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Numerous initiatives at the national, state, and local levels are focused on addressing the U.S. maternal health crisis. However, most efforts fail to center women's voices and personal perspectives about pregnancy experiences and complications. This article describes the Illinois Maternal Health Digital Storytelling Project conducted by the University of Illinois at Chicago, in partnership with StoryCenter, a storytelling nonprofit organization based in Berkeley, California. The project aimed to elevate voices (stories) to complement other sources of data on maternal outcomes. We relied on partners to help recruit storytellers with a self-identified perinatal-related challenge. We screened interested individuals using a trauma-informed approach and a social worker provided storytellers with support during the project. Two groups participated in this project, one in 2021 and another in 2022, culminating with 10 digital stories. Both instances were conducted virtually and included group and individual skills-based sessions where storytellers learned to create and edit their digital stories. The storytellers own their digital stories and provided consent to include them in ongoing dissemination efforts. In September 2021, a webpage was launched to house the stories, and this resource is being shared widely. Evaluation efforts of the webpage are ongoing to understand how these digital stories are being used to inform maternal health efforts. Digital stories add richness to ongoing maternal health prevention work and may serve as a powerful tool to elicit understanding among providers, practitioners, and constituents. [ABSTRACT FROM AUTHOR]

In response to disproportionately high rates of infant mortality and preterm birth among women of color and women in poverty in Fresno County, California, community and academic partners coordinated a community-based participatory research (CBPR) project with local residents. Social isolation and stress, inaccessible prenatal care, and dissatisfaction with care experiences were identified as leading predictors of poor birth outcomes. The PRECEDE-PROCEED framework was used to lead the CBPR effort that resulted in the development of a model of group prenatal care, named Glow! Group Prenatal Care Program (Glow! Program). Group prenatal care (GPNC), which focuses on pregnancy health assessments, education, and peer support, has the potential to address the health and social priorities of women during pregnancy. As a result of the employed CBPR process and the extensive participation from stakeholders, this modified GPNC model responds to the unique needs of the at-risk community members, the agencies aiming to improve maternal-child health experiences and outcomes, and the prenatal care providers offering it to their patients. The methods from this study can be applied in the design and implementation of community-based health care interventions. Returning to community partners throughout the design, implementation, and evaluation phases underscored that health care interventions cannot be designed in silos, and require flexibility to respond to factors that promote improved maternal and infant outcomes, which affect the end goal for the intervention. [ABSTRACT FROM AUTHOR]

Health and economic inequities among U.S. racial/ethnic minority women and children are staggering. These inequities underscore a dire need for intersectionality-informed, social-justice-oriented maternal and child (MCH) policies and programs for U.S. women and children. In response, we developed the "Intersectionality Policymaking Toolkit: Key Principles for an Intersectionality Informed Policymaking Process to Serve Diverse Women, Children and Families" to assist U.S. policymakers/aides, practitioners, and other stakeholders in developing more equitable MCH policies/programs. This article describes the Toolkit development process and initial assessments of acceptability and feasibility for use in MCH policymaking. Between 2018 and 2021, we utilized the process that the World Health Organization (WHO) used to develop its WHO Surgical Safety Checklist to develop the content (e.g., case studies) and format (i.e., structure), make strategic decisions (e.g., core items, primary audiences, timing of utilization), test concepts, and receive feedback. We convened a 2-day planning meeting with experts (n = 8) in intersectionality, policymaking, and MCH to draft the Toolkit. Next, we convened half-day workshops with policymaking and program leadership and staff in Washington, DC, New Orleans, LA, and Santa Fe, NM, to refine the Toolkit (n = 37). Then we conducted an initial assessment of the Toolkits' acceptability and feasibility using surveys (n = 21), followed by focus groups (n = 7). The resulting Toolkit distills Critical Race Theory's and intersectionality's most critical elements into a user-friendly modality to promote and enhance equitable MCH policies and programs for diverse U.S. women and families. [ABSTRACT FROM AUTHOR]

