Abstract
Japanese encephalitis vaccination in pregnancy among US active duty military women
Anna Bukowinski, MPH1, Zeina Khodr, PhD2, Richard Chang, MPH2, Gia Gumbs, MPH1, Ava Conlin, DO, MPH2 and Susan Farrish, MD, MPH2
(1)Naval Health Research Center (Leidos), San Diego, CA, (2)Naval Health Research Center (HJF), San Diego, CA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Japanese encephalitis (JE) is a flavivirus endemic to regions in Asia and the Western Pacific. JE vaccination (3-dose series ≤2011, 2-dose series ≥2009) is an inactivated vaccine required among US service members deployed to and stationed in JE endemic regions. The current JE vaccination formulation in the United States has been shown to be safe in pregnancy through animal models, but epidemiologic studies are lacking. We conducted a descriptive analysis to determine the prevalence of JE vaccination in pregnancy among active duty military mothers.
The study population included 163,596 pregnancies ending in live deliveries to military mothers from 2003–2014. Pregnancies were captured by the Department of Defense Birth and Infant Health Research program and linked to immunization records. Women who received JE vaccination in pregnancy were compared with those who did not. There were 446 mothers vaccinated in pregnancy: 415 in the first trimester and 31 in the second/third trimester. Of the mothers vaccinated in pregnancy, 231 (51.8%) received their first dose and 69 (15.5%) received >1 dose. Most mothers were vaccinated with the 3-dose (69.1%) versus 2-dose (30.9%) formulation. Vaccinated mothers were more likely to be younger, unmarried, in the Marines, enlisted rank, and in an occupation other than health care or combat. They were also more likely to have received other non-recommended vaccines in pregnancy.
Understanding characteristics of women who receive JE vaccination in pregnancy may help guide future policy. The increasing number of military women makes vaccine safety in pregnancy a priority for protecting military families.
Assessment of individual and community needs for health education Epidemiology Public health or related research
Abstract
Tracking and Addressing Preterm Birth and Low Birth Weight: An Evaluation of St. Louis Children’s Hospital's Raising St. Louis Program
Sarah Reinhold, MPH1 and Melody Schaeffer, MPH2
(1)St. Louis Children's Hospital, St. Louis, MO, (2)St. Louis, St. Louis, MO
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Preterm birth and low birth weight (LBW) remains the major cause of mortality in newborn infants. Disparities exist in vulnerable populations including African Americans and those with low socioeconomic status. St. Louis Children’s Hospital’s provides Raising St. Louis (RSTL), a home visitation program beginning in pregnancy until the child reaches 5. The program is designed to improve birth outcomes, track child development and provide social services and resources.
RSTL is evaluated through a mixed-methods approach, tracking the number of participants, birth outcomes, and behavioral information.
Since inception in 2014, 367 babies have been born into the program; 89.4% babies are black. Preterm birth and LBW had a statistically significant relationship. 15.5% were born with a LBW (<5 lbs 0 oz) and 25.6% were born preterm (<37 weeks of gestation). Additionally, race had statistically significant relationships with LBW and preterm births. A sample of 63 births in 2017 were analyzed. Risk factors with statistical significance related to preterm births include reported drug use during pregnancy (55.6% born premature), reported smoking during pregnancy (75.0% born premature), and age of mother (57.1% born premature). Risk factors with statistical significance related to LBW include reported drug use during pregnancy (55.6% wit LBW), and reported smoking during pregnancy (75.0% with LBW). Identifying risk factors in pregnant clients can prompt staff to provide extra counseling to improve birth outcomes.
Raising St. Louis focuses on improving the well-being of mothers, infant and children by tracking and improving birth outcomes for vulnerable populations in the St. Louis area.
