653 Perceived stress among low income pregnant women in during the COVID-19 pandemic

Approximately 15% of US women currently smoke during pregnancy. An important step toward providing effective smoking cessation interventions during pregnancy is to identify individuals who are more likely to encounter difficulty quitting. Pregnant smokers frequently report smoking in response to intrapersonal factors (e.g., negative emotions), but successful cessation attempts can also be influenced by interpersonal factors (i.e., influence from close others). This study examined the association between emotion regulation difficulties, positive and negative social control (e.g., encouragement, criticism), and smoking cessation-related variables (i.e., smoking quantity, withdrawal symptoms) among pregnant smokers. Data were drawn from the pretreatment wave of a smoking cessation trial enrolling low-income pregnant women who self-reported smoking in response to negative affect (N = 73). Greater emotion regulation difficulties were related to greater smoking urges (b = 0.295, p = .042) and withdrawal symptoms (b = 0.085, p = .003). Additionally, more negative social control from close others was related to fewer smoking days (b = -0.614, p = .042) and higher smoking abstinence self-efficacy (b = 0.017, p = .002). More positive social control from close others interacted with negative affect smoking (b = -0.052, p = .043); the association between negative affect smoking and nicotine dependence (b = 0.812, p < .001) only occurred at low levels of positive social control. Findings suggest that emotion regulation difficulties may contribute to smoking during pregnancy by exacerbating women's negative experiences related to smoking cessation attempts. Negative social control was related to lower smoking frequency and greater confidence in quitting smoking, suggesting that it may assist pregnant smokers' cessation efforts. Positive social control buffered women from the effects of negative affect smoking on nicotine dependence.

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Identifying Mobile Health Technology Experiences and Preferences of Low-Income Pregnant Women with Diabetes

Journal of Diabetes Science and Technology ◽

10.1177/1932296821993175 ◽

2021 ◽

pp. 193229682199317

Author(s):

Karolina Leziak ◽

Eleanor Birch ◽

Jenise Jackson ◽

Angelina Strohbach ◽

Charlotte Niznik ◽

...

Keyword(s):

Pregnant Women ◽

Mobile Health ◽

Low Income ◽

Self Regulation ◽

Health Inequities ◽

Comparison Method ◽

Rapid Expansion ◽

Self Management ◽

Postpartum Women ◽

Design Elements

Background: Rapid expansion of mobile technology has resulted in the development of many mobile health (“mHealth”) platforms for health monitoring and support. However, applicability, desirability, and extent of tailoring of these platforms for pregnant women, particularly in populations who experience the greatest health inequities—such as women with diabetes mellitus (DM) and/or those with greater socioeconomic barriers—remains unknown. The objective is to understand low-income pregnant women’s experiences and preferences for mHealth tools to support DM health and improve DM self-management during pregnancy. Methods: Low-income pregnant and postpartum women were included in individual interviews or focus groups; women with type 2 DM, gestational DM, or no DM were included. Analysis was performed with the constant comparison method. Results: In this population of 45 ( N=37 with DM) low-income, largely minority, pregnant and postpartum women, 100% reported access to smartphones and prior experience with apps. Interest in mHealth to support health and engagement during pregnancy was high. Preferences for general mHealth features included education that reduces uncertainty, support communities, visualizing progress, convenient access to information, and support for better management of pregnancy-related tasks. Preferred design elements included personalization, interactive features, and integrated graphics. Women with DM expressed multiple additional DM-specific needs, including support tools for DM self-management and self-regulation tasks. Conclusion: Pregnant and postpartum women, especially those with DM, desire mHealth technology to support engagement and to adapt lifestyle guidelines and treatment requirements for a healthy pregnancy. Further work to develop mHealth interventions tailored for target populations remains a key step in reducing health inequities and promoting access to evidence-based perinatal health interventions.

