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A Community-Academic Partnership to Reduce Environmental Barriers to Healthy Lifestyles for Pregnant and Postpartum Wome

A Community-Academic Partnership to Reduce Environmental Barriers to Healthy Lifestyles for Pregnant and Postpartum Women in Detroit. Edith C. Kieffer University of Michigan School of Public Health Department of Health Behavior & Health Education.

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A Community-Academic Partnership to Reduce Environmental Barriers to Healthy Lifestyles for Pregnant and Postpartum Wome

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  1. A Community-Academic Partnership to Reduce Environmental Barriers to Healthy Lifestyles for Pregnant and Postpartum Women in Detroit Edith C. Kieffer University of Michigan School of Public Health Department of Health Behavior & Health Education

  2. EXCESSIVE PREGNANCY WEIGHT GAIN AND POSTPARTUM WEIGHT RETENTION ALMOST UNIVERSAL AND FREQUENT CONTACT PRENATAL AND POSTPARTUM CARE HIGH AND RISING PREVALENCE OF OBESITY AND TYPE 2 DIABETES, ESPECIALLY LOW INCOME AND MINORITY WOMENPREGNANCY AND POSTPARTUM PERIODS: UNDERESTIMATED OPPORTUNITY FOR EARLY INTERVENTION AND RISK REDUCTION

  3. PREVALENCE OF PRE-PREGNANCY OVERWEIGHT/ OBESITY AND EXCESSIVE PREGNANCY WEIGHT GAIN AMONG AFRICAN-AMERICAN AND LATINO WOMEN IN DETROIT Pre-pregnancy overweight and obesity African American women: 47% Latino women: 37% Excessive pregnancy weight gain African American women: 53% Latino women: 37%

  4. PROJECT GOAL Key Aim: Community participation in planning program and policy interventions Women, influential people and program/policy leaders discussed: • weight, pregnancy-related weight gain, weight retention • diet and exercise • barriers to healthy eating and regular exercise • strategies/recommendations

  5. PROMOTING HEALTHY LIFESTYLES AMONG WOMEN COLLABORATION MODEL

  6. COMMUNITY-ACADEMIC RELATIONSHIPS Steering Committee • Community members, community agencies, faculty & postdoctoral fellows • Activities: Planning study methods and interview content; identifying and screening potential interviewers; problem-solving; analyzing data; planning interventions Community Members • Steering Committee participants • Interviewers, moderators, notetakers • Debriefing and data analysis Key Program and Policy Leaders • Focus group participants • Learning, sharing strategies, discussing future roles

  7. CHARACTERISTICS OF PARTICIPANTS INDIVIDUAL AND FOCUS GROUP INTERVIEWS • Low income; recruited from WIC, prenatal clinics Eastside/African-American Women • most from Detroit; similar neighborhoods, lifestyles • most not married/without partner; several children • influential person most often female Southwest/Latino Women • most from Mexico; half from rural areas • different communities and lifestyles • most married/with partner; some had children • influential person most often male partner POLICY FOCUS GROUP PARTICIPANTS Eastside group: • majority African-American, long or life-time Detroit residents; many women with children; many shared experiences Southwest group: • diverse ethnicity; some Latinos; most not lifetime residents; mostly women, some with children; some shared experiences

  8. ENVIRONMENTAL INFLUENCES ON EATING AND EXERCISE POOR ACCESS TO HEALTHY FOODS Inadequate stores in community • few or no larger stores within community • neighborhood stores: dirty environment; liquor, cigarettes, junk food; costly, poor quality, outdated foods, including little or no produce Policy focus group participants added: • few stores (none, Eastside) stock fruits and vegetables, whole-grain and lower-fat foods; only suburban markets offer food tasting, recipe demonstrations that expose shoppers to new foods and preparation methods Limited access to cheaper, well-stocked suburban stores and produce markets • lack of private transportation, poor public transportation Neighborhood safety (Latinas) barrier to walking to stores • Traffic, crime

  9. ENVIRONMENTAL INFLUENCES ON EATING AND EXERCISE BARRIERS TO REGULAR EXERCISE • Inadequate public facilities/lack of safe, clean parks and recreation centers • Inadequate sidewalks • Heavy traffic (especially Southwest Detroit • Cracked sidewalks • Air pollution (especially Southwest Detroit) • Men, prostitutes on streets • Crime • Weather (extreme heat, cold/ice)

  10. INTERACTIONS OF PHYSICAL AND SOCIAL ENVIRONMENTAL BARRIERS Poverty increases impact of environmental barriers Community Level Poverty • Inadequate community resources for healthy eating and exercise • few public facilities, programs • inadequate transportation • poor maintenance of parks and sidewalks • poor lighting • Fewer private facilities • poorer quality • higher cost: income ratio • fewer amenities such as child care • Crime • Heavy traffic • Air and waste pollution Family/Individual Level Poverty • Reduced access to community resources and to alternatives outside of the neighborhood • fewer resources (income, transportation, knowledge, skills) • social isolation (language, culture, child/family care responsibilities, transportation)

  11. WOMEN’S STRATEGIES FOR REDUCINGENVIRONMENTAL BARRIERS

  12. POLICY/PROGRAM LEADERS’ STRATEGIESFOR REDUCING ENVIRONMENTAL BARRIERS

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