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Nutrition knowledge and beliefs of middle-income pregnant women
WEDNESDAY, OCTOBER 27 POSTER SESSION: COMMUNITY NUTRITION -11 -l gI I
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NUTRITION KNOWLEDGE AND BELIEFS OF MIDDLE-INCOME PREGNANT WOMEN. S.E. Rome, MS, RD, J.F. Pope, PhD, RD, AE. Hunt, PhD, RD, and N.M. Tolman, PhD, RD, College of Human Ecology, Louisiana Tech University, Ruston, LA To determine what women know and believe about maternal nutrition, a convenience sample of 100 recently delivered women at two private hospitals was surveyed using a personal interview and questionnaire format. Data collection included sociodemographic characteristics, an assessment of nutrition knowledge and beliefs about nutrition during pregnancy, as well as sources of nutrition information. Most of the women were white (78%), married (86%), had at least a high school education (88%), and were from middle and upper socioeconomic households (78%). This was the first pregnancy for almost half of the participants (45%). Thirty-three percent of the women reported having seen a dietitian during pregnancy; most of these women reported complications which would result in a "high-risk pregnancy" classification. Of the women who saw a dietitian during pregnancy, 94% indicated that the information provided was useful. The mean score ( standard deviation) on the nutrition knowledge component of the questionnaire was 8.86 + 2.43 out of a possible 16 points. Higher scores were associated with higher levels of education and socioeconomic status, but were not associated with age or with whether or not the women had seen a dietitian during pregnancy. Responses to the belief statements indicated that most women held beliefs that were consistent with current recommendations; however, a number of women had misconceptions. Most women agreed with statements concerning the need for good nutrition during pregnancy, and 81% expressed a desire for increased availability of prenatal nutrition education. Based on these results, the authors conclude that middle and upper income women in this area would benefit from and would be receptive to prenatal nutrition education programs.
RAPID ETHNOGRAPHIC RESEARCH IN THE SPECIAL SUPPLEMENTAL FOOD PROGRAM FOR WOMEN, INFANTS, AND CHILDREN: PAINTING PICTURES OF DIFFERENT CULTURES. K. Saluja, MPH, RD, G. G. Harrison, PhD, and E. P. Jenks, MEd, RD, Public Health Foundation WIC Program, Los Angeles, CA In May of 1992, the Special Supplemental Food Program for Women, Infants, and Children (WIC) of the Public Health Foundation of Los Angeles County, California undertook a project to explore the beliefs, perceptions and experiences relevant to the design and delivery of WIC services for several ethnic groups in Los Angeles. The Rapid Ethnographic Assessment procedure was used. This included standard anthropometrical methods, formal and informal interviews and participant observations. The objective of this project was to gather information about how WIC-enrolled or WIC-eligible women make decisions regarding pregnancy, infant feeding, child and family planning. Results rearing, health care included a "Private Knowledge vs Public Denial" model of the African-American pregnancy; a better understanding of the Armenian culture, especially the views on motherhood and family planning; the isolation and helplessness felt by many recent immigrants; and the differing views on educating and disciplining children among the ethnicities studied. Perceptions of health care services vary considerably between ethnic groups. In conclusion, because of this research, WIC education and counseling materials, staff in-service trainings and program policies will be evaluated and revised to be more ethnically appropriate for WIC participants.
WEIGHT GAIN DURING PREGNANCY: NUTRITIONAL KNOWLEDGE AS A PREDICTOR. V.L. Shayna, MS, RD, A.R. Alizadeh, K.E. Heller, DDS, MPH, R.K. Nadjarian, MPH, F. Seizer, D.S. Shin, MPH, and R.E. Story, School of Public Health, University of Michigan, Ann Arbor, MI Low birthweight in infants is a leading cause of morbidity and mortality during the first year of life. It has been shown that maternal weight gain during pregnancy is a predictor of infant birthweight. Factors affecting maternal weight gain could impact infant health. We investigated whether nutritional knowledge, pre-pregnancy body mass index (BMI), gestational age, and fear of prenatal weight gain predicted weight gain during pregnancy. We sampled 172 pregnant women attending childbirth preparation classes in three counties in Southeastern Michigan (mean age=26.7, age range 14-39, SD 5.6; mean gestation=32 weeks; mean education level: some college; 89% primagravida). Each woman filled out a questionnaire assessing her nutritional knowledge, food intake, pre-pregnancy body mass index, and weight gain during pregnancy. Our response rate was 100%. Stepwise multiple linear regression analysis was performed, with the dependent variable total prenatal weight gain and the independent variables: nutritional knowledge of food group recommendations, BMI, weeks gestation, and fear of prenatal weight gain. Significant predictors of prenatal weight gain included BMI (p=.004), weeks gestation (p=.0001) and fear of gaining weight during pregnancy (p=.000 1). Increased fear of prenatal weight gain was associated with a lower weight gain. Nutritional knowledge was not a significant predictor of prenatal weight gain. This may be due to the overall low level of knowledge in our sample. Participants were asked to identify the recommended daily servings in each food group and were given ranges to choose from. Results included means of 75% correct responses for dairy and fruits/vegetables, 70% correct responses for protein and 1.8% correct responses for gains. Our data suggest that nutritional knowledge is deficient in the prenatal population. From an educational standpoint, improving a woman's nutritional knowledge would be easier to implement than improving either her prenatal BMI or fears of gaining weight during pregnancy.
