Publications by authors named "Ruth Petersen"

37 Publications

Setting the Stage for Reimbursable Pediatric Healthy Weight Programs.

Child Obes 2021 09;17(S1):S1-S2

Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, GA, USA.

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http://dx.doi.org/10.1089/chi.2021.29012DOI Listing
September 2021

COVID-19 and Chronic Disease: The Impact Now and in the Future.

Prev Chronic Dis 2021 06 17;18:E62. Epub 2021 Jun 17.

National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.

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http://dx.doi.org/10.5888/pcd18.210086DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8220960PMC
June 2021

Changes in High Weight-for-Length among Infants Enrolled in Special Supplemental Nutrition Program for Women, Infants, and Children during 2010-2018.

Child Obes 2021 09 6;17(6):408-419. Epub 2021 May 6.

Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA, USA.

Infants and young children with high weight-for-length are at increased risk for obesity in later life. This study describes prevalence of high weight-for-length and examines changes during 2010-2018 among 11,366,755 infants and young children 3-23 months of age in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). Children's weights and lengths were measured. High weight-for-length was defined as ≥2 standard deviations above sex and age-specific median on World Health Organization growth charts. Adjusted prevalence differences (APDs) between years were calculated as 100 times marginal effects from logistic regression models. APD was statistically significant if 95% confidence interval did not include 0. Adjusted prevalence of high weight-for-length decreased from 2010 to 2014, and leveled off through 2018 overall, in boys and girls, those 6-11 and 18-23 months of age, and non-Hispanic whites, non-Hispanic blacks, Hispanics, and Asians/Pacific Islanders. For 12-17 months old and American Indian/Alaska Native infants and young children, adjusted prevalence decreased from 2010 to 2014, and then increased slightly through 2018. Among 56 WIC state or territorial agencies, 33 had significant decreases between 2010 and 2018, whereas 8 had significant increases. Between 2014 and 2018, prevalence decreased significantly in 12 agencies and increased significantly in 23. The results indicate overall declines in prevalence of high weight-for-length from 2010 to 2018, with a prevalence stabilization since 2014. Continued surveillance is needed. Obesity prevention strategies in WIC and multiple settings are important for ensuring healthy child growth.
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http://dx.doi.org/10.1089/chi.2021.0055DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8554792PMC
September 2021

State-Specific Prevalence of Obesity Among Children Aged 2-4 Years Enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children - United States, 2010-2016.

MMWR Morb Mortal Wkly Rep 2019 Nov 22;68(46):1057-1061. Epub 2019 Nov 22.

Obesity negatively affects children's health because of its associations with cardiovascular disease risk factors, type 2 diabetes, asthma, fatty liver disease, victimization stemming from social stigma and bullying, and poor mental health (e.g., anxiety and depression) (1). Children who have overweight or obesity in early childhood are approximately four times as likely to have overweight or obesity in young adulthood as their normal weight peers (2). Obesity prevalence is especially high among children from low-income families (3). In 2010, the overall upward trend in obesity prevalence turned downward among children aged 2-4 years enrolled in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), a program of the U.S. Department of Agriculture (USDA); prevalence decreased significantly in all racial/ethnic groups and in 34 of the 56 WIC state or territory agencies during 2010-2014 (4). A more recent study among young children enrolled in WIC reported that the overall obesity prevalence decreased from 15.9% in 2010 to 13.9% in 2016 and statistically significant decreases were observed in all age, sex, and racial/ethnic subgroups (3). However, this study did not provide obesity trends at the state level. In collaboration with USDA, CDC used data from the WIC Participant and Program Characteristics (WIC PC) to update state-specific trends through 2016. During 2010-2016, modest but statistically significant decreases in obesity prevalence among children aged 2-4 years enrolled in WIC occurred in 41 (73%) of 56 WIC state or territory agencies. Comprehensive approaches that create positive changes to promote healthy eating and physical activity for young children from all income levels,* strengthen nutrition education and breastfeeding support among young children enrolled in WIC, and encourage redemptions of healthy foods in WIC food packages could help maintain or accelerate these declining trends.
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http://dx.doi.org/10.15585/mmwr.mm6846a3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6871901PMC
November 2019

Trends in Meeting Physical Activity Guidelines Among Urban and Rural Dwelling Adults - United States, 2008-2017.

