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1.
Disaster Med Public Health Prep ; : 1-8, 2022 May 02.
Artigo em Inglês | MEDLINE | ID: mdl-35492019

RESUMO

OBJECTIVE: Researchers and public health professionals need to better understand individual engagement in coronavirus disease 2019 (COVID-19) mitigation behaviors to reduce the human and societal costs of the current pandemic and prepare for future respiratory pandemics. We suggest that developing measures of individual mitigation behaviors and testing them among high-risk individuals, including pregnant people, may help to reduce overall morbidity and mortality by quickly identifying targets for messaging around mitigation until sufficient vaccination uptake is reached. METHODS: We surveyed pregnant people in California over 2 waves of the COVID-19 pandemic to explore mitigation behaviors. We developed and validated a novel Viral Respiratory Illness Mitigation Scale (VRIMS). RESULTS: Seven measures loaded onto a single factor with good psychometric properties. The overall sample scale average was high over both waves, indicating that most pregnant Californians engaged in most of the strategies most of the time. Older participants, minoritized participants, those living in more urban contexts, and those surveyed during a surge reported engaging in these strategies most frequently. CONCLUSIONS: Clinicians and researchers should consider using reliable, validated measures like the VRIMS to identify individuals and communities that may benefit from additional education on reducing risk for COVID-19, future respiratory pandemics, or even seasonal flu.

2.
Vaccine ; 40(19): 2755-2760, 2022 04 26.
Artigo em Inglês | MEDLINE | ID: mdl-35361501

RESUMO

BACKGROUND: A key mitigation strategy to the COVID-19 pandemic has been the development and roll-out of vaccines. However, pregnant and lactating people were not included in initial vaccine trials and this population is hesitant to receive the vaccine, despite contrary recommendations from the American College of Obstetrics and Gynecology and the Centers for Disease Control and Prevention. Understanding the reasons behind this hesitancy is vital to promote vaccine uptake. METHODS: We surveyed pregnant people in California from December 2020 to January 2021 (n = 387) to describe cognitions and decision-making regarding COVID-19 vaccination. Using descriptive, regression-based analyses, we examined rates of planned uptake and reasoning among individuals who reported COVID-19 vaccine hesitancy. RESULTS: Overall, the pregnant Californians that we surveyed were aware of the COVID-19 vaccines. Of 387 participants, 43% reported planning to get the vaccine as soon as possible. The remaining 57% were hesitant: 27% responded that they would not receive the vaccine. Some demographic features did predict more COVID-19 vaccine hesitancy, particularly younger age (AOR = 0.95, p = 0.025) and living in a less urban context (AOR = 0.80, p = 0.041). Essential worker status also was associated with vaccine hesitancy. Having had, or intending to have, a flu vaccine was negatively associated with COVID-19 vaccine hesitancy (p < 0.001). The most commonly reported reason for COVID-19 vaccine hesitancy was "I don't know enough about the vaccine." Low levels of self-reported knowledge were highly predictive of hesitancy. CONCLUSIONS: Terms like "vaccine hesitance" and "anti-vax" do not adequately characterize decisions regarding delaying COVID-19 vaccination. Rather, these decisions are largely based on the lack of knowledge about the impacts of vaccination on pregnancy, fetal development, and later child wellbeing. This lack of knowledge should be countered by conversations between individual healthcare providers and their pregnant patients, and better inclusion of pregnant people and children in vaccine trials.


Assuntos
COVID-19 , Vacinas contra Influenza , COVID-19/prevenção & controle , Vacinas contra COVID-19 , Criança , Estudos Transversais , Feminino , Humanos , Lactação , Pandemias , Gravidez , SARS-CoV-2 , Estados Unidos , Vacinação
3.
Qual Health Res ; 32(1): 31-47, 2022 01.
Artigo em Inglês | MEDLINE | ID: mdl-34558371

RESUMO

What is breastfeeding "success"? In this article, we challenge the traditional biomedical definition, instead centering visions of success described by breastfeeding mothers themselves. Using semi-structured interviews, quantitative surveys, and written narratives of 38 first-time mothers in the United States, we describe five common pathways through the first-year postpartum, a taxonomic distinction far more complex than a success-failure dichotomy: sustained breastfeeding, exclusive pumping, combination feeding, rapid weaning, and grinding back to exclusivity. We also explore the myriad ways in which mothers define and experience breastfeeding success, and in the process uncover the ways that cultural narratives-especially intensive mothering-color those experiences. Finally, we discuss how these experiences are shaped by infant feeding pathway. In doing so, we discover nuance that has gone unexplored in the breastfeeding literature. These findings have implications for supporting, promoting, and protecting breastfeeding in the United States and other high-income countries.


