Last data update: Oct 28, 2024. (Total: 48004 publications since 2009)
Records 1-8 (of 8 Records) |
Query Trace: Levis DM[original query] |
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Family Perceptions of Newborn Cytomegalovirus Screening: A Qualitative Study
Cannon MJ , Levis DM , McBride H , Watson D , Rheaume C , Hall MAK , Lanzieri TM , Demmler-Harrison G . Int J Neonatal Screen 2021 7 (4) OBJECTIVES: We sought to understand long-term retrospective parental perceptions of the utility of newborn screening in a context where many affected children never develop sequelae but where intensive support services and ongoing healthcare were provided. STUDY DESIGN: Qualitative study. METHODS: Focus groups and interviews among parents (N = 41) of children with congenital CMV who had been enrolled in a long-term follow-up study at a large medical college for a mean of 22 years following diagnosis. Groups included parents whose children were: symptomatic at birth; initially asymptomatic but later developed sensorineural hearing loss; and who remained asymptomatic into adulthood. RESULTS: With proper follow-up support, newborn CMV screening was viewed positively by parents, who felt empowered by the knowledge, though parents often felt that they and healthcare providers needed more information on congenital CMV. Parents in all groups valued newborn CMV screening in the long term and believed it should be embedded within a comprehensive follow-up program. CONCLUSIONS: Despite initial distress, parents of CMV-positive children felt newborn CMV screening was a net positive. Mandatory or opt-out screening for conditions with variable presentations and treatment outcomes may be valuable in contexts where follow-up and care are readily available. |
Using theory-based messages to motivate U.S. pregnant women to prevent cytomegalovirus infection: results from formative research
Levis DM , Hillard CL , Price SM , Reed-Gross E , Bonilla E , Amin M , Stowell JD , Clark R , Johnson D , Mask K , Carpentieri C , Cannon MJ . BMC Womens Health 2017 17 (1) 131 BACKGROUND: An estimated 1 in 150 infants is born each year with congenital cytomegalovirus (CMV); nearly 1 in 750 suffers permanent disabilities. Congenital CMV is the result of a pregnant woman becoming infected with CMV. Educating pregnant women about CMV is currently the best approach to prevention. Limited research is available on how to effectively communicate with women about CMV. We conducted formative research on fear appeals theory-based messages about CMV and prevention with U.S. women. Fear appeal theories suggest that message recipients will take action if they feel fear. METHODS: First, we conducted in-depth interviews (N = 32) with women who had young children who tested positive for CMV. Second, we conducted eight focus groups (N = 70) in two phases and two cities (Phase 2: Atlanta, GA; Phase 3: San Diego, CA) with pregnant women and non-pregnant women who had young children. Few participants knew about CMV before the focus groups. Participants reviewed and gave feedback on messages created around fear appeals theory-based communication concepts. The following concepts were tested in one or more of the three phases of research: CMV is severe, CMV is common, CMV is preventable, CMV preventive strategies are similar to other behavior changes women make during pregnancy, CMV preventive strategies can be incorporated in moderation to reduce exposure, and CMV is severe but preventable. RESULTS: Participants recommended communicating that CMV is common by using prevalence ratios (e.g., 1 in 150) or comparing CMV to other well-known disabilities. To convey the severity of CMV, participants preferred stories about CMV along with prevention strategies. Participants also welcomed prevention strategies when it included a message about risk reduction. In general, participants said messages were motivating, even if they felt that it could be difficult to make certain behavior changes. CONCLUSIONS: Findings from this research can contribute to future efforts to educate pregnant women about CMV, especially regarding use of fear appeals-based messages. Pregnant women may face certain challenges to practicing prevention strategies but, overall, are motivated make changes to increase their chances of having a healthy baby. |
Examining parents' experiences and information needs regarding early identification of developmental delays: qualitative research to inform a public health campaign
