... by Gavin, Amelia R., Ph.D., UNIVERSITY OF MICHIGAN, 2004, 181 pages; 3150202. ... White dispa... more ... by Gavin, Amelia R., Ph.D., UNIVERSITY OF MICHIGAN, 2004, 181 pages; 3150202. ... White disparity in low birth weight (LBW) and preterm delivery (PTD), which is one of the most persistent and least understood public health concerns in the United States (Hoffman & Hatch ...
Introduction: The rapid uptake of telehealth for perinatal care during the coronavirus disease-20... more Introduction: The rapid uptake of telehealth for perinatal care during the coronavirus disease-2019 (COVID-19) pandemic has led to mixed evidence as to its effectiveness, with limited research demonstrating satisfaction and appropriateness for communities at risk for poor birth outcomes. The purpose of this article is to describe the experiences of virtual care during pregnancy and postpartum among a diverse group of pregnant/birthing people in Washington State during the COVID-19 pandemic. Methods: We conducted a thematic analysis study exploring experiences of care during the COVID-19 pandemic for 15 pregnant and birthing people in Washington State. This secondary analysis utilized data specific to experiences receiving care via telehealth. Results: Three dominant themes were identified: loss of connection and relationships with providers; need for hands-on interactions for reassurance; and virtual care is good for some things but not all—desire for immediate, accessible care when...
Grandmaternal education may be related to grandchild birth weight (GBW) through maternal early-li... more Grandmaternal education may be related to grandchild birth weight (GBW) through maternal early-life develop-ment; however, conventional regression models may be endogenously confounded. Alternative models employing explicit structural assumptions may provide incrementally clearer evidence. We used data from the US National Longitudinal Study of Adolescent to Adult Health (1995–2009; 1,681 mother-child pairs) to estimate “direct effects” of grandmaternal educational level (less than high school, high school diploma or equivalent, or college degree) at the time of the mother’s birth on GBW, adjusted for maternal life-course factors: maltreatment as a child, education and income as an adult, prepregnancy overweight, and prenatal smoking. Using conventional and marginal structural model (MSM) approaches, we estimated 54-g (95 % confidence interval: −14.0, 122.1) and 87-g (95 % confidence in-terval: 10.9, 162.5) higher GBWs per increase in educational level, respectively. The MSM allowed...
AimsTo explore the experiences of care for pregnant and birthing people, and the nurses who cared... more AimsTo explore the experiences of care for pregnant and birthing people, and the nurses who cared for them, during the COVID‐19 pandemic, with special emphasis on the impact of visitor restrictions policies.DesignQualitative study using critical thematic analysis.MethodsWe conducted semi‐structured interviews with 15 community members who were pregnant and/or gave birth and 14 nurses who worked in the perinatal setting between April and August 2020. Participants were recruited via purposive and snowball sampling, and interviews were conducted virtually via the Zoom platform. The research team used critical thematic analysis methods informed by other interpretive methodologies to arrive at resultant themes.ResultsParticipants described experiences pertaining to how visitor restriction policies are not equitable and disproportionately impact Black, Indigenous, and People of Color (BIPOC) families, and the direct impacts of not having support people, and also provided recommendations f...
Journal of Racial and Ethnic Health Disparities, 2021
Objectives To test the association between racial discrimination and cardiovascular-related condi... more Objectives To test the association between racial discrimination and cardiovascular-related conditions and whether PTSD mediates this relationship in a nationally representative sample of non-Hispanic Blacks. Methods We used data from the 2013 National Epidemiologic Survey on Alcohol and Related Conditions to conduct logistic regression analyses to examine the association between racial discrimination, PTSD, and cardiovascular-related conditions. We also performed mediation analyses to assess whether the association between racial discrimination and cardiovascular conditions was partly explained by PTSD. Results Racial discrimination was positively associated with both PTSD and cardiovascular-related conditions. Additionally, PTSD was positively associated with cardiovascular conditions. Results from the fully adjusted mediation models suggest that PTSD significantly mediated the association between racial discrimination and cardiovascular conditions. Conclusions Our results demonstrate an association between racial discrimination and cardiovascular-related conditions that is significantly mediated by PTSD. To improve cardiovascular functioning among non-Hispanic Blacks, health care professionals in conjunction with Black communities must adopt culturally competent screening for and treatment for PTSD. To address racial differences in cardiovascular conditions, public health efforts must address institutional policies that negatively alter health opportunities among the Black population.
Objective: This study examined whether there were racial/ethnic differences in the prevalence of ... more Objective: This study examined whether there were racial/ethnic differences in the prevalence of antenatal depression based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria in a community-based sample of pregnant women. Method: Data were drawn from an ongoing registry of pregnant women receiving prenatal care at a university obstetric clinic from January 2004 through March 2010 (N =1997). Logistic regression models adjusting for sociodemographic, psychiatric, behavioral and clinical characteristics were used to examine racial/ethnic differences in antenatal depression as measured by the Patient Health Questionnaire. Results: Overall, 5.1% of the sample reported antenatal depression. Blacks and Asian/Pacific Islanders were at increased risk for antenatal depression compared to non-Hispanic White women. This increased risk of antenatal depression among Blacks and Asian/Pacific Islanders remained after adjustment for a variety of risk factor...