Assuntos
Aleitamento Materno , Mães , Feminino , Humanos , Lactente , Período Pós-Parto , Pesquisa Qualitativa , Inquéritos e Questionários
4.
J Am Coll Health ; : 1-7, 2021 Jul 22.
Artigo em Inglês | MEDLINE | ID: mdl-34293273

RESUMO

OBJECTIVE: Despite the growing student parent population, many postsecondary institutions in the United States (U.S.) lack sufficient lactation policies for students. The objective of this study was to explore breastfeeding students' perceived awareness and use of on-campus lactation rooms and identify barriers and facilitators to expressing milk on campus.Participants:A convenience sample of breastfeeding students enrolled in colleges/universities in the U.S.Methods:Information about students' experiences expressing milk on campus was collected via an online survey. Thematic analysis was used to qualitatively analyze self-reported barriers/facilitators to expressing.Results:Ninety-three participants representing 68 unique institutions completed the survey. Barriers to expressing on campus included inadequate lactation spaces, lack of storage for breast pump equipment/expressed milk, and lack of time to express. Conversely, access to adequate lactation spaces, having appropriate breast pump equipment, and on-campus social support, were important facilitators.Conclusion:Comprehensive lactation policies may improve on-campus breastfeeding experiences among students.

5.
J Pediatr Psychol ; 46(7): 768-778, 2021 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-34270767

RESUMO

OBJECTIVE: To test breastfeeding duration and responsive parenting as independent predictors of infant weight change from birth to 12 months, and to test the moderating effect of a tiered parenting intervention on relations between breastfeeding and responsive parenting in relation to infant weight change. METHODS: Mother-infant dyads (N = 403) were participants in the ongoing Smart Beginnings (SB) randomized controlled trial testing the impact of the tiered SB parenting model that incorporates two evidence-based interventions: Video Interaction Project (VIP) and Family Check-Up (FCU). The sample was low income and predominantly Black and Latinx. Responsive parenting variables (maternal sensitivity and intrusiveness) came from coded observations of mother-infant interactions when infants were 6 months. Continuous weight-for-age (WFA) z-score change and infant rapid weight gain (RWG) from 0 to 12 months were both assessed. RESULTS: Longer breastfeeding duration was significantly associated with less WFA z-score change. The relationship between breastfeeding duration and WFA z-score change was significant only for infants in the intervention group. Intrusive parenting behaviors were also associated with greater WFA z-score change after accounting for breastfeeding duration. CONCLUSIONS: This study is one of the first to test both breastfeeding and parenting in relation to infant weight gain in the first year. Findings may have implications for family-focused child obesity prevention programs.


Assuntos
Aleitamento Materno , Poder Familiar , Criança , Comportamento Alimentar , Feminino , Humanos , Lactente , Recém-Nascido , Relações Mãe-Filho , Mães
6.
BMC Pregnancy Childbirth ; 21(1): 477, 2021 Jul 02.
Artigo em Inglês | MEDLINE | ID: mdl-34215218

