Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.
ADVANCED SEARCH
Log in
Top
Maternal and Child Health Journal
Published in: Maternal and Child Health Journal 1/2009

01-01-2009

Design of the Central Pennsylvania Women’s Health Study (CePAWHS) Strong Healthy Women Intervention: Improving Preconceptional Health

Authors: Danielle Symons Downs, Mark Feinberg, Marianne M. Hillemeier, Carol S. Weisman, Gary A. Chase, Cynthia H. Chuang, Roxanne Parrott, Lori A. Francis

Published in: Maternal and Child Health Journal | Issue 1/2009

Login to get access

Abstract

Considerable evidence suggests that modifiable risk factors for adverse pregnancy outcomes such as preterm birth and low birthweight include obesity, sedentary behavior, and infections. There is a growing consensus that the preconceptional and interconceptional periods may be an ideal time for preventive intervention targeting these risk factors; enhancing health before pregnancy would subsequently reduce the risk for poor pregnancy outcomes. This paper provides an overview of the development of a health behavior intervention, Strong Healthy Women, that aims to improve women’s preconceptional and interconceptional health. We describe the rationale, delivery, and targeted outcomes of the program, as well as the design of an ongoing trial currently testing program efficacy. The content areas are also discussed and include pregnancy-conception, stress, physical activity, nutrition, infection, sources of smoke in the home, and substance use. This intervention protocol may offer researchers and healthcare professionals a framework for designing other programs aiming to improve women’s preconceptional health.
Literature
1.
Centers for Disease Control and Prevention. (2006). Proceedings from the Preconception Health and Health Care Clinical, Public Health, and Consumer Workgroup Meetings. CDCP, Atlanta, GA. Accessed on 23 May 2007 at: http://​www.​cdc.​gov/​ncbddd/​preconception/​documents/​Workgroup%20​Proceedings%20​June06.​pdf.
2.
Institute of Medicine. (2006). Preterm birth: Causes, consequences, and prevention. Washington, DC: National Academies Press.
3.
U.S. Department of Health and Human Services (2000). Healthy people 2010: Understanding and improving health (2nd Ed.). Washington D.C.: U.S. Government Printing.
4.
Hamilton, B. E., Minino, A. M., Martin, J. A., Kochanek, K. D., Strobino, D. M., & Guyer, B. (2007). Annual summary of vital statisics. Pediatrics, 119, 345–360.PubMedCrossRef
5.
Peck, L. (2003). Alexander K. Maternal, infant, and child health in rural areas. In: L. Gamm, L. L. Hutchinson, B. J. Dabney, & A. M. Dorsey (Eds.) Rural healthy people 2010: A Companion document to healthy people 2010, Vol 2. College Station, TX: The Texas A&M University System Health Science Center, School of Rural Public Health, Southwest Rural Health Research Center.
6.
Frick, K. D., & Lantz, P. M. (1999). How well do we understand the relationship between prenatal care and birth weight? Health Services Research, 34(5 Pt 1), 1063–1073; discussion 74–82.
7.
Lu, M. C., Tache, V., Alexander, G. R., Kotelchuck, M., & Halfon, N. (2003). Preventing low birth weight: Is prenatal care the answer? Journal of Maternal-Fetal and Neonatal Medicine, 13(6), 362–380.PubMedCrossRef
8.
Lu, M. C., & Halfon, H. (2003). Racial and ethnic disparities in birth outcomes: A life-course perspective. Maternal and Child Health Journal, 7(1), 13–30.PubMedCrossRef
9.
Grason, H., Hutchins, J., & Silver, G. (1999). Charting a course for the future of Women’s and Perinatal Health, Vol II. Baltimore, MD: Women’s and Children’s Health Policy Center, Johns Hopkins School of Public Health.
10.
