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，最终可能影响婴儿的结局。积极的健康实践是妇女在怀孕期间从事的行为，以优化孕产妇和胎儿的健康;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提高我们对包括母胎依恋（MFA）在内的因素以及孕产妇身心健康如何影响健康状况不良风险较高的人群中妊娠期健康实践的理解。在早产、出生体重不足和其他不良后果方面的许多健康差距与那些社会、经济和健康状况不良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期间身体健康状况不佳（肥胖症，妊娠糖尿病和先兆子痫）和心理健康状况不佳（抑郁症，创伤后应激障碍[PTSD]）的风险增加。一个描述性的，纵向的混合方法研究将进行24-28周的妊娠和非裔美国妇女的一个小组之间收集的定量数据将参加同时定性访谈，这将提高我们的理解，在少数民族，是什么影响妇女的倾向，在怀孕期间从事积极的健康做法。MFA的增加表明怀孕期间的健康做法有所增加;然而，有限的研究主要集中在已婚白色妇女身上。了解MFA水平对那些母亲-胎儿和婴儿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至关重要。具体目标是：一曰：研究MFA对妊娠期卫生实践和婴儿健康结局的影响，2：分析产妇特征和产妇身心健康对MFA的影响，3：分析产妇特征、产妇身心健康和MFA对妊娠期卫生实践和婴儿结局的影响，4：探讨妇女对MFA的看法，包括促进或阻碍依恋的因素以及怀孕期间的健康做法。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怀孕结果差异。为了实现这一目标，关键是要确定存在的差距，在护理的改善可以最大限度地改善妊娠结局，以及个人生活方式的变化可以最好地与改善医疗保健相互作用，以优化妊娠和婴儿的结局。

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.