Reducing Psychosocial and Behavioral Pregnancy Risk Factors: Results of a Randomized Clinical Trial Among High-Risk Pregnant African American Women

We evaluated the efficacy of a primary care intervention targeting pregnant African American women and focusing on psychosocial and behavioral risk factors for poor reproductive outcomes (cigarette smoking, secondhand smoke exposure, depression, and intimate partner violence). Pregnant African Ameri...

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Bibliographic Details
Published in:American journal of public health (1971) 2009-06, Vol.99 (6), p.1053-1061
Main Authors: Joseph, Jill G, El-Mohandes, Ayman A. E, Kiely, Michele, El-Khorazaty, M. Nabil, Gantz, Marie G, Johnson, Allan A, Katz, Kathy S, Blake, Susan M, Rossi, Maryann W, Subramanian, Siva
Format: Article
Language:English
Subjects:
African Americans
African Americans - psychology
Alcohol use
Babies
Behavior
Behavior modification
Behavior Therapy - methods
Biological and medical sciences
Birth weight
Births
Clinical trials
Collaboration
Counseling - methods
Depressive Disorder - diagnosis
Depressive Disorder - prevention & control
Depressive Disorder - therapy
Domestic violence
Drug use
Female
Gynecology
Humans
Infant mortality
Intervention
Interviews
Low income groups
Medical sciences
Mental depression
Mental health
Mental health care
Minority & ethnic groups
Miscellaneous
Obstetrics
Pregnancy
Pregnancy - ethnology
Pregnancy - psychology
Pregnancy Outcome
Prenatal care
Prenatal Care - methods
Primary care
Primary Health Care - methods
Public health
Public health. Hygiene
Public health. Hygiene-occupational medicine
Regression Analysis
Research and Practice
Risk Factors
Risk Reduction Behavior
Smoking
Smoking - adverse effects
Smoking - psychology
Smoking Cessation - methods
Smoking Prevention
Social psychology
Spouse Abuse - diagnosis
Spouse Abuse - prevention & control
Spouse Abuse - psychology
Suicides & suicide attempts
Tobacco smoke
Tobacco Smoke Pollution - adverse effects
Tobacco Smoke Pollution - prevention & control
Treatment Outcome
Womens health
Young Adult
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Summary:We evaluated the efficacy of a primary care intervention targeting pregnant African American women and focusing on psychosocial and behavioral risk factors for poor reproductive outcomes (cigarette smoking, secondhand smoke exposure, depression, and intimate partner violence). Pregnant African American women (N = 1044) were randomized to an intervention or usual care group. Clinic-based, individually tailored counseling sessions were adapted from evidence-based interventions. Follow-up data were obtained for 850 women. Multiple imputation methodology was used to estimate missing data. Outcome measures were number of risks at baseline, first follow-up, and second follow-up and within-person changes in risk from baseline to the second follow-up. Number of risks did not differ between the intervention and usual care groups at baseline, the second trimester, or the third trimester. Women in the intervention group more frequently resolved some or all of their risks than did women in the usual care group (odds ratio = 1.61; 95% confidence interval = 1.08, 2.39; P = .021). In comparison with usual care, a clinic-based behavioral intervention significantly reduced psychosocial and behavioral pregnancy risk factors among high-risk African American women receiving prenatal care.
ISSN:0090-0036
1541-0048
DOI:10.2105/AJPH.2007.131425