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Grace B, Shawe J, Stephenson J. Exploring fertility knowledge amongst healthcare professional and lay population groups in the UK: a mixed methods study. HUM FERTIL 2023:1-10. [PMID: 36600193 DOI: 10.1080/14647273.2022.2153349] [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: 01/06/2023]
Abstract
As the average age of first-time parents continues to rise, there has been a concerted effort by educators, policy makers and several reproductive health groups to improve fertility awareness. This study explored fertility knowledge of lay men and women and healthcare professionals (HCPs) using the same test instrument, providing a new and unique perspective compared with previous studies. Results were obtained from 1082 survey respondents: 347 HCPs, 319 men and 413 women, 105 of whom were trying to conceive (TTC). A total of 35 interviewees were purposively sampled to include 9 HCPs, 13 men and 13 women from the reproductive age range and of varying ethnic and educational backgrounds. Interview data were transcribed and analysed using the framework method. The proportion of HCPs correctly answering the survey knowledge questions was 47.1 (95% CI = 41.7%, 52.5%) compared to 44.4% for women (95% CI = 38.9%, 50.1%); 49.9% (95% CI = 39.0, 59.9%) for women TTC; and 32.5% (95% CI = 27.1%, 37.9%) for men. HCPs were ranked as the most trusted source for seeking fertility information. Overall HCPs did not demonstrate better fertility knowledge than lay participants, with inconsistencies regarding where responsibility lies for providing the right information to patients. HCPs need to improve their knowledge about fertility to help improve patient's fertility awareness.
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Affiliation(s)
- Bola Grace
- Department of Sexual and Reproductive Health, Faculty of Population Health Sciences, UCL Institute for Women's Health, University College London, London, UK
| | - Jill Shawe
- Faculty of Health, University of Plymouth, Plymouth, UK.,Department of Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Judith Stephenson
- Department of Sexual and Reproductive Health, Faculty of Population Health Sciences, UCL Institute for Women's Health, University College London, London, UK
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Ukoha WC, Mtshali NG. Preconception care practices among primary health care nurses working in public health facilities in KwaZulu-Natal. Glob Health Action 2022; 15:2112395. [PMID: 36161863 PMCID: PMC9542517 DOI: 10.1080/16549716.2022.2112395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Preconception care (PCC) is necessary to identify and deal with all the risk factors before conception. Some aspects of PCC, like folic acid supplementation, would be relevant to people desiring a pregnancy. Alternatively, PCC could provide contraceptive support to those with no pregnancy intention. In South Africa, primary healthcare nurses provide a comprehensive package of essential services in public health facilities to about 90% of the population at no cost. Therefore, they are the key providers of promotive, preventive, and curative services, including PCC. OBJECTIVE This study aimed to determine the level of PCC practice among primary healthcare nurses and identify determinants of effective practice. METHODS This cross-sectional descriptive survey was conducted among 196 nurses undertaking a specialisation Primary HealthCare program in a selected higher education institution. A pretested questionnaire was used to collect data that were analysed with SPSS version 27 software. RESULTS The overall practice of PCC was 87.8%. Older participants were significantly less likely to exhibit good PCC practice than their younger counterparts. Female participants were also less likely to have good PCC practices than their male counterparts. Married participants were significantly more likely to practice PCC than their unmarried counterparts. Participants practicing in rural areas were also less likely to have good PCC practices than their urban counterparts. CONCLUSION The PCC practice of most primary healthcare nurses in the study is relatively high. The study also identified the determinants of good PCC practice that can enhance its practice. There is a need to revisit the PCC training of healthcare workers, as most indicated the need for further training.
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Affiliation(s)
- Winifred Chinyere Ukoha
- School of Nursing and Public Health, Howard College, University of KwaZulu-Natal, Durban, South Africa
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Grace B, Shawe J, Barrett G, Usman NO, Stephenson J. What does family building mean? A qualitative exploration and a new definition: a UK-based study. Reprod Health 2022; 19:203. [PMID: 36307844 PMCID: PMC9617350 DOI: 10.1186/s12978-022-01511-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 10/08/2022] [Indexed: 11/24/2022] Open
Abstract
Background The importance of improving men’s and women’s knowledge of sexual and reproductive health has been emphasised in numerous global health policies. Fertility awareness literature highlights a disproportionately higher number of articles related to pregnancy-prevention compared to pregnancy-planning, which is justifiable in many contexts. However, recent concerted effort to improve fertility-awareness warrants a closer investigation of basic reproductive health terminologies. The objective of this study is to explore participants’ views of “family building” and provide a definition. Methods We conducted 35 qualitative in-depth interviews on men, women and healthcare professionals who were sampled from a UK cross-sectional survey. We asked participants about terms such as ‘family planning’ and ‘family building’ to elicit views and explored the appropriateness of the term “family building.” Data were transcribed and analysed via Framework analysis.
