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Adekunle TB. US black women's pregnancy communication networks: A qualitative network analysis. Soc Sci Med 2024; 353:117028. [PMID: 38943860 DOI: 10.1016/j.socscimed.2024.117028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Revised: 05/21/2024] [Accepted: 05/27/2024] [Indexed: 07/01/2024]
Abstract
The ongoing Black maternal health crisis necessitates a closer examination of how Black women in the United States utilize communication to mitigate the dangers racism poses for pregnancy, delivery and the postpartum period. Previous studies have highlighted the importance of supportive networks to Black women's wellbeing during pregnancy. However, few studies utilize a qualitative network approach to explore communication about pregnancy and related risks within a social network. Twenty-eight Black women from 12 US states who self-identified as previously, currently or recently pregnant, were recruited to participate in this study. Following data collection, participants' networks and related commentary from the interview were qualitatively analyzed for composition and context of networks (who is in the network and why?) and the content of communication (what is discussed and how?). This study found that Black women's perceptions of pregnancy risk and enactment of agency in response to risk was influenced by communication with individuals within their communication networks. The findings of this study also demonstrate that emotional support and guidance for navigating the dangers of the healthcare system constituted an important component of communication with strong ties, including partners, family members and close friends. Additionally, Black women enacted agency in response to pregnancy risk by leaning on trusted experts (healthcare providers) within their networks. However, this study also found limitations to the role of pregnancy communication networks. First, negative ties (relations) with alters (individuals with whom Black women have communication ties) and unwanted advice or guidance was found to be a source of stress. Furthermore, although mothers were an essential source of support for many women, differences related to generation, culture and the circumstances of pregnancy limited the relevance of the advice Black women receive from their mothers. Finally, immigrant women faced an additional challenge, as their support networks were sometimes geographically distant from them.
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Affiliation(s)
- Tiwaladeoluwa B Adekunle
- Center for Education in Health Sciences, Institute for Public Health and Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
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2
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McKay FH, Vo M, George NA, John P, Kaushal J, van der Pligt P. Cross-cultural food practices and nutrition seeking behaviors among pregnant and postpartum Indian women living in Australia. Health Care Women Int 2024:1-23. [PMID: 38215307 DOI: 10.1080/07399332.2024.2303518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 01/05/2024] [Indexed: 01/14/2024]
Abstract
No research has explored the experiences of Indian women who become pregnant after they migrate to Australia, and how their existing traditions mix with their new environment and subsequently impact eating patterns. Semi-structured interviews were conducted with eleven women of Indian heritage who were living in Australia, and data were thematically analyzed. The researchers identified two main themes were identified (a) foods to eat and which to avoid, and (b) support networks and sources of health information during pregnancy. Women get advice and information from a range of sources and have diverse attitudes and beliefs about cultural food practices. that are both rigid and flexible, as well as traditional and contemporary.
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Affiliation(s)
- Fiona H McKay
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
- Institute for Health Transformation, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Minnie Vo
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Neetu Abey George
- School of Health and Social Development, Faculty of Health, Deakin University, Geelong, Victoria, Australia
| | - Preethi John
- Global Business School for Health, University College London, London, UK
| | - Jyotsna Kaushal
- Center for Water Sciences, Chitkara University Institute of Engineering and Technology, Chitkara University, Rajpura, Punjab, India
| | - Paige van der Pligt
- Institute for Physical Activity and Nutrition (IPAN), Deakin University, Geelong, Victoria, Australia
- Department of Nutrition, Western Health, Footscray, Victoria, Australia
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Carandang RR, Epel E, Radin R, Lewis JB, Ickovics JR, Cunningham SD. Perceived Stress and Depressive Symptoms Are Associated With Emotional Eating but Not Nutritional Intake During Pregnancy: A Prospective Cohort Study. J Midwifery Womens Health 2024; 69:64-70. [PMID: 37358371 DOI: 10.1111/jmwh.13537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
INTRODUCTION Pregnancy is a major life event during which women may experience increased psychological distress and changes in eating behaviors. However, few studies have investigated the influence of psychological distress on pregnant women's eating behaviors. The primary objective of this prospective study was to examine the associations of changes in perceived stress and depressive symptoms with emotional eating and nutritional intake during pregnancy. In addition, we examined the direct and moderating effects of perceived social support. METHODS Participants were racially diverse pregnant women (14-42 years) from 4 clinical sites in Detroit, MI, and Nashville, TN (N = 678). We used multiple linear and logistic regression models to determine if changes in stress and depressive symptoms across pregnancy were associated with changes in emotional eating and nutritional intake. We examined residualized change in stress and depressive symptoms from second to third trimester of pregnancy; positive residualized change scores indicated increased stress and depressive symptoms. RESULTS Participants showed significant improvement in emotional eating and nutritional intake from second to third trimester of pregnancy (P < .001 for both). At second trimester, higher depressive symptoms were associated with a greater likelihood of emotional eating (P < .001) and worse nutritional intake (P = .044) at third trimester. Increased stress and depressive symptoms during pregnancy were both associated with increased risk, whereas increased perceived social support reduced risk of emotional eating at third trimester (stress: adjusted odds ratio [AOR], 1.17; 95% CI, 1.08-1.26; depressive symptoms: AOR, 1.05; 95% CI, 1.01-1.08; social support: AOR, 0.93; 95% CI, 0.88-0.99). None were associated with changes in nutritional intake. Perceived social support did not show any moderating effects. DISCUSSION Increased psychological distress during pregnancy may increase emotional eating. Efforts to promote healthy eating behaviors among pregnant women should consider and address mental health.
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Affiliation(s)
- Rogie Royce Carandang
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut
| | - Elissa Epel
- Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
- Center for Health and Community, University of California San Francisco, San Francisco, California
| | - Rachel Radin
- Department of Psychiatry and Behavioral Sciences, UCSF Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California
- Center for Health and Community, University of California San Francisco, San Francisco, California
| | - Jessica B Lewis
- Department of Chronic Disease Epidemiology, Yale School of Public Health, Yale University, New Haven, Connecticut
| | - Jeannette R Ickovics
- Department of Social and Behavioral Sciences, Yale School of Public Health, Yale University, New Haven, Connecticut
| | - Shayna D Cunningham
- Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, Connecticut
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Flagg AM, Lin B, Crnic KA, Gonzales NA, Luecken LJ. Intergenerational Consequences of Maternal Childhood Maltreatment on Infant Health Concerns. Matern Child Health J 2023; 27:1981-1989. [PMID: 37294466 DOI: 10.1007/s10995-023-03717-1] [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] [Accepted: 05/21/2023] [Indexed: 06/10/2023]
Abstract
INTRODUCTION Childhood maltreatment is a well-established risk factor for health problems in adulthood and may also have intergenerational consequences for infant health. Childhood maltreatment may confer risk for infant health by undermining caregiver capacities for sensitive and responsive caregiving. However, associations among childhood maltreatment, maternal sensitivity, and infant health are not well understood. These processes may be of particular importance among low-income and ethnic minority populations for whom disparities in maltreatment exposure and poorer health outcomes are well-established. METHOD The current study drew data from a sample of low-income, Mexican American families to examine whether maternal childhood maltreatment would be associated with more infant health concerns, and whether lower maternal sensitivity would explain their associations. Data were collected from 322 mother-infant dyads during home visits completed during pregnancy and when infants were 12, 18, and 24 weeks old. RESULTS Maternal childhood maltreatment exposure and lower maternal sensitivity were both associated with more infant health concerns. Maternal childhood maltreatment was not associated with maternal sensitivity. DISCUSSION These findings highlight potential intergenerational consequences of maternal childhood maltreatment for infant health and underscore a need for evaluating pre- and postnatal mechanisms through which these effects may be perpetuated. Furthermore, results indicate that maternal sensitivity may represent a promising target for interventions seeking to counteract intergenerational transmission processes. Clarification about underlying risk processes and potentiating resiliency characteristics may elucidate ways to better support mothers and infants across the lifespan.
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Affiliation(s)
- Amanda M Flagg
- Department of Psychology, University at Albany, State University at New York, Albany, NY, USA.
| | - Betty Lin
- Department of Psychology, University at Albany, State University at New York, Albany, NY, USA
| | - Keith A Crnic
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Nancy A Gonzales
- Department of Psychology, Arizona State University, Tempe, AZ, USA
| | - Linda J Luecken
- Department of Psychology, Arizona State University, Tempe, AZ, USA
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Lozano-Hernández CM, Cladellas YP, Gil Conesa M, Garin O, Forés MF, del Cura-González I. Functional social support: A systematic review and standardized comparison of different versions of the DUFSS questionnaire using the EMPRO tool. PLoS One 2023; 18:e0291635. [PMID: 37713437 PMCID: PMC10503721 DOI: 10.1371/journal.pone.0291635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 09/03/2023] [Indexed: 09/17/2023] Open
Abstract
BACKGROUND Functional social support is one of the most established predictors of health, and the Duke-UNC Functional Social Support Questionnaire (DUFSS) is one of the most commonly used instruments to measure this parameter. The objective of this study is to systematically review the available evidence on the psychometric and administration characteristics of the different versions of the DUFSS and perform a standardized assessment though to a specifically designed tool. METHODS A systematic review was performed in the PubMed/MEDLINE, SCOPUS, WOS and SCIELO databases. All articles that contained information on the development process of the instrument, the psychometric properties and aspects related to its administration were included, without restrictions based on publication date, language, or the version of the questionnaire that was studied. The selection and extraction procedure were carried out by two researchers. The articles finally included were peer-reviewed through a standardised assessment using the Evaluating the Measurement of Patient-Reported Outcomes (EMPRO) tool. PROSPERO registration number: CRD42022342977. RESULTS A total of 54 articles were identified. After eliminating duplicates and screening articles based on the selection criteria, 15 studies that examined the DUFSS questionnaire resulting in 4 different versions: 3 articles obtained the 8-item version; 11 the 11-item version; and a single article obtained two versions, the 14-item version and the 5-item version. At least 60% of them did so in a young adult population, predominantly female and with a medium-low socio-economic level or with characteristics of social vulnerability. The EMPRO evaluation showed that the 11-item version (54.01 total score) was the only one that had been studied on all recommended attributes and had higher total scores than the other versions: 8 items (36.31 total score), 14 items (27.48 total score) and 5 items (23.81 total score). This difference appears in all attributes studied, with the highest scores in "reliability (internal consistency)" and "validity". CONCLUSIONS Of the 4 versions identified in the DUFSS questionnaire, the 11-item version was found to be optimal based on the EMPRO standardized tool. Although, a priori, we could prioritise its use in epidemiological studies over the other versions, it should be noted that this version should also be used with caution because there are attributes that have not been studied.
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Affiliation(s)
- Cristina M. Lozano-Hernández
- Interuniversity Doctoral Program in Epidemiology and Public Health, Rey Juan Carlos University, Alcorcon (Madrid), Spain
- Research Unit, Primary Health Care Management Madrid, Madrid, Spain
- Research Network on Chronicity, Primary Care and Health Promotion -RICAPPS- (RICORS), Spain
- Biosanitary Research and Innovation Foundation of Primary Care (FIIBAP), Spain
| | - Yolanda Pardo Cladellas
- Networking Group of the Centre for Biomedical Research, Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Unit, Institut Mar d’Investigacion Mèdiques (IMIM-Hospital del Mar), Barcelona, Spain
- Autonomous University of Barcelona, Spain
| | - Mario Gil Conesa
- Preventive Medicine and Public Health Physician, Castellón General Hospital, Castellón, Valencian Community, Castellón, Spain
| | - Olatz Garin
- Networking Group of the Centre for Biomedical Research, Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Pompeu Fabra University, Barcelona, Spain
| | - Montserrat Ferrer Forés
- Networking Group of the Centre for Biomedical Research, Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- Health Services Research Unit, Institut Mar d’Investigacion Mèdiques (IMIM-Hospital del Mar), Barcelona, Spain
- Pompeu Fabra University, Barcelona, Spain
| | - Isabel del Cura-González
- Research Unit, Primary Health Care Management Madrid, Madrid, Spain
- Research Network on Chronicity, Primary Care and Health Promotion -RICAPPS- (RICORS), Spain
- Department of Medical Specialties and Public Health. Faculty of Health Sciences Rey Juan Carlos University, Madrid, Spain
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Katzow MW, Messito MJ, Mendelsohn AL, Scott MA, Gross RS. Protective Effect of Prenatal Social Support on the Intergenerational Transmission of Obesity in Low-Income Hispanic Families. Child Obes 2023; 19:382-390. [PMID: 36112108 PMCID: PMC10468550 DOI: 10.1089/chi.2021.0306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Background: Prepregnancy overweight/obesity (OW/OB) is a strong risk factor for child obesity. Few studies have identified modifiable factors that mitigate this risk. Objective: The objective of this study was to determine if prenatal social support buffers the effect of prepregnancy OW/OB on child birth weight z-score (BWz) and weight-for-age z-score (WFAz) trajectory. Methods: We performed a longitudinal secondary analysis of 524 mother-infant pairs enrolled in a randomized controlled trial of the Starting Early Program, a child obesity prevention program for Hispanic families with low income. Social support was assessed in the third trimester of pregnancy; maternal prepregnancy OW/OB and child WFAz from birth to age 3 years were obtained from medical records. Linear regression and multilevel modeling tested the effects of maternal prepregnancy OW/OB on child weight outcomes, and whether prenatal social support moderated these effects. Results: Prepregnancy OW/OB was associated with significantly higher child BWz (B = 0.23, p = 0.01) and WFAz trajectories (B = 0.19, 0.01). The interaction between social support and prepregnancy OW/OB was negatively related to child BWz (B = -0.26, p = 0.02) and WFAz trajectory (B = -0.40, p = 0.047). Conclusions: Prenatal social support may be protective against the intergenerational transmission of obesity risk. Interventions for the prevention of child obesity should consider incorporating social support into their design. Clinical Trial Registration Number: NCT01541761.
