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Jeon N, Kent-Marvick J, Sanders JN, Hanson H, Simonsen SE. Comparing maternal factors associated with postpartum depression between primiparous adolescents and adults: A large retrospective cohort study. Birth 2024; 51:218-228. [PMID: 37849418 DOI: 10.1111/birt.12785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2022] [Revised: 06/29/2023] [Accepted: 09/22/2023] [Indexed: 10/19/2023]
Abstract
OBJECTIVES This study aimed to estimate the prevalence of diagnosed postpartum depression (PPD) and the likelihood of PPD among primiparous women. We also evaluated differences in the influence of various maternal factors associated with PPD in adolescent versus adult mothers. METHODS We conducted a retrospective cohort study using electronic health records linked to birth certificates to evaluate the associations between maternal factors and PPD diagnosis. The study population was stratified into adults and adolescents based on age at delivery. We evaluated socioeconomic, demographic, psychological, and clinical factors associated with PPD in each of the age-defined maternal cohorts using multivariable logistic regression analyses. RESULTS A total of 61,226 primiparous women, including 6435 (11%) mothers younger than 20 years old, were included in the study. The overall PPD rate was 4.0%, with the age-specific PPD rate measuring 1.6 times higher in adolescents than in adult women (6.1% vs. 3.8%). Compared with adults, adolescents were less likely to obtain firsttrimester prenatal care (33% vs. 16%), more likely to have recent tobacco use (11% vs. 6%), and more likely to have had an infection during pregnancy (5% vs. 1%). In adjusted models, significant factors for PPD in both groups included a history of depression or anxiety, tobacco use, and long-acting reversible contraception use. CONCLUSIONS In this cohort of first-time mothers, adolescents had higher rates of PPD diagnosis as well as PPD-associated maternal factors than adults. Increased awareness of PPD risk in adolescents and early intervention, including integrating mental healthcare into prenatal care, may help benefit adolescents and reduce the risk and severity of PPD.
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Affiliation(s)
- Nakyung Jeon
- College of Pharmacy and Research Institute for Drug Development, Pusan National University, Busan, South Korea
| | - Jacqueline Kent-Marvick
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
- Interdisciplinary Training in Cancer, Caregiving & End-of-Life Care, College of Nursing, University of Utah, Salt Lake City, Utah, USA
| | - Jessica N Sanders
- Department of Obstetrics and Gynecology, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Heidi Hanson
- Department of Surgery, School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Sara E Simonsen
- College of Nursing, University of Utah, Salt Lake City, Utah, USA
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Thompson JR, Risser LR, Dunfee MN, Schoenberg NE, Burke JG. Place, Power, and Premature Mortality: A Rapid Scoping Review on the Health of Women in Appalachia. Am J Health Promot 2021; 35:1015-1027. [PMID: 33906415 DOI: 10.1177/08901171211011388] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Appalachian women continue to die younger than in other US regions. We performed a rapid scoping review to summarize women's health research in Appalachia from 2000 to 2019, including health topics, study populations, theoretical frameworks, methods, and findings. DATA SOURCE We searched bibliographic databases (eg, PubMed, PsycINFO, Google Scholar) for literature focusing on women's health in Appalachia. STUDY INCLUSION AND EXCLUSION CRITERIA Included articles were: (1) on women's health in Appalachia; (2) published January 2000 to June 2019; (3) peer-reviewed; and (4) written in English. We excluded studies without reported data findings. DATA EXTRACTION Two coders reviewed articles for descriptive information to create summary tables comparing variables of interest. DATA SYNTHESIS Two coders co-reviewed a sub-sample to ensure consensus and refine data charting categories. We categorized major findings across the social-ecological framework. RESULTS A search of nearly 2 decades of literature revealed 81 articles, which primarily focused on cancer disparities (49.4%) and prenatal/pregnancy outcomes (23.5%). Many of these research studies took place in Central Appalachia (eg, 42.0% in Kentucky) with reproductive or middle-aged women (82.7%). Half of the studies employed quantitative methods, and half used qualitative methods, with few mixed method or community-engaged approaches (3.7%). Nearly half (40.7%) did not specify a theoretical framework. Findings included complex multi-level factors with few articles exploring the co-occurrence of factors across multiple levels. CONCLUSIONS Future studies should: 1) systematically include Appalachian women at various life stages from under-represented sub-regions; 2) expand the use of rigorous methods and specified theoretical frameworks to account for complex interactions of social-ecological factors; and 3) build upon existing community assets to improve health in this vulnerable population.
