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Mei TL, Aligne CA, VanScott JL. A Visit to the Pediatrician as a Part of Comprehensive Prenatal Care? Matern Child Health J 2024; 28:76-82. [PMID: 37864772 PMCID: PMC10876718 DOI: 10.1007/s10995-023-03791-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/30/2023] [Indexed: 10/23/2023]
Abstract
INTRODUCTION The American Academy of Pediatrics and the American College of Obstetricians and Gynecologists recommend that expectant parents receive a preventive visit with a pediatrician in the prenatal period (a pediatric prenatal visit, or PPV). Discussing newborn health topics in the prenatal period tends to be more effective than immediately postpartum, and research suggests, for example, that the PPV increases timely childhood immunizations. However, only 22% of expectant parents have these visits, and there are significant disparities by race and income. METHODS A 2-min online survey with open-ended questions was emailed to 304 eligible obstetrics providers in Rochester, NY. Simple descriptive statistics and chisquare analysis were applied to survey responses. Responses were organized within the framework of knowledge, attitudes, and practices to identify barriers to guideline adherence resulting in chronic under-utilization of the PPV. RESULTS Ninety obstetric providers completed the survey. 66 reported awareness of the PPV, and 45 reported referring patients for a PPV. However, in open-ended questions, respondents expressed confusion between the PPV and a "meet and greet" visit with a pediatrician. Some respondents believed that the PPV is not covered by insurance, even though these visits are covered by Medicaid and marketplace insurance. Providers who had personally received one as a parent expressed positive attitudes. DISCUSSION These findings indicate that unfamiliarity with the PPV is one barrier to referral. Educating providers about the guideline recommendations, evidence base, and insurance coverage could overcome this barrier. Doing so could reduce disparities in utilization of the pediatric prenatal visit.
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Affiliation(s)
- Tiffany L Mei
- Department of Obstetrics and Gynecology, Tufts Medical Center, Boston, USA
| | - C Andrew Aligne
- Department of Pediatrics, The Hoekelman Center, Golisano Children's Hospital, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue Box 777, Rochester, NY, 14642, USA.
| | - Jessica L VanScott
- Infectious Diseases Division, Center for Community Practice, University of Rochester School of Medicine and Dentistry, Rochester, NY, USA
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Williams CE, Berkowitz D, Rackin HM. Exploring the experiences of pregnant women in the U.S. during the first year of the Covid-19 pandemic. THE JOURNAL OF SOCIAL ISSUES 2022; 79:JOSI12567. [PMID: 36718412 PMCID: PMC9877755 DOI: 10.1111/josi.12567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 10/01/2022] [Accepted: 10/02/2022] [Indexed: 06/18/2023]
Abstract
In this paper, we integrate the stress process model with symbolic interactionism to frame our analysis of interviews with 35 women who were pregnant and/or gave birth during the first year of the Covid-19 pandemic. We detail three stressors, highlight their variation, and discuss how they coped with these stressors. Women reported having to navigate contradictory information about the public health crisis, but Black participants simultaneously endured added strain from a heightened awareness of racialized violence. To cope with an overabundance of precarious and contradictory messages, some women sought out information (i.e., information gatherers), others eschewed information (i.e., information avoiders), and most established protective "bubbles." Next, women experienced disruptions in pregnancy rituals but coped by reframing their expectations. This stressor, however, was less acute for women with a prior birth. Third, women shared feelings of social isolation and reduced social support, which were intensified if pregnancy complications occurred. Women coped by relying on telecommunication and at-home monitoring devices. Our study shows how pregnant women experienced and coped through adversity to mitigate stressors amid pandemonium.
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Affiliation(s)
| | - Dana Berkowitz
- Department of SociologyLouisiana State UniversityBaton RougeLouisianaUSA
| | - Heather M. Rackin
- Department of SociologyLouisiana State UniversityBaton RougeLouisianaUSA
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Yang W, Xu H, Miao W, Geng Z, Geng G. Effects of transitional care based on the social support theory for older patients with osteoporotic vertebral compression fractures: A quasi-experimental trial. Australas J Ageing 2022; 42:185-194. [PMID: 35996354 DOI: 10.1111/ajag.13129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/19/2022] [Accepted: 07/27/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES This study aimed to investigate the effects of transitional care (TC) programs on the health outcomes of discharged older patients with osteoporotic vertebral compression fractures (OVCFs). METHODS A total of 160 older patients were recruited from two campuses of a public teaching hospital in China. Patients were grouped according to the campus to which they were admitted. The TC programs commenced one day before discharge and lasted 6 months after discharge. Repeated-measures analysis of variance was used to analyse the effects of the TC programs. RESULTS The TC programs improved the discharge of older patients with OVCF in their activities of daily living (ADLs), pain levels and social support, and decreased fracture recurrence rates. CONCLUSIONS This study provides evidence of concurrent clinical improvements and health outcomes in discharged older patients with OVCFs from the effects of TC programs based on social support theory.