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Affiliation(s)
- Michelle W. Katzow
- Division of General Pediatrics, Department of Pediatrics, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- The Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Mary Jo Messito
- Division of General Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Alan L. Mendelsohn
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
| | - Marc A. Scott
- Department of Applied Statistics, Social Science, and Humanities, New York University Steinhardt School of Culture, Education, and Human Development, New York, NY, USA
| | - Rachel S. Gross
- Division of General Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, New York, NY, USA
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Haeusslein L, Gano D, Gay CL, Kriz RM, Bisgaard R, Vega M, Cormier DM, Joe P, Walker V, Kim JH, Lin C, Sun Y, Franck LS. Relationship between social support and post-discharge mental health symptoms in mothers of preterm infants. J Reprod Infant Psychol 2023; 41:260-274. [PMID: 34587850 PMCID: PMC8960471 DOI: 10.1080/02646838.2021.1984404] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 09/17/2021] [Indexed: 10/20/2022]
Abstract
BACKGROUND Social support is associated with decreased symptoms of postpartum mood and anxiety disorders (PMAD) in mothers of healthy infants, but less is known about social support and PMADs in mothers with preterm infants. The purpose of this study was to examine the relationship between social support and symptoms of PMADs reported by mothers in the months following hospital discharge of their preterm infant. METHODS Mothers of infants less than 33 weeks gestational age were enrolled from neonatal intensive care units (NICU) at 6 sites. Mothers completed PMAD measures of depression, anxiety and post-traumatic stress approximately 3 months following their infant's discharge. Multivariable regression was used to evaluate relationships between social support and PMAD measures. RESULTS Of 129 mothers, 1 in 5 reported clinically significant PMAD symptoms of: depression (24%), anxiety (19%), and post-traumatic stress (20%). Social support was strongly inversely associated with all 3 PMADs. Social support explained between 21% and 26% of the variance in depression, anxiety and post-traumatic stress symptoms. CONCLUSION Increased social support may buffer PMAD symptoms in mothers of preterm infants after discharge. Research is needed to determine effective screening and interventions aimed at promoting social support for all parents during and following their infant's hospitalisation.
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Affiliation(s)
- Laurel Haeusslein
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Dawn Gano
- Department of Neurology and Pediatrics, UCSF
| | - Caryl L. Gay
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Rebecca M. Kriz
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, USA
| | - Robin Bisgaard
- Intensive Care Nursery, UCSF Benioff Children’s Hospital, San Francisco
| | - Myrna Vega
- Intensive Care Nursery, UCSF Benioff Children’s Hospital, San Francisco
| | | | - Priscilla Joe
- Division of Neonatology, UCSF Benioff Children’s Hospital, Oakland
| | - Valencia Walker
- Department of Pediatrics, Division of Neonatology, The Ohio State University College of Medicine, Columbus, Ohio
| | - Jae H. Kim
- Division of Neonatology, Perinatal Institute, Cincinnati Children’s Hospital Medical Center
| | - Carol Lin
- Division of Neonatology, Kaiser Permanente Santa Clara
| | - Yao Sun
- Division of Neonatology, UCSF Benioff Children’s Hospital, San Francisco
| | - Linda S. Franck
- Department of Family Health Care Nursing, University of California, San Francisco, San Francisco, California, USA
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Florian S, Ichou M, Panico L, Pinel-Jacquemin S, Vrijkotte TGM, Harskamp-van Ginkel MW, Huang RC, Carson J, Rodriguez LSM, Subiza-Pérez M, Vrijheid M, Fernández-Barrés S, Yang TC, Wright J, Corpeleijn E, Cardol M, Isaevska E, Moccia C, Kooijman MN, Voerman E, Jaddoe V, Welten M, Spada E, Rebagliato M, Beneito A, Ronfani L, Charles MA. Differences in birth weight between immigrants' and natives' children in Europe and Australia: a LifeCycle comparative observational cohort study. BMJ Open 2023; 13:e060932. [PMID: 36958776 PMCID: PMC10040079 DOI: 10.1136/bmjopen-2022-060932] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/17/2023] [Indexed: 03/25/2023] Open
Abstract
OBJECTIVE Research on adults has identified an immigrant health advantage, known as the 'immigrant health paradox', by which migrants exhibit better health outcomes than natives. Is this health advantage transferred from parents to children in the form of higher birth weight relative to children of natives? SETTING Western Europe and Australia. PARTICIPANTS We use data from nine birth cohorts participating in the LifeCycle Project, including five studies with large samples of immigrants' children: Etude Longitudinale Française depuis l'Enfance-France (N=12 494), the Raine Study-Australia (N=2283), Born in Bradford-UK (N=4132), Amsterdam Born Children and their Development study-Netherlands (N=4030) and the Generation R study-Netherlands (N=4877). We include male and female babies born to immigrant and native parents. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome is birth weight measured in grams. Different specifications were tested: birth weight as a continuous variable including all births (DV1), the same variable but excluding babies born with over 4500 g (DV2), low birth weight as a 0-1 binary variable (1=birth weight below 2500 g) (DV3). Results using these three measures were similar, only results using DV1 are presented. Parental migration status is measured in four categories: both parents natives, both born abroad, only mother born abroad and only father born abroad. RESULTS Two patterns in children's birth weight by parental migration status emerged: higher birth weight among children of immigrants in France (+12 g, p<0.10) and Australia (+40 g, p<0.10) and lower birth weight among children of immigrants in the UK (-82 g, p<0.05) and the Netherlands (-80 g and -73 g, p<0.001) compared with natives' children. Smoking during pregnancy emerged as a mechanism explaining some of the birth weight gaps between children of immigrants and natives. CONCLUSION The immigrant health advantage is not universally transferred to children in the form of higher birth weight in all host countries. Further research should investigate whether this cross-national variation is due to differences in immigrant communities, social and healthcare contexts across host countries.
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Affiliation(s)
- Sandra Florian
- French National Institute for Demographic Studies, INED, Paris, France
| | - Mathieu Ichou
- French National Institute for Demographic Studies, INED, Paris, France
| | - Lidia Panico
- French National Institute for Demographic Studies, INED, Paris, France
- Centre for Research on Social Inequalities (CRIS), Sciences Po, Paris, France
| | | | - Tanja G M Vrijkotte
- Department of Public Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Margreet W Harskamp-van Ginkel
- Department of Public Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam Public Health Research Institute, Reproduction and Development Research Institute, Amsterdam, The Netherlands
| | - Rae-Chi Huang
- Nutrition and Health Innovation Research Institute, Edith Cowan University School of Medical and Health Sciences, Perth, Western Australia, Australia
| | - Jennie Carson
- Telethon Kids Institute, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
| | - Loreto Santa Marina Rodriguez
- Sub Directorate for Public Health and Addictions of Gipuzkoa, Ministry of Health of the Basque Government, San Sebastián, Spain
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastián, Spain
| | - Mikel Subiza-Pérez
- Group of Environmental Epidemiology and Child Development, Biodonostia Health Research Institute, San Sebastián, Spain
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Martine Vrijheid
- Spanish Consortium for Research on Epidemiology and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
- ISGlobal, Barcelona, Spain
| | | | - Tiffany C Yang
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford Institute for Health Research, Bradford, UK
| | - John Wright
- Bradford Teaching Hospitals NHS Foundation Trust, Bradford Institute for Health Research, Bradford, UK
| | - Eva Corpeleijn
- Department of Epidemiology, GECKO Drenthe Cohort, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Marloes Cardol
- Department of Epidemiology, GECKO Drenthe Cohort, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Elena Isaevska
- Dipartimento di Scienze Mediche, Universita degli Studi di Torino, Torino, Italy
| | - Chiara Moccia
- Department of Medical Sciences, University of Turin, Torino, Italy
| | - Marjolein N Kooijman
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Ellis Voerman
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Vincent Jaddoe
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Marieke Welten
- The Generation R Study Group, University Medical Center, Erasmus Medical Center, Rotterdam, The Netherlands
- University Medical Center, Erasmus Medical Center Department of General Pediatrics, Rotterdam, The Netherlands
| | - Elena Spada
- Unit of Epidemiology, Meyer Children's University Hospital, Florence, Italy
| | - Marisa Rebagliato
- Predepartamental Unit of Medicine, Universitat Jaume I, Castello de la Plana, Comunitat Valenciana, Spain
- CIBERESP, Madrid, Spain
| | - Andrea Beneito
- Joint Research Unit in Epidemiology, Environment and Health, FISABIO, Valencia, Spain
| | - Luca Ronfani
- Clinical Epidemiology and Public Health Research Unit, Istituto di Ricovero e Cura a Carattere Scientifico materno infantile Burlo Garofolo, Trieste, Italy
| | - Marie-Aline Charles
- Inserm and INED Joint Research Group, Paris, France
- Université Paris Cité, Inserm, Inrae, Cress, Paris, France
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9
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Wilkie G, Leung K, Moore Simas TA, Tucker KL, Chasan-Taber L. The Association Between Acculturation and Diet and Physical Activity Among Pregnant Hispanic Women with Abnormal Glucose Tolerance. J Womens Health (Larchmt) 2022; 31:1791-1799. [PMID: 36040352 PMCID: PMC9805839 DOI: 10.1089/jwh.2022.0017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Background: Hispanic women are disproportionately affected by gestational diabetes mellitus (GDM), yet few studies have assessed the impact of acculturation on health behaviors that may reduce GDM risk. Materials and Methods: We assessed relationships between acculturation and meeting American Diabetes Association guidelines for macronutrient intake and American College of Obstetricians and Gynecologists guidelines for physical activity (PA) using baseline data from Estudio Project Aiming to Reduce Type twO diabetes, a randomized trial conducted in Massachusetts (2013-2017) among 255 Hispanic pregnant women with hyperglycemia. Acculturation was assessed via the Psychological Acculturation Scale, duration of time and generation in the continental United States, and language preference; diet with 24-hours dietary recalls; and PA with the Pregnancy Physical Activity Questionnaire (PPAQ). Results: The majority of participants who reported low psychological acculturation (74.9%), preferred English (78.4%), were continental U.S. born (58.0%), and lived in the continental United States ≥5 years (91.4%). A total of 44.8%, 81.8%, 22.9%, and 4.6% of women met guidelines for carbohydrate, protein, fat, and fiber intakes, respectively; 31.9% met guidelines for PA. Women with higher acculturation were less likely to meet carbohydrate guidelines (English preference: adjusted risk ratios [aRR] 0.45, 95% confidence intervals [CI] 0.23-0.75; U.S. born: aRR 0.60, 95% CI 0.36-0.91; duration of time in United States: aRR 0.96, 95% CI 0.92-0.99). Women with higher acculturation were more likely to meet PA guidelines (U.S. born: aRR 1.95, 95% CI 1.11-3.44). Conclusions: In summary, higher acculturation was associated with lower likelihood of meeting dietary guidelines but greater likelihood of meeting PA guidelines during pregnancy. Interventions aimed at reducing GDM in Hispanics should be culturally informed and incorporate acculturation. Clinical Trial Registration: clinicaltrials.gov NCT01679210.
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Affiliation(s)
- Gianna Wilkie
- Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Katherine Leung
- Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Tiffany A. Moore Simas
- Department of Obstetrics and Gynecology, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Pediatrics, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Psychiatry, and University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
- Department of Population and Quantitative Health Sciences, University of Massachusetts Chan Medical School, Worcester, Massachusetts, USA
| | - Katherine L. Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell, Lowell, Massachusetts, USA
| | - Lisa Chasan-Taber
- Department of Biostatistics and Epidemiology, School of Public Health and Health Sciences, University of Massachusetts, Amherst, Massachusetts, USA
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10
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Linking social features of fitness apps with physical activity among Chinese users: Evidence from self-reported and self-tracked behavioral data. Inf Process Manag 2022. [DOI: 10.1016/j.ipm.2022.103096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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11
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Jiang L, Zhu Z. Maternal mental health and social support from online communities during pregnancy. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:e6332-e6344. [PMID: 36256486 PMCID: PMC10092248 DOI: 10.1111/hsc.14075] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 07/29/2022] [Accepted: 10/01/2022] [Indexed: 06/16/2023]
Abstract
Social determinants of public health have gained increasing attention. This paper studied whether social support from online communities related to maternal mental health. We focused on online maternity communities that group users with a similar prenatal status to facilitate their exchange of personal experiences and knowledge about maternal caring during pregnancy. Such online maternity communities are getting increasingly popular and can be found across countries and societies. We invited users-currently pregnant and gave birth within 1 year at the time of the study-from one such community in China to participate in a survey. The survey measured their perceived social support (PSS) exclusively from the peer group in the online community, their mental health and newborns' birth outcomes (N = 500). Users reported high score in PSS from the online peer group which was comparable to the ones from family, significant other and friends in other studies. We used linear regression models to examine the effects of PSS on mental health and birth outcomes. We found that a one-point increase in the PSS score was associated with a 0.19-point (p < 0.1) decrease in the prenatal depression and a 0.26-point (p < 0.01) decrease in the postnatal depression, which was equivalent to 3% and 4.5% of the average respectively. Moreover, a one-point increase in the PSS score was associated with a 14.49-gram increase in a newborn's weight (p < 0.01).