Background: Low birthweight is a health issue disproportionately experienced by Black women. In Hillsborough County, Florida, Black women experience higher rates of low birthweight compared to the rest of Florida. This study examines the feasibility of a second attempt to use a digital low birthweight campaign to increase knowledge about low birthweight and pregnancy among Black women in Hillsborough. Methods: Content for the Growing and Glowing campaign was delivered on social media through a web series with local prenatal care providers and educational images. Two cross-sectional surveys examined changes in pregnancy-related knowledge, attitudes, and behaviors among Black women in Hillsborough. Digital metrics showed campaign reach and engagement. Results: Growing and Glowing attained 1,234 followers, 805,437 impressions, and a reach of 19,875. Web series videos were viewed almost 27,000 times, with 89% average viewer retention. The website attracted 2,634 unique page views. Evaluation surveys showed significant improvements in positive pregnancy-related intentions. Women aware of the campaign showed significantly higher awareness of the importance of prenatal care, and higher awareness of local resources. Conclusion: Results from the second study of this campaign approach suggest that using a highly targeted digital intervention can be a well-received and potentially effective way to deliver pregnancy-related health information to Black women, even during a global pandemic. This approach has numerous benefits in reaching women who may fall outside traditional health marketing approaches. [ABSTRACT FROM AUTHOR]

In Hamilton County, Ohio, the infant mortality rate is above the national average and the Black infant mortality rate is more than 3 times the white infant mortality rate. These racial disparities in infant mortality cannot be explained through other socio-economic characteristics like education, income, housing, or medical insurance. Research has shown that racism, not race itself, is the driving force behind the high disparity in infant mortality rates in Hamilton County and the nation as well. The World Health Organization (WHO) and the Institute of Medicine have long cited institutional/structural racism and cultural racism as a key factor in health disparity. A paradigm shift needed to occur to address the consequences of racism within the lives of Black women, namely disempowerment and agency. The Commission on Social Determinants of Health (CSDH) model was which engaged Black women and positioned them as an asset, to share in the process of strategizing, creating, and implementing a plan. Queens Village was founded to implement the CSDH model and address the upstream determinants of infant mortality through cultivating a sense of community. [ABSTRACT FROM AUTHOR]

In 2016, the North Carolina Division of Public Health launched the Improving Community Outcomes for Maternal and Child Health program to invest in evidence-based programs to address three aims: improve birth outcomes, reduce infant mortality, and improve health outcomes for children 0 to 5 years old. Five grantees representing 14 counties were awarded 2 years of funding to implement one evidence-based strategy per aim using a collective impact framework, the principles of implementation science, and a health equity approach. Local health departments served as the backbone organization and provided ongoing support to grantees and helped them form community action teams (CATs) comprising implementation team members, community experts, and relevant stakeholders who met regularly. Focus groups with each grantee's CAT were held during 2017 and 2019 to explore how CATs used a collective impact framework to implement their chosen evidence-based strategies. Results show that grantees made the most progress engaging diverse sectors in implementing a common agenda, continuous communication, and mutually reinforcing activities. Overall, grantees struggled with a shared measurement system but found that a formal tool to assess equity helped use data to drive decision making and program adaptations. Grantees faced logistical challenges holding regular CAT meetings and sustaining community expert engagement. Overtime, CATs cultivated community partnerships and multicounty collaboratives viewed cross-county knowledge sharing as an asset. Future collective impact initiatives should allow grantees more time upfront to form their CAT to plan for sustained community engagement before implementing programs and to incorporate a tool to center equity in their work. [ABSTRACT FROM AUTHOR]

The 2010 Affordable Care Act provided for evidence-based home visiting and an accompanying continuous quality improvement (CQI) process in all states and territories. This is an organizational-level study of one state's qualitative approach to CQI during early implementation, when data system infrastructure and local agency capacity were still developing. We examined the CQI topics created by local agencies and operationalized through a qualitative, strength-based CQI process. During the first 18 months, state and local site teams (n = 21) participated in 150 CQI teleconferences. We used qualitative content analysis of teleconference notes to identify issues important to sites and that could be addressed through a qualitative CQI process. Seven categories of CQI topics emerged: participant enrollment and retention; administrative infrastructure and capacity; programmatic resources and practices; community advisory boards; home visitor skill development; systems integration and strategic partnerships; and hiring home visiting staff. Sites added local nuances to frame and address CQI topics. When local sites identify their own CQI topics in early implementation, they addressed program need at multiple levels of influence. A few sites addressed individually focused topics traditional to CQI. Most often, sites engaged with institution- or community-focused topics atypical for CQI but nonetheless essential to launching a program: building skills and capacity for administrative and program implementation, and engaging with the local system of services. Oversight agencies should be prepared to address program, organization, partner or system level issues through CQI to foster program establishment. A site-centered, strength-based approach can support programs even when quantitative data are limited. [ABSTRACT FROM AUTHOR]