RESUMO

BACKGROUND: During public health emergencies, including the COVID-19 pandemic, access to adequate healthcare is crucial for providing for the health and wellbeing of families. Pregnant and postpartum people are a particularly vulnerable subgroup to consider when studying healthcare access. Not only are perinatal people likely at higher risk for illness, mortality, and morbidity from COVID-19 infection, they are also at higher risk for negative outcomes due to delayed or inadequate access to routine care. METHODS: We surveyed 820 pregnant people in California over two waves of the COVID-19 pandemic: (1) a 'non-surge' wave (June 2020, n = 433), and (2) during a 'surge' in cases (December 2020, n = 387) to describe current access to perinatal healthcare, as well as concerns and decision-making regarding childbirth, over time. We also examined whether existing structural vulnerabilities - including acute financial insecurity and racial/ethnic minoritization - are associated with access, concerns, and decision-making over these two waves. RESULTS: Pregnant Californians generally enjoyed more access to, and fewer concerns about, perinatal healthcare during the winter of 2020-2021, despite surging COVID-19 cases and hospitalizations, as compared to those surveyed during the COVID-19 'lull' in the summer of 2020. However, across 'surge' and 'non-surge' pandemic circumstances, marginalized pregnant people continued to fare worse - especially those facing acute financial difficulty, and racially minoritized individuals identifying as Black or Indigenous. CONCLUSIONS: It is important for clinicians, researchers, and policymakers to understand whether and how shifting community transmission and infection rates may impact access to perinatal healthcare. Targeting minoritized and financially insecure communities for increased upstream perinatal healthcare supports are promising avenues to blunt the negative impacts of the COVID-19 pandemic on pregnant people in California.


Assuntos
COVID-19 , Tomada de Decisões , Status Econômico , Acesso aos Serviços de Saúde , Assistência Perinatal , Adolescente , Adulto , Entorno do Parto , COVID-19/epidemiologia , California/epidemiologia , Feminino , Humanos , Grupos Minoritários , Parto , Gravidez , Cuidado Pré-Natal , SARS-CoV-2 , Inquéritos e Questionários , Adulto Jovem
7.
Breastfeed Med ; 16(7): 530-538, 2021 07.
Artigo em Inglês | MEDLINE | ID: mdl-34115545

RESUMO

Objective: To assess whether in-hospital infant formula supplementation impacts later successful breastfeeding among healthy mother-infant dyads in the United States who are not intending to exclusively use infant formula. Study Design: Using secondary analysis of a national longitudinal survey (Infant Feeding Practices Study II, n = 2,399), we estimated effects of in-hospital infant formula supplementation on later breastfeeding success by matching mothers whose infants received in-hospital formula supplementation with mothers whose infants did not. Estimates were compared across four matching methods. Outcomes of breastfeeding success included likelihood of following a sustained breastfeeding trajectory for the first year postpartum; feelings of favorability and breastfeeding as long as desired postweaning; and breastfeeding intention, initiation, and duration for subsequent children. Results: In-hospital formula supplementation halved the likelihood of following a breastfeeding trajectory characterized by sustained exclusive breastfeeding. Supplementation decreased feelings of favorability toward breastfeeding postweaning but did not impact the likelihood of feeling that one breastfed as long as desired. Supplementation did not impact intention to breastfeed a future child; it did, however, decrease the likelihood of breastfeeding initiation with a subsequent child by >66% and reduced average duration of breastfeeding any subsequent children by >6 weeks. Conclusion: A lack of experimental methodologies in previous studies makes it difficult to determine a causal link between infant formula in the hospital and less breastfeeding success. Assuming we have accounted for all appropriate confounders, this study provides evidence for such a causal link. Birth hospital policies and practices should speak of this risk of harm.


Assuntos
Aleitamento Materno , Fórmulas Infantis , Criança , Suplementos Nutricionais , Comportamento Alimentar , Feminino , Hospitais , Humanos , Lactente , Estados Unidos/epidemiologia
9.
J Dev Behav Pediatr ; 41(3): 180-186, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31613842

