Subjective well-being, happiness, and environmental health factors related to women planning a pregnancy or pregnant, using mobile health intervention

Objectives: To compare the environmental health results in women trying to get pregnant or pregnant using a mobile health application (Green Page) through healthcare professionals or self-completed by women, and to explore the relationship between the subjective well-being of these women with their lifestyles and environmental factors. Methods: A descriptive study with mixed methods was conducted in 2018. A mobile health survey was used in two phases. Phase 1 was a cross-sectional study through professionals (n = 1100) followed by phase 2, a convenience sampling through women's self-reporting (n = 3425). A personalized report was downloadable with health recommendations for the well-being of the mother and child. Results: Of the 3205 participants (mean age = 33 years, SD = 0.2 years), 1840 were planning a pregnancy and 1365 were pregnant. One in five pregnant women had a low level of happiness. Globally, subjective well-being and happiness were found to be negatively associated with lack of contact with nature, sedentary lifestyle, excess weight, environmental exposure, and older age in pregnancy. Precisely 45%, 60%, and 14% of women were exposed to tobacco, alcohol, and illegal drugs, respectively. The women self-reported levels of risk factors higher than when the tool was used by or through professionals. Conclusions: The use of mobile health interventions focused on environmental health during planning or pregnancy periods could help improve the quality of healthcare and foster greater involvement of women in their self-care process, thus promoting empowerment, healthier environments, and lifestyles. Ensuring equity of access and data protection are global challenges to be addressed.The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This work was supported by the Foundation for Formation and Research (FFIS) from Murcia's Drug Commissioner Office (Ecosistema Saludable, Neurodesallorro Saludable), the National Plan on Drugs, Ministry of Health, Spain (ID8437); the Mount Sinai International Exchange Program for Minority Student (Grant MD001452) from the National Center on Minority Health and Health Disparities of the U.S. National Institutes of Health; and the Sociedad de Pediatría del Sureste de España and its contribution to the project “Profile of childhood and adolescence environmental health in the region of Murcia” (FFIS-DF-2022-36). EOP is supported by a postdoctoral contract from the Instituto Murciano de Investigaciones Biosanitarias Virgen de la Arrixaca (IMIB-Arrixaca, Murcia, Spain).S

