Rapid Repeat Research Articles

Separation of Water Level Change From Atmospheric Artifacts Through Application of Independent Component Analysis to InSAR Time Series

AbstractIn recent years, synthetic aperture radar (SAR) interferometry (InSAR) has emerged as a valuable tool for measuring water level change (WLC) to study hydrodynamic processes in coastal wetlands. However, the highly dynamic wet atmosphere conditions common in these areas have a significant impact on InSAR observations, producing errors in the derived values. Standard methods for estimating atmospheric noise in InSAR time series lack the spatial or temporal resolution needed to adequately correct for wet tropospheric delays. In this study, we utilize the Independent Component Analysis (ICA) signal decomposition technique to identify the likely WLC signal and eliminate atmospheric noise in a time series derived from rapid repeat measurements made with the L‐band uninhabited aerial vehicle synthetic aperture radar airborne instrument. The method compares in‐situ water level measurements with the independent components (IC) to identify the ICA components corresponding to WLC. The signal‐to‐noise ratio between the WLC after the ICA‐based filtering and in situ water level gauges used for validation reaches 16 dB compared to an average of 2.6 dB before filtering. The excluded IC are used to generate maps showing a time series of likely atmospheric features. The identified features in the maps generally correspond to atmospheric features identifiable in Next Generation Weather Radar (NEXRAD) S‐band ground weather radar reflectivity maps collected during the SAR acquisitions. The method is sufficiently general to be applied to any InSAR‐derived surface displacement time series.

Evaluating the real-world implementation of the Family Nurse Partnership in England: a data linkage study.

The Family Nurse Partnership is an intensive home visiting programme for adolescent mothers. We aimed to evaluate the effectiveness of the Family Nurse Partnership on outcomes up to age 7 using national administrative data. We created a linked cohort of all mothers aged 13-19 using data from health, educational and children's social care and defined mothers enrolled in the Family Nurse Partnership or not using Family Nurse Partnership system data. Propensity scores were used to create matched groups for analysis. One hundred and thirty-six local authorities in England with active Family Nurse Partnership sites between 2010 and 2017. Mothers aged 13-19 at last menstrual period with live births between April 2010 and March 2019, living in a Family Nurse Partnership catchment area and their firstborn child(ren). The Family Nurse Partnership includes up to 64 home visits by a family nurse from early pregnancy until the child's second birthday and is combined with usual health and social care. Controls received usual health and social care. Indicators of child maltreatment (hospital admissions for injury/maltreatment, referral to social care services); child health and development (hospital utilisation and education) outcomes and maternal hospital utilisation and educational outcomes up to 7 years following birth. Family Nurse Partnership Information System, Hospital Episode Statistics, National Pupil Database. Of 110,520 eligible mothers, 25,680 (23.2%) were enrolled in the Family Nurse Partnership. Enrolment rates varied across 122 sites (range: 11-68%). Areas with more eligible mothers had lower enrolment rates. Enrolment was higher among mothers aged 13-15 (52%), than 18-19 year-olds (21%). Indicators of child maltreatment: we found no evidence of an association between the Family Nurse Partnership and indicators of child maltreatment, except for an increased rate of unplanned admissions for maltreatment/injury-related diagnoses up to age 2 for children born to Family Nurse Partnership mothers (6.6% vs. 5.7%, relative risk 1.15; 95% confidence interval 1.07 to 1.24). Child health and developmental outcomes: there was weak evidence that children born to Family Nurse Partnership mothers were more likely to achieve a Good Level of Development at age 5 (57.5% vs. 55.4%, relative risk 1.05; 95% confidence interval 1.00 to 1.09). Maternal outcomes: There was some evidence that Family Nurse Partnership mothers were less likely to have a subsequent delivery within 18 months of the index birth (8.4% vs. 9.3%, relative risk 0.92; 95% confidence interval 0.88 to 0.97). Younger and more vulnerable mothers received higher numbers of visits and were more likely to achieve fidelity targets. Meeting the fidelity targets was associated with some outcomes. Bias by indication and variation in the intervention and usual care over time and between areas may have limited our ability to detect effects. Multiple testing may have led to spurious, significant results. This study supports findings from evaluations of the Family Nurse Partnership showing no evidence of benefit for maltreatment outcomes measured in administrative data. Amongst all the outcomes measured, we found weak evidence that the Family Nurse Partnership was associated with improvements in child development at school entry, a reduction in rapid repeat pregnancies and evidence of increased healthcare-seeking in the mother and child. Future evaluations should capture better measures of Family Nurse Partnership interventions and usual care, more information on maternal risk factors and additional outcomes relating to maternal well-being. The study is registered as NIHR CRN Portfolio (42900). This award was funded by the National Institute of Health and Care Research (NIHR) Health and Social Care Delivery Research programme (NIHR award ref: 17/99/19) and is published in full in Health and Social Care Delivery Research; Vol. 12, No. 11. See the NIHR Funding and Awards website for further award information.

