Programming of the stress response system during gestation has lifelong effects that put the infant at risk for multiple stress-related pathologies. Populations most vulnerable to prenatal stress are African-Americans and individuals of low socioeconomic status. The Pregnancy Risk Assessment Monitoring System (PRAMS) research project, a collaboration between the Centers for Disease Control and Prevention and individual state health departments, was employed for this study. Tennessee data from 2009 were compiled from individual birth certificates and PRAMS questionnaire responses to examine the influence of maternal stressors, race and low income on birth outcomes. The number of stressors was only a significant predictor of having an infant small for gestational age when moderated by Medicaid status. Medicaid status was a positive predictor of both problematic birth and preterm delivery, but did not predict small or large for gestational age. The relationship between race and birth outcomes overall was moderated by age, with young African-American mothers less likely than European-Americans and older African-American mothers to have adverse birth outcomes.
This article addresses the importance of breastfeeding for the social work profession. Because breastfeeding is a critical component of maternal and child health, persistent racial and socioeconomic breastfeeding inequality is a social justice issue in need of social work commitment. Even while breastfeeding rates have been increasing in the United States there are some groups of mothers who initiate breastfeeding less frequently or have trouble with sustaining breastfeeding for recommended lengths. These mothers and their babies thus miss out on the ample benefits of this nurturing interaction. Using social work's unique disciplinary perspective and commitment to social justice, the authors place essential understanding of breastfeeding health benefits within the core values of the National Association of Social Work ethical code. The practice context for early breastfeeding intervention with mothers and families is discussed with acknowledgment of the maternal-child health focus at the root of the profession. Recognition of the potential of contemporary social work to advance breastfeeding equity through practice, scholarship, and action positions breastfeeding support activities as integral to meeting the grand challenges of the social work profession.
The current study examined and compared the relative influence of ecological factors on youth antisocial behaviors (i.e., aggression and rule‐breaking) using longitudinal data while assessing the moderating effect of youth attention‐deficit/hyperactivity disorder (ADHD) diagnosis. The study used the fifth and sixth wave of data from the Fragile Families and Child Wellbeing Study (n = 2595; mean age = 9.26 at wave five) for the analysis. Multivariate models show that youth ADHD, physically and psychologically abusive parenting, peer victimization, and community cohesion were important predictors of youth antisocial behaviors. Furthermore, youth ADHD diagnosis moderated some associations between the ecological factors and antisocial behaviors, suggesting that youth with and without ADHD may respond to some ecological contexts differently regarding the concerning behaviors. The findings imply that interventions targeting youth antisocial behaviors should involve collaboration across systems and coordination across programs to tackle a multilayered ecological context, especially when youth with ADHD are involved.
Objective
To investigate the frequency and impact of contraceptive coercion in the Appalachian region of the United States.
Data Sources and Study Setting
In fall 2019, we collected primary survey data with participants in the Appalachian region.
Study Design
We conducted an online survey including patient‐centered measures of contraceptive care and behavior.
Data Collection/Extraction Methods
We used social media advertisements to recruit Appalachians of reproductive age who were assigned female at birth (N = 622). After exploring the frequency of upward coercion (pressure to use contraception) and downward coercion (pressure not to use contraception), we ran chi‐square and logistic regression analyses to explore the relationships between contraceptive coercion and preferred contraceptive use.
Principal Findings
Approximately one in four (23%, n = 143) participants reported that they were not using their preferred contraceptive method. More than one‐third of participants (37.0%, n = 230) reported ever experiencing coercion in their contraceptive care, with 15.8% reporting downward coercion and 29.6% reporting upward coercion. Chi‐square tests indicated that downward (χ2(1) = 23.337, p < 0.001) and upward coercion (χ2(1) = 24.481, p < 0.001) were both associated with a decreased likelihood of using the preferred contraceptive method. These relationships remained significant when controlling for sociodemographic factors in a logistic regression model (downward coercion: Marginal effect = −0.169, p = 0.001; upward coercion: Marginal effect = −0.121, p = 0.002).
Conclusions
This study utilized novel person‐centered measures to investigate contraceptive coercion in the Appalachian region. Findings highlight the negative impact of contraceptive coercion on patients' reproductive autonomy. Promoting contraceptive access, in Appalachia and beyond, requires comprehensive and unbiased contraceptive care.
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