Vulnerable Pregnant Women Research Articles

Discussing health behavior change during pregnancy: co-creation of a training and conversation tool

Abstract Background Health risk behaviors during pregnancy are major risk factors for adverse health outcomes for mother and child, and they are more prevalent among vulnerable pregnant women. However, interventions often do not sufficiently meet the needs of disadvantaged groups. Changing behavior is more likely when people feel autonomous and when a behavior aligns with our identity (how we see ourselves). Despite the clear importance of identity in health behavior change, very few identity- based interventions exist for pregnant women, let alone for vulnerable pregnant women. Through co-creation, this study aims to develop an identity- and autonomy- based training program and conversation tool tailored to the needs and preferences of healthcare professionals and vulnerable pregnant women. Methods Four co-creation sessions were conducted with five professionals from medical and social domains, and five (expectant) parents in vulnerable situations. The Participatory Learning and Action research methodology was applied to ensure an equal and democratic process in designing the training and conversation tool. Results The training for professionals will focus on enhancing knowledge about the importance of identity and autonomy in behavior change, and on improving their self-efficacy through practicing the conversation tool. Example of the conversation tool, which can be integrated into daily practice, is a comic strip illustrating the conflict of being a smoker and a mother. Conclusions During intervention development, it is important to consider the needs and preferences of end-users, particularly for whom few appropriate interventions exist. Involving end-users yields valuable insights for feasible (e.g. one-consultation time frame) and accessible (e.g. easy-to-understand language) interventions. This study aligns with public health efforts toward early intervention and health promotion among vulnerable groups. Key messages • During intervention development, it is important to consider the needs and preferences of end-users. • This study aligns with public health efforts toward early intervention and health promotion among vulnerable groups.

Enhancing maternal health service utilization among highly vulnerable pregnant women through a human-centered design process: Study protocol for a quasi-experimental study in Oromia, Ethiopia

Background Disproportionate uptake of and access to maternal and child health services remain significant challenges across and within countries. Differing geographic, economic, environmental, and social factors contribute to varying degrees of vulnerabilities among individuals, which manifest as disparities in maternal and newborn health outcomes. Designing solutions according to need is vital to improve maternal and child health outcomes. In this paper, we describe our study protocol on evaluating the effectiveness of an intervention package developed through a human-centered design (HCD) process in improving maternal health service uptake among vulnerable pregnant women in rural areas of Ethiopia. Methods The study has two distinct phases. For both phases, solutions will be developed leveraging HCD approaches to improve institutional delivery and antenatal care uptake among vulnerable pregnant women. Final solutions will be implemented in collaboration with community health workers and health officers. A community-based, quasi-experimental, mixed-method study design is used to assess differences between intervention and control arms. A panel sample will be enrolled after screening for pregnancy and vulnerability level and surveyed at baseline and midline in Phase 1. In Phase 2, a post-only study will be conducted in the same intervention and control sites. Pregnant women will receive refined solutions for six months, which will be evaluated using end-line assessment. Qualitative interviews will be conducted among vulnerable pregnant women and healthcare providers. Conclusions and Implications Our sequential approach to evaluating initial solutions, which in turn will be used to inform the enhancement of solutions, will provide practical insights into how solutions are accepted among vulnerable women and how they can be better integrated into women’s lives and health systems. Our findings on program effectiveness and implementation research will be disseminated to the Ethiopian Ministry of Health and its partners to inform large-scale implementation at the national level.

Eating Behaviors during Pregnancy: A Cross-Sectional Study.