Demographic and pregnancy-related predictors of postnatal contraception uptake: A cross-sectional study.

To examine the uptake of postnatal contraception (PNC) and experiences of PNC care across a geographical region of England. Cross-sectional online survey. The North East and North Cumbria Integrated Care System (ICS). Women who had completed a pregnancy in the previous 3 years. The uptake of PNC by accessed method(s) and the availability of preferred method(s) is described, and adjusted odds ratios are reported for group differences in uptake by characteristics of interest. Uptake of medically prescribed/administered contraception and uptake of long-acting reversible contraception (LARC) during the postnatal period, and access to preferred PNC methods. Although almost half of respondents (47.1%; n = 1178) reinitiated some form of sexual activity during the postnatal period, only 38.7% (n = 969) of respondents accessed a medically prescribed/administered contraceptive method postnatally, and only 15.5% (n = 389) of respondents accessed a LARC. It is a matter of concern that 18.8% (n = 451) of respondents indicated that they were unable to access their preferred PNC. In multivariate analysis, younger age, lower household income, higher multiparity, operative delivery, unplanned pregnancy and not breastfeeding were significant predictors of higher PNC uptake. The uptake of PNC in this cohort was low, with almost a fifth of women unable to access their preferred method. However, there was some evidence that women belonging to groups perceived to be at risk of rapid repeat pregnancy were more likely to access reliable PNC methods.

A Polyvinylpyrrolidone Nanofibrous Sensor Doubly Decorated with Mesoporous Graphene to Selectively Detect Acetic Acid Vapors.

An original approach has been proposed for designing a nanofibrous (NF) layer using UV-cured polyvinylpyrrolidone (PVP) as a matrix, incorporating mesoporous graphene carbon (MGC) nanopowder both inside and outside the fibers, creating a sandwich-like structure. This architecture is intended to selectively adsorb and detect acetic acid vapors, which are known to cause health issues in exposed workers. The nanocomposite MGC-PVP-NFs layer was fabricated through electrospinning deposition onto interdigitated microelectrodes (IDEs) and stabilized under UV-light irradiation. To enhance the adhesion of MGC onto the surface of the nanocomposite polymeric fibers, the layer was dipped in a suspension of polyethyleneimine (PEI) and MGC. The resulting structure demonstrated promising electrical and sensing properties, including rapid responses, high sensitivity, good linearity, reversibility, repeatability, and selectivity towards acetic acid vapors. Initial testing was conducted in a laboratory using a bench electrometer, followed by validation in a portable sensing device based on consumer electronic components (by ARDUINO®). This portable system was designed to provide a compact, cost-effective solution with high sensing capabilities. Under room temperature and ambient air conditions, both laboratory and portable tests exhibited favorable linear responses, with detection limits of 0.16 and 1 ppm, respectively.

Prospective associations of maternal stressors with child psychosocial problems through the occurrence of child physical abuse and changes in family dynamics

Early childbearing is associated with high maternal stress and family violence. However, the long-term effects of rapid repeat pregnancy (RRP) in young motherhood on child outcomes remain largely unknown. This study examined the pathways between maternal RRP at young ages and child psychosocial problems and emergency room visits in later years. A total of 232 Chinese mother-child dyads provided baseline data in 2015 (Time 1; T1) and follow-up data 6 years later in 2021 (Time 2; T2). At T1, mothers completed questionnaires about child physical abuse frequency and family cohesion and reported their own stress levels. At T2, mothers were re-surveyed with the same questionnaires about child physical abuse frequency and family cohesion. Children’s psychosocial problems were assessed through parent proxy-reports and records of emergency room visits were retrieved from hospital databases. After adjusting for demographic information, maternal history of RRP was associated with child physical abuse at T1 (β = .15, p < .05) and in turn linked to child physical abuse recurrence (β = .22, p < .01) and emergency room visits at T2 (β = .22, p < .001). Improved family cohesion over time did not break the link between maternal RRP and child physical abuse recurrence. Poor family dynamics can lead to child physical abuse recurrence and worsen developmental outcomes in children, particularly when coupled with other risk factors such as maternal RRP at young ages. Early interventions to enhance support and reduce vulnerabilities are important for preventing child physical abuse in at-risk families.

