Maternal Health Behaviors Research Articles

Effects of postpartum mobile phone-based education on maternal and infant health in Ecuador

ObjectiveTo evaluate the effects of a mobile phone-based intervention on postnatal maternal health behavior and maternal and infant health in a middle-income country. MethodsA prospective evaluation enrolled consecutive postpartum women at two public hospitals in Quito, Ecuador, between June and August 2012. Inclusion criteria were live birth, no neonatal intensive care admission, and Spanish speaking. Intervention and control groups were assigned via random number generation. The intervention included a telephone-delivered educational session and phone/text access to a nurse for 30days after delivery. Maternal and infant health indicators were recorded at delivery and 3months after delivery via chart review and written/telephone-administered survey. ResultsOverall, 102 women were assigned to the intervention group and 76 to the control group. At 3months, intervention participants were more likely to attend the infant's postnatal check-up (P=0.022) and to breastfeed exclusively (P=0.005), and less likely to feed formula (P=0.016). They used more effective forms of contraception (more implants P=0.023; fewer condoms P=0.036) and reported fewer infant illnesses (P=0.010). There were no differences in maternal acute illness or check-up attendance. ConclusionMobile phone-based postnatal patient education is a promising strategy for improving breastfeeding, contraceptive use, and infant health in low-resource settings; different strategies are needed to influence postpartum maternal health behavior.

Prenatal Programming of Infant Neurobehaviour in a Healthy Population.

Identifying the prenatal origins of mental conditions is of increasing interest, yet most studies have focused on high-risk populations and cannot disentangle prenatal and postnatal programming effects. Thus, we examined whether profiles of neurobehaviour indicative of future risk could be identified in healthy 1-3-day-old infants, and examined associations with perinatal risk factors. Participants included 627 healthy mothers and term infants from a population-based US cohort. Neurobehaviour was assessed within 24-72 h after delivery with the NICU Network Neurobehavioural Scales (NNNS). A model-based clustering algorithm was used to derive neurobehavioural profiles from NNNS scores. Maternal health histories, pregnancy conditions and behaviours, labour/delivery factors, and infant attributes were examined in relation to the neurobehavioural profiles. Seven discrete neurobehavioural profiles were identified, including one average functioning profile, and two inversely patterned below and above average profiles. Higher pregnancy weight gain (OR 1.44, 95% CI 1.10, 1.88) and birthweight percentiles (OR 1.46, 95% CI 1.10, 1.95) were associated with greater odds of below average newborn neurobehaviour. Above average neurobehaviour was associated with experiencing longer gestations (OR 1.29, 95% CI 1.02, 1.64) and higher 5-min APGAR scores (OR 2.43, 95% CI 1.07, 5.52). Maternal pregnancy alcohol use (OR 0.54, 95% CI 0.33, 0.89), and fetal distress (OR 0.10, 95% CI 0.01, 0.72) were associated with lower likelihood of having average neurobehaviour. Distinct profiles of neurobehaviour can be derived in a healthy population of newborns, with different sets of perinatal factors predicting different patterns of neurobehaviour. These findings suggest a potential in utero origin for mental health risk.

Ethnic differences in cognitive development in the first 7 years: does maternal generational status matter?

BackgroundDifferences in cognitive development have been observed across a variety of ethnic minority groups but relatively little is known about the persistence of these developmental inequalities over time or generations.MethodsA...

Why are poorer children at higher risk of obesity and overweight? A UK cohort study.

