South Dakota Pregnancy Risk Assessment Monitoring System (PRAMS)

The Pregnancy Risk Assessment Monitoring System (PRAMS) was developed by the Centers for Disease Control and Prevention (CDC) in 1987 and is done in collaboration with various state health departments. PRAMS is a statewide survey that collects valuable information from new mothers on behaviors and attitudes before, during and after pregnancy to find out why some babies are born healthy and others are not. Currently, 47 states, New York City, Puerto Rico, the District of Columbia and the Great Plains Tribal Chairmen’s Health Board (GPTCHB) participate in the PRAMS survey, representing approximately 83% of all U.S. live births. The Ethel Austin Martin Program at South Dakota State University, in partnership with the South Dakota Department of Health, conducted South Dakota PRAMS-like surveys in 2014 and 2016, and is currently conducting the CDC-sponsored PRAMS with the Department of Health, which began in 2017

Experience Implementing a Public Health Surveillance System Designed for Fathers of Infants on a South Dakota American Indian Reservation

Introduction: Paternal behaviors and attitudes during pregnancy are not known. A health survey for fathers of recently born infants was developed to be administered concurrently with a maternal survey to assess parental behaviors and attitudes before, during and after pregnancy. Methods: Participants were parents of 149 American Indian infants born from April 1 and Dec. 31, 2015 who were recruited prospectively from data of all births in prespecified reservation counties representing Sisseton Wahpeton Oyate of the Lake Traverse Reservation. Data collection was via hard-copy or online survey. Results: Response rate among mothers was 62 percent (n=92). Of 149 births, 126 listed a father on the birth certificate and 51 percent (n=64) of these completed surveys on average 4.7 months post-birth. Healthwise, 90 percent of fathers reported being overweight or obese, but a small percent visited a health care worker in the previous year to be checked for diabetes (11 percent) or hypertension (14 percent). Among fathers who smoked in the last two years (73 percent), 77 percent of the mothers also smoked compared to 20 percent of mothers smoking if the father did not smoke (pConclusion: Conducting a health survey with both fathers and mothers in a reservation setting is feasible and the father’s attitudes and behaviors related to breastfeeding and smoking were associated with maternal health behaviors. Most fathers attended health care visits with the mother, but they were not being screened for health conditions despite a large proportion being overweight and smokers. Prenatal and antenatal visits may provide an opportune time to engage fathers and address paternal health issues

Cross-Sectional and Longitudinal Association between Glycemic Status and Body Composition in Men: A Population-Based Study

This study sought to evaluate the associations between changes in glycemic status and changes in total body (TB), trunk, and appendicular fat (FM) and lean mass (LM) in men. A population-based study of men aged 20–66 years at baseline were included in cross-sectional (n = 430) and three-year longitudinal (n = 411) analyses. Prediabetes was defined as fasting glucose 100–125 mg/dL. Type 2 diabetes (T2D) was determined by: self-reported diabetes, current anti-diabetic drug use (insulin/oral hypoglycemic agents), fasting glucose (≥126 mg/dL), or non-fasting glucose (≥200 mg/dL). Body composition was evaluated by dual-energy X-ray absorptiometry. Longitudinal analyses showed that changes in TB FM and LM, and appendicular LM differed among glycemic groups. Normoglycemic men who converted to prediabetes lost more TB and appendicular LM than men who remained normoglycemic (all, p \u3c 0.05). Normoglycemic or prediabetic men who developed T2D had a greater loss of TB and appendicular LM than men who remained normoglycemic (both, p \u3c 0.05). T2D men had greater gains in TB FM and greater losses in TB and appendicular LM than men who remained normoglycemic (all, p \u3c 0.05). Dysglycemia is associated with adverse changes in TB and appendicular LM

South Dakota Pregnancy Survey 2016 Data Report

The South Dakota Department of Health, in conjunction with the EA Martin Program at South Dakota State University, conducted a 2016 Pregnancy Risk Assessment Monitoring System (PRAMS)-like surveillance project. The 2016 South Dakota PRAMS-like survey was a statewide population-based survey based on a stratified random sample of women who gave birth to a live-born infant, thereby allowing rates to be estimated for South Dakota mothers giving birth in 2016. The topics included in this survey were selected to enhance our understanding of maternal attitudes and behaviors around the time of pregnancy and the weighted response rate was 67.6%

Resistant Starch Type 4-enriched Diet Lowered Blood Cholesterols and Improved Body Composition in a Double Blind Controlled Cross-over Intervention