Spatial Variability in Salt Marsh Drainage Controlled by Small Scale Topography

AbstractWater movement in coastal wetlands is affected by spatial differences in topography and vegetation characteristics as well as by complex hydrological processes operating at different time scales. Traditionally, numerical models have been used to explore the hydrodynamics of these valuable ecosystems. However, we still do not know how well such models simulate water‐level fluctuations beneath the vegetation canopy since we lack extensive field data to test the model results against observations. This study utilizes remotely sensed images of sub‐canopy water‐level change to understand how marshes drain water during falling tides. We employ rapid repeat interferometric observations from the NASA's Uninhabited Aerial Vehicle Synthetic Aperture Radar instrument to analyze the spatial variability in water‐level change within a complex of marshes in Terrebonne Bay, Louisiana. We also used maps of herbaceous aboveground biomass derived from the Airborne Visible/Infrared Imaging Spectrometer‐Next Generation to evaluate vegetation contribution to such variability. This study reveals that the distribution of water‐level change under salt marsh canopies is strongly influenced by the presence of small geomorphic features (&lt;10 m) in the marsh landscape (i.e., levees, tidal channels), whereas vegetation plays a minor role in retaining water on the platform. This new type of high‐resolution remote sensing data offers the opportunity to study the feedback between hydrodynamics, topography and biology throughout wetlands at an unprecedented spatial resolution and test the capability of numerical models to reproduce such patterns. Our results are essential for predicting the vulnerability of these delicate environments to climate change.

Prevalence and correlates of very rapid repeat pregnancy: Pregnancy Risk Assessment Monitoring System, United States, 2009-2020.

Most rapid repeat pregnancies, defined as those occurring within 18 months of a previous birth, are unintended. These pregnancies are associated with later initiation of prenatal care and are more common among people with lower socio-economic status and among racially and ethnically minoritised populations. To assess prevalence and correlate pregnancies occurring in the immediate period after a live birth in the United States, using the Pregnancy Risk Assessment Monitoring System (PRAMS). We assessed data from the 2009-2020 PRAMS, a population-based survey of perinatal maternal characteristics of mothers of liveborn infants in US locations. We assessed pregnancies reported during the immediate postpartum period (approximately 2-6 months post-delivery), and term this 'very rapid repeat pregnancy' (VRRP). We assessed the adjusted prevalence of VRRP from 2009 to 2020. From 2016 to 2020, we calculated adjusted prevalence ratios (aPR) with 95% confidence intervals (CI) for maternal characteristics. The adjusted prevalence of VRRP ranged from 0.38% (95% CI: 0.29, 0.48) in 2009 to 0.76% (95% CI: 0.61, 0.91) in 2020. Demographic characteristics associated with VRRP included younger age, lower educational attainment, and being unmarried. Black mothers had a higher prevalence of VRRP compared to white mothers. Mothers who attended a healthcare visit in the 12 months preconception had a lower prevalence of VRRP as did mothers who attended a postpartum check-up, compared to their counterparts without these visits. Among those receiving prenatal care, mothers whose prenatal healthcare provider asked about postpartum contraception birth had a lower prevalence of VRRP, compared to those not asked about postpartum contraception. VRRP appeared to increase over time in 2009-2020. Mothers who are younger, Black, have lower educational attainment, or who did not attend healthcare visits before or after pregnancy had a higher prevalence of VRRP and may comprise a population who would benefit from additional family planning resources.