Results When asked what ‘family planning’ meant to them, study participants stated that the term meant the avoidance of pregnancy. They viewed it as an “umbrella term for the use of contraception methods,” that “paradoxically, the term family planning almost has a negative connotation regarding having a family,” but could not state similar terminology for planning a family. Reasons cited for this perspective include the focus of school education and usage in clinical settings. Conclusions In the absence of an explicit definition in literature, we generated a new definition for family building as follows: “Family building refers to the construction or formation of a family, which can include steps or actions taken by an individual towards having children. In contrast to family planning, the intent focuses on pregnancy planning and childbearing rather than pregnancy prevention. However, it can also include actions taken to space the number of children one has.” Some balance in the global public health messages, including bridging the gap in reproductive health literature, policies, processes and practices may contribute to the effort to improve fertility knowledge. Use of appropriate terminologies help optimise reproductive health services in order to enable men and women achieve their desired fertility intentions, whatever they may be. Trial registration Not applicable Global health policies have emphasised the importance of improving individual’s knowledge of sexual and reproductive health. Fertility awareness literature highlights a disproportionately higher number of articles related to pregnancy-prevention compared to pregnancy-planning, which is justifiable in many contexts. However, the recent concerted effort to improve fertility awareness warrants a closer investigation of basic terminologies in the field. For example, although the term family planning encompasses attaining the desired number of children and spacing pregnancies, it is almost synonymous with not having children, while there is currently no widely accepted equivalent terminology for planning to have children, either in general usage or clinical settings. We conducted 35 qualitative in-depth interviews on men, women and healthcare professionals who were sampled from a UK cross-sectional survey. When asked what ‘family planning’ meant to them, study participants stated avoidance of pregnancy. They viewed it as an “umbrella term for the use of contraception methods”, that “paradoxically, the term family planning almost has a negative connotation regarding having a family,” but could not state similar terminology for planning a family. We introduced family building and provided a new definition. We believe that some balance in the global public health messages, including revisiting widely used terminologies can help bridge the gap in reproductive health literature, and contribute to the effort to improve fertility knowledge. Additionally, this has implications for promotion of preconception and optimising reproductive health in relevant policies, processes and practices, in order to help people achieve their desired fertility intentions, whatever they may be.
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Affiliation(s)
- Bola Grace
- Research Department of Reproductive Health, UCL EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, Room 236 Medical School Building, 74 Huntley Street, London, WC1E 6A, UK.
| | - Jill Shawe
- Faculty of Health, University of Plymouth Devon, Plymouth, UK.,SW Clinical School, Royal Cornwall Hospital, Truro, UK
| | - Geraldine Barrett
- Research Department of Reproductive Health, UCL EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, Room 236 Medical School Building, 74 Huntley Street, London, WC1E 6A, UK
| | | | - Judith Stephenson
- Research Department of Reproductive Health, UCL EGA Institute for Women's Health, Faculty of Population Health Sciences, University College London, Room 236 Medical School Building, 74 Huntley Street, London, WC1E 6A, UK
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Rabiei Z, Shariati M, Mogharabian N, Tahmasebi R, Ghiasi A, Motaghi Z. Exploring the reproductive health needs of men in the preconception period: A qualitative study. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2022; 11:208. [PMID: 36003252 PMCID: PMC9393946 DOI: 10.4103/jehp.jehp_58_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 02/12/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Male reproductive health is a necessary pillar of childbearing. If a reproductive health assessment is conducted in the preconception period, the chance of a healthy pregnancy can increase. This qualitative study aimed to explore men's reproductive health needs before conception in Iran. MATERIALS AND METHODS This research was a qualitative study conducted in Bushehr city, Iran to explore men's reproductive health needs from April 2021 to November 2021. 30 semistructured interviews were conducted with married men, women, healthcare providers, and specialists individually in the health centers. The sampling method used in this study was purpose-based with maximum variety. All interviews were digitally recorded and transcribed verbatim in Persian and analyzed using directional content analysis. MAXQDA software version 12 was used to facilitate data analysis. RESULTS From the data analysis, 2 themes, 15 categories, and 38 subcategories emerged. The themes included evaluation and health promotion recommendations. It consisted of 10 categories: reproductive life plan evaluation, medical history evaluation, family and genetic history evaluation, social history evaluation, sexual health evaluation, medication evaluation, laboratory evaluation, physical examination, lifestyle evaluation, and mental health evaluation. Health promotion recommendations included five categories: nutritional recommendations, stress management, avoiding harmful behaviors, protective measures against harmful exposure, and need for education. CONCLUSIONS Our results showed that men need a comprehensive evaluation of reproductive health and recommendations to improve their health in the preconception period. Our study findings can inform healthcare providers to increase men's participation in reproductive health.
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Affiliation(s)
- Zeinab Rabiei
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Mohammad Shariati
- Department of Community Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Naser Mogharabian
- Department of Clinical Sciences, Sexual Health and Fertility Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Rahim Tahmasebi
- Department of Biostatistics, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Ashraf Ghiasi
- Department of Midwifery, School of Nursing and Midwifery, Birjand University of Medical Sciences, Birjand, Iran
| | - Zahra Motaghi
- Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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Perceptions and Practice of Preconception Care by Healthcare Workers and High-Risk Women in South Africa: A Qualitative Study. Healthcare (Basel) 2021; 9:healthcare9111552. [PMID: 34828600 PMCID: PMC8618283 DOI: 10.3390/healthcare9111552] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 11/07/2021] [Accepted: 11/08/2021] [Indexed: 12/26/2022] Open
Abstract
Preconception care is biomedical, behavioural, and social health interventions provided to women and couples before conception. This service is sometimes prioritised for women at high risk for adverse pregnancy outcomes. Evidence revealed that only very few women in Africa with severe chronic conditions receive or seek preconception care advice and assessment for future pregnancy. Thus, this study aimed to explore the perceptions and practice of preconception care by healthcare workers and high-risk women in Kwa-Zulu-Natal, South Africa. This exploratory, descriptive qualitative study utilised individual in-depth interviews to collect data from 24 women at high risk of adverse pregnancy outcomes and five healthcare workers. Thematic analysis was conducted using Nvivo version 12. Five main themes that emerged from the study include participants’ views, patients’ access to information, practices, and perceived benefits of preconception care. The healthcare workers were well acquainted with the preconception care concept, but the women had inconsistent acquaintance. Both groups acknowledge the role preconception care can play in the reduction of maternal and child mortality. A recommendation is made for the healthcare workers to use the ‘One key’ reproductive life plan question as an entry point for the provision of preconception care.
