Perceived Barriers to Type 2 Diabetes Prevention for Low-Income Women With a History of Gestational Diabetes: A Qualitative Secondary Data Analysis.

Purpose: The purpose of this qualitative study was to examine perceived barriers to adoption of lifestyle changes for type 2 diabetes prevention among a diverse group of low-income women with a history of gestational diabetes mellitus (GDM).

Methods: A secondary data analysis of 10 semistructured focus group discussions was conducted. Participants were low-income African American, Hispanic, and Appalachian women ages 18 to 45 years who were diagnosed with GDM in the past 10 years.

A quality improvement collaborative increased preventive education and screening rates for women at high-risk for type 2 diabetes mellitus in primary care settings.

Aims: Type 2 diabetes mellitus (T2DM) rates continue to increase across women of reproductive age in the United States. The Ohio Type 2 Diabetes Learning Collaborative aimed to improve education and screening for T2DM among women aged 18-44years at high risk for developing T2DM.

Methods: Fifteen primary care practices across Ohio participated in a 12-month quality improvement (QI) collaborative, which included monthly calls to share best practices, one-on-one QI coaching, and Plan-Do-Study-Act cycles.

Pregnant? Validity of the pregnancy checkbox on death certificates in four states, and characteristics associated with pregnancy checkbox errors.

Background: Maternal mortality rates in the United States appear to be increasing. One potential reason may be increased identification of maternal deaths after the addition of a pregnancy checkbox to the death certificate. In 2016, 4 state health departments (Georgia, Louisiana, Michigan, and Ohio) implemented a pregnancy checkbox quality assurance pilot, with technical assistance provided by the Centers for Disease Control and Prevention.

Severe Maternal Morbidity, A Tale of 2 States Using Data for Action-Ohio and Massachusetts.

Purpose Describe how Ohio and Massachusetts explored severe maternal morbidity (SMM) data, and used these data for increasing awareness and driving practice changes to reduce maternal morbidity and mortality. Description For 2008-2013, Ohio used de-identified hospital discharge records and International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes to identify delivery hospitalizations. Massachusetts used existing linked data system infrastructure to identify delivery hospitalizations from birth certificates linked to hospital discharge records.

Prevalence and Changes in Preexisting Diabetes and Gestational Diabetes Among Women Who Had a Live Birth - United States, 2012-2016.

Diabetes during pregnancy increases the risk for adverse maternal and infant health outcomes. Type 1 or type 2 diabetes diagnosed before pregnancy (preexisting diabetes) increases infants' risk for congenital anomalies, stillbirth, and being large for gestational age (1). Diabetes that develops and is diagnosed during the second half of pregnancy (gestational diabetes) increases infants' risk for being large for gestational age (1) and might increase the risk for childhood obesity (2); for mothers, gestational diabetes increases the risk for future type 2 diabetes (3).

Evaluation of a federally funded mass media campaign and smoking cessation in pregnant women: a population-based study in three states.

Objectives: In 2012, theCenters for Disease Control and Prevention initiated a national anti-smoking campaign, (). As a result of the campaign, quit attempts among smokers increased in the general population by 3.7 percentage points.

Impact of the 5As brief counseling on smoking cessation among pregnant clients of Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) clinics in Ohio.

Objectives: We assessed whether smoking cessation improved among pregnant smokers who attended Women, Infants and Children (WIC) Supplemental Nutrition Program clinics trained to implement a brief smoking cessation counseling intervention, the 5As: ask, advise, assess, assist, arrange.

Methods: In Ohio, staff in 38 WIC clinics were trained to deliver the 5As from 2006 through 2010. Using 2005-2011 Pregnancy Nutrition Surveillance System data, we performed conditional logistic regression, stratified on clinic, to estimate the relationship between women's exposure to the 5As and the odds of self-reported quitting during pregnancy.

A Mixed-Methods Assessment of a Brief Smoking Cessation Intervention Implemented in Ohio Public Health Clinics, 2013.

Objectives: In 2006, the state of Ohio initiated the implementation of a brief smoking cessation intervention (5As: Ask, Advise, Assess, Assist, and Arrange) in select public health clinics that serve low-income pregnant and post-partum women. Funds later became available to expand the program statewide by 2015. However, close to half of the clinics initially trained stopped implementation of the 5As.

Ohio primary health care providers' practices and attitudes regarding screening women with prior gestational diabetes for type 2 diabetes mellitus--2010.

Introduction: Gestational diabetes mellitus (GDM) is associated with a 7-fold increased lifetime risk for developing type 2 diabetes mellitus. Early diagnosis of type 2 diabetes is crucial for preventing complications. Despite recommendations for type 2 diabetes screening every 1 to 3 years for women with previous diagnoses of GDM and all women aged 45 years or older, screening prevalence is unknown.

Improving care for women with a history of gestational diabetes: a provider perspective.