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Affiliation(s)
| | - Zhen Zhu
- Kent Business SchoolUniversity of KentCanterburyUK
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12
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Nguyen LD, Nguyen LH, Ninh LT, Nguyen HTT, Nguyen AD, Vu LG, Nguyen HSA, Nguyen SH, Doan LP, Vu TMT, Tran BX, Latkin CA, Ho CSH, Ho RCM. Women's holistic self-care behaviors during pregnancy and associations with psychological well-being: implications for maternal care facilities. BMC Pregnancy Childbirth 2022; 22:631. [PMID: 35945522 PMCID: PMC9364562 DOI: 10.1186/s12884-022-04961-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 07/20/2022] [Indexed: 12/12/2022] Open
Abstract
Background Self-care behaviors during pregnancy significantly impacts mother and children's health. This study aimed to explore the self-care behaviors and the associations of these behaviors with the psychological well-being of women during pregnancy, as well as the mediating effects of different social support with these associations. Methods A cross-sectional data of 562 pregnant women at Hanoi Obstetrics & Gynecology Hospital and Ca Mau Obstetrics & Pediatrics in Vietnam were analyzed. Questions about self-care behaviors, pregnancy characteristics, social support, and psychological well-being were asked. Multivariate regression models were performed. Structural Equation Modeling (SEM) was employed to test the mediating effects of different social support with the association between self-care behaviors and psychological well-being. Findings Only 13% of pregnant women often or always did physical exercise at least three times a week, and 40% consumed enough fiber and five servings of vegetables a day. Only 78.7% always avoided alcohol drinking, and 53.9% of pregnant women avoided being exposed to second-hand smoking and 71,7% avoided using traditional medicine without physicians’ prescriptions. Around 66% of pregnant women always or often had prenatal care checkups as scheduled. Information sources, social support and childbirth expectation were major drivers for self-care practices. SEM model showed that social support mediated the relationship between maternal health behaviors and mental well-being. Conclusion This study highlighted the remarkable gaps in self-care practices among our pregnant women, which were significantly associated with their mental well-being. Social support-oriented consultancy and interventions should be warranted for improving behaviors and the mental well-being of pregnant women in Vietnam.
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Affiliation(s)
- Lam Duc Nguyen
- Department of Anaesthesiology, Hanoi Medical University, Hanoi, Vietnam
| | - Long Hoang Nguyen
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Ly Thi Ninh
- Social Affair Department, Ca Mau Obstetrics & Pediatrics Hospital, Ca Mau, Vietnam
| | | | - Anh Duy Nguyen
- Hanoi Obstetrics and Gynecology Hospital, Hanoi, Vietnam
| | - Linh Gia Vu
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam.,Faculty of Nursing, Duy Tan University, Da Nang, 550000, Vietnam
| | | | - Son Hoang Nguyen
- Center of Excellence in Evidence-Based Medicine, Nguyen Tat Thanh University, Ho Chi Minh City, Vietnam
| | - Linh Phuong Doan
- Institute for Global Health Innovations, Duy Tan University, Da Nang, Vietnam. .,Faculty of Nursing, Duy Tan University, Da Nang, 550000, Vietnam.
| | | | - Bach Xuan Tran
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam.,Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Carl A Latkin
- Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Cyrus S H Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Roger C M Ho
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.,Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, Singapore, Singapore
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13
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Health Behaviors and Behavior Change during Pregnancy: Theory-Based Investigation of Predictors and Interrelations. SEXES 2022. [DOI: 10.3390/sexes3030027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
(1) Background: Preventing pregnancy complications and maternal deaths and helping women stay healthy before, during, and after pregnancy by means of sexual health and behavior is imperative. Previous research demonstrated that a lack of social support and perceived discrimination have adverse effects on pregnancy outcomes. These determinants may impact health behavior as an important mediator of pregnancy outcomes. To better understand this relation, the Compensatory Carry-Over Action Model (CCAM) was applied. The research question was: how do predictors of health behavior, specifically intention, planning, self-efficacy, social support, and discrimination, interrelate with different health behaviors during pregnancy? (2) Methods: By means of qualitative interviews with ten pregnant women (20–39 years, mean = 28.6) from different cultural backgrounds, the predictors of health behaviors and experiences with pregnancy, including racial discrimination, were investigated. (3) Results: Not all women changed their unhealthy behaviors even though their higher-level goal was to ensure their baby’s and their own health. This appeared partially due to lack of social support, racial discrimination, and unexpected pregnancy side effects. The women who previously performed health behaviors revealed a healthier pattern with maintaining or even expanding their health behaviors, while those performing no health behavior in the past reported more obstacles with a healthy lifestyle. (4) Conclusions: Pregnant women appear to be having difficulties translating good intentions into behavior. The reasons include lack of support, fear, and insecurity, which impact self-efficacy and planning. Improvements in health behaviors were facilitated by specific circumstances, such as working from home. Policy and practice should take these aspects into account and help mobilize support and overcome discrimination by means of more rights and support for pregnant women while also empowering the individuals.
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14
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Mitchell AM, Kowalsky JM, Christian LM, Belury MA, Cole RM. Perceived social support predicts self-reported and objective health and health behaviors among pregnant women. J Behav Med 2022; 45:589-602. [PMID: 35449357 DOI: 10.1007/s10865-022-00306-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 03/07/2022] [Indexed: 02/06/2023]
Abstract
Perinatal health and health behaviors play a crucial role in maternal and neonatal health. Data examining psychosocial factors which predict self-reported health and health behaviors as well as objective indicators downstream of health behaviors among pregnant women are lacking. In this longitudinal study design with 131 pregnant women, perceived social support was examined as a predictor of self-rated health and average levels of sleep quality, health-promoting and health-impairing behaviors, and red blood cell (RBC) polyunsaturated fatty acids across early, mid, and late pregnancy. Participants provided a blood sample and fatty acid methyl esters were analyzed by gas chromatography. Measures included the Multidimensional Scale of Perceived Social Support, Pittsburgh Sleep Quality Index, and Prenatal Health Behavior Scale. Regression models demonstrated that, after adjustment for income, race/ethnicity, age, relationship status, pre-pregnancy body mass index, greater social support was associated with better self-rated health (p = 0.001), greater sleep quality (p = 0.001), fewer health-impairing behaviors (p = 0.02), and higher RBC omega-3 fatty acids (p = 0.003). Associations among social support with health-promoting behaviors, RBC omega-6 fatty acids, or gestational weight gain were not significant. Findings underscore the benefits of perceived social support in the context of pregnancy. Examination of pathways that link social support with these outcomes will be meaningful in determining the ways in which perinatal psychosocial interventions may promote health.
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Affiliation(s)
- Amanda M Mitchell
- Department of Counseling and Human Development, College of Education and Human Development, University of Louisville, Woodford and Harriett Porter Building, 1905 South 1st Street, Louisville, KY, 40292, USA.
| | | | - Lisa M Christian
- Department of Psychiatry &, Behavioral Health, The Ohio State University Wexner Medical Center, Columbus, OH, USA
- The Institute for Behavioral Medicine Research, The Ohio State University Wexner Medical Center, Columbus, OH, USA
| | - Martha A Belury
- Department of Human Nutrition, The Ohio State University, Columbus, OH, USA
| | - Rachel M Cole
- Department of Human Nutrition, The Ohio State University, Columbus, OH, USA
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15
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Nawabi F, Krebs F, Lorenz L, Shukri A, Alayli A, Stock S. Understanding Determinants of Pregnant Women's Knowledge of Lifestyle-Related Risk Factors: A Cross-Sectional Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19020658. [PMID: 35055480 PMCID: PMC8775702 DOI: 10.3390/ijerph19020658] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/21/2021] [Accepted: 12/29/2021] [Indexed: 12/27/2022]
Abstract
Research indicates that a woman’s lifestyle during pregnancy influences her child’s health and development. Therefore, women need to possess sufficient knowledge regarding the elements of a healthy lifestyle during pregnancy. To date, there has been little research on the assessment of lifestyle knowledge of pregnant women in the perinatal healthcare setting. This study describes the development and application of a knowledge-based questionnaire for pregnancy to be used in a lifestyle intervention trial conducted in Germany. Within the trial, pregnant women receive counselling on lifestyle topics. These topics are based on the German initiative ‘Healthy Start—Young Family Network’ (GiL), which provides evidence-based recommendations regarding diet and lifestyle before and during pregnancy. These serve as a basis for health professionals who provide counselling on healthy lifestyle choices during the antenatal period. The questionnaire consists of eight items, each of which can be answered using ‘Yes’, ‘No’ or ‘Don’t know’. The pregnant women who completed the questionnaire at baseline around the twelfth week of gestation were recruited within the host trial from gynaecological practices in Germany. Demographic variables and the respondents’ answers to the questionnaire were analysed using descriptive statistics and regression analyses. Descriptive statistics show that more than 85% of participants answered the majority of questions (n = 5) correctly. Questions on whether tap water is safe and the normal range for gestational weight gain (GWG) were answered correctly by about 62% and 74% of the women, respectively, and the question on whether it is beneficial to obtain information on breastfeeding at an early stage was answered correctly by about 29%. The results of the regression analyses indicate that age, gestational week, education and income are positive predictors for answering the questionnaire correctly. Nullipara and migration background are predictors for answering the questions incorrectly. This study indicates that there are gaps in women’s knowledge regarding lifestyle during pregnancy. Particular focus on certain topics, such as breastfeeding and normal GWG ranges, is still required during counselling. Our analysis shows that migration background is a predictor of insufficient knowledge and incorrect answers to the questions. Women with such backgrounds require special attention during antenatal counselling in order to cater to their needs and the gaps in their knowledge.
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16
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Gross RS, Brown NM, Mendelsohn AL, Katzow MW, Arana MM, Messito MJ. Maternal Stress and Infant Feeding in Hispanic Families Experiencing Poverty. Acad Pediatr 2022; 22:71-79. [PMID: 33940204 PMCID: PMC8556387 DOI: 10.1016/j.acap.2021.04.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Revised: 04/10/2021] [Accepted: 04/23/2021] [Indexed: 01/03/2023]
Abstract
OBJECTIVES Maternal stress has been associated with early child obesity through pathways related to decreased exclusive breastfeeding and increased nonresponsive maternal-infant feeding styles. We sought to gain an in-depth understanding of how maternal stress, sadness, and isolation are perceived to affect feeding, in order to inform modifiable targets of intervention. METHODS We conducted semi-structured qualitative interviews with Hispanic mothers living in poverty with young infants between 3 and 7 months old (n = 32) from the intervention group of a randomized controlled trial of an early child obesity prevention intervention (Starting Early Program). Bilingual English-Spanish interviewers conducted the interviews, which were audio recorded, transcribed, and translated. Building on an existing theoretical framework developed by the National Scientific Council on the Developing Child, we used an iterative process of textual analysis to code the transcripts, until thematic saturation was reached. RESULTS Three key themes were described: 1) maternal stress responses were varied and included positive (brief and mild), tolerable (sustained but limited long-term impacts), or toxic stress (sustained and severe); 2) buffers included support from family, infants, health care providers, social service programs, and community organizations; 3) perceived effects on infant feeding included decreased breastfeeding due to concerns about stress passing directly through breast milk and indirectly through physical closeness, and increased nonresponsive feeding styles. CONCLUSIONS Maternal stress, particularly toxic stress, was perceived to negatively affect infant feeding. Mothers reported disrupting healthy feeding to avoid infant exposure to stress. Interventions to enhance buffering may help to mitigate toxic stress and promote healthy feeding interactions.