Raspa M , Levis DM , Kish-Doto J , Wallace I , Rice C , Barger B , Green KK , Wolf RB . J Dev Behav Pediatr 2015 36 (8) 575-85 OBJECTIVE: The purpose of this study was to assess the approach and materials of Centers for Disease Control and Prevention's "Learn the Signs. Act Early." (LTSAE) health education campaign, which aims to improve awareness of developmental milestones and early warning signs of developmental delay among parents of young children. METHODS: We conducted 2 phases of qualitative research. Focus groups assessed the campaign's objectives by exploring the experiences of parents with children who have developmental delays or disabilities to determine facilitators of and barriers to identification. In-depth interviews were conducted with parents of typically developing children, who reviewed campaign materials and provided feedback on appropriateness, appeal, and clarity with regard to the campaign's objectives. RESULTS: Phase 1: Parents were typically the first to express concern about their child's development, and most talked with their child's health care provider. Two categories of health care providers emerged: those who proactively asked about a child's development, used tools to facilitate conversations, and made referrals, and those who did not ask about development, told parents to "wait and see," and did not provide information about services and supports. Few parents knew about special education services before identification. Phase 2: Participants found the campaign materials appealing, but were unclear about how to act early and why acting early was important. CONCLUSIONS: Results affirmed LTSAE's evidence-based approach to educating parents about child development. Additional campaign considerations include providing more information about how to act early and why acting early is important and enhancing outreach to providers to help them communicate with concerned parents. |
Maternal cigarette smoking and congenital heart defects
Correa A , Levis DM , Tinker SC , Cragan JD . J Pediatr 2015 166 (4) 801-4 Congenital heart defects (CHDs) are of public health concern because they affect approximately 1% of newborns,1-3 are a leading cause of infant mortality,4 and often result in increased use and costs of health services among affected children, adolescents, and adults.5 In recent decades, epidemiologic research has made notable progress in the identification of modifiable risk factors for some CHDs (eg, congenital rubella infection, use of certain medications, and pregestational diabetes).6 For most CHDs, however, the causes remain unknown. In this issue of The Journal, Sullivan et al7 describe results of a population-based study in which they assessed the possible association of maternal periconceptional cigarette smoking and the occurrence of CHDs among live births by linking self-reports of cigarette smoking on birth certificates with records of children with CHD (ie, cases) identified from birth certificates and a statewide hospital discharge registry. The authors examined 19 specific CHD phenotypes and observed associations between maternal cigarette smoking during the first trimester of pregnancy and 3 phenotypes: pulmonary valve anomalies, pulmonary artery anomalies, and isolated secundum type of atrial septal defects. They also observed a suggestion of a doseresponse relationship between maternal cigarette smoking and the risk of CHDs examined as a group. These findings are of interest because they highlight: (1) methodologic issues common to studies of associations of maternal cigarette smoking, a prevalent and modifiable exposure, with specific CHD phenotypes in the offspring; (2) challenges in interpreting the nature of observed associations between maternal cigarette smoking and CHDs; and (3) opportunities for prevention and smoking cessation efforts among women of childbearing age. |
Understanding Women's Preconception Health Goals: Audience Segmentation Strategies for a Preconception Health Campaign
Lynch M , Squiers L , Lewis MA , Moultrie R , Kish-Doto J , Boudewyns V , Bann C , Levis DM , Mitchell EW . Soc Mar Q 2014 20 (3) 148-164 This article discusses the social marketing planning process and strategies used to design a preconception health campaign, Show Your Love, launched in February 2013. Developing a social marketing strategy for preconception health is a challenging endeavor, in part because preconception health represents a set of diverse behaviors and the audience for the campaign is quite large, encompassing all women of childbearing age whether they intend to become pregnant or not. The network of organizations implementing the campaign, the National Preconception Health Consumer Workgroup, required a broad audience segmentation strategy; therefore, two large audiences were selected. This commentary describes the two primary audiences selected for the campaign based on the Transtheoretical Model-intenders (those in contemplation, preparation, and action) and nonintenders (precontemplators)-and explores how levels of knowledge, motivations, the campaign product, and the campaign goals are distinct for each audience. Additionally, the authors describe potential extensions to the segmentation strategy that could offer finer grained approaches for social marketers who may be building on the Show Your Love campaign or designing other programs in this area. |