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Serum Concentrations of Selected Organochlorines in Pregnant Women and Associations with Pregnancy Outcomes. A Cross-Sectional Study from Two Rural Settings in Cambodia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17207652 ◽

2020 ◽

Vol 17 (20) ◽

pp. 7652

Author(s):

Margit Steinholt ◽

Shanshan Xu ◽

Sam Ol Ha ◽

Duong Trong Phi ◽

Maria Lisa Odland ◽

...

Keyword(s):

Polychlorinated Biphenyls ◽

Pregnant Women ◽

Gestational Age ◽

Low Income ◽

Cross Sectional Study ◽

Maternal Serum ◽

Sectional Study ◽

Serum Samples ◽

Cross Sectional ◽

Rural Settings

We conducted a cross-sectional study among 194 pregnant women from two low-income settings in Cambodia. The inclusion period lasted from October 2015 through December 2017. Maternal serum samples were analyzed for persistent organic pollutants (POPs). The aim was to study potential effects on birth outcomes. We found low levels of polychlorinated biphenyls (PCBs) and organochlorine pesticides (OCP), except for heptachlors, β-hexachlorocyclohexane (HCH), heptachlor epoxide, and p,p’-DDE. There were few differences between the two study locations. However, the women from the poorest areas had significantly higher concentrations of p,p’-DDE (p < 0.001) and hexachlorobenzene (HCB) (p = 0.002). The maternal factors associated with exposure were parity, age, residential area, and educational level. Despite low maternal levels of polychlorinated biphenyls, we found significant negative associations between the PCB congeners 99 (95% CI: −2.51 to −0.07), 138 (95% CI: −1.28 to −0.32), and 153 (95% CI: −1.06 to −0.05) and gestational age. Further, there were significant negative associations between gestational age, birth length, and maternal levels of o,p’-DDE. Moreover, o,p’-DDD had positive associations with birth weight, and both p,p’-DDD and o,p’-DDE were positively associated with the baby’s ponderal index. The poorest population had higher exposure and less favorable outcomes.

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Improving oral health in low-income pregnant women with a nurse practitioner-directed oral care program

Journal of the American Academy of Nurse Practitioners ◽

10.1111/j.1745-7599.2011.00606.x ◽

2011 ◽

Vol 23 (5) ◽

pp. 249-257 ◽

Cited By ~ 15

Author(s):

Nancy J. Cibulka ◽

Sandra Forney ◽

Kathy Goodwin ◽

Patricia Lazaroff ◽

Rebecca Sarabia

Keyword(s):

Oral Health ◽

Pregnant Women ◽

Nurse Practitioner ◽

Low Income ◽

Oral Care ◽

Care Program

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Assessment of knowledge and practices of Internally Displaced pregnant women attending to antenatal clinic center at Arbat camp in Sulaimani, Kurdistan Region of Iraq

Kurdistan Journal of Applied Research ◽

10.24017/science.2018.1.10 ◽

2017 ◽

Vol 3 (1) ◽

pp. 52-56

Author(s):

Layla Abdulkhalk Abass

Keyword(s):