A metabolic health crisis is evident as cardiovascular diseases (CVD) remain the leading cause of mortality in the United States. Effects of resistant starch type 4 (RS4), a prebiotic fiber, in comprehensive management of metabolic syndrome (MetS) remain unknown. This study examined the effects of a blinded exchange of RS4-enriched flour (30% v/v) with regular/control flour (CF) diet on multiple MetS comorbidities. In a double blind (participants-investigators), placebo-controlled, cluster cross-over intervention (n = 86, age≥18, 2-12 week interventions, 2-week washout) in the United States, individuals were classified as having MetS (With-MetS) or not (No-MetS) following International Diabetes Federation (IDF)-criteria. RS4 consumption compared with CF resulted in 7.2% (p = 0.002) lower mean total cholesterol, 5.5% (p = 0.04) lower non-HDL, and a 12.8% (p \u3c 0.001) lower HDL cholesterol in the With-MetS group. No-MetS individuals had a 2.6% (p = 0.02) smaller waist circumference and 1.5% (p = 0.03) lower percent body fat following RS4 intervention compared to CF. A small but significant 1% increase in fat-free mass was observed in all participants combined (p = 0.02). No significant effect of RS4 was observed for glycemic variables and blood pressures. RS4 consumption improved dyslipidemia and body composition. Incorporation of RS4 in routine diets could offer an effective strategy for public cardio-metabolic health promotion

Rural vs. Non-rural Differences and Longitudinal Bone Changes by DXA and pQCT in Men Aged 20-66 Years: A Population-Based Study

The purpose of this research was to determine whether there were differences in estimated means and rates of change in BMC, bone area, BMD and measures of bone geometry among men (n=544) from three distinct populations (Hutterite [rural], rural non-Hutterite, non-rural), and whether activity levels or calcium intake explain these population differences. Men were enrolled in the South Dakota Rural Bone Health Study and followed for 7.5 years to estimate means and rates of change in bone mass, density, size and geometry. Femoral neck (FN) and spine measurements were obtained every 18 months by DXA and distal radius (4% and 20%) measurements by pQCT. Activity measurements and calcium intake were obtained quarterly for the first 3 years and at 54, 72, and 90 months. Rural men had greater percent time in moderate plus vigorous activity (mean ± SD: 22 ± 10 vs. 15 ± 8%,

Higher BMC and areal BMD in Children and Grandchildren of Individuals with Hip or Knee Replacement

The relationship between aBMD and osteoarthritis (OA) remains unclear. We compared aBMD, BMC and bone size among children and grandchildren of Hutterites with hip or knee replacement (n=23 each) to children and grandchildren of age- and sex-matched controls (178 children and 267 grandchildren). There were no differences in anthropometric measures or activity levels between case and control probands, but femoral neck (FN) and spine (LS) aBMD and Z-scores were greater in cases than controls (0.89 vs. 0.80 g/cm2; 1.15 vs. 1.03 g/cm2; 1.5 vs. 0.8; 2.4 vs. 1.2: all por =2 years post-menarcheal or males\u3e or =18 years): 33 were not classified. Post-menarcheal, but not premenarcheal, granddaughters of cases had greater hip, FN and LS aBMD Z-scores (0.7 vs. -0.1; 0.6 vs. -0.1; 0.8 vs. -0.3); greater hip and spine aBMD (1.03 vs. 0.95, 1.10 vs. 0.98 g/cm2); greater femoral neck and spine BMC (4.77 vs. 4.21, 66.7 vs. 55.4 g); and greater spine bone area (60.7 vs. 56.6 cm2) compared to granddaughters of controls (all,

Safe Sleep Behaviors Among South Dakota Mothers and the Role of the Healthcare Provider.