Administer health education strategies, interventions and programs Advocacy for health and health education Conduct evaluation related to programs, research, and other areas of practice Epidemiology
Abstract
Teen drivers' cellphone use while driving: Results from a representative sample of students in Puerto Rico
Linnette Rodriguez-Figueroa, MS, PhD1, Juan C. Reyes-Pulliza, EdD1, Margarita R. Moscoso-Alvarez, PhD2 and Hector Coln, PhD1
(1)University of Puerto Rico, Graduate School of Public Health, San Juan, PR, Puerto Rico, (2)University of Puerto Rico, Rio Piedras Campus, San Juan, PR, Puerto Rico
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Making cellphone calls and texting can distract a driver and increase their risk of accidents. Little is known about distracted phone use practices among Hispanic teens. The aim of this study was to estimate the prevalence of cellphone use while driving among adolescents in Puerto Rico by gender and age, and its association with other risky behaviors in this population. The sample in this island-wide school-based cross-sectional survey was selected using a multi-stage stratified cluster sampling design, and was representative of all 7th-12th grade students in PR. Only data from students age 16 or older was evaluated (n=1,641). Data was collected using a pre-coded self-administered questionnaire. Proportions were compared using chi-square tests. Odds ratios were also computed. All analyses were performed on weighted data. Approximately 32% of the students reported cellphone use while driving in the last year, most of which had both texted and dialed a phone call. Prevalence was higher among males (41%) and older students (44%). Students aged 17-18 were two times more likely to text (OR=1.95;95%CI=1.54-2.46) and three times more likely to make a call (OR=3.12;95%CI=2.49-3.91) while driving than those aged 16. Males were two times more likely to text (OR=2.30;95%CI=1.81-2.92) and to make a call (OR=2.05;95%CI=1.64-2.56) than females. Teens who used cellphones while driving were also more likely to engage in other risky behaviors such as substance use (cigarette, alcohol, illicit drugs) and sexual activity. Education programs geared towards adolescents that emphasize the dangers of distracted driving should be targeted to these high risk groups.
Administer health education strategies, interventions and programs Epidemiology Other professions or practice related to public health Public health or related research Social and behavioral sciences
Abstract
Trends in Gestational Weight Gain in South Carolina, 2004 - 2015
Marilyn Wende, BS, MSPH1, Jihong Liu, ScD1, Alexander McLain, Ph.D.2 and Sara Wilcox, PhD1
(1)University of South Carolina, Columbia, SC, (2)Epidemiology and Biostatistics, Columbia, SC
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Objective: To examine secular trends in gestational weight gain (GWG) in South Carolina (SC) from 2004 to 2015. Consistent with the increasing trend in pre-pregnancy obesity in the U.S, we hypothesize to observe a similar increasing trend in GWG z-scores (GWGZ) over the decade and the trend would vary by GWGZ percentiles, racial groups and by pre-pregnancy BMI status.
Methods: Data came from SC 2004-2015 birth certificates (n = 525,411). We calculated standardized GWGZ, using smoothed reference values for GWG to account for gestational age and pre-pregnancy BMI. We used quantile regression to examine trends in GWGZ percentiles, adjusting for population characteristic changes.
Results: From 2004-2015, SC women experienced a 0.17 GWGZ increase. At the 5th percentile, overall GWGZ increased by 0.67 and the positive increase in GWGZ was also seen in White (0.57), African American (0.28), normal weight (0.57), overweight (0.68) and obese class I (0.21) women. Underweight women showed modest decreases (-0.05) in GWG Z at the 5th percentile. Overall, modest decreases in GWGZ (-0.07) for the 95th percentile was observed. The decrease was also observed in white women (-0.08), African Americans (-0.02), underweight (-0.09), and normal weight (-0.07) women. Only Hispanic women showed an increase in GWGZ (0.02) at the 95th percentile.
Significance: This study found an increasing trend in GWGZ in SC. These trends are promising, since increases mainly occurred in lower GWG groups (5th percentile) while decreases occurred in those with the highest GWG (95th percentile). However, Hispanic women experienced an unfavorable trend.
Epidemiology Public health or related research
Abstract
Association between in-utero exposure to Maternal smoking and subsequent orofacial clefts in the infant
Bosky Soni
University of Illinois at Urbana Champaign, Champaign, IL
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: One of the greatest risk factors for non-chromosomal defects in a fetus is maternal smoking. Oral clefts are one of the most common birth defects associated with intrauterine smoke exposure. The potential association between pregnant women smoking during three trimesters and infants presenting with orofacial clefts was analyzed.
Method: This data were collected from the natality data of the National Vital Statistics System which contains demographics on 99.53% of births from 50 states in the United States. The sample consisted of approximately 3.98 million births that occurred in year 2015.
Study design: This cross-sectional study focused on maternal smoking prior to and during all 3 trimesters of pregnancy, as well as smoking only during first trimester, smoking in first and second trimesters, and resulting orofacial cleft birth defects in newborn babies. Statistical analysis was conducted using chi-
squares and logistic regression.
Result: Mothers who smoked cigarettes before and during all 3 trimesters of pregnancy had a 31% higher chance of having a child with cleft lip/palate defect (OR = 1.31, 95% CI 1.132-1.513) while adjusting for mother’s age, education, prenatal care, race, marital status, gestational diabetes and hypertension status.