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Affiliation(s)
- Jessica R Thompson
- Department of Behavioral and Community Health Sciences, 51303University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA
| | - Lauren R Risser
- Department of Behavioral and Community Health Sciences, 51303University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA
| | | | | | - Jessica G Burke
- Department of Behavioral and Community Health Sciences, 51303University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA
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How to Screen Suitable Service Improve Community Health Care Services by University Students in Taiwan. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17155402. [PMID: 32727094 PMCID: PMC7432445 DOI: 10.3390/ijerph17155402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 07/20/2020] [Accepted: 07/23/2020] [Indexed: 12/14/2022]
Abstract
Engaging in social contributions to enhance social participation and attending community experiential service learning or internship courses have become an essential learning experience for university students. On the basis of postmodern education theories, this study adopted images and oral accounts involving personal experiences to construct a postmodern education research scheme by using the method of collaborative ethnography. This study selected and performed the following services: filming a community documentary, administering community health dance classes, and archiving community cultural artifacts in databases. Interviews were also administered to facilitate implementation of the actual services. Community health services commonly seen in Taiwan and abroad were compiled, and the resources required for each service were examined. Subsequently, factor analysis was performed to explore the characteristic of these services in order to recommend feasible services for university students to undertake. The results indicated that the eight resources required for the 59 common community health services were (1) a designated space or venue, (2) materials, (3) monetary resources, (4) human resources, (5) expertise, (6) professional equipment, (7) patience, and (8) empathy. The results revealed three principal components, namely labor services, high-resource services, and professional services, for a total explanatory power of 67.99%; the individual explanatory power of these components accounted for 25.04%, 21.81%, and 21.15%, respectively. Next, community health care services suitable for university students to perform were selected and implemented, and these services were well received. The study results indicated that community and environmental justice can be realized by identifying with the value of community health services and promoting postmodern education theories and social norms. The research results are suitable for implementation after the COVID-19 pandemic.
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Rutebemberwa E, Ssemugabo C, Tweheyo R, Turyagaruka J, Pariyo GW. Biomedical drugs and traditional treatment in care seeking pathways for adults with epilepsy in Masindi district, Western Uganda: a household survey. BMC Health Serv Res 2020; 20:17. [PMID: 31907036 PMCID: PMC6945646 DOI: 10.1186/s12913-019-4879-2] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2019] [Accepted: 12/27/2019] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Many patients with epilepsy in sub-Saharan Africa do not receive adequate treatment. The purpose of the study was to identify the health care providers where patients with epilepsy sought care and what treatment they received. METHODS A cross sectional study was conducted across 87 out of 312 villages in Masindi district. A total of 305 households having patients with epilepsy were surveyed using an interviewer administered questionnaire. Data was entered and analysed in Epi-info ver 7 for univariate and bivariate analysis, and in Stata SE ver 15.0 for multivariable analysis. Sequences of health providers consulted in care seeking, rationale and drugs used, and factors associated with choice of provider were assessed. RESULTS A total of 139 out of 305 (45.6%) households offered some treatment regimen at home when patients got symptoms of epilepsy with 44.6% (62/139) giving herbs and 18.0% (25/139) offering prayers. Eight different types of providers were consulted as first contact providers for treatment of epilepsy. Health centres received the highest percentage 35.4% (108/305) followed by hospitals 20.9% (64/305). A total of 192 of 305 (63.0%) households received anti-epileptic drugs, 13.1% (40/305) received prayers and 21.6% (66/305) received herbs at the first contact care seeking. Compared to a health centre as the first choice provider, other facilities more significantly visited were; hospitals if they were perceived as nearer (adj. Coeff 2.16, 95%CI 0.74, 3.59, p = 0.003), churches / mosques if cure for epilepsy was expected (adj. Coeff 1.91, 95%CI 0.38, 3.48, p = 0.014), and traditional healer for those aged ≥46 years (adj. Coeff 5.83, 95%CI 0.67, 10.99, p = 0.027), and friends/neighbour for traders (adj. Coeff 2.87, 95%CI 0.71, 5.04, p = 0.009). CONCLUSION Patients with epilepsy seek treatment from multiple providers with the public sector attending to the biggest proportion of patients. Engaging the private sector and community health workers, conducting community outreaches and community sensitization with messages tailored for audiences including the young, older epileptics, traditional healers as stakeholders, and traders could increase access to appropriate treatment for epilepsy.