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Collie-Akers V, Landry S, Ehule NJ, Pecha D, Beltran MM, Gilbert C, Abresch C. Enhancing the Capacity of Local Health Departments to Address Birth Equity: The Institute for Equity in Birth Outcomes. Matern Child Health J 2021; 25:1010-1018. [PMID: 33929652 PMCID: PMC8184551 DOI: 10.1007/s10995-021-03135-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/19/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Significant and persistent racial and ethnic disparities exist related to infant mortality and other birth outcomes. Few models exist that aim to prepare organizations to implement essential features, such as community engagement or intervening on social determinants of health. METHODS Between 2013 and 2015, teams from seven local health departments participated in the Institute for Equity in Birth Outcomes (EI) with the goals of building capacity and implementing changes to address equity in birth outcomes. Four of the teams enrolled in the first cohort (2013-2015), and three enrolled in cohort two (2014-2015). To examine the EI effort and its impact on capacity and implementation of changes, two types of assessments were completed. Capacities of the teams in specific key areas were assessed using "Best Change Process" instruments at the completion of participation in the EI. Teams also documented on an ongoing basis implementation of interventions. The data were analyzed using descriptive statistics and Pearson Correlation tests. RESULTS Best Change Process capacity scores were higher in the first cohort than in the second and were highly correlated with implementation of changes (Pearson's Correlation = 0.838, p = 0.037). Collectively, the teams implemented about 32 new programs, policies, practices, and systems changes aimed at addressing equity in birth outcomes. Most interventions were based on scientific recommendations and local epidemiologic data. DISCUSSION The results of the study suggest the EI is a promising approach that may result in strong capacity and ability to implement interventions aimed at addressing equity in birth outcomes.
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Affiliation(s)
- Vicki Collie-Akers
- Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 1008, Kansas City, KS 66160 USA
| | - Sarah Landry
- Department of Population Health, University of Kansas Medical Center, 3901 Rainbow Boulevard, MS 1008, Kansas City, KS 66160 USA
| | - N. Jessica Ehule
- University of Nebraska Medical Center, 982170 Nebraska Medical Center, Omaha, NE 68198-2170 USA
| | - Denise Pecha
- University of Nebraska Medical Center, 982170 Nebraska Medical Center, Omaha, NE 68198-2170 USA
| | | | - Carol Gilbert
- University of Nebraska Medical Center, 982170 Nebraska Medical Center, Omaha, NE 68198-2170 USA
| | - Chad Abresch
- University of Nebraska Medical Center, 982170 Nebraska Medical Center, Omaha, NE 68198-2170 USA
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Sardasht FG, Keramat A, Motaghi Z. Investigating Reproductive Life Plan in Pregnant Women Referred to Teaching Hospitals of Mashhad, Iran. IRANIAN JOURNAL OF NURSING AND MIDWIFERY RESEARCH 2021; 26:120-126. [PMID: 34036058 PMCID: PMC8132867 DOI: 10.4103/ijnmr.ijnmr_13_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Revised: 03/09/2020] [Accepted: 12/14/2020] [Indexed: 11/25/2022]
Abstract
Background: Reproductive Life Planning (RLP) is a person-centered approach that investigates the reproductive needs, values, and priorities of each person and not only reduces the risk of unwanted pregnancies but also improves pregnancy outcomes and childbirth by investigating the health behaviors and underlying diseases of each individual. Therefore, the present study was conducted to assess RLP in pregnant women. Materials and Methods: This descriptive cross-sectional study was carried out on 1019 pregnant women who were referred to outpatient clinics of teaching hospitals in Mashhad, Iran, during May–August 2019. The participants were selected using a convenience sampling method. The data collection tool used was a questionnaire. Data analysis was performed in SPSS software. Results: The results of this study showed that about two-thirds of the participants had a plan for their reproductive years. The age range of the participants was 13–47 years. Among the women, 38.60% had experienced failure of contraceptive method, and 32.20% had an unmet need for family planning. Moreover, only one-third of the women had been referred for preconception care, but 88.70% of the pregnant women had their initial prenatal care visit in their first trimester. Conclusions: Given the considerable number of unwanted pregnancies and unmet needs for family planning in the present study, the modification of family planning policies seems necessary. Various strategies have been proposed to prevent unintended pregnancies such as RLP. The long-term goals of RLP are to plan pregnancies and improve maternal and infant outcomes.
