Biomedical subjects

M L Poland

Publications and source records attributed to M L Poland.

At least 19 recordsLinked to original sources

PubMed1993

Punishing pregnant drug users: enhancing the flight from care.

One hundred forty-two low income women were interviewed postpartum to determine their attitudes regarding the potential effects of a punitive law on the behavior of substance-using pregnant women. The convenience sample was primarily black (85.2%) and single (81%) and 14.8% admitted use of illicit drugs during pregnancy. A goodness-of-fit chi-square analysis revealed that subjects believed a punitive law would be a significant deterrent to substance-using gravida seeking prenatal care, drug testing or drug treatment (P < 0.01). Comments indicated that substance-using pregnant women would 'go underground' to avoid detection and treatment for fear of incarceration and loss of their children.

Alcohol Drinking↗

PubMed1992

Correlates of battering during pregnancy.

Battering during pregnancy affects the health of both pregnant women and their unborn children. The purpose of this retrospective study of 488 primarily Medicaid-eligible postpartum women was to identify the constellation of factors associated with violence. The prevalence of battering during pregnancy was 7%, similar to that found in other studies. Significant correlates of battering included anxiety, depression, housing problems, inadequate prenatal care, and drug and alcohol use. Woman battering by a partner during pregnancy was associated with a greater severity of this constellation of patterns than those experiencing abuse before pregnancy only, or those experiencing physical attack by someone other than their partner. These factors are important to recognize in nursing assessment of pregnant women.

Adult↗

PubMed1992

Effects of a home visiting program on prenatal care and birthweight: a case comparison study.

Recent reports have stressed the importance of social support services to the health and well being of pregnant women and their newborns. The impact of paraprofessional support services on the amount of prenatal care received and birthweight was studied in a sample of 111 low-income women. Paraprofessionals were women who had been on public assistance and successfully attained health and human services for themselves and their infants. They were similar to the patients they served in educational background and ethnicity. A six-week training program prepared them to counsel and assist pregnant women with health and social services, housing, food, transportation and other basic necessities. Women attending a publically-funded prenatal clinic were randomly assigned to a paraprofessional. A comparison group matched for ethnicity, parity and trimester entering prenatal care was also selected. Women followed by a paraprofessional had significantly more prenatal appointments (8.0 vs 6.5 visits) and infants with average higher birthweight (3125 grams) over the matched comparison group (3273 grams). While intensity of contact with a paraprofessional contributed significantly to the amount of prenatal care received by patients of paraprofessionals, the mechanism for improvement in birthweight is unknown.

Adolescent↗

PubMed1991

Prenatal care: a path (not taken) to improved perinatal outcome.

Six hundred and six low income women were studied postpartum to assess the relationship among medical risk factors, use of alcohol and drugs, race, content/amount of prenatal care and birth weight. Content of prenatal care was defined by the number of medical procedures performed and amount of care was determined by the Kessner Index. Women received prenatal care in 1-4 different sites. Those remaining in or transferring to sites performing the least number of routine prenatal procedures delivered babies with lower birth weights than those selecting sites performing more procedures. A path analysis (LISREL) constructed a priori to model the relationships among medical risk factors, use of alcohol and drugs, race, content/amount of prenatal care received and birth weight, revealed that women at high medical risk were more likely to receive care at sites offering more medical procedures while those who abused drugs and alcohol were significantly less likely to receive such care. Medical risk factors and the use of alcohol and drugs had significant negative effects on birth weight, while content and amount of prenatal care contributed to improved birth weight. These findings are discussed relative to issues of access to high quality prenatal care by patients at greatest risk and to the prevention of low birth weight infants.

Adolescent↗

PubMed1990

Effects of social supports on attitudes, health behaviors and obtaining prenatal care.

The influence of social support on attitudes, health behaviors and attaining prenatal care was assessed in 300 postpartum patients. Demographic, medical, sociocultural, attitudinal and behavioral factors were assessed by interview and review of the medical chart. Three discrete social support factors (intimacy, comfort, security) were identified by factor analysis. The presence of social support was correlated with positive prenatal attitudes, not using drugs, and adequate health resources. Stepwise multiple-regression analysis demonstrated that one social support factor (intimacy), two health behaviors (not drinking and not smoking while pregnant), and parity accounted for 22% of the variance in amount of prenatal care.

Adult↗

PubMed1990

Enhancing the adolescent reproductive process: efforts to implement a program for black adolescent fathers.

The importance of adolescent fathers participating more fully in pregnancy and childrearing has been emphasized increasingly in the literature. This article describes the development and evaluation of childbearing clinical services designed for adolescent fathers. This multidisciplinary effort used an action research model that integrates empirical research into ongoing programs, continuously monitoring progress. It is comprised of five elements: population description, determination of clients' health needs, assessment and development of resources, evaluation of program services, and monitoring of outcomes. Although the study was not designed exclusively for black adolescents, 95% of the individuals who participated were black. The cultural composition of the study population suggests and impact on the findings. Suggestions are made for future program efforts with adolescent parents.

