Effects of Group Prenatal Care on Food Insecurity during Late Pregnancy and Early Postpartum
Effects of Group Prenatal Care on Food Insecurity during Late Pregnancy and Early Postpartum
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DOI：
10.1007/s10995-015-1886-8
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发表时间：
2016-05-01
影响因子：
2.3
通讯作者：
Covington-Kolb, Sarah
中科院分区：
文献类型：
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作者：
Heberlein, Emily C.;Frongillo, Edward A.;Covington-Kolb, Sarah
目的 本研究比较了妊娠晚期和产后早期群体与个体产前保健对 (1) 妇女粮食安全和 (2) 粮食不安全妇女心理社会结果的影响。方法和结果 我们招募了 248 名接受 CenteringPregnancy (TM) 团体产前护理 (N = 124) 或个人产前护理 (N = 124) 的 248 名不同种族、低收入孕妇来完成妊娠早期、妊娠晚期和产后早期的调查，其中 84% 完成了三项调查。 26% 的团体参与者和 31% 的个人护理参与者表示在怀孕早期存在粮食不安全问题 (p = 0.493)。在多重逻辑回归模型中，选择团体护理与个人护理的女性更有可能报告妊娠后期（0.85 vs. 0.66 平均预测概率，p < 0.001）和产后（0.89 vs. 0.78 平均预测概率，p = 0.049）的粮食安全。在意向治疗模型中，在最初粮食不安全的女性中，小组参与者更有可能在妊娠后期（0.67 vs. 0.35 个人护理平均预测概率，p < 0.001）和产后（0.76 vs. 0.57 个人护理平均预测概率，p = 0.052）实现粮食安全。小组参与者更有可能改变对提供健康食品和扩大食物资源的看法。与个人护理组相比，怀孕早期食物不安全的参与者表现出更高的母婴依恋量表得分（个人护理组为 89.8 分，个人护理组为 86.2 分，p = 0.032）。结论 团体产前护理为妇女提供了健康教育和分享经验和知识的机会，这可以通过增强管理家庭粮食资源的信心和技能来改善粮食安全。卫生部门的干预措施可以补充粮食援助计划，解决怀孕期间的粮食不安全问题。
Objective This study compared the effects of group to individual prenatal care in late pregnancy and early postpartum on (1) women's food security and (2) psychosocial outcomes among food-insecure women. Methods and Results We recruited 248 racially diverse, low-income, pregnant women receiving CenteringPregnancy (TM) group prenatal care (N = 124) or individual prenatal care (N = 124) to complete surveys in early pregnancy, late pregnancy, and early postpartum, with 84 % completing three surveys. Twenty-six percent of group and 31 % of individual care participants reported food insecurity in early pregnancy (p = 0.493). In multiple logistic regression models, women choosing group versus individual care were more likely to report food security in late pregnancy (0.85 vs. 0.66 average predicted probability, p < 0.001) and postpartum (0.89 vs. 0.78 average predicted probability, p = 0.049). Among initially food-insecure women, group participants were more likely to become food-secure in late pregnancy (0.67 vs. 0.35 individual care average predicted probability, p < 0.001) and postpartum (0.76 vs. 0.57 individual care average predicted probability, p = 0.052) in intention-to-treat models. Group participants were more likely to change perceptions on affording healthy foods and stretching food resources. Group compared to individual care participants with early pregnancy food insecurity demonstrated higher maternal-infant attachment scale scores (89.8 vs. 86.2 points for individual care, p = 0.032). Conclusions Group prenatal care provides health education and the opportunity for women to share experiences and knowledge, which may improve food security through increasing confidence and skills in managing household food resources. Health sector interventions can complement food assistance programs in addressing food insecurity during pregnancy.