A Contextual Psychology Approach to Improving Health Outcomes in the Perinatal Period
| dc.contributor.advisor | Berkman, Elliot | |
| dc.contributor.author | Lightcap, April | |
| dc.date.accessioned | 2023-07-06T14:00:19Z | |
| dc.date.available | 2023-07-06T14:00:19Z | |
| dc.date.issued | 2023-07-06 | |
| dc.description.abstract | The United States holds alarming records for highest infant and maternal mortality rates in the developed world. The US infant mortality rate is on par with many low and middle income countries, and despite the decline in maternal mortality rates globally, pregnancy-related deaths in the US have trended upwards. The Birth Your Way perinatal health promotion program was designed to address this US public health crisis by amplifying the ability of federal maternal child health programs to mitigate the primary infant mortality risk factors, Neonatal Intensive Care Unit (NICU) admissions, low birthweight and preterm deliveries, and the key maternal mortality risk factor, Cesarean delivery. The federal Medicaid program buffers mortality risk via increased access to perinatal healthcare services; while the federal Women, Infants and Children supplemental nutrition program (WIC) improves health outcomes via improved prenatal nutrition. Employing an implementation science approach, the Birth Your Way intervention has been developed and evaluated in collaboration with Medicaid and WIC partners in a model public health test site. The Birth Your Way intervention is the first to utilize an Acceptance and Commitment Therapy (ACT) approach to increase pregnant individuals’ adherence to the WIC prenatal nutrition protocol via increases in psychological flexibility, the psychological mechanism underlying ACT. A pragmatic randomized clinical trial was conducted to examine Birth Your Way program effects on psychological flexibility, perinatal nutrition and infant and maternal birth outcomes. Results from the Birth Your Way pragmatic randomized clinical trial demonstrate the ACT-based intervention’s potential to bolster WIC program effects and mitigate poor infant birth outcomes when a minimum dose is received. The current study documents a promising role for the application of ACT in the prenatal period to increase maternal engagement in values-directed actions and healthy dietary behaviors and to decrease the likelihood of NICU admissions, low birthweight, and preterm deliveries. Expanding the reach of ACT-based programs across Medicaid distributors to amplify WIC program engagement could prove a critical component in the public health effort to mitigate the US infant and maternal mortality crisis. | en_US |
| dc.identifier.uri | https://hdl.handle.net/1794/28480 | |
| dc.language.iso | en_US | |
| dc.publisher | University of Oregon | |
| dc.rights | All Rights Reserved. | |
| dc.title | A Contextual Psychology Approach to Improving Health Outcomes in the Perinatal Period | |
| dc.type | Electronic Thesis or Dissertation | |
| thesis.degree.discipline | Department of Psychology | |
| thesis.degree.grantor | University of Oregon | |
| thesis.degree.level | doctoral | |
| thesis.degree.name | Ph.D. |
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