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March of Dimes Home Page
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Monday, October 29, 2007 - 2:10 PM
37
Preconceptional Health Promotion in Low-income Rural Communities: Randomized Trial Results from the Central Pennsylvania Women's Health Study (CePAWHS-II)
Marianne M. Hillemeier1, Carol S. Weisman2, John J. Botti2, Danielle Symons Downs3, Mark Feinberg4, and Gary A. Chase2. (1) Health Policy and Administration, Pennsylvania State University, 604 Ford Building, University Park, PA, USA, (2) College of Medicine, Pennsylvania State University, 600 Centerview Drive, A210, Hershey, PA, USA, (3) Department of Kinesiology, Pennsylvania State University, University Park, PA, USA, (4) Center for Child and Adult Development, Pennsylvania State University, S109 Henderson Building South, University Park, PA, USA
Background:
Because the determinants of adverse pregnancy outcomes include health-related behaviors and socially determined risk factors, improving women's preconceptional health cannot be accomplished in clinical care settings alone. Opportunities exist to improve preconceptional health and pregnancy outcomes in community settings as well.
Objectives:
To develop and test a multidimensional behavioral intervention to improve pre- and interconceptional women's health-related behaviors in selected low-income rural communities in Central Pennsylvania.
Methods:
Strong Healthy Women was developed to modify behaviors related to stress management, nutrition, physical activity, alcohol/substance use, smoking, and prevention of gynecologic infections, all of which were prevalent risk factors identified in a population-based survey of the target population. Strong Healthy Women was tested in a randomized trial of 692 pre- and interconceptional women ages 18-35 in 15 low-income rural communities. Women were recruited using a triangular recruitment approach. The intervention was conducted with small groups of women in six two-hour sessions held over a three-month period. Baseline and followup health risk assessments were conducted for both intervention and control subjects.
Results:
Pre-post changes in biomarkers, behavioral intent, self-efficacy for behavior change, and behaviors were analyzed, controlling for appropriate covariates. Preliminary results show significant pre-post changes for variables related to nutrition, folic acid supplementation, and physical activity.
Conclusion and implications for practice:
Preliminary results suggest that Strong Healthy Women can improve specific pre- and interconceptional health-related behaviors among low-income rural women. This intervention shows promise, and further studies are warranted in additional communities.