Traumatic Brain Injury among Patients Admitted in Neurosurgical Unit in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Traumatic brain injuries are one of the leading causes of mortality, morbidity, and economic burden in context to Nepal. Non-contrast computed tomography is used for rapid diagnosis and repeat computed tomography helps to detect the progression and complications of cerebral injury. The aim of this study was to find out the prevalence of traumatic brain injury among patients admitted in the neurosurgical unit in a tertiary care centre. This descriptive cross-sectional study was conducted among patients admitted to the neurosurgery unit in the tertiary care centre from 1 August 2019 to 29 August 2020. Ethical approval was taken from Institutional Review Committee (Reference number: CMC-IRC/075/076-156). Convenience sampling method was used. Point estimate and 95% Confidence Interval were calculated. Among 350 patients admitted in the neurosurgical unit, the prevalence of traumatic brain injury was 140 (40%) (34.87-45.13, 95% Confidence Interval). Change in management was required among 28 (20%) when computed tomography was done within 12-24 hours. Among them, 27 (19.29%) underwent surgical intervention after a repeat computed tomography scan. The prevalence of traumatic brain injury was found to be higher than similar studies done in similar settings. contusion; craniotomy; traumatic brain injury.

Contraceptive use among young mothers with repeat births: Evidence from a qualitative study in KwaZulu-Natal, South Africa.

Teenage pregnancy and rapid repeat pregnancies are declining globally, but they continue to be a significant health issue. Many studies have explored contraceptive use by adolescents, but too date there is a lack of literature on the contraceptive use dynamics of young women in repeat births. This study was conducted in Umlazi, a township located in the province of KwaZulu-Natal. A total of 50 interviews with young mothers aged 18-24 years were conducted. The results revealed that contraceptive use among young mothers remains a challenge, resulting in a significant lack of contraceptive use. This study concludes that much more needs to be done to help young women protect themselves from unwanted and unplanned repeat pregnancies, which includes raising contraception awareness as well as educating young women about their own sexual reproductive health.

RPTRF: A rapid perfect tandem repeat finder tool for DNA sequences

The sequencing of eukaryotic genomes has shown that tandem repeats are abundant in their sequences. In addition to affecting some cellular processes, tandem repeats in the genome may be associated with specific diseases and have been the key to resolving criminal cases. Any tool developed for detecting tandem repeats must be accurate, fast, and useable in thousands of laboratories worldwide, including those with not very advanced computing capabilities. The proposed method, the Rapid Perfect Tandem Repeat Finder (RPTRF), minimizes the need for excess character comparison processing by indexing the input file and significantly helps to accelerate and prepare the output without artifacts by using an interval tree in the filtering section. The experiments demonstrated that the RPTRF is very fast in discovering all perfect tandem repeats of all categories of any genomic sequences. Although the detection of imperfect TRs is not the focus of the RPTRF, comparisons show that it even outperforms some other tools (in five selected gold standards) designed explicitly for this purpose.The implemented tool and how to use it are available on GitHub.

高灵敏度, 超宽响应范围, 环境耐受性高的多模式离 子凝胶基传感器

In recent years, skin-like ionic sensors have attracted considerable attention due to their excellent performance, feasibility, and biocompatibility. However, developing a multifunctional, stable, durable, highly sensitive skinlike ionic sensor is a challenge. Herein, a composite ionogel with good durability, environmental tolerance (freezing and vacuum resistance), ionic conductivity, self-healing capability, high adhesion and stretchability was fabricated via a simple UV initiated polymerization. The ionogel could be easily assembled into strain, pressure, and temperature sensors for detecting changes in the external environment. In strain and pressure sensing tests, the ionogel-based sensor exhibited high sensitivity (gauge factor GF = 14.7), a wide response range (1%–1600%), rapid response time (95.8 ms), high stability, and repeatability (50% for 1000 cycles). Therefore, it could trace not only wide joint movements but also subtle changes in facial expressions (frowning). The sensor could also be assembled into a knock sensor and a high-precision touch pad sensor for message transmission. The ionogel-based sensor exhibited high sensitivity to temperature variations from 0 to 120°C and a low detection threshold (0.1°C). Thus, the proposed ionogel-based sensor has enormous potential in multifunctional electronic and sensory device applications.

Perinatal Health Profiles Associated With Removal From the Home and Subsequent Child Protective Services Report in Maltreated Infants.

Infants face the highest risk of abuse and neglect nationally. There is a compelling need to understand the individual risk factors and needs of families of maltreated infants so that prevention efforts can be tailored for optimal effectiveness. Using linked birth certificate and CPS records data, we employed latent class analysis to identify distinct profiles of perinatal health factors associated with infant maltreatment. Classes were then regressed onto two key child welfare outcomes-removal from the home and re-report. Results indicated 10 latent classes primarily associated with supervisory neglect and presumed prenatal substance exposure. Rapid repeat pregnancy, smoking during pregnancy and inadequate prenatal care emerged as key risk factors. Presumed substance exposure was associated with high risk of removal from the home and low risk of re-report. The opposite was found for supervisory neglect. Substantial variation existed across classes and types of maltreatment, suggesting a need for tailored prevention strategies.