Perinatal women enrolled in home visiting (HV) programs exhibit high rates of depression, substance use, and intimate partner violence (IPV). While HV programs have increasingly screened for these psychosocial risks, initiation and uptake of community-based services to address these risks remain challenging. This project used a community-engaged research approach to engage key HV stakeholders in developing the screening, referral, and individualized prevention and treatment (SCRIPT) model. We highlight how a group of key HV stakeholders—the SCRIPT Advisory Panel—collaborated with academic researchers to develop the SCRIPT model by reviewing literature on HV programs' response to psychosocial risk factors and qualitative data obtained from mental health, substance use, and IPV service providers to whom HV programs referred clients. SCRIPT focuses on (a) screening for psychosocial risks, (b) developing partnerships with outside agencies to address these risk factors, and (c) establishing concrete and systematic processes for client referral and monitoring with outside agencies. SCRIPT provides a structured model for HV programs to systematically identify clients for key psychosocial risks and structure their referral and monitoring process when working with social service agencies. Future work should examine the impact of SCRIPT on mental health, substance use, and IPV service access and use by a vulnerable population. [ABSTRACT FROM AUTHOR]

Intimate partner violence (IPV) has well-documented adverse impact on survivors and their children. In this article, we describe the development and formative evaluation of a trauma-informed, user-friendly Smartphone-based mobile application (app) to address the unmet health needs and improve the well-being of mothers who have experienced IPV. A multidisciplinary team of IPV experts developed the app (called Thrive) in partnership with software developers. Thrive includes three sections: Myself (maternal self-care, stress coping skills), My Child (stress signs in children, talking to children about IPV, mother–child dyadic communication), and My Life (hospital- and community-based resources). Sixteen providers (social workers, IPV advocates, and health care providers) and eight IPV survivors provided feedback about Thrive via structured interviews. Participants found Thrive to be user-friendly, informative, trauma-informed, and a potential alternative to handouts. Participants had several recommendations including allowing users to add their own content and providing social support mechanisms. Initial feedback sessions have demonstrated preliminary acceptability of one of the first health education apps for mothers who have experienced IPV. Next steps include revising Thrive based on user feedback, testing Thrive via a longitudinal outcome evaluation, and working with hospital and community-based partners to disseminate Thrive to IPV survivors around the country. [ABSTRACT FROM AUTHOR]

Pregnant women are increasingly using mobile apps as a source of supplemental information. These pregnancy-related mobile apps present women with contradictory risk recommendations without the medical research to support their claims. The content analysis describes a sample of the pregnancy-tracking mobile application environment open to pregnant mothers and uses the social amplification of risk framework. Within this framework, written recommendations and the presence or absence of corresponding citations on controversial topics in pregnancy were recorded and risk was coded as received contradictory information. Of the 48 pregnancy-tracking mobile apps downloaded, 11 (22.9%) were associated with either a seller or a developer with a medical background. Only 24 of 48 (50.0%) of the apps cited a source, such as a health professional agency or peer-reviewed research journal for health recommendations. In our results, we show a sampling of contradictory risk recommendations made by mobile apps that cite or do not cite their source for that recommendation on 8 controversial topics in pregnancy. Findings suggest providers treating pregnant women must be aware of the complex information environment and help them navigate the risk information they encounter on some of the most popular pregnancy-tracking mobile apps. [ABSTRACT FROM AUTHOR]

Teens from neighborhoods that have experienced historical and contemporary disinvestment have among the highest rates of teen pregnancy, yet they have less access to resources to reduce unintended pregnancies. In recognition of this, the New York City Department of Health and Mental Hygiene (NYCDOHMH) developed the Youth-Friendly Pharmacy Initiative. Over 7 consecutive months in 2015, educational materials and free NYCDOHMH condoms were placed strategically in independent pharmacies in the South Bronx. Refills were made monthly. Pharmacists were directed to order free refills from the NYCDOHMH after the project ended. To evaluate the feasibility of the study, a survey with teens (15-19 years) at the study midpoint and a 3-month post follow-up assessment were conducted. The retention rate over 7 months was 96.4% (27/28 pharmacies). Forty-three percent (2,068/4,830) of the booklets and 87.9% (43,841/49,850) of the condoms were taken by patrons. The posters and pamphlets were recognized by 63.6% and 27.3% of the teens, respectively. Forty-percent of the teens were aware of the free condoms, and one third had taken the free condoms. In the post assessment, 20% of the sampled pharmacies independently sought out resources for free condom refills. Pharmacies are positive sexual and reproductive health resources for underserved teens. [ABSTRACT FROM AUTHOR]