Eating disorders are complex illnesses with serious long-term consequences. They are linked to negative outcomes such as miscarriage, low birth weight, and other obstetric and postpartum difficulties. Our study in Muscat, Oman, examines the eating habits of pregnant women who consult primary care physicians. In this study, our aim is to identify key sociodemographic factors linked with eating disorders in Oman. We used the Eating Disorder Examination Questionnaire to assess the potential for the presence of eating disorders. Chi-Square and Fisher's Exact tests were used to analyze relationships between improper eating behavior and independent variables. The study showed that 1.6% of participants had a potential diagnosis of an eating disorder, with the most common inappropriate behavior being binge eating at a prevalence of 18.8%. A pre-gestational low Body Mass Index (BMI) was associated with a higher prevalence of binge eating during pregnancy. Additionally, we found that pregnant women who were working were more prone to self-induced vomiting. High BMI before pregnancy was significantly associated with various inappropriate eating behaviors, such as restraint behavior (p = 0.000), shape concern (p = 0.000), weight concern (p = 0.040), eating (p = 0.045), laxative use (p = 0.020), and excessive exercise (p = 0.043). The study reveals a high prevalence of eating disorders in pregnancy. Less educated women exhibit higher laxative use, while working women show more instances of binge eating and self-induced vomiting. These findings emphasize the critical need to prioritize targeted interventions and support for vulnerable pregnant women.

The Effect of the Implementation of the Supplementary Feeding Consumption Compliance Card on the Compliance Level Among Pregnant Women at the North Ponorogo Health Center

Background: Chronic Energy Deficiency (CED) is the cause of non-obstetric medical complications in pregnancy that occurs over a long period of time. The Providing Additional Food (PAF) program for vulnerable pregnant women is a supplementation strategy in overcoming nutritional problems, but the program has not been able to run well, based on observations made and also interviews with officers, it is known that some pregnant women have not been regular in consuming PAF biscuits. Researchers want to know the effect of implementing the PAF consumption compliance card on the level of compliance of CED pregnant women at the North Ponorogo Community Health Center. Methods: This study uses an experimental research method. The research design with a pre-experimental approach is in the form of a one-group pretest-posttest design. The sample was taken using the total population sampling technique. The independent variable in this study was the implementation of the PAF consumption compliance card while the dependent variable was the level of compliance of CED pregnant women consuming PAF. Data collection uses interviews and obedient cards as instruments. Data analysis was carried out by normality test and the result of a p value of > 0.05 could be carried out, then the Paired Sample t-Test could be carried out to find out if there was a difference. Results: The results of the Paired samples t-test showed that there was a difference in the compliance of CED pregnant women before and after being given an obedience card, which can be seen at the value of p = 0.0001473. Conclusions: It can be concluded that compliance cards have proven effective in increasing the compliance of CED pregnant women in consuming PAF. Therefore, it is recommended to implement compliance cards as a reminder and monitor for pregnant women regarding PAF consumption.

The impact of a reproductive health voucher in Uganda using a quasi-experimental matching design

This study assesses the impact of a voucher project that targeted vulnerable and poor pregnant women in Uganda. Highly subsidised vouchers gave access to a package of safe delivery services consisting of four antenatal visits, safe delivery, one postnatal visit, the treatment and management of selected pregnancy-related medical conditions and complications, and emergency transport. Vouchers were sold during the project’s operational period from 2016 to 2019. This study covers 8 out of 25 project-benefiting districts in Uganda and a total of 1,881 pregnancies, including both beneficiary and non-beneficiary mothers. Using a matching design, the results show a positive effect on the survival of new-born babies. The difference in the survival rate between the control group and the treatment group is 5.4% points, indicating that the voucher project reduced infant mortality by more than 65 per cent.

Effects on Child Development and Parent-Child Interaction of the FACAM Intervention: A Randomized Controlled Study of an Interdisciplinary Intervention to Support Women in Vulnerable Positions through Pregnancy and Early Motherhood.