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Affiliation(s)
- Wenwen Yang
- School of Medicine, Nantong University, Nantong, Jiangsu, China
| | - Haiyan Xu
- Department of Nursing, Yancheng First People's Hospital, Yancheng, Jiangsu, China
| | - Weiwei Miao
- School of Medicine, Nantong University, Nantong, Jiangsu, China
| | - Zihan Geng
- School of Medicine, Nantong University, Nantong, Jiangsu, China
| | - Guiling Geng
- School of Medicine, Nantong University, Nantong, Jiangsu, China
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Molin B, Zwedberg S, Berger AK, Sand A, Georgsson S. Disempowering women-a mixed methods study exploring informational support about pain persisting after childbirth and its consequences. BMC Pregnancy Childbirth 2022; 22:510. [PMID: 35739466 PMCID: PMC9229078 DOI: 10.1186/s12884-022-04841-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Accepted: 06/16/2022] [Indexed: 12/03/2022] Open
Abstract
Background Access to information is essential to achieving individual empowerment; meaning the ability to exercise control, manage one’s own condition and make informed decisions. However, studies have shown that information provided to women regarding physiological changes during the postpartum period and postpartum health was inadequate, incorrect, or inconsistent. Methods The aim of this study was to explore informational support about pain persisting after childbirth and its consequences. A sequential explanatory mixed methods design was used. In the first, quantitative phase, 1,171 women, who gave birth eight months earlier, completed a self-administered questionnaire. In the second, qualitative phase, 20 women who experienced chronic pain were interviewed. Descriptive statistics and qualitative content analysis were used to analyse the data. Results The majority of the women did not receive information about pain persisting after childbirth, or the information was insufficient or incorrect. They did not know when and where to seek help and did not consult health care professionals. In addition, the lack of information had a negative impact on women’s psychological well-being. All women expressed the need to be informed by health care professionals, irrespective of the individual risk of developing chronic pain. Conclusions Health services should ensure availability of information to give the women opportunity to achieve empowerment to make good health decisions, increase control over their health and well-being as well as to enhance their self-efficacy. We propose that a booklet or leaflet with relevant information about the risk of developing chronic pain, symptoms and treatment, along with advice about appropriate health care settings should be provided as part of antenatal or postnatal care.
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Affiliation(s)
- Beata Molin
- Department of Clinical Science Intervention and Technology (CLINTEC), Division of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital, 141 86, Stockholm, Huddinge, Sweden. .,Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden.
| | - Sofia Zwedberg
- Department of Health Promoting Science, Sophiahemmet University, Stockholm, Sweden.,Theme Children's & Women's Health, PA Pregnancy Care and Delivery, Karolinska University Hospital, Stockholm, Sweden
| | | | - Anna Sand
- Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden
| | - Susanne Georgsson
- Department of Clinical Science Intervention and Technology (CLINTEC), Division of Obstetrics and Gynaecology, Karolinska Institutet, Karolinska University Hospital, 141 86, Stockholm, Huddinge, Sweden.,The Swedish Red Cross University, Stockholm, Sweden
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Guille C, Hall C, King C, Sujan A, Brady K, Newman R. Listening to women and pregnant and postpartum people: Qualitative research to inform opioid use disorder treatment for pregnant and postpartum people. DRUG AND ALCOHOL DEPENDENCE REPORTS 2022; 3:100064. [PMID: 36845990 PMCID: PMC9948937 DOI: 10.1016/j.dadr.2022.100064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 04/13/2022] [Accepted: 05/09/2022] [Indexed: 11/22/2022]
Abstract
Background The diagnosis of Opioid Use Disorder (OUD) during pregnancy has increased 2-to-5-fold over the past decade and barriers to treatment are significant. Technology-based solutions have the potential to overcome these barriers and deliver evidence-based treatment. However, these interventions need to be informed by end-users. The goal of this study is to gain feedback from peripartum people with OUD and obstetric providers about a web-based OUD treatment program. Methods Qualitative interviews were conducted with peripartum people with OUD (n = 18) and focus groups were conducted with obstetric providers (n = 19). Feedback from these interviews informed the development of text message-based screening, brief phone-based intervention and referral to treatment program, called Listening to Women and Pregnant and Postpartum People (LTWP). Once developed, further qualitative interviews with peripartum people with OUD (n = 12) and obstetric providers (n = 21) were conducted to gather feedback about the LTWP program. Results Patients reported that a relationship with a trusted provider is paramount for treatment engagement. Providers reported that time constraints and complex patient needs prohibit them from treating OUD and that evidence-based Screening, Brief Intervention and Referral to Treatment (SBIRT) are not implemented effectively in routine prenatal care. Neither patients nor providers were enthusiastic about our web-based intervention for OUD; thus, results were used to guide the development of LTWP to improve implementation of SBIRT during prenatal care. Conclusions End-user informed, technology-enhanced SBIRT has the potential to improve the implementation of SBIRT during routine prenatal care, and in turn, improve maternal and child health.