RESUMO

OBJECTIVE: To examine the associations between breastfeeding intensity and underexplored features of maternal-child interaction quality over and above the influence of breastfeeding initiation. METHODS: The current study leveraged an on-going, multisite randomized controlled trial of a tiered parenting program for 462 Medicaid-eligible mothers and their infants in the United States. We examined whether breastfeeding intensity and exclusivity was associated with observed maternal sensitivity, intrusiveness, and detachment, as well as self-reported maternal verbal responsiveness, 6 months infant age. Analyses controlled for breastfeeding initiation, demographics, and early parenting experiences. RESULTS: Higher intensity breastfeeding at 6 months was significantly related to higher maternal sensitivity (ß = 0.12, p = 0.004) and lower maternal intrusiveness (ß = -0.10, p = 0.045). There was no significant association between breastfeeding intensity at 6 months and detachment (ß = -0.02, no significant [ns]) or self-reported verbal responsiveness (ß = 0.11, ns). Results were the same when intensity was measured as a dichotomous indicator for exclusive breastfeeding. Effect sizes were small-to-moderate, ranging from Cohen's d = 0.26 to 0.31. Associations did not vary by site, race/ethnicity, infant difficultness, or household poverty. CONCLUSION: The finding that breastfeeding intensity was significantly and independently associated with maternal sensitivity and intrusiveness is novel in the literature on low-income families from the United States. These findings have implications for breastfeeding promotion strategies and indicate that future research should explore synergistic or spillover effects of interventions aimed at maternal-child interaction quality into the infant feeding domain, particularly in the primary care setting.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Comportamento Materno , Grupos Minoritários/estatística & dados numéricos , Relações Mãe-Filho , Pobreza/estatística & dados numéricos , Adulto , Feminino , Humanos , Lactente , Comportamento Materno/etnologia , Medicaid/estatística & dados numéricos , Estados Unidos , Adulto Jovem
10.
Womens Health Issues ; 29(6): 506-512, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31628004

RESUMO

OBJECTIVE: We aimed to determine whether the association between time off work and a near-exclusive breastfeeding trajectory is moderated by perceived employer support for breastfeeding. METHODS: We conducted a secondary analysis of working mothers (n = 1,468) from the Infant Feeding Practices Study II, a longitudinal observational (2005-2007) study of U.S. infant feeding behaviors. Previous studies have found four latent infant feeding subgroups in the Infant Feeding Practices Study II sample, each following a distinct breastfeeding intensity trajectory. Multivariate least-squares regression was conducted to estimate whether time off work after delivery predicted increased membership in the subgroup characterized by near-exclusive breastfeeding, and whether this association was moderated by perceived employer support for workplace breastfeeding. RESULTS: Both time off work and perception of more breastfeeding support were independently, positively related to probability of membership in the near-exclusive breastfeeding trajectory (ß = 0.16, p = .019, and ß = 0.14, p = .004, respectively). The interaction of these two factors suggests an attenuation effect. The addition of paid leave to the model did not change the estimates. CONCLUSION: The positive relationship between time off and trajectory membership was significant only for mothers who perceived their workplaces to be unsupportive of breastfeeding.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Comportamento Alimentar , Mães/estatística & dados numéricos , Licença Parental/normas , Salários e Benefícios/estatística & dados numéricos , Local de Trabalho/estatística & dados numéricos , Local de Trabalho/normas , Adolescente , Adulto , Feminino , Humanos , Lactente , Recém-Nascido , Licença Parental/estatística & dados numéricos , Gravidez , Adulto Jovem
11.
Matern Child Nutr ; 15(1): e12655, 2019 01.
Artigo em Inglês | MEDLINE | ID: mdl-30216665

RESUMO

Patterns of breastfeeding over time are not currently well understood. Limited qualitative and quantitative evidence suggests that there may be latent subgroups of mothers in the United States following very different trajectories of breast milk provision for their infants. This study used a quantitative modelling method (group-based trajectory modelling) to identify and describe these subgroups. Using data from the Infant Feeding Practices Study II (n = 3,023), the authors identified four distinct trajectories of breastfeeding intensity, each of which included a substantial subset of the total sample. A model with four groups fit the data well by objective and conceptual standards. Bivariate associations were analysed, and significant difference between trajectory group membership was found on an array of maternal and family determinants, including maternal demographics, hospital experience, and psychosocial resources, as well as on postweaning perceptions. These associations were used to create group profiles for each subgroup. Controlling for sociodemographic covariates, we also found that trajectory membership was significantly associated with several health outcomes for the target child 6 years later, including certain infections, picky eating, and health care utilization; trajectory group membership was also associated with maternal breastfeeding of subsequent children and maternal body mass index (BMI) at Year 6. Child BMI z-score and maternal breast cancer diagnosis were not significantly different across trajectory groups after accounting for confounding covariates, nor was time missed from school for the target child. Though exploratory, the initial identification and description of these four subgroups suggest future directions using breastfeeding trajectory methods, with potential implications for measurement, intervention development, and targeting.