NUTRITION AND FEEDING RISK IDENTIFICATION TOOL PROJECT. S. A. Sondel, RD, MEd, and M. A. Baroni, RN, PhD, School of Nursing, University of Wisconsin, Madison, WI Since many children with developmental disabilities and/or special health care needs are in fact difficult to feed, unrecognized and unresolved early feeding difficulties could result in less than optimal physical and/or cognitive growth and parent-infant interactions. This project evolved from a concern for the lack of nutritional and feeding support for Wisconsin Birth to Three Programs. A tool and a manual for interpretation of results was developed. The first step is to screen for primary prevention and nutrition/feeding risk identification for all children being served by Birth to Three Programs. This initial step was developed to be used by Birth to Three program personnel, regardless of their nutritional feeding knowledge. The second step is to provide a method for assessment of those children who would potentially benefit from nutrition or feeding intervention within the context of their individual needs, their families and available community resources. Interpretation requires involvement from professionals with nutrition/feeding expertise. This method resulted from collaboration with an interdisciplinary advisory committee including focus groups from four state Birth to Three Programs and pilot testing with two Birth to Three Programs. Preliminary analysis of pilot testing indicated among medical risks the most common diagnosis was prematurity and respiratory disease. The most frequent feeding problems included gagging, constipation, reluctance to eat textures, picky eating and pica. The level of expressed parental concern for nutrition and feeding was 60%, for growth 28%, and behavior at mealtime 52%. The researcher's recommendations for need for second level assessment was significantly higher than Birth to Three staff. Results indicate this is an effective method for screening and assessment and could set the foundation for the third step of referral/intervention. This may include facilitating the provision of anticipatory guidance, coordination of involved service providers or broad-based interdisciplinary intervention. Discrepancies in determination of need for second level assessment suggest the need for systematic training of Early Intervention Staff. This tool could be adapted for use in other settings serving this at-risk population, such as public health departments or perinatal follow-up centers.
A-76 / SEITEMBER 1993 SUPPLEMENT VOLUME 93 NUMBER 9
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NUTRITION KNOWLEDGE AND BELIEFS OF MIDDLE-INCOME PREGNANT WOMEN. S.E. Rome, MS, RD, J.F. Pope, PhD, RD, AE. Hunt, PhD, RD, and N.M. Tolman, PhD, RD, College of Human Ecology, Louisiana Tech University, Ruston, LA To determine what women know and believe about maternal nutrition, a convenience sample of 100 recently delivered women at two private hospitals was surveyed using a personal interview and questionnaire format. Data collection included sociodemographic characteristics, an assessment of nutrition knowledge and beliefs about nutrition during pregnancy, as well as sources of nutrition information. Most of the women were white (78%), married (86%), had at least a high school education (88%), and were from middle and upper socioeconomic households (78%). This was the first pregnancy for almost half of the participants (45%). Thirty-three percent of the women reported having seen a dietitian during pregnancy; most of these women reported complications which would result in a "high-risk pregnancy" classification. Of the women who saw a dietitian during pregnancy, 94% indicated that the information provided was useful. The mean score ( standard deviation) on the nutrition knowledge component of the questionnaire was 8.86 + 2.43 out of a possible 16 points. Higher scores were associated with higher levels of education and socioeconomic status, but were not associated with age or with whether or not the women had seen a dietitian during pregnancy. Responses to the belief statements indicated that most women held beliefs that were consistent with current recommendations; however, a number of women had misconceptions. Most women agreed with statements concerning the need for good nutrition during pregnancy, and 81% expressed a desire for increased availability of prenatal nutrition education. Based on these results, the authors conclude that middle and upper income women in this area would benefit from and would be receptive to prenatal nutrition education programs.
