Home
Browse All
DRL Collection Development Policy
Links to non-OHSU Collections
OHSU Campus Building Names
Digital Collections Blog
Log in
|
Help
Search
Advanced Search
Find results with:
error div
Add another field
Search by date
from
after
before
on
to
Searching collections:
Student Scholar Archive
Add or remove collections
Home
Student Scholar Archive
A collaborative, intersectional approach to health disparities in pregnancy
Reference URL
To link to this object, paste this link in email, IM or document
To embed this object, paste this HTML in website
A collaborative, intersectional approach to health disparities in pregnancy
View Description
Download
small (250x250 max)
medium (500x500 max)
large ( > 500x500)
Full Resolution
368.pdf
Description
Rights
http://www.ohsu.edu/xd/education/library/services/theses-dissertations/rights-statement.cfm
Title
A
collaborative
,
intersectional
approach
to
health
disparities
in
pregnancy
Creator.PersonalName
Bloom
,
Tina
Thesis.Degree
Ph.D.
Thesis.Major
Nursing
Thesis.DateDegreeAwarded
June
2008
Institution
Oregon Health & Science University
School
School of Nursing
Thesis.Chair
Houck, Gail M.
Thesis.Committee
Curry, Mary Ann
Glass, Nancy E.
Hernandez, Rebecca
Subject.MeSH
Health Status Disparities
Risk Factors
Stress, Physiological
Mothers
Pregnant Women
Poverty
Call Number
WY4 B6552 2008
Description.Abstract
Health
disparities
in
maternal-child
outcomes
(preterm
birth
,
low
birthweight
,
infant
mortality
, and
maternal
mortality)
are
substantial
,
well
documented
, and in
many
cases
,
growing
worse
.
Many
research
approaches
have
focused
on
single
risk
factors
,
yet
many
risk
categories
(e.g.
,
minority
status
,
socioeconomic
status
,
violence
,
substance
abuse
, and
mental
health
issues)
overlap
substantially
.
Further
,
stress
and
discrimination
are
potentially
common
factors
to
risk
categories
, but their
role
in
maternal-child
health
disparities
is
not
well
understood
. This
mixed-method
,
participatory
research
study
aimed
to
address
this
gap
by
describing
the
experience
of
pregnancy
and
early
motherhood
among
a
sample
of
diverse
,
primarily
low-income
mothers
. The
study
focused
on
mothers’
experiences
of
stress
and
discrimination
related
to
race
,
socioeconomic
status
,
violence
,
mental
health
issues
,
and/or
substance
use
,
using
an
intersectional
framework
to
understand
how these
factors
overlapped
and
intersected
. A
mixed-methods
survey
with
demographics
,
six
quantitative
measures
and
qualitative
interview
probes
was
developed
from
literature
review
. The
unique
perspective
and
expertise
of
participants
in the
study
was
privileged
in the
design
of the
study
questions
and in the
interpretation
of the
findings
.
Eight
low-income
mothers
(lay
advisors)
evaluated
the
survey
for
appropriateness
,
completeness
,
understandability
, and
offensiveness
, and
additional
questions
were
added
in a
collaborative
revision
process
with
lay
advisors
.
Measures
were the
Detroit
Area
Study
Discrimination
Questionnaire
(DAS-DQ)
,
Perceived
Stress
Scale
(PSS)
,
Center
for
Epidemiologic
Studies
Revised
Scale
(CESD-R)
,
Posttraumatic
Stress
Checklist
Civilian
Version
(PCL)
,
My
Exposure
to
Violence
measure
(MyETV)
, and
Danger
Assessment
(DA)
. These
measures
described
women’s
lifetime
exposures
to
discrimination
,
perceived
stress
levels
,
depressive
and
PTSD
symptoms
, and
lifetime
exposures
to
violence
.
Semi-structured
qualitative
interview
questions
covered
the
same
domains
, as
well
as
asking
participants
to
describe
their
priorities
for
information
and
support
for
mothers
.
Twenty-four
participants
took
part
in the
interviews
.
All
were
low-income
mothers
who
were
currently
pregnant
and/or
had
given
birth
in the
past
three
years
, and were
recruited
from
WIC
clinics
, a
low-income
health
clinic
, and
Healthy
Start
sites
in the
metropolitan
Portland
area
.
