scholarly journals Identifying urban built environment factors in pregnancy care and maternal mental health outcomes

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yiye Zhang ◽  
Mohammad Tayarani ◽  
Shuojia Wang ◽  
Yifan Liu ◽  
Mohit Sharma ◽  
...  
Keyword(s):  
Mental Health ◽  
Prenatal Care ◽  
Built Environment ◽  
Maternal Mental Health ◽  
Air Pollutant ◽  
Urban Setting ◽  
Equation Modeling ◽  
Built Environments ◽  
Care Providers ◽  
Environment Factors

Abstract Backgrounds Risk factors related to the built environment have been associated with women’s mental health and preventive care. This study sought to identify built environment factors that are associated with variations in prenatal care and subsequent pregnancy-related outcomes in an urban setting. Methods In a retrospective observational study, we characterized the types and frequency of prenatal care events that are associated with the various built environment factors of the patients’ residing neighborhoods. In comparison to women living in higher-quality built environments, we hypothesize that women who reside in lower-quality built environments experience different patterns of clinical events that may increase the risk for adverse outcomes. Using machine learning, we performed pattern detection to characterize the variability in prenatal care concerning encounter types, clinical problems, and medication prescriptions. Structural equation modeling was used to test the associations among built environment, prenatal care variation, and pregnancy outcome. The main outcome is postpartum depression (PPD) diagnosis within 1 year following childbirth. The exposures were the quality of the built environment in the patients’ residing neighborhoods. Electronic health records (EHR) data of pregnant women (n = 8,949) who had live delivery at an urban academic medical center from 2015 to 2017 were included in the study. Results We discovered prenatal care patterns that were summarized into three common types. Women who experienced the prenatal care pattern with the highest rates of PPD were more likely to reside in neighborhoods with homogeneous land use, lower walkability, lower air pollutant concentration, and lower retail floor ratios after adjusting for age, neighborhood average education level, marital status, and income inequality. Conclusions In an urban setting, multi-purpose and walkable communities were found to be associated with a lower risk of PPD. Findings may inform urban design policies and provide awareness for care providers on the association of patients’ residing neighborhoods and healthy pregnancy.

scholarly journals Identifying Urban Built Environment Factors in Pregnancy Care and Maternal Mental Health Outcomes

2021 ◽  
Author(s):  
Yiye Zhang ◽  
Mohammad Tayarani ◽  
Shuojia Wang ◽  
Yifan Liu ◽  
Mohit Sharma ◽  
...  
Keyword(s):  
Mental Health ◽  
Machine Learning ◽  
Prenatal Care ◽  
Built Environment ◽  
Air Pollutant ◽  
Urban Setting ◽  
Equation Modeling ◽  
Built Environments ◽  
Care Providers ◽  
Environment Factors

Abstract Backgrounds: Environmental risk factors related to the built environment have been associated with women’s mental health and preventive care. This study sought to identify built environment factors that are associated with variations in prenatal care and subsequent pregnancy-related outcomes in an urban setting. Methods: In a retrospective observational study using machine learning, we characterized the types and frequency of events in prenatal care that are associated with the various built environment factors of the patients’ residing neighborhoods. We hypothesize that, in comparison to women living in high-quality built environments, women who reside in low-quality built environments experience a different pattern of clinical events that may increase the risk for adverse outcomes. Using machine learning, we performed pattern detection to characterize the variability in prenatal care with respect to encounter types, clinical problems, and medication prescriptions. Structural equation modeling was used to test the associations among built environment, prenatal care variation, and pregnancy outcome. The main outcome is postpartum depression (PPD) diagnosis within 1 year following childbirth. The exposures were the quality of the built environment in the patients’ residing neighborhoods. Electronic health records (EHR) data of pregnant women (n=8,949) who had live delivery at an urban academic medical center in 2015 to 2017 were included in the study. Results: We discovered prenatal care patterns that were summarized into three common types. Women who experienced the prenatal care pattern with the highest rates of PPD were more likely to reside in neighborhoods with homogeneous land use, lower walkability, lower air pollutant concentration, and lower accessibility to retail stores after adjusting for age, neighborhood average education level, marital status, and income inequality. Conclusions: In an urban setting, multi-purpose and walkable communities were found to be associated with a lower risk of PPD. Findings may inform urban design policies and provide awareness for care providers on the association of patients’ residing neighborhoods and healthy pregnancy.

scholarly journals Prenatal Care Disruptions and Associations With Maternal Mental Health During the COVID-19 Pandemic