Background. Oral health is a significant public health issue; yet barriers to implementing the prenatal oral health guidelines into practice remain. This formative research aimed to identify key implementation science characteristics to inform the development of an eHealth application (app) to assist providers in implementing the prenatal oral health guidelines during prenatal visits. Method. Guided by the Consolidated Framework for Implementation Research, the clinic's infrastructure, workflow, and contextual factors were assessed via clinic observation, technology assessment, prenatal provider interviews (n = 4), clinic staff interviews (n = 8), and two focus groups with oral health providers (n = 16). Results. System-level factors influencing future implementation were identified regarding structural characteristic, networks/communication, culture, external policy/incentives, relative advantage, complexity, design quality/packaging, knowledge/beliefs, and personal attributes. Discussion. Findings provided vital information and will directly inform the design and implementation of an eHealth app that aims to facilitate the translation of the interprofessional prenatal oral health guidelines into clinical prenatal oral health practices. [ABSTRACT FROM AUTHOR]

Group prenatal care (GPNC) is an alternative model to traditional individual care and may improve public health outcomes. Prior studies suggest that interest in GPNC varies widely and few studies have examined characteristics predictive of interest in this model. The purpose of this study was to inform GPNC recruitment efforts by examining likelihood of participation delineated by characteristics and GPNC perceptions. Pregnant participants received information about GPNC then completed a survey measuring demographic, psychosocial, and reproductive characteristics, likelihood to participate in GPNC, and factors influencing selections. Respondents expressed varied levels of likelihood to participate in GPNC; 16.2% low likelihood, 44.9% moderate likelihood, and 38.9% high likelihood. Characteristics were similar between groups, and thus their use is not recommended when targeting recruitment efforts. Benefits outweighed barriers and threats for the high likelihood category, barriers and threats outweighed benefits for the low likelihood category, and benefits, barriers, and threats were balanced for the moderate likelihood category. Accurately assessing likelihood of participating in GPNC efficiently identifies individuals who are clearly either going to decline or participate, as well as promotes targeted recruitment efforts directed at those who are ambivalent. Understanding and addressing perceived benefits, barriers, and threats supports effective GPNC recruitment. [ABSTRACT FROM AUTHOR]

A theoretical framework serves as a roadmap for the implementation and application of a complex, health promotion intervention; is used to test hypotheses; and guides analysis and evaluation of the intervention. The purpose of this article is to demonstrate how a theoretical framework was developed and used to guide the implementation of Healthy Beginning Initiative (HBI) to promote uptake of HIV services in a low-income country. We used the guide for developing a theoretical framework published in Health Promotion Practice. Developing the theoretical framework included seven steps: (1) identifying the essential elements of the intervention; (2) identifying the variables and the context; (3) listing the postulated mechanisms, mediating variables, and postulated outcomes; (4) identifying existing theoretical models supporting the theoretical framework underdevelopment; (5) scripting the theoretical framework into either a figure or sets of statements; (6) conducting content and face validation of the theoretical framework; and (7) revising the theoretical framework. The theoretical framework was developed and used to evaluate HBI's impact on HIV testing, linkage to care and retention in care for pregnant women, their male partners, and newborns. The theoretical framework will also be adapted for other screenings and other settings while remaining true to the essential elements of HBI. [ABSTRACT FROM AUTHOR]

