Reducing Psychosocial and Behavioral Pregnancy Risk Factors: Results of a Randomized Clinical Trial Among High-Risk Pregnant African American Women

Joseph, Jill G.; El-Mohandes, Ayman; Kiely, Michele; El-Khorazaty, Mohamed; Gantz, Marie G.; Johnson, Allan A.; Katz, Kathy; Blake, Susan; Rossi, Maryann W.; Subramanian, Siva

doi:10.2105/ajph.2007.131425

Cited by 73 publications

(80 citation statements)

References 62 publications

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“…Given that the majority of respondents at the 5-month postpartum follow-up had completed at least three of the four counseling sessions, they may be the women who received adequate exposure to the tailored CBC components. This finding is consistent with studies that report a significant effect on smoking cessation of cognitive behavioral interventions with multiple sessions (i.e., three to eight) (Dornelas et al, 2006; Joseph et al, 2009; Reitzel et al, 2010). …”

Section: Discussionsupporting

confidence: 92%

Cognitive-behavioral intervention to promote smoking cessation for pregnant and postpartum inner city women

et al. 2015

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This study evaluated a theory-guided cognitive-behavioral counseling (CBC) intervention for smoking cessation during pregnancy and postpartum. It also explored the mediating role of cognitive-affective variables on the impact of CBC. Underserved inner city pregnant women (N = 277) were randomized to the CBC or a best practice (BP) condition, each of which consisted of two prenatal and two postpartum sessions. Assessments were obtained at baseline, late pregnancy, and 1- and 5-months postpartum. An intent-to-treat analysis found no differences between the two groups in 7-day point-prevalence abstinence. However, a respondents-only analysis revealed a significantly higher cessation rate in the CBC (37.3 %) versus the BP (19.0 %) condition at 5-months postpartum follow-up. This effect was mediated by higher quitting self-efficacy and lower cons of quitting. CBC, based on the Cognitive-Social Health Information Processing model, has the potential to increase postpartum smoking abstinence by assessing and addressing cognitive-affective barriers among women who adhere to the intervention.

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Section: Discussionsupporting

confidence: 92%

Cognitive-behavioral intervention to promote smoking cessation for pregnant and postpartum inner city women

et al. 2015

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“…Not only were our low income participants more often minorities, they were also more often overweight or obese. Psychosocial factors like stress and depression are common among low income (23), minority (24, 25), and obese (26, 27) women. Enduring multiple hardships, as discussed in this study, that might potentially lead to stress and depression are highly prevalent in low income women during pregnancy with 14% of low income women experiencing 4 or more hardships (28).…”

Section: Discussionmentioning

confidence: 99%

The Web of Risk Factors for Excessive Gestational Weight Gain in Low Income Women

Paul

Graham

Olson

2012

Matern Child Health J

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Objectives To gain an in-depth understanding of issues related to gestational weight gain (GWG) including general health, diet, and physical activity among high- and low-income women and to elucidate socio-ecological and psychosocial risk factors that increase risk for excessive gestational weight gain. Methods We conducted 9 focus groups with high (n=4 groups) and low (n=5 groups) income pregnant women aged 18-35 years to discuss health, GWG, diet and physical activity following a discussion guide. The constant comparative method was used to code focus group notes and to identify emergent themes. Themes were categorized within the integrative model of behavioral prediction. Results Low income women, in contrast to high income women, had higher BMIs, had more children, and were African American. Diet and physical activity behaviors reported by low income women were more likely to promote positive energy balance than were those of high income women. The underlying behavioral, efficacy, and normative beliefs described by both groups of women explained most of these behaviors. Experiencing multiple risk factors may lead to 1) engaging in several behavior changes during pregnancy unrelated to weight and 2) holding more weight gain-promoting beliefs than weight maintaining beliefs. These factors could inhibit diet and physical activity behaviors and/or behavior changes that promote energy balance and in combination, result in excessive GWG. Conclusions Low income women experience multiple risk factors for excessive GWG and successful interventions to prevent excessive GWG and pregnancy related weight gain will need to recognize the complex web of influences.

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“…Patients with prior trauma cost health care systems disproportionately more than those without such trauma (Bonomi, Anderson, Rivara, & Thompson, 2009; Bonomi, Anderson, & Rivara, 2008; Fang, Brown, Florence, & Mercy, 2012). Despite the prevalence and impact of psychosocial adversity, and the availability of evidence-based interventions, few health care providers routinely screen for this type of experience, and many are unclear about how to best respond (Bair-Merritt et al, 2014; Garg, Butz, Dworkin, Lewis, & Serwint, 2009; Hochstein et al, 2001; Joseph et al, 2009; Kemper, 1992; Sugg & Inui, 1992; Van Hook et al, 2007). …”

Section: Introductionmentioning

confidence: 99%

Addressing Psychosocial Adversity Within the Patient-Centered Medical Home: Expert-Created Measurable Standards

et al. 2015

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The Patient-Centered Medical Home (PCMH) may be improved by embedding identification and response for patients’ experiences with psychosocial adversity, but how this might optimally occur in practice has not been well-specified. We sought input from an expert panel to define feasible elements that could adapt the PCMH to adequately respond to patients’ experiences with psychosocial adversity. From December 2012 through September 2013, we used a Delphi process to systematically obtain expert opinions and reach consensus. We invited 37 experts to participate in three successive and iterative rounds of questionnaires, with each round based on aggregated, de-identified data from the prior round. We first asked experts to generate elements to adapt the PCMH, using the National Committee for Quality Assurance (NCQA’s) established six PCMH standards as the foundation. We then asked the experts to rate these elements on a 5-point Likert scale, and finally specify what they considered the most and least valuable elements. Eighteen of the 37 (49%) invited experts responded to the first survey, and constituted our sample. Experts identified 35 elements that fell under the six NCQA standards. The top rated elements included using a screening tool to identify adversity; training providers to address psychosocial adversity; having a team member with mental health expertise; providing culturally-competent care; and having written patient information related to adversity and coping. This study derived key elements that may enhance the PCMH’s ability to improve patient outcomes by purposefully identifying and responding to their psychosocial adversity.

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Reducing Psychosocial and Behavioral Pregnancy Risk Factors: Results of a Randomized Clinical Trial Among High-Risk Pregnant African American Women

Cited by 73 publications

References 62 publications

Cognitive-behavioral intervention to promote smoking cessation for pregnant and postpartum inner city women

Cognitive-behavioral intervention to promote smoking cessation for pregnant and postpartum inner city women

The Web of Risk Factors for Excessive Gestational Weight Gain in Low Income Women

Addressing Psychosocial Adversity Within the Patient-Centered Medical Home: Expert-Created Measurable Standards

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