scholarly journals Features and impact of trust-based relationships between community health workers and low-income pregnant women with chronic health conditions: A focus group study

2019 ◽  
Author(s):  
Lisa M. Boyd ◽  
Renee Mehra ◽  
Jordan Thomas ◽  
Jessica Lewis ◽  
Shayna Cunningham
Keyword(s):  
United States ◽  
Chronic Disease ◽  
Focus Group ◽  
Pregnant Women ◽  
Community Health ◽  
Low Income ◽  
Chronic Conditions ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health

Abstract Background Pregnancy can be a particularly stressful time for women with underlying chronic conditions. Chronic health conditions such as hypertension, cardiovascular disease, and diabetes are associated with obstetric morbidity and mortality and poor birth outcomes, and are becoming more prevalent among pregnant women in the United States. In light of the American Public Health Association’s call to increase the reach of community health worker (CHW) interventions, the aim of this paper is to better understand how to effectively support women with chronic disease during pregnancy by examining the impact of CHW support from the perspective of pregnant women.Methods Clients and CHWs were recruited from three community-based organizations in the eastern United States running Merck for Mothers-funded interventions to support pregnant women in urban settings. Nine focus groups and eight interviews were conducted with 40 low-income clients with chronic conditions and 18 CHWs and program staff. Focus group and interview data were analyzed using grounded theory-informed thematic analysis.Results Clients reported that CHWs contributed to their well-being during pregnancy in numerous ways and credited CHWs with improvements in mental health and health behaviors. Services like providing guidance around nutrition appeared to play a role in improving client management of chronic disease. CHWs’ ability to build trust-based relationships through emotional attendance, authenticity, and prioritization of clients’ needs facilitated the stress reduction and salubrious behavioral change reported by clients.Conclusions CHWs provide care for the whole woman during pregnancy, an approach that is unique within healthcare and confers multiple benefits. CHW intervention is particularly valuable for women facing challenges such as chronic disease and limited access to resources. Additional municipal, state, and federal resources should be devoted to expanding programs that provide vulnerable mothers with comprehensive care.

scholarly journals PURPOSE AND NUMBER OF CHRONIC HEALTH CONDITIONS AMONG OLDER ADULTS

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S841-S841
Author(s):  
Janis Sayer ◽  
Jennifer L Smith ◽  
Cate O’Brien ◽  
Joseph G Bihary ◽  
Dugan O’Connor ◽  
...  
Keyword(s):  
Older Adults ◽  
Chronic Disease ◽  
Chronic Conditions ◽  
The Body ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Positive Health ◽  
Chronic Health ◽  
Sense Of Purpose ◽  
New Findings

Abstract An overwhelming three-quarters of persons age 65 and over have multiple chronic health conditions (Gerteis et al., 2014). With a growing population of older adults, understanding the factors that predict health and reduce the risk of chronic disease is critical. Recent evidence finds that a high sense of purpose- “the belief that one’s life is purposeful and meaningful” (Ryff & Keyes, 1995, p. 720)- is associated with positive health outcomes among older adults. This study investigated the association between purpose and number of chronic conditions among older adults, and whether the relationship depended on age. The study included 6148 older adults (mean age=83.8) who participated in a larger study on wellness. Participants completed a survey that included a measure of sense of purpose and questions about chronic health conditions. Data were analyzed controlling for demographics, optimism, pessimism, social contact, BMI, physical activity, and smoking. Lower levels of purpose were significantly associated with higher numbers of chronic conditions. There was a significant interaction between purpose and age, such that relatively younger older adults with high levels of purpose had fewer chronic conditions. There was no relationship between purpose and number of chronic conditions for the oldest adult participants. The results add new findings to the body of research that demonstrates that sense of purpose is associated with chronic disease. As sense of purpose is modifiable, interventions that increase purpose among older adults, with an emphasis on the youngest-old, should be developed and implemented.

Safe Start Community Health Worker Program: A Multisector Partnership to Improve Perinatal Outcomes Among Low-Income Pregnant Women With Chronic Health Conditions

2020 ◽  
Vol 110 (6) ◽  
pp. 836-839 ◽  
Author(s):  
Shayna D. Cunningham ◽  
Valerie Riis ◽  
Laura Line ◽  
Melissa Patti ◽  
Melissa Bucher ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Community Health ◽  
Health Worker ◽  
Community Health Worker ◽  
Perinatal Outcomes ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
City Hospital ◽  
Chronic Health ◽  
Community Health Worker Program

Safe Start is a community health worker program representing a partnership between a high-volume, inner-city, hospital-based prenatal clinic; a community-based organization; a large Medicaid insurer; and a community behavioral health organization to improve perinatal outcomes among publicly insured pregnant women with chronic health conditions in Philadelphia, Pennsylvania. As of June 2019, 291 women participated in the program. Relative to a comparison group (n = 300), Safe Start participants demonstrate improved engagement in care, reduced antenatal inpatient admissions, and shorter neonatal intensive care unit stays.

scholarly journals Chronic health conditions related to quality of life for federal civil servants

2015 ◽  
Vol 36 (2) ◽  
pp. 35-41 ◽  
Author(s):  
Luciana Eduardo Fernandes Saraiva ◽  
Lays Pinheiro de Medeiros ◽  
Marjorie Dantas Medeiros Melo ◽  
Manuela Pinto Tiburcio ◽  
Isabelle Katherinne Fernandes Costa ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Chronic Conditions ◽  
Civil Servant ◽  
Civil Servants ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
Daily Work ◽  
Work And Life