Untreated depression presents a distinct set of risks for pregnancy complications. Past studies h... more Untreated depression presents a distinct set of risks for pregnancy complications. Past studies have connected antenatal depression with adverse birth outcomes. The purpose of this study was to conduct an updated systematic review and meta-analysis examining the relationship between depression during pregnancy and associated adverse birth outcomes in US populations during the period 2010-20. As a trend, disparities in adverse pregnancy outcomes and maternal morbidities for Black pregnant people compared with those for White pregnant people continue to rise. Addressing mental health conditions during pregnancy has the potential to ameliorate a large and excessive burden on adverse birth outcomes among childbearing people and their offspring. Policy solutions to encourage, mandate, and reimburse universal depression screening during pregnancy are warranted.
Racial disparities in sleep have been reported with Black adolescents showing the least amount of... more Racial disparities in sleep have been reported with Black adolescents showing the least amount of sleep relative to other youth. Yet, few within-group studies have examined factors that protect Black adolescents from sleep problems. To address this gap, we tested whether parent ethnic-racial socialization (i.e., instilling a sense of cultural and racial pride) at fourth grade moderated the associations between bedtime sleep problems at third and sixth grade. Using data from a sample of Black parents and children who participated in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (n = 173), we found that for children with low, but not high, parent ethnic-racial socialization at fourth grade bedtime problems increased from third and sixth grade. We discuss these findings within the existing parent ethnic-racial socialization and sleep literatures and how they further our understanding of the protective effects of parent ethnic-racial socialization. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
The COVID-19 pandemic created a massive shift in health care systems, including within pregnancy ... more The COVID-19 pandemic created a massive shift in health care systems, including within pregnancy and birth care. To explore how experiences of pregnancy and birth were impacted, 15 patient participants and 14 nurse participants were interviewed and transcripts analyzed using critical thematic analysis. Patients highlighted how adaptations to care were inadequate to meet their needs, a desire for support in response to stress, and the impact of COVID on patients’ experiences. Nurses identified how inconsistencies in policies impacted nurses’ ability to care for patients, the impact on nurses from hospital actions, and the impact on patients from hospital actions. Both groups discussed how system changes had disparate impacts on marginalized communities, leading to racially-biased care. This pandemic will continue to have lasting impact on pregnant and birthing families, and the nurses who care for them, and it is imperative that hospitals examine their role and any potential impacts.
... by Gavin, Amelia R., Ph.D., UNIVERSITY OF MICHIGAN, 2004, 181 pages; 3150202. ... White dispa... more ... by Gavin, Amelia R., Ph.D., UNIVERSITY OF MICHIGAN, 2004, 181 pages; 3150202. ... White disparity in low birth weight (LBW) and preterm delivery (PTD), which is one of the most persistent and least understood public health concerns in the United States (Hoffman & Hatch ...
Introduction: The rapid uptake of telehealth for perinatal care during the coronavirus disease-20... more Introduction: The rapid uptake of telehealth for perinatal care during the coronavirus disease-2019 (COVID-19) pandemic has led to mixed evidence as to its effectiveness, with limited research demonstrating satisfaction and appropriateness for communities at risk for poor birth outcomes. The purpose of this article is to describe the experiences of virtual care during pregnancy and postpartum among a diverse group of pregnant/birthing people in Washington State during the COVID-19 pandemic. Methods: We conducted a thematic analysis study exploring experiences of care during the COVID-19 pandemic for 15 pregnant and birthing people in Washington State. This secondary analysis utilized data specific to experiences receiving care via telehealth. Results: Three dominant themes were identified: loss of connection and relationships with providers; need for hands-on interactions for reassurance; and virtual care is good for some things but not all—desire for immediate, accessible care when...
Grandmaternal education may be related to grandchild birth weight (GBW) through maternal early-li... more Grandmaternal education may be related to grandchild birth weight (GBW) through maternal early-life develop-ment; however, conventional regression models may be endogenously confounded. Alternative models employing explicit structural assumptions may provide incrementally clearer evidence. We used data from the US National Longitudinal Study of Adolescent to Adult Health (1995–2009; 1,681 mother-child pairs) to estimate “direct effects” of grandmaternal educational level (less than high school, high school diploma or equivalent, or college degree) at the time of the mother’s birth on GBW, adjusted for maternal life-course factors: maltreatment as a child, education and income as an adult, prepregnancy overweight, and prenatal smoking. Using conventional and marginal structural model (MSM) approaches, we estimated 54-g (95 % confidence interval: −14.0, 122.1) and 87-g (95 % confidence in-terval: 10.9, 162.5) higher GBWs per increase in educational level, respectively. The MSM allowed...