Background: There is limited evidence on which risk factors attenuate income inequalities in child overweight and obesity; whether and why these inequalities widen as children age. Method: Eleven thousand nine hundred and sixty five singletons had complete data at age 5 and 9384 at age 11 from the Millennium Cohort Study (UK). Overweight (age 5 : 15%; age 11 : 20%) and obesity (age 5 : 5%; age 11 : 6%) were defined using the International Obesity Taskforce body mass index cut-points. To measure socioeconomic inequalities, we used quintiles of family income and as risk factors, we considered markers of maternal health behaviours and of children’s physical activity, sedentary behaviours and diet. Binary and multinomial logistic regression models were used. Results: The unadjusted analyses revealed stark income inequalities in the risk of obesity at age 5 and 11. At age 5, children in the bottom income quintile had 2.0 (95% CI: 1.4–2.8) increased relative risk of being obese whilst at age 11 they had 3.0 (95% CI: 2.0–4.5) increased risk compared to children in the top income quintile. Similar income inequalities in the risk of overweight emerged by age 11. Physical activity and diet were particularly important in explaining inequalities. Income inequalities in obesity and overweight widened significantly between age 5 and 11 and a similar set of risk factors protected against upward and promoted downward movements across weight categories. Conclusions: To reduce income inequalities in overweight and obesity and their widening across childhood the results support the need of early interventions which take account of multiple risk factors.

A population-based analysis of factors that predict early language and cognitive development

Readiness for school learning is an important predictor of subsequent educational achievement, which in turn predicts health and social outcomes into adulthood. This longitudinal study used population-based administrative data from multiple sectors to follow a cohort of children (n=8983) from the prenatal period to kindergarten to examine early childhood development factors associated with academic school readiness as measured on the language and cognitive development domain of the Early Development Instrument (EDI). Structural equation modelling was used to study the complex inter-relationships among the EDI scores and the explanatory variables, which included maternal prenatal health behaviors, child health at birth, family risk factors, and neighborhood socioeconomic status. Our findings suggest that when multiple influences on early childhood development are considered together, family risk factors are the key driver of academic school readiness, and family risk, in turn, is strongly influenced by neighborhood socioeconomic status.

Socio-demographic inequalities across a range of health status indicators and health behaviours among pregnant women in prenatal primary care: a cross-sectional study

BackgroundSuboptimal maternal health conditions (such as obesity, underweight, depression and stress) and health behaviours (such as smoking, alcohol consumption and unhealthy nutrition) during pregnancy have been associated with negative pregnancy outcomes. Our first aim was to give an overview of the self-reported health status and health behaviours of pregnant women under midwife-led primary care in the Netherlands. Our second aim was to identify potential differences in these health status indicators and behaviours according to educational level (as a proxy for socio-economic status) and ethnicity (as a proxy for immigration status).MethodsOur cross-sectional study (data obtained from the DELIVER multicentre prospective cohort study conducted from September 2009 to March 2011) was based on questionnaires about maternal health and prenatal care, which were completed by 6711 pregnant women. The relationships of education and ethnicity with 13 health status indicators and 10 health behaviours during pregnancy were examined using multilevel multiple logistic regression analyses, adjusted for age, parity, number of weeks pregnant and either education or ethnicity.ResultsLower educated women were especially more likely to smoke (Odds Ratio (OR) 11.3; 95 % confidence interval (CI) 7.6– 16.8); have passive smoking exposure (OR 6.9; 95 % CI 4.4–11.0); have low health control beliefs (OR 10.4; 95 % CI 8.5–12.8); not attend antenatal classes (OR 4.5; 95 % CI 3.5–5.8) and not take folic acid supplementation (OR 3.4; 95 % CI 2.7–4.4). They were also somewhat more likely to skip breakfast daily, be obese, underweight and depressed or anxious. Non-western women were especially more likely not to take folic acid supplementation (OR 4.5; 95 % CI 3.5–5.7); have low health control beliefs (OR 4.1; 95 % CI 3.1–5.2) and not to attend antenatal classes (OR 3.3; 95 % CI 2.0–5.4). They were also somewhat more likely to have nausea, back pains and passive smoking exposure.ConclusionsSubstantial socio-demographic inequalities persist with respect to many health-related issues in medically low risk pregnancies in the Netherlands. Improved strategies are needed to address the specific needs of socio-demographic groups at higher risk and the structures underlying social inequalities in pregnant women.