Monitoring the pH Value of an Aqueous Micellar Solution in Real-Time Using a Fiber Optofluidic Laser

Fiber optofluidic lasers (FOFLs) have attracted considerable research attention in the field of biochemical sensing due to their merits such as high sensitivity, low sample consumption, and real-time dynamic response. In this paper, we employ a Whispering Gallery Mode (WGM)-based FOFL to monitor the pH variation of rhodamine B (RB) aqueous micellar solution, in which small changes in pH are transformed into a dynamic response of the lasing spectral information in real-time, with a sensitivity of up to 7.3 nm/pH in the spectral shift for the pH in the range of 4.56–6.50. The sensor possesses a rapid response, high repeatability, good photostability, excellent reversibility, and immunity to the interference from the pump light, which can be used for in situ and real-time measurements in a wide range of biochemical applications. Additionally, the distinct dependence of lasing emission of RB molecules bound to surfactant micelles on the pH of an aqueous solution opens the possibility of using RB as an interfacial acid-base indicator.

Association of Male Partners' Gender-Equitable Attitudes and Behaviors with Young Mothers' Postpartum Family Planning and Maternal Health Outcomes in Kinshasa, DRC.

Inequitable gender norms can contribute to rapid repeat pregnancies and adverse maternal health outcomes among adolescent girls and young women. This study examined associations between male partners’ gender-equitable attitudes and behaviors and postpartum family planning (FP) and maternal and newborn health (MNH) outcomes among first-time mothers aged 15–24 in Kinshasa, Democratic Republic of the Congo. Participants were 1335 couples who were successfully interviewed in the Momentum project’s 2018 baseline and 2020 endline surveys. Multivariable regression models were used to analyze predictors of postpartum FP discussion and use, shared MNH decision making, completion of the maternal health continuum of care, and exclusive breastfeeding. Male involvement in maternal health was significantly associated with FP discussion and shared decision making. Male partners’ willingness to be involved in routine childcare and shared decision making were significant positive predictors of exclusive breastfeeding. Postpartum FP outcomes were shaped by the intersection of marital status and male partners’ gender-equitable attitudes, intimate partner violence perpetration, and willingness to engage in routine childcare activities to constitute advantage for some outcomes and disadvantage for others. Interventions must use multiple measures to better understand how young mothers’ health outcomes are shaped by their male partners’ gender-related attitudes and behaviors.

Child Marriage, Reproductive Outcomes, and Service Utilization among Young Afghan Women: Findings from a Nationally Representative Survey in Afghanistan.

This study explored the prevalence of child marriage and its association with reproductive outcomes and service utilization among young women in Afghanistan. We conducted a secondary analysis of data from the 2015 Afghanistan Demographic and Health Survey (DHS), focusing on women aged 20-24 years old based on the United Nations' recommendation on child marriage study. Multivariate logistic models examined the association between child marriage, reproductive outcomes, and service utilization. An estimated 52% of the Afghan women aged 20-24 married at ages less than 18 years. Poverty and illiteracy were associated with the higher likelihood of early marriage. There was a significant negative relationship between child marriage and history of rapid repeat childbirth, delivery by skilled personnel, and institutional delivery. In both adjusted and unadjusted models, women married at age ≤14 were more likely to experience terminated or unintended pregnancy, inadequate ANC, unmet need for family planning, and fistula; while, for those married at age 15-17 years, only terminated or unintended pregnancy remained significant. Strict international law enforcement and advocacy are needed in the current situation of Afghanistan to increase young women's education, promote their civil rights, and improve their autonomy and role in decision-making concerning their fertility preferences and reproductive health.

034 How to avoid pregnancy? Contraception

The use of effective contraceptive methods is a cornerstone of adolescent pregnancy prevention. Pregnancy itself is an important opportunity to counsel on future contraceptive plans, as rapid repeat pregnancy is common among adolescent mothers.

Immediate versus delayed postabortal insertion of contraceptive implant.