Adolescent↗

PubMed1990

Quality of prenatal care; selected social, behavioral, and biomedical factors; and birth weight.

Two hundred two poor, mainly black women were studied to assess the effects of selected social, behavioral, and biologic factors on birth weight. A path analysis was used to model hypotheses about the interrelationships among these variables. Six sociocultural factors had direct paths to quality of prenatal care: amount of insurance, delay in telling others about the pregnancy, attitudes toward health professionals, month of gestation in which the pregnancy was suspected, perception of the importance of prenatal care, and initial attitude toward the pregnancy. Together, these factors accounted for 64% of the variance in the quality of prenatal care received. Four variables had direct paths to birth weight: month in which the pregnancy was suspected, quality of prenatal care, hypertension, and substance abuse, which together accounted for 13% of the variance in birth weight. The key findings were the relative impact that the quality of prenatal care, especially the source of care, had on birth weight, and the potential for improving birth outcomes by addressing the negative effects of underlying social factors.

Attitude↗

PubMed1988

Clinical applications of self-esteem and locus of control to adolescent health.

Self-esteem and locus of control are two associated constructs representing, respectively, a generalized self-evaluation and an assessment of personal control. Measures representing these constructs generally rely on self-report. These measures have been applied to adolescent health as predictors and outcomes. Most studies rely on chi 3, t-test, and ANOVA analysis and report mixed results in attaining significant group comparisons on issues including contraceptive use, adolescent pregnancy, and substance abuse. Few studies employ multiple regression or discriminant function analysis assessing the relative influence or predictive accuracy and sensitivity of these measures. Studies using these analyses report limited or nonsignificant contributions of these measures to clinical issues (e.g., adolescent fatherhood, adolescent pregnancy, substance abuse, medical management) relative to variables such as patient age, social class, parental attitudes, and peer relationships. Our discussion of these results addresses the validity of self-reports of self-esteem and locus of control versus observation procedures assessing these constructs by verbal and nonverbal presentation of self, analytic procedures appropriate to clinical prediction of behavior by person and situation characteristics, and procedures to advance the clinical adoption of behavioral measures.

Adolescent↗

PubMed1988

Effects of stress and characteristic adaptability on semen quality in healthy men.

Semen from 28 healthy volunteers was assessed for basic semen measure and percent of abnormal morphologic forms every 2 weeks for 6 months. Concurrent self-reports were obtained on abstinence, frequency of ejaculation, health behavior and status, experienced stress, social support, and life events. A single assessment of characteristic adaptability (ego resiliency) also was obtained. Significant between-subject positive correlations were reported among selected semen measures, abstinence, and ego-resiliency. Stress was correlated negatively with semen measures of volume and percent normal morphologic forms.

Adult↗

PubMed1988

Correlates of parenting on a neonatal intensive care unit: maternal characteristics and family resources.

The association of maternal characteristics, family resources, and receipt of prenatal care with parenting behaviors observed in a neonatal intensive care unit (NICU; n = 383) was assessed. The parenting behavior of mothers not receiving prenatal care (n = 128) was compared to that of mothers of the preceding and subsequent admissions (n = 256) by retrospective chart review. Parenting variables included frequency of visits to the NICU and evaluative ratings of parents' involvement with their infant. Parenting of the no-prenatal-care group was significantly less favorable than the control on all comparisons. Factor analysis supported a priori grouping of parenting variables. A stepwise multiple regression of maternal and family characteristics to the factor-derived variable, parenting, showed significant contributions for prenatal drug use and father involvement. Pediatric interventions assessing maternal social and behavioral characteristics are proposed.

Female↗

PubMed1988

Correlates of neonatal morbidity: maternal characteristics and family resources.

The association of mental characteristics, family resources, and receipt of prenatal care with infant birth weight, gestational age, and Apgar scores was assessed in a retrospective review of an extant computerized data base of admissions to a neonatal intensive care unit (NICU; n = 3,818). Prediction variables included mother's age, marital status, health insurance, parity, prenatal health problems, and prenatal drug use. Less favorable infant birth status was associated with prenatal health problems, being single, not having private insurance, obtaining a prior elective abortion, prenatal drug use, and not receiving prenatal care. Stepwise multiple regressions of predictor variables to birth weight and lack of prenatal care were performed. Low birth weight was associated with being single, receiving no prenatal care, and being Black. Lack of prenatal care was associated with mother's age, high parity, prenatal health problems, and prenatal illicit drug use. Pediatric interventions assessing maternal social and behavioral characteristics are proposed.

Apgar Score↗

PubMed1987

Effects of social supports on attitudes and health behaviors of pregnant adolescents.