Conclusion: Because of the relationship between maternal smoking and risk of cleft lip/palate defects, it is extremely important to educate women on the benefits of smoking cessation before, during, and after pregnancy. This study supports a need for more interventions and campaigns to help with curbing of this toxic behavior.
Administer health education strategies, interventions and programs Biostatistics, economics Epidemiology
Abstract
Advancing Diversity and Health Equity through MCH Training Programs
Michelle Tissue, MPH1, Cheryl Altice, MPH1, Samantha Croffut, MPH, RDN2, Madhavi M. Reddy, MSPH1 and Hae Young Park, MPH1
(1)Health Resources and Services Administration, Maternal and Child Health Bureau, Rockville, MD, (2)Health Resources and Services Administration, Rockville, MD
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
This session will examine the success of HRSA’s Maternal and Child Health (MCH) Training Program in advancing diversity and health equity by developing a MCH workforce that is culturally and linguistically competent and reflects the racial and ethnic diversity of the nation. Secondary data analysis of performance measure data (2010 to 2015) collected through the discretionary grant information system was performed. Outcomes of interest included: (1) percentage of long-term trainees and faculty from an underrepresented racial or ethnic group; (2) percentage of long-term trainees from an underrepresented racial or ethnic group, by discipline; and (3) percentage of trainees from Pipeline and MCH Public Health Catalyst Programs from an underrepresented racial or ethnic group. Over six years, program efforts have led to an increase in trainees from underrepresented racial and ethnic groups (19.3% to 25.8% and 7.2% to 9.1%, respectively) and an increase in faculty from underrepresented racial and ethnic groups (11.4% to 15.4% and 5.1% to 6.2%, respectively) across all programs. Percentage of diverse long-term trainees in nursing, psychology, public health, and social work also increased. In two MCH Training Programs with an emphasis on recruitment of underrepresented trainees (Pipeline and Catalyst Programs), over 50% of trainees are from an underrepresented racial or ethnic group. The MCH Training Program has advanced health equity through the recruitment of diverse faculty and students, inclusion of cultural and linguistic competence and family-centered care in curriculum, and integration of health equity principles in resources and training for future MCH leaders and practicing MCH professionals.
Advocacy for health and health education Diversity and culture Planning of health education strategies, interventions, and programs
Abstract
Assessing worry regarding Zika virus infection in South Carolina: A 2016 Pregnancy Risk Assessment Monitoring System analysis
Chelsea Richard, MSPH, PhD(c)1, Kristin Simpson, MSW, MPA2, Harley Davis, MSPH, PhD1 and Sabrina Karim, MBBS, MPH, PhD(c)3
(1)South Carolina Department of Health and Environmental Control, Columbia, SC, (2)S.C. Dept. of Health & Environmental Control, Columbia, SC, (3)University of South Carolina, Columbia, SC
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Objectives/Background: A Zika supplement was added to the Pregnancy Risk Assessment Monitoring System (PRAMS) questionnaire beginning in July 2016 in South Carolina (SC). PRAMS is a survey of women who have recently given birth. The supplement included questions regarding knowledge, receipt of a blood test, any travel by the mom or her husband/male partner outside of the US, and condom use surrounding the Zika outbreak. The objective of the current study was to examine risk perceptions of Zika for women who gave birth from April to August 2016.
Methods: Preliminary supplemental data on level of worry about Zika infection were obtained from SC mothers that completed the PRAMS survey between July and November 2016 (n = 238; weighted N = 22,272). Survey analysis methods were used in SAS 9.4 to obtain prevalence estimates and 95% confidence intervals (CIs).
Results: Approximately 21.2% (95% CI: 12.3-30.2) of women reported that they were “very worried” about getting infected with Zika virus during their most recent pregnancy; while, approximately 11.3% (95% CI: 3.7-18.9) reported that they had never heard of Zika.
Conclusions: Overall, the majority of women had heard of the Zika virus but had varying levels of worry about being infected. These preliminary findings demonstrate that the outreach and communication efforts of DHEC were effective and reached their intended audience. When more data become available, we will investigate if there were any demographic differences in the different levels of worry.
Epidemiology Public health or related research
Abstract
Inequities in Prevalence of Depression and Substance Use Among New England Youth
Rodrigo Monterrey, MPA1, Charles Drum, MPA, JD, PhD2, Kimberly Phillips, PhD3 and Sara Rainer3
(1)MA DPH, Boston, MA, (2)American Association on Health and Disability, Rockville, MD, (3)University of New Hampshire, Durham, NH
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Issue: Often, people who are White experience better health compared to racial and ethnic minority groups, even though neither race nor ethnicity are genetic predispositions for poor health outcomes. Similarly, people without disabilities often experience better health than people with disabilities, even though disability is not equivalent to poor health. These health inequities are also evident among high school-aged youth.