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Affiliation(s)
- Rachel S. Gross
- Division of General Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, 462 First Avenue, New York, NY, 10016
| | - Nicole M. Brown
- Strong Children Wellness Medical Group, 163-18 Jamaica Avenue, Jamaica, NY, 11432
| | - Alan L. Mendelsohn
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, 462 First Avenue, New York, NY, 10016
| | - Michelle W. Katzow
- Division of General Pediatrics, Department of Pediatrics, Zucker School of Medicine at Hofstra/Northwell, 269-01 76th Ave, New Hyde Park, NY, 11040
| | - Mayela M. Arana
- Division of General Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, 462 First Avenue, New York, NY, 10016
| | - Mary Jo Messito
- Division of General Pediatrics, Department of Pediatrics, New York University Grossman School of Medicine, 462 First Avenue, New York, NY, 10016
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17
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Cofie LE, Hirth JM, Lee JGL. Social Support Networks and Foreign-Birth Status Associated With Obesity, Hypertension and Diabetes Prevalence Among 21-30 and 50-70 Year Old Adults Living in the San Francisco Bay Area. Am J Health Promot 2021; 35:1105-1113. [PMID: 34000826 PMCID: PMC9933210 DOI: 10.1177/08901171211016320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To examine whether social network characteristics of US-and foreign-born individuals are related to hypertension, diabetes and obesity prevalence. DESIGN Cross-sectional. SETTING Six San Francisco Bay Area counties. PARTICIPANTS N = 1153 cohorts of young and older adults (21-30 and 50-70 years). MEASURES Network structure and support measures were calculated using name elicitation and interpreter questions common in egocentric surveys. Hypertension and diabetes were self-reported, and overweight/obesity was determined using body mass index calculations. Foreign-birth status was based on country of birth. ANALYSIS Adjusted and unadjusted logistic regression models were used to examine associations between network characteristics and hypertension, diabetes and overweight/obesity. These relationships were tested for moderation by foreign-birth status, age and gender. RESULTS Higher percentages of family members (AOR = 4.16, CI: 1.61-10.76) and same-sex individuals (AOR = 3.41, CI: 1.25-9.35) in the composition of respondents' networks were associated with overweight/obesity. Higher composition of family members (AOR = 3.54, CI: 1.09-11.48) was associated with hypertension. Respondents whose networks composed of higher numbers of advice individuals (AOR = 0.88, CI: 0.77-0.99), female respondents (AOR = 0.52, CI: 0.35-0.77) and foreign-born respondents (AOR = 0.54, CI: 0.32-0.92) were less likely to report overweight/obesity. Diabetes was associated with higher composition of individuals living within 5-minutes to respondents (AOR = 5.13, CI: 1.04-25.21). CONCLUSION Family and network support members such as advice individuals could be potential targets for chronic disease prevention, particularly among older adults and immigrants.
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Affiliation(s)
- Leslie E. Cofie
- Department of Health Education and Promotion, East Carolina University,Corresponding author: East Carolina University, 2309 Belk Building, Greenville, NC 27858, 252-328-5995,
| | - Jacqueline M. Hirth
- Center for Interdisciplinary Research in Women’s Health, Department of Obstetrics & Gynecology, University of Texas Medical Branch
| | - Joseph G L Lee
- Department of Health Education and Promotion, East Carolina University
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18
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Morey BN, Valencia C, Park HW, Lee S. The central role of social support in the health of Chinese and Korean American immigrants. Soc Sci Med 2021; 284:114229. [PMID: 34284265 PMCID: PMC8638775 DOI: 10.1016/j.socscimed.2021.114229] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 07/08/2021] [Accepted: 07/12/2021] [Indexed: 01/22/2023]
Abstract
Prior research contends that social support positively influences health by optimizing individuals' psychological processes such as appraisals, emotions, and sense of control-known as stress-buffering effects. This study tests this theoretical concept by examining whether the association between social support and health can be explained by the psychological processes of perceived stress and distress among Chinese and Korean American immigrants. Furthermore, we examine what predicts social support in this population, with a particular focus on factors related to immigration. Using a total sample of 400 Chinese and Korean American immigrants, we examine the association between social support and self-rated health (SRH), accounting for demographic factors, socioeconomic status, perceived stress, and perceived distress using multivariable logistic regression models. We conducted a mediation analysis using the Karlson, Holm, and Breen (KHB) method to determine whether perceived stress and distress partly explained the association between social support and SRH. Findings showed a strong total effect of higher social support on better SRH. Furthermore, mediation was detected, with perceived stress and distress explaining 42.98% of the total effect of social support on SRH. Multivariable linear regression models revealed that social support among Chinese and Korean American immigrants was associated with marital status, employment, ethnic identity, and acculturative stress. This study highlights the centrality of social support for Chinese and Korean American immigrants, which lowers perceived stress and distress, leading to better overall health. By confirming these stress-buffering effects, our findings suggest that bolstering social support among vulnerable Chinese and Korean American immigrant populations can have a positive effect on health by optimizing stress appraisals.
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Affiliation(s)
- Brittany N Morey
- University of California, Irvine, Program in Public Health, Department of Health, Society, & Behavior, 653 E. Peltason Dr., Anteater Instruction and Research Building (AIRB) 2022, Irvine, CA, 92697-3957, USA.
| | - Connie Valencia
- University of California, Irvine, Program in Public Health, Department of Health, Society, & Behavior, 653 E. Peltason Dr., Irvine, CA, 92697-3957, USA.
| | - Hye Won Park
- University of California, Irvine, School of Medicine, Department of Medicine, 1001 Health Sciences Rd., Irvine, CA 92617, USA.
| | - Sunmin Lee
- University of California, Irvine, School of Medicine, Department of Medicine, 1001 Health Sciences Rd., Irvine, CA 92617, USA.
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19
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Ahlers-Schmidt CR, Schunn C, Hervey AM, Torres M, Cordoba AP. Safe sleep community baby showers to reduce infant mortality risk factors for women who speak Spanish. Sleep Health 2021; 7:603-609. [PMID: 34417149 DOI: 10.1016/j.sleh.2021.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 07/06/2021] [Accepted: 07/07/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES In the United States, sleep-related deaths are one of the primary causes of death for infants age 28 days to one year. The American Academy of Pediatrics (AAP) developed Safe Sleep Recommendations which provide risk reduction strategies for sleep-related infant deaths. Interventions such as Safe Sleep Community Baby Showers have increased knowledge and intentions to engage in these safe sleep behaviors for women who speak English. This study assessed the feasibility, acceptability and initial outcomes of Safe Sleep Community Baby Showers for women who speak Spanish. METHODS Six Spanish Safe Sleep Community Baby Showers were held in Sedgwick County, Kansas. One hundred forty-six pregnant or recently delivered women who spoke Spanish completed pre- and post-assessments. Univariate comparisons were made using McNemar's test for paired dichotomous variables. RESULTS Participants had a high school diploma/General Educational Diploma (GED) or less (75.3%), and were uninsured (52.1%) or had Medicaid (n = 49; 33.6%). The majority reported being very satisfied (n = 130; 89.0%) or satisfied (n = 8; 5.5%). Compared to baseline, significant increases in intentions and confidence to follow the AAP Safe Sleep Recommendations were observed following the events. The majority of participants reported intending to place their infant on the back to sleep (98.6%), use only a safe surface (crib, portable crib, bassinet; 99.3%), and only include safe items (firm mattress, fitted sheet; 93.5%) (all p < .001). CONCLUSIONS Study findings support both feasibility and acceptability of modifying Safe Sleep Community Baby Showers to provide culturally and linguistically appropriate education for women who speak Spanish. Initial outcomes suggest increased intentions to follow safe sleep recommendations.
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Affiliation(s)
- Carolyn R Ahlers-Schmidt
- University of Kansas School of Medicine-Wichita, Center for Research for Infant Birth and Survival, Wichita, Kansas, USA.
| | - Christy Schunn
- Kansas Infant Death and SIDS (KIDS) Network, Wichita, Kansas, USA
| | - Ashley M Hervey
- University of Kansas School of Medicine-Wichita, Center for Research for Infant Birth and Survival, Wichita, Kansas, USA
| | - Maria Torres
- Kansas Infant Death and SIDS (KIDS) Network, Wichita, Kansas, USA
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20
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Bilecen B, Vacca R. The isolation paradox: A comparative study of social support and health across migrant generations in the U.S. Soc Sci Med 2021; 283:114204. [PMID: 34271369 DOI: 10.1016/j.socscimed.2021.114204] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2020] [Revised: 06/11/2021] [Accepted: 07/01/2021] [Indexed: 10/20/2022]
Abstract
Social isolation and international migration have potentially adverse effects on physical and mental health, and may compound each other when migrants have limited access to supportive social networks. This problem may be particularly serious in older age groups, who are more vulnerable to illness and isolation. We analyze population representative data from a detailed survey of social networks and health in the San Francisco Bay Area, U.S., to compare access to different types of social support and health outcomes among first-generation migrants, second-generation migrants, and nonmigrants between 50 and 70 years old (N = 674). We find that first-generation migrants report systematically lower levels of social support and poorer self-rated health compared to nonmigrants, even after controlling for sociodemographic characteristics. While social support is strongly and positively associated with health in the general population, this relationship is null or, in some cases, reversed among migrants in the first and second generations. These results provide further evidence that migration operates as an adverse social determinant of health, and suggest an isolation paradox: migrants are healthier than nonmigrants only at very low levels of social support, and they do not experience the same beneficial health effects of social support as nonmigrants.
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Affiliation(s)
- Başak Bilecen
- Department of Sociology, University of Groningen, Grote Kruisstraat 2/1 9712 TS Groningen/NL, Building 2222 - Room 305, the Netherlands.
| | - Raffaele Vacca
- Department of Sociology and Criminology & Law, University of Florida, 330 Newell Dr. Gainesville, FL, 32611-7330, USA.
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21
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Florian S, Ichou M, Panico L. Parental migrant status and health inequalities at birth: The role of immigrant educational selectivity. Soc Sci Med 2021; 278:113915. [PMID: 33905985 DOI: 10.1016/j.socscimed.2021.113915] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 01/25/2021] [Accepted: 04/06/2021] [Indexed: 11/25/2022]
Abstract
Immigrants tend to exhibit better health than natives despite immigrants' more disadvantaged socioeconomic status. This paradox has often been attributed to immigrants' pre-migration selectivity. However, most empirical studies investigating the role of selectivity have focused on adult health; less attention has been paid to children's birth outcomes outside the U.S. context. Using data from the Etude Longitudinale Française depuis l'Enfance (ELFE), a nationally representative sample of over 18000 births in France in 2011, we investigate the role of immigrant parents' educational selectivity in shaping four birth outcomes: birthweight, low birthweight, prematurity, and being born small for gestational age. Results from linear and logistic regressions confirm a health advantage for children of immigrants compared to natives despite lower parental socioeconomic status, mainly among children of Middle Eastern and North African parents. Immigrant parents' positive pre-migration educational selectivity explains most of this health advantage, predominantly among children with two immigrant parents. Further, mediation analyses indicate that the effect of educational selectivity is partially mediated by parental health behaviors, particularly smoking during pregnancy. Furthermore, analyses suggest that selectivity improves birth outcomes only for children of recent arrivals, with less than five years of residence in France. The beneficial effect of selectivity declines with length of residence, suggesting that a process of "unhealthy assimilation," coupled with the cumulative exposure to health risks and disadvantaged living conditions, may lead to the erosion of the protective effect of immigrant selectivity.
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Affiliation(s)
- Sandra Florian
- Institut National d'Etudes Démographiques (INED), 9 cours des Humanités, CS 50004, 93322, Aubervilliers, Cedex, France.
| | - Mathieu Ichou
- Institut National d'Etudes Démographiques (INED), 9 cours des Humanités, CS 50004, 93322, Aubervilliers, Cedex, France.
| | - Lidia Panico
- Institut National d'Etudes Démographiques (INED), 9 cours des Humanités, CS 50004, 93322, Aubervilliers, Cedex, France.
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22
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Choi S, Toyama J, Brecht ML. Effect of Disclosure on Receiving Spousal Support in Korean Immigrants With Type 2 Diabetes. DIABETES EDUCATOR 2020; 46:559-568. [PMID: 33063629 DOI: 10.1177/0145721720964580] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE The purpose of this study was to investigate factors associated with receiving diabetes spousal support in a sample of Korean immigrants with type 2 diabetes (T2DM) and to test whether disclosure (culture-specific factor) is a significant predictor of spousal support receipt in this group. METHODS A cross-sectional survey was conducted with a convenience sample of 136 US community-dwelling Korean immigrants with T2DM ages 46 to 89 years old. Potential predictors were sociodemographic factors (age, gender, education, years in US), personal characteristics (quality of marriage and depression), diabetes severity (duration of diabetes, A1C, insulin use), diabetes self-management, diabetes worries/concerns (psychological factor), and disclosure of worries (cultural factor). The study used validated survey instruments including Diabetes Care Profile for spousal support received, Summary of Diabetes Self-Care Activities, Problem Area in Diabetes, and Diabetes Distress Disclosure Index. Descriptive statistics, correlations, and hierarchical multivariable linear regression models were conducted. RESULTS Six predictors (education level, years spent in the US, glucose control status, diabetes self-management level, diabetes worries/concerns, and disclosure of diabetes worries) were significantly related to receiving spousal support. At least some college education, less time in the US, better glucose control (lower A1C), poor self-management, more diabetes worries, and more disclosure of diabetes worries/distress were associated with receiving higher level of spousal support. Disclosure was the strongest predictor. CONCLUSION Receiving spousal support for diabetes self-management among Korean immigrants is influenced by 6 factors identified in this study. Disclosing diabetes worries (cultural factor) is most impactful.
