Background: Perinatal depression negatively affects maternal and child well-being. While socioeconomic status (SES) has been found to play a key role in mental health, the relationship between its various facets (i.e., employment, health insurance) and risk for PD remains understudied, particularly among diverse urban samples.

Methods: Electronic medical records data from 4,052 perinatal individuals (41.9% Black, 34.6% publicly insured, M_age=33.1 and SD=5.6) were collected. Depressive symptom severity was measured via the Edinburgh Postnatal Depression Scale (EPDS). Differences between those who were employed vs. unemployed and those with private vs. public health insurance were examined using bivariate and regression analyses.

Results: Unemployment was significantly associated with Black race, younger average age, and higher average total EPDS scores (p≤.001). Public health insurance utilization was significantly associated with Black and non-Hispanic race, younger average age, higher average total EPDS scores, and lifetime mood disorder (p<.001). Unadjusted individual regressions revealed that unemployment (B=1.73, SE=0.42, p<.001) and public health insurance utilization (B=1.56, SE=0.17, p<.001) were independently and significantly associated with higher EPDS scores. In the final adjusted model, unemployment (B=1.26, SE=0.50, p =.011) and lifetime mood disorder diagnosis (B=3.11, SE=0.47, p <.001) significantly predicted higher EPDS scores.

Conclusion: This study demonstrates that unemployment is associated with greater depressive symptoms among a diverse perinatal sample. Addressing structural and societal barriers to employment or access to health insurance has the potential to improve population-level perinatal mental health. Future research should investigate how other facets of SES (e.g., housing, neighborhood safety, access to prenatal care) compound PD risk.

Background: Childhood asthma, a significant public health issue disproportionately affecting underserved populations, leads to high morbidity and healthcare costs. School-based asthma therapy (SBAT) programs have demonstrated promise in improving asthma outcomes and reducing healthcare utilization. School nurses play a crucial role in delivering school-based health services and managing chronic conditions like asthma. This study explores the experiences of school nurses implementing SBAT.

Methods: This qualitative study gathered data from purposively sampled school nurses in two Ohio school districts from 2022 to 2024. Focus groups, conducted in person or via Zoom using open-ended questions including facilitators, barriers, and suggested program improvements. Thematic analysis, utilized by NVivo for data organization and coding, and XMind for concept mapping and visualization, identified key themes related to SBAT implementation.

Results: Eighteen female school nurses (11 White, 5 Black, 2 Hispanic/Latino) participated in this study. Focus groups revealed 18 themes related to in-school asthma management and SBAT participation, under 4 categories: (i) Education, (ii) Symptom Management, (iii) System Concerns, and (iv) Benefits/Reasons to Join. Key facilitators were increased education/resources and convenient medication delivery. Barriers included inconsistent care coordination, absent nurse leadership, and COVID-19 disruptions. Enhanced training was the primary improvement suggested.

Conclusions: The findings highlight key components for SBAT implementation, emphasizing the need for tailored education, effective symptom management, addressing systemic issues, and leveraging programs like SBAT to improve care and outcomes. These insights provide valuable implications for interventions, policies, and practices aimed at improving asthma management and outcomes for students with asthma within educational settings.

Background: In 2023, 17.9 % of households with children under 18 years were affected by food insecurity. This impedes child’s development due to lack of nutrition and increases the likelihood of mental health problems and learning disabilities. The effect of food insecurity on the mental health of children needs to be explored further. This study examines the impact of food insecurity on children’s mental health aged 0 to 17 years in the US.

Objectives: To assess the impact of food insecurity on self-reported mental health of children aged 0 to 17 years.

Methods: Using data from the 2022 National Survey of Children’s Health (N=54,103), adjusted odds ratios and 95% confidence intervals were calculated from multivariate logistic regressions using R.

Results: Children experiencing food insecurity were more likely to report mental problems than those with sufficient foods (33.0% vs. 24.4%, OR: 1.52, p<0.001). Those with food insecurity were also more likely to be enrolled in special education (19.6% vs. 9%, OR:2.46, p<0.001. Older children (6-11 years: OR = 0.39, p = 0.001; 12-17 years: OR = 0.33, p < 0.001) had lower odds of having mental problems compared to children aged 0 to 5 years. Family income status and racial/ethnical backgrounds were not statistically significant.

Conclusion: Food insecurity was significantly associated with mental health problems and enrollment in special education among children in the US. Advocating for policies that provide sufficient food to children can decrease the prevalence of these challenges, leading to a healthier start for children in America.

Background: Bullying is a significant public health issue, affecting mental health, social development, and academic outcomes. While research has focused on individual and school-based factors, the role of household composition in bullying behaviors is less explored. This study examines how different household structures (two-parent, single-parent, and grandparent-headed households) influence the likelihood of children bullying others and being bullied, with attention to gender, race, and number of children in the household.

Methods: Data from the 2021-2022 National Survey of Children’s Health (NSCH; n = 104,995) were used to assess associations between household composition and bullying behaviors among children aged 6–17. Logistic regression models controlled for race, gender, and household size, while examining effect modification by these factors.