Contraceptive implants are one of the most effective contraceptive methods, providing a long duration of pregnancy protection and a high safety profile. Hence this method is suitable for optimizing the interpregnancy interval, especially for women undergoing abortion. Women who have had abortions are at high risk of rapid repeat pregnancies. Provision of effective contraception at the time of an abortion visit can be a key strategy to increase access and uptake of contraception. A review of the evidence was needed to evaluate progestin-releasing implants for immediate use at the time of abortion, including whether immediate placement impacts the effectiveness of medical abortion, which relies on antiprogestogens. To compare contraceptive implant initiation rates, contraceptive effectiveness, and adverse outcomes associated with immediate versus delayed insertion of contraceptive implants following abortion. We searched for all relevant studies regardless of language or publication status up to September 2019, with an update search in March 2021. We searched the Cochrane Central Register of Controlled Trials (CENTRAL) (Ovid EBM Reviews), MEDLINE ALL (Ovid), Embase.com, CINAHL (EBSCOhost) (Cumulative Index to Nursing and Allied Health Literature), Global Health (Ovid), LILACS (Latin American and Caribbean Health Science Information database), Scopus, ClinicalTrials.gov, and the WHO ICTRP. We examined the reference lists of pertinent articles to identify other studies. We sought randomized controlled trials (RCTs) comparing immediate versus delayed insertion of contraceptive implant for contraception following abortion. We followed the standard procedures recommended by Cochrane. To identify potentially relevant studies, two review authors (JS, LS) independently screened the titles, abstracts, and full texts of the search results, assessed trials for risk of bias, and extracted data. We computed the risk ratio (RR) with 95% confidence intervals (CIs) for binary outcomes, and the mean difference (MD) with 95% CIs for continuous variables. We found three RCTs including a total of 1162 women. Our GRADE assessment of the overall certainty of the evidence ranged from moderate to very low, downgraded for risk of bias, inconsistency, and imprecision. Utilization rate at six months may be slightly higher for immediate compared with delayed insertion (RR 1.10, 95% CI 1.05 to 1.15; 3 RCTs; 1103 women; I2 = 62%; low certainty evidence). Unintended pregnancy within six months after abortion was probably lower with immediate insertion compared with delayed insertion (RR 0.25, 95% CI 0.08 to 0.77; 3 RCTs; 1029 women; I2 = 0%; moderate certainty evidence). Immediate insertion of contraceptive implants probably improves the initiation rate compared to delayed insertion following medical abortion (RR 1.26 for medical abortion, 95% CI 1.21 to 1.32; 2 RCTs; 1014 women; I2 = 89%; moderate certainty evidence) and may also improve initiation following surgical abortion (RR 2.32 for surgical abortion, 95% CI 1.79 to 3.01; 1 RCT; 148 women; I2 = not applicable; low certainty evidence). We did not pool results for the implant initiation outcome over both abortion types because of very high statistical heterogeneity. For medical termination of pregnancy, we found there is probably little or no difference between immediate and delayed insertion in overall failure of medical abortion (RR 1.18, 95% CI 0.58 to 2.40; 2 RCTs; 1001 women; I2 = 68%;moderate certainty evidence). There may be no difference between immediate and delayed insertion on rates of abnormal bleeding at one month after abortion (RR 1.00, 95% CI 0.88 to 1.14; 1 RCT; 462 women; I2 = not applicable; low certainty evidence). Provision of progestin-releasing implants concurrently with abortifacient agents likely has little or no negative impact on overall failure rate of medical abortion. Immediate insertion probably improves the initiation rate of contraceptive implant, as well as unintended pregnancy rate within six months after abortion, compared to delayed insertion. There may be no difference between immediate and delayed insertion approaches in bleeding adverse effects at one month after abortion.

The Impact of a Home Visiting Program Enhanced to Address Repeat Adolescent Pregnancy-A Randomized Controlled Trial of Steps to Success.

