Suchergebnisse

OBJECTIVE(S): The contraception mandate of the Affordable Care Act (ACA) could reduce unintended pregnancies by increasing access and affordability of contraceptive resources, such as long-acting reversible contraceptives (LARCs). The objective of this study was to assess: (1) whether unintended pregnancies decreased following the contraception mandate, and (2) whether this decrease differed by demographic characteristics (race/ethnicity, insurance, or relationship status). STUDY DESIGN: We used data on sexually active, fecund women of reproductive age from the National Survey of Family Growth (NSFG) (unweighted n=7,409). We used logistic regression to compare odds of unintended pregnancy between pre-mandate (2008–2010) and post-mandate (2013–2015) periods, both overall and stratified by demographic characteristics. RESULTS: Paralleling an increase in LARC use (p<0.01), the percentage of women experiencing unintended pregnancy in the prior year decreased from 5.5% to 4.9% (p=0.45), and the percentage of pregnancies that were unintended in the prior year decreased from 44.7% to 37.9% (p=0.21) following the mandate. Overall, the odds of experiencing unintended pregnancy decreased 15% from the pre-mandate to post-mandate period (OR: 0.85, 95% CI: 0.62, 1.17; p=0.32), with the greatest reduction in odds observed in women with government-sponsored insurance (OR: 0.63, 95% CI: 0.41, 0.97; p=0.04). CONCLUSIONS: Unintended pregnancy decreased in NSFG respondents in the two years following the contraception mandate, but this observation may have been due to chance. The current study, however, is limited by its early study period which could under-estimate the mandate's full effect. More effort is required to identify and address additional barriers to contraception and reproductive autonomy.

AbstractWe examined Australian parents' opinions of primary school food and nutrition education (FNE) via a cross‐sectional survey that collected quantitative and qualitative data. Most parents agreed that primary schools should teach FNE, starting at either the first or the second year of primary school and delivered weekly or fortnightly for approximately 1–2 h. The majority of parents believed that FNE could be incorporated into several school subjects. Many believed that FNE should be taught to ensure equity and to promote healthy eating among children. Consideration of parents' opinions about school FNE programmes could help design and deliver more effective FNE programmes.

The black-white disparity in preterm birth has been well documented in the USA. The racial/ethnic composition of a neighborhood, as a marker of segregation, has been considered as an underlying cause of the racial difference in preterm birth. However, past literature using cross-sectional measures of neighborhood racial/ethnic composition has shown mixed results. Neighborhoods with static racial/ethnic compositions over time may have different social, political, economic, and service environments compared to neighborhoods undergoing changing racial/ethnic compositions, which may affect maternal health. We extend the past work by examining the contribution of neighborhood racial/ethnic composition trajectories over 20 years to the black-white difference in preterm birth. We used natality files (N = 477,652) from birth certificates for all live singleton births to non-Hispanic black and non-Hispanic white women in Texas from 2009 to 2011 linked to the Neighborhood Change Database. We measured neighborhood racial/ethnic trajectories over 20 years. Hierarchical generalized linear models examined relationships between neighborhood racial/ethnic trajectories and preterm birth, overall and by mother's race. Findings showed that overall, living in neighborhoods with a steady high proportion non-Hispanic black was associated with higher odds of preterm birth, compared with neighborhoods with a steady low proportion non-Hispanic black. Furthermore, while black women's odds of preterm birth was relatively unaffected by neighborhood proportions of the Latinx or non-Hispanic white population, white women had the highest odds of preterm birth in neighborhoods characterized by a steady high proportion Latinx or a steady low proportion non-Hispanic white. Black-white differences were the highest in neighborhoods characterized by a steady high proportion white. Findings suggest that white women are most protected from preterm birth when living in neighborhoods with a steady high concentration of whites or in neighborhoods with a ...

Purpose
This study aims to examine Victorian primary school parents' perspectives about a potential school-provided lunch program (LP).


Design/methodology/approach
An online cross-sectional survey was conducted in Victoria, Australia, in 2022 to explore parents' perceptions regarding the lunch menu, funding source, amount willing to pay, frequency of meals and special dietary needs of a school-provided LP.


Findings
Over half of parents (57% out of 359) said they would allow their child to participate in a school LP, 34% were unsure and only 9% said they would not. The opportunity for hot cooked lunches at school and the perceived convenience for parents were the top two reasons for favouring such a program. Fifty-eight percent were in favour of hybrid-type funding from both the government and parents. The most preferred amount to pay per meal was AUD5-6 (43%), followed by AUD3-4 (25%). Parents expected meals to be healthy and made from whole food and cater to the special dietary and cultural needs of their children. They also expected enough time to be allocated so children could eat and enjoy the meals.


Originality/value
To the best of the authors' knowledge, this is the first study to explore Victorian parents' perceptions regarding the above aspects of a school-provided LP. The findings suggest that parents are receptive to a school-provided LP; they, however, did have several expectations regarding the menu and time for eating. These findings provide important directions for designing future school-provided LPs at primary schools in Australia.

AbstractIt has been proposed that low birth weight is associated with high levels of blood pressure in later life. The aim of this study was to assess the relationship of blood pressure to birth weight and current body size during growth and adulthood. A total of 711 female multiple births, with one group of 244 in their growth phase mean age 12.0 (2.3)(SD) years and the other of 467 adults (mean age 35.2 (12.6) years), had height, weight and both systolic (SBP) and diastolic (DBP) blood pressures measured, and self-reported their birth weight. Regression analyses were performed to assess the cross-sectional and within-pair associations of blood pressure to birth weight, with and without adjustments for current body size. Within-pair analysis was based on 296 twin pairs. Cross-sectionally, a reduction in birth weight of 1 kg was associated with 2 to 3 mm Hg higher age-adjusted SBP, which was of marginal significance and explained about 2% of the population variance. Adjustment for body mass index did not significantly change this association. Within-pair analyses found no association between birth weight and SBP or DBP, even after adjusting for current body size. After age, current body size was the strongest predictor of systolic BP. The weak association of blood pressure to birth weight cross-sectionally is of interest, but any within-pair effect of birth weight on blood pressure must be minimal compared with the effect of current body size.