MMWR Morb Mortal Wkly Rep 2019 Jun 14;68(23):513-518. Epub 2019 Jun 14.

Division of Nutrition, Physical Activity and Obesity, National Center for Chronic Disease Prevention and Health Promotion, CDC.

Since the release of the 2008 Physical Activity Guidelines for Americans (https://health.gov/paguidelines/2008/pdf/paguide.pdf), the age-adjusted percentage of adults meeting the combined aerobic and muscle-strengthening guidelines increased from 18.2% to 24.3% in 2017 (1). Trends in urban and rural areas, across demographic subgroups, and among subgroups within urban and rural areas have not been reported. CDC analyzed 2008-2017 National Health Interview Survey (NHIS) data to examine trends in the age-standardized prevalence of meeting physical activity guidelines among adults aged ≥18 years living in urban and rural areas. Among urban and rural residents, prevalence increased from 19.4% to 25.3% and from 13.3% to 19.6%, respectively. Nationally, all demographic subgroups and regions experienced increases over this period; increases for several groups were not consistent year-to-year. Among urban residents, the prevalence was higher during 2016-2017 than during 2008-2009 for all demographic subgroups and regions. During the same period, prevalence was higher across all rural-dwelling subgroups except Hispanics, adults with a college education, and those living in the South U.S. Census region. Urban and rural communities can implement evidence-based approaches, including improved community design, improved access to indoor and outdoor recreation facilities, social support programs, and community-wide campaigns to make physical activity the safe and easy choice for persons of all ages and abilities (2-4). Incorporating culturally appropriate strategies into local programs might help address differences across subgroups.
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http://dx.doi.org/10.15585/mmwr.mm6823a1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6613551PMC
June 2019

Racial and Ethnic Disparities in Adult Obesity in the United States: CDC's Tracking to Inform State and Local Action.

Prev Chronic Dis 2019 Apr 11;16:E46. Epub 2019 Apr 11.

National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia.

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http://dx.doi.org/10.5888/pcd16.180579DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6464044PMC
April 2019

Addressing Childhood Obesity for Type 2 Diabetes Prevention: Challenges and Opportunities.

Diabetes Spectr 2018 Nov;31(4):330-335

Division of Nutrition, Physical Activity, and Obesity, Centers for Disease Control and Prevention, Atlanta, GA.

Addressing the problem of childhood obesity is an important component of preventing type 2 diabetes. Although children and their families ultimately make decisions about diet, physical activity, and obesity management, many groups have a role in making these choices easier. They do this by providing families with tools and resources and by implementing policies and practices that support a healthy diet and physical activity in the places where children and their families spend their time. Diabetes educators are an important part of the solution.
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http://dx.doi.org/10.2337/ds18-0017DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6243220PMC
November 2018

Ten Years of Breastfeeding Progress: The Role and Contributions of the Centers for Disease Control and Prevention and Our Partners.

Breastfeed Med 2018 10;13(8):529-531

Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC) , Atlanta, Georgia .

For most infants, there is no better source of nutrition than breast milk. Breastfeeding is more than a lifestyle choice; it is an investment in the health of mothers and babies. Over the past 10 years, efforts from multiple sectors have contributed to significant increases in breastfeeding initiation and duration. This report summarizes progress, initiatives that contributed to this success, and areas where more work is needed.
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http://dx.doi.org/10.1089/bfm.2018.0116DOI Listing
October 2018

CDC's Active People, Healthy Nation: Creating an Active America, Together.

J Phys Act Health 2018 07 22;15(7):469-473. Epub 2018 Jun 22.

Physical activity can reduce the risk of at least 20 chronic diseases and conditions and provide effective treatment for many of these conditions. Yet, physical activity levels of Americans remain low, with only small improvements over 20 years. The Centers for Disease Control and Prevention (CDC) considered what would accelerate progress and, as a result, developed Active People, Healthy Nation, an aspirational initiative to improve physical activity in 2.5 million high school youth and 25 million adults, doubling the 10-year improvement targets of Healthy People 2020. Active People, Healthy Nation will implement evidence-based guidance to improve physical activity through 5 action steps centered on core public health functions: (1) program delivery, (2) partnership mobilization, (3) effective communication, (4) cross-sectoral training, and (5) continuous monitoring and evaluation. To achieve wide-scale impact, Active People, Healthy Nation will need broad engagement from a variety of sectors working together to coordinate activities and initiatives.
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http://dx.doi.org/10.1123/jpah.2018-0249DOI Listing
July 2018

A 2017 Update: Centers for Disease Control and Prevention's Contributions and Investments in Breastfeeding.