Results: Children in single-parent (AOR = 1.3, 95% CI: 1.2–1.3) and grandparent-headed households (AOR = 1.5, 95% CI: 1.4–1.7) were more likely to engage in bullying. These children also had higher odds of being bullied (Single-parent: AOR = 1.1, 95% CI: 1.1–1.2; Grandparent-headed: AOR = 1.2, 95% CI: 1.1–1.3). Gender and race moderated these associations, with male and White children showing higher rates of bullying and victimization.

Conclusion: Household composition significantly influences bullying behaviors, particularly for children in non-traditional family structures. The findings highlight the need for family-based interventions and integrated anti-bullying strategies that address both family dynamics and demographic factors.

Background:

Childbirth is a significant life event where quality of care greatly impacts maternal well-being. However, disrespectful and abusive treatment during childbirth remains problematic in many healthcare settings, affecting women's experiences and satisfaction.

Objective:

To assess the perceptions of mothers on respectful maternity care during labor.

Methods:

This qualitative study used a descriptive phenomenological approach to examine mothers' experiences with respectful maternity care during childbirth at a secondary-level hospital in Kumasi, Ghana. Individual, face-to-face interviews were conducted with 12 purposively sampled mothers receiving antenatal and postnatal services, using a semi-structured interview guide in English. Data was analyzed through inductive thematic analysis using NVivo 20.0

Results:

Women viewed respectful maternity care as the absence of verbal abuse, consideration of their choices, concern for their well-being, and access to knowledgeable providers. The study revealed both positive experiences (friendly care, attention to needs) and negative ones (mistreatment, lack of informed consent, delayed care), which significantly influenced maternal satisfaction.

Conclusion:

The study emphasizes the importance of respectful maternity care in enhancing childbirth experiences and satisfaction. Healthcare providers need training in respectful communication and informed consent. Hospital management should increase maternity staffing and establish feedback mechanisms to ensure women's voices are heard.

Background

Despite global declines in maternal and infant mortality, significant disparities persist across Latin America. Understanding how social, environmental, and health factors influence these outcomes is critical for equity-driven intervention. This review synthesizes current evidence to analyze multilevel determinants associated with maternal and infant mortality in Latin America.

Methods

36 original studies were reviewed, reporting maternal mortality, infant mortality, low birth weight, preterm birth, and C-section rates across Latin America. Variables extracted included ethnicity, antenatal care (ANC) access, urban vs. rural residence, environmental exposures, education, and social marginalization. Independent t-tests analyzed associations between determinants and health outcomes.

Results

Maternal mortality was significantly higher in rural (150/100,000) compared to urban areas (20/100,000) (p=0.024), with infant mortality displaying a similar trend (24.3/1,000 vs. 9.4/1,000) (p=0.019). Surprisingly, maternal mortality was also higher among populations who received 4 ANC visits (220/100,000 vs. 30/100,000) (p=0.025), suggesting poor care quality or delayed care-seeking among high-risk populations. Notably, C-section rates were higher in urban areas (50.61% vs. 14.95%) (p < 0.0001), and among women with secondary education (45.37%) compared to those without (20%) (p=0.037). Preterm birth rates were also elevated in urban regions (12.97% vs. 5.56%) (p=0.022). Environmental exposures—ambient and indoor air pollution, pesticides, and heavy metals—were associated with higher low birth weight rates (10.3% vs. 4.6%) (p=0.048), highlighting the need for environmental risk reduction.

Conclusion

Multilevel social and systemic barriers continue to shape maternal and infant health in Latin America. Findings may inform future policy and interventions, speaking to present determinants and current gaps in resources.

Objectives: This study explored caregivers' perspectives on the effectiveness of a school-based asthma program (SBAT) in improving asthma management and quality of life for children with asthma.

Methods: A mixed-methods approach study integrated quantitative longitudinal survey and qualitative focus group data from 119 caregivers of SBAT-enrolled children. Quantitative measures included asthma-related quality of life (QoL), asthma illness representations, and self-reported healthcare utilization. Qualitative data were gathered through focus groups with caregivers (n=41) using semi-structured interview guides to provide deeper insights into their experiences and perceptions.

Results: Eighty-two percent of children were Black, 61% male, 89% poor, and had a mean age of 8 years. Quantitative findings revealed significant improvements in children's asthma-related QoL from baseline to the end of summer: activity limitations (p = .02), emotional functioning (p = .05), and overall QoL (p = .01). One caregiver stated, “You know, she's been able to perform in gym and play outside better.” Caregivers' perceptions of asthma symptoms and well-controlled asthma improved significantly by the end of the school year (p = .03 and 9% increase, respectively). Emergency department visits and hospitalizations decreased significantly (p = .005 and p = .04, respectively). Another caregiver reported “that was a genius idea, because it helped, she stopped being hospitalized after that.”