Public health practitioners have increasingly leveraged technology-based communication to get health information into the hands of hard-to-reach populations; however, best practices for outreach and enrollment into mobile health (mHealth) programs are lacking. This article describes enrollment results from campaigns focused on enrolling underserved pregnant women and mothers in Text4baby—a free, mHealth service—to inform outreach strategies for mHealth programs. Text4baby participants receive health and safety information, interactive surveys, alerts, and appointment reminders through at least three weekly texts and a free app—timed to users' due date or babies' birth date. Text4baby worked with partners to implement national, state, and community-based enrollment campaigns. Descriptive statistics were used to compare baseline enrollment prior to a campaign with enrollment during a campaign to generate enrollment estimates. Enrollment rates were calculated for campaigns for which the number targeted/reached was available. National television campaigns resulted in more than 10,000 estimated enrollments. Campaigns that were integrated with an existing program and text-based recruitment had the highest enrollment rates, ranging from 7% to 24%. Facebook advertisements and traditional media targeting providers and consumers were least effective. mHealth programs should consider text-based recruitment and outreach via existing programs; additional research is needed on return on investment for different outreach strategies and on the effectiveness of different outreach strategies at reaching and enrolling specific target populations. [ABSTRACT FROM AUTHOR]

A systematic behavior change communication (BCC) process was designed to enable local partners to effectively conduct formative research and develop a comprehensive BCC strategy, as part of a pneumonia prevention and control program implemented from 2017 to 2021 by the Red Cross Red Crescent in Ethiopia, Ivory Coast, Mali, Sudan, and Zambia.Qualitative content analysis was used to identify, categorize, and summarize key results, lessons, and recommendations related to the BCC process from country evaluation data.Key elements to success of a locally implemented BCC process include: (1) through simple formative research, understanding household decision-making dynamics for timely health seeking and coexistence of modern and traditional medicine; (2) explicitly analyze motivators for uptake of protective behaviors, with strong and deliberate community participation to validate and tailor BCC messages and channels; (3) ensuring that the challenges to access basic services, such as water and sanitation facilities, are adequately addressed as critical enabling factors for behavior change. Other implications include a need for innovative solutions to physical and economic barriers in areas where large distances, lack of transportation, or cost hinder caregivers seeking care for sick children.Community health programs that apply a BCC process through local partners can be effective in achieving behavioral outcomes. Participatory planning and involvement of the community in iterative rounds of validation improved the relevance, appropriateness, and impact. Further research is needed to determine the effectiveness of different communication methods and sustained impact on health outcomes. [ABSTRACT FROM AUTHOR]

This article presents the feasibility and acceptability of using mobile health technology by community health workers (CHWs) in San Juan Province, Dominican Republic, to improve identification of pregnancy complications and access to care for pregnant women. Although most women in the Dominican Republic receive four antenatal care visits, poor women and adolescents in remote areas are more likely to have only one initial prenatal visit to verify the pregnancy. This community-based research began when community leaders raised concern about the numbers of their mothers who died in childbirth annually; San Juan's maternal mortality rate is 144/100,000 compared to the Caribbean rate of 85/100,000. Eight CHWs in three communities were taught to provide third-trimester antenatal assessment, upload the data on a mobile phone application, send the data to the local physician who monitored data for "red flags," and call directly if a mother had an urgent problem. Fifty-two pregnant women enrolled, 38 were followed to delivery, 95 antenatal care postintake were provided, 2 urgent complications required CHW home management of mothers, and there were 0 deaths. Stakeholders endorsed acceptability of intervention. Preliminary data suggest CHWs using mobile health technology is feasible, linking underserved and formal health care systems with provision of primary care in mothers' homes. [ABSTRACT FROM AUTHOR]

The overall goal of this pilot quality improvement (QI) intervention was to (1) assess the feasibility of making a WIC (Women, Infants, and Children) systems-level change that added measurement of maternal weight and discussion of maternal health habits into each postpartum maternal and offspring visit in rural clinics in Colorado and (2) assess the impacts of the intervention on maternal diet, physical activity, and weight status. A mixed-method evaluation approach was used involving the collection of quantitative data (HeartSmartMoms usage reports, manual WIC chart reviews [to calculate screening rates], pre-/postsurveys, and weight status [body mass index]) and qualitative data (focus groups and project team meeting minutes). It was determined it is feasible to make a short-term systems-level change; however, many barriers were encountered in doing so, and the results were not sustained. The QI intervention did decrease participants' daily consumption of sugarsweetened beverages and maternal weight status (controlling for maternal age and language), but did not improve any other eating/physical activity behaviors. Lessons learned and recommendations to improve the implementation of health promotion interventions aimed at improving postpartum maternal health, which can increase health during the periconceptional phase, and in turn, improve the health outcomes for a child, are discussed. [ABSTRACT FROM AUTHOR]

