The British Columbia Healthy Connections Project: findings on socioeconomic disadvantage in early pregnancy.
Adolescents
Cumulative disadvantage
Maternal health
Pregnancy
Socioeconomic disadvantage
Journal
BMC public health
ISSN: 1471-2458
Titre abrégé: BMC Public Health
Pays: England
ID NLM: 100968562
Informations de publication
Date de publication:
22 Aug 2019
22 Aug 2019
Historique:
received:
15
02
2019
accepted:
13
08
2019
entrez:
24
8
2019
pubmed:
24
8
2019
medline:
27
11
2019
Statut:
epublish
Résumé
Maternal exposure to socioeconomic disadvantage increases the risk of child injuries and subsequent child developmental and mental health problems - particularly for young mothers. To inform early intervention planning, this research therefore aimed to describe the health and social adversities experienced by a cohort of girls and young women in early pregnancy in British Columbia (BC), Canada. Participants were recruited for the BC Healthy Connections Project (BCHCP), a randomized controlled trial examining the effectiveness of Nurse-Family Partnership, a home visitation program, in improving child and maternal outcomes. Baseline data were collected from 739 participants on trial entry. Participants were selected on the basis of preparing to parent for the first time and experiencing socioeconomic disadvantage. Analyses involved descriptive statistics and age-group comparisons. Most participants reported having low income (84%), having limited education (52%) and being single (91%) at trial entry. Beyond these eligibility criteria, other health and social adversities included: housing instability (52%); severe anxiety or depression (47%); other diagnosed mental disorders (22%); prenatal nicotine and cannabis use (27 and 21%); physical health problems (20%); child maltreatment when younger (56%); and intimate partner violence recently (50%). As well, few (29%) had received income assistance entitlements. More than two thirds (70%) were experiencing four or more forms of adversity. Age-group differences were observed for cognitive functioning, being single, low income, limited education, psychological distress and service use (p-value ≤0.05). This cohort was selected on the basis of socioeconomic disadvantage. Yet all participants were experiencing substantial added adversities - at higher rates than other Canadians. Furthermore, despite Canada's public programs, these pregnant girls and young women were not being adequately reached by social services. Our study adds new data to inform early intervention planning, suggesting that unacceptably high levels of socioeconomic disadvantage exist for some young British Columbians. Therefore greater health and social supports and services are warranted for these young mothers and their children. Registered August 24, 2012 with ClinicalTrials.gov Identifier: NCT01672060 . Active not recruiting.
Sections du résumé
BACKGROUND
BACKGROUND
Maternal exposure to socioeconomic disadvantage increases the risk of child injuries and subsequent child developmental and mental health problems - particularly for young mothers. To inform early intervention planning, this research therefore aimed to describe the health and social adversities experienced by a cohort of girls and young women in early pregnancy in British Columbia (BC), Canada.
METHODS
METHODS
Participants were recruited for the BC Healthy Connections Project (BCHCP), a randomized controlled trial examining the effectiveness of Nurse-Family Partnership, a home visitation program, in improving child and maternal outcomes. Baseline data were collected from 739 participants on trial entry. Participants were selected on the basis of preparing to parent for the first time and experiencing socioeconomic disadvantage. Analyses involved descriptive statistics and age-group comparisons.
RESULTS
RESULTS
Most participants reported having low income (84%), having limited education (52%) and being single (91%) at trial entry. Beyond these eligibility criteria, other health and social adversities included: housing instability (52%); severe anxiety or depression (47%); other diagnosed mental disorders (22%); prenatal nicotine and cannabis use (27 and 21%); physical health problems (20%); child maltreatment when younger (56%); and intimate partner violence recently (50%). As well, few (29%) had received income assistance entitlements. More than two thirds (70%) were experiencing four or more forms of adversity. Age-group differences were observed for cognitive functioning, being single, low income, limited education, psychological distress and service use (p-value ≤0.05).