To identify perceived roles with regard to care for women with gestational diabetes mellitus (GDM) history and resources for improving care among women with a history of GDM from the perspective of obstetrician/gynecologists (OB/GYNs), certified nurse midwives (CNM), family practitioners, and internists. In 2010, a survey was sent to a random sample of OB/GYNs, CNM, family practitioners, and internists (n = 2,375) in Ohio to assess knowledge, attitudes, and postpartum practices regarding diabetes prevention for women with a history of GDM. A total of 904 practitioners completed the survey (46 %).

Strategies associated with higher postpartum glucose tolerance screening rates for gestational diabetes mellitus patients.

Background: Most women with histories of gestational diabetes mellitus do not receive a postpartum screening test for type 2 diabetes, even though they are at increased risk. The objective of this study was to identify factors associated with high rates of postpartum glucose screening.

Methods: This cross-sectional analysis assessed characteristics associated with postpartum diabetes screening for patients with gestational diabetes mellitus (GDM)-affected pregnancies self-reported by randomly sampled licensed obstetricians/gynecologists (OBs/GYNs) in Ohio in 2010.

Comprehensive smoke-free policies: a tool for improving preconception health?

Lower income women are at higher risk for preconception and prenatal smoking, are less likely to spontaneously quit smoking during pregnancy, and have higher prenatal relapse rates than women in higher income groups. Policies prohibiting tobacco smoking in public places are intended to reduce exposure to secondhand smoke; additionally, since these policies promote a smoke-free norm, there have been associations between smoke-free policies and reduced smoking prevalence. Given the public health burden of smoking, particularly among women who become pregnant, our objective was to assess the impact of smoke-free policies on the odds of preconception smoking among low-income women.

Trends in body mass index among Ohio's third-grade children: 2004-2005 to 2009-2010.

Substantial variation across states in the prevalence and trends in childhood overweight and obesity indicate a need for state-specific surveillance to make state comparisons to national estimates and identify high-risk populations. The purpose of this study was to examine body mass index (BMI) trends among third-grade children in Ohio between the 2004-2005 and 2009-2010 school years and examine changes in prevalence of obesity by specific demographic subgroups. Third-grade children (n=33,672) were directly weighed and measured throughout the school years by trained health care professionals.

Gestational diabetes mellitus and postpartum care practices of nurse-midwives.

Introduction: Postpartum screening for glucose intolerance among women with recent histories of gestational diabetes mellitus (GDM) is important for identifying women with continued glucose intolerance after birth, yet screening rates are suboptimal. In a thorough review of the literature, we found no studies of screening practices among certified nurse-midwives (CNMs). The objectives of our study were to estimate the prevalence of postpartum screening for abnormal glucose tolerance and related care by CNMs for women with recent histories of GDM and to identify strategies for improvement.

Access to patient-centered medical home among Ohio's Children with Special Health Care Needs.

Medical homes deliver primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective. Children with special health care needs (CSHCN) require a wide range of support to maintain health, making medical home access particularly important. We sought to understand independent risk factors for lacking access.

Preconception health indicators: a comparison between non-Appalachian and Appalachian women.

To compare preconception health indicators (PCHIs) among non-pregnant women aged 18-44 years residing in Appalachian and non-Appalachian counties in 13 U.S. states.

Inter-rater reliability of ohio school-based overweight and obesity surveillance data.

Measurement of height and weight in large studies may force the use of multiple measurers. The purpose of this study was to evaluate the reliability of height, weight, and body mass index (BMI) measures collected by multiple measurers in a large, statewide BMI surveillance program. A random subsample of schools (n=30) was selected from schools that participated in the 2009 to 2010 Ohio third-grade Oral Health/BMI surveillance program.

Methods for a survey of overweight and obesity coordinated with oral health surveillance among Ohio third-grade students.

Introduction: Data on overweight and obesity prevalence among children enable state and local officials to develop, target, fund, and evaluate policies and programs to address childhood overweight. During the 2004-2005 school year, the Ohio Department of Health (ODH) conducted surveillance of elementary school-aged children through coordination with the ODH oral health survey to create a system that would provide county and state estimates of obesity and overweight prevalence.

Methods: We used a stratified, cluster-sampling survey design.

Integrated program enhancements increased utilization of Farmers' Market Nutrition Program.

Three New York State agencies undertook a state-wide initiative in 2001 to enhance the effectiveness of the Special Supplemental Program for Women, Infants, and Children (WIC) Farmers' Market Nutrition Program (FMNP) for both families and farmers. The program enhancements included four components intended to influence market and consumer behavior: hiring a state-wide Cornell Cooperative Extension staff member to initiate and coordinate FMNP promotion efforts; increased collaboration among state-level agencies; local-level community capacity-building; and dissemination of newly developed nutrition education resources. Because components were overlapping and potentially synergistic, the total effect was considered.