Barriers to breastfeeding for Black mothers are well documented in the literature. Local context is crucial for understanding and addressing barriers. Our research used the photovoice method to amplify the voices of Black mothers in Chatham County, Georgia. Guided by the sociol-ecological model, this photovoice project explored and identified the social, cultural, and physical barriers to breastfeeding that the mothers experienced. Two additional themes emerged through data analysis: personal comfort with public breastfeeding and the women's recommendations for breastfeeding support and normalization. Lack of physical spaces, lack of peer and family support, the need to overcome the stigma associated with breastfeeding, and advocating for more lactation spaces were commonly stated by the participants. These results led to the creation of a policy toolkit, a breastfeeding policy template, a proclamation to make the City of Savannah a Breastfeeding Family Friendly Community, an online photobook to share the experiences of the mothers, and additional paths of dialogue to increase inclusivity and expand health equity within Chatham County. [ABSTRACT FROM AUTHOR]

This poem is an autoethnopoetic exploration of my experiences of in vitro fertilization. Repetition is offered throughout the poem to create a counter-narrative and a ritual of joy in what often can be a stigmatized, shrouded, complex phenomenon. The poem amplifies the saliency of embodied knowledges for public health, not just quantitative ones, and seeks to situate IVF within the reproductive and birth justice movements. To view the original version of this poem, see the supplemental material section of this article online. [ABSTRACT FROM AUTHOR]

The Parents as Teachers (PAT) Health Literacy Demonstration project assessed the impact of integrating data-driven reflective practices into the PAT home visitation model to promote maternal health literacy. PAT is a federally approved Maternal, Infant, Early Childhood Home Visiting program with the goal of promoting school readiness and healthy child development. This 2-year demonstration project used an open-cohort longitudinal design to promote parents’ interactive and reflective skills, enhance health education, and provide direct assistance to personalize and act on information by integrating an empowerment paradigm into PAT’s parent education model. Eight parent educators used the Life Skills Progression instrument to tailor the intervention to each of 103 parent–child dyads. Repeated-measures analysis of variance, paired t tests, and logistic regression combined with qualitative data demonstrated that mothers achieved overall significant improvements in health literacy, and that home visitors are important catalysts for these improvements. These findings support the use of an empowerment model of health education, skill building, and direct information support to enable parents to better manage personal and child health and health care. [ABSTRACT FROM AUTHOR]

The National Children’s Study (NCS) is a prospective observational study examining the effects of environmental influences on child health and development in the United States. Videovoice is a health advocacy and promotion methodology wherein participants use participatory videography and interviewing techniques to identify issues of concern, communicate knowledge, and advocate for community health. This study describes a videovoice project, implemented in six Cook County, IL, communities targeted by the NCS for participant recruitment. A 6-week, videovoice training was conducted to train and empower NCS community outreach and engagement personnel. Pre/post evaluations were administered, and participant footage was qualitatively analyzed to identify overarching themes informing future outreach. Participants reported significant increases (p < .05) in videography/photography skills, community outreach/communication abilities, and awareness of important community health issues. Major themes included the following: high community knowledge of local health issues, low community knowledge of the NCS, and identification of barriers to participation. Two promotional videos were created to address these barriers and educate communities about the NCS. A 6-week, videovoice project was effective in training NCS community outreach personnel and enhancing NCS community engagement within six target Cook County, IL, communities via the production of community-engaged NCS promotional videos. [ABSTRACT FROM PUBLISHER]

Background. African American infants in San Francisco suffer a mortality rate two to three times higher than Whites, yet prior discussion groups with African American residents suggested they were unaware of this disparity. Methods. Social marketing techniques were used to develop and implement three campaigns to increase awareness. The campaign themes were (1) infant mortality disparities, (2) proper infant sleep position, and (3) taking action to reduce disparities. Mediums to carry messages included bus ads, radio ads, church fans, and posters and cards distributed at clinics, daycares, agency waiting rooms, and community organizations. Campaign effectiveness was evaluated using telephone surveys of African Americans. Results. Almost 62% report some exposure to Campaign 1, 48.5% to Campaign 2, and 48.9% to Campaign 3. Chi-square analyses reveal a statistically significant increase in awareness of the disparity (39.6% vs. 62.7%, p < .0005, odds ratio [OR] = 2.5, confidence interval [CI] = 2.1-3.2). Although there was no overall significant increase in knowledge about proper sleep position, respondents who report any exposure to this campaign are more likely to know about sleep position (70.7% vs. 63.8%, p < .0001, OR = 2.2, CI = 1.6-3.2). Conclusions. Social marketing is an effective tool to increase disparity awareness, especially among groups disproportionately affected by the disparity. [ABSTRACT FROM PUBLISHER]