Health inequality can have a profound impact on a child's life. Maternal mental health challenges can hinder bonding, leading to impaired functioning and poorer child outcomes. To provide extra support for vulnerable pregnant women, the FACAM intervention offers the services of a health nurse or family therapist from pregnancy until the child starts school. This study examined the effects of FACAM intervention on pregnant women in vulnerable positions and their children until the child turned two years old. We randomly assigned 331 pregnant women to either FACAM intervention or care as usual and assessed them at baseline and when the infant was 3-6, 12-13.5, and 24 months old. The primary outcome was maternal sensitivity measured by Coding Interactive Behavior (CIB). Secondary outcomes included the parent-child relationship, child social-emotional development, child developmental progress, parent-child interaction, and child development. Our findings indicate that care-as-usual children were significantly more involved than FACAM children when the child was 4-6 months old (b = -0.25, [-0.42; -0.08] d = -0.42). However, we suspect this result is due to a biased dropout. We did not find any significant differences in any other outcomes. Therefore, the study suggests that the FACAM intervention is not superior to care as usual regarding child development and parent-child interaction outcomes.

Advances in Zika virus vaccines and therapeutics: A systematic review

Zika virus (ZIKV) is the causative agent of a viral infection that causes neurological complications in newborns and adults worldwide. Its wide transmission route and alarming spread rates are of great concern to the scientific community. Numerous trials have been conducted to develop treatment options for ZIKV infection. This review highlights the latest developments in the fields of vaccinology and pharmaceuticals developments for ZIKV infection. A systematic and comprehensive approach was used to gather relevant and up-to-date data so that inferences could be made about the gaps in therapeutic development. The results indicate that several therapeutic interventions are being tested against ZIKV infection, such as DNA vaccines, subunit vaccines, live-attenuated vaccines, virus-vector-based vaccines, inactivated vaccines, virus-like particles, and mRNA-based vaccines. In addition, approved anti-ZIKV drugs that can reduce the global burden are discussed. Although many vaccine candidates for ZIKV are at different stages of development, none of them have received Food and Drug Authority approval for use up to now. The issue of side effects associated with these drugs in vulnerable newborns and pregnant women is a major obstacle in the therapeutic pathway.

Enhancing quality of life, public health, and economic development in the Global South through waterborne disease prevention with ultraviolet C light-emitting diode technology

Waterborne diseases pose a significant public health challenge in the Global South, attributed to inadequate access to clean water, insufficient sanitation infrastructure, and poor water treatment systems. These factors contribute to the contamination of water sources with microbial pathogens, placing individuals at a heightened risk of contracting waterborne diseases. Waterborne diseases in the Global South are caused by various bacterial pathogens, parasites, and viruses, with factors such as climate change, water scarcity, and human pollution influencing their proliferation. Vulnerable populations, including children, pregnant women, and immunocompromised individuals, bear the brunt of these diseases, resulting in preventable deaths and hindering socioeconomic development due to health-care costs. Traditional methods for combating these diseases have limitations, leading to the need for alternative water disinfection strategies, such as ultraviolet C light-emitting diodes (UVC LEDs). This review examines both the current state of waterborne diseases in the Global South (i.e., disease prevalence, causes, and public/systemic impacts) and the current landscape of UVC LED technology for water disinfection. Through the lens of this multi-focus review, we also explore the potential widespread implementation of UVC LED technology for water disinfection as a method of combating waterborne diseases to improve public health outcomes. Regulatory frameworks for UVC LED water treatment systems in the Global South remain limited. To address this limitation, we recommend an essential implementation framework that includes legislation, partnerships, sustainability, affordability, industrial and environmental standards, and robust evaluation protocols. Finally, we provide a substantial overview of the future directions and research opportunities in UVC LED technology and water treatment mechanisms aiming for promising public health outcomes. Embracing UVC LED technology can help address persistent disease challenges and improve public health in regions with limited infrastructure, thereby moving closer to achieving the United Nation’s Sustainable Development Goals and emphasizing the significance of universal access to improved WASH (safe water, sanitation, and hygiene) conditions.