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Affiliation(s)
- Fatemeh Ghaffari Sardasht
- Student Research Committee, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Afsaneh Keramat
- Reproductive Studies and Women's Health Research Center, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Zahra Motaghi
- Department of Reproductive Health, School of Nursing and Midwifery, Shahroud University of Medical Sciences, Shahroud, Iran
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Maeda E, Miyata A, Boivin J, Nomura K, Kumazawa Y, Shirasawa H, Saito H, Terada Y. Promoting fertility awareness and preconception health using a chatbot: a randomized controlled trial. Reprod Biomed Online 2020; 41:1133-1143. [PMID: 33039321 DOI: 10.1016/j.rbmo.2020.09.006] [Citation(s) in RCA: 27] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/21/2020] [Accepted: 09/08/2020] [Indexed: 01/25/2023]
Abstract
RESEARCH QUESTION What are the effects of using a fertility education chatbot, i.e. automatic conversation programme, on knowledge, intentions to improve preconception behaviour and anxiety? DESIGN A three-armed, randomized controlled trial was conducted using an online social research panel. Participants included 927 women aged 20-34 years who were randomly allocated to one of three groups: a fertility education chatbot (intervention group), a document about fertility and preconception health (control group 1) or a document about an irrelevant topic (control group 2). Participants' scores on the Cardiff Fertility Knowledge Scale and the State-Trait Anxiety Inventory, their intentions to optimize preconception behaviours, e.g. taking folic acid, and the free-text feedback provided by chatbot users were assessed. RESULTS A repeated-measures analysis of variance showed significant fertility knowledge gains after the intervention in the intervention group (+9.1 points) and control group 1 (+14.9 points) but no significant change in control group 2 (+1.1 points). Post-test increases in the intentions to optimize behaviours were significantly higher in the intervention group than in control group 2, and were similar to those in control group 1. Post-test state anxiety scores were significantly lower in the intervention group than in control group 1 and control group 2. User feedbacks about the chatbot suggested technical limitations, e.g. low comprehension of users' words, and pros and cons of using the chatbot, e.g. convenient versus coldness. CONCLUSIONS Providing fertility education using a chatbot improved fertility knowledge and intentions to optimize preconception behaviour without increasing anxiety, but the improvement in knowledge was small. Further technical development and exploration of personal affinity for technology is required.
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Affiliation(s)
- Eri Maeda
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita 010-8543, Japan.
| | - Akane Miyata
- Reproduction Center, Dokkyo Medical University, Saitama 343-8555, Japan
| | - Jacky Boivin
- Cardiff Fertility Studies Research Group, School of Psychology, Cardiff University, Cardiff CF10 3AT, UK
| | - Kyoko Nomura
- Department of Environmental Health Science and Public Health, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Yukiyo Kumazawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | - Hiromitsu Shirasawa
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
| | | | - Yukihiro Terada
- Department of Obstetrics and Gynecology, Akita University Graduate School of Medicine, Akita 010-8543, Japan
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Bowling J, Simmons M, Dodge B, Sundarraman V, Lakshmi B, Dharuman ST, Herbenick D. Family Formation Goals Among Sexual and Gender Minority Individuals in Urban India. Stud Fam Plann 2019; 50:357-373. [PMID: 31482573 DOI: 10.1111/sifp.12102] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Sexual and Gender Minority (SGM) individuals' (nonheterosexual or noncisgender) desires and intentions to form families have been under-researched. Further, research on family formation among SGM individuals is even more scant in India. Family formation, a significant milestone for many individuals, has important implications for overall health. Using data from interviews (n=25) and focus group discussions (8 participants) with SGM individuals in Bangalore, Chennai, and Kolkata, we explore desires and intentions related to parenting. Pressure to have children was ubiquitous, though participants' parenting-related desires varied. Participants considering parenting noted many priorities including their financial stability, relationships with partners, and the legality and legitimacy of their partnerships. Adoption and assisted biological reproduction (e.g., IVF) were the preferred methods of family formation. Experiences and expectations of stigma for themselves and their children shaped participants' limited control over parenting-related decisions. However, they exerted agency as they navigated achieving their ideals for family formation.
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Hipp SL, Chung-Do J, McFarlane E. Systematic Review of Interventions for Reproductive Life Planning. J Obstet Gynecol Neonatal Nurs 2019; 48:131-139. [PMID: 30664840 DOI: 10.1016/j.jogn.2018.12.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/01/2018] [Indexed: 10/27/2022] Open
Abstract
OBJECTIVE To systematically review the literature on interventions for reproductive life planning (RLP). DATA SOURCES We searched PubMed, CINAHL Plus, and PsycINFO for studies of the implementation and/or evaluation of an RLP intervention using the following search terms: reproductive life planning, intervention, program, evaluation, trial, strategy, assessment, survey, tool, and education. No limitations were set on languages or geographic locations of the studies. Records from 1990 through 2017 were searched. STUDY SELECTION The initial search yielded 133 results after duplicates were excluded. Titles and abstracts were screened to determine whether articles met the inclusion criteria, and 110 articles were excluded. We completed a full-text review of 23 articles, and 9 articles met inclusion criteria. A secondary citations search and manual review of reference lists of articles already included in the review yielded an additional three articles. A total of 12 articles were identified for final inclusion. DATA EXTRACTION We reviewed each article to assess study design, sample size and participants, study objectives, and outcome measures of the RLP intervention or evaluation implemented. DATA SYNTHESIS We grouped studies into three categories according to outcomes measured: perceptions and acceptability of the intervention, change in knowledge after the intervention, and change in health behavior after the intervention. We used the Grading of Recommendations Assessment, Development and Evaluation (GRADE) system to evaluate the evidence of effectiveness for each outcome measured in each study. CONCLUSION There is a dearth of literature in which researchers tested and documented the effectiveness of extant RLP interventions. Current evidence highlights a positive reception of RLP in clinical practice, but data are limited with regard to its effectiveness in initiating changes in knowledge or behavioral outcomes. Process and outcome evaluations are needed to build the evidence base for RLP.