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Affiliation(s)
- Sarah Choi
- UCLA School of Nursing, University of California at Los Angeles, Los Angeles, California
| | - Joy Toyama
- Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Mary-Lynn Brecht
- UCLA School of Nursing, University of California at Los Angeles, Los Angeles, California
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Remmert JE, Mosery N, Goodman G, Bangsberg DR, Safren SA, Smit JA, Psaros C. Breastfeeding Practices Among Women Living with HIV in KwaZulu-Natal, South Africa: An Observational Study. Matern Child Health J 2020; 24:127-134. [PMID: 31832911 DOI: 10.1007/s10995-019-02848-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Exclusive breastfeeding (EBF) is the safest infant feeding option in resource-limited settings, though women living with HIV have the lowest rates of EBF. Barriers to EBF in the absences of a formal intervention in women living with HIV in KwaZulu-Natal, where the prevalence of HIV among pregnant women is among the highest in the world, are understudied. Thus, this study sought to describe barriers to EBF and examine differences in social support, disclosure status, mood, and HIV-related stigma among women with different feeding methods. METHODS Women living with HIV enrolled in preventing mother-to-child transmission treatment (n = 156) were interviewed postpartum (M = 13.1 weeks) at a district hospital and self-reported infant feeding method, reasons not breastfeeding (if applicable), and HIV disclosure status. Mood, HIV-related stigma, functional social support, and HIV-related social support were also assessed. RESULTS No participants reported mixed feeding, 30% reported EBF, and 70% reported exclusive formula feeding. Commonly reported reasons for not breastfeeding included fear of HIV transmission to the infant and being away from the infant for extended periods of time. Social support (p = 0.02) and HIV-related social support (p < 0.01) were significantly higher in women who had attempted breastfeeding compared to women who never attempted breastfeeding. DISCUSSION Rates of EBF in this sample are lower than in other recent studies, suggesting this sample experiences multiple barriers to EBF. Healthcare providers should seek to correct misconceptions regarding HIV transmission and breastfeeding practices. Social and logistical support for EBF may be important considerations for future interventions.
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Affiliation(s)
- Jocelyn E Remmert
- Center for Weight, Eating and Lifestyle Science, Drexel University, Philadelphia, USA
| | - Nzwakie Mosery
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Georgia Goodman
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, 1 Bowdoin Square, 7th Floor, Boston, MA, 02114, USA
| | - David R Bangsberg
- School of Public Health, Oregon Health Sciences University - Portland State University, Portland, OR, USA
| | - Steven A Safren
- Department of Psychology, University of Miami, Coral Gables, FL, USA
| | - Jennifer A Smit
- MatCH Research Unit (MRU), Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa.,Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Christina Psaros
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, 1 Bowdoin Square, 7th Floor, Boston, MA, 02114, USA.
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Psaros C, Smit JA, Mosery N, Bennett K, Coleman JN, Bangsberg DR, Safren SA. PMTCT Adherence in Pregnant South African Women: The Role of Depression, Social Support, Stigma, and Structural Barriers to Care. Ann Behav Med 2020; 54:626-636. [PMID: 32128556 PMCID: PMC7459185 DOI: 10.1093/abm/kaaa005] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Depression is a robust predictor of nonadherence to antiretroviral (ARV) therapy, which is essential to prevention of mother-to-child transmission (PMTCT). Women in resource-limited settings face additional barriers to PMTCT adherence. Although structural barriers may be minimized by social support, depression and stigma may impede access to this support. PURPOSE To better understand modifiable factors that contribute to PMTCT adherence and inform intervention development. METHODS We tested an ARV adherence model using data from 200 pregnant women enrolled in PMTCT (median age 28), who completed a third-trimester interview. Adherence scores were created using principal components analysis based on four questions assessing 30-day adherence. We used path analysis to assess (i) depression and stigma as predictors of social support and then (ii) the combined associations of depression, stigma, social support, and structural barriers with adherence. RESULTS Elevated depressive symptoms were directly associated with significantly lower adherence (est = -8.60, 95% confidence interval [-15.02, -2.18], p < .01). Individuals with increased stigma and depression were significantly less likely to utilize social support (p < .01, for both), and higher social support was associated with increased adherence (est = 7.42, 95% confidence interval [2.29, 12.58], p < .01). Structural barriers, defined by income (p = .55) and time spent traveling to clinic (p = .31), did not predict adherence. CONCLUSIONS Depression and social support may play an important role in adherence to PMTCT care. Pregnant women living with HIV with elevated depressive symptoms and high levels of stigma may suffer from low social support. In PMTCT programs, maximizing adherence may require effective identification and treatment of depression and stigma, as well as enhancing social support.
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Affiliation(s)
- Christina Psaros
- Behavioral Medicine Program, Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, MA
| | - Jennifer A Smit
- MatCH Research Unit, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
- School of Pharmacy and Pharmacology, Faculty of Health Sciences, University of Kwazulu-Natal, Durban, South Africa
| | - Nzwakie Mosery
- MatCH Research Unit, Department of Obstetrics and Gynaecology, Faculty of Health Sciences, University of the Witwatersrand, Durban, South Africa
| | - Kara Bennett
- Bennett Statistical Consulting, Inc., Ballston Lake, NY
| | - Jessica N Coleman
- Department of Psychology and Neuroscience, Duke University, Durham, NC
- Duke Global Health Institute, Duke University, Durham, NC
| | - David R Bangsberg
- School of Public Health, Oregon Health Sciences University–Portland State University, Portland, OR
| | - Steven A Safren
- Department of Psychology, University of Miami, Coral Gables, FL
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Zarrabi Jourshari F, Zargham Hajebi M, Saravani S, Eghbali Z. The Effect of Antenatal Physiological Classes on Depression, Anxiety and Social Support in the Last Month of Pregnancy. ACTA ACUST UNITED AC 2020. [DOI: 10.29252/jhc.22.1.65] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Ranjkesh F, Soltanshahi Z, Azh N, Griffiths M. Effect of spouse's participation in childbirth preparation classes in the promotion of social support among pregnant women: A field trial. SOCIAL HEALTH AND BEHAVIOR 2020. [DOI: 10.4103/shb.shb_22_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Sigle W, Goisis A. Mind the gap: The health advantages that accompany parental marriage vary by maternal nativity. Population Studies 2019; 73:369-386. [PMID: 31570057 DOI: 10.1080/00324728.2019.1654613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Using data from the UK Millennium Cohort Study (MCS), we examine whether and how the health benefits of having two biological parents in a continuous marital relationship vary by maternal nativity and ethnicity, comparing UK-born White mothers with: (1) White mothers born in wealthy countries; (2) ethnic minority mothers from South Asia; and (3) ethnic minority mothers born in Africa. Making novel use of classification and regression tree (CART) methods, we examine whether marital status is a uniform marker of economic advantage or better health-related behaviours across the four maternal nativity and ethnic groups. The findings, which indicate that the health-related advantages associated with parental marriage are not uniform across the four nativity and ethnic groups, have implications for future research on family gaps in well-being and the socio-economic determinants of health.
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Affiliation(s)
- Wendy Sigle
- London School of Economics and Political Science
| | - Alice Goisis
- London School of Economics and Political Science.,University College London.,Max Planck Institute for Demographic Research
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Yang FJ. Is childhood migration a mental health risk? Exploring health behaviors and psychosocial resources as pathways using the cross-sectional Canadian Community Health Survey. SOCIAL SCIENCE RESEARCH 2019; 83:102303. [PMID: 31422841 DOI: 10.1016/j.ssresearch.2019.04.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2018] [Revised: 04/07/2019] [Accepted: 04/18/2019] [Indexed: 06/10/2023]
Abstract
Drawing on the Stress Process Model, this study investigates the effect of early migration on health behaviors and psychosocial resources. Further, I consider whether health behaviors and psychosocial processes lead to higher psychological distress for childhood immigrants in adulthood. Cross-sectional data from the Canadian Community Health Survey-Mental Health 2012 (N = 4282) reveal that compared to adult immigrants, childhood immigrants are not only four times more likely to use drugs, but also experience greater interpersonal strain. However, health behaviors such as these contribute less to psychological distress than do psychosocial resources. Additionally, longer duration of migration is found to reduce psychological distress when controlling for age at migration, thus suggesting the migrant health literature should examine age-salient life challenges at the time of migration, instead of continuing to use duration of migration as a proxy for negative acculturation.
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Katzow M, Messito MJ, Mendelsohn AL, Scott MA, Gross RS. The Protective Effect of Prenatal Social Support on Infant Adiposity in the First 18 Months of Life. J Pediatr 2019; 209:77-84. [PMID: 30879731 PMCID: PMC6535345 DOI: 10.1016/j.jpeds.2019.02.017] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2018] [Revised: 01/22/2019] [Accepted: 02/13/2019] [Indexed: 12/28/2022]
Abstract
OBJECTIVE To determine whether prenatal social support was associated with infant adiposity in the first 18 months of life in a low-income, Hispanic sample, known to be at high risk of early child obesity. STUDY DESIGN We performed a longitudinal analysis of 262 low-income, Hispanic mother-infant pairs in the control group of the Starting Early child obesity prevention trial. Prenatal social support was measured using an item from the Maternal Social Support Index. We used multilevel modeling to predict weight-for-length z-score trajectories from birth to age 18 months and logistic regression to predict macrosomia and overweight status at ages 6, 12, and 18 months. RESULTS High prenatal social support was independently associated with lower infant adiposity trajectories from birth to age 18 months (B = -0.40; 95% CI, -0.63 to -0.16), a lower odds of macrosomia (aOR = 0.35; 95% CI, 0.15-0.80), and a lower odds of overweight at ages 12 (aOR = 0.28; 95% CI, 0.10-0.74) and 18 months (aOR = 0.35; 95% CI, 0.14-0.89). Prenatal social support was not significantly associated with overweight status at age 6 months. CONCLUSIONS Prenatal social support may protect against excessive infant adiposity and overweight in low-income, Hispanic families. Further research is needed to elucidate mechanisms underlying these associations and to inform preventive strategies beginning in pregnancy.
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Affiliation(s)
- Michelle Katzow
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, New York, NY.
| | - Mary Jo Messito
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, New York, NY
| | - Alan L Mendelsohn
- Division of Developmental-Behavioral Pediatrics, Department of Pediatrics, New York University School of Medicine, New York, NY
| | - Marc A Scott
- Department of Applied Statistics, Social Science, and Humanities, New York University Steinhardt School of Culture, Education, and Human Development, New York, NY
| | - Rachel S Gross
- Division of General Pediatrics, Department of Pediatrics, New York University School of Medicine, New York, NY
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Dorst MT, Anders SH, Chennupati S, Chen Q, Purcell Jackson G. Health Information Technologies in the Support Systems of Pregnant Women and Their Caregivers: Mixed-Methods Study. J Med Internet Res 2019; 21:e10865. [PMID: 31094327 PMCID: PMC6532338 DOI: 10.2196/10865] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 01/31/2019] [Accepted: 03/30/2019] [Indexed: 11/14/2022] Open
Abstract
Background The quality and quantity of families’ support systems during pregnancy can affect maternal and fetal outcomes. The support systems of expecting families can include many elements, such as family members, friends, and work or community groups. Emerging health information technologies (eg, social media, internet websites, and mobile apps) provide new resources for pregnant families to augment their support systems and to fill information gaps. Objective This study sought to determine the number and nature of the components of the support systems of pregnant women and their caregivers (eg, family members) and the role of health information technologies in these support systems. We examined the differences between pregnant women’s support systems and those of their caregivers and the associations between support system composition and stress levels. Methods We enrolled pregnant women and caregivers from advanced maternal-fetal and group prenatal care clinics. Participants completed surveys assessing sociodemographic characteristics, health literacy, numeracy, and stress levels and were asked to draw a picture of their support system. Support system elements were extracted from drawings, categorized by type (ie, individual persons, groups, technologies, and other) and summarized for pregnant women and caregivers. Participant characteristics and support system elements were compared using the Pearson chi-square test for categorical variables and Wilcoxon ranked sum test for continuous variables. Associations between support system characteristics and stress levels were measured with Spearman correlation coefficient. Results The study enrolled 100 participants: 71 pregnant women and 29 caregivers. The support systems of pregnant women were significantly larger than those of caregivers—an average of 7.4 components for pregnant women and 5.4 components for caregivers (P=.003). For all participants, the most commonly reported support system elements were individual persons (408/680, 60.0%), followed by people groups (132/680, 19.4%), technologies (112/680, 16.5%), and other resources (28/680, 4.1%). Pregnant women’s and caregivers’ technology preferences within their support systems differed—pregnant women more often identified informational websites, apps, and social media as parts of their support systems, whereas caregivers more frequently reported general internet search engines. The size and components of these support systems were not associated with levels of stress. Conclusions This study is one of the first demonstrating that technologies comprise a substantial portion of the support systems of pregnant women and their caregivers. Pregnant women more frequently reported specific medical information websites as part of their support system, whereas caregivers more often reported general internet search engines. Although social support is important for maternal and fetal health outcomes, no associations among stress, support system size, and support system components were found in this study. As health information technologies continue to evolve and their adoption increases, their role in patient and caregiver support systems and their effects should be further explored.