Meeting the needs of pregnant women in socially vulnerable situations: A phenomenological qualitative study

ObjectiveVulnerability relates to fragile physical, psychological, and socio-environmental circumstances. Pregnant women's social vulnerability can lead to disruptions in their medical follow-ups, prematurity, and increased infant mortality rates, such that their special needs must be considered. Yet, despite different governments' ‘perinatality’ plans, international literature suggests their care can be improved. Although quantitative studies regularly evaluate these plans, few studies have assessed vulnerable pregnant women's views. This study explores the needs and expectations of vulnerable women regarding their follow-ups during pregnancy and identified strategies to improve their circumstances. MethodsThe study was a phenomenological qualitative study involving semi-structured interviews with women who gave birth in the past six months (December 2017 to June 2018) and who fulfilled at least one vulnerability criterion. The women were recruited by French midwives and general practitioners (GPs). FindingsConcerning these vulnerable pregnant women, three phenomenological categories emerged: 1) they need to be monitored by a single trusted contact; 2) they seek medical and social support adapted to their situations that addresses their needs; and 3) they expect kind and person-centred communication skills from professionals who provide them appropriate information. ConclusionWe identified various international recommendations to screen and care for vulnerable pregnant women, but still these women often experience numerous challenges. Finally, the implementation of recommendations for healthcare professionals based on women's real-life experiences could help optimise the identification of vulnerable pregnant women as well as their follow-up care.

Opportunities in Assessing and Regulating Organohalogen Flame Retardants (OFRs) as a Class in Consumer Products.

In 2015, the U.S. Consumer Product Safety Commission (CPSC) received and then, in 2017, granted a petition under the Federal Hazardous Substances Act to declare certain groups of consumer products as banned hazardous substances if they contain nonpolymeric, additive organohalogen flame retardants (OFRs). The petitioners asked the CPSC to regulate OFRs as a single chemical class with similar health effects. The CPSC later sponsored a National Academy of Sciences, Engineering, and Medicine (NASEM) report in 2019, which ultimately identified 161 OFRs and grouped them into 14 subclasses based on chemical structural similarity. In 2021, a follow-up discussion was held among a group of scientists from both inside and outside of the CPSC for current research on OFRs and to promote collaboration that could increase public awareness of CPSC work and support the class-based approach for the CPSC's required risk assessment of OFRs. Given the extensive data collected to date, there is a need to synthesize what is known about OFR and how class-based regulations have previously managed this information. This commentary discusses both OFR exposure and OFR toxicity and fills some gaps for OFR exposure that were not within the scope of the NASEM report. The objective of this commentary is therefore to provide an overview of the OFR research presented at SOT 2021, explore opportunities and challenges associated with OFR risk assessment, and inform CPSC's work on an OFR class-based approach. A class-based approach for regulating OFRs can be successful. Expanding the use of read-across and the use of New Approach Methodologies (NAMs) in assessing and regulating existing chemicals was considered as a necessary part of the class-based process. Recommendations for OFR class-based risk assessment include the need to balance fire and chemical safety and to protect vulnerable populations, including children and pregnant women. The authors also suggest the CPSC should consider global, federal, and state OFR regulations. The lack of data or lack of concordance in toxicity data could present significant hurdles for some OFR subclasses. The potential for cumulative risks within or between subclasses, OFR mixtures, and metabolites common to more than one OFR all add extra complexity for class-based risk assessment. This commentary discusses scientific and regulatory challenges for a class-based approach suggested by NASEM. This commentary is offered as a resource for anyone performing class-based assessments and to provide potential collaboration opportunities for OFR stakeholders. https://doi.org/10.1289/EHP12725.

Maternal multimorbidity - experiences of women seeking asylum during pregnancy and after childbirth: a qualitative study