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Bodin M, Tydén T, Käll L, Larsson M. Can Reproductive Life Plan-based counselling increase men's fertility awareness? Ups J Med Sci 2018; 123:255-263. [PMID: 30541376 PMCID: PMC6327788 DOI: 10.1080/03009734.2018.1541948] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Revised: 10/23/2018] [Accepted: 10/25/2018] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Many men have limited knowledge about reproductive health and fertility. The aim of the study was to evaluate if Reproductive Life Plan (RLP)-based counselling during a sexual health visit could increase men's fertility awareness. MATERIAL AND METHODS The study was a randomized controlled trial including 201 men aged 18-50 who visited either of two participating sexual health clinics in Sweden for sexually transmitted infection testing during 2014-2016. All men received standard care, and men in the intervention group (IG) also received oral and written RLP-based information about lifestyle and fertility. Awareness about fertility and lifestyle-related factors were the main outcomes, measured through a questionnaire before the intervention and through a telephone survey after three months. Impressions from the counselling were also assessed at follow-up. RESULTS A majority (71%) of men wanted children in the future. General fertility awareness increased from a mean score of 4.6 to 5.5 out of 12 (P = 0.004) in the IG. The mean number of accurate lifestyle factors (that could affect fertility) mentioned increased from 3.6 to 4.4 (P < 0.001) in the IG. There were no improvements in the control group. Among the men in the IG, 76% had a positive experience of the counselling, and 77% had received new information. CONCLUSION The intervention managed to increase different aspects of men's fertility awareness. In the future, the format for preconception care for men needs further development. Including men in preconception health policy guidelines and identifying suitable actors for care provision would be important first steps.
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Affiliation(s)
- Maja Bodin
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
- Centre for Gender Research, Uppsala University, Uppsala, Sweden
| | - Tanja Tydén
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
| | - Lisa Käll
- Centre for Gender Research, Uppsala University, Uppsala, Sweden
| | - Margareta Larsson
- Department of Women’s and Children’s Health, Uppsala University, Uppsala, Sweden
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DiPietro Mager N, Mills C, Snelling A. Utility of reproductive life plans in identification of potentially teratogenic medication use: A pilot study. Birth 2018; 45:50-54. [PMID: 29052257 DOI: 10.1111/birt.12318] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2017] [Revised: 09/17/2017] [Accepted: 09/18/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Teratogenic medications increase risks of miscarriage, fetal death, and/or birth defects. It is important to identify whether women of childbearing potential are taking these medications and to minimize exposure to these agents through change in drug therapy before conception and/or use of effective contraception to prevent conception. OBJECTIVE To determine the utility of reproductive life plans as tools to identify women using potentially teratogenic medications. METHODS A retrospective review was conducted on reproductive life plans completed by women receiving services as part of the Toledo-Lucas County Healthy Start program. The medication section of the reproductive life plan was reviewed to determine: if it was completed; categories of medications reported (prescription, over-the-counter, vitamin/herbal); potentially teratogenic medications listed; contraception use and method. RESULTS Medication lists were completed for 437 of the 580 reproductive life plans reviewed (75%). Thirty-five women (8%) reported use of a potentially teratogenic medication; most commonly reported agents included blood pressure medications and antidepressants. Only 10 women taking a potentially teratogenic medication (29%) reported using some form of contraception, half of which reported use of a less effective method such as condoms. CONCLUSION The reproductive life plan can be a useful tool to identify women of childbearing age who require intervention due to use of potentially teratogenic medications. Efforts are needed to ensure complete and accurate reporting of medication use in reproductive life plans, and to promote effective contraceptive use among women taking potentially teratogenic medications.
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Affiliation(s)
| | - Caitlin Mills
- University of Toledo College of Pharmacy and Pharmaceutical Sciences, Toledo, OH, USA
| | - April Snelling
- Maternal and Child Health, Toledo-Lucas County Health Department, Toledo, OH, USA.,ProMedica Physicians Group, Toledo, OH, USA
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Okour AM, Saadeh RA, Zaqoul M. Evaluation of Family Planning Counselling in North Jordan. Sultan Qaboos Univ Med J 2018; 17:e436-e443. [PMID: 29372086 DOI: 10.18295/squmj.2017.17.04.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Revised: 08/14/2017] [Accepted: 09/21/2017] [Indexed: 11/16/2022] Open
Abstract
Objectives Counselling plays a key role in enhancing reproductive services, providing contraception-related information and supporting long-term family planning for women of childbearing age. This study aimed to evaluate family planning counselling sessions in selected governmental and private clinics in northern Jordan. Methods This cross-sectional study was conducted between January and June 2016 in Irbid, Jordan. A total of 200 women attending two private clinics affiliated with the Jordanian Association for Family Planning and Protection (JAFPP) and six governmental clinics were invited to participate in the study. Counselling sessions were attended by an independent observer and evaluated with regards to their compliance with the standard Greet, Ask, Tell, Help, Explain, Return (GATHER) framework. Results A total of 198 women participated in the study (response rate: 99.0%), including 80 women (40.4%) from JAFPP clinics and 118 (59.6%) from governmental clinics. In total, 42.9% of the counselling sessions were deemed adequate, with providers applying 80% or more of the GATHER framework, while 26.8% of the sessions were deemed semi-adequate and 30.3% were considered inadequate. Counselling services provided in the governmental clinics were significantly less adequate than those provided in JAFPP clinics (P <0.001). Conclusion The quality of counselling services in governmental family planning centres in Jordan needs to be improved to ensure that women receive the highest possible level of care. Healthcare policymakers should therefore focus on developing and supporting effective family planning counselling services in northern Jordan.