Authors:
Ruth Petersen

Breastfeed Med 2017 10 17;12(8):465-467. Epub 2017 Aug 17.

Director, Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention (CDC) , Atlanta, Georgia .

Given that breastfeeding is important to the health of infants and their mothers, the Centers for Disease Control and Prevention's (CDC) goal is to ensure that new mothers understand the benefits of breastfeeding and, when they choose to breastfeed, have the supports they need to successfully initiate and continue breastfeeding until they reach their goals. This report summarizes CDC's current contributions and investments in breastfeeding.
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http://dx.doi.org/10.1089/bfm.2017.0093DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6402809PMC
October 2017

Improving Population Health by Incorporating Chronic Disease and Injury Prevention Into Value-Based Care Models.

N C Med J 2016 Jul-Aug;77(4):257-60

program manager, Chronic Disease and Injury Section, North Carolina Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina.

Today's health system transformation provides a prime opportunity to leverage the capacity of public health to reduce the burden of chronic disease and injury, improve population health, and contain health care costs. Health care settings and organizations should support public health capacity as a key investment in population health.
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http://dx.doi.org/10.18043/ncm.77.4.257DOI Listing
September 2016

Community Health Workers: An Integral Part of an Integrated Health Care Team.

N C Med J 2016 Mar-Apr;77(2):129-30

section chief, North Carolina Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina.

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http://dx.doi.org/10.18043/ncm.77.2.129DOI Listing
May 2016

It takes a community: The North Carolina Division of Public Health and the North Carolina area health education center program partner to reduce strokes and heart attacks.

N C Med J 2012 Nov-Dec;73(6):469-75

Division of General Internal Medicine and Clinical Epidemiology, School of Medicine, University of North Carolina at Chapel Hill, USA.

The North Carolina Division of Public Health is leading a statewide project using a combination of approaches to address cardiovascular risk factors including obesity, hypertension, diabetes, and cigarette smoking. The objectives are to decrease tobacco use, increase physical activity, improve nutrition, and increase access to evidence-based clinical preventive services targeting hypertension, hypercholestrolemia, tobacco use, and weight management.
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August 2013

Shape your world.

N C Med J 2012 Jul-Aug;73(4):289

Physical Activity and Nutrition Branch, NC Department of Health and Human Services, 5505 Six Forks Rd, Raleigh, NC 27699, USA.

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November 2012

The North Carolina Division of Public Health's vision for healthy and sustainable communities.

N C Med J 2012 Jul-Aug;73(4):286-9

Physical Activity and Nutrition Branch, Division of Public Health, NC Department of Health and Human Services, Raleigh, NC 27699, USA.

The North Carolina Division of Public Health is working to improve access to physical activity through changes in the built environment by participating in the Healthy Environments Collaborative and by leading the state's Communities Putting Prevention to Work project and the Shape Your World movement.
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November 2012

Forging new partnerships to build healthier communities for a healthier state.

N C Med J 2012 Jul-Aug;73(4):270-3

Division of Public Health, North Carolina Department of Health and Human Services, Raleigh, North Carolina, USA.

Building healthy communities is critical to reducing the rates of chronic diseases impacting millions of North Carolinians. In 2011, North Carolina's overall health status ranking was 32nd in the nation (with 1 being the best). It is well recognized that health is impacted by a variety of individual, social, environmental, and economic factors, which are complex, interrelated, and influenced by a variety of other factors. Creating healthy communities provides options for people to make health-promoting choices. Such communities include transportation alternatives, access to healthy foods and places to be active, opportunities for economic growth and education, and clean air and water. Creating communities that provide these types of options requires the work of different sectors, many of which may not have health as their main mission, such as those that focus on commerce, planning, transportation, and environmental and natural resources. This article outlines the need for healthier communities and highlights the innovative partnerships and work being done by individuals and agencies at the state, local, and national levels to build healthier communities across North Carolina.
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November 2012

The health and economic burden of chronic diseases in North Carolina.