2021 ◽  
Vol 2 ◽  
Author(s):  
Taylor Groulx ◽  
Mercedes Bagshawe ◽  
Gerald Giesbrecht ◽  
Lianne Tomfohr-Madsen ◽  
Erin Hetherington ◽  
...  
Keyword(s):  
Mental Health ◽  
Prenatal Care ◽  
Maternal Mental Health ◽  
Well Being ◽  
Care Providers ◽  
Support Person ◽  
General Anxiety ◽  
French Speaking ◽  
Novel Coronavirus ◽  
The Impact

As the novel coronavirus (COVID-19) spread across Canada in March 2020, provinces imposed restrictions. These changes impacted how pregnant individuals received prenatal care and experienced childbirth. The stress caused by these changes may negatively affect the well-being of pregnant individuals with impacts on the developing child. This study investigated the impact of the pandemic on prenatal care and birth plans of pregnant individuals in Canada and potential associations with maternal mental health. Data from 4,604 participants was collected from English- and French-speaking Canadians between April 5 and June 1, 2020 as part of the Canada-wide Pregnancy During the COVID-19 Pandemic study. Symptoms of maternal depression, general anxiety, and pregnancy-related anxiety were assessed. Participants also answered questions about disruptions and changes to prenatal care and their birth plans due to the COVID-19 pandemic. Logistic regression was used to estimate associations between prenatal care disruptions and maternal mental health. Cancellation of prenatal appointments and birth plan changes (specifically changes to childcare during birth and change of support person attending the birth) were significantly associated with greater odds of experiencing clinically elevated depression, anxiety, and/or pregnancy-related anxiety symptoms. These results highlight the need for reliable and accessible prenatal care during the pandemic, such as the integration of mental health screenings and co-ordination of prenatal care providers.

scholarly journals Prenatal care disruptions and associations with maternal mental health during the COVID-19 pandemic

2021 ◽  
Author(s):  
Taylor Groulx ◽  
Mercedes Bagshawe ◽  
Gerald Giesbrecht ◽  
Lianne Tomfohr-Madsen ◽  
Erin Hetherington ◽  
...  
Keyword(s):  
Mental Health ◽  
Prenatal Care ◽  
Maternal Mental Health ◽  
Well Being ◽  
Additional Stress ◽  
Care Providers ◽  
Support Person ◽  
General Anxiety ◽  
Novel Coronavirus ◽  
The Impact

As the novel coronavirus (COVID-19) spread across Canada in March 2020, provinces imposed strict lockdowns causing restrictions and disruptions to health care. These changes impacted how pregnant individuals received prenatal care and experienced childbirth. The additional stress caused by these changes may negatively affect the well-being of pregnant individuals and the developing child. This study investigated the impact of the pandemic on prenatal care and birth plans of pregnant individuals in Canada and potential associations with maternal mental health. Data from 4604 participants was collected from English- and French-speaking Canadians between April 5-June 1, 2020 as part of the Canada-wide Pregnancy During the COVID-19 Pandemic study. Symptoms of maternal depression, general anxiety, and pregnancy-related anxiety were assessed. Participants also answered questions about disruptions and changes to prenatal care and their birth plans due to the COVID-19 pandemic. Logistic regression was used to estimate associations between prenatal care disruptions and maternal mental health. Cancellation of prenatal appointments and birth plan changes (specifically changes to childcare during birth and change of support person attending the birth) were significantly associated with greater odds of experiencing clinically-elevated depression, anxiety, and/or pregnancy-related anxiety symptoms. These results illustrate the need for reliable and accessible prenatal care during the pandemic, such as the integration of mental health screenings and co-ordination of prenatal care providers.

Optimizing Maternal Mental Health Within A Primary Health Care Centre: A Model Program

2008 ◽  
Vol 27 (2) ◽  
pp. 105-116 ◽  
Author(s):  
Angela Bowen ◽  
Marilyn Baetz ◽  
Nora Mckee ◽  
Nancy Klebaum
Keyword(s):  
Mental Health ◽  
Health Care ◽  
Health Care Providers ◽  
Service Providers ◽  
Maternal Mental Health ◽  
Care Program ◽  
Postpartum Women ◽  
Care Providers ◽  
Health Care Centre ◽  
Women Health

Depression is a common problem that affects approximately 10 to 15% of pregnant and postpartum women. Health care providers often fail to recognize depression in this population, and pregnant and postpartum women may be reluctant to seek help because of the stigma associated with mental illness. This article describes the Maternal Mental Health Program, an innovative, shared care program that brings together previously fragmented services and co-locates multidisciplinary clinicians within a primary care setting. This approach shows promise with respect to improving mental health outcomes; meeting the needs of women, health care students, and service providers; and increasing awareness of and access to specialized mental health care.