CONCLUSIONS
CONCLUSIONS
This cohort was selected on the basis of socioeconomic disadvantage. Yet all participants were experiencing substantial added adversities - at higher rates than other Canadians. Furthermore, despite Canada's public programs, these pregnant girls and young women were not being adequately reached by social services. Our study adds new data to inform early intervention planning, suggesting that unacceptably high levels of socioeconomic disadvantage exist for some young British Columbians. Therefore greater health and social supports and services are warranted for these young mothers and their children.
TRIAL REGISTRATION
BACKGROUND
Registered August 24, 2012 with ClinicalTrials.gov Identifier: NCT01672060 . Active not recruiting.
Identifiants
pubmed: 31438906
doi: 10.1186/s12889-019-7479-5
pii: 10.1186/s12889-019-7479-5
pmc: PMC6704647
doi:
Banques de données
ClinicalTrials.gov
['NCT01672060']
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
1161Subventions
Organisme : BC Ministries of Health and Child and Family Development
ID : XLP0764X01
Références
Psychol Med. 2002 Aug;32(6):959-76
pubmed: 12214795
Child Abuse Negl. 2003 Feb;27(2):169-90
pubmed: 12615092
J Epidemiol Community Health. 2004 Aug;58(8):680-5
pubmed: 15252071
Violence Vict. 2005 Oct;20(5):529-47
pubmed: 16248489
Science. 2006 Jun 30;312(5782):1900-2
pubmed: 16809525
BMC Pediatr. 2006 Nov 09;6:30
pubmed: 17094808
Lancet. 2009 Jan 17;373(9659):250-66
pubmed: 19056113
J Int Neuropsychol Soc. 2009 May;15(3):438-50
pubmed: 19402930
Annu Rev Public Health. 2010;31:329-47 3p following 347
pubmed: 20070189
BMC Pregnancy Childbirth. 2010 May 24;10:24
pubmed: 20497553
Chronic Dis Can. 2010 Jun;30(3):84-94
pubmed: 20609292
Acad Pediatr. 2010 Sep-Oct;10(5):293-301
pubmed: 20674531
J Scand Stud Criminol Crime Prev. 2008 Dec 1;9(S1):2-24
pubmed: 20885797
Clin Child Fam Psychol Rev. 2011 Mar;14(1):1-27
pubmed: 21052833
Annu Rev Public Health. 2011;32:381-98
pubmed: 21091195
PLoS One. 2012;7(4):e35193
pubmed: 22496906
Am J Public Health. 2012 Oct;102(10):1893-901
pubmed: 22897526
Am J Public Health. 2013 Feb;103(2):e8-e15
pubmed: 23237180
Soc Sci Med. 2013 Aug;90:24-31
pubmed: 23746605
Midwifery. 2014 Jun;30(6):688-95
pubmed: 24041564
Dev Psychobiol. 2014 Jul;56(5):1027-35
pubmed: 24523069
BMC Med Res Methodol. 2014 Mar 25;14:42
pubmed: 24669751
CMAJ. 2014 Jun 10;186(9):E324-32
pubmed: 24756625
Science. 2014 May 23;344(6186):856-61
pubmed: 24855261
Int Rev Psychiatry. 2014 Aug;26(4):392-407
pubmed: 25137105
Am J Epidemiol. 2015 Apr 1;181(7):496-503
pubmed: 25740788
Lancet. 2016 Jan 9;387(10014):146-55
pubmed: 26474809
BMC Health Serv Res. 2016 Aug 04;16(a):349
pubmed: 27488474
Proc Natl Acad Sci U S A. 2016 Dec 27;113(52):14949-14952
pubmed: 27956615
Behav Sci (Basel). 2017 Feb 08;7(1):null
pubmed: 28208690
Pharmacol Ther. 2018 Feb;182:133-151
pubmed: 28847562
BMC Pediatr. 2018 Feb 23;18(1):83
pubmed: 29475430
Can J Psychiatry. 2019 Apr;64(4):227-231
pubmed: 30978136
J Health Soc Behav. 1978 Mar;19(1):2-21
pubmed: 649936