<p> The purpose of this project was to create a brochure based on current healthy pregnancy outcome recommendations with additional recommendations for reducing organophosphate (OP) pesticide exposure and promotion of nutrition quality of organic versus conventionally grown food. Specific objectives of the project were: (a) review the literature and depth of the problem, (b) review existing similar healthy pregnancy outcome educational material, (c) develop a brochure for the purpose of educating women of childbearing age and pregnant women about healthy pregnancy outcome recommendations, and (d) develop tools to measure learner comprehension of the information presented in the brochure, as well as obtain recommendations for improving the brochure. An expert panel reviewed the brochure and modifications were made based on their suggestions. Implementing the resulting evidence-based brochure could help increase healthy pregnancy outcomes and improve the overall health of women and children.</p>

<p> <b><u>Background:</u></b> Weight gained during childbearing has significant implications for maternal and child health. Both too much and too little weight gained during pregnancy can result in adverse outcomes. Recommendations for ideal gestational weight gain (GWG) have been developed by the Institute of Medicine, but achieving these standards remains a challenge. Better understanding of the wider context in which women experience pregnancy may aid in the development of novel interventions to improve trends in healthy GWG. Neighborhoods define one such dimension of women&rsquo;s wider context that is emerging as a promising factor in this area of research. However, limited work has considered long-term exposure to neighborhood environments or the role of women&rsquo;s perceptions of their neighborhood environments in relation to either inadequate or excessive GWG. </p><p> <b><u>Methods:</u></b> This dissertation explores the associations between long- and short-term exposure to neighborhood social and socioeconomic context and GWG using data from the 1979 National Longitudinal Survey of Youth. It additionally investigates associations between objective and perceived measures of neighborhood social context in relation to GWG. The first paper investigates associations between long-term, cumulative neighborhood socioeconomic deprivation and GWG. The second paper investigates associations between objectively measured and perceptions of point-in-time neighborhood social environment and GWG. Objective neighborhood social environment is measured using neighborhood socioeconomic deprivation. Perceived neighborhood social environment is assessed from women&rsquo;s self-report of problems within their neighborhood environment. The final paper in this dissertation conducts a systematic review of the literature to characterize the reporting error associated with use of self-reported, pregnancy-related weight in efforts to move the field toward developing bias correction techniques to address methodological limitations of this measure. While not directly related to understanding neighborhoods and GWG, this issue is relevant to future studies in this area that rely on self-reported weight. </p><p> <b><u>Conclusion:</u></b> The papers included in this dissertation illustrate the importance of considering both long-term and short-term measures of neighborhood social context in order to fully understand how neighborhood environments impact inadequate and excessive GWG. In particular, long-term measures of exposure to neighborhood environments should be more fully considered in order to better understand how neighborhoods can support healthy GWG. Interventions based on this improved knowledge of the environment in which women experience weight gain during pregnancy may improve GWG outcomes and health trajectories of both mother and child. Future studies in this area may also benefit from more rigorous study of variation of reporting error in self-reported pregnancy-related weight by maternal characteristics, which will aid in the development of bias correction techniques for these widely used measures.</p>

<p> <b>Background:</b> There have been significant gains in smoking cessation among pregnant women, but the rate of postpartum relapse remains high. Smoking is harmful to both the mother and child's health and women need to be educated about the risk of relapse and effective strategies to remain smoke free. The high rate of early postpartum relapse suggests that interventions must take place soon after delivery. Perinatal nurses are in the ideal position to begin the introduction of relapse prevention strategies, but many do not feel confident in providing these interventions. Despite evidence that nurses can be effective in providing tobacco counseling, few nurses actually follow through with recommended guidelines and assist and arrange follow up care. </p><p> <b>Methods:</b> A multi-site, interventional study was conducted using a pre-test/post-test design. A total of 162 perinatal nurses from four hospitals participated in a smoking cessation and relapse prevention counseling education program. Participants completed pre, post and one month follow up tests assessing perceived knowledge, attitude, self-efficacy, and behavior toward smoking cessation and relapse prevention counseling in the postpartum period. Descriptive statistics were used to characterize respondents; one way repeated ANOVAs were used to evaluate differences in scores on attitude, self-efficacy, knowledge and behavior. </p><p> <b>Results:</b> There was a significant increase in scores on knowledge, self-efficacy and behavior from pretest to follow up test. Although quitline referral scores increased from pre to follow-up test, the scores were very low. There were no significant differences in scores related to participant age, years of experience or level of education. OB nurses had significantly higher scores than neonatal nurses on all constructs. </p><p> <b>Conclusions/Implications:</b> Results indicate that a brief educational program is effective in increasing perinatal nurses' tobacco counseling knowledge, self-efficacy and behavior. Specific tobacco counseling educational programs for neonatal nurses need to be developed. Interventions are needed to increase nurses' quitline referrals for postpartum women at risk of smoking relapse.</p>

Thesis (M Nursing)--University of South Australia, 1997

Thesis (Ed.D.)--University of Tulsa, 1985. / Bibliography: leaves 77-85.

Thesis (Ed. D.)--Teachers College, Columbia University, 1986. / Typescript; issued also on microfilm. Sponsor: Valentina Harrell. Dissertation Committee: Barbara Stevens. Bibliography: leaves 86-88.

Thesis (Ed.D.) -- Teachers College, Columbia University, 1989. / Sponsor: Alice R. Rines. Dissertation Committee: Richard M. Wolf. Typescript; issued also on microfilm. Bibliography: leaves 126-127.

Thesis (Ed.D.)--Teachers College, Columbia University. / Typescript; issued also on microfilm. Includes tables. Sponsor: Eleanor Lambertsen. Dissertation Committee: Pauline Gratz, Kenneth Herrold, . Includes bibliographical references.

Thesis--New York University. / Includes bibliographical references (leaves 58-61).

Thesis--PlanB (M.S.)--University of Wisconsin--Stout, 1999. / Includes bibliographical references.