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Affiliation(s)
- Abdulhakeem M Okour
- Department of Public Health & Community Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Rami A Saadeh
- Department of Public Health & Community Medicine, Jordan University of Science & Technology, Irbid, Jordan
| | - Mona Zaqoul
- Department of Public Health & Community Medicine, Jordan University of Science & Technology, Irbid, Jordan
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Hipp S, Carlson A, McFarlane E, Sentell TL, Hayes D. Insights in Public Health: Improving Reproductive Life Planning in Hawai'i: One Key Question®. HAWAI'I JOURNAL OF MEDICINE & PUBLIC HEALTH : A JOURNAL OF ASIA PACIFIC MEDICINE & PUBLIC HEALTH 2017; 76:261-264. [PMID: 28900582 PMCID: PMC5592382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
- Sarah Hipp
- University of Hawai'i at Manoa, Office of Public Health Studies, Honolulu, HI (SH)
| | - Alyssa Carlson
- University of Hawai'i at Manoa, Office of Public Health Studies, Honolulu, HI (SH)
| | - Elizabeth McFarlane
- University of Hawai'i at Manoa, Office of Public Health Studies, Honolulu, HI (SH)
| | - Tetine L Sentell
- Office of Public Health Studies at the University of Hawai'i at Manoa
| | - Donald Hayes
- Hawai'i Department of Health Lance K. Ching PhD, MPH and Ranjani R. Starr MPH from the Hawai'i Department of Health
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15
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Evolutionary Concept Analysis of Reproductive Life Planning. J Obstet Gynecol Neonatal Nurs 2016; 46:78-90. [PMID: 27837650 DOI: 10.1016/j.jogn.2016.07.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2016] [Indexed: 10/20/2022] Open
Abstract
Reproductive life planning is recommended as an important topic of discussion at every health care interaction with women and men of reproductive age; however, this intervention has not been well studied. Therefore, the purpose of this evolutionary concept analysis was to synthesize the relevant literature, identify the essential attributes of the concept, and develop a conceptual definition to guide future research and to help implement reproductive life planning in routine health care practice.
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16
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Maternal Health Risk Assessment and Behavioral Intervention in the NICU Setting Following Very Low Birth Weight Delivery. Matern Child Health J 2016; 20:28-38. [DOI: 10.1007/s10995-016-2183-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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17
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Rethinking the Well Woman Visit: A Scoping Review to Identify Eight Priority Areas for Well Woman Care in the Era of the Affordable Care Act. Womens Health Issues 2016; 26:135-46. [PMID: 26817659 DOI: 10.1016/j.whi.2015.11.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2015] [Revised: 11/11/2015] [Accepted: 11/23/2015] [Indexed: 11/22/2022]
Abstract
PURPOSE The annual pap smear for cervical cancer screening, once a mainstay of the well woman visit (WWV), is no longer recommended for most low-risk women. This change has led many women and their health care providers to wonder if they should abandon this annual preventive health visit altogether. Changing guidelines coinciding with expanded WWV coverage for millions of American women under the Patient Protection and Affordable Care Act have created confusion for health care consumers and care givers alike. Is there evidence to support continued routine preventive health visits for women and, if so, what would ideally constitute the WWV of today? METHODS A scoping review of the literature was undertaken to appraise the current state of evidence regarding a wide range of possible elements to identify priority areas for the WWV. FINDINGS A population health perspective taking into consideration the reproductive health needs of women as well as the preventable and modifiable leading causes of death and disability was used to identify eight domains for the WWV of today: 1) reproductive life planning and sexual health, 2) cardiovascular disease and stroke, 3) prevention, screening, and early detection of cancers, 4) unintended injury, 5) anxiety, depression, substance abuse, and suicidal intent, 6) intimate partner violence, assault, and homicide, 7) lower respiratory disease, and 8) arthritis and other musculoskeletal problems. CONCLUSIONS The WWV remains a very important opportunity for prevention, health education, screening, and early detection and should not be abandoned.