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Affiliation(s)
- Elizeus Rutebemberwa
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda. .,African Centre for Health and Environmental Studies, Kampala, Uganda.
| | - Charles Ssemugabo
- Department of Disease Control and Environmental Sciences, Makerere University School of Public Health, Kampala, Uganda
| | - Raymond Tweheyo
- Department of Health Policy, Planning and Management, Makerere University School of Public Health, Kampala, Uganda.,Department of Public Health, Lira University, Lira, Uganda
| | - John Turyagaruka
- District Health Office, Masindi District Local Government, Masindi, Uganda
| | - George William Pariyo
- Johns Hopkins Bloomberg School of Public Health, Department of International Health, Baltimore, MD, USA
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Linn BK, Ely GE, Staton M. Latent Profiles of Health and Reproductive Risk and Protective Factors among Women in Appalachia. JOURNAL OF SOCIAL WORK PRACTICE IN THE ADDICTIONS 2020; 20:155-167. [PMID: 33209100 PMCID: PMC7668409 DOI: 10.1080/1533256x.2020.1748976] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
Women who use opiates and are involved in the criminal justice system in Appalachia may be prone to adverse health outcomes. In this study, we performed a latent class analysis of risk and protective factors on 400 drug-using women recruited from rural, Appalachian jails. A two-profile solution best fit the data. Both profiles evinced low levels of condom use, reproductive and physical health screens, and STD history. However, the primary substantive difference between the profiles was partner risk behavior: the higher risk class had main male partners with histories of injection drug use and incarceration. Results suggest that interventions need to be tailored to unique profiles of risk and protective factors, which should include taking partner risk into consideration.
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Affiliation(s)
- Braden K Linn
- Clinical and Research Institute on Addictions, University at Buffalo, The State University of New York, Buffalo, NY
| | - Gretchen E Ely
- School of Social Work, University at Buffalo, The State University of New York, Buffalo, NY
| | - Michele Staton
- University of Kentucky, College of Medicine, Medical Behavioral Science Building, Lexington, KY
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Hay-McCutcheon MJ, Hyams A, Yang X, Parton J. Hearing loss and social support in urban and rural communities. Int J Audiol 2018; 57:610-617. [PMID: 29671659 DOI: 10.1080/14992027.2018.1461262] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
OBJECTIVE Perceived social support and hearing handicap were assessed in adults with and without hearing loss who lived in different geographical regions of Alabama. DESIGN The Hearing Handicap Inventory for Adults (HHIA) assessed emotional and social consequences of hearing loss. The Medical Outcomes Study (MOS) Social Support Survey and the Social Functioning, Role Emotional and Mental Health scales of the SF-36 were administered. STUDY SAMPLE Data were collected from 71 study participants with hearing loss and from 45 adults without hearing loss. RESULTS Degree of hearing loss and outcomes from the HHIA did not differ between adults who lived in rural or urban settings. Tangible support was poorer for adults with hearing loss who lived in rural settings compared to those who lived in urban settings. For adults without hearing loss, residency was not associated with tangible support. For these adults, income was associated with other types of social support (i.e. informational support, affection, positive social interaction). CONCLUSIONS Adults with hearing loss living in rural areas had poor perceived tangible support. The provision of support to address a hearing loss could be worse for these adults compared to adults who lived in urban settings.
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Affiliation(s)
| | - Adriana Hyams
- b Department of Psychology , The University of Alabama , Tuscaloosa , AL , USA.,c Department of Psychiatry , Rhode Island Hospital , Providence , RI , USA
| | - Xin Yang
- d Department of Information Systems, Statistics and Management Science , The University of Alabama , Tuscaloosa , AL , USA
| | - Jason Parton
- d Department of Information Systems, Statistics and Management Science , The University of Alabama , Tuscaloosa , AL , USA
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