The influence of social support on maternal attitudes and behaviors was assessed in 57 third-trimester adolescent women attending an urban prenatal clinic. Sociodemographic characteristics, social support, self-esteem, and feelings about pregnancy were measured by questionnaire. The support and influence of the adolescent father was emphasized. Social support was measured as a multidimensional construct derived by a priori and empirical procedures. The outcomes measured were the amount of prenatal care, attendance at scheduled postpartum appointments, and pleasure with the pregnancy. Stepwise multiple-regression analyses were used to assess the contributions of the predictor to criterion variables. Pleasure with pregnancy was positively associated with the receipt of assistance from the adolescent's mother, favorable opinions of friends, and satisfaction with living arrangements. Attendance at postpartum visits was associated with high self-esteem. Notably absent as significant contributors were sociodemographic characteristics, receipt of emotional and tangible support from the adolescent father, and expectation of aid from social-assistance programs.

Adolescent↗

PubMed1987

Barriers to receiving adequate prenatal care.

One hundred eleven postpartum patients who received varying amounts of prenatal care (no care, inadequate care, intermediate care, and adequate care) were assessed for demographic, medical and sociocultural factors by interview and review of the medical chart. Six sociocultural factors identified by stepwise multiple regression contributed to 49% of the variance for amount of prenatal care: amount of insurance, attitudes toward health professionals, delays in suspecting pregnancy, delay in telling others about the pregnancy, perception of the importance of prenatal care, and initial attitudes about being pregnant. Results are discussed in terms of developing outreach programs altered to the patient's needs and life-styles.

Adult↗

PubMed1986

Pregnant adolescents' health-information needs. Implications for health education and health seeking.

The prenatal health information needs of 142 predominantly black, urban, and low-income adolescents (mean age = 16.9 years) were assessed by questionnaire early in the third trimester of pregnancy. Factor analysis identified three clusters of health topics labeled new morbidity, depressed somatization, and pregnancy. Relationships of these factors to self-esteem and health seeking were assessed in a subset (n = 57). A high score on depressed somatization was associated with low self-esteem and missed postpartum visits. Implications for planning prenatal education and effecting appropriate health-seeking behaviors are discussed.

Adolescent↗

PubMed1985

Variation of semen measures within normal men.

Variation in semen measures was assessed bimonthly in 15 healthy men over a 6-month period. Average within-subject coefficients of variation for sperm count, morphologic features, motility, and semen volume demonstrate considerable variation. Each day of abstinence increased the volume by an increment of 0.62 ml, the count by 17.6 X 10(6)/ml, and motility by 1.2%. Sperm count and semen volume correlated positively within subjects. Intraclass and serial correlations of semen measures provided an empirical clinical guide to the number and spacing of specimens. Three specimens spaced no more than 2 weeks apart established a reliable semen profile. Findings can be applied to basic research and clinical practice.

Adult↗

PubMed1985

Primary care of adolescents. Issues in program development and implementation.

Recent reviews of adolescent primary care urge the development of a dynamic program evaluation strategy. An action research evaluation model that combines service, training, and research to foster the development and implementation of primary care services is presented. The strategy includes description of patient populations, determination of patient health care needs, specification of service objectives, assessment of health care resources, and evaluation of service procedures and outcomes. Elements of the action research strategy are applied to evaluate two current issues in adolescent primary care: family-oriented versus adolescent-limited services and "new morbidity".

Adolescent↗

PubMed1985

Health needs of high school students in Detroit.

This project identified the health care needs and information concerns of high school students who were potential patients for a new adolescent health clinic in Detroit. Questionnaires assessed current health problems, information needs, and factors affecting use of health services by 613 predominantly black, urban, high school students at a regional high school (n = 187, X age = 16.8) and a neighborhood high school (n = 426, X age = 15). Reported health problems included eating the proper foods, school problems, acne, depression, and headaches. Expressed health information needs included skin problems, drugs, gender, and birth control. Differences among school, age, and gender were noted. Subjects preferred continuity of provider care and receiving health information by private, direct, patient-physician contact. The findings were used in staff training and in program planning for the adolescent health clinic for high-risk youth.

Adolescent↗

PubMed1985

Psychologic aspects of vaginal agenesis.

An assessment of the psychologic aspects of total vaginal agenesis was done on 54 patients. Emotional reactions to the diagnosis and treatment varied with the age of the patient and her relationship with her parents. Some were initially depressed, questioning themselves as females and their futures as wives and mothers. Sterility was the most difficult aspect to accept. Postoperative compliance with dilator use varied with the extent of the preparation for surgery and the extent of the open, supportive relationships with the staff and family. Prolonged counseling, with monitoring of emotional reactions and reinforcement with factual information, was a vital part of the medical management and had an impact on the final result.

Adolescent↗