Racial differences in the health of childbearing-aged women.

UNLABELLED: The incidence of preterm birth in the United States varies by race/ethnicity and socioeconomic status. Given the unsatisfactory reduction in preterm birth with interventions directed at single risk factors, we examined the preconceptional health of childbearing-aged women of different racial/ethnic groups to understand the risk prior to pregnancy. PURPOSE: To evaluate the preconceptional health of childbearing-aged women by examining specific health factors implicated in preterm birth in light of racial/ethnic and socioeconomic factors. We tested the hypothesis that subgroups with historically high levels of preterm birth would have poorer preconceptional health compared to other groups and that the economic influence would be similar across groups. STUDY DESIGN AND METHODS: We performed a secondary analysis of cross-sectional population-based data from the National Health and Nutrition Examination Survey 2001-2002 and 2003-2004 data sets, including 1,497 of 2,108 eligible White, African American, and Mexican American women. We measured health using select indicators of cardiovascular and metabolic disorders, infectious disease, and sexual and substance-use behaviors associated with increased risk for preterm birth and conducted comparisons within and across racial groups. We used adjusted logistic regression by race. RESULTS: In addition to increased rates of preterm birth shown in the literature, childbearing-aged African American women have poorer overall preconceptional health than the other groups. Measures of socioeconomic status affect preconceptional health differently for each racial/ethnic group. CLINICAL IMPLICATIONS: Racial/ethnic subgroups with higher rates of preterm birth experience poorer health preconceptionally. Clinicians should address preconceptional health risks for preterm birth in all childbearing-aged women, paying attention to racial/ethnic-specific risks identified here.

Immersion in another culture: one strategy for increasing cultural competency.

Educating nursing students in the United States to be culturally competent is a challenge. Undergraduate and graduate nursing students, including nurse-midwifery students were paired with faculty on a short-term transcultural nursing experience in Choluteca, Honduras. Students provided health screenings, prenatal assessments, and birth attendance. Learning objectives were designed to improve cultural competency in the healthcare setting for nursing students. A case study exemplar in the labor and delivery setting is presented. As a result of the cultural immersion experience, the student demonstrates versatility and flexibility in clinical practice, reflecting the skills necessary to adapt interventions to populations and circumstances.

Undergraduate and graduate students partnering in a short term transcultural experience in Honduras.

Undergraduate and graduate nursing students were partnered in a short-term transcultural nursing experience in Choluteca Honduras. Learning objectives specific to the level of the student were developed to meet their individual needs with a women's health focus. Learning opportunities were created to encourage interaction between the undergraduate and graduate students. The students partnered to deliver women's health care in a primary health care clinic, through a women's health seminar, a community health fair, in a hospital-based labor management clinical experience and in a rural health clinic.