Antenatal Care ◽

Pregnant Women ◽

Low Income ◽

Reproductive Age ◽

Good Knowledge ◽

Internally Displaced Persons ◽

Islamic State ◽

Displaced Persons ◽

Kurdistan Region ◽

Internally Displaced

Internally displaced persons are peoples displaced in it is own country but not crossed a border. After (Islamic State of Iraq and Syria attacked in 2014 to Iraq, millions of Iraqi people flee from their own city war zone to safe camps in Kurdistan region north of Iraq, Arbat camp is one of these camps. Iraqi civilian people constitute most new displacement persons around the world as at least 2.2 million were displaced in 2014. An important part of basic maternal health care is antenatal care that must be provided during pregnancy. Aim of this study is to provide demographic data of Internally Displaced Persons pregnant women and the effect on antenatal care knowledge and practices among of Arbat camp that visits to camp health centers on their health. Assessment of knowledge and practices of pregnant women about antennal care. A cross-sectional descriptive study has been conducted to assess the knowledge and practices of (103) women attended to antenatal care of internally displaced persons) at Arbat camps between 1 January to 30 June 2016. Data collected through the questionnaire form by face-to-face interview. Statistical analyses performed by using SPSS version 16.0, to find descriptive analysis like percentage and frequency and for relative statistical analysis. The results have revealed that most of the pregnant women were in the active reproductive age group 18-25 years old 56(54.4%) pregnant women, housewives 102(99%), illiterate 48(46.6%) pregnant women, were in families that have low income with 48(46.6%) pregnant women with significant relation to the knowledge and practices to antenatal care. In conclusion, most pregnant women have very good knowledge about antenatal care except about performing oral health hygiene during pregnancy. The majority of pregnant women in camps have very good knowledge about all practices that must be do during antenatal except taking medication without a physician prescription.

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Global Disease Outbreaks and Effects on Maternal, Newborn & Child Health in Global South, a Systematic Review

International Journal of TROPICAL DISEASE & Health ◽

10.9734/ijtdh/2020/v41i1130334 ◽

2020 ◽

pp. 47-58

Author(s):

O. Orjingene ◽

N. L. Akondeng ◽

A. Kone-Coulibaly ◽

T. Ogojah ◽

M. Ganama

Keyword(s):

Health Care ◽

Child Health ◽

Pregnant Women ◽

Low Income ◽

Hospital Admissions ◽

Disease Outbreaks ◽

Global South ◽

Hiv Positive ◽

Newborn And Child Health ◽

And Child Health

Background/Aim: The world has witnessed several disease outbreaks both in the past and in recent times. Apart from loss of lives as a result of such outbreaks, there are also disruptions in health care provision and utilization due to certain measures aimed at curtailing the spread of such outbreaks. This study aimed to seek evidence from existing literature on the effects of disease outbreaks on maternal, newborn and child health care in Global South. Methods: A Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used and 14 literatures met the inclusion criteria. Results: HIV/AIDS pandemic affected the Maternal Newborn and Child Health since increased cases of anaemia, hospital admissions, still births in HIV positive pregnant and cases of foetal anaemia reported in infants born from HIV positive pregnant women were reported. No COVID-19 pandemic related-effects on MNCH observed since no maternal deaths and transmission from infected pregnant women to their newborns reported. Indirect effects of pandemics on MNHC include reduced service delivery and demand/utilization as well as inaccessibility due to diverse reasons. Discussion: The Government should put in place palliative measures for low-income citizens; engage and sensitize women, pregnant women and their children on available health care services and mitigation measures in place to access with minimal or no risk of being infected in a secure environment.

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Contact With Nature as a Mental Health Buffer for Lower Income Communities During the COVID-19 Pandemic

Frontiers in Sustainable Cities ◽

10.3389/frsc.2021.688473 ◽

2021 ◽

Vol 3 ◽

Author(s):

Amber L. Pearson ◽

Teresa Horton ◽

Karin A. Pfeiffer ◽

Rachel Buxton ◽

Joseph Gardiner ◽

...

Keyword(s):

