Abstract
Introduction
The stalled U.S. infant mortality rate and persistent disparities in adverse pregnancy
outcomes may be addressed by optimizing a woman’s health throughout her childbearing
years. This study examines women’s knowledge and behaviors related to preconception
risk factors in two community health centers serving lower income, racially diverse
populations.
Methods
A survey was administered among a convenience sample of women ages 18 to 44 years
(n = 340). Questions focused on health behaviors and conditions, knowledge of risk factors,
and recommendations of health care providers. Outcomes include the prevalence of risk
factors and correlations between the presence of a risk factor and either a respondent’s
knowledge or a health care provider’s recommendation. Data were analyzed for total
respondents and two subgroups: Black, non-Hispanic and Hispanic.
Results
Despite strong knowledge of risk factors in the preconception period, high-risk behaviors
and conditions existed: 63% of women overweight or obese, 20% drinking alcohol, and
42% taking a multivitamin. Significant differences in risk factors were noted between
Black, non-Hispanic and Hispanic respondents. Overweight/obesity (t = 3.0; p < .05) and alcohol use (χ2 = 9.2; p < .05) were higher among Black, non-Hispanics, whereas Hispanic women had lower rates
of multivitamin use (χ2 = 11.1; p < .05). The majority of respondents recall being spoken to by a health care provider
about pregnancy-related risks. Most risk factors were not influenced by provider’s
recommendations, including multivitamin use, drinking alcohol, and smoking. However,
birth control use was correlated with a provider’s recommendation (χ2 = 7.6; p < .05). Correlations between the presence of risk factors and respondent’s knowledge
existed for immunizations (χ2 = 9.6; p < .05), but not for multivitamin use, drinking alcohol, or smoking.
Conclusion
Our study identified behaviors amenable to change. Knowledge alone or a doctor’s recommendation
are not enough to change those behaviors. Innovative programs and support systems
are required to encourage women to adopt healthy behaviors throughout the childbearing
years.
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Biography
Linda Harelick, MS, MBA, DrPH(c), is a doctoral candidate in Health Policy and Management at New York Medical College School of Health Sciences and Practice. She completed her internship in the area of preconception health from which the data for this paper is derived. Her dissertation topic focuses on the disparities in oral health status and access issues.
Biography
Deborah Viola, MBA, PhD, is Associate Professor and Associate Director of the Doctoral Program, as well as a Research Scholar at the Center for Long Term Care Research & Policy at New York Medical College School of Health Sciences and Practice. Research interests include regional health care planning, long-term care for the developmentally disabled, caregiving across the lifespan, and the impact of income support policies on population health.
Biography
Denise Tahara, MBA, PhD, is Assistant Professor and Director of MPH Studies at New York Medical College School of Health Sciences and Practice. Her research interests include system-wide performance improvement, preconception healthcare, wellness and chronic disease management education, and sustainability practices in healthcare. Dr. Tahara is a CPA in New York State.
Article info
Publication history
Published online: May 25, 2011
Accepted:
March 16,
2011
Received in revised form:
March 16,
2011
Received:
August 20,
2010
Identification
Copyright
© 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.