Place of residence and maternal health behaviours

Place of residence and maternal health behaviours

Maternal Socioeconomic Status and the Odds of Failing to Receive Preconception Counseling: An Epidemiologic Study Using 2009-2011 PRAMS Data

s / Annals of Epidemiology 25 (2015) 702e719 718 Results: Geometric means for serum cotinine level and FeNOwere 0.29ng/ml and 13.04 ppb, respectively. There was a statistically significant inverse relationship between serum cotinine levels and FeNO (r2 1⁄40.172, b1⁄4.061, p-value<0.001). The inverse relationship was strongest among current smokers (b1⁄40.101, p-value <0.001), followed by ex/non-smokers (b1⁄4.025, pvalue< 0.001), adjusted for potential confounders. Conclusion: The results of the study show that serum cotinine suppresses FeNO levels regardless of the smoking status. However, the inverse relationship between serum cotinine and FeNO levels among ex/non-smokers suggest that secondhand smoke may predispose susceptible individuals to adverse health outcomes. P66. Maternal Socioeconomic Status and the Odds of Failing to Receive Preconception Counseling: An Epidemiologic Study Using 2009-2011 PRAMS Data Katherine Nystrom MPH. Emory University Rollins School of Public Health Purpose: While scientific evidence is growing to support the improvement of women’s preconception health as an effective way to reduce poor pregnancy and infant outcomes, maternal socioeconomic status has not been explored as an exposure in the preconception health paradigm. The purpose of this study was to determine the degree to which maternal characteristics, psychosocial factors, and health behaviors explain or mediate the influence of socioeconomic factors on the receipt of preconception counseling. Methods: This study was a secondary analysis of Pregnancy Risk Assessment Monitoring System (PRAMS) data from 6 states that included the following question in their PRAMS questionnaire: “Before you got pregnant with your new baby, did a doctor, nurse, or other health care worker talk to you about how to prepare for a healthy pregnancy and baby?” The sample is a population-based sample of 27,458 womenwho gave birth to a live infant during the years 2009-2011. Results: Only 32.7% of respondents reported receiving preconception counseling. By using multivariable logistic regression, we found modest evidence for income and education variation, although not in a clear dose-response gradient. We observed a protective, albeit non-significant, effect of extreme poverty (annual income <$10,000) against the failure to receive preconception counseling. Women earning between $10,000 and $49,999 annually or having less than 16 years of education were less likely to receive preconception counseling. Conclusions: Based on our findings, it appears that the provision of preconception care, or women’s recognition of the receipt of preconception care, remains substandard. P67. Estimation of the Burden of CIN Lesions Preventable by Vaccination with Bivalent, Quadrivalent or 9-Valent HPV Vaccines Chandrika Piyathilake PhD, Michelle Chambers MS, Suguna Badiga PhD, Walter Bell MD, Ronald Alvarez MD, Edward Partridge MD, Maurizio Macaluso MD, DrPH. UAB Purpose: To estimate and compare the potential impact of currently available prophylactic HPV vaccines on preventing varying grades of histologically confirmed cervical intraepithelial neoplasia (CIN2+). Methods: 2296 women with histological diagnoses were tested for 37 HPV genotypes. To estimate the proportion of CIN 2 and 3 lesions that could have been prevented by immunization with bivalent (16/18), quadrivalent (6/11/ 16/18) or 9-valent (6/11/16/18/31/35/45/52/58) vaccines, we used the histology profile of women in the same race and age category who were negative for the HPV vaccine genotypes to compute the expected number of CIN 2 and 3 lesions in the absence of infection with the vaccine genotypes, and subtracted the expected numbers from the observed. We estimated alternative expected and preventable numbers using more specific patterns of infection as the reference, and a regression model including terms for genotype groups and relevant interactions. Results: The proportion of preventable CIN 2+ lesions, especially CIN 2 lesions, among African American (AA) women increased with the 9-valent vaccine compared to bivalent or quadrivalent vaccines (from 4% to 42%). However, 20-30% of CIN 3 lesions are not preventable by the 9-valent vaccine. Alternative estimation methods yielded similar results. Conclusions: Widespread use of the 9-valent HPV vaccine would considerably reduce the prevalence of CIN 3 in our population, but the prevalence of CIN 2+ associated with HPVs not included in the 9-valent vaccine would be sufficiently high to warrant follow-up. It is unclear whether these CIN 2 + lesions would progress to more advanced lesions over time.

