Preventing low birth weight: marketing and volunteer outreach

The Intervention of Outreach: Best Practices

Public health nurses (PHNs) use the intervention of outreach to improve health status by locating "at-risk" or "of interest" populations, providing information about health concerns and linking the population to resources to address the health concerns. The purpose of this study was to analyze PHNs' use of the intervention of outreach. Knowledge about best practices can contribute to the ability to successfully implement outreach activities. The descriptive qualitative study involved interviewing 10 Minnesota PHNs. Findings suggest strategies to increase outreach effectiveness. Recommendations include providing education on population-based concepts, such as community assessment and at-risk populations, and using interventions from the Public Health Intervention Wheel in conjunction with outreach.

Use of public health nursing services: relationship to adequacy of prenatal care and infant outcome

Timing of initial public health nurse contact and number of nurse contacts were examined for their relationship to adequacy of prenatal physician care, infant birthweight, and gestational age. Three historical cohort groups were drawn from three downstate Illinois counties: 1) public health nursing clients (N = 506); 2) Women, Infant, and Children Nutrition Program clients (N = 314); and 3) clients receiving neither of these services (N = 403). Data were obtained from local health department records and a state birth certificate data tape. Descriptive statistics and logistic and multiple regression were used to analyze data. Timing of initial public health contact was significantly correlated to adequacy of prenatal physician contact and infant gestational age. No relationship was found between either timing of initial public health nursing contact or number of these contacts and infant birthweight. The number of public health nursing and physician contacts exerted an additive effect on birthweight and gestational age. Findings lend support for case-finding activities that result in public health nursing contacts early in pregnancy. The importance of multidisciplinary approaches to prenatal care is suggested.

Prenatal peer counseling: an answer to the persistent difficulties with prenatal care for low-income women

Our intention in this article is to provide the reader with the theoretical framework of prenatal peer counseling. A second article describing a prenatal peer program that is functional in the province of Quebec will be presented subsequently with its outcomes and recommendations. However, before planning the implementation of such a program or even assessing its effectiveness, one must understand how peer counseling can be used as an assistive strategy and why it is perceived to be a community approach worth considering with pregnant women from poor socioeconomic backgrounds. This approach addresses most problems encountered when prenatal programs fail to meet the specific needs of these women. Principles of the therapeutic community and its derivatives are put forward to lay the theoretical foundation of prenatal peer counseling. The studies reviewed show that psychosocial variables associated with pregnancy outcome and poverty such as anxiety, social support, and self-esteem can be positively influenced through a prenatal peer counseling program. We strongly recommend that nurses working with low-income families consider prenatal peer counseling as an empowering strategy for mothers within a given community.

The effectiveness of community health nursing interventions: a literature review

As the devastating impact of many public health problems becomes more evident nationwide, a need exists for effective programs aimed at community-oriented health promotion. Escalating health care costs, however, severely limit available health care resources, threatening the demise of many public health efforts. During this time of imminent reform in our national health care system, it is imperative for community health nurses to elicit support by demonstrating the efficacy of their interventions (Oda & Boyd, 1987). This article describes services provided by community health nurses and documents the effectiveness of these interventions based on available literature. The programs reviewed represent community health nursing strategies developed in response to the needs of high-risk families, geographic communities, and vulnerable population groups. Both descriptive analyses and outcome-evaluation studies are used to support the effectiveness of home-based and community-centered community health nursing interventions. Recommendations eliciting support for community health nursing practice from legislators, policy makers, practice agencies, professional organizations, educators, and research institutions are included.

Social networks and help-seeking experiences of pregnant teens

OBJECTIVE

To describe low-income pregnant teens' perceptions of their social network characteristics and their prenatal help-seeking experiences.

DESIGN

Descriptive, cross sectional.

SETTING

Prenatal clinic of an urban hospital (n = 29) and two other sites (n = 2).

PARTICIPANTS

Thirty-one unmarried, low-income, pregnant teenage girls.

MAIN OUTCOME MEASURES

Social network characteristics, including social support; relationships between social network characteristics and demographic variables; and help-seeking characteristics.

RESULTS

Length of pregnancy was negatively correlated with network size (-.45, p = .011), emotional support (-.40, p = .026), tangible support (-.38, p = .033), and prenatal support (-.41, p = .022). Compared with older teens (18-19 years old), younger teens (16-17 years old) perceived their families, relatives, or both as providing a larger proportion of their total support (t(28) = 2.64, p = .014) and prenatal support (t(25.55) = 2.93, p = .007), and friends as providing a smaller proportion of their total support. Types of help most often needed were emotional and financial. The resource most used was the teen's mother, followed by the father of the unborn child. Barriers to help were most often the unavailability of someone on whom the teen relied and financial inadequacies.

CONCLUSIONS

The perception of less support as pregnancy progresses may indicate a gap between needs and resources. Differences in younger and older teens' support sources and the focus of help seeking on emotional and financial support have implications for nursing care.