RAPID ETHNOGRAPHIC RESEARCH IN THE SPECIAL SUPPLEMENTAL FOOD PROGRAM FOR WOMEN, INFANTS, AND CHILDREN: PAINTING PICTURES OF DIFFERENT CULTURES. K. Saluja, MPH, RD, G. G. Harrison, PhD, and E. P. Jenks, MEd, RD, Public Health Foundation WIC Program, Los Angeles, CA In May of 1992, the Special Supplemental Food Program for Women, Infants, and Children (WIC) of the Public Health Foundation of Los Angeles County, California undertook a project to explore the beliefs, perceptions and experiences relevant to the design and delivery of WIC services for several ethnic groups in Los Angeles. The Rapid Ethnographic Assessment procedure was used. This included standard anthropometrical methods, formal and informal interviews and participant observations. The objective of this project was to gather information about how WIC-enrolled or WIC-eligible women make decisions regarding pregnancy, infant feeding, child and family planning. Results rearing, health care included a "Private Knowledge vs Public Denial" model of the African-American pregnancy; a better understanding of the Armenian culture, especially the views on motherhood and family planning; the isolation and helplessness felt by many recent immigrants; and the differing views on educating and disciplining children among the ethnicities studied. Perceptions of health care services vary considerably between ethnic groups. In conclusion, because of this research, WIC education and counseling materials, staff in-service trainings and program policies will be evaluated and revised to be more ethnically appropriate for WIC participants.
WEIGHT GAIN DURING PREGNANCY: NUTRITIONAL KNOWLEDGE AS A PREDICTOR. V.L. Shayna, MS, RD, A.R. Alizadeh, K.E. Heller, DDS, MPH, R.K. Nadjarian, MPH, F. Seizer, D.S. Shin, MPH, and R.E. Story, School of Public Health, University of Michigan, Ann Arbor, MI Low birthweight in infants is a leading cause of morbidity and mortality during the first year of life. It has been shown that maternal weight gain during pregnancy is a predictor of infant birthweight. Factors affecting maternal weight gain could impact infant health. We investigated whether nutritional knowledge, pre-pregnancy body mass index (BMI), gestational age, and fear of prenatal weight gain predicted weight gain during pregnancy. We sampled 172 pregnant women attending childbirth preparation classes in three counties in Southeastern Michigan (mean age=26.7, age range 14-39, SD 5.6; mean gestation=32 weeks; mean education level: some college; 89% primagravida). Each woman filled out a questionnaire assessing her nutritional knowledge, food intake, pre-pregnancy body mass index, and weight gain during pregnancy. Our response rate was 100%. Stepwise multiple linear regression analysis was performed, with the dependent variable total prenatal weight gain and the independent variables: nutritional knowledge of food group recommendations, BMI, weeks gestation, and fear of prenatal weight gain. Significant predictors of prenatal weight gain included BMI (p=.004), weeks gestation (p=.0001) and fear of gaining weight during pregnancy (p=.000 1). Increased fear of prenatal weight gain was associated with a lower weight gain. Nutritional knowledge was not a significant predictor of prenatal weight gain. This may be due to the overall low level of knowledge in our sample. Participants were asked to identify the recommended daily servings in each food group and were given ranges to choose from. Results included means of 75% correct responses for dairy and fruits/vegetables, 70% correct responses for protein and 1.8% correct responses for gains. Our data suggest that nutritional knowledge is deficient in the prenatal population. From an educational standpoint, improving a woman's nutritional knowledge would be easier to implement than improving either her prenatal BMI or fears of gaining weight during pregnancy.
NUTRITION AND FEEDING RISK IDENTIFICATION TOOL PROJECT. S. A. Sondel, RD, MEd, and M. A. Baroni, RN, PhD, School of Nursing, University of Wisconsin, Madison, WI Since many children with developmental disabilities and/or special health care needs are in fact difficult to feed, unrecognized and unresolved early feeding difficulties could result in less than optimal physical and/or cognitive growth and parent-infant interactions. This project evolved from a concern for the lack of nutritional and feeding support for Wisconsin Birth to Three Programs. A tool and a manual for interpretation of results was developed. The first step is to screen for primary prevention and nutrition/feeding risk identification for all children being served by Birth to Three Programs. This initial step was developed to be used by Birth to Three program personnel, regardless of their nutritional feeding knowledge. The second step is to provide a method for assessment of those children who would potentially benefit from nutrition or feeding intervention within the context of their individual needs, their families and available community resources. Interpretation requires involvement from professionals with nutrition/feeding expertise. This method resulted from collaboration with an interdisciplinary advisory committee including focus groups from four state Birth to Three Programs and pilot testing with two Birth to Three Programs. Preliminary analysis of pilot testing indicated among medical risks the most common diagnosis was prematurity and respiratory disease. The most frequent feeding problems included gagging, constipation, reluctance to eat textures, picky eating and pica. The level of expressed parental concern for nutrition and feeding was 60%, for growth 28%, and behavior at mealtime 52%. The researcher's recommendations for need for second level assessment was significantly higher than Birth to Three staff. Results indicate this is an effective method for screening and assessment and could set the foundation for the third step of referral/intervention. This may include facilitating the provision of anticipatory guidance, coordination of involved service providers or broad-based interdisciplinary intervention. Discrepancies in determination of need for second level assessment suggest the need for systematic training of Early Intervention Staff. This tool could be adapted for use in other settings serving this at-risk population, such as public health departments or perinatal follow-up centers.
A-76 / SEITEMBER 1993 SUPPLEMENT VOLUME 93 NUMBER 9