High feedback versus low feedback of prenatal ultrasound for reducing maternal anxiety and improving maternal health behaviour in pregnancy.

Prenatal ultrasound is one of many techniques used in screening and diagnosis. It gives parents instant access to the images of the fetus. Receiving information promotes knowledge and understanding, but it may also increase maternal anxiety. To compare high feedback versus low feedback during prenatal ultrasound for reducing maternal anxiety and improving maternal health behaviour. We searched the Cochrane Pregnancy and Childbirth Group's Trials Register (12 May 2015), the Central Register of Controlled Trials (The Cochrane Library 2015, Issue 5), MEDLINE (January 1966 to 12 May 2015), and the ISRCTN Registry (12 May 2015). We handsearched citation lists of relevant publications. We did not apply any language or date restrictions. Randomised controlled trials (RCTs) of high feedback (women can see the monitor screen and receive detailed visual and verbal explanations) versus low feedback (women can not see the monitor screen and women are given only a summary statement of the scan) during prenatal ultrasound. The primary outcome measure was maternal state anxiety. Two review authors independently assessed trials for inclusion and risk of bias, extracted data and checked for accuracy. We have expressed results as risk ratio (RR) or mean differences (MD), together with their 95% confidence intervals (CI). We included four studies (365 women). Three RCTs (346 participants) reported the effect of high versus low feedback during ultrasound on state anxiety scores (mean difference (MD) 0.92, 95% confidence interval (CI) -0.58 to 2.43; participants = 346; three studies, low quality evidence). Two trials (148 participants) reported women's views of the level of feedback. They do not show that women in the high feedback groups are more likely to choose very positive adjectives to describe their feelings after the scan (risk ratio (RR) 3.30; 95% CI 0.73 to 14.85). Women who had a high feedback during ultrasound were more likely to stop smoking during pregnancy (RR 2.93, 95% CI 1.25 to 6.86; participants = 129; one study; low quality evidence) and to avoid alcohol during pregnancy (RR 2.96, 95% CI 1.15 to 7.60; participants = 129; one study; low quality evidence). Downgrading of evidence was based on the unclear risk of bias of included studies, wide CI crossing the line of no effect or presence of heterogeneity. There is insufficient evidence to support either high or low feedback during a prenatal ultrasound to reduce maternal anxiety and promote health behaviour.

Research on maternal health behaviors for Yi-nationality women in poor rural areas based on the theory of reasoned action

To analyze the status of maternal health behaviors and it's risk factors for Yi-nationality women in poor rural areas of Sichuan province. In 2012, multi-stage stratified cluster sampling method was used to select 14 villages of two poor counties in Liangshan Yi-nationality autonomous prefecture Sichuan province. At least 10 women who have infants aged 0-12 months were selected in each simple villages, a total of 284. The structured questionnaire was developed on the basis of the theory of reasoned action. Yi-nationality female college students were trained as investigators. Research indicators included prenatal care rate, hospital delivery rate, postpartum examination rate, socio-demographic characteristics, maternal health care knowledge. χ² test was used to compare the differences of above indicators among different groups. The structural equation model were used to statistical analyze. In the 284 subject women, 51.7% (147/284) women owned more than 2 children, 41.6% (118/284) women were more than 30 years old, 87.3% (248/284) women were illiteracy. The prenatal care rate was 69.7% (197/284), the hospital delivery rate was 26.8% (76/284), and the postnatal check rate was 22.9% (65/284). The influence factors of maternal health behaviors included the number of children, age and education (χ² were 10.92, 13.24, 9.58; P values were 0.027, 0.004, 0.008, respectively).The structural equation model analysis results showed that the maternal health behaviors were directly or indirectly affected by subjective norms (β = 0.236, P < 0.001), women's cognition (β = 0.226, P = 0.020) and women's attitudes on maternal health behavior (β = 0.157, P = 0.001). Among subjective norms, women have high compliance to their husbands (β = 0.850, P < 0.001), their peers (β = 0.708, P < 0.001), and their mothers-in-law (β = 0.636, P < 0.001). There were still serious problems in maternal health behaviors for Yi-nationality women in poor rural areas. The main factors included not only the women's cognition and attitudes for maternal health, but also the attitudes of important social relationships.