N C Med J 2010 Jan-Feb;71(1):92-5

Centers for Disease Control and Prevention, Chronic Disease and Injury Section, North Carolina of Public Health, USA.

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June 2010

Effects of an incentive-based online physical activity intervention on health care costs.

J Occup Environ Med 2008 Nov;50(11):1209-15

Division of Kinesiology, University of Michigan Health Management Research Center, Ann Arbor, Mich 48104-1689, USA.

Objective: To test whether participation in an incentive-based online physical activity program for employees was associated with a moderation in health care costs.

Methods: Health care claims trends from 2003 to 2005 were analyzed among a matched sample of participants and nonparticipants. Medical and pharmacy costs, hospital inpatient costs, and emergency room costs were examined.

Results: The average annual health care costs for participants increased by $291 per year compared with an increase of $360 for nonparticipants (P = 0.09). Higher levels of participation were associated with smaller increases in health care costs. Participants had a significantly smaller increase in inpatient hospital costs (+$20 vs +$119), heart disease costs ($-8 vs $46), and diabetic costs (+$1 vs +$16) compared with nonparticipants.

Conclusions: Participation in an online employee physical activity intervention was associated with smaller increases in health care costs compared to nonparticipants.
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http://dx.doi.org/10.1097/JOM.0b013e31818dc438DOI Listing
November 2008

Effectiveness of employee internet-based weight management program.

J Occup Environ Med 2008 Feb;50(2):163-71

Analysts International and UNC School of Public Health, Chapel Hill, NC, USA.

Objective: To evaluate an employee Internet-based weight management program.

Methods: Changes in eating habits, stage of change, body weight, and weight categories were compared between enrollment and 6 months after enrollment. Weights and weight categories were compared among a subset of participants and non-participants at 12 months.

Results: Seven thousand seven hundred forty-three International Business Machines employees enrolled in the program between December 2004 and February 2006, and 74% were overweight or obese (body mass index > or =25). At 6 months, follow-up survey respondents (1639) had significantly increased most healthy eating habits (eg, 20% decrease in junk foods) and the frequency of healthy foods eaten (eg, 12% increase in fruits). The percentage of participants in the normal weight category had increased from 27.0% to 29.8%, while average weight decreased from 182.6 to 180.2 lbs (P < 0.05). Increased web site usage was associated with increased weight loss and stage of change improvements. At 12 months, a higher percentage of participants had moved into the normal weight category compared with the percentage of non-participants (+2.0% points; P < 0.05), although there were no differences in average weight change.

Conclusions: Despite issues of limited penetration and potential self-selection, this Internet-based program had utility in reaching a large number of employees in dispersed work settings, and it led to improved eating habits and improved stage of change at 6 months and more individuals moving into the normal weight category at 6 and 12 months.
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http://dx.doi.org/10.1097/JOM.0b013e31815c6cf6DOI Listing
February 2008

Pregnancy and STD prevention counseling using an adaptation of motivational interviewing: a randomized controlled trial.

Perspect Sex Reprod Health 2007 Mar;39(1):21-8

Department of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA.

Context: Given levels of unintended pregnancy and STDs, an effective counseling intervention is needed to improve women's consistent use of effective prevention methods.

Methods: A sample of 764 women aged 16-44 who were at risk of unintended pregnancy were enrolled in a randomized controlled trial in North Carolina in 2003-2004. Intervention participants received pregnancy and STD prevention counseling, adapted from motivational interviewing, both at enrollment and two months later; controls received only a session of general health counseling. Levels of contraceptive use (categorized as high, low or none on the basis of the effectiveness of the method and the consistency of use) and barriers to use were measured at two, eight and 12 months; chi-square tests were used to compare selected outcomes between the groups. Rates of unintended pregnancy and chlamydia infection were assessed over the study period.

Results: At baseline, 59% of all participants reported a high level of contraceptive use, 19% a low level and 22% nonuse. At two months, the proportions of intervention and control participants who had improved their level of use or maintained a high level (72% and 66%, respectively) were significantly larger than the proportions who had reported a high level of use at baseline (59% and 58%, respectively). No significant differences were found between the groups at 12 months, or between baseline and 12 months for either group. During the study, 10-11% of intervention and control participants became pregnant, 1-2% received a chlamydia diagnosis and 7-9% had another STD diagnosed.

