Using the March of Dimes "Becoming a Mom" Prenatal Program to Improve Maternal Attitudes and Knowledge

BACKGROUND: Premature birth, low birth weight, birth defects, and Sudden Infant Death Syndrome were identified as issues contributing to infant mortality in Kansas by the state’s Blue Ribbon Panel. The March of Dimes Becoming a Mom (BAM) prenatal program was implemented in four counties identified with high infant mortality rates and significant birth numbers (Geary, Saline, Sedgwick, and Shawnee) by the Kansas Blue Ribbon Panel. The purpose of this study was to identify the changes in prenatal attitudes, knowledge, and health outcomes among BAM program participants. METHODS: A collaborative community-based model incorporating multidisciplinary teams was created to address the health disparity gap in birth outcomes. Patients participated in multiple prenatal education sessions using a curriculum developed by the March of Dimes. A pre-/post-test design was implemented for the prenatal sessions. Changes in attitudes were assessed using descriptive statistics. Paired t-tests were used to assess the difference in knowledge questions from pre- and post-tests. Health outcomes were analyzed using descriptive statistics. RESULTS: Participants were 69% White, 87% spoke English, 64% were under age 26, 41% were employed full time, 45% had some high school or had a diploma, 39% had Medicaid, and 49% were enrolled in WIC (N=114). Participants demonstrated a statistically significant increase in knowledge among 14 out of 32 questions including: identifying signs of preterm labor, what to do during preterm labor, postpartum symptoms, and baby sleep position. There were also changes in prenatal attitudes including: need for prenatal care as soon as possible, continuing prenatal care when feeling healthy and not smoking during pregnancy. Relative frequencies were tabulated for week of delivery, infant birth weight, type of delivery, and presence of maternal and infant medical conditions. CONCLUSION: The March of Dimes BAM program participants reported improvements in prenatal knowledge. The BAM program can improve maternal knowledge through a community-based collaborative model of care. The combined prenatal education program with quality prenatal care can result in better maternal and child health outcomes

A Qualitative Assessment of Kansas Tracking and Reporting of Controlled Substances (K-TRACS)

Introduction. This study assessed the Kansas Tracking and Reporting of Controlled Substances system (K-TRACS), the online controlled prescription medication monitoring website in Kansas. The specific aims were to determine if and when pharmacists and physicians in Kansas were using K-TRACS and to identify any perceived benefits or barriers to using K-TRACS. Methods. A non-randomized, convenience sample of Kansas pharmacists and family physicians were interviewed face to face using a guided semi-structured questionnaire. NVivo 10 (QSR International Pty Ltd.) was used to analyze data. Results. Ten physicians and sixteen pharmacists were interviewed. All pharmacists and 70% of physicians were using K-TRACS. Usage was prompted by encounters with new patients or unease with the patient interaction. The perceived benefits included increased communication with the patient and all providers, increased provider comfort with treating chronic pain, and altered prescriber habits. Barriers to the use of K-TRACS were identified as login, password, and operating system problems. Conclusions. Among study participants, K-TRACS is used regularly, is perceived to be a benefit to providers, patients and communities, and has become a useful new tool in the treatment of chronic pain. K-TRACS is perceived to facilitate increased communication between providers and with patients

Describing Adolescent Breastfeeding Environments Through Focus Groups in an Urban Community

Purpose: Breastfeeding is a potential solution to improve health outcomes for adolescent mothers and infants. Adolescence is a risk factor for low breastfeeding rates and is associated with a higher risk for perinatal complication. This study investigated facilitators and barriers to adolescent breastfeeding initiation and duration in an urban setting. Methods: Four, 1-hour focus groups were conducted. Twenty-nine (N = 29) adolescent mothers and pregnant adolescents participated and described attitudes toward breastfeeding, attitudes among family and friends, current knowledge, and barriers and facilitators for breastfeeding. Results: Four themes emerged, including the following: behavioral histories of breastfeeding, community assets, social support, and barriers. Participants identified positive histories and community resources such as local hospitals and social services as facilitators. Lifestyle, independence, lack of support from family and primary care providers, social stigma/embarrassment, and difficulty with breastfeeding techniques were described as barriers. Conclusion: A comprehensive and integrated primary care and public health community effort is needed to support and improve adolescent breastfeeding. Further examination of integrated interventions focused on adolescent breastfeeding behaviors through an environmental approach is needed

Validation of a Single Question Health Literacy Screening Tool for Older Adults

Objectives: Health Literacy skills are important for people of all ages. Older adults have the lowest health literacy rates. The purpose of this study was to assess health literacy rates and validate the use of a screening tool with older adults. Methods: Participants included a convenience sample, age 65 years or older, English speaking with corrected vision of 20/100 or better and typical cognitive skills. Participants completed the 36-item Short Test of Functional Health Literacy Assessment (STOFHLA) and a single item screening (SIS) tool. Results of STOFHLA and SIS were compared using nonparametric statistics. Results: Of the 64 participants, 94% had adequate scores on the STOFHLA, while 64% self-reported confidence in filling out medical forms, p = .006, χ 2 = 7.606, df (1). Conclusion: Results suggest that use of health literacy screening tools for older adults may be of value. Additional studies are needed to expand the study sample and validate the findings of this study

SARS-CoV2, the COVID-19 Pandemic and Community Perceptions

The purpose of this study was to describe knowledge and beliefs about SARS-CoV2 and COVID-19 and explore the gaps between current media coverage of health risks and what the general public knows about the virus and its outcome. A 37-question survey was developed and administered to a community collaborative group in a Midwestern state in the United States. Fifty-three participants completed the survey. When asked where participants found their information, a majority reported the internet (33.9%, n = 18/53) and radio and/or tv (28.3%, n = 15/53). Most participants showed a basic level of COVID-19 knowledge, but few could identify the 3 most frequent symptoms of COVID-19 (7.5%, n = 4/53). The results from this study highlight the continued need for increased public health communication. Educational efforts should focus on social media and internet outlets to address COVID-19 misinformation, strategies to address vaccine hesitancy, and the associated communication gap to help address related health disparities

Health Literacy and Older Adults

Objective: The objective of this review was to assess published literature relating to health literacy and older adults. Method: The current review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Results: Eight articles met inclusion criteria. All studies were conducted in urban settings in the United States. Study sample size ranged from 33 to 3,000 participants. Two studies evaluated health-related outcomes and reported significant associations between low health literacy and poorer health outcomes. Two other studies investigated the impact of health literacy on medication management, reporting mixed findings. Discussion: The findings of this review highlight the importance of working to improve health care strategies for older adults with low health literacy and highlight the need for a standardized and validated clinical health literacy screening tool for older adults