The Relationship Between Maternal Education and Child Health Outcomes in Urban Australian Children in the First 12 Months of Life.

To describe the relationship between maternal education and child health outcomes at 12 months of age in a cohort of children in urban Australia, and to determine whether this relationship could be explained by the intermediate factors of maternal health behaviour and the social environmental context. Data were derived from The Environments for Health Living Griffith Birth Cohort Study. Women attending their third trimester antenatal appointment at one of three public hospitals were recruited between 2006 and 2010 and invited to complete a 48-item, baseline self-administered questionnaire. Twelve months following the birth of their baby, a follow-up questionnaire consisting of 63 items was distributed. Women for whom complete follow-up data were not available were different from women who did complete follow-up data. The children of women with follow-up data-whom at the time of their pregnancy had not completed school or whose highest level of education was secondary school or a trade-had respectively a 59 and 57 % increased chance of having had a respiratory/infectious disease or injury in the first year of life (according to parent proxy-reports), compared to children of women with a tertiary education. When maternal behavioural and social environmental factors during pregnancy were included in the model (n=1914), the effect of secondary education was still evident but with a reduced odds ratio of 1.35 (95 % CI 1.07-1.72) and 1.19 (95 % CI 0.87-1.64), respectively. The effect of not having completed school was no longer significant. Results indicate that the relationship between maternal education and child outcomes may be mediated by maternal social environmental and behavioural factors. Results are likely an underestimation of the effect size, given the under representation in our cohort of participants with maternal characteristics associated with elevated risk of infant morbidity.

The Integrated Gateway Model: A catalytic approach to behavior change

ObjectivesTo develop and test an Integrated Gateway Model of behaviors and factors leading to subsequent positive reproductive, maternal, and child health behaviors. MethodsA secondary analysis was conducted using previously published household survey data collected from men (n=5551; 2011) and women (n=16144; 2011) in Nigeria and women in Egypt (n=2240; 2004–2007). The number of health behaviors each potential gateway behavior predicted was assessed by multivariate regression, adjusting for potential confounders. The influence of gateway factors on gateway behaviors was tested via interaction terms. Gateway behaviors and factors were ranked by the number of health outcomes predicted, both separately and synergistically. ResultsThe key gateway behavior identified in both datasets was spousal communication about family planning, whereas the key gateway factor was exposure to family planning messages. ConclusionsThe model could facilitate innovative research and programming that in turn might promote cascades of positive behaviors in reproductive, maternal, and child health.

Health Behavior's Deference in Intended and Unintended Pregnancies

Most of unintended pregnancies occur in developing countries that cause mortality and morbidity in the number of mothers every day. In unintended pregnancies, women Show different health behaviors such as late initiation of prenatal care or supplement taking. This case-control survey conducted on 240 parturient presenting for vaginal delivery. Samples were selected using a continued method and accordingly unintended or intended pregnancies were placed in two groups: case (n=80) and control (n=160). Health behaviors were recorded using given questions, and prenatal care clinics. Statistical analysis was performed using man-Whitney, Students t-test, and chi-squared test where appropriate. Finding of present study showed a meaningful statistical difference evidences for maternal health behaviors. There was statistical difference between two groups in preconception counseling, entry into prenatal care, and supplement taking. According to the findings of the present study, unintended pregnancies are more likely to result in adverse health behaviors. It is recommended that health services be delivered effectively to women to make them aware of unintended pregnancy morbidity and to encourage family programming in their life.