BackgroundMany women seeking asylum during pregnancy and after childbirth have ill-health but detection and assessment of all physical, psychological, and social health needs (maternal multimorbidity) are often difficult as part of routine maternity care. Healthcare providers are key for the early identification and management of vulnerable pregnant women who have additional physical, psychological, and social health needs. We sought to explore the impact of the asylum-seeking process, understanding of wellbeing, expressed health needs (in terms of maternal multimorbidity), and the experiences of maternity care of women seeking asylum during pregnancy and after childbirth in Liverpool, United Kingdom. Enabling factors and barriers to access woman-centred care were also explored.MethodsKey informant interviews (n = 10) and one focus group discussion (n = 4) were conducted with women attending a non-profit charitable pregnancy support group. Transcribed interviews were coded by topic and then grouped into categories. Thematic framework analysis was undertaken to identify emerging themes.ResultsThe asylum-seeking process negatively impacted women making them feel anxious and depressed with little control or choice over their future. Women reported feeling stressed regarding poor standard of accommodation, low income, dispersal and the uncertainty of their asylum application outcome. Wellbeing during pregnancy and after childbirth was understood to be multifactorial and women understood that their physical health needs were interlinked and negatively impacted by complex psychological and social factors. Women reported that their expectations of maternity services were often exceeded, but information giving, and the use of language interpreters needed to be improved. Women expressed the need for more psychological and social support throughout pregnancy and after childbirth.ConclusionsA multidisciplinary team, with links and effective referral pathways to maternal mental health and social services, are necessary for women seeking asylum, to ensure a more integrated, comprehensive assessment of maternal multimorbidity and to provide maternity care in a way that meets all health needs.

Investigating eHealth lifestyle interventions for vulnerable pregnant women: a scoping review of facilitators and barriers (Preprint)

Investigating eHealth lifestyle interventions for vulnerable pregnant women: a scoping review of facilitators and barriers (Preprint)

Topics of Women’s Health Research in the United States, Canada, European Union, and Japan in 2012-2022

Purpose: This study investigated recent trends in the topics of women's health research in the United States (US), Canada, Japan, and the European Union where various research projects related to women and gender have been conducted.Methods: To explore recent international women's health research, we selected research projects conducted between 2012 and 2022 from the US National Institute of Health, Canada's Research Information System, Japan's Health, Labor and Welfare Science Research Performance Database, and the European Union's CORDIS website. We categorized the identified research into three main areas; common or serious diseases and conditions affecting women, diseases, and conditions specific to women, and factors influencing women's health.Results: The focus of health research expanded beyond traditional views of women, gender, and gender differences. Projects addressed the health needs of vulnerable groups, including refugees, migrants, incarcerated women, trans individuals, and pregnant women with autism. They also explored the connections between gender and racial differences in women's health. This inclusive approach considered the gaps and intersections within women's health.Conclusion: Future women's health research in Korea will need to consider the intersectionality of gender, aging, and immigration. Environment-based approach in the research of drug addiction, mental health, nursing, and care would be important.

Shared decision making on mode of delivery following a prior cesarean delivery in Dar es Salaam, Tanzania.

Shared decision-making between clinicians and pregnant women with prior cesarean on the subsequent mode of delivery improves trial of labor rates, and reduces the number of repeat cesarean sections and their related complications. However, this practice is insufficient worldwide and the factors influencing it are still unknown. The study aimed at determining the proportion of pregnant women involved in shared decision-making and its associated factors in Dar es Salaam. A cross-sectional analytical study among 350 pregnant women with one prior cesarean section. Data was collected using a structured questionnaire and SPSS 23 was used for analysis. A score of 80 or higher on the nine-item Shared Decision-Making Questionnaire (SDM-Q9) was used to calculate the proportion of women, and the associated factors were obtained using a logistic regression model. P value of < 0.05 was considered significant. The proportion of pregnant women involved in shared decision making was 38%. Factors that were significantly associated with sharing decision making were; having low level of education (AOR 0.55 95% CI 0.33-0.91), being married/having partner (AOR 2.58 95% CI 1.43-4.63), having a companion who had active participation (AOR 3.31 95% CI 1.03-10.6) and being familiar with the clinician (AOR 5.01 95% CI 1.30-19.2). To promote practice of shared decision making in our setting, encouragement of socially vulnerable pregnant women's participation in decision-making by health care professionals, encouragement of companion participation during antenatal care and promotion of personal continuity of care to improve familiarity to clinicians are needed.