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Affiliation(s)
- Constance Guille
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St, 5 South, MSC861, Charleston, SC 29425, USA
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
| | - Casey Hall
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC, USA
| | - Courtney King
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St, 5 South, MSC861, Charleston, SC 29425, USA
| | - Ayesha Sujan
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St, 5 South, MSC861, Charleston, SC 29425, USA
- Department of Psychological and Brain Sciences, Indiana University – Bloomington, Bloomington, IN, USA
| | - Kathleen Brady
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, 67 President St, 5 South, MSC861, Charleston, SC 29425, USA
- Department of Psychological and Brain Sciences, Indiana University – Bloomington, Bloomington, IN, USA
| | - Roger Newman
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, SC, USA
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Bishaw KA, Worku S, Tilahun M. Prevention of puerperal sepsis in northwest Ethiopia: Knowledge and practice of postnatal women; A multicenter cross-sectional study. SAGE Open Med 2022; 10:20503121221085842. [PMID: 35371488 PMCID: PMC8972931 DOI: 10.1177/20503121221085842] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 02/17/2022] [Indexed: 11/24/2022] Open
Abstract
Objectives: Puerperal sepsis is a life-threatening condition that can lead to death and long-term morbidities of postnatal women, such as chronic pelvic pain, pelvic inflammatory disease, and secondary infertility. Therefore, the study aimed to assess the knowledge and practice of postnatal women at Debre Markos town health facilities toward the prevention of puerperal sepsis and its associated factors. Methods: A multicenter cross-sectional study was conducted from 1 to 30 July 2020. In all, 404 sampled postnatal women took part in the study. A systematic random sampling technique was employed to select each study participant. Data were entered into Epi data 4.6 and analyzed by statistical package for social sciences 25. Multivariate logistic regression was carried out for variables with a p value less than 0.25 in bivariate logistic regression to determine significant associations between the outcome and independent variables. The statistical significance was determined using a 95% confidence interval with a p value of less than 0.05. Results: The study reported that 44.6% and 40.8% of postnatal women had adequate knowledge, and good practice toward the prevention of puerperal sepsis, respectively. Factors associated with knowledge were urban residence [adjusted odds ratio = 5.84, 95% confidence interval = (3.54–9.46)], primiparity [adjusted odds ratio = 1.85, 95% confidence interval = (1.19–2.89)], and attending formal education [adjusted odds ratio = 2.41, 95% confidence interval = (1.11–5.22)] of study participants. Attending formal education [adjusted odds ratio = 2.46, 95% confidence interval = (1.13–5.37)] and having adequate knowledge [adjusted odds ratio = 2.34, 95% confidence interval = (1.49–3.67)] were factors associated with the prevention practice of postnatal women toward puerperal sepsis. Conclusion: Less than half of postnatal women had adequate knowledge and good practice to prevent puerperal sepsis. As a result, obstetric caregivers and other concerned bodies should consider strategies to increase the awareness level of women about puerperal sepsis. Interventions to improve the community’s educational level should also be considered.
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Affiliation(s)
- Keralem Anteneh Bishaw
- Department of Midwifery, College Health Sciences, Debre Markos University, Debre Markos, Ethiopia
| | - Shewangzaw Worku
- School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Melkamu Tilahun
- School of Medicine, Debre Markos University, Debre Markos, Ethiopia
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