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Affiliation(s)
| | - Shilo H Anders
- Vanderbilt University Medical Center, Nashville, TN, United States
| | | | - Qingxia Chen
- Vanderbilt University Medical Center, Nashville, TN, United States
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Non AL, León-Pérez G, Glass H, Kelly E, Garrison NA. Stress across generations: A qualitative study of stress, coping, and caregiving among Mexican immigrant mothers. ETHNICITY & HEALTH 2019; 24:378-394. [PMID: 28669238 DOI: 10.1080/13557858.2017.1346184] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 05/17/2017] [Indexed: 06/07/2023]
Abstract
OBJECTIVE Hispanic immigrants represent the largest and fastest growing ethnic minority within the US, justifying increased attention to identify factors that influence declining immigrant health across generations. This study investigates the range of psychosocial stress exposures and coping mechanisms of Mexican immigrant mothers, and implications for the health of their US-born children. DESIGN We conducted 10 focus groups with 1st generation Mexican-born immigrant mothers (n = 32 women) in Nashville, TN, in the summer of 2014. Focus groups elicited challenges and benefits of life as an immigrant mother. Data were analyzed using a modified grounded theory approach. RESULTS We identified four themes that indicate how maternal stressors could impact children's health: (1) work-family tradeoff, (2) limited freedom/mobility, (3) reduction of social networks, and (4) transmission of anxiety and fears to children. Women in our study also engage in a range of coping mechanisms, including the creation of new social networks, seeking support in religion, and seeking help from community resources. CONCLUSION These results highlight the importance of developing new questionnaires to elicit stress exposures for Mexican immigrant mothers. Findings also suggest the value of intervention strategies and social policies that would ultimately improve maternal and child health in this marginalized population.
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Affiliation(s)
- Amy L Non
- a Department of Anthropology , University of California San Diego , La Jolla , CA , USA
- b Department of Anthropology , Vanderbilt University , Nashville , TN , USA
| | | | - Holly Glass
- b Department of Anthropology , Vanderbilt University , Nashville , TN , USA
| | - Emma Kelly
- b Department of Anthropology , Vanderbilt University , Nashville , TN , USA
| | - Nanibaa' A Garrison
- d Treuman Katz Center for Pediatric Bioethics , Seattle Children's Hospital and Research Institute , Seattle , WA , USA
- e Department of Pediatrics, Division of Bioethics , University of Washington , Seattle , WA , USA
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Palmer R, Layte R, Kearney J. The maternal health behaviours of non-Irish nationals during pregnancy and the effect of time living in Ireland. Public Health 2019; 170:95-102. [PMID: 30981154 DOI: 10.1016/j.puhe.2019.02.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2018] [Revised: 01/02/2019] [Accepted: 02/22/2019] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Maternal health behaviours (MHBs) can influence pregnancy outcomes. Despite efforts internationally to encourage positive MHBs, women often fail to comply with pregnancy guidelines. International studies show differences in MHBs between nationalities and an effect of time spent in the host country. There is limited Irish data in this area, with no previous research relating to the effect of time in Ireland. STUDY DESIGN This study is a cross-sectional analysis of the Growing Up in Ireland infant cohort, a nationally representative longitudinal study. METHODS Examination of the MHBs of non-Irish nationals during pregnancy and the effect of time in Ireland on the said behaviours. RESULTS An association was found between time spent in Ireland and increased alcohol consumption prevalence. Those living in Ireland for ≤5 years were 60.8% less likely to consume alcohol during pregnancy (0.000) and 29.3% less likely to take folic acid before conception (0.021). Those who smoked during pregnancy were 98.6% more likely to consume alcohol (0.000) and those who consumed alcohol were 95.2% more likely to smoke during pregnancy (0.000). CONCLUSIONS The results demonstrate differences in MHBs and the influence of time living in Ireland. These findings are of relevance for policy and intervention planning to optimise pregnancy outcomes among non-nationals.
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Affiliation(s)
- R Palmer
- School of Biological Sciences, Technological University for Dublin, Dublin 2, Ireland; School of Medicine, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland.
| | - R Layte
- School of Medicine, Trinity College Dublin, The University of Dublin, Dublin 2, Ireland; Economic and Social Research Institute, Dublin 2, Ireland
| | - J Kearney
- School of Biological Sciences, Technological University for Dublin, Dublin 2, Ireland
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Maleki-Saghooni N, Amel Barez M, Karimi FZ. Investigation of the relationship between social support and breastfeeding self-efficacy in primiparous breastfeeding mothers. J Matern Fetal Neonatal Med 2019; 33:3097-3102. [PMID: 30632820 DOI: 10.1080/14767058.2019.1568986] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Background: Breastfeeding is one of the public health priorities in the world. Reduction and early discontinuation of breastfeeding have many harmful effects on maternal, child, and community health. Various factors affect breastfeeding and its sustainability including breastfeeding self-efficacy (BSE) and social support. Since breastfeeding is a behavior that needs knowledge, skills, support, and self-confidence for the mother.Objective: to investigate the relationship between social support and self-efficacy in primiparous breastfeeding women referring to Mashhad health centers. This cross-sectional study was conducted on 300 primiparous breastfeeding mothers with less than 6 months infants referring to healthcare centers of Mashhad, Iran.Materials and methods: The study population was selected through a multistage random sampling method. Data gathering was done by demographic form, Breastfeeding Self-efficacy Scale and perceived social support questionnaire. Data were analyzed using descriptive and inferential statistics, through SPSS version 16 (SPSS Inc., Chicago, IL).Results: Mean score of BSE and social support was 130.89 ± 13.60 and 67.36 ± 5.52, respectively. Stepwise linear regression analysis was used to examine the relationship between social support and BSE precisely. The results showed that social support had a significant effect on BSE (p < .001, β = 0.35, t = 6.44).Conclusions: According to the present study, social support was significantly related to the BSE. Therefore, those with more social support had higher rates of BSE. Therefore, receiving support from the woman's social network members in form of participation and encouragement, during the breastfeeding is necessary.
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Affiliation(s)
- Nahid Maleki-Saghooni
- Students' Research Committee, School of Nursing and Midwifery, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Malikeh Amel Barez
- Department of Midwifery, Mashhad Medical Sciences Branch, Islamic Azad University, Mashhad, Iran
| | - Fatemeh Zahra Karimi
- Nursing and Midwifery Care Research Center, Mashhad University of Medical Sciences, Mashhad, Iran
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Pollack AZ, Rivers K, Ahrens KA. Parity associated with telomere length among US reproductive age women. Hum Reprod 2019; 33:736-744. [PMID: 29452389 DOI: 10.1093/humrep/dey024] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 01/24/2018] [Indexed: 11/14/2022] Open
Abstract
STUDY QUESTION Is telomere length related to parity among a nationally representative sample of US reproductive age women? SUMMARY ANSWER History of live birth was associated with shorter telomere length. WHAT IS KNOWN ALREADY Shorter telomeres have been linked with a range of chronic health conditions and mortality and parity has been associated with health indicators. However, there is a lack of research on how parity relates to telomere length. STUDY DESIGN, SIZE, DURATION This nationally representative, cross-sectional study included 1954 women from the National Health and Nutrition Examination Survey, 1999-2002, the only survey period which includes measurement of telomere length. PARTICIPANTS/MATERIALS, SETTING, METHODS Women aged 20-44 were included. Parity, defined as number of previous live births, was ascertained by questionnaire. Leukocyte telomere length was measured by polymerase chain reaction and reported as a ratio in relation to standard reference DNA (T/S ratio). The relationship between leukocyte T/S ratio and parity was examined using survey weighted linear regression. Models were adjusted for race/ethnicity, age, BMI, income-to-poverty ratio, education, early age at menarche and smoking status. MAIN RESULTS AND THE ROLE OF CHANCE Among reproductive age women in the US, the adjusted mean leukocyte T/S ratio was 4.2% (95% CI: 0.9, 7.3) shorter in parous compared with nulliparous women. Parity was associated with 116 fewer base pairs (95% CI: 26, 204) on average, using estimated coefficients from the adjusted linear regression models and mean covariate values. LIMITATIONS REASONS FOR CAUTION This study was cross-sectional and therefore was unable to establish temporality. The dataset lacked information on social factors, stress and fertility status, which may help explain these findings. Only two previous studies have examined this question and our findings should be interpreted with caution. WIDER IMPLICATIONS OF THE FINDINGS These findings in a nationally representative sample of US reproductive age women suggest that history of live birth may be associated with accelerated cellular aging. The magnitude of the observed association was greater than that of the impact of smoking or obesity on telomere length, suggesting that parity may have an independent influence on cellular aging and warrant further study. STUDY FUNDING/COMPETING INTEREST(S) The study was funded in part by the Undergraduate Research Scholars Program at George Mason University. The authors have no conflicts of interest. TRIAL REGISTRATION NUMBER NA.
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Affiliation(s)
- A Z Pollack
- Department of Global and Community Health, College of Health and Human Services, George Mason University, 4400 University Drive MS5B7, Fairfax, VA 22030, USA
| | - K Rivers
- Department of Global and Community Health, College of Health and Human Services, George Mason University, 4400 University Drive MS5B7, Fairfax, VA 22030, USA
| | - K A Ahrens
- Office of Population Affairs, Office of the Assistant Secretary for Health, Department of Health and Human Services, 1101 Wootton Parkway, Suite 700, Rockville, MD 20852, USA
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Somers JA, Jewell SL, Hanna Ibrahim M, Luecken LJ. Infants' Biological Sensitivity to the Effects of Maternal Social Support: Evidence Among Mexican American Families. INFANCY 2018; 24:275-296. [PMID: 32677201 DOI: 10.1111/infa.12266] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 08/01/2018] [Accepted: 09/01/2018] [Indexed: 01/17/2023]
Abstract
The identification of infants who are most susceptible to both negative and positive social environments is critical for understanding early behavioral development. This study longitudinally assessed the interactive effects of infant vagal tone (respiratory sinus arrhythmia; RSA) and maternal social support on behavioral problems and competence among 322 low-income Mexican American mother-infant dyads (infants: 54.1% female) and explored sex differences. Infant RSA was calculated from resting HR data at 6 weeks of age. Mothers reported on general social support, partner support, and family support at 6 months, and infant behavioral problems and competence at 1 year. Two-way interactions (RSA × support source) were evaluated to predict behavioral problems and competence, adjusting for covariates. Results indicated higher competence among infants with lower RSA whose mothers reported higher general support or higher partner support. Interactive effects on behavior problems of RSA with maternal partner or family support were only found for female infants: Girls with higher RSA showed more behavior problems when mothers reported low support, but fewer problem levels in the context of high support. Our results suggest that infant RSA is an important moderator of the effects of the early social environment on early development.
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Coker ES, Gunier R, Huen K, Holland N, Eskenazi B. DNA methylation and socioeconomic status in a Mexican-American birth cohort. Clin Epigenetics 2018; 10:61. [PMID: 29760810 PMCID: PMC5941629 DOI: 10.1186/s13148-018-0494-z] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 04/25/2018] [Indexed: 11/25/2022] Open
Abstract
Background Maternal social environmental stressors during pregnancy are associated with adverse birth and child developmental outcomes, and epigenetics has been proposed as a possible mechanism for such relationships. Methods In a Mexican-American birth cohort of 241 maternal-infant pairs, cord blood samples were measured for repeat element DNA methylation (LINE-1 and Alu). Linear mixed effects regression was used to model associations between indicators of the social environment (low household income and education, neighborhood-level characteristics) and repeat element methylation. Results from a dietary questionnaire were also used to assess the interaction between maternal diet quality and the social environment on markers of repeat element DNA methylation. Results After adjusting for confounders, living in the most impoverished neighborhoods was associated with higher cord blood LINE-1 methylation (β = 0.78, 95%CI 0.06, 1.50, p = 0.03). No other neighborhood-, household-, or individual-level socioeconomic indicators were significantly associated with repeat element methylation. We observed a statistical trend showing that positive association between neighborhood poverty and LINE-1 methylation was strongest in cord blood of infants whose mothers reported better diet quality during pregnancy (pinteraction = 0.12). Conclusion Our findings indicate a small yet unexpected positive association between neighborhood-level poverty during pregnancy and methylation of repetitive element DNA in infant cord blood and that this association is possibly modified by diet quality during pregnancy. However, our null findings for other adverse SES indicators do not provide strong evidence for an adverse association between early-life socioeconomic environment and repeat element DNA methylation in infants.