Enfermería medioambiental: hoja verde de embarazo

Introducción: El embarazo y la lactancia constituyen periodos críticos de vulnerabilidad a las exposiciones medioambientales. La Organización Mundial de la Salud insta al desarrollo de herramientas clínicas de cribado en salud medioambiental (hoja verde) para que los profesionales sanitarios puedan identificar y manejar los riesgos medioambientales así como promover estilos de vida y ambientes más saludables. Objetivo: Describir y estudiar la frecuencia de exposición a factores de riesgo medioambiental al inicio de la gestación a través del cribado mediante la realización de la hoja verde con especial atención a la exposición de drogas legales e ilegales. Material y método: Estudio descriptivo con la Hoja Verde de embarazo en 1500 parejas embarazas de riesgo (de XI-2009 a I-2013) durante el screening del primer trimestre de embarazo en la Región de Murcia. Resultados: La media de edad fué de 34.1 años en las mujeres y 36.1 años en sus parejas. Un 10% de las familias tenían bajos recursos económicos ( 40 gr/día). El 4.9% de las mujeres embarazas se sometieron a alguna prueba (Radiación Ionizante) en algún momento del embarazo y más del 70% de las embarazadas empezaron la ingesta de ácido fólico de forma postconcepcional. El 60.5% de las mujeres embarazadas estuvieron expuestas a pesticidas y el 8.1% tuvieron un uso intensivo. El modelo de conducta de la pareja es determinante para el consumo de alcohol y drogas ilegales de la mujer. Conclusiones: La hoja verde es una herramienta clínica útil, fácil de usar y reproducible para la detección, prevención y probablemente para el manejo de riesgos medioambientales. La exposición a drogas y otros factores de riesgo medioambiental son elevados al inicio del embarazo en la Región de Murcia. El abordaje como ‘pareja embarazada’ en la hoja verde es muy importante para mejorar la calidad global del embarazo integrando a la pareja como parte importante del proceso. La Enfermerería y matronas, ocupan un lugar estratégico y privilegiado para el desarrollo de tareas relacionadas con la salud medioambiental durante el embarazo, la lactancia y periodo de crianza. Es necesario estimular la capacitación y formación de enfermeros y matronas desde el pregrado al postgrado en salud medioambiental. Introduction: Pregnancy and lactation are critical periods vulnerable to environmental exposures. The World Health Organization recommends the development of clinical screening tools focused on environmental health (Green Page) for health professionals to identify and address environmental health risk factors, and promote healthier lifestyles and environments. Objective: Describe and study the frequency of exposure to environmental health risk factors at the begining of gestation through screening using the Green Page with emphasis on exposure to illicit and non-illicit drugs. Methods: Descriptive study using the Green Page among 1500 pregnant couples of high risk between November, 2009 to January, 2013 conducted during the first trimester of pregnancy screenings. Results: Average age (years) 34.1 (females) and 36.1 (males). 10% of families are poor (<800€ /month). 87% of the woman are native of Spanish origin. 30.3% are first-time mothers. At the beginning of pregnancy 34.9% of women and 45% of their partners are smokers. Intrauterine exposure to tobacco is as high as 56%. 10.1% of pregnant women are exposed to an illegal drug at least once a week (3.1% are active illicit drug users). 68.1% of pregnant women consumed alcohol at the beginning of pregnancy. 11.5% recalls an episode of excessive drinking during this period. 11.7% of men are high risk drinkers (>40 grams/day). 4.9% of pregnant women has undergone an X-Ray during pregnancy and more than 70% started taking postconceptional folic acid. 60.5% of pregnant women are exposed to pesticides and 8.1% used pesticides intensively. The behavior modeled by the father helps determine consumption of illicit drugs and alcohol by the mother. Conclusion: The Green Page is a useful clinical tool for screening that is easy to use and reproducible and may be useful for addressing and preventing environmental health risk factors. Exposure to drugs and other environmental health risk factors are elevated at the beginning of pregnancy. The approach of using ¨pregnant couple¨ in the Green Page is important for improving the overall quality of pregnancy by integrating the couple as an important part of the process. Nurses and midwives, have a privileged and strategic role in the development of tasks related to environmental health during pregnancy, lactation and childhood. It is necessary to improve the environmental health training and preparation of nurses and midwives from the undergraduate to postgraduate level

Enfermagem Ambiental: Recuperando a ligação com a saúde reproductiva

El período periconcepcional, embrionario/fetal y lactancia/crianza constituyen una de las ventanas de vulnerabilidad a exposiciones medioambientales más importante de la vida de un individuo. Enfermeras y matronas por su forma de entender el binomio salud/enfermedad ocupan un lugar estratégico para el desarrollo de tareas relacionadas con la salud medioambiental en gereral y durante estos periodos en particular. Diferentes asociaciones enfermeras, así como instituciones sanitarias internacionales instan a los profesionales de enfermería a ejercer tareas que permitan reconocer y manejar factores de riesgo medioambiental (riesgos físicos, quimicos, biológicos, sociales y psicosociales) y a promover factores de protección en sus comunidades, en la pareja embarazada y en su descendencia. Existen experiencias enfermeras como la consulta de enfermería de salud medioambiental reproductiva y la hoja verde como herramienta clínica de cribado medioambiental que permiten, de manera sistemática y organizada, identificar, modificar y promover estilos de vida más sanos y más saludables. La capacitación de los profesionales de enfermería y el aumento de la conciencia medioambiental en los cuidados, tiene un impacto positivo en la calidad de los embarazos, su descendencia, sus familias y la comunidad que los rodea.The periconcepcional and prenatal periods, as well as breastfeeding and breeding periods, constitute the most important windows of vulnerability for environmental exposures. Midwifes and nurses have an specific and insight regarding the duality of health and illness. They are strategic health professionals to develop the environmental health approach during these vulnerable periods of life. International institutions and nursery asociations urge nurse professionals to recognise environmental risk factors (physicochemical, biologic and psychosocial) and to promotives factors in communities, during pregnancy and childhood. There are environmental health experiences, such as the use of “Green Page questionnaire” during the reproductive environmenral health assessment. This questionnaire is a sistematic screening that promotes healthier lifestyles. Incresing the general awareness about environmental health as well as health professionals further education have a positive impact in pregnancies, their offspring, families and communities in a broader perspective.O periconcepcional, período embrionário / fetal e amamentação / parentalidade constituem uma das mais importantes opções/ possibilidades de vulnerabilidade às exposições ambientais na vida de um indivíduo. Enfermeiras e parteiras, para sua compreensão do binômio saúde / doença, ocupam um lugar estratégico para o desenvolvimento de tarefas relacionadas à saúde ambiental em geral e durante esses períodos em particular. Diferentes associações de enfermagem, bem como instituições internacionais de saúde, eles pedem os profissionais de enfermagem a realizar tarefas que lhes permitam reconhecer e gerenciar os fatores de risco ambientais (físicos, químicos, biológicos, sociais e psicossociais) e promover fatores de proteção em suas comunidades, no casal grávido e sua prole. Há experiências de enfermeiros como a da consulta de enfermagem em saúde reprodutiva ambiental e a “Folha Verde” como ferramenta clínica de triagem ambiental que permite, de forma sistemática e organizada, identificar, modificar e promover estilos de vida mais saudáveis e saudáveis. A capacitação dos profissionais de enfermagem e o aumento da conscientização ambiental no cuidado têm impacto positivo na qualidade das gestações, seus filhos, suas famílias e a comunidade que os cerca

