Facilitators and Barriers to Health Promoting Practices During Pregnancy

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Description (provided by applicant): Many factors influence the health of pregnant women and their fetuses and, ultimately, may affect infant outcomes. Positive health practices are those behaviors a woman engages in while pregnant to optimize maternal and fetal health; however, what influences a woman to maintain these practices during pregnancy is not fully understood. The proposed descriptive, longitudinal mixed methods study seeks to enhance our understanding of how factors including maternal-fetal attachment (MFA), and maternal physical and emotional health impact health practices in pregnancy in a population at higher risk for poor health outcomes. Many of the health disparities in preterm delivery, low birth weight and other poor outcomes are associated with those racial and ethnic groups exposed to poor social, economic and health conditions. Furthermore, these vulnerable populations are at increased risk of poor physical health (obesity, gestational diabetes, and preeclampsia) and poor mental health (depression, post-traumatic stress disorder [PTSD]) during pregnancy, and in the post-partum period. A descriptive, longitudinal mixed methods study will be conducted with quantitative data collected between 24-28 weeks gestation and a sub-group of African-American women will participate in concurrent qualitative interviews which will enhance our understanding, in ethnic minorities, of what influences a woman's inclination to engage in positive health practices during pregnancy. Increased MFA has shown to increase health practices during pregnancy; however, the limited research has largely focused on married White women. It is critical to understand the implications of MFA levels in those women at higher risk for poor maternal-fetal and infant outcomes, and how a woman's health status influences MFA. Specific aims are: 1: to examine the impact of MFA on health practices during pregnancy and infant health outcomes, 2: to analyze the influence of maternal characteristics and maternal physical and emotional health on MFA, 3: to analyze the influence of maternal characteristics, maternal physical and emotional health, and MFA on health practices during pregnancy and infant outcomes, and 4: to explore women's perceptions of MFA including factors which foster or discourage attachment as well as health practices during pregnancy. As health care professionals committed to serving the public, we must be concerned and devoted to eliminating the well-documented disparities in pregnancy outcomes which exist between racial and ethnic groups. To achieve this, it is critical to identify where the disparities exist, where improvements in nursing can most improve pregnancy outcomes, and where individual life style changes can best interact with improved health care to optimize both pregnancy and infant outcomes.