pregnancy and gestational diabetes mellitus (GDM). GDM is associated with increased risk for perinatal death, obesity, and subsequent type 2 diabetes (T2D) for the offspring. Moreover, mothers with GDM are also at increased risk for T2D post-partum. Yet few lifestyle interventions exist to reduce GDM risk prior to pregnancy. We describe the process of adapting an existing validated preconception counseling intervention for AI/AN adolescent girls at-risk for GDM and their mothers. Perspectives and recommendations were gathered from a diverse array of stakeholders to assure the new program called Stopping GDM was culturally responsive and developed with tribal voices and perspectives represented. METHODS We conducted focus groups and individual interviews with multiple AI/AN stakeholders (n = 55). Focus groups and interviews were digitally recorded, transcribed verbatim, and analyzed using a thematic content approach to construct cross-cutting themes across the focus groups and interviews. RESULTS Four key themes emerged reflecting issues important to planning a reproductive health intervention: 1) Limited awareness, knowledge, and health education resources about GDM; 2) The importance of acknowledging traditional AI/AN values and the diversity of traditions and culture among AI/AN tribes; 3) The need to cultivate healthy decision-making skills and empower girls to make safe and healthy choices; and 4) Lack of communication about reproductive health between AI/AN mothers and daughters and between AI/AN women and health care professionals. CONCLUSION Findings have been used to inform the cultural tailoring and adaptation of an existing preconception counseling program, originally designed for non-AI/AN adolescent girls with diabetes, for AI/AN adolescents at-risk for GDM in future pregnancies.
Collapse
Affiliation(s)
- Kelly R Moore
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Sarah A Stotz
- Centers for American Indian and Alaska Native Health, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Martha Ann Terry
- School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Ellen W Seely
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Kelly Gonzales
- School of Public Health, Oregon Health & Science University - Portland State University, Portland, OR, USA
| | | | - Kristen J Nadeau
- Children's Hospital Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | | | | | - Denise Charron-Prochownik
- University of Pittsburgh School of Nursing, Pittsburgh, PA, USA.
- Department of Health Promotion and Development, Professor Nursing and School of Public Health, School of Nursing, University of Pittsburgh, 440 Victoria Bldg, Pittsburgh, USA.
| |
Collapse
|
5
|
Lawton B, Clarke MJ, Gibson-Helm M, Boyle JA. The lives of women and babies matter: A call for action in Indigenous and First Nations women's health and wellbeing. Int J Gynaecol Obstet 2021; 155:167-169. [PMID: 34651699 DOI: 10.1002/ijgo.13929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Beverley Lawton
- Te Tātai Hauora o Hine - Centre for Women's Health Research, Faculty of Health, Victoria University of Wellington, Wellington, New Zealand
| | - Marilyn J Clarke
- Coffs Harbour Health Campus, New South Wales Health, Coffs Harbour, New South Wales, Australia
| | - Melanie Gibson-Helm
- Te Tātai Hauora o Hine - Centre for Women's Health Research, Faculty of Health, Victoria University of Wellington, Wellington, New Zealand.,Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jacqueline A Boyle
- Monash Centre for Health Research and Implementation, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| |
Collapse
|