Abstract Background Evidence suggests that the association between dietary energy density (DED) and body composition in children is different than in adults. The purpose of this study was to measure if DED differed by race/ethnicity and if DED was associated with adiposity markers in children. Methodology Dietary intake and body composition were measured...
Abstract Objectives Perinatal Quality Collaboratives across the United States are initiating projects to improve health and healthcare for women and infants. We compared an evidence-based group prenatal care model to usual individual prenatal care on birth outcomes in a multi-site expansion of group prenatal care supported by a state-wide multidisciplinary Perinatal Quality Collaborative. Methods We analyzed 15,330 pregnant women aged 14–48 across 13 healthcare practices in South...
Abstract Objectives Originally developed to assess emergency preparedness, evidence suggests the Social Vulnerability Index (SVI) may also be useful to investigate multilevel environmental and social influences on health risk behaviors and outcomes. This ecological study explores the application of the SVI as a predictor of teen pregnancy rates across counties in the United States (U.S.) and identifies areas with greatest need for community-based interventions. Methods County-level...
Abstract Background Infants who are iron-deficient anemic seek and receive less stimulation from their caregivers, predisposing such children to be functionally isolated. Objectives To test the sequence whereby iron deficiency in infancy contributes to children’s disengagement from the environment, which reduces parent stimulation which, in turn, contributes...
Abstract Objectives To explore factors that shape decisions made regarding employee benefits and compare the decision-making process for workplace breastfeeding support to that of other benefits. Methods Sixteen semi-structured, in-depth interviews were conducted with Human Resource Managers (HRMs) who had previously participated in a breastfeeding-support survey. A priori codes were used, which were based on a theoretical model informed by organizational behavior theories, followed...
Abstract Background Rural populations face unique health disparities that prevent women from accessing reproductive health care services. Telehealth initiatives offer a health care delivery tool to increase access to contraception. Objective To understand women’s contraceptive needs and perceptions of accessing contraception through telehealth services. ...
Abstract Introduction Standard survey measures of fertility preferences, such as the desire for and preferred timing of future births, do not capture the complexity of individuals’ preferences. New research focuses on additional dimensions of emotions and expectations surrounding childbearing. Few quantitative studies, however, consider the influence of all three dimensions of fertility preferences concurrently. ...
Abstract Objectives Despite renewed interest in expansion of multi-tasked community health workers (CHWs) there is limited research on HIV and maternal health integration at the community-level. This study assessed the impact of integrating CHW roles for HIV and maternal health promotion on facility delivery utilization in rural Tanzania. Methods A 36-month...
Abstract Objectives Evidence suggests that maternal psychological distress is an under-diagnosed condition that can have lasting impacts on child outcomes. Models based solely on maternal outcomes have not found screening to be cost-effective. This research explores the effects of self-reported maternal psychological distress on children’s language and behavioural development up to the age of 7. ...
Abstract Objectives To characterize the health and health care experiences of children in the U.S. Virgin Islands (USVI), assess differences by household poverty status, and provide comparisons to the general U.S. child population. Methods Data are from the 2011–2012 National Survey of Children’s Health, which included 2342 USVI children, aged 0–17 years....
Abstract Objective Alternative primary care structures such as group well-child care (GWCC) may enhance care for families, particularly those subject to structural vulnerabilities such as poverty or restrictive immigration policies. The purpose of this study was to characterize how group dynamics in GWCC impact the perceptions of low-income, immigrant, and/or Spanish-speaking parents of health services. Methods Using Spanish and English interview guides that were conceptually identical,...
Abstract Purpose We report on a successful quality improvement project designed to increase access to perinatal mental health services through universal screening for postpartum depression (PPD) and facilitating referrals for evaluation and treatment, at a multi-site, integrated system of pediatric and obstetric practices in Houston, Texas. Description Obstetric...
Abstract Objectives Several types of epidemiologic studies suffer from decreasing participation rates, resulting in potential selection bias and delay or termination of studies. We aimed to determine the feasibility of online methods for recruitment of pregnant women into a prospective cohort study. Methods In addition to traditional recruitment through prenatal care providers, we advertized participation in the PRegnancy and Infant DEvelopment (PRIDE) Study, an ongoing prospective...
Abstract Objectives Pregnant young women gain more weight than recommended by the National Academy of Medicine, increasing the likelihood of adverse maternal and fetal outcomes. The purpose of this study is to use online social media to understand beliefs and practices surrounding weight gain, diet and exercise during pregnancy among young women. Methods Facebook posts were mined from young women ages 16 to 24 during pregnancy who were consented from two Midwest primary care clinics...
Abstract Objectives Involuntary child removal via the child protection system disproportionately affects marginalized women, yet the impacts on maternal health are under-investigated. This study prospectively examined the association of child removal with self-rated health of mothers who are sex workers. Given high levels of intergenerational family separation in this population, particularly among Indigenous sex workers, we also estimated...