Injuries involving motor vehicles continue to be the biggest threat to the safety of children. Although child safety seats (CSS) have been established as a central countermeasure in decreasing injury risk, the majority of parents do not use the correct car seat correctly. There are many challenges in promoting correct car seat use, which itself is a complex behavior. To advance this critical protective behavior, the public health community would benefit from clarifying CSS messaging, communicating clearly, and addressing the conflicting recommendations of product use. In this article, we present current challenges in promoting CSS use and draw on health communication and other fields to offer recommendations for future work in this area. [ABSTRACT FROM PUBLISHER]

Alcohol-exposed pregnancies are especially of concern for American Indians. The Indian Health Service reported that 47% to 56% of pregnant patients admitted to drinking alcohol during their pregnancy. In addition, rates of Fetal Alcohol Syndrome are estimated to be as high as 3.9 to 9.0 per 1,000 live births among American Indians in the Northern Plains, making prevention of alcohol-exposed pregnancies an important public health effort for this population. The goal of this article is to add to the literature on universal prevention of Fetal Alcohol Spectrum disorders by describing the development, dissemination, and evaluation of a media campaign on Fetal Alcohol Spectrum Disorders that was created by and for American Indian communities in the Northern Plains. [ABSTRACT FROM PUBLISHER]

Congenital cytomegalovirus (CMV) is the most common congenital infection in the United States, causing permanent disabilities in more than 5,500 children born each year. In the absence of a vaccine, a promising means of prevention is through a behavioral intervention that educates women about CMV and promotes adherence to hygiene guidelines during pregnancy. Although effective behavioral interventions have been identified for other infectious diseases with similar transmission modes, current research has not yet identified an effective intervention for CMV. One way to gather evidence and identify key elements of a successful CMV intervention is through a social marketing approach. This article describes a five-step process for applying social marketing principles to the research and development, implementation, and evaluation of a CMV behavioral intervention. [ABSTRACT FROM PUBLISHER]

Public health practitioners have increasingly leveraged technology-based communication to get health information into the hands of hard-to-reach populations; however, best practices for outreach and enrollment into mobile health (mHealth) programs are lacking. This article describes enrollment results from campaigns focused on enrolling underserved pregnant women and mothers in Text4baby-a free, mHealth service-to inform outreach strategies for mHealth programs. Text4baby participants receive health and safety information, interactive surveys, alerts, and appointment reminders through at least three weekly texts and a free app-timed to users' due date or babies' birth date. Text4baby worked with partners to implement national, state, and community-based enrollment campaigns. Descriptive statistics were used to compare baseline enrollment prior to a campaign with enrollment during a campaign to generate enrollment estimates. Enrollment rates were calculated for campaigns for which the number targeted/reached was available. National television campaigns resulted in more than 10,000 estimated enrollments. Campaigns that were integrated with an existing program and text-based recruitment had the highest enrollment rates, ranging from 7% to 24%. Facebook advertisements and traditional media targeting providers and consumers were least effective. mHealth programs should consider text-based recruitment and outreach via existing programs; additional research is needed on return on investment for different outreach strategies and on the effectiveness of different outreach strategies at reaching and enrolling specific target populations.

The Texas Public Health Training Center (TPHTC) provides quality training and education for the full spectrum of public health workers. As part of this mission, the TPHTC creates continuing education modules for nontraditional public health workers, such as community health workers (CHWs), through a culturally competent curriculum development process. CHWs, like many public health workers, must be certified by the state of Texas to practice within its borders, and continuing education is required to maintain certification. By involving CHWs and community members in its curriculum development process, the TPHTC is able to produce training modules that are more suitable for this unique and important segment of the public health workforce. The iterative curriculum development process is described here, along with a state-approved curriculum resulting from this method. As the value of the nontraditional public health workforce gains more recognition, sound curriculum design will be increasingly important to support and strengthen these nontraditional professions. [ABSTRACT FROM PUBLISHER]