Conclusions: Repeated counseling sessions may be needed to improve contraceptive decision-making and to reduce the risk of unintended pregnancy and STDs.
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http://dx.doi.org/10.1363/3902107DOI Listing
March 2007

Acceptance and use of emergency contraception with standardized counseling intervention: results of a randomized controlled trial.

Contraception 2007 Feb 11;75(2):119-25. Epub 2006 Oct 11.

Department of Maternal and Child Health, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599, USA.

Objective: The objective of this work was to evaluate the acceptance, use and recall of an optional advance prescription for emergency contraception (EC).

Materials And Methods: This study used as randomized controlled trial evaluating contraceptive counseling intervention with women aged 16-44 years who were at risk for unintended pregnancy (N=737). Intervention participants (n=365) received contraceptive counseling with optional advance EC prescription. Control women (n=372) received no contraceptive or EC counseling. Among intervention participants, initial acceptance and use of EC in first 2 months were evaluated. Among all participants, differences were evaluated between recall of EC discussion and use of EC.

Results: Among 365 intervention women, 336 received EC counseling and 51% of these 336 accepted advance EC prescription. At 2 months, among the women who had accepted EC, 6% had filled and used their prescription and 8% had filled but not used their prescription. At 12 months, intervention women were significantly more likely than controls to recall talking about EC (33% vs. 5%) and obtaining a prescription (38% vs. 6%), but there were no differences in the use of EC (6% vs. 6%).

Conclusion: When the option is available for EC counseling, approximately half of women accepted advance prescription for EC. However, few women who received information and/or an advance prescription remembered discussing EC, filled the prescription or used EC over 12 months.
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http://dx.doi.org/10.1016/j.contraception.2006.08.009DOI Listing
February 2007

Gynecologic and contraceptive services provided by certified nurse-midwives in North Carolina.

J Midwifery Womens Health 2006 Nov-Dec;51(6):410-4

Frontier School of Midwifery and Family Nursing.

Gynecologic care by midwives has been little represented in the peer-reviewed literature despite the fact that the majority of midwives provide these services. Offering patients a variety of contraceptive options is important for informed choice and consent and for reducing the unintended pregnancy rate, which is nearly 50% in the United States. This study describes the volume of gynecologic care and the contraceptive methods provided by certified nurse-midwives (CNMs) in North Carolina. The study was conducted using a cross-sectional, confidential, self-administered mail questionnaire completed by 133 CNMs in clinical practice in North Carolina. The majority of the CNMs worked in private practice settings (67%), in urban areas (60%), and had 10 or fewer years of experience (62%). The median number of women seen weekly for gynecologic care was 15 (range 0-80), and 30% of CNMs provided gynecologic care to more than 25 women each week. The contraceptive methods discussed and provided by the CNMs were comprehensive. The high percentage of midwives providing gynecologic care merits further study of the content and quality of this care.
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http://dx.doi.org/10.1016/j.jmwh.2006.08.007DOI Listing
January 2007

Effects of daily environmental enrichment on memory deficits and brain injury following neonatal hypoxia-ischemia in the rat.

Neurobiol Learn Mem 2007 Jan 23;87(1):101-8. Epub 2006 Aug 23.

Programa de Pós-graduação em Neurociências, ICBS, Universidade Federal do Rio Grande do Sul, Brazil.

Environmental enrichment (EE) results in improved learning and spatial memory, as well as attenuates morphological changes resulting from cerebral ischemia in adult animals. This study examined the effects of daily EE on memory deficits in the water maze and cerebral damage, assessed in the hippocampus and cerebral cortex, caused by neonatal hypoxia-ischemia. Male Wistar rats in the 7th postnatal day were submitted to the Levine-Rice model of neonatal hypoxia-ischemia (HI), comprising permanent occlusion of the right common carotid artery and a period of hypoxia (90 min, 8%O(2)-92%N(2)). Starting two weeks after the HI event, animals were stimulated by the enriched environment (1h/day for 9 weeks); subsequent to the stimulation, performance of animals in the water maze was assessed. HI resulted in spatial reference and working memory impairments that were completely reversed by EE. Following the behavioral study, animals were killed and the hippocampal volume and cortical area were estimated. There was a significant reduction of both hippocampal volume and cortical area, ipsilateral to arterial occlusion, in HI animals; environmental stimulation had no effect on these morphological measurements. Presented data indicate that stimulation by the daily environmental enrichment recovers spatial memory deficits caused by neonatal hypoxia-ischemia without affecting tissue atrophy in either hippocampus or cortex.
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http://dx.doi.org/10.1016/j.nlm.2006.07.003DOI Listing
January 2007

Reducing African-American women's sexual risk: can churches play a role?

