Impact on Maternal and Infant Outcomes by Intervening With Maternal Health Behavior
Yukiko Washio (RTI International)
Biography:Yukiko Washio is a researcher at Substance Use, Gender, and Applied Research of RTI International and an adjunct faculty at Obstetrics and Gynecology Department at Temple University Lewis Katz School of Medicine. She consults in both the US and Japan for public health research and implementation using behavior analysis. She currently teaches behavior analysis at Capella University. Her research focus and interest are intervention development, adaptation, and testing to address persistent maternal health behavioral issues that tend to result in a major economic burden at the societal level. Her behavior analysis graduate and postdoctoral training thrives on development of behavioral interventions and professional network to expand research activities and dissemination.
Abstract: Women are often motivated to stay healthy for the well-being of their child during pregnancy and lactation. Generally speaking, women who are pregnant are recommended to eat healthy, exercise properly, and stay away from substance use, including illicit and prescription drugs, alcohol, marijuana, and tobacco, which are potentially harmful to their child. Additionally, breastfeeding is increasingly encouraged as the most recommended feeding practice for at least 6 months, if not longer, to maintain the health of women and their infants. While most women are able to practice a healthy lifestyle during pregnancy and lactation, women with certain social determinants (such as socioeconomic disadvantage, younger age, race/ethnic status, mental health issues, violence exposure, and reproductive and sexual health issues) have difficulties maintaining healthy lifestyles during these critical periods. Various treatment options including behavioral and pharmacological interventions have been developed using computer-based and telecommunication technology to address substance, alcohol, and tobacco use, breastfeeding, contraceptive use, and adherence to maternal-infant care among pregnant and postpartum populations. Tested interventions include, but are not limited to, brief interventions, contingency management, cognitive behavioral therapy, peer and group support, additional to other forms of counseling, and pharmacological treatment such as bupropion. Treatment interventions generally provide education and referral information, nudge to focus on healthy practices, reinforcement on healthy behavior, and cognitive and behavioral exercises such as skill training, to increase the value of natural or contrived reinforcers to engage in healthy behavior. Comprehensive and combined intervention approaches are probably the most ideal for intervening with pregnant and postpartum populations to address intertwined health issues and social determinants that interact with each other. With under-resourced communities, healthcare settings, and workforces that deal with pregnant and postpartum populations, dissemination and sustainability of evidence-based interventions is another major challenge that we need to face. This presentation provides an overview of maternal health behavioral issues, some of the intervention studies, and challenges and efforts to overcome sustainability issues.