Prevalence of tobacco at the beginning of pregnancy in 1500 pregnant couples of high risk

Introduction Environmental consulting Nursing (Reproductive) is a clinical consultation detection, intervention and prevention of exposures to environmental hazards at critical periods of pregnancy (gametogenesis and pregnancy) with special attention to tobacco. The working tool is the “hoja verde” Objective: The objective of this work is to identify the prevalence of tobacco at the beginning of pregnancy and in the 12th week of gestation in pregnant couples at risk in the HCU Virgen de la Arrixaca. Methods Descriptive study using the Green Page among 1500 pregnant couples of high risk between November, 2009 to January, 2013 conducted during the first trimester of pregnancy screenings. Results Average age (years) 34.1 (females) and 36.1 (males). 87% of the woman are native of Spanish origin. At the beginning of pregnancy 34.9% of women and 45% of their partners are smokers. Intrauterine exposure to tobacco is as high as 56%. In the 12th week of gestation the percentage decreased to 17.3%. In the couples there was little change (41.5%). Conclusions Exposure to tobacco and other environmental health risk factors are elevated at the beginning of pregnancy. The approach of using ¨pregnant couple¨ in the Green Page is important for improving the overall quality of pregnancy by integrating the couple as an important part of the process. Nurses and midwives, have a privileged and strategic role in the development of tasks related to environmental health during pregnancy,. It is necessary to improve the environmental health training and preparation of nurses and midwives from the undergraduate to postgraduate levels

Group consultation for smoking cessation in pediatrics

Introduction Health beings long before birth. Exposure to tobacco smoke (active or passive) is one of the leading causes of pregnancy complications and a risk factor for developing multiple pediatric diseases. The objective of this work is to explain how the consultation for smoking cessation of the Pediatric Environmental Health Unit works. This consultation focuses on pregnant couples although smoking cessation is also offered to parents with children diagnosed with respiratory diseases as well as parents of survivors of pediatric cancer. Methods The consult has a group structure (although in exceptional cases is done individually) and is divided into 5 in-person and 5 telephone sessions. The main actions developed in the consult are the control of nicotine dependence, and above all, behavioral and emotional dependence to tobacco. Smoking cessation consultation in pediatrics is aimed at pregnant couples or both parents (if both are smokers). Results During 2016/2017, we have developed 7 therapy groups with a mean of 5 patients per group. The individuals who have not attended all sessions and also do not respond to the telephone calls are excluded from the results. Cessation rate until the end of pregnancy is 60%. Emotional and behavioral control is very important during pregnancy and in relatives of sick children. The inclusion of the partner in the process is very important so that the cessation is long-lasting, while also promoting a smoke free childhood environments. Conclusions The strengths of group therapy are that individuals with the same characteristics (feelings, fears, motivations ...), also avoid feeling lonely during the process. The group can solve doubts and questions (fears, shyness ...) that otherwise would not be resolved. It helps us to establish pertinent emotional linkages among patients within the group. The results indicate a strong adherence to treatment