Abstract Introduction We examined the prevalence of autism spectrum disorders (ASDs) in Massachusetts (MA) comparing children born via assisted reproductive technology (ART) and children born to women with indicators of subfertility but no ART (Subfertile), to children born to women with neither ART nor indicators of subfertility (Fertile). We assessed the direct, indirect, and total effects of ART and subfertility on ASD among singletons....
Abstract Objective Low birth weight (LBW) is a significant health problem in the United States, and the incidence is higher in women with low socioeconomic status. Observational and epidemiological studies have revealed that social support reduces the risk of adverse pregnancy outcomes. However, the current literature lacks research regarding the perceived social support of pregnant women in relation to birth weight from a qualitative perspective. This study explored the perceptions...
Abstract Objective To examine associations between maternal experiences of discrimination and child biomarkers of toxic stress in a multiethnic, urban sample of mothers and children (4–9 years). Methods Data were drawn from a cross-sectional study of maternal–child dyads (N = 54) living in low-income neighborhoods in New Haven, Connecticut, USA. Mothers reported...
Abstract Objective Higher rates of adverse outcomes have been reported for early term (37 0 to 38 6 weeks) versus full term (≥ 39 0 weeks) infants, but differences in breastfeeding outcomes have not been systematically evaluated. This study examined breastfeeding initiation and exclusivity in early and full term infants in a large US based sample. Methods ...
Abstract Introduction Despite the significant healthcare policy and program implications, a summary measure of health for children with medical complexity (CMC) has not been identified. It is unclear whether existing population health approaches apply to CMC. We conducted a systematic review of the existing peer-reviewed research literature on CMC to describe the health outcomes currently measured for CMC. ...
Abstract Objectives Retrospective, cross-sectional estimates of pregnancy intention, as used in the Demographic Health Survey (DHS), are the global norm. The London Measure of Unplanned Pregnancy (LMUP) is a newer, psychometrically validated measure which may be more reliable. This paper assesses the reliability of the LMUP and the DHS question over the first postnatal year and explores the effects of maternal characteristics or pregnancy...
Abstract Introduction Pregnant women initiating antiretroviral therapy (ART) in sub-Saharan Africa have been shown to have sub-optimal engagement in care, particularly after delivery, and interventions to improve engagement in care for this unique population are urgently needed. Methods We enrolled 25 pregnant women living with HIV at each of two large antenatal...
Abstract Objective Previous work is conflicted regarding the relationship between motor skill development and physical activity. One potential explanation for this equivocality is the difficulty and lack of precision in physical activity measurement, particularly within preschool populations. Our exploration of plank performance as a proxy measure for fitness addresses a void in the literature, as few studies have investigated the role...
Abstract Objectives Clinical rotations are an important aspect of undergraduate medical education. However, as patient satisfaction scores receive increasing attention, the impact of medical student participation on patient satisfaction and perception of quality of care is unclear. Previous studies from the Emergency Department and outpatient settings show that medical students do not negatively impact satisfaction scores. The authors...
Abstract Objective HIV-exposed uninfected infants are almost twice as likely to die compared to infants born to HIV-uninfected women. HIV-exposed uninfected children whose mothers are on ART and who are breastfed have the lowest risk of dying by 24 months of age. Interventions to improve breastfeeding among HIV-infected mothers are needed. We aimed to assess the association between support/counseling provided by healthcare workers following delivery and the rate of exclusive breastfeeding...
Abstract Objectives To examine the association between changes in contextual economic factors on childhood obesity in the US. Methods We combined data from 2003, 2007, and 2011/2012 National Surveys of Children’s Health for 129,781 children aged 10–17 with 27 state-level variables capturing general economic conditions, labor supply, and the monetary or time...
Abstract Objectives To examine the association between gun violence and birth outcomes among women in Chicago. Methods Using a 5-year set of birth files (2011–2015) merged with census and police data, birth outcomes including low birth weight (LBW, BW < 2500 g), preterm birth (PTB, < 37 weeks gestation), and small-for-gestational-age (SGA, BW < 10th...
Abstract Objectives This study sought to describe the knowledge and perceptions of pregnant women in Miami-Dade County concerning Zika virus (ZIKV) in their community, to characterize their testing behaviors, and to identify any barriers that would keep them from seeking testing. Methods The Florida Department of Health in Miami-Dade County partnered with...
Abstract The effects of place on human health and development have been extensively studied in recent years in the adult and adolescent populations, but minimal research has addressed neighborhood effects in early childhood. This analysis of the National Survey of Children’s Health 2011/2012 cross-sectional survey examined relationships between risk for developmental disability in early childhood and neighborhood characteristics in a nationally-representative sample of children...
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