J Natl Med Assoc 2006 Jul;98(7):1151-9

Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.

Purpose: This study investigates: 1) perceptions of clergy regarding their current counseling and the need for future programs concerning sexual risk-taking, 2) sexual risk behaviors among a group of African-American women, 3) women's attitudes regarding condom use, and 4) women's receptiveness to church programs regarding sexual risks.

Methods: The clergy of 50 randomly selected predominantly African-American churches in five North Carolina counties were contacted regarding participation. Female parishioners ages 18-30 from participating churches were invited to complete written surveys concerning women's health.

Results: Of 50 clergy repeatedly contacted, 38 declined to participate and eight did not complete the interview. Only four interviews could be completed. Counseling regarding sexual risk was not common among the four clergy. They often advised parishioners to practice abstinence. Survey data was received from 142 respondents at 14 churches. Nearly 84% of the women surveyed had a history of sexually transmitted diseases (STDs). Almost all of the respondents were receptive to a church program regarding sexual risks.

Conclusions: Despite the sexual risks among African-American women, in this study, many clergy were unwilling to address prevention and were uncomfortable discussing issues related to sexual health. However, the few clergy who agreed to participate were very receptive to future programs.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2569486PMC
July 2006

Asking about intimate partner violence: advice from female survivors to health care providers.

Patient Educ Couns 2005 Nov;59(2):141-7

Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Magee-Womens Hospital, 300 Halket Street, Pittsburgh, PA 15213, USA.

Understanding the perspectives of women who have experienced IPV will allow us to identify specific techniques of addressing IPV that increase patient comfort and willingness to disclose and/or seek help. Our study objective was to identify what advice women who had experienced IPV would give health providers regarding how to ask about and discuss the issue of IPV. The women in our study advised that providers (1) give a reason for why they are asking about IPV to reduce women's suspicions and minimize stigma, (2) create an atmosphere of safety and support, (3) provide information, support and access to resources regardless of whether the woman discloses IPV. They emphasized that a provider's asking about IPV is an opportunity to raise patient awareness of IPV, communicate compassion and provide information and not merely a screening test to diagnose a pathologic condition.
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http://dx.doi.org/10.1016/j.pec.2004.10.008DOI Listing
November 2005

Seizing the 9-month moment: addressing behavioral risks in prenatal patients.

Patient Educ Couns 2006 May 26;61(2):228-35. Epub 2005 Oct 26.

Division of Behavioral Sciences, University of California San Francisco, 350 Parnassus Avenue, Suite 905, San Francisco, CA 94117, USA.

Objective: Our qualitative study explored prenatal care providers' methods for identifying and counseling pregnant women to reduce or stop smoking, alcohol use, illicit drug use, and the risk of domestic violence.

Methods: We conducted six focus groups (five with OB/Gyn physicians, one with nurse practitioners and certified nurse midwives), total N=49, using open-ended questions. Investigators analyzed transcripts to identify and describe themes.

Results: Three major themes emerged: (1) specific risk-prevention tactics or strategies exist that are useful during pregnancy; (2) some providers address patients' isolation or depression; and (3) providers can adopt a policy of "just chipping away" at risks. Specific tactics included normalizing risk prevention, using specific assessment techniques and counseling strategies, employing a patient-centered style of smoking reduction, and involving the family.

Conclusions: Providers generally agreed that addressing behavioral risks in pregnant patients is challenging. Patient-centered techniques and awareness of patients' social contexts help patients disclose and discuss risks.

Practice Implications: Brief but routine assessment and risk reduction messages require little time of the provider, but can make a big difference to the patient, who may make changes later.
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http://dx.doi.org/10.1016/j.pec.2005.04.001DOI Listing
May 2006
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