IMPROVING WOMEN'S PRECONCEPTIONAL HEALTH Findings from a Randomized Trial of the Strong Healthy Women Intervention in the Central Pennsylvania Women's Health Study
IMPROVING WOMEN'S PRECONCEPTIONAL HEALTH Findings from a Randomized Trial of the Strong Healthy Women Intervention in the Central Pennsylvania Women's Health Study
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DOI：
10.1016/j.whi.2008.07.008
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发表时间：
2008-11-01
影响因子：
3.2
通讯作者：
Chinchilli, Vernon M.
中科院分区：
文献类型：
--
作者：
Hillemeier, Marianne M.;Downs, Danielle Symons;Chinchilli, Vernon M.
目的.改善妇女怀孕前的健康是减少对母亲和儿童不利的怀孕结果的一项重要战略。本文报道了一项随机试验的第一个前测-后测结果，该试验采用独特的、多维度的、小组形式的干预措施，即“强壮的健康女性”，旨在改善孕前和孕间妇女的健康行为和健康状况。在宾夕法尼亚州中部的15个低收入农村社区招募了年龄在18-35岁之间的未怀孕的孕前和孕间妇女（n = 692）。女性以2比1的比例随机分配到干预组和对照组;参与者在14周时接受基线和随访健康风险评估，并完成问卷调查以评估行为变量。本报告的分析样本包括362名完成两项风险评估的妇女。结果包括态度和健康相关的行为变化的措施。与对照组相比，干预组的女性更有可能报告更高的自我效能，吃健康食品，并感知更高的出生结果的先入为主的控制;更大的意图吃健康食品和更多的身体活动;更频繁的阅读食品标签，与推荐水平一致的身体活动，以及每日使用多种维生素和叶酸。发现了显著的剂量效应：参加的每一次额外的干预会议与更高的出生结果的内部概念控制，阅读食品标签，从事放松运动或冥想压力管理，以及每天使用多种维生素和叶酸有关。归因于干预的态度和行为变化主要与营养和体力活动有关。这些结果表明，这些主题可以成功地解决与前和interconceptual妇女以外的临床环境中以社区为基础的干预措施。
Purpose. Improving the health of women before pregnancy is an important strategy for reducing adverse pregnancy outcomes for mother and child. This paper reports the first pretest-post-test results from a randomized trial of a unique, multidimensional, small group format intervention, Strong Healthy Women, designed to improve the health behaviors and health status of preconceptional and interconceptional women.Methods. Nonpregnant pre- and interconceptional women ages 18-35 were recruited in 15 low-income rural communities in Central Pennsylvania (n = 692). Women were randomized in a ratio of 2-to-1 to intervention and control groups; participants received a baseline and follow-up health risk assessment at 14 weeks and completed questionnaires to assess behavioral variables. The analytic sample for this report consists of 362 women who completed both risk assessments. Outcomes include measures of attitudinal and health-related behavior change.Main Findings. Women in the intervention group were significantly more likely than controls to report higher self-efficacy for eating healthy food and to perceive higher preconceptional control of birth outcomes; greater intent to eat healthy foods and be more physically active; and greater frequency of reading food labels, physical activity consistent with recommended levels, and daily use of a multivitamin with folic acid. Significant dose effects were found: Each additional intervention session attended was associated with higher perceived internal preconceptional control of birth outcomes, reading food labels, engaging in relaxation exercise or meditation for stress management, and daily use of a multivitamin with folic acid.Conclusions. The attitudinal and behavior changes attributable to the intervention were related primarily to nutrition and physical activity. These results show that these topics can be successfully addressed with pre- and interconceptional women outside the clinical setting in community-based interventions.