Introduction: In the last decade, state and national programs and policies aimed to increase access to postpartum contraception; however, recent data on population-based estimates of postpartum contraception is limited.
Methods: Using Pregnancy Risk Assessment Monitoring System data from 20 sites, we conducted multivariable-adjusted weighted multinomial regression to assess variation in method use by insurance status and geographic setting (urban/rural) among people with a recent live birth in 2018. We analyzed trends in contraceptive method use from 2015 to 2018 overall and within subgroups using weighted multinomial logistic regression.
Matern Child Health J
September 2020
Background: Women experiencing unintended and short-interval pregnancies are at increased risk for adverse outcomes. Nationally, researchers report disparities in women's use of effective contraceptive methods based on demographic, cultural, financial and system-level factors. Despite 58% of Louisiana births being unplanned, researchers have not reported on these relationships in Louisiana.
View Article and Find Full Text PDFObjective: To examine preventable pregnancy-related deaths in Louisiana by race and ethnicity and maternal level of care to inform quality improvement efforts.
Methods: We conducted a retrospective observational descriptive analysis of Louisiana Pregnancy-Associated Mortality Review data of 47 confirmed pregnancy-related deaths occurring from 2011 to 2016. The review team determined cause of death, preventability, and contributing factors.
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.
View Article and Find Full Text PDFRates of short-interval pregnancies that result in unintended pregnancies remain high in the United States and contribute to adverse reproductive health outcomes. Long-acting reversible contraception methods have annual failure rates of <1%, compared with 9% for oral contraceptive pills, and are an effective strategy to reduce unintended pregnancies. To increase access to long-acting reversible contraception in the immediate postpartum period, several State Medicaid programs, which include those in Iowa and Louisiana, recently established reimbursement policies to remove the barriers to reimbursement of immediate postpartum long-acting reversible contraception insertion.
View Article and Find Full Text PDFCommon features of successful, local-level, Fetal Infant Mortality Review (FIMR) Programs are identified by the National Fetal and Infant Mortality Review (NFIMR) Program, including medical records abstraction and home interviews, case reviews by a case review team (CRT), and community systems action recommendations implemented by a community action team (CAT). This paper presents Louisiana's FIMR program, an adaptation of NFIMR recommendations. In 2001, the Louisiana Maternal and Child Health Program began a statewide FIMR Network (LaFIMR) based on the NFIMR model.
View Article and Find Full Text PDFMatern Child Health J
August 2011
This is a prospective study to evaluate ability of a nurse care coordinator to: (1) improve ability of a pediatric clinic to meet medical home (MH) objectives and (2) improve receipt of services for families of children with special health care needs (CSHCN). A nurse was hired to provide care coordination for CSHCN in an urban, largely Medicaid pediatric academic practice. CSHCN were identified using a CSHCN Screener.
View Article and Find Full Text PDFOBJECTIVE This study examines the usefulness of childhood glucose homeostasis variables (glucose, insulin, and insulin resistance index [homeostasis model assessment of insulin resistance {HOMA-IR}]) in predicting pre-diabetes and type 2 diabetes and related cardiometabolic risk factors in adulthood. RESEARCH DESIGN AND METHODS This retrospective cohort study consisted of normoglycemic (n = 1,058), pre-diabetic (n = 37), and type 2 diabetic (n = 25) adults aged 19-39 years who were followed on average for 17 years since childhood. RESULTS At least 50% of the individuals who ranked highest (top quintile) in childhood for glucose homeostasis variables maintained their high rank by being above the 60th percentile in adulthood.
View Article and Find Full Text PDFThe purpose of this study was to examine factors associated with nonadherence to highly active antiretroviral therapy (HAART) in patients seen in HIV clinics throughout nonurban Louisiana. A convenience sample of 273 patients from 8 areas in nonurban Louisiana were interviewed to obtain demographic, clinical and adherence information. Associations between demographic, clinical, and behavioral factors and nonadherence were examined.
View Article and Find Full Text PDFThe Framingham risk score (FRS), developed in a white cohort aged 30-74 years, is increasingly used in the early risk identification for coronary artery disease (CAD). This study examines the relationship between FRS and carotid artery intima-media thickness (IMT), a surrogate marker of coronary atherosclerosis, in black and white individuals aged 20-37 years. Five hundred seventeen young adults (aged 20-37 years; 71% white, 39% male) enrolled in the Bogalusa Heart Study had carotid artery ultrasonography.
View Article and Find Full Text PDFAlthough risk factors for coronary artery disease are also associated with increased carotid artery intima-media thickness (IMT) as measured by B-mode ultrasonography in middle-aged and older persons, information on the impact of multiple risk factors on the IMT of different segments of the carotid artery in young adults is limited. This relation was examined in a sample of 518 black and white subjects (mean age 32 years; 71% white, 39% male) enrolled in the Bogalusa Heart Study. IMT was thicker and more skewed in the bulb compared with other carotid segments.
View Article and Find Full Text PDFPurpose: The relationship between social support and depressive symptomatology in cancer patients is well established, yet the extent to which patient variables impact this relationship is not well known. The purpose of this study was to examine whether the relationship of social support to the severity of depressive symptoms varies by patient age and gender.
Description Of The Study: A sample of 342 cancer outpatients were administered self-report measures of depressive symptoms, perceived adequacy of social support, satisfaction with family functioning, and the size of their social support network.