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Kransdorf LN, Raghu TS, Kling JM, David PS, Vegunta S, Knatz J, Markus A, Frey KA, Chang YHH, Mayer AP, Files JA. Reproductive Life Planning: A Cross-Sectional Study of What College Students Know and Believe. Matern Child Health J 2015; 20:1161-9. [DOI: 10.1007/s10995-015-1903-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Bello JK, Lapin B, Poston L, Hirshfeld M, Hosack A. The Role of Patient Activation in Contraceptive Use. Womens Health Issues 2015; 26:161-7. [PMID: 26542384 DOI: 10.1016/j.whi.2015.09.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 09/18/2015] [Accepted: 09/21/2015] [Indexed: 12/13/2022]
Abstract
PURPOSE Many unintended pregnancies occur due to to contraceptive misuse and nonuse, which is partly due to to lack of knowledge and low self-efficacy related to contraception. We conducted an exploratory, cross-sectional study among low-income women to examine the relationship between knowledge, skills, and confidence in managing one's health, measured using the Patient Activation Measure (PAM) and factors that influence contraceptive use. METHODS A survey and chart review were conducted among 18- to 45-year-old women from a community health center in Chicago, Illinois, to measure the relationship between activation, self-confidence in avoiding pregnancy, contraception use, and contraceptive counseling. Associations between PAM and outcomes were evaluated using the χ(2) test and adjusted logistic regression models. RESULTS Among 112 participants (61% Latina, 15% Black, 14% White), we found no differences in PAM by age, race/ethnicity, or parity. Women with higher PAM were more likely to be confident they could avoid pregnancy compared with women with lower PAM (50% vs. 7%; p = .02). Higher PAM remained a significant predictor for self-confidence after risk adjustment (odds ratio, 3.13; 95% CI, 1.11-8.78; p = .031). Greater confidence in avoiding pregnancy was associated with using a moderately or highly effective contraceptive method (43% vs. 14%; p = .047). Women with lower PAM were less likely to receive contraceptive counseling in the prior month (0% vs. 57%; p < .01). CONCLUSIONS Patient activation may be an important construct for understanding factors that influence women's contraceptive use, including self-confidence in avoiding pregnancy until it is desired and receiving contraceptive services in primary care.
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Affiliation(s)
- Jennifer K Bello
- Department of Family Medicine, NorthShore University HealthSystem, Evanston, Illinois; Department of Family Medicine, University of Chicago, Chicago, Illinois.
| | - Brittany Lapin
- Department of Family Medicine, NorthShore University HealthSystem, Evanston, Illinois
| | - Lindsay Poston
- Department of Family Medicine, University of Chicago, Chicago, Illinois
| | | | - Allison Hosack
- Department of Family Medicine, NorthShore University HealthSystem, Evanston, Illinois
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Abstract
BACKGROUND In 2006, the U.S. Centers for Disease Control and Prevention issued 10 recommendations on preconception care, which included the statement that reproductive life planning should be considered an individual's responsibility across his or her life span. PURPOSE The purpose of this article is to provide a concept analysis of reproductive life planning using Walker and Avant's method as an organizing framework. METHODS Search engines were employed to review the existing knowledge base of the concept of reproductive life planning. FINDINGS The findings suggest that reproductive life planning is integral to preconception care and family planning. Attributes, antecedents, and consequences associated with reproductive life planning are discussed. Model, borderline, and contrary cases are also provided to illustrate the concept. PRACTICE IMPLICATIONS A reproductive life plan can serve as a framework for promoting reproductive health across the life span of both men and women. Healthcare providers must assess the individual's ability to understand and utilize educational resources to ensure full and effective participation in reproductive life planning.
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Affiliation(s)
- Fuqin Liu
- Texas Woman's University College of Nursing, Denton, TX
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21
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Bello JK, Adkins K, Stulberg DB, Rao G. Perceptions of a reproductive health self-assessment tool (RH-SAT) in an urban community health center. PATIENT EDUCATION AND COUNSELING 2013; 93:655-663. [PMID: 24094839 DOI: 10.1016/j.pec.2013.09.004] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2013] [Revised: 08/14/2013] [Accepted: 09/03/2013] [Indexed: 06/02/2023]
Abstract
OBJECTIVE Physicians face barriers to incorporating recommended contraceptive and preconception health services, including reproductive life plans (RLPs), into primary care. With promising findings from early studies of RLPs, we examined the impact of a novel reproductive health self-assessment tool (RH-SAT) on reproductive health counseling. METHODS We created the RH-SAT for an urban community health center population and trained providers on preconception and contraceptive guidelines. Semi-structured interviews were conducted to assess perceptions of the tool with 22 patients and with all 15 providers at the clinic. Transcripts were thematically analyzed using a grounded theoretical approach. RESULTS Patients and providers reported the RH-SAT presented new and thought-provoking material that promoted patient participation and facilitated counseling. CONCLUSION This RH-SAT is acceptable and useful to patients and providers in an underserved urban health center. In accordance with Medical Communication Alignment Theory (MCAT), increased patient participation in reproductive health discussions may alert providers to patient interest in these topics. PRACTICE IMPLICATIONS This study provides preliminary evidence that the RH-SAT can help overcome barriers to reproductive health counseling in primary care. Providers may wish to incorporate tools into their practice to improve communication with patients about their reproductive health goals.
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Affiliation(s)
- Jennifer K Bello
- Department of Family Medicine, The University of Chicago, Chicago, USA; Department of Family Medicine, NorthShore University Health System, Evanston, USA.