Interdisciplinary collaboration in the care of vulnerable pregnant women: Experience of community midwives in Norway

Interdisciplinary collaboration in the care of vulnerable pregnant women: Experience of community midwives in Norway

Training for the qualification of care management for high-risk pregnant women in Amazon, Brazil

Abstract Background Maternal care is a worldwide concern, especially at vulnerable settings, as Amazonas, Brazil, where insufficiency of training institutions and professionals and environmental issues are challenges for vulnerable pregnant women care, including indigenous and riverside population. PlanificaSUS project, which is developed nationwide aiming to support and integrate of Specialized Outpatient Care (SOC) and Primary Health Care (PHC). Objectives Between September 2022 and January 2023, the PlanificaSUS developed a training in 2 Amazonas’ municipalities to qualify work practices at PHC and SOC aiming integrality and equitable care for pregnant women. Target audience was health professionals and managers. The following care management tools were used as didactic materials: i. Clinical Guideline for Pregnancy, Childbirth and Puerperium; ii. Risk Stratification Form; iii. Care Sharing Form; and iv. Care Plan. The training last 4 hours, with 3 levels of cognitive process as learning objectives. Activity 1 (understanding): consisted of handling the presented tools and reflections based on the local reality. Activity 2 (application): participants groups simulated the use of tools in clinical cases. Activity 3 (analysis): planning actions to implement tools in local work process after training. Results 48 professionals and managers participated in the training. It was verified that participants did not know the care management tools. Preliminary 2-month results indicate that the tools were incorporated into work process of 5 PHC units. Among 167 pregnant women previously registered, 72% had been stratified using the clinical guideline and the risk stratification form. Of those, 17% were at high risk, among which 38% had the care plan and the form to share care with SOC prepared by PHC team. Conclusions The training supports care management based on population needs, allowing care qualification and greater systemic rationality, despite vulnerability and low resources. Key messages • The training enabled health professionals and managers to understand the real health needs of the population and to qualify their care practices for vulnerable pregnant women in Amazon, Brazil. • The training contributed to qualify the access and care of high-risk pregnant women and those in vulnerable situations to the specialized outpatient care integrated with the PHC in Amazon, Brazil.

The effect of an adapted Mindfulness-Based Stress Reduction program on mental health, maternal bonding and birth outcomes in psychosocially vulnerable pregnant women: a study protocol for a randomized controlled trial in a Danish hospital-based outpatient setting

BackgroundStress and mental disorders in pregnancy can adversely affect the developing fetus. Women with a preconception history of mental disorders or of psychosocial vulnerabilities are at increased risk of experiencing perinatal stress or mental health problems. Mindfulness-Based-Stress-Reduction (MBSR) is an acceptable intervention for pregnant women and has a growing evidence-base with meta-analyses consistently pointing to reductions in symptoms of stress, anxiety and depression. This study protocol aim to address the need for a wider array of evidence-based and non-pharmacological options during pregnancy to reduce stress and improve mental health in a psychosocially highly vulnerable group of women.MethodsPregnant women with a preconception history of mental disorders or psychosocial vulnerabilities (n = 240) will be recruited from an obstetric ambulatory clinic at Copenhagen University Hospital, Hvidovre, Denmark. Recruitment for the study began in March 2022 and will continue until the desired number of participants is reached. Consenting pregnant women will be randomized to one of two study arms, an adapted MBSR program as add on to usual care or usual care alone. The primary outcome is mental wellbeing at nine months post-randomization. Secondary and exploratory outcomes include stress, anxiety, depression, and maternal antenatal attachment, experience of childbirth, delivery and mode of delivery. Mindfulness and self-compassion are examined as possible mediators of the effect on outcomes.DiscussionTeaching the skills of mindfulness meditation to a psychosocially vulnerable group of pregnant women could prove a viable and non-pharmacological approach to improve mental health and wellbeing during pregnancy, reduce stress and support the transition to parenthood. Mindfulness-Based Stress Reduction does not target a particular group, and results from the study is thus of potential relevance for pregnant women in general as a means of reducing stress and improving perinatal mental health and wellbeing.Trial registrationClinicalTrials.gov: NCT05300646. Registered March 29, 2022.

