A depression preventive intervention for rural low-income African-American pregnant women at risk for postpartum depression

BACKGROUND The Mothers and Babies Course (MB) was recognized by the U.S. Preventive Services Task Force as an evidence-based prevention of postpartum depression (PPD) intervention that should be recommended to pregnant women at risk for PPD. OBJECTIVE This report examines the feasibility and acceptability of enhancing the MB 1-on-1 intervention with the addition of 36 short message service (SMS) text messages that targeted three areas: reinforcement of skills, between session homework reminders, and responding to self-monitoring texts (MB-TXT). METHODS In partnership with 9 home visiting programs, 28 ethnically and racially diverse pregnant women (M=25.6 weeks, SD=9.0) received the MB-TXT. Feasibility was defined by home visitors’ adherence to logging into the HealthySMS platform to enter session data and trigger text messages within seven days of the in-person session. Acceptability of MB-TXT was measured by participants’ usefulness and understanding ratings of the text messages and responses to the self-monitoring text messages. RESULTS On average, home visitors followed the study protocol and entered session-specific data between 5.50-61.17 days following MB 1-on-1 sessions and indicated that participants completed the between session homework almost half the time (M=5.36, SD=3.71). Participants responded to self-monitoring texts at a high level (89.3%) and rated the text message content as very useful and understandable. CONCLUSIONS This report contributes to a growing line of research focused on digital adaptations of MB. SMS is a low-cost, accessible digital tool that can be easily integrated into existing interventions, and implemented in community-based organizations and healthcare systems that serve women at risk for PPD. CLINICALTRIAL ClinicalTrials.gov Identifier: NCT03420755

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Racial/Ethnic Differences in Diet Quality and Eating Habits Among WIC Pregnant Women: Implications for Policy and Practice

American Journal of Health Promotion ◽

10.1177/0890117119883584 ◽

2019 ◽

Vol 34 (2) ◽

pp. 169-176 ◽

Cited By ~ 2

Author(s):

Alla M. Hill ◽

Danielle L. Nunnery ◽

Alice Ammerman ◽

Jigna M. Dharod

Keyword(s):

African American ◽

Pregnant Women ◽

African American Women ◽

Healthy Eating ◽

Diet Quality ◽

Low Income ◽

Eating Behaviors ◽

Dietary Habits ◽

Healthy Eating Index ◽

American Women

Purpose: One of the major federal food assistance programs, the Special Supplemental Program for Women, Infants, and Children (WIC), serves approximately 1.5 million low-income pregnant women per year; however, limited information is available on their dietary habits. This is critical because low-income women are at higher risk of gaining excess weight during pregnancy. Thus, the study objectives were to (1) determine the overall diet quality of WIC pregnant women and (2) examine diet quality and eating behaviors by race/ethnicity and other sociodemographics. Design: This was a cross-sectional study. Setting: One of the 3 WIC offices in a north-central county in North Carolina, USA. Sample: Pregnant women (n = 198) in the second trimester. Measures: Interviews included sociodemographics, food security, diet, and eating behaviors. Diet quality was assessed by the Healthy Eating Index (HEI) 2010 scores. Analysis: Descriptives, bivariate analysis, and multivariate analysis. Results: Average participant age was 26 years, and the mean HEI-2010 score was 56 of maximum score of 100. Specifically, African American women consumed significantly lower servings of whole grains (β = −1.71; 95% CI: −3.10 to −0.32; P < .05) and dairy (β = −1.42; 95% CI: −2.51 to −0.33; P < .05) compared with non-Hispanic white women. Hispanic women scored higher in daily intake of fruits (β = 0.98; 95% CI: 0.17-1.79; P < .05) and for consuming empty calories in moderation (β = 1.57; 95% CI: 0.06-3.09; P < .05). Frequency of intake of fast foods/outside meals was higher among African American women (57%, P = .025). Conclusion: Efforts are warranted to promote optimal nutrition among WIC pregnant women. Specifically, African American women are highly vulnerable to poor dietary habits during pregnancy. Further investigation of barriers/facilitators for healthy eating is necessary to address nutrition disparities among WIC pregnant women.

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Utilizing Dietetics Education Objectives to Support a Low-Income Community Program Targeting At-Risk Pregnant Women

Journal of the Academy of Nutrition and Dietetics ◽

10.1016/j.jand.2012.06.338 ◽

2012 ◽

Vol 112 (9) ◽

pp. A93

Author(s):

N.D. Ridgway ◽

D.L. Habash ◽

E. Reisdorf ◽

M.L. Nahikian-Nelms ◽

P.T. Gabbe

Keyword(s):

At Risk ◽

Pregnant Women ◽

Low Income ◽

Community Program ◽

Dietetics Education

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PrEP Uptake and Emergent HIV infections in Southern Arizona: Is There A Disconnect?

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.1111 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S438-S439 ◽

Cited By ~ 1

Author(s):

Anca Georgescu ◽

Cesar Egurrola ◽

Spencer Schaff ◽

Julia Fisher ◽

Shannon Smith ◽

...

Keyword(s):

At Risk ◽

African American ◽

American Indian ◽

Low Income ◽

Border Region ◽

Hiv Care ◽

Minority Population ◽

Newly Diagnosed ◽

Populations At Risk ◽

Significant Difference

Abstract Background Despite expansion of antiretroviral therapy in recent years and growing evidence for PrEP (pre exposure prophylaxis) efficacy, HIV incidence has continued to rise while PrEP uptake has remained low, particularly in populations at risk. Our goal is to compare these populations and further identify discrepancies in populations at risk in Southern Arizona. Methods We retroactively reviewed health records for patients evaluated at Banner University Medical Center Tucson outpatient clinics between January 2014 and September 2016, either with a new HIV diagnosis or prescribed tenofovir/emtricitabine for PrEP. Results We identified 147 patients with new HIV diagnoses and 65 patients evaluated for PrEp. 63% of the newly diagnosed HIV were of Hispanic, African American or American Indian descend (46%, 14% and 3% respectively) while the majority of PrEP patients were White (58%) with a statistically significant difference between the groups (P = 0.006). There was no significant difference between the age groups [28 (19%) of the HIV and 13 (20%) of the PrEP were 18–24] or gender (88% of people accessing HIV care were men, vs. 91% men seen for PrEP). Insurance information at the time of presentation was available for 145 HIV and 64 PrEP patients with statistically significant differences between the groups. 31(21%) newly diagnosed HIV had no insurance and 71 (49%) had a Medicaid plan while 45 (70%) of PrEP patients has a private insurance plan (P < 0.001). None of the people accessing PrEP reported iv drug use as a risk factor compared with 16 (11%) of the newly diagnosed (P = 0.003). Retention in care at 3 months was similar (76% of HIV and 75% of PrEP). The predominant risk categories were MSM with multiple partners and/or condomless anal sex for both groups. Conclusion To our knowledge this is the first study evaluating HIV and PrEP health care disparities in a border region of the Southwestern US, which is home to a large Hispanic minority population. Our findings suggest that low income minority populations, such as Hispanic, African American and American Indian in this region continue to have a higher risk for HIV acquisition and highlights the ongoing need to expand research on how these populations perceive their risk for HIV and navigate complex systems, such as health insurance, when seeking clinical services for PreP. Disclosures All authors: No reported disclosures.

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