Designing Healthier Built Environments

2018 ◽  
Author(s):  
Pedro Gullón ◽  
Gina S. Lovasi
Keyword(s):  
Mental Health ◽  
Physical Activity ◽  
Type 2 Diabetes ◽  
Built Environment ◽  
Health Outcomes ◽  
Low Income ◽  
Built Environments ◽  
Street Connectivity ◽  
Research Challenges

The “built environment” is comprised of human-made structures and systems, and aspects include access to and attractiveness of walkable destinations (e.g., retail stores, parks) and community design features (e.g., street connectivity, sidewalk access). A variety of built environment characteristics can influence health outcomes and behaviors, including physical activity, obesity, type 2 diabetes, hypertension, and mental health, as well as sleep and use of tobacco and alcohol. This chapter discusses the large and complex accumulated research on the built environment as well as the methods used to study it, research challenges, policy implication, and how to bring together partnerships for policy change. This chapter also discusses the research conducted across populations (e.g., children, low-income individuals) and geographies (e.g., urban and rural geographies).

Maternal Mental Health Mediates the Relationship Between Household Food Insecurity and Early Child Development in Brazil

2021 ◽  
Vol 42 (1) ◽  
pp. 77-90
Author(s):  
Jéssica Pedroso ◽  
Fernando José Herkrath ◽  
Gabriela Buccini ◽  
Sonia Isoyama Venancio ◽  
Rafael Pérez-Escamilla ◽  
...  
Keyword(s):  
Mental Health ◽  
Structural Equation Modeling ◽  
Structural Equation ◽  
Maternal Mental Health ◽  
Unwanted Pregnancy ◽  
Equation Modeling ◽  
Early Child Development ◽  
Household Food Insecurity ◽  
Household Food ◽  
The Relationship

Background: Optimal early child development (ECD) is fundamental for every child to achieve their developmental potential and thrive. Household food insecurity (HFI) is a risk factor for suboptimal development, but there is still a need to better understand the pathways that explain this relationship. Objective: To evaluate whether maternal mental health and infant’s diet mediate the association between HFI and ECD using structural equation modeling. Methods: Cross-sectional study with 474 mother–infant dyads. Mothers answered a questionnaire that evaluated variables through validated instruments. Structural equation modeling analyses were conducted to obtain standardized effects (β) and bias-corrected 95% CI, enabling comparisons between the magnitude of the effects. The following observed variables were included: HFI, ECD, consumption of a healthy and diverse diet, the presence of a partner in the household, wanted pregnancy, and current breastfeeding. Latent variables were included to evaluate mental health, poverty, and neonatal health. Results: Poor maternal mental health mediated the relationship between HFI and ECD (β = −.05), but a healthy and diverse diet was not a mediator in this relationship. Poverty was related to lower development scores directly (β = .21) and indirectly (β = .02). Not having a partner (β = .05) and having an unwanted pregnancy (β = .02) predicted indirectly lower development scores. Conclusions: Poor maternal mental health mediates the relationship between HFI and ECD, and ECD is influenced by poverty, single motherhood, and unwanted pregnancy through different pathways. Therefore, public policies and interventions that aim to promote an optimal ECD should also approach these aspects.

Digital Health Systems in Maternal Mental Health: A Focus Group Assessment of Patient Needs and Views (Preprint)

2020 ◽  
Author(s):  
Alexandra Zingg ◽  
Laura Carter ◽  
Deevakar Rogith ◽  
Amy Franklin ◽  
Sudhakar Selvaraj ◽  
...  
Keyword(s):  
Mental Health ◽  
Focus Group ◽  
Digital Technology ◽  
Postnatal Care ◽  
Maternal Mental Health ◽  
Healthcare Management ◽  
Digital Tools ◽  
Easy Access ◽  
Care Providers ◽  
Depressive Episodes