Mental Health ◽

Perceived Stress ◽

Low Income ◽

Longitudinal Research ◽

Positive Association ◽

Depression Symptoms ◽

Health Issues ◽

Mental Health Issues ◽

As Stress ◽

Perceived Access

Despite a growing number of research outputs on the importance of nature contact during the COVID-19 pandemic, we know of no longitudinal research conducted prior to and during the pandemic among low-income and minority ethnicity populations, i.e., those that might be most affected. Furthermore, we have scant information about how and to what degree contact with nature might protect mental health or mitigate worsening of mental health during the pandemic. We filled these gaps using a subset of a longitudinal study of n = 86 individuals in low-income, predominantly African American, neighborhoods in Detroit, MI, USA. The study addressed the following research questions: (1) did self-reported use and perceived value of nature change during, vs. prior to, the pandemic; (2) did perceived access to outdoor spaces buffer people against mental health issues such as stress, anxiety and depression symptoms; or (3) did objectively measured quality of nature views from home buffer people against mental health issues, taking into account relevant covariates and pandemic experiences (e.g., loss of employment, death of a friend/relative)? While attitudes to nature improved slightly from pre- to during the pandemic, we also observed significant decreases in most types of outdoor physical activity and passive enjoyment of nature (e.g., smelling plants/rain). We found a positive association between visibility of greenspace and perceived stress and anxiety, which not only contradicts previous research findings, but was especially surprising given that overall there was a decrease in perceived stress from 2019–2020. We did not detect associations between perceived access/use of nature and mental health. However, higher depressive symptoms were associated with exposure to more COVID-19-related stressors (lost employment, death of friends from COVID-19, etc.). Taken together, our results indicate that COVID-19 may serve to prolong or exacerbate mental health issues, rather than create them, in this population and that low quality greenspace may perhaps limit the ability for nature view to buffer mental health during the pandemic.

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Recruitment of low-income pregnant women into a dietary and dental care intervention: lessons from a feasibility trial

10.21203/rs.2.10813/v2 ◽

2020 ◽

Author(s):

Amanda Rodrigues Amorim Adegboye ◽

Paula G Cocate ◽

Camila Benaim ◽

Maria Claudia da Veiga Carvalho ◽

Michael M Schlüssel ◽

...

Keyword(s):

Clinical Trial ◽

Pregnant Women ◽

Low Income ◽

Quantitative Data ◽

Health Centre ◽

Feasibility Trial ◽

Random Allocation ◽

Eligibility Criteria ◽

Related Factors ◽

Phone Calls

Abstract Background: There are difficulties in carrying out research in low-income urban communities, but the methodological challenges and suggestions on how to deal with them are often undocumented. The aim of this study is to describe the challenges of recruiting and enrolling low-income pregnant women with periodontitis to a clinical trial on vitamin D/calcium milk fortification and periodontal therapy (PT) and describe the patient-, study protocol- and setting-related factors related to women’s ineligibility and refusal to participate in the study. Methods: A mixed-method sequential exploratory design was applied. Qualitative and quantitative data on recruitment to a 2x2 factorial feasibility clinical trial were used. 18 women attending the health centre in a low-income area in Duque de Caxias (Rio de Janeiro, Brazil) took part in focus group discussions and data were thematically analysed. Quantitative data were analysed using appropriate descriptive statistics, including absolute and relative frequencies. Results: Of all referrals (767), 548 (78.5%) did not meet the initial eligibility criteria. The main reason for exclusion (58%) was advanced gestational age (>20 weeks) at first prenatal appointment. In the periodontal examination (dental screen), the main reason for exclusion was the presence of extensive caries (64 out of 127 exclusions). Non-participation of those eligible after the periodontal examination was approximately 24% (22 out 92 eligible women) and predominantly associated with patient-related barriers (e.g. transportation barriers, family obligations, unresponsive to phone calls, and disconnected telephones). The study recruited 70 women with periodontitis in 53 weeks and did not reach the benchmark of 120 women in 36 weeks (58.3% of the original target). Recruitment was severely hindered by health centre closures due to general strikes. The recruitment yields were 9.1% (70/767) of all women contacted at first prenatal visit and 76.1% (70/92) of those screened eligible and enrolled in the trial. Women did not report concerns regarding random allocation and considered fortified milk as a healthy and safe food for pregnant women. Some women reported that financial constraints (e.g. transportation cost) could hinder participation in the study. Conclusion: Engagement between the research team and health centre staff (e.g. nurses) facilitated referral and recruitment, yet some pregnant women failed to participate in the study largely due to significant patient-related socio-demographic barriers and setting-related factors. Our data illustrate the complexity of overcoming recruitment and enrolment challenges for clinical trials in resource-limited settings.

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