Fine Particulate Matter Metal Composition, Oxidative Potential, and Adverse Birth Outcomes in Los Angeles.

Although many studies have linked prenatal exposure to to adverse birth outcomes, little is known about the effects of exposure to specific constituents of or mechanisms that contribute to these outcomes. Our objective was to investigate effects of oxidative potential and metal components from non-exhaust traffic emissions, such as brake and tire wear, on the risk of preterm birth (PTB) and term low birth weight (TLBW). For a birth cohort of 285,614 singletons born in Los Angeles County, California, in the period 2017-2019, we estimated speciated exposures modeled from land use regression with cokriging, including brake and tire wear related metals (barium and zinc), black carbon, and three markers of oxidative potential (OP), including modeled reactive oxygen species based on measured iron and copper (ROS), OH formation (), and dithiothreitol (DTT) loss (). Using logistic regression, we estimated odds ratios (OR) and 95% confidence intervals (CI) for PTB and TLBW with speciated exposures and mass as continuous variables scaled by their interquartile range (IQR). For both metals and oxidative potential metrics, we estimated increased risks for PTB (ORs ranging from 1.01 to 1.03) and TLBW (ORs ranging from 1.02 to 1.05) per IQR exposure increment that were robust to adjustment for mass. Associations for mass, black carbon, metal components, and oxidative potential (especially ROS and ) with adverse birth outcomes were stronger in Hispanic, Black, and mixed-race or Native American women. Our results indicate that exposure to metals from brake and tire wear and particle components that contribute to oxidative potential were associated with an increased risk of PTB and TLBW in Los Angeles County, particularly among Hispanic, Black, and mixed-race or Native American women. Thus, reduction of mass only may not be sufficient to protect the most vulnerable pregnant women and children from adverse effects due to traffic source exposures. https://doi.org/10.1289/EHP12196.

COVID-19–Related Insomnia Populations Research and Management Strategies: A Review

Abstract Coronavirus disease 2019 (COVID-19) has affected the quality of sleep for various populations, causing anxiety and depression worldwide. COVID-19–related insomnia (COVIDRI) appears to be more common in certain populations, including females, urban residents and other individuals who reside in high-risk COVID-19–related areas, lack higher socioeconomic and educational levels, have a history of underlying mental illness, have no access to social support and work, or have been mandated for isolation. Among vulnerable populations, pregnant women, adolescents and children are more likely to suffer from anxiety and depression, which leads to irregular sleep-wake cycles and significantly poor sleep quality. Insomnia in COVID-19 patients is associated with decreased immune levels, excessive psychological stress and severe anxiety. The COVIDRI incidence and severity among frontline healthcare workers is high, especially among females and those working in isolation wards and intensive care units. The factors related to COVIDRI for college students during home study are stress from upcoming graduation, disharmonious family relationships and inadaptability to online education. For military personnel, anxiety and depression are the main causes of poor sleep quality. Based on the characteristics of different populations, active Chinese and Western medications, non-drug therapy, psychological counseling and suitable sleep management are vital measures to strengthen immunity, alleviate insomnia and limit recurrence.

Mosque-Based Disaster-Resistant Family Improvement Training in Sukopuro Village, Malang District

Sukopuro Village is one of the areas in Jabung District, Malang Regency, which consists of 13 RWs (Rukun Warga) and 53 RTs (Rukun Tetangga). In the last two years, almost all nations of the world, including Indonesia, have experienced the COVID-19 pandemic, according to data from the Indonesian Ministry of Health, starting from the announcement of President Joko Widodo's first case on March 2 2020, a total of 6,046,467 cases were recorded with 5,882,062 recovered cases. and cases of death amounted to 156,240. Three important points of the proposed program Disaster resilient families (Katana), namely: (1) Katana can become a pillar of community and family resilience against disaster risk; (2) Katana must involve vulnerable groups, children, pregnant women, the elderly and women; and (3) Katana utilizes the closest community institutions that already exist in their environment.