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Affiliation(s)
- Eric S. Coker
- Center for Environmental Research and Children’s Health (CERCH), School of Public Health, University of California, Berkeley, CA USA
- Berkeley, USA
| | - Robert Gunier
- Center for Environmental Research and Children’s Health (CERCH), School of Public Health, University of California, Berkeley, CA USA
- Berkeley, USA
| | - Karen Huen
- Center for Environmental Research and Children’s Health (CERCH), School of Public Health, University of California, Berkeley, CA USA
- Richmond, USA
| | - Nina Holland
- Center for Environmental Research and Children’s Health (CERCH), School of Public Health, University of California, Berkeley, CA USA
- Richmond, USA
| | - Brenda Eskenazi
- Center for Environmental Research and Children’s Health (CERCH), School of Public Health, University of California, Berkeley, CA USA
- Berkeley, USA
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Maheri A, Sadeghi R, Shojaeizadeh D, Tol A, Yaseri M, Rohban A. Depression, Anxiety, and Perceived Social Support among Adults with Beta-Thalassemia Major: Cross-Sectional Study. Korean J Fam Med 2018; 39:101-107. [PMID: 29629042 PMCID: PMC5876044 DOI: 10.4082/kjfm.2018.39.2.101] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Revised: 04/22/2017] [Accepted: 05/08/2017] [Indexed: 01/25/2023] Open
Abstract
Background Considering the high prevalence of depression and anxiety among thalassemia patients and the role of social support in preventing mental disorders, this study aimed to determine prevalence of depression, anxiety, and perceived social support (PSS) among adults with beta-thalassemia major. Methods This cross-sectional study was performed with 389 adults with beta-thalassemia major. Data were collected via a questionnaire consisting of three parts: demographic and medical information, the Persian version of the hospital anxiety and depression scale, and the Persian version of the Multidimensional Scale of Perceived Social Support. Data were analyzed using IBM SPSS ver. 23.0 (IBM Corp., Armonk, NY, USA) through analytical statistics (independent-samples t-test, one-way analysis of variance, Pearson correlation coefficient, and multilevel linear regression), and the results less than 0.05 were considered to be significant. Results The mean scores of depression, anxiety, and PSS of patients were 7.42±3.17, 7.47±4.35, and 41.8±8.64, respectively. Of 389 patients, 19.8% had depression and 23.7% had an anxiety disorder. Relationships of depression and anxiety with age, the level of education, job, and family income were statistically significant, as were those of PSS with age, thalassemia center, family income, job, and the level of education. PSS from family, friends, and significant others were the significant predictive factors of depression and anxiety among adult patients with beta-thalassemia major. Conclusion Considering the PSS as a factor influencing the reduction in depression and anxiety in thalassemia patients, social support from the social networks (spouse, family members, friends, and healthcare workers) should be integrated with interventions that are designed to improve the mental and physical health of thalassemia patients.
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Affiliation(s)
- Aghbabak Maheri
- Reproductive Health Research Center, Department of Public Health, School of Health, Urmia University of Medical Sciences, Urmia, Iran
| | - Roya Sadeghi
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Davoud Shojaeizadeh
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Azar Tol
- Department of Health Education and Promotion, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Mehdi Yaseri
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
| | - Alireza Rohban
- Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran
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Hopkins AL, Yeoman M, Ritenbaugh C. Healthy foods prepared at home: Diet and support as protective strategies during pregnancy for Hispanic women. Ecol Food Nutr 2018; 57:140-161. [PMID: 29323534 DOI: 10.1080/03670244.2018.1423971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Birth outcomes tend to be better among Hispanics than among other ethnic groups, even when matched for poverty and education, and foreign-born Latinas compared to their US-born counterparts. These patterns suggest that sociocultural factors exhibited by recent immigrants have the potential to protect birth outcomes against the instability of minority and low socioeconomic status. To discover potential sociocultural factors, a pilot qualitative study was carried out in Tucson, Arizona, with 18 Hispanic mothers. The two most prevalent factors reported were (1) a healthy diet prepared at home from minimally processed ingredients, and (2) constant and comprehensive social support. When comparing responses related to diet by interview language preference, a proxy for acculturation, there was very little difference between participants who interviewed in Spanish and those who interviewed in English. This result may be explained by greater maternal social support and higher education levels among those who interviewed in English.
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Affiliation(s)
- Allison L Hopkins
- a Department of Anthropology , Texas A&M University, College Station , Texas , USA
| | - Michelle Yeoman
- b Departments of Veterinary Integrative Biosciences and Anthropology , Texas A&M University, College Station , Texas , USA
| | - Cheryl Ritenbaugh
- c Department of Family and Community Medicine , University of Arizona, Tucson , Arizona , USA
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Jewell SL, Letham-Hamlett K, Hanna Ibrahim M, Luecken LJ, MacKinnon DP. Family Support and Family Negativity as Mediators of the Relation between Acculturation and Postpartum Weight in Low-Income Mexican-Origin Women. Ann Behav Med 2017; 51:856-867. [PMID: 28470505 PMCID: PMC5670022 DOI: 10.1007/s12160-017-9909-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Obesity presents a significant health concern among low-income, ethnic minority women of childbearing age. PURPOSE The study investigated the influence of maternal acculturation, family negativity, and family support on postpartum weight loss among low-income Mexican-origin women. METHODS Low-income Mexican-origin women (N=322; 14% born in the U.S.) were recruited from a prenatal clinic in an urban area of the Southwest U.S. Acculturation was assessed during a prenatal home visit (26-38 weeks gestation), and post-birth family support and general family negativity were assessed at 6 weeks postpartum. Objective maternal weight measures were obtained at five time points across the first postpartum year. RESULTS Higher acculturation predicted higher family support and family negativity. Higher family support predicted decreasing weight across the first postpartum year, and higher family negativity predicted higher weight at 6 weeks postpartum and increasing weight across the first postpartum year. In combination, family negativity and support mediated the impact of acculturation on postpartum weight gain. CONCLUSIONS Cultural and family-related factors play a significant role in postpartum weight gain and loss for low-income Mexican-origin women.
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Affiliation(s)
- Shannon L Jewell
- Department of Psychology, Arizona State University, P.O. Box 871104, Tempe, AZ, 85287-1104, USA
| | - Kirsten Letham-Hamlett
- Department of Psychology, Arizona State University, P.O. Box 871104, Tempe, AZ, 85287-1104, USA
| | - Mariam Hanna Ibrahim
- Department of Psychology, Arizona State University, P.O. Box 871104, Tempe, AZ, 85287-1104, USA
| | - Linda J Luecken
- Department of Psychology, Arizona State University, P.O. Box 871104, Tempe, AZ, 85287-1104, USA.
| | - David P MacKinnon
- Department of Psychology, Arizona State University, P.O. Box 871104, Tempe, AZ, 85287-1104, USA
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Newtonraj A, Kaur M, Gupta M, Kumar R. Level, causes, and risk factors of stillbirth: a population-based case control study from Chandigarh, India. BMC Pregnancy Childbirth 2017; 17:371. [PMID: 29132325 PMCID: PMC5684767 DOI: 10.1186/s12884-017-1557-4] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 11/02/2017] [Indexed: 12/13/2022] Open
Abstract
Background Globally, India ranks first in the absolute number of stillbirths. Hence, the level, causes, and risk factors of stillbirths were estimated to facilitate designing of prevention strategy. Methods Capture and recapture method was used to identify 301 stillbirths from 1st July 2013 to 31st August 2014 in Chandigarh Union Territory of India. Verbal autopsies (n = 181) were done at household level to identify causes of stillbirths. Risk factors were determined using case-control approach. Women who had a stillbirth in the past 3 months were enrolled as cases (n = 181) and those who had live-birth in same neighbourhood were included as controls (n = 181). Statistical differences in the distribution of characteristics of cases and controls were tested by t test and chi square test respectively for quantitative and categorical variables. In logistic regression models adjusted odds ratios (aOR) and 95% confidence intervals (CIs) were estimated for various risk factors. Results Stillbirth rate was estimated to be 16/1000 birth. Antepartum causes were more common (68%) than intrapartum causes (32%). Among maternal conditions, hypertension (18.2%) and chorio-amnionitis (13.8%), and among foetal conditions, growth restriction (19.9%) and congenital anomalies (18.8%) were the leading causes. In about half of the stillbirths foetal (48%) and maternal (44.7%) causes were unidentifiable. Risk factors of stillbirths were: higher maternal age (aOR 1.1, 95%CI 1.0–1.2), vaginal delivery (aOR 8.1, 95%CI 2.6–26), induced labour (aOR 2.6, 95%CI 1.5–4.5), green or light brown liquor (aOR 2.0, 95%CI 1.1–3.8), preterm delivery (aOR 6.4, 95%CI 3.7–11) and smaller household size (aOR 1.2, 95% CI 1.1–1.3). Conclusions Stillbirth rate was high in Chandigarh Union Territory of India. Major causes and risk factors amenable to interventions were infections, hypertension, congenital malformations, foetal growth restriction, pre-maturity and household size. Therefore, better maternity ante-natal and intra-natal care is required to achieve a single digit stillbirth rate. Electronic supplementary material The online version of this article (10.1186/s12884-017-1557-4) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ariarathinam Newtonraj
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Manmeet Kaur
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India.
| | - Madhu Gupta
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
| | - Rajesh Kumar
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, 160 012, India
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Cheng ER, Taveras EM, Hawkins SS. Paternal Acculturation and Maternal Health Behaviors: Influence of Father's Ethnicity and Place of Birth. J Womens Health (Larchmt) 2017; 27:724-732. [PMID: 29087779 DOI: 10.1089/jwh.2017.6439] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVES Studies show disparities in maternal health behaviors according to acculturation, but whether paternal factors influence these patterns is unknown. We assessed the relationships between fathers' ethnicity and place of birth with maternal smoking during pregnancy and breastfeeding initiation overall and for 30 major ethnic groups. MATERIALS AND METHODS Data were from the Standard Certificate of Live Births on 1,053,096 births in Massachusetts between 1996 through 2010. We examined the concordance of maternal and paternal ethnicity and place of birth across three categories (United States-born white, United States-born Other ethnicity, and foreign-born), and then in relation to maternal smoking during pregnancy and breastfeeding initiation. Multivariable models adjusted for maternal age, marital status, education, plurality, parity, prenatal care, delivery source of payment, and year of birth. RESULTS United States-born white mothers were less likely to smoke during pregnancy (adjusted odds ratio [AOR] 0.66; 95% confidence interval [CI]: 0.60, 0.73) and more likely to initiate breastfeeding (AOR 1.56; 95% CI: 1.46, 1.66) if their partners were foreign-born. In contrast, foreign-born mothers whose partners were United States-born of Other ethnicity or United States-born white had a 1.65-5.12 higher odds of smoking during pregnancy and were 26%-41% less likely (AORs 0.59-0.74) to initiate breastfeeding than if their partners were also foreign-born. Results were consistent across most racial/ethnic groups. CONCLUSIONS Our findings offer new insight into the social pathways by which acculturation impacts maternal health behaviors and add to growing evidence that fathers are valuable to maternal health. Future efforts to understand how acculturation results in poorer maternal health behaviors should account for paternal influences.
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Affiliation(s)
- Erika R Cheng
- 1 Section of Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine , Indianapolis, Indiana
| | - Elsie M Taveras
- 2 Division of General Academic Pediatrics, Department of Pediatrics, Massachusetts General Hospital for Children , Boston, Massachusetts.,3 Department of Nutrition, Harvard T.H. Chan School of Public Health , Boston, Massachusetts
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Radzilani-Makatu M. Episodic emotions of Tshivenda cultural community mothers towards their adolescent children’s pregnancies. JOURNAL OF PSYCHOLOGY IN AFRICA 2017. [DOI: 10.1080/14330237.2017.1375197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Alfonso VH, von Ehrenstein O, Bandoli G, Ritz B. The Influence of Pre-natal Supplement Initiation on Preterm Birth Among Majority Hispanic Women in Los Angeles County: The Role of Nativity. Matern Child Health J 2017; 20:1861-8. [PMID: 27060911 DOI: 10.1007/s10995-016-1990-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Objectives Despite being encouraged to take pre-natal supplements, suboptimal micronutrient intake is common in pregnancy, especially among Hispanic women. In this study, we assessed whether initiation and timing of pre-natal vitamin use influences the risk of preterm birth. Methods Women who gave birth to singletons in 2003 in Los Angeles County, California, were enrolled into a population-based case-control study. Focusing on non-Hispanic white and Hispanic women, associations between timing of pre-natal supplement use and preterm birth were assessed using logistic regression. Results Among Hispanic mothers, the odds of preterm birth increased the later a woman initiated pre-natal supplement use in pregnancy. The magnitude of this association was larger in US-born compared to foreign-born Hispanic women. Conclusions These findings suggest that nativity may modify the relationship between pre-natal supplement use and preterm birth possibly due to underlying differences in diet composition of Hispanic women by place of birth.