Kotelchuck, M. (2003). Building on a life-course perspective in maternal and child health. Maternal and Child Health Journal, 7(1):5–11.PubMedCrossRef
11.
Korenbrot, C. C., Steinberg, A., Bender, C., & Newberry, S. (2002). Preconception care: A systematic review. Maternal and Child Health Journal, 6, (2), 75–88.PubMedCrossRef
12.
Wise, P. H. (2003). The anatomy of a disparity in infant mortality. Annual Review Public Health, 24, 341–362.
13.
Moos, M. K. (2004). Preconceptional health promotion: Progress in changing a prevention paradigm. The Journal of Perinatal and Neonatal Nursing, 18(1), 2–13.
14.
Goldenberg, R. L., & Culhane, J. F. (2005). Prepregnancy health status and the risk of preterm delivery. Archives of Pediatrics and Adolescent Medicine, 159(1), 89–90.PubMedCrossRef
15.
Haas, J. S., Fuentes-Afflick, E., Stewart, A. L. et al. (2005). Prepregnancy health status and the risk of preterm delivery. Archives of Pediatrics and Adolescent Medicine, 159(1), 58–63.PubMedCrossRef
16.
Centers for Disease Control and Prevention. (2006). Recommendations to improve preconception health and health care—United States: A report of the CDC/ATSDR preconception care work group and the select panel on preconception care. Morbidity and Mortality Weekly Report, 55, (RR-6), 1–23.
17.
Baldwin, M., & Stevenson, Y. (2001). A model for providing health care to indigenous women living in remote areas. International Journal of Circumpolar Health, 60(4), 623–631.PubMed
18.
Laditka, S. B., Laditka, J. N., Bennett, K. J., & Probst, J. C. (2005). Delivery complications associated with prenatal care access for Medicaid-insured mothers in rural and urban hospitals. Journal of Rural Health, 21(2), 158–166.PubMedCrossRef
19.
Hillemeier, M. M., Weisman, C. S., Chase, G. A., & Dyer, A. M. (2007). Individual and community predictors of preterm birth and low birthweight along the rural–urban continuum in central Pennsylvania. Journal of Rural Health, 21(1), 42–48.CrossRef
20.
Jesse, D. E., Seaver, W., & Wallace, D. C. (2003). Maternal psychosocial risks predict preterm birth in a group of women from Appalachia. Midwifery, 19(3), 191–202.PubMedCrossRef
21.
Hobel, C. J., Ross, M. G., Bemis, R. L., Bragonier, J. R., Nessim, S., Sandhu, M., Bear, M. B., & Mori, B. (1994). The West Los Angeles preterm birth prevention project. I. Program impact on high-risk women. American Journal of Obstetrics and Gynecology, 170(1 Pt. 1), 54–62.PubMed
22.
Althuizen, E., van Poppel, M. N. M., Seidell, J. C., van der Wijden, C., & van Mechelen, W. (2006). Design of the New Life (style) study: A randomized controlled trial to optimize maternal weight development during pregnancy. BMC Public Health, 6, 168. doi:10.​1186/​1471-2458-6-168
23.
Godlee, F. (2001). Publishing study protocols: making them visible will improve registration, reporting, and recruitment. BMC News Views, 2, 4.
24.
Hillemeier, M. M., Weisman, C. S., Chase, G. A., & Romer, M. (2006). Preterm delivery and low birthweight among rural women: The importance of preconception physical and mental health status. In: Coward, R. T., Davis, L. A., Gold, C. H., Smiciklas-Wright, H., Thorndyke, L. E., & Vondracek, F. W. (Eds.). Rural women’s health: Mental, behavioral, and physical issues. New York, NY: Springer Publishing.
25.
Misra, D. P., Guyer, B., & Allston, A. (2003). Integrated perinatal health framework. A multiple determinants model with a life span approach. American Journal of Preventive Medicine, 25(1), 65–75.PubMedCrossRef
26.
Weisman, C. S., Hillemeier, M. M., Chase, G. A., Dyer, A. M., Baker, S. A., Feinberg, M., Symons Downs, D., & Parrott, R. L. et al. (2006). Preconceptional health: Risks of adverse pregnancy outcomes by reproductive life stage in the Central Pennsylvania Women’s Health Study (CePAWHS). Women’s Health Issues, 16, 216–224.PubMedCrossRef