INTRODUCTION: The purpose of this report was to determine the prevalence of safe sleep practices among South Dakota mothers, and the impact that education from their healthcare provider had on infant safe sleep practices as defined by the American Academy of Pediatrics (AAP). METHOD: A population-based survey was administered to a random sample of mothers delivering in 2017. Data were weighted to obtain statewide and race-specific (white, non-Hispanic; American Indian; other races) prevalence rates. RESULTS: Weighted response rate was 67 percent, with 9.9 percent of mothers giving birth in 2017 completing a survey. Greater than 85 percent of mothers met recommendations regarding placing their infant on their back, breastfeeding, not consuming alcohol or illicit drugs during pregnancy, and attending 80 percent or more of prenatal visits. Less than 85 percent met recommendations regarding infant always sleeping alone on an approved sleep surface (30.8 percent), room-sharing without bed-sharing (44.3 percent), keeping soft objects and loose bed- ding out of crib (47.7 percent), and avoiding smoke exposure during and after pregnancy (82.1 percent). Only 7.7 percent of mothers met all eight recommendations. Healthcare providers talking to the mother about placing the infant to sleep in a crib and placing the crib in the mother\u27s room were associated with a higher percent of mothers meeting these recommendations. Although the health care provider asking the mother if she was going to breastfeed was not associated with ever breastfeeding (p=0.95), if the mother received information from the doctor about breastfeeding she was slightly more likely to breastfeed than if she did not receive information (90.3 vs. 85 percent, p=0.06). CONCLUSIONS: A low percentage of South Dakota mothers met all eight AAP safe sleep recommendations that could be assessed using these data. Health care providers can influence a mother\u27s compliance with some of the safe sleeping recommendations

South Dakota Pregnancy Risk Assessment Monitoring System (PRAMS)-Like 2014 Data Report

The health status of South Dakotans is commonly reported from public health surveillance surveys. Surveys such as the Behavioral Risk Factor Surveillance System (BRFSS) provide information that is used by policy makers, public health professionals, advocacy groups, health care organizations, and others to develop initiatives to improve the health of the population. South Dakota has one of the highest infant mortality rates in the U.S., ranking in the bottom half of states, yet there are little data available on factors that influence health behaviors and attitudes of mothers that can ultimately influence birth outcomes. The Pregnancy Risk Assessment Monitoring System (PRAMS) survey is a Centers for Disease Control and Prevention (CDC) recommended tool to provide this type of information. The CDC established the PRAMS in 1987 to obtain information about maternal behavior and experiences that may be associated with adverse birth outcomes. The survey is disseminated to women who have recently given birth to live-born infants. In 2014, 40 states participated in PRAMS and provided data to the CDC. South Dakota has not been funded by CDC and has not conducted a statewide PRAMS. In 2007, however, a Tribal PRAMS was conducted that included all South Dakota American Indian births over a 6-month period. In 2013 the South Dakota Department of Health contracted with the Ethel Austin Martin Program at South Dakota State University to conduct a statewide PRAMS-like survey during 2014. It was decided that the 2014 South Dakota PRAMS would follow the CDC PRAMS protocol. A random sample of South Dakota residents who delivered a live-born infant in 2014 was selected from birth certificate files to complete the survey through mail, online website or by telephone. American Indian and other race infants were oversampled to ensure sufficient numbers to obtain reliable estimates. Data were collected on a variety of topics that included: intendedness of pregnancy, access to prenatal care, health insurance, infant sleeping positions, medical problems during pregnancy, delivery of the infant, and health-related behaviors of the mother (e.g., smoking and alcohol use). The majority of the questions came from the CDC PRAMS core and standardized questions. In addition, questions about adverse childhood experiences (ACE) were added due to the increasing recognition of the role of stress in early life on adult behaviors and health. Questions about illegal drug use during the three months prior to pregnancy also were added in August of 2014. The 2014 PRAMS provides information for South Dakota to assess overall pregnancy experiences and maternal health behaviors, and data from the PRAMS may be used to develop, modify, or evaluate programs for new mothers and their children. Furthermore, the PRAMS will provide useful baseline data to assess future trends in problematic areas. The 2014 PRAMS was implemented to collect this information and to demonstrate the statewide capacity to successfully conduct the PRAMS in South Dakota

Pedometer Readings and Self-reported Walking Distances in a Rural Hutterite Population

PURPOSE: This study assessed the accuracy with which a rural population reported daily walking distances using a 7-day activity recall questionnaire obtained quarterly compared to pedometer readings.METHODS: Study participants were 48 Hutterite men and women aged 11-66 years.FINDINGS: Pedometer-miles quartiles were associated with self-reported daily miles (P=.008) and self-reported previous-year average miles (P=.03) quartiles. Among males, the relationship between pedometer-miles and self-reported daily miles differed depending upon walking pace, with a stronger correlation at a faster pace (interaction, P=.006). Among females, pedometer-miles correlated with age and remained associated with self-reported daily and previous-year average miles when age was in the statistical model (P=.006 and .008). The difference between pedometer-miles and self-reported previous-year average miles tended to increase with age (P=.06).CONCLUSIONS: SDPAR may be a useful instrument in measuring miles walked/day among rural populations