Assuntos
Aleitamento Materno/estatística & dados numéricos , Modelos Estatísticos , Adolescente , Adulto , Feminino , Humanos , Lactente , Recém-Nascido , Estudos Longitudinais , Leite Humano , Mães/estatística & dados numéricos , Estados Unidos/epidemiologia , Adulto Jovem
12.
Child Dev ; 88(2): 459-465, 2017 03.
Artigo em Inglês | MEDLINE | ID: mdl-28160274

RESUMO

This special section of Child Development brings together experts in developmental science and intervention research to incorporate current evidence on resilience for vulnerable populations and give concrete suggestions for action and research. This commentary synthesizes the contributions of the articles, noting themes such as simultaneous attention to multiple risk, protective, and promotive processes; integrating new principles from clinical and therapeutic interventions; and adapting intervention approaches for new populations. It then describes additional directions for interventions to maximize resilience, including approaches that address social psychological processes, issues related to demographic and other forms of diversity, policy-related individual behaviors, and sequenced interventions across the life span. It also gives suggestions for integrating implementation science on expansion and scale with behavioral intervention science.


Assuntos
Desenvolvimento Infantil , Psicoterapia/métodos , Populações Vulneráveis/psicologia , Criança , Humanos
13.
J Hum Lact ; 33(1): 220-224, 2017 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-28135484

RESUMO

BACKGROUND: Prior research in high-income countries finds that young mothers tend to breastfeed their infants for shorter durations than older mothers; however, there are gaps in our understanding of the processes by which age influences breastfeeding. Research aim: The primary objective of this study was to test the mediating effects of parity and education attainment on the association between maternal age and two breastfeeding outcomes: total duration and duration of exclusive breastfeeding. METHODS: This study was a secondary data analysis of the IFPS II, a prospective, longitudinal study of ~ 4,900 American mothers. Robust and bias-corrected regression analyses tested the direct effect of age and the indirect effects of age through parity and education for each outcome of interest. RESULTS: Parity and education attainment together explain nearly all of the association between maternal age and both measures of breastfeeding duration. The mediating role of education is significantly larger than parity for both outcomes. CONCLUSION: These findings indicate that maternal age primarily indexes parity and education but contributes minimally to breastfeeding duration via a direct effect. The findings have implications for intervention development and targeting strategies.


Assuntos
Aleitamento Materno/psicologia , Escolaridade , Paridade , Fatores de Tempo , Adolescente , Adulto , Fatores Etários , Aleitamento Materno/estatística & dados numéricos , Feminino , Comportamentos Relacionados com a Saúde , Humanos , Estudos Longitudinais , Mães/psicologia , Mães/estatística & dados numéricos , Estudos Prospectivos , Estados Unidos
14.
Adv Child Dev Behav ; 51: 231-55, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27474428

RESUMO

More than 4 million unauthorized parents of legal status children currently reside in the United States (Capps, Fix, & Zong, 2016). Developmental scientists and intervention researchers hoping to work with these mixed-status families face a myriad of challenges, largely generated from the population's policy-driven social exclusion. Despite the challenges, there is a moral imperative to work with and support parents and children currently living in mixed-status households. This chapter applies a social justice perspective, largely stemming from Prilleltensky's critical community psychological framework, to improve the relevance and usefulness of research on mixed-status families (Prilleltensky & Nelson, 1997). We discuss the utility of this social justice perspective in theory building, study design and implementation, and dissemination of findings regarding mixed-status families, with exemplars from recent research.


Assuntos
Emigração e Imigração , Família , Distância Psicológica , Justiça Social , Imigrantes Indocumentados , Adolescente , Criança , Pesquisa Participativa Baseada na Comunidade , Emigrantes e Imigrantes , Humanos , Disseminação de Informação , Pais , Política Pública , Estados Unidos
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