Library Bulletin - Journal Articles - February 2010
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PREGNANCY
GASTON, Anca and PRAPAVESSIS, Harry. Maternal-fetal disease information as a source of exercise motivation during pregnancy. Health Psychology Vol 28, No 6 - November 2009: 726-733
Abstract: Objective: A Protection Motivation Theory (PMT) framework was used to examine whether information about the role of exercise in preventing maternal-fetal disease served as a meaningful source of exercise motivation. Design: Pregnant women (n = 208) were randomly assigned into one of three conditions: PMT, attention control, and noncontact control. Women in the PMT group read a brochure about the benefits of exercise during pregnancy incorporating the major components of PMT; perceived vulnerability (PV), perceived severity (PS), response efficacy (RE), and self-efficacy (SE). Participants in the attention-control condition read a brochure about diet. Following treatment, all participants completed measures of their beliefs toward maternal-fetal disease and exercise, goal intention (GI), and implementation intention (IMI). One week later, a measure of self-reported exercise behavior was collected. Main Outcome Measures: Main outcome measures were PMT variables (PV, PS, RE, and SE), GI, IMI, and follow-up physical activity. Results: Participants assigned to the PMT-present group reported significantly higher PS, RE, SE, GI, and increased exercise behavior. PS, RE, and SE predicted GI, GI predicted IMI, and IMI predicted exercise behavior. Conclusion: Information grounded in PMT is effective in influencing pregnant women's beliefs and intentions as well as changing their initial behavior.
HARDEN, Angela and BRUNTON, Ginny and others. Teenage pregnancy and social disadvantage: systematic review integrating controlled trials and qualitative studies. British Medical Journal 21 November 2009: 1182-1185
Abstract: Objectives: To determine the impact on teenage pregnancy of interventions that address the social disadvantage associated with early parenthood and to assess the appropriateness of such interventions for young people in the United Kingdom. Design: Systematic review, including a statistical meta-analysis of controlled trials on interventions for early parenthood and a thematic synthesis of qualitative studies that investigated the views on early parenthood of young people living in the UK. Data sources: 12 electronic bibliographic databases, five key journals, reference lists of relevant studies, study authors, and experts in the field. Review methods: Two independent reviewers assessed the methodological quality of studies and abstracted data. Results: Ten controlled trials and five qualitative studies were included. Controlled trials evaluated either early childhood interventions or youth development programmes. The overall pooled effect size showed that teenage pregnancy rates were 39% lower among individuals receiving an intervention than in those receiving standard practice or no intervention (relative risk 0.61; 95% confidence interval 0.48 to 0.77). Three main themes associated with early parenthood emerged from the qualitative studies: dislike of school; poor material circumstances and unhappy childhood; and low expectations for the future. Comparison of these factors related to teenage pregnancy with the content of the programmes used in the controlled trials indicated that both early childhood interventions and youth development programmes are appropriate strategies for reducing unintended teenage pregnancies. The programmes aim to promote engagement with school through learning support, ameliorate unhappy childhood through guidance and social support, and raise aspirations through career development and work experience. However, none of these approaches directly tackles all the societal, community, and family level factors that influence young people’s routes to early parenthood. Conclusions: A small but reliable evidence base supports the effectiveness and appropriateness of early childhood interventions and youth development programmes for reducing unintended teenage pregnancy. Combining the findings from both controlled trials and qualitative studies provides a strong evidence base for informing effective public policy.
LOWRY, R J and BILLETT, A and others. Increasing breastfeeding and reducing smoking in pregnancy : a social marketing success improving life chances for children. Perspectives in Public Health Volume 129, No 6 - November 2009: 277-280
Abstract: Aims: The aim of this study is to evaluate an intervention using social marketing principles to increase breastfeeding and reduce smoking during pregnancy in a population to improve life chances for children born in a town in north east England. Method: Breastfeeding and smoking cessation attendance rates were measured against targets set in a government-local health authority agreement. Results: Targets were bettered in both breastfeeding and smoking cessation. Conclusion: This social marketing-based approach is successful.