Conclusion: The SBAT program positively impacted children's asthma management and QoL, with caregivers reporting increased confidence and improved perceptions of asthma control. However, emotional and relational aspects of asthma care remain challenges, underscoring the need for continuous support and education for caregivers.

Background: Maternal and child health (MCH) home visiting programs support families through education, resources, and relationships. The demanding nature of this work can lead to burnout among home visitors. This longitudinal study examined the well-being of Florida Maternal, Infant, and Early Childhood Home Visiting (MIECHV) staff across three time points: 2016 (n=37), 2021 (n=171), and 2024 (n=62). Florida MIECHV serves over 2,500 families in 35 counties.

Methods: A repeated cross-sectional design assessed compassion satisfaction, burnout, and secondary traumatic stress using the Professional Quality of Life Scale. Contextual surveys captured information about respondents' professional experiences, including position, length of service, training, and specific job-related stressors. A one-way ANOVA with Tukey post hoc tests compared trends across years.

Results: Burnout levels showed a downward trend over time, remaining consistently low, while secondary traumatic stress remained low and stable across years. Compassion satisfaction increased significantly from 2016 to 2021 (p<0.001) and remained high through 2024 despite evolving challenges. In 2016, paperwork burdens and caseload management were prominent stressors associated with lower compassion satisfaction scores. By 2021, the COVID-19 pandemic introduced pressures such as transitioning to virtual visits; however, compassion satisfaction improved significantly during this period. In 2024, inflation-related family needs and inflexible schedules emerged as challenges.

Conclusions: Despite evolving challenges, home visitors demonstrated increasing compassion satisfaction and stable, lower levels of burnout and stress. Understanding trends in home visitors' well-being is essential for maintaining a stable, effective workforce and can inform policy decisions that support home visitors and the families they serve.

Background: Black and Hispanic women continue to experience the highest risks of adverse perinatal health outcomes due to systemic racism. It is unknown if these risks are increased among Black and Hispanic women with disabilities, who may experience additional barriers to perinatal healthcare.

Methods: We conducted a secondary analysis of Pregnancy Risk Assessment Monitoring System (PRAMS) data from Black and Hispanic participants between 2018-2019 (N=9,034). Maternal disability was the primary exposure measured using the Washington Group-Short Set of Questions on Functioning. Study outcome variables were small for gestational age, preterm birth, low birthweight, and attendance at a six-week postpartum visit. We employed multivariable logistic regression to estimate adjusted odds ratios (aOR) and 95% confidence intervals (CI).

Results: The prevalence of disability was 7.3%. Compared to participants without disabilities, participants with any disability were significantly less likely to have a small for gestational age infant (aOR=0.56, 95% CI=0.37, 0.86) and to attend a six-week postpartum visit (aOR=0.38, 95% CI=0.25, 0.57). There were no significant differences in preterm birth (aOR=1.18, 95% CI=0.80, 1.73) or low birthweight (aOR=1.11, 95% CI=0.80, 1.55). In subgroup analyses, disability was associated with a significantly lower odds of small for gestational age among Black participants (aOR=0.50, 95% CI=0.31, 0.81).

Conclusions: Maternal disability was associated with lower odds of having a small for gestational age infant and lower odds of attending the six-week postpartum visit. Understanding the contributors to these findings is warranted, including ways to improve postpartum healthcare delivery for Black and Hispanic women with disabilities.

Introduction. Skin-to-skin contact (SSC) immediately after birth, part of the Baby-Friendly Hospital Initiative, is a proven strategy for improving neonatal outcomes, infant survival rates, maternal bonds and healthy breastfeeding practices. Yet, its practice remains inconsistent (12% prevalence) in Nigeria. To the extent that ANC visits raise SSC awareness, urban-rural differences in ANC content and delivery in Nigerian may influence SSC utilization even where ANC use is adequate.

Objective. To assess association(s) between ANC adequacy and SSC in Nigeria, considering a key moderating factor (urban-rural differences).

Methods. Using Nigeria Demographic Health Survey (2018), ANC adequacy and SSC prevalence were estimated. Multiple logistic regression models assessed the association between ANC adequacy and SSC, and moderating effects of urban-rural disparities on the association.

Results. 71.04% and 87.99% of mothers fell short of adequate ANC use and skin-to-skin contact immediately after birth. Mothers who adequately used ANC had 2.77 higher odds (OR_adj = 2.77, 95% CI = 2.15 – 3.58) of applying SSC compared to those inadequately used ANC. This association varied by residence (p for interaction <.001), with stronger odds of SSC reported in urban areas (OR_adj = 3.61, 95% CI = 2.71 – 4.80) than in rural (OR_adj = 1.74, 95% CI = 1.02 – 2.97) areas.

Conclusion. Enhancing ANC adequacy by incorporating standardized SSC education sessions into ANC programs can advance SSC adoption among new/expectant Nigerian mothers. Integrating SSC training into rural midwifery and traditional birth attendants’ training programs can reduce knowledge gaps, promoting SSC discourse during ANC visits and post-delivery.