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Affiliation(s)
- Vivian H Alfonso
- Department of Epidemiology, University of California, Los Angeles, Fielding School of Public Health, Box 951772, Los Angeles, CA, 90095, USA.
| | - Ondine von Ehrenstein
- Department of Community Health Sciences, University of California, Los Angeles, Fielding School of Public Health, Box 951772, Los Angeles, CA, 90095, USA
| | - Gretchen Bandoli
- Department of Epidemiology, University of California, Los Angeles, Fielding School of Public Health, Box 951772, Los Angeles, CA, 90095, USA
| | - Beate Ritz
- Department of Epidemiology, University of California, Los Angeles, Fielding School of Public Health, Box 951772, Los Angeles, CA, 90095, USA
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The Latina Birth Weight Paradox: the Role of Subjective Social Status. J Racial Ethn Health Disparities 2017; 5:747-757. [DOI: 10.1007/s40615-017-0419-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2017] [Revised: 06/27/2017] [Accepted: 07/17/2017] [Indexed: 01/08/2023]
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Preciado A, D'Anna-Hernandez K. Acculturative stress is associated with trajectory of anxiety symptoms during pregnancy in Mexican-American women. J Anxiety Disord 2017; 48:28-35. [PMID: 27780654 PMCID: PMC5737703 DOI: 10.1016/j.janxdis.2016.10.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 10/05/2016] [Accepted: 10/05/2016] [Indexed: 02/01/2023]
Abstract
Over half of pregnant women report anxiety symptoms and these symptoms may be precipitated by stressful experiences. Anxiety rates may be higher in Mexican-American women who experience sociocultural stressors, such as acculturation, acculturative stress and discrimination. However, the role of such stressors on the trajectory of anxiety symptoms across pregnancy is not yet known. Mexican-American women (n=151) completed surveys across pregnancy about acculturation, acculturative stress, perceived discrimination, and state anxiety. Multilevel modeling found that acculturation (Anglo orientation, b=0.050, SE=0.379, t (137.561)=0.134, p=0.894; Mexican orientation, b=0.775, SE=0.692, t (133.424)=1.121, p=0.264) and perceived discrimination (b=-1.259, SE=0.921, t (137.489)=-1.367, p=0.174) were not associated with the trajectory of anxiety symptoms. However, acculturative stress, even while controlling for perceived stress, was associated with high levels of anxiety symptoms that were elevated early in pregnancy (b=-0.045, SE=0.022, t (135.749)=-2, p=0.047). This work highlights the unique role of acculturative stress in risk for prenatal anxiety in early pregnancy.
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Affiliation(s)
- Andrea Preciado
- Department of Psychology, California State University San Marcos, United States.
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Artieta-Pinedo I, Paz-Pascual C, Grandes G, Espinosa M. Framework for the establishment of a feasible, tailored and effective perinatal education programme. BMC Pregnancy Childbirth 2017; 17:58. [PMID: 28178926 PMCID: PMC5299744 DOI: 10.1186/s12884-017-1234-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2015] [Accepted: 01/21/2017] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Antenatal education needs to be renewed and adapted to the needs of women. OBJECTIVES to assess women needs, identify factors that influence the desired outcomes, and propose a framework for developing new perinatal education based on the guidance published by the UK Medical Research Council for the development and evaluation of complex interventions in primary care. METHODS For this study: (a) four focus group sessions were held from October to November 2010 in Bizkaia (Spain) with 30 women exploring their needs during pregnancy and postpartum; (b) two literature reviews were conducted on women's needs at these times and theoretical models of healthcare education; and (c) seven discussion and consensus sessions were run with a group of experts composed of midwifes, gynaecologists, paediatricians, and paediatric and postpartum nurses. RESULTS Various areas for improvement were identified: needs assessment of each woman/family, consideration of pregnancy and childbirth as normal physiological processes, participation of fathers, establishment of social networks, continuity of postpartum care, better access to and training for midwives, and more flexible format and contents for the programme. We propose a woman-focused framework that includes three exploratory interviews during pregnancy, personalized interventions coordinated between professionals, empowerment to choose the type of birth, and postpartum activities. CONCLUSION New perinatal education should be on-going and focused on each woman. It is necessary to assess the feasibility of implementing this type of programme, depending on the context, professionals' readiness for change and characteristics of the proposed interventions. Then, its effectiveness and sustainability must be assessed.
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Affiliation(s)
- Isabel Artieta-Pinedo
- Primary Care Midwife Zuazo Health Centre, Barakaldo, (Bizkaia); and Associate Professor of the School of Nursing, University of the Basque Country, Leioa, Bizkaia, Spain.
- Primary Care Research Unit of Bizkaia, Centro de Salud de Deusto, 4ª planta, 48014, Bilbao, Bizkaia, Spain.
| | - Carmen Paz-Pascual
- Primary Care Midwife in Sestao Health Centre, Bizkaia; and Lecturer in the Midwifery Training Unit of the Basque Country, Bilbao, Bizkaia, Spain
| | - Gonzalo Grandes
- Primary Care Research Unit of Bizkaia, Centro de Salud de Deusto, 4ª planta, 48014, Bilbao, Bizkaia, Spain
| | - Maite Espinosa
- Primary Care Research Unit of Bizkaia, Centro de Salud de Deusto, 4ª planta, 48014, Bilbao, Bizkaia, Spain
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Paz Pascual C, Artieta Pinedo I, Grandes G, Espinosa Cifuentes M, Gaminde Inda I, Payo Gordon J. [Perceived needs of women regarding maternity. Qualitative study to redesign maternal education]. Aten Primaria 2016; 48:657-664. [PMID: 27039971 PMCID: PMC6875922 DOI: 10.1016/j.aprim.2015.12.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Revised: 12/07/2015] [Accepted: 12/09/2015] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES To assess women's perceptions of their needs during the process of becoming a mother and identify what they want from maternal education. DESIGN Qualitative study with focus groups. SETTING Bizkaia health region, Basque Health Service (Osakidetza), Spain. PARTICIPANTS Thirty one women were recruited consecutively by midwives at six Osakidetza health centres. METHODS Four sessions were held from September to November 2010 in Bizkaia (Spain), the four groups being stratified by socioeconomic status and stage of the process (pregnancy vs. postnatal period). To collate the information related to the various topics discussed, we used manifest content analysis that was facilitated by use of ATLAS.ti software. RESULTS The focus of the women worries changes over time. In early pregnancy, women's main concern was for "everything to go well". As the pregnancy progressed, they needed more emotional support and wanted to feel confident and be self-reliant to face their fears of the birth and care for their child. They needed greater accompaniment in the puerperium and less pressure concerning breastfeeding. They also wanted an extended programme of perinatal rather than just antenatal education, which was more participatory and flexible and greater participation of their partner. CONCLUSION Women have the same social and family networks needs, regardless of cultural differences between Anglo-Saxon and Southern European countries. We recommend an perinatal education to empower women to manage their own health and that of their family and link the health system with other networks of personal and social support for women.
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Affiliation(s)
- Carmen Paz Pascual
- Servicio Vasco de Salud/Osakidetza, Unidad Docente de Matronas del País Vasco, Centro de Salud de Markonzaga , OSI Barakaldo Sestao , Bizkaia, España.
| | - Isabel Artieta Pinedo
- Servicio Vasco de Salud/Osakidetza, Escuela Universitaria de Enfermería de la EHU-UPV, Centro de Salud de Zuazo , OSI Barakaldo Sestao , Bizkaia, España
| | - Gonzalo Grandes
- Medicina Familiar y Comunitaria, Medicina Preventiva y Salud Pública, Unidad de Investigación de Atención Primaria, Servicio Vasco de Salud/Osakidetza, Bilbao, Bizkaia, España
| | - Maite Espinosa Cifuentes
- Unidad de Investigación de Atención Primaria, Servicio Vasco de Salud/Osakidetza, Bilbao, Bizkaia, España
| | - Idoia Gaminde Inda
- Unidad de Evaluación, Servicio de Investigación, Innovación y Formación Sanitaria, Departamento de Salud, Gobierno de Navarra, Pamplona, Navarra, España
| | - Janire Payo Gordon
- Unidad de Investigación de Atención Primaria, Servicio Vasco de Salud/Osakidetza, Bilbao, Bizkaia, España
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Miller TL, Jacobson DL, Somarriba G, Neri D, Kurtz-Vraney J, Graham P, Gillman MW, Landy DC, Siminski S, Butler L, Rich KC, Hendricks K, Ludwig DA. A multicenter study of diet quality on birth weight and gestational age in infants of HIV-infected women. MATERNAL AND CHILD NUTRITION 2016; 13. [PMID: 27863014 DOI: 10.1111/mcn.12378] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/06/2016] [Revised: 07/21/2016] [Accepted: 08/12/2016] [Indexed: 11/30/2022]
Abstract
We determined factors associated with diet quality and assessed the relationship between diet quality, birth weight, and gestational age in a prospective national multicenter cohort study. We evaluated diet quality with the Healthy Eating Index (HEI, scale 0-100) in the third trimester of pregnancy with three 24-hr multiple-pass dietary recalls in 266 HIV+ women enrolled in the Pediatric HIV/AIDS Cohort Study. Covariates included demographics, food security, pre-pregnancy body mass index, HIV disease severity, substance use, and antiretroviral exposures. A two-stage multivariate process using classification and regression trees (CART) followed by multiple regression described HEI tendencies, controlled possible confounding effects, and examined the association of HEI with birth weight and gestational age. To assess the stability of the CART solution, both the HEI 2005 and 2010 were evaluated. The mean HEI scores were 56.1 and 47.5 for the 2005 and 2010 HEI, respectively. The first-stage CART analysis examined the relationship between HEI and covariates. Non-US born versus US-born mothers had higher HEI scores (15-point difference, R2 = 0.28). There was a secondary partition due to alcohol/cigarette/illicit drug usage (3.5-point difference, R2 = 0.03) among US-born women. For the second-stage CART adjusted multiple regression, birth weight z-score was positively related to HEI 2005 and 2010 (partial r's > 0.13, P's ≤ 0.0398), but not gestational age (r = 0.00). We conclude that diet quality among HIV+ women is associated with higher birth weight. Despite the influence of a large cultural effect and poor prenatal behaviors, interventions to improve diet in HIV+ women may help to increase birth weight.
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Affiliation(s)
- Tracie L Miller
- Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Denise L Jacobson
- Center for Biostatistics in AIDS Research, Harvard School of Public Health, Boston, Massachusetts, USA
| | - Gabriel Somarriba
- Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Daniela Neri
- Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Joy Kurtz-Vraney
- Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Patricia Graham
- Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
| | - Matthew W Gillman
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, Massachusetts, USA
| | - David C Landy
- Department of Orthopedic Surgery, University of Chicago Medical Center, Chicago, Illinois, USA
| | - Suzanne Siminski
- Amherst Office, Frontier Science Technology Research Foundation INC, New York, USA
| | - Laurie Butler
- Amherst Office, Frontier Science Technology Research Foundation INC, New York, USA
| | - Kenneth C Rich
- Department of Pediatrics, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kristy Hendricks
- Department of Pediatrics, Dartmouth Medical School, Lebanon, New Hampshire, USA
| | - David A Ludwig
- Division of Pediatric Clinical Research, Department of Pediatrics, Leonard M. Miller School of Medicine, University of Miami, Miami, Florida, USA
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Vega CMV, Brown P, Murphy C, Figueroa A, Cordero J, Alshawabkeh A. Community Engagement and Research Translation in Puerto Rico's Northern Karst Region: The PROTECT Superfund Research Program. New Solut 2016; 26:475-495. [PMID: 30081770 PMCID: PMC6083881 DOI: 10.1177/1048291116667715] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
We describe here the social science-environmental health collaboration in PROTECT, the Puerto Rico Testsite for Exploring Contamination Threats, which is one of eighteen Superfund Research Program centers funded by the National Institute of Environmental Health Sciences. This collaboration has multiple facets: (1) create a holistic, unified research program that addresses the complexity of environmental contamination, (2) offer research participants an engaged and respectful interaction with the research team, (3) provide cross-training, in which the team's social scientists learn environmental health and the environmental health scientists learn social science, and (4) provide training for graduate students and post-docs in multiple disciplines in this burgeoning form of collaboration.
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Affiliation(s)
| | - Phil Brown
- Northeastern University, Boston, MA, USA
| | | | - Abigail Figueroa
- Recinto de Ciencias Medicas, Universidad de Puerto Rico, San Juan, Puerto Rico
| | - Jóse Cordero
- University of Puerto Rico, San Juan, Puerto Rico
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50
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Massetti GM, Thomas CC, Ragan KR. Disparities in the Context of Opportunities for Cancer Prevention in Early Life. Pediatrics 2016; 138:S65-S77. [PMID: 27940979 PMCID: PMC5161109 DOI: 10.1542/peds.2015-4268j] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/16/2016] [Indexed: 11/24/2022] Open
Abstract
Persistent health disparities are a major contributor to disproportionate burden of cancer for some populations. Health disparities in cancer incidence and mortality may reflect differences in exposures to risk factors early in life. Understanding the distribution of exposures to early life risk and protective factors for cancer across different populations can shed light on opportunities to promote health equity at earlier developmental stages. Disparities may differentially influence risk for cancer during early life and create opportunities to promote health equity. Potential risk and protective factors for cancer in early life reveal patterns of disparities in their exposure. These disparities in exposures can manifest in downstream disparities in risk for cancer. These risk and protective factors include adverse childhood experiences; maternal alcohol consumption in pregnancy; childhood obesity; high or low birth weight; benzene exposure; use of assisted reproductive technologies; pesticide and insecticide exposure; isolated cryptorchidism; early pubertal timing; exposure to radiation; exposure to tobacco in utero and in early life; allergies, asthma, and atopy; and early exposure to infection. Disparities on the basis of racial and ethnic minority status, economic disadvantage, disability status, sex, geography, and nation of origin can occur in these risk and protective factors. Vulnerable populations experience disproportionally greater exposure to risk factors in early life. Addressing disparities in risk factors in early life can advance opportunities for prevention, promote health equity, and possibly reduce risk for subsequent development of cancer.
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Affiliation(s)
- Greta M. Massetti
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Cheryll C. Thomas
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Kathleen R. Ragan
- Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia
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