Likelihood of emergency contraception use among African-American women at risk of adverse birth outcomes.

Nearly a half million infants in the United States are born preterm or with low birth weight each year. Providing women who have had a prior adverse birth outcome with access to family planning can help reduce the incidence of subsequent high-risk pregnancies and adverse outcomes. One effective option to prevent unintended pregnancy for women with a prior adverse birth outcome who either do not use contraception consistently or whose contraception fails is emergency contraception (EC). The purpose of our study was to understand willingness to use EC among African-American women who recently had an adverse birth outcome. The Healthy Births Healthy Communities (HBHC) Interconceptional Care Project (ICCP) targeted high-risk African-American women from two low-income Chicago neighborhoods who recently had an adverse birth outcome. The aim of HBHC ICCP was to improve participants' future birth outcomes by providing medical and social services and helping women to clarify their reproductive life goals. Information about participants' pregnancy intentions and willingness to use EC was measured in an interview shortly after enrollment into the study. Over 90% of the 131 women in our study either did not want to become pregnant or did not know if they wanted to become pregnant within the next 2 years. These women had 4.4 times higher odds of reporting willingness to use EC as compared to women who reported a desire to become pregnant within the next 2 years (75.6 vs. 50.0%, respectively; AOR: 4.4; 95% CI 1.1, 17.6). EC is an essential part of the reproductive toolkit for women at high risk of adverse birth outcomes who are not intending pregnancy, along with reproductive life planning and use of effective contraception.

The effects of acculturation on healthy lifestyle characteristics among Hispanic fourth-grade children in Texas public schools, 2004-2005.

BACKGROUND: Childhood obesity is a national epidemic that disproportionately affects Hispanic children. Evidence suggests that increased acculturation among this population adversely affects diet and other healthy lifestyle characteristics, leading to higher rates of overweight and obesity. Healthy lifestyle characteristics must be understood in order to prevent or decrease overweight and obesity among Hispanic children. METHODS: Using the School Physical Activity and Nutrition (SPAN) study, we examined cross-sectional data on healthy lifestyle characteristics collected in Texas public schools from Hispanic fourth-grade children in 2004-2005. We calculated adjusted odds ratios and associated confidence intervals using multivariate logistic regression analyses to analyze the association between acculturation and healthy lifestyle characteristics among Spanish-speaking Hispanic children compared to English-speaking Hispanic children. RESULTS: Spanish-speaking Hispanic boys consumed more milk and fruit than English-speaking Hispanic boys (milk: adjusted odds ratio [AOR]: 1.7, p = .02; fruit: AOR: 2.5, p = .0001). The likelihood that Spanish-speaking Hispanic boys and girls did not know that there is a relationship between overweight and health problems were 2 times greater (boys: AOR: 1.7, p = .03; girls: AOR: 2.2, p = .006) than their English-speaking Hispanic counterparts. Likelihood of weight loss attempts was greater among Spanish-speaking Hispanic boys than English-speaking Hispanic boys (AOR: 1.9, p = .04). CONCLUSIONS: Results are mixed. Lower levels of acculturation appear to be associated with both positive and negative healthy lifestyle characteristics, depending on sex. These findings have important implications for school health policies and programs and should be distributed to school administrators.