Women’s perspectives on smoking and pregnancy and graphic warning labels
Levis DM , Stone-Wiggins B , O'Hegarty M , Tong VT , Polen KND , Cassell CH , Council M . Am J Health Behav 2014 38 (5) 755-764 OBJECTIVES: To explore women's knowledge, attitudes, and beliefs about adverse outcomes associated with smoking during pregnancy and which outcomes might motivate cessation; to explore reactions to graphic warnings depicting 2 adverse outcomes. METHODS: Twelve focus groups were conducted with women of childbearing age who were current smokers. RESULTS: Participants had low to moderate awareness of many outcomes and believed it was acceptable to smoke in the first trimester before knowledge of pregnancy. Perceived susceptibility to outcomes was low. Motivators included risk-focused information, especially serious risks to the baby (eg, stillbirth, SIDS). Graphic warnings produced strong reactions, especially the warning with a real photo. CONCLUSIONS: Despite barriers to reducing rates of smoking during pregnancy, educational information and photos depicting babies' risks could motivate women to quit. |
Women's knowledge, attitudes, and beliefs about Down syndrome: a qualitative research study
Levis DM , Harris S , Whitehead N , Moultrie R , Duwe K , Rasmussen SA . Am J Med Genet A 2012 158A (6) 1355-62 Women who are or may become pregnant need up-to-date information about Down syndrome (DS). Asking women about their knowledge, opinions, resources, and information needs on the topic of DS is an important precursor to develop effective strategies for education. We conducted 24 focus groups (N = 111) in two US cities with women who were recently pregnant (who had a child ≤3 years old without DS) and women who planned to have a child in the next year. Groups were further segmented by age and race-ethnicity. Questions explored women's knowledge, attitudes, and beliefs about DS; resources used to obtain information about health and DS; and information needs on the topic of DS. All participants reported having some knowledge of DS: facial features, chromosomal condition, and maternal age as a risk factor. Many participants had misconceptions, including the life expectancy for persons with DS, other maternal and paternal risk factors, and the idea that having a child with DS would disrupt their lives. Participants requested stories to help illustrate what life is like for families with DS. Many Hispanic and African American participants said they only saw or knew of Caucasian persons with DS and requested culturally diverse educational materials about DS. Participants said they would seek information on DS from the Internet and from their health care providers. Results suggest that women need tailored materials that contain clinical information about DS as well as information about living with a child with DS. (Published 2012. This article is a U.S. Government work and is in the public domain in the USA.) |
Preconception health: awareness, planning, and communication among a sample of US men and women
Mitchell EW , Levis DM , Prue CE . Matern Child Health J 2010 16 (1) 31-9 It is important to educate both men and women about preconception health (PCH), but limited research exists in this area. This paper examines men's and women's awareness of exposure to PCH information and of specific PCH behaviors, PCH planning, and PCH discussions with their partners. Data from Porter Novelli's 2007 Healthstyles survey were used. Women and men of reproductive age were included in the analysis (n = 2,736) to understand their awareness, planning, and conversations around PCH. Only 27.9% of women and men reported consistently using an effective birth control method. The majority of men (52%) and women (43%) were unaware of any exposure to PCH messages; few received information from their health care provider. Women were more aware than men of specific pre-pregnancy health behaviors. Women in the sample reported having more PCH conversations with their partners than did men. PCH education should focus on both women and men. Communication about PCH is lacking, both between couples and among men and women and their health care providers. PCH education might benefit from brand development so that consumers know what to ask for and providers know what to deliver. |
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