HOLISTIC OBSTETRICAL PROBLEM EVALUATION (HOPE): TESTING A THEORY TO PREDICT BIRTH OUTCOMES IN A GROUP OF WOMEN FROM APPALACHIA

The purpose of this study was to test the Holistic Obstetrical Problem Evaluation (HOPE) theory by determining the effects of prenatal factors from the biophysical, psychosocial, spiritual, and perceptual domains of the HOPE theory with infant birth outcomes. Face-to-face interviews were conducted using standard and reliable questionnaires with a convenience sample of 120 pregnant women between the ages of 14 and 44 years and 16-28 weeks gestation, and attending three prenatal clinics in East Tennessee. Based on the multiple regression analysis, absence of maternal partner support during pregnancy and African-American race predicted variance for infant birth weight ( p < .05), while lower levels of self-esteem, use of drugs and alcohol, and active religiosity predicted shorter length of gestation at birth ( p < .05). The multiple logistic regression analysis model revealed that the HOPE theory was significantly related to a greater incidence of preterm birth ( p = .03), Chi 2 = 28.16, R 2 = .22. Within this model, lower levels of self-esteem and a woman's negative perception of her pregnancy, were significant predictors for preterm birth ( p < .05). Although there was preliminary support for this holistic theory, further research with a larger and more diverse population of women is needed.     

Misuse of analysis of covariance in aging research and some partial solutions

Abstract

Geron-tological researchers are reminded of the inappropriateness of analysis of covariance wherein the covariate is correlated with the independent variable, typically age. Two partial solutions are suggested that deal with the confounding of age effects with such uncontrolled variables as, for example, initial ability level or level of education.     

Rural Disparities in the Distribution of Policies that Support Healthy Eating in US Secondary Schools

The distribution of food and nutrition policies and practices from 28 US states representing 6,732 secondary schools was evaluated using data from the 2008 School Health Profiles principal survey. School policies and practices evaluated were: availability of low-nutrient, energy-dense (LNED) snacks/drinks; use of healthy eating strategies; banning food marketing; availability of fruits and vegetables; and food package sizes. For each school, school-level demographic characteristics (percentage of students enrolled in free/reduced-price meals, minority enrollment, and geographic location) were also evaluated. Schools in small town/rural locations had significantly fewer policies that support healthy eating strategies and ban food marketing, and were less likely to serve fruits and vegetables at school celebrations, have fruits and vegetables available in vending or school stores, and limit serving-size packages. Schools serving the highest percentage of minority students consistently reported the same or better school food environments. However, schools serving the highest percentage of low-income students had varied results: vending and LNED vending policies were consistently better and fruit and vegetable availability–related policies were consistently worse. Disparities in the distribution of policies and practices that promote healthy school food environments seem most pronounced in small town/rural schools. The data also support the need for continued reinforcement and the potential for expansion of these efforts in urban and suburban areas and schools with highest minority enrollment.