Interviews
were
conducted
in
women’s
homes
or
private
and
safe
settings
of their
choosing
,
e.g.
,
coffee
shops
or
cafes
.
Women
were
compensated
for their
time
at
each
interview
. The
investigator
administered
quantitative
measures
followed
by the
qualitative
questions
; the
qualitative
interview
portion
of the
interview
was
audiotaped
and
transcribed
.
Quantitative
measures
were
analyzed
for
descriptive
purposes
, with
frequencies
,
means
,
standard
deviations
, and
ranges
of
scores
reported
.
Qualitative
data
were
analyzed
and
coded
using
a
qualitative
descriptive
approach
. A
priority
was
describing
experiences
of
stress
and
discrimination
associated
with
risk
categories
for
poor
maternal-child
outcomes
, and how these
categories
of
risk
overlapped
and
intersected
.
Mothers’
priorities
for
support
and
information
to
ameliorate
the
impact
of
stressors
was also a
priority
.
Interviews
continued
until
data
saturation
was
reached
.
Study
findings
were
returned
to
lay
advisors
for
discussion
,
interpretation
, and
revision
.
Mothers
in the
sample
were
very
low
income
, with
over
half
under
federal
poverty
guidelines
, and
financial
difficulties
were the
most
prevalent
stressor
.
Violence
exposures
across
the
lifespan
were
extremely
high
, as were
levels
of
depressive
and
posttraumatic
stress
disorder
symptoms
.
Six
themes
emerged
from the
qualitative
analysis
:
1)
stress
impacted
women’s
health
negatively
;
2)
the
various
stressors
in
women’s
lives
intersected
in
complex
ways
;
3)
childhood
socioeconomic
status
impacted
adult
stress
levels
and
health
;
4)
health
care
providers
played
a
clear
role
in
mitigating
or
exacerbating
mothers’
difficulties
;
5)
many
mothers
feel
isolated
and
alone
, and this
compounds
their
stress
tremendously
; and
6)
women
feel
that they
can
generally
find
information
and
resources
for
themselves
, but
most
identify
connecting
with
other
mothers
with
similar
lives
,
difficulties
, and
interests
as
important
to
reduce
the
impact
of
stress
.
Vulnerable
mothers
who
have
multiple
risk
categories
for
poor
maternal-child
outcomes
feel
that
stress
has a
substantial
impact
upon
their
health
.
Risk
factors
and
stressors
overlap
in
women’s
lives
substantially
, and the
intersectional
framework
is
a
useful
lens
for
examining
these
complex
relationships
.
Health
care
providers
can
be
extremely
important
in
addressing
stress
in
women’s
lives
;
adopting
the
trauma-informed
care
model
is
one
way
to
provide
the
empathetic
and
connected
care
that
vulnerable
women
need
from their
caregivers
. A
key
aspect
of this
model
is
the
facilitation
of
connections
between
women
,
which
was a
high
priority
for
mothers
in this
sample
. The
CenteringPregnancy
model
, a
model
for
group
prenatal
care
,
may
be
one
way
to
help
facilitate
such
connections
in the
health
care
setting
, and the
concept
was
appealing
to
mothers
interviewed
.
Future
research
is
needed
to
explore
the
impact
of
such
interventions
on
mothers’
health
outcomes
.
Language
eng
Type
Text
Format.Use
Needs Adobe Acrobat to view
Format.FileSize
1419452 Bytes
OCLC number
239609522
you wish to report:
Your comment:
Your Name:
Submit
Cancel
...
Back to top
Select the collections to add or remove from your search
A
B
C
D
E
F
G
H
I
J
K
L
M
N
O
P
Q
R
S
T
U
V
W
X
Y
Z
Select All Collections
B
Beauty of the PNW Collection
C
Campus Collection
Classic Article Collection
Clinical Outcomes Research Initiative (CORI)
CSETech
F
FDA Drug Approval Documents
N
Naturopathic Medicine Historical Collection
O
OHSU Historical Collections & Archives
OHSU Oral History Collection
ONPRC Collection
S
Student Scholar Archive
500
You have selected:
1
OK
Cancel