Funded Research
Central Pennsylvania Women's Health Study: Extending the Strong Healthy Women Behavior Change Intervention to Urban Areas
Source: PA Tobacco Settlement Fund
Active: 11/24/2008 - 06/30/2010
Investigator(s):
Carol Weisman
John Botti
Danielle Downs
Mark Feinberg
Marianne Hillemeier
Recent recommendations to improve preconception health and health care in the United States (CDC, 2006) have inspired calls for innovative approaches to reduce adverse pregnancy outcomes, including strategies for improving women's health before they become pregnant. This research builds on initial findings of the effectiveness of the "Strong Healthy Women" intervention, which was developed at Penn State as part of the Central Pennsylvania Women's Health Study (CePAWHS). The intervention is a 6-session, small-group format health behavior change program for pre- and interconceptional women. The content targets prevalent risk factors for adverse pregnancy outcomes identified in CePAWHS population-based surveys. In a randomized trial involving 692 non-pregnant women ages 18-35 in 15 low-income rural communities in Central Pennsylvania, analyses showed significant improvement in multiple targeted risk factors for adverse pregnancy outcomes including attitudes, intentions, and behaviors related to nutrition, physical activity, and folic acid supplementation. Because this trial focused on a largely white population, the goal of this project is to modify the "Strong Healthy Women" intervention to optimally engage urban African American women. The specific aims are: (1) To conduct focus groups with race/ethnically diverse pre- and interconceptional women in three urban low-income communities in Central Pennsylvania (Harrisburg, Lancaster, and York), to guide modifications of the "Strong Healthy Women" intervention; and (2) To pilot test the modified aspects of the Strong Healthy Women intervention in race/ethnically diverse groups of pre- and interconceptional women in Harrisburg, Lancaster, and York. Participants will be recruited from community settings in partnership with community organizations in a manner similar to the initial CePAWHS study. Three focus groups will be conducted in each of the three urban areas, for a total of 9 focus groups. Two focus groups in each area will be comprised of African American women, and one group will be comprised of white women. Focus group data will be used to modify the intervention content to ensure that the content is accessible and motivating to urban women. Once the content modifications have been made, pilot testing of the modified content will be carried out in 3 additional focus groups in each urban area, with participants selected from the previously conducted focus groups. The expected outcome is development of a modified version of the "Strong Healthy Women" intervention that can be tested in a randomized controlled trial (external funding is being sought for this trial). Behavior change interventions like "Strong Healthy Women" that contribute to a reduction in risks of adverse pregnancy outcomes, and to the elimination of disparities in these outcomes across geographic and race/ethnic groups, are of great public health importance and will have substantial impact on the overall health status of these women, as well as their children and families.