AimsTo explore the experiences of care for pregnant and birthing people, and the nurses who cared... more AimsTo explore the experiences of care for pregnant and birthing people, and the nurses who cared for them, during the COVID‐19 pandemic, with special emphasis on the impact of visitor restrictions policies.DesignQualitative study using critical thematic analysis.MethodsWe conducted semi‐structured interviews with 15 community members who were pregnant and/or gave birth and 14 nurses who worked in the perinatal setting between April and August 2020. Participants were recruited via purposive and snowball sampling, and interviews were conducted virtually via the Zoom platform. The research team used critical thematic analysis methods informed by other interpretive methodologies to arrive at resultant themes.ResultsParticipants described experiences pertaining to how visitor restriction policies are not equitable and disproportionately impact Black, Indigenous, and People of Color (BIPOC) families, and the direct impacts of not having support people, and also provided recommendations f...
Journal of Racial and Ethnic Health Disparities, 2021
Objectives To test the association between racial discrimination and cardiovascular-related condi... more Objectives To test the association between racial discrimination and cardiovascular-related conditions and whether PTSD mediates this relationship in a nationally representative sample of non-Hispanic Blacks. Methods We used data from the 2013 National Epidemiologic Survey on Alcohol and Related Conditions to conduct logistic regression analyses to examine the association between racial discrimination, PTSD, and cardiovascular-related conditions. We also performed mediation analyses to assess whether the association between racial discrimination and cardiovascular conditions was partly explained by PTSD. Results Racial discrimination was positively associated with both PTSD and cardiovascular-related conditions. Additionally, PTSD was positively associated with cardiovascular conditions. Results from the fully adjusted mediation models suggest that PTSD significantly mediated the association between racial discrimination and cardiovascular conditions. Conclusions Our results demonstrate an association between racial discrimination and cardiovascular-related conditions that is significantly mediated by PTSD. To improve cardiovascular functioning among non-Hispanic Blacks, health care professionals in conjunction with Black communities must adopt culturally competent screening for and treatment for PTSD. To address racial differences in cardiovascular conditions, public health efforts must address institutional policies that negatively alter health opportunities among the Black population.
Objective: This study examined whether there were racial/ethnic differences in the prevalence of ... more Objective: This study examined whether there were racial/ethnic differences in the prevalence of antenatal depression based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, diagnostic criteria in a community-based sample of pregnant women. Method: Data were drawn from an ongoing registry of pregnant women receiving prenatal care at a university obstetric clinic from January 2004 through March 2010 (N =1997). Logistic regression models adjusting for sociodemographic, psychiatric, behavioral and clinical characteristics were used to examine racial/ethnic differences in antenatal depression as measured by the Patient Health Questionnaire. Results: Overall, 5.1% of the sample reported antenatal depression. Blacks and Asian/Pacific Islanders were at increased risk for antenatal depression compared to non-Hispanic White women. This increased risk of antenatal depression among Blacks and Asian/Pacific Islanders remained after adjustment for a variety of risk factor...
Untreated depression presents a distinct set of risks for pregnancy complications. Past studies h... more Untreated depression presents a distinct set of risks for pregnancy complications. Past studies have connected antenatal depression with adverse birth outcomes. The purpose of this study was to conduct an updated systematic review and meta-analysis examining the relationship between depression during pregnancy and associated adverse birth outcomes in US populations during the period 2010-20. As a trend, disparities in adverse pregnancy outcomes and maternal morbidities for Black pregnant people compared with those for White pregnant people continue to rise. Addressing mental health conditions during pregnancy has the potential to ameliorate a large and excessive burden on adverse birth outcomes among childbearing people and their offspring. Policy solutions to encourage, mandate, and reimburse universal depression screening during pregnancy are warranted.
Racial disparities in sleep have been reported with Black adolescents showing the least amount of... more Racial disparities in sleep have been reported with Black adolescents showing the least amount of sleep relative to other youth. Yet, few within-group studies have examined factors that protect Black adolescents from sleep problems. To address this gap, we tested whether parent ethnic-racial socialization (i.e., instilling a sense of cultural and racial pride) at fourth grade moderated the associations between bedtime sleep problems at third and sixth grade. Using data from a sample of Black parents and children who participated in the National Institute of Child Health and Human Development Study of Early Child Care and Youth Development (n = 173), we found that for children with low, but not high, parent ethnic-racial socialization at fourth grade bedtime problems increased from third and sixth grade. We discuss these findings within the existing parent ethnic-racial socialization and sleep literatures and how they further our understanding of the protective effects of parent ethnic-racial socialization. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
The COVID-19 pandemic created a massive shift in health care systems, including within pregnancy ... more The COVID-19 pandemic created a massive shift in health care systems, including within pregnancy and birth care. To explore how experiences of pregnancy and birth were impacted, 15 patient participants and 14 nurse participants were interviewed and transcripts analyzed using critical thematic analysis. Patients highlighted how adaptations to care were inadequate to meet their needs, a desire for support in response to stress, and the impact of COVID on patients’ experiences. Nurses identified how inconsistencies in policies impacted nurses’ ability to care for patients, the impact on nurses from hospital actions, and the impact on patients from hospital actions. Both groups discussed how system changes had disparate impacts on marginalized communities, leading to racially-biased care. This pandemic will continue to have lasting impact on pregnant and birthing families, and the nurses who care for them, and it is imperative that hospitals examine their role and any potential impacts.
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Papers by Amelia Gavin