Description: Members of the New England Regional Health Equity Council worked together to develop a data report and call to action based on regional analyses from the 2015 Youth Risk Behavior Surveillance System (YRBS). The sample included youth grades 9 through 12 in the five New England states. Results showed statistically significant differences in indicators of depression and substance use by race, ethnicity, and disability status.
Lessons Learned: YRBS is a promising source for performing regional health surveillance on high school-aged youth from minority racial / ethnic groups. Information about disability status is more limited. Reducing health inequities among minority youth requires a collaborative effort across stakeholders, including public health professionals, health care providers, researchers, policymakers, educators, program managers, and the general public. These findings can be used to raise awareness and understanding of youth who are most vulnerable, and foster greater dialogue and collaboration to address health inequities in New England and other regions.
Advocacy for health and health education Diversity and culture Planning of health education strategies, interventions, and programs
Abstract
Injuries, Violence, and Bullying Among Middle School Students in Oman
Richard Peyton, MPH1, Kathryn Jacobsen, PhD, MPH2 and Shamika Ranasinghe, MS2
(1)American Academy of Pediatrics, Itasca, IL, (2)George Mason University, Fairfax, VA
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Injuries account for a substantial proportion of the burden of disease in adolescents globally. This paper describes injury rates and associated exposures, and risk behaviors in Oman’s 2010 Global School-based Student Health Survey (GSHS).
This study used complex samples analysis to examine nationally-representative data from 1,606 students who participated in the 2010 Oman GSHS.
In total, 34.0% of the students reported having at least one injury in the past year that caused at least one day activities or required medical treatment. The most common injury was broken bones or dislocated joint. The most common injury cause was falling. 38.4% of students reported being bullied in the previous month, 38.8% reported being physically attacked in the previous year, and 47.6% reported being in physical fights. Both injured boys and girls reported experiencing significantly more bullying, fights, and attacks than their non-injured classmates, even though only 9.6% of injured students reported that their most serious injury in the past year was the result of an assault, and students reporting assaults did not have significantly higher odds of exposure to these types of peer violence. More than half of the bullied students reported that the most frequent type of peer victimization they experienced was being made fun of with sexual jokes, comments, or gestures. Sexual bullying was the most common type of bullying reported by girls and boys.
Promoting healthier peer relationships may help to reduce injuries in this age group as well as reducing the harmful effects of bullying.
Diversity and culture Epidemiology Public health or related public policy Social and behavioral sciences
Abstract
Maternal Preconception Health and Neighborhood Factors in Relation to Preterm Birth in Georgia, 2012-2014
Michelle Livings, MPH1, Betty Lai, PhD1, Michelle D'Amico2 and Philip Hudson2
(1)Georgia State University, Atlanta, GA, (2)Georgia State University
APHA's 2018 Annual Meeting & Expo (Nov. 10 - Nov. 14)
Background: Previous research has explored the relationships between (1) neighborhood factors and maternal preconception health and (2) maternal preconception health and preterm birth. Determining how maternal preconception health and neighborhood factors simultaneously contribute to preterm birth will help researchers and clinicians better understand and address the complex risk factors of preterm birth.
Methods: Data were collected during 2012-2014 in the Georgia Pregnancy Risk Assessment Monitoring System. Data were geocoded by census tract to American Community Survey 2011-2015 5-year estimates (n=2962). Descriptive statistics were calculated. Effects of maternal preconception health and neighborhood factors on preterm birth were analyzed using hierarchical generalized linear modeling (SAS PROC GLIMMIX).
Results: From 2012-2014, about 9.38% of Georgia moms gave birth to a preterm infant. Considering cross-level interactions, for women who reported recently dieting and lived in census tracts with 1% more crowded households than average, the estimated odds of preterm birth were 0.83 times the estimated odds for the average interaction (95% CI 0.81-0.85). For women with a pre-pregnancy chronic disease who lived in rural counties, the estimated odds of preterm birth were 1.35 times the estimated odds for the average interaction (95% CI 1.17-1.57).
Conclusions: Maternal preconception health and neighborhood factors were simultaneously significantly associated with preterm birth, demonstrating the complexity of risk factors associated with preterm birth. Programs to promote healthy weight management and exercise before pregnancy and to ensure adequate access to prenatal care in rural counties could improve maternal preconception health and decrease preterm births.
Biostatistics, economics Epidemiology Public health or related research