Gender disparities among the association between cumulative family-level stress & adolescent weight status

ObjectiveTo investigate precursors to gender-related obesity disparities by examining multiple family-level stress indices. MethodsAnalyses was based on adolescents born between 1975 and 1991 to women from the 1979 National Longitudinal Study of Youth data set (N=4762). Three types of family-level stressors were captured from birth to age 15: family disruption and conflict, financial strain, and maternal risky health behaviors, along with a total cumulative risk index. Body mass index was constructed on reference criteria for children outlined by the Centers for Disease Control. Multivariate logistic regressions were conducted for the three types of family stressors and for the total cumulative index. ResultsThe accumulation of family disruption and conflict and financial stress was positively related to female adolescents being overweight/obese. Childhood exposure to maternal risky health behaviors was positively associated with higher weight status for male adolescents. Total cumulative stress was related to overweight/obesity for females, but not males. ConclusionDifferent family-level stress indices are associated with the weight status of female and male adolescents. Combining types of family-level stress into one cumulative index appears to mask these differences.

213. Pregnant Adolescents' Family Formation and Perceived Partner Supportiveness in Early Pregnancy and Postpartum

Lack of partner support during adolescent pregnancy and postpartum are associated with negative maternal health behaviors, adverse emotional health, and low birth weight. Engaging young expectant fathers in prenatal pregnancy programs can improve birth outcomes; however, interventions designed to involve male partners are largely lacking. This study examined the impact of a prenatal program on pregnant adolescents' family formation and perceptions of partner support.

Maternal Health Status and Behaviours of Immigrant Women

Background/Objectives: The purposes of this study were to explore the type and frequency of material health status and behaviors in immigrant women and to examine factors affecting maternal health outcomes. Methods/Statistical analysis: This cross-sectional study was conducted with a sample of 106 female marriage immigrants. A well-developed questionnaire was used to measure health-related needs and behaviors and socio-demographic data. The data collection was conducted by face-to-face interview and translators were used when needed. Results: The main findings showed that 33% of participants used birth control methods, 54% performed exclusive breastfeeding for six months, 78% received prenatal care, 67% received postpartum care, 19% had at least one health problem associated with pregnancy, and 21% experienced natural or induced abortion. These indicate that the immigrant participants tend to have somewhat different health problems and behaviors as compared with the general Korean female population. Furthermore, determining factors associated with maternal health outcomes were age, original nationality, employment status, communication experiences with husband and parents-in-law, knowledge about public health center services, and needs for childrearing services in public health centers. Conclusion/Application: Developing culture-specific strategies to improve maternal health outcomes and to communicate effectively with their families is necessary to increase the accessibility of public health services in female marriage immigrants. Keywords: Health Services Needs and Demand, Health Status, Immigrants, Maternal Welfare.

Yoga for Chronic Depressive Symptoms in Pregnancy: A Commentary and Call to Action

Women with depressive symptoms during pregnancy are in great need of safe, inexpensive, non-pharmacologic, accessible, and effective adjunctive therapies to enhance well-being, reduce the burden of symptoms both during their pregnancy and into the postpartum period, and prevent chronic sequelae. Because maternal depressive symptoms are associated with a variety of poor maternal-child outcomes (e.g., poor maternal health behaviors, suicide, poor maternal-fetal/child attachment, intrauterine growth restriction, adult-onset chronic illnesses in offspring, among others), a focus on adequate symptom management during pregnancy is an urgent clinical and research priority. Prenatal yoga is a promising modality which involves gentle physical activity, breathing practices, and relaxation practices that may empower women to self-manage symptoms, enhance well-being, and reduce symptom burden during pregnancy and into the postpartum period. Continued high-quality research is warranted which uses established theoretical frameworks and which builds on my team’s and others’ preliminary research studies which have demonstrated that pregnant women prefer to play an active role in symptom management and that they view prenatal yoga as an accessible, preferred form of mindful physical activity. Yoga for depression in pregnancy 3.