27.
American College of Sports Medicine. (2000). ACSM’s guidelines for exercise testing and prescription (6th ed.). Philadelphia: Lippincott, Williams, & Wilkins.
28.
Evans, R. G., & Stoddart, G. L. (1990). Producing health, consuming health care. Social Science and Medicine, 31, 1347–1363.PubMedCrossRef
29.
Diabetes Prevention Program Research Group. (2002). The Diabetes Prevention Research Group: Reduction in the incidence of type 2 diabetes with lifestyle intervention or metformin. The New England Journal of Medicine, 346, 393–403.CrossRef
30.
Will, J. C., Farris, R. P., Sanders, C. G., Stockmyer, C. K., & Finkelstein, E. A. (2004). Health promotion interventions for disadvantaged women: Overview of the WISEWOMAN projects. Journal of Women’s Health, 13(5), 484–502.PubMedCrossRef
31.
Will, J. C., Massoudi, B., Mokdad, A., et al. (2001). Reducing risk for cardiovascular disease in Uninsured women: Combined results from two WISEWOMAN projects. Journal of the American Medical Women’s Association, 56(4), 161–165.PubMed
32.
Napholz, L. (2002). Stress-reduction psychoeducational interventions for black working women. The Nursing Clinics of North America, 37(2), 263–272.PubMedCrossRef
33.
Peterson, K. E., Sorensen, G., & Pearson, M., et al. (2002). Design of an intervention addressing multiple levels of influence on dietary and activity patterns of low-income, postpartum women. Health Education Research, 17(5), 531–540.PubMedCrossRef
34.
Baranowski, T., Anderson, C., & Carmack, C. (1998). Mediating variable framework in physical activity interventions: How are we doing? How might we do better? American Journal of Preventive Medicine, 15, 266–297.PubMedCrossRef
35.
Bandura, A. (1986). Social foundations of thought and action. Englewood Cliffs, NJ: Prentice-Hall.
36.
Ajzen, I. (1991). The theory of planned behavior. Organizational Behavior and Human Decision Processes, 50, 179–211.CrossRef
37.
Guttman, N., & Salmon, C. T. (2004). Guilt, fear, stigma and knowledge gaps: Ethical issues in public health communication interventions. Bioethics, 18, 531–552.PubMedCrossRef
38.
Maibach, E. W., & Cotton, D. (1995). Moving people to behavior change: A staged social cognitive approach to message design. In: E. Maibach & Parrott R. (Eds.), Designing health messages (pp. 41–64). Thousand Oaks, CA: Sage Publications Inc.
Metadata
Title
Design of the Central Pennsylvania Women’s Health Study (CePAWHS) Strong Healthy Women Intervention: Improving Preconceptional Health
Authors
Danielle Symons Downs
Mark Feinberg
Marianne M. Hillemeier
Carol S. Weisman
Gary A. Chase
Cynthia H. Chuang
Roxanne Parrott
Lori A. Francis
Publication date
01-01-2009
Publisher
Springer US
Published in
Maternal and Child Health Journal / Issue 1/2009
Print ISSN: 1092-7875
Electronic ISSN: 1573-6628
DOI
https://doi.org/10.1007/s10995-008-0323-7

Other articles of this Issue 1/2009

Maternal and Child Health Journal 1/2009 Go to the issue

OriginalPaper

Severe Vitamin D-deficiency and the Health of North China Children

OriginalPaper

Food Security During Infancy: Implications for Attachment and Mental Proficiency in Toddlerhood

OriginalPaper

Emotional Development and Nutritional Status of HIV/AIDS Orphaned Children Aged 6–12 Years Old in Thailand

OriginalPaper

Want Your Paper Published Faster? Read on…

OriginalPaper

Racial Disparities in Perinatal Outcomes and Pregnancy Spacing Among Women Delaying Initiation of Childbearing

OriginalPaper

Household Conditions, Eczema Symptoms and Rhinitis Symptoms: Relationship with Wheeze and Severe Wheeze in Children Living in the Polokwane Area, South Africa