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Stern J, Larsson M, Kristiansson P, Tydén T. Introducing reproductive life plan-based information in contraceptive counselling: an RCT. Hum Reprod 2013; 28:2450-61. [PMID: 23842564 PMCID: PMC3748861 DOI: 10.1093/humrep/det279] [Citation(s) in RCA: 78] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
STUDY QUESTION Can reproductive life plan (RLP)-based information in contraceptive counselling before pregnancy increase women's knowledge of reproduction, and of the importance of folic acid intake in particular? SUMMARY ANSWER The RLP-based information increased women's knowledge of reproduction including knowledge of folic acid intake. WHAT IS KNOWN ALREADY Many women have insufficient knowledge of reproduction, including a health-promoting lifestyle prior to conception, and highly educated women in particular postpone childbearing until an age when their fertile capacity has started to decrease. STUDY DESIGN, SIZE, DURATION The study was an randomized controlled trial with one intervention group (IG) and two control groups (CG1, CG2). A sample size calculation indicated that 82 women per group would be adequate. Recruitment took place during 3 months in 2012 and 299 women were included. The women were randomized in blocks of three. All groups received standard care (contraceptive counselling, Chlamydia testing, cervical screening). In addition, women in the IG were given oral and written RLP-based information about reproduction. PARTICIPANTS/MATERIALS, SETTING, METHODS A total of 299 out of 338 (88%) Swedish-speaking women visiting a Student Health Centre were included (mean age 23 years); response rate was 88%. Before the counselling, women in the IG and the CG1 completed a baseline questionnaire, including questions about lifestyle changes in connection to pregnancy planning, family planning intentions and knowledge of reproduction (e.g. the fecundity of an ovum). At follow-up 2 months after inclusion, a structured telephone interview was performed in all groups (n = 262, 88% participation rate). MAIN RESULTS AND THE ROLE OF CHANCE There was no difference between the groups regarding the mean knowledge score at baseline. The IG scored higher at follow-up than at baseline (P < 0.001); the mean increased from 6.4 to 9.0 out of a maximum 20 points. The women in the CG1 scored no differently at follow-up than at baseline. The difference in the knowledge score between the IG and the two CGs was significant (P < 0.001), whereas no difference was shown between the two CGs. There was no difference between the groups at baseline regarding how many women could mention folic acid intake among the things to do when planning to get pregnant. At follow-up, 22% in the IG, 3% in CG1 and 1% in CG2 mentioned folic acid intake (P < 0.001). At follow-up, more women in the IG also wished to have their last child earlier in life (P < 0.001) than at baseline, while there was no difference in the CG1. LIMITATIONS, REASONS FOR CAUTION As the study sample consisted of university students, it is possible that the effect of the intervention was connected to a high level of education and conclusions for all women of reproductive age should be drawn with caution. WIDER IMPLICATIONS OF THE FINDINGS The provision of RLP-based information seems to be a feasible tool for promoting reproductive health. STUDY FUNDING/COMPETING INTEREST(S) Study funding was received from the Faculty of Medicine, Uppsala University, Sweden. There are no conflicts of interest. TRIAL REGISTRATION NUMBER ClinicalTrial.gov Identifier NCT01739101.
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Affiliation(s)
- J Stern
- Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden.
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Berndt AE, Williams PC. Hierarchical regression and structural equation modeling: two useful analyses for life course research. FAMILY & COMMUNITY HEALTH 2013; 36:4-18. [PMID: 23168342 DOI: 10.1097/fch.0b013e31826d74c4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
This article reviews the life course perspective and considers various life course hypotheses such as trajectories, transitions, critical periods, sequencing, duration, and cumulative effects. Hierarchical regression and structural equation modeling are suggested as analyses to use in life course research. Secondary analysis was performed on the Early Head Start Research and Evaluation Study, 1996-2010, to illustrate their strengths and challenges. Models investigated the influence of mother and infant characteristics and of parent-child dysfunction at 14 and 24 months to children's cognitive outcomes at 36 months. Findings were interpreted and discussed in the context of life course hypotheses.
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Affiliation(s)
- Andrea E Berndt
- School of Nursing, Family and Community Health Systems Department, The University of Texas Health Science Center at San Antonio, San Antonio, TX 78229, USA.
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Bloch JR. Using geographical information systems to explore disparities in preterm birth rates among foreign-born and U.S.-born Black mothers. J Obstet Gynecol Neonatal Nurs 2012; 40:544-54. [PMID: 22273411 DOI: 10.1111/j.1552-6909.2011.01273.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
OBJECTIVE To examine spatial patterns of neighborhood contextual factors of stress with preterm birth (PTB) and nativity (foreign-born and U.S.-born) among Black mothers. DESIGN Descriptive geographic-spatial research. SETTING & PARTICIPANTS Births to Philadelphia residents during 2003-2005 in the context of Philadelphia residential neighborhoods (N = 350) were studied. METHODS All data were aggregated to neighborhood levels (census tracts). Maps were created to assess geographic-spatial patterns. A geographic information system (GIS) database was created that imported geo-coded data on births, crime (assaults with guns and domestic abuse), poverty, race, and nativity (foreign-born vs. U.S.-born). RESULTS Clear visual patterns of "bad" neighborhoods emerged and were significantly associated with higher prevalence of PTB for foreign-born Black and U.S.-born Black mothers (p < .0001). CONCLUSIONS This study demonstrated how GIS visually clarified important spatial patterns of adverse living conditions and PTB prevalence. Nurses can use GIS to better understand living environments of mothers and their families and to target interventions in geographical areas with the greatest service needs. Further research on individual and contextual factors is warranted to address the observed health disparities among the heterogeneous groups of foreign-born Black mothers. Despite limitations of aggregate data, it is clear that where mothers live matters. This has important implications for nursing practice and policy.
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Affiliation(s)
- Joan Rosen Bloch
- College of Nursing and Health Professions, Drexel University, 245 N. 15th Street, Philadelphia, PA 19102, USA.
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Simmonds K, Likis FE. Caring for Women with Unintended Pregnancies. J Obstet Gynecol Neonatal Nurs 2011; 40:794-807. [DOI: 10.1111/j.1552-6909.2011.01293.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022] Open
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