Facilitators and Barriers to Health Promoting Practices During Pregnancy

描述(由申请人提供)：许多因素影响孕妇及其胎儿的健康，并最终可能影响婴儿的结局。积极的健康做法是指妇女在怀孕期间为优化母婴健康而采取的行为；然而，影响妇女在怀孕期间保持这些做法的因素尚不完全清楚。拟议的描述性、纵向混合方法研究旨在加强我们对包括母胎依恋(MFA)在内的因素以及母亲的身体和情感健康如何影响健康结局不良风险较高人群的怀孕健康做法的理解。早产、低出生体重和其他不良结局方面的许多健康差距与那些面临不良社会、经济和卫生条件的种族和族裔群体有关。此外，这些弱势群体在怀孕期间和产后面临身体健康不良(肥胖、妊娠期糖尿病和先兆子痫)和精神健康不良(抑郁症、创伤后应激障碍[PTSD])的风险增加。将进行一项描述性的纵向混合方法研究，在怀孕24-28周期间收集定量数据，并将参加同时进行的定性访谈，这将增强我们对少数民族妇女在怀孕期间从事积极健康做法的倾向的理解。增加的MFA表明，在怀孕期间增加健康实践；然而，有限的研究主要集中在已婚白人妇女。关键是要了解MFA水平对那些母婴结局不良风险较高的妇女的影响，以及妇女的健康状况如何影响MFA。具体目标是：1：考察MFA对孕期健康行为和婴儿健康结局的影响；2：分析母亲特征和母亲身心健康对MFA的影响；3：分析母亲特征、母亲身心健康和MFA对孕期健康行为和婴儿结局的影响；4：探讨女性对MFA的认知，包括促进或不鼓励依恋和孕期健康行为的因素。作为致力于为公众服务的卫生保健专业人员，我们必须关注并致力于消除种族和族裔群体之间存在的有据可查的妊娠结局差异。要实现这一点，关键是要确定哪里存在差异，哪里改进护理最能改善妊娠结局，哪里个人生活方式变化与改善的卫生保健最能相互作用，以优化怀孕和婴儿结局。

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.