Citation

Joseph JG, El-Mohandes AA, Kiely M, El-Khorazaty MN, Gantz MG, Johnson AA, Katz KS, Blake SM, Rossi MW, Subramanian S. Am. J. Public Health 2009; 99(6): 1053-1061.

Affiliation

Children's Research Institute, Children's National Medical Center, Washington, DC, USA.

Copyright

(Copyright © 2009, American Public Health Association)

DOI

10.2105/AJPH.2007.131425

PMID

19372532

PMCID

PMC2679805

Abstract

OBJECTIVES: 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). METHODS: 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. RESULTS: 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). CONCLUSIONS: 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.

Language: en