REID, Bernie and SINCLAIR, Marlene and others. A meta-synthesis of pregnant women's decision-making processes with regard to antenatal screening for Down syndrome. Social Science and Medicine Vol 69, No 11 - December 2009: 1561-1573
Abstract: The diffusion of antenatal screening programmes for Down syndrome has triggered much discussion about their powerful potential to enhance pregnant women's autonomy and reproductive choices. Simultaneously, considerable debate has been engendered by concerns that such programmes may directly contribute to the emergence of new and complex ethical, legal and social dilemmas for women. Given such discussion and debate, an examination of women's decision-making within the context of antenatal screening for Down syndrome is timely. This paper aims to undertake a meta-synthesis of qualitative studies examining the factors influencing pregnant women's decisions to accept or decline antenatal screening for Down syndrome. The meta-synthesis aims to create more comprehensive understandings and to develop theory which might enable midwives and other healthcare professionals to better meet the needs of pregnant women as they make their screening decisions. Ten electronic health and social science databases were searched together with a hand-search of eleven journals for papers published in English between 1999 and 2008, using predefined search terms, inclusion and exclusion criteria, and a quality appraisal framework. Nine papers met the criteria for this meta-synthesis, providing an international perspective on pregnant women's decision-making. Twelve themes were identified by consensus and combined into five core concepts. These core concepts were: destination unknown; to choose or not to choose; risk is rarely pure and never simple; treading on dreams, and betwixt and between. A conceptual framework is proposed which incorporates these themes and core concepts, and provides a new insight into pregnant women's complex decision-making processes with regard to antenatal screening for Down syndrome. However, further research is necessary to determine whether or not the development of a model of decision-making may empower pregnant women in making choices about screening.
SMITH, Debbie Michelle and ROBERTS, Ron. Social acceptance: a possible mediator in the association between socio-economic deprivation and under-18 pregnancy rates? Journal of Youth Studies Vol 12, No 6 - December 2009: 669-683
Abstract: This study examines the social acceptance of young (under-18) pregnancy by assessing people's acceptance of young pregnancy and abortion in relation to deprivation. A cross-sectional survey design was conducted in two relatively affluent and two relatively deprived local authorities in London (n=570). Contrary to previous findings, participants were significantly more accepting of young pregnancy in the more affluent areas and if they were young parents. When controlling for other personal characteristics, only age remained significantly related to acceptance, and there was evidence of an interaction between level of area deprivation and age. The work supported previous findings, with people in more affluent areas being the most accepting of abortion. Age and ethnicity were significantly associated with acceptance of abortion after adjusting for level of area deprivation. An interaction effect between ethnicity and area deprivation was found. The importance of the psychosocial processes behind acceptance of young pregnancy was highlighted. Area deprivation does not have a uniform influence over people who vary in their personal characteristics. Young pregnancy prevention programmes and support groups for young parents must address the influence of social deprivation, age and ethnicity and how this affects the fabric of young people's lives.
TRIVEDI, D and BROOKS, F and others. Early fatherhood: a mapping of the evidence base relating to pregnancy prevention and parenting support. Health Education Research Vol 24, No 6 - December 2009: 999-1028
Abstract: Teenage pregnancy prevention programmes targeted at young women have received considerable attention from researchers and programme developers. However, to date, relatively limited information is available on preventing teenage fatherhood or improving outcomes for young fathers. A notable gap is concerned with understanding the forms of sexual health programmes that are most effective from the perspective of young men. We conducted a systematic mapping to identify studies involving young men aimed at preventing teenage pregnancy, improving outcomes for teenage fathers or exploring the perspectives of young men around pregnancy and fatherhood. We searched a wide range of electronic databases from January 1996 to August 2008. Three quantitative and 15 qualitative studies were identified, of which nine were UK based. Key themes related to the inappropriateness of current sexual health promotion to respond to the needs of young men. While young men often possessed very similar ideals to young women, existing programmes were problematic when they negatively stereotyped young men and ineffectively addressed models of masculinity or the difficulties young men may have forming meaningful relationships. Further investigations are required on programme development for young men, particularly on sexual health promotion interventions for ‘looked-after’ young men and those from unstable childhoods.