Performing a brief warm-up exercise before a major or minor laparoscopic procedure significantly improved the intraoperative performance of residents irrespective of the difficulty of the case.
BackgroundPregnancy and the postpartum period provide windows of opportunity to impact perinatal and lifelong preventive health behavior for women and their families, but these opportunities are often missed. Understanding racial/ethnic differences in information and communication technology (ICT) use could inform technology-based interventions in diverse populations.ObjectiveThe objective of the study was to evaluate differences in the use of ICT between racial and ethnic groups as well as by English language proficiency.MethodsWe conducted a cross-sectional study of 246 women who were aged 18 years or older and pregnant or within 1 year of delivery. They were recruited from 4 hospital-based outpatient clinics and completed a self-administered survey. We used multivariate regression analysis to evaluate the association between race/ethnicity and ICT (mobile phone/short message service [SMS] text message, Internet, and social network) usage by race/ethnicity and perceived English language proficiency after adjusting for age, income, marital status, and insurance status.ResultsIn all, 28% (69/246) of participants were Latina, 40% (98/246) were African American, 23% (56/246) were white, and 9% (23/246) from other racial/ethnic groups. Of the Latinas, 84% (58/69) reported limited English language proficiency and 59% (41/69) were uninsured. More than 90% of all participants reported mobile phone use, but more than 25% (65/246) had changed phone numbers 2 or more times in the past year. Compared to white women, African American women were less likely to SMS text message (OR 0.07, 95% CI 0.01-0.63) and Latinas were less likely to use the Internet to find others with similar concerns (OR 0.23, 95% CI 0.08-0.73). Women with limited English language proficiency were less likely to use the Internet overall (OR 0.30, 95% CI 0.09-0.99) or use email (OR 0.22, 95% CI 0.08-0.63) compared to women with adequate English language proficiency.ConclusionsMobile phones are widely available for the delivery of health interventions to low-income, racially diverse pregnant and postpartum women, but disparities in Internet use and SMS text messaging exist. Interventions or programs requiring Web-based apps may have lower uptake unless alternatives are available, such as those adapted for limited English proficiency populations.
Background: Rates of postpartum visit attendance are low among all women, and particularly for low-income women. Experts in obstetrics, women's health, and health disparities are calling for novel, holistic approaches to postpartum care to better meet the needs of women and that respond to existing health care disparities. Materials and Methods: We conducted a single-site parallel-arm randomized controlled trial to determine the feasibility and effect of a co-located, co-timed 4–6 weeks postpartum obstetrics visit and well-newborn pediatric visit ( i.e ., “mommy-baby visit”) compared with an enhanced usual postpartum visit, that is, staff scheduled the postpartum visit for the patient before hospital discharge. Results: One hundred sixteen women, of whom 76.7% ( n = 89) were Latina immigrants, were enrolled postdelivery and randomized to a mommy-baby visit ( n = 58, 49.5%) or to enhanced usual care ( n = 58, 50.4%). Almost all study participants attended their postpartum visit ( n = 109, 94.0%). There was no significant difference in postpartum visit attendance rate by randomization assignment (91.4% of mommy-baby vs. 96.6% of enhanced usual care participants). Study participants, mommy-baby intervention and enhanced usual care arms combined, were significantly more likely to attend the postpartum visit than historical controls (94.0% vs. 69.7%, respectively, p < 0.001). Conclusions: In a randomized controlled trial, we showed postpartum visit attendance rates were high for participants in both the mommy-baby and enhanced usual care arms. Postpartum visit scheduling assistance was provided to all participants and may have increased postpartum visit attendance and thereby attenuated the effect of the intervention. It is encouraging that a low-cost, low-tech, low-touch intervention, that is, postpartum appointment scheduling before hospital discharge, could increase postpartum visit attendance.
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