A small but growing body of evidence suggests individualized support services and improved access to contraception can promote healthy birth spacing among adolescent mothers. This study examines the effectiveness of Steps to Success, a 2-year home visiting program in San Angelo, Texas, enhanced with content designed to reduce rapid repeat pregnancy among young mothers, increase fathers' involvement, and support mothers' education and career aspirations. The study used a randomized controlled trial, with 594 young mothers ages 14-20 randomly assigned to either a program group that received Steps to Success or a control group that received an existing home visiting program focused only on parenting and child development. Women in both research groups completed a baseline survey upon enrolling in the study and 1- and 2-year follow-up surveys. After 2years, participants in the Steps to Success and existing home visiting groups had similar rates of repeat pregnancy. However, women in the Steps to Success group were more likely to use long-acting reversible contraceptives (effect size = 0.18, p = 0.066), particularly younger adolescent mothers ages 14-18 (effect size = 0.34, p = 0.010). Steps to Success also decreased the incidence of unprotected sex for younger adolescent mothers (effect size = -0.25, p = 0.035). Steps to Success did not improve outcomes in other domains. Steps to Success improved some outcomes related to healthy birth spacing among younger adolescent mothers. Communities interested in similar programming may want to consider focusing their services on this age group.

AIM for Teen Moms: Social Support’s Role in Contraception Use Among Young Mothers

PurposeRapid repeat pregnancy is associated with negative outcomes for teen mothers and their offspring. Contraceptive use can reduce this risk. We explored the impact of AIM for Teen Moms, a future-oriented behavioral intervention, on emotional and tangible support and the influence of this support on the attitudes, intentions, and past 3-month contraceptive use behaviors. MethodParticipants were 295 first-time moms (ages 15–19) in Los Angeles County who participated in a randomized control trial intervention to reduce rapid repeat pregnancies. Participants completed surveys at baseline and 36-months. Hypotheses were tested using multivariate and interaction analysis. ResultsTeen mothers in treatment group reported more emotional (β =.13, p < .05) and tangible support (β =.13, p < .05). Higher tangible support was positively associated with birth control attitudes (β =.13, p < .05), which, in turn, predicted intention to use birth control (β =.31, p < .001). Intention to use birth control also predicted higher past 3-month birth control use (β =.18, p < .01); there was also a direct path from attitude to 3-month birth control use (β =.35, p < .001). There was no association between emotional support and birth control attitudes, intentions, or behaviors. ConclusionAIM for Teen Mom’s effects on contraception use at 36 months was mediated by social support, specifically tangible support, which, in turn, affected birth control attitudes, intentions, and reported birth control use. Interventionists must consider how intervention content can specifically address the building of target support to meet the needs of teen mothers.

Understanding the impacts of child marriage on the health and well-being of adolescent girls and young women residing in urban areas in Egypt

BackgroundEgypt has made progress in delaying age at marriage, but child marriage continues to be practiced in many places across the country. This study investigates the impacts of child marriage on the health and wellbeing of girls residing in urban Egypt using a multi-method approach.MethodsThe quantitative component leveraged data from the 2014 Egypt Demographic and Health Survey and focused on (1) reproductive health, (2) maternal health and (3) social outcomes among a subsample of ever-married urban women ages 20–24 (N = 1041). Simple and multivariable logistic regressions were used to estimate prevalence odds ratios and 95% confidence intervals for associations between child marriage and the three sets of outcomes. The qualitative component drew from 11 focus groups, 23 in-depth interviews, and 13 key informant interviews conducted in three urban sites in Egypt. The data was thematically analyzed using a combination of inductive and deductive coding.ResultsThe prevalence of marriage under age 18 was 13.22%. Child marriage was significantly associated with ever use of contraception (Adjusted Odds Ratio (AOR) 2.95 95% CI 1.67–5.19), multiple births (AOR 12.93 95% CI 5.45–30.72), rapid repeat childbirth (AOR 2.20 95% CI 1.34–3.63), and pregnancy termination (AOR 1.89 95% CI 1.11–3.23). Many of these associations disappeared after adjusting for marriage duration. Girls married under age 18 had larger spousal age gaps (AOR 2.06; 95% CI 1.24–3.41) and higher odds of FGM (AOR 2.14; 95% CI 1.11–4.13). They were significantly more likely to report receiving no ANC care (AOR 0.39; 95% CI 0.19–0.80), and less likely to deliver through C-section (AOR: 0.53; 95% CI 0.34–0.83). Consequences emerging from the qualitative data centered around five themes: (1) Access to and use of sexual and reproductive health services; (2) exposure to FGM; (3) marriage and birth registration; (4) marital relations; and (5) relationship with in-laws.ConclusionFindings provide important insights into the practice of child marriage in urban areas in Egypt and illustrate a range of adverse consequences associated with the practice.