BACKGROUND Peripartum depression has an incidence rate of approximately 11% among pregnant women and new mothers in the U.S, yet many cases go undiagnosed and untreated due to psychosocial and logistical barriers. The interdisciplinary nature of PPD management presents a challenging scenario for communication and coordination between care providers and patients. Digital technologies offer many opportunities to improve mental healthcare management for women seeking pre- and-postnatal care. They provide a discrete, practical medium that is well-suited for the sensitive nature of mental health. However, current digital interventions in this domain provide suboptimal support and their responsiveness to end user needs is quite limited. OBJECTIVE Our objective is to map the terrain of information needs of women seeking pre-and-postnatal care, specifically for the management of their mental health. Ultimately, we will apply the derived insights to inform our development efforts of a novel digital solution to be used in an academic clinical setting. METHODS This qualitative study consists of semi-structured focus group interviews with a total of nine patients receiving care at an academic Obstetrics and Gynecology clinic. Discussion questions covered topics such as smartphone use and pregnancy apps. A total of two sessions were conducted and audio recorded. Data from the recordings were analyzed through thematic analysis. Overarching themes and views from the sessions were annotated. A survey was also administered to assess participants’ information seeking behavior and use of popular applications. RESULTS Access to smartphones and data plans was not an issue for participants. All used at least one pregnancy app, and three used additional health apps such as pedometers. Easy access to informational and human resources such as evidenced-based pregnancy information, their healthcare providers, and their peers was common across participants. The sense of community offered in discussion boards was also important to participants. Lack of postpartum support and limited personalization of user experience in current digital tools were identified as gaps and barriers for management of PPD and other mental health disorders. Digital technology features recommended by participants were: 1) a journaling feature, 2) online library of keywords linking to credible information, 3) a responsive bi-directional communication pathway to interact with their clinical team, and 4) personalized support for second pregnancy, diabetes, and prior depressive episodes. CONCLUSIONS Users prefer digital technology systems that go beyond a generic approach. They also want these systems to be adaptable to their needs at the moment, whether it is consulting with their provider or simply seeking peer support. Future technologies aimed at maternal mental health should focus on the individual needs of patients, while at the same time offering them common digital tools such as online communities and easy access to reliable information. CLINICALTRIAL N/A

Longitudinal predictors of adult socioeconomic attainment: The roles of socioeconomic status, academic competence, and mental health

2011 ◽  
Vol 23 (1) ◽  
pp. 315-324 ◽  
Author(s):  
Lisa Slominski ◽  
Arnold Sameroff ◽  
Katherine Rosenblum ◽  
Tim Kasser
Keyword(s):  
Mental Health ◽  
Socioeconomic Status ◽  
Educational Attainment ◽  
Structural Equation ◽  
Maternal Mental Health ◽  
Academic Competence ◽  
Occupational Attainment ◽  
Equation Modeling ◽  
Socioeconomic Attainment ◽  
Family Ses

AbstractEducational attainment and occupational status are key markers of success in adulthood. We expand upon previous research that focused primarily on the contributions of academic competence and family socioeconomic status (SES) by investigating the role of mental health in predicting adult SES. In a longitudinal study spanning 30 years, we used structural equation modeling to examine how parental mental health in early childhood and family SES, offspring academic competence, and offspring mental health in adolescence relate to occupational and educational attainment at age 30. Results were that adolescent academic competence predicted adult educational attainment, and that educational attainment then predicted occupational attainment. The pathways between academic competence and occupational attainment, family SES and educational attainment, and family SES and occupational attainment were not significant. In contrast, adolescent mental health not only predicted educational attainment, but was also directly related to adult occupational attainment. Finally, early maternal mental health was associated with offspring's adult socioeconomic attainment through its relations with adolescent academic competence and mental health. These results highlight the importance of mental health to adult socioeconomic attainment.

scholarly journals Cyberbullying Among School Adolescents in an Urban Setting of a Developing Country: Experience, Coping Strategies, and Mediating Effects of Different Support on Psychological Well-Being

2021 ◽  
Vol 12 ◽  
Author(s):  
Anh Toan Ngo ◽  
Anh Quynh Tran ◽  
Bach Xuan Tran ◽  
Long Hoang Nguyen ◽  
Men Thi Hoang ◽  
...  
Keyword(s):  
Mental Health ◽  
Coping Strategies ◽  
Family Support ◽  
Structural Equation ◽  
Well Being ◽  
Psychological Problems ◽  
Mediating Effect ◽  
Urban Setting ◽  
Equation Modeling ◽  
Mediating Effects

Background: This study examined the cyberbullying experience and coping manners of adolescents in urban Vietnam and explored the mediating effect of different support to the associations between cyberbullying and mental health issues.Methods: A cross-sectional study was performed on 484 students at four secondary schools. Cyberbullying experience, coping strategies, psychological problems, and family, peer, and teacher support were obtained. Structural equation modeling was utilized to determine the mediating effects of different support on associations between cyberbullying and psychological problems.Results: There were 11.6 and 28.3% of students who reported that they experienced and observed at least one cyberbullying act in the last 3 months, respectively. Among the victims, only 48.2% tried to stop the perpetrators. Meanwhile, the majority of observers belonged to the “Intervene” group who tried to report cyberbullying acts or help victims. Family support was found to partially mediate associations between cyberbullying experience and observation with levels of psychological problems among adolescents.Conclusion: The 3-month rate of cyberbullying experience and observation among urban adolescents aged 11–14 was low. However, current coping strategies against cyberbullying were not sufficient. Family support is an important factor that should be considered for designing interventions to mitigating the impacts of cyberbullying on the mental health of adolescents.

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