185647 Improving birth and breastfeeding outcomes among urban, adolescent, African-American mothers

Tuesday, October 28, 2008

M. Christopher Gibbons, MD, MPH , Urban Health Institute, Johns Hopkins University, Baltimore, MD
Nadra C. Tyus, DrPH , Urban Health Institute, Johns Hopkins University, Baltimore, MD
Background: Pregnant, adolescent females are at increased risk for multiple health complications associated with pregnancy and delivery. In addition, significant disparities in preterm birth and breastfeeding rates exist between White and African-American, adolescent, pregnant mothers. In the US, approximately 12% of all deliveries are preterm. The rate of preterm births among African-Americans women is 17.8% . Very little community-based, interventional work has been done to reduce this disparity among this age group.

Methods: We designed a culturally and age appropriate, healthy pregnancy intervention targeting young (age < 20 years), African-American mothers. The intervention involved Community Health Workers delivering structured evidence-based educational content and social support over a 12-16 week period during pregnancy.

Results: To date, approximately 300 women have or are receiving the intervention. Of these young women, 174 have delivered their babies and completed the intervention. Four mothers had medication related post partum breastfeeding contraindications and five women had abortions. Two women suffered miscarriages. As such, 163 adolescent African-American, pregnant females received the breastfeeding intervention and delivered their babies. Of these remaining young women, only 5 (3%) delivered their babies preterm. As well, 115 (70.5%) reported initiating breastfeeding.

Conclusions: A Community Health Worker-led intervention model that provides evidence-based education and behavioral support may be an innovative and effective method to enhance maternity health services among urban, adolescent, African-American mothers. In addition, CHWs can play an instrumental role in reducing preterm births and enhancing breastfeeding rates of underserved populations.

Learning Objectives:
1) Identify a myriad of factors that are important for addressing birth outcomes and breastfeeding behaviors of urban, adolescent, African-American mothers 2) Discuss intervention methods that integrate CHWs into maternity health services 3) Outline educational and social support components that are essential to enhancing birth and nutritional outcomes of African-American infants.

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have published a book and manuscripts regarding health disparities and community health worker programs.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

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