The Effect of Centering Pregnancy versus Traditional Prenatal Care Models on Improved Adolescent Health Behaviors in the Perinatal Period

Study ObjectiveTo determine if the CenteringPregnancy model of prenatal care improves maternal health behaviors in adolescent pregnancy. DesignWe conducted a retrospective chart review comparing 150 pregnant adolescents who received prenatal care between 2008 to 2012 with CenteringPregnancy to those receiving care in traditional prenatal care models with either multiprovider or single-provider visits. Outcome measures included weight gain during pregnancy, compliance to prenatal care appointments, infant feeding method, postpartum follow up and contraceptive use postpartum. A χ2 analysis was used to compare outcomes between the 3 groups at a 2-tailed α of .05. ResultsFifty individuals were evaluated in each group. Adolescents in the CenteringPregnancy group were more likely to comply with prenatal and postpartum visits and to meet the 2009 Institute of Medicine gestational weight guidelines for weight gain in pregnancy than were adolescents in either multiprovider (62.0% vs 38.0%, P = .02) or single-provider (62.0% vs 38.0%, P = .02) groups. The CenteringPregnancy group was also more likely to solely breastfeed compared with adolescents in the multiprovider group (40.0% vs 20.0%, P = .03) and include breastfeeding in addition to bottle-feeding compared with both multiprovider (32.0% vs 14.0%, P = .03) and single-provider (32.0% vs 12.0%, P = .03) patient groups. Additionally, the CenteringPregnancy group had increased uptake of long-acting reversible contraception and were less likely to suffer from postpartum depression. ConclusionsCenteringPregnancy Prenatal Care program aids in compliance to prenatal visits, appropriate weight gain, increased uptake of highly effective contraception, and breastfeeding among adolescent mothers.

Implementation of an evidence-based parenting programme with a Latina population: feasibility and preliminary outcomes

Purpose – The purpose of this paper is to examine the implementation and adaptation of group Triple P, an evidence-based parenting intervention developed in Australia, for a Latina population living in the USA. Design/methodology/approach – Mothers with pre-school age children participated in the programme, which was offered by a community mental health agency. The final study sample consisted of 174 Latina mothers. Findings – Participation in group Triple P was associated with clinically significant improvements in maternal mental health, parenting styles, and child behaviour problems. Additionally, mothers reported high levels of satisfaction with the programme. Practical implications – Triple P is a promising intervention for Latina caregivers who are concerned about the behaviour of their young children. It can be implemented successfully into community-based mental health care systems. Originality/value – This is the first study to examine the applicability of Triple P to Latina caregivers.

Health Behavior Change in Pregnant Women: A Two-Phase Study

Maternal health behaviors during pregnancy/infancy can have a significant impact on maternal and child health. Many women engage in health risk behaviors during pregnancy. Multiple health behavior change (MHBC) interventions provide support to change health behaviors, but further information is needed on potential targets for such an intervention, as well as on the feasibility of technology use and e-health with this population. Two studies were completed as part of this project. First, a survey to examine views regarding health behaviors, desires to change health behaviors, and use of technology was completed by 68 pregnant women presenting for routine care. Based on survey findings, a brief MHBC e-health educational intervention related to breastfeeding, healthy nutrition/lifestyle, and stress management, using iPad(®) (Apple, Cupertino, CA) and text-messaging media, was then developed and piloted in the home with five pregnant women. In the survey, the majority of participants reported interest in receiving help to improve health behaviors, including losing weight or eating a healthier diet, breastfeeding, smoking cessation, and help with depression. The majority of women reported access to a computer with Internet, a phone, and frequent use of text messaging. In the second phase, results suggest that the home-based intervention was feasible and that the technology was convenient and user-friendly. Pregnant women are interested in improving health behaviors and found a brief technology-based e-health intervention feasible, convenient, and user-friendly. In-home technology appears to be a feasible and convenient approach to addressing the multiple health behavior change needs of pregnant women.