OBJECTIVE: The aim of this study is to correlate the QOL domains of the civil servants to the type and number of chronic health conditions. METHOD: A transversal, quantitative study, conducted at the Department of Civil Servant Assistance of the Federal University of Rio Grande do Norte with 215 civil servants, during the period from March to May 2011. RESULTS: Among the chronic health conditions studied, there was significant relationship between non-communicable chronic disease and QOL scores, correlating weakly (r <-376; p <0.008) in the other fields. It was found that the greater the number of chronic conditions, the lower the values on the QOL scale. CONCLUSION: The quality of life of civil servants is negatively influenced by chronic health conditions, compromising, in general, their daily work and life activities.

scholarly journals IS BEING A PREMATURE OR HAVING ABNORMAL BIRTH WEIGHT ASSOCIATED WITH DEPRESSION AMONG 6 - 17 YEARS OLD U.S. CHILDREN?

2018 ◽  
Vol 23 (suppl_1) ◽  
pp. e51-e51
Author(s):  
Abdulaziz Bahassan ◽  
Colin Depp
Keyword(s):  
Mental Health ◽  
United States ◽  
Birth Weight ◽  
Low Birth Weight ◽  
Very Low Birth Weight ◽  
The United States ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Chronic Health ◽  
History Of

Abstract BACKGROUND Reports in 2015 showed that premature birth rate in the United States increased when compared to 2014 data, and this was the first increment since 2007. Major complications of prematurity and birth weight abnormalities are well known, but other complications including mental health abnormalities require more investigation to understand their association well. OBJECTIVES We aimed in this study to determine if prematurity and birth weight abnormalities including very low birth weight (VLBW) and low birth weight (LBW) are associated with depression among United States children aged between six and seventeen years old. ​ DESIGN/METHODS This is a cross sectional study using data from the National Survey of Children’s Health (NSCH) 2011–2012. When we applied our selection criteria, 84,182 children out of the total 95,677 NSCH population were selected. Our exclusion criteria were: age less than six years, child’s history of cerebral palsy, and mental retardation. Multivariable logistic regression was done to control for confounding effects when studying the association of prematurity, birth weight abnormalities and depression. ​ RESULTS Our results reveal that 3.6% of our population had history of depression, 11% were born prematurely, 7.4% had low birth weight, and 1.5% had very low birth weight. Depression was more frequent in children who were born prematurely (prevalence 4.3%) when compared to children born at term. Different models were built to analyze the association between prematurity, birth weight abnormalities and depression. There was no detectable statistically significant association when controlling for demographic data (age, gender, race, family structure) and mental health risk factors (parental poor mental health, chronic health conditions) as well as other factors. Results reveal that children who had chronic health conditions or had adverse family experiences have greater odds of having depression. On the other hand, African-American, male, and younger (6–11 years old) children have lower odds of depression. ​ CONCLUSION Further longitudinal studies are required to establish a causal relationship of behavioral and psychological complications, and to determine the biological mechanisms of brain development that could be associated with depression among premature infants or those who have birth weight abnormalities.

Aging Societies and the Ethical Challenges of Long Life

2018 ◽  
Author(s):  
Allison R. Heid ◽  
Steven H. Zarit
Keyword(s):  
United States ◽  
Life Expectancy ◽  
End Of Life ◽  
The United States ◽  
Chronic Health Conditions ◽  
Health Conditions ◽  
Older Individuals ◽  
Ethical Challenges ◽  
Chronic Health

Individuals are living longer than they ever have before with average life expectancy at birth estimated at 79 years of age in the United States. A greater proportion of individuals are living to advanced ages of 85 or more and the ratio of individuals 65 and over to individuals of younger age groups is shrinking. Disparities in life expectancy across genders and races are pronounced. Financial challenges of sustaining the older population are substantial in most developed and many developing countries. In the United States in particular, employer-based pension programs are diminishing. Furthermore, Social Security will begin taking in less money than it pays out as early as 2023, and the debate over its future in part entails discussions of equitable distribution of resources for the young in need and the old. Living longer is associated with a greater number of chronic health conditions—over two-thirds of Medicare beneficiaries in the United States have two or more chronic health conditions that require complex self-management regimes partnered with informal and formal care services from family caregivers and institutional long-term services and supports. Caregiver burden and stress is high as are quality care deficiencies in residential long-term care settings. The balance of honoring individuals’ autonomous wishes and providing person-centered care that also addresses the practicalities of safety is an ever-present quandary. Furthermore, complex decisions regarding end-of-life care and treatments plague the medical and social realms, as more money is spent at the end of life than at any other point and individuals’ wishes for less invasive treatment are often not accommodated. Yet, despite these challenges of later life, a large percentage of older individuals are giving financial support, time, and energy to younger generations, who are increasingly strained by economic hardship, the pressures on dual earner parents, and the problems faced by single parenthood. Older individuals’ engagement in society and the help they provide others runs counter to stereotypes that render them helpless and lonely. Overall, the ethical challenges faced by society due to the aging of the population are considerable. Difficult decisions that must be addressed include the sustainability of programs, resources, and social justice in care, as well as how to marshal the resources, talents, and wisdom that older people provide.

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