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NIH-DC Initiative to Reduce Infant Mortality in Minority Populations

Principal investigator: Michele Kiely, Dr.P.H.

Building Futures for Youth (BFY)

The primary goal of the project was to reduce the number of adolescent pregnancies by delaying the initiation of sexual intercourse. The target population included the 2001-2002 cohort of 5th grade students from 16 Washington, DC, elementary schools, consisting of predominantly African American and Latino youth and their parents. Elementary schools were randomly assigned to either the intervention or control condition; the cohort of 5th graders was followed through 7th grade. The intervention strategy included a culturally appropriate curriculum for children, incorporating developmental, social, and study skills, and understanding of puberty and sexuality. The parent curriculum complemented the children's. Control schools did not receive any intervention during the study.

BFY is currently undergoing an analysis of previous efforts, with a focus on strengthening the intervention methodology, including delivering interventions and data collection.

Interventions for Risk Factors in Pregnant Women in Washington, DC: An Integrated Approach (Project DC-HOPE)
Project DC-HOPE targeted psychosocial and behavioral risk factors that can influence the incidence of preterm births and low birth weight infants. The study examined the effectiveness of an integrated intervention program aimed at smoking cessation (including second-hand smoke), depression, and partner abuse. The effort is unique in that it targets both biological and psychosocial risks and addresses them in a single integrated intervention. Also unique is the inclusion of second-hand smoke as a risk factor.

The Prevention of Fetal Alcohol Effects (FAE II) Study in the District of Columbia
This project was funded through the National Institute of Alcoholism and Alcohol Abuse and assessed providers' acceptance and use of the data obtained through audio computer-assisted self-interview (A-CASI). The study was conducted in two clinics in D.C. that provide prenatal and general primary care to minority women. The goal was to increase the rate of screening for alcohol exposure and risk drinking among pregnant women and women of childbearing age.

Phase III

Teen Mothers Project
The goal of the Teen Mothers Project is to test the effectiveness of a community-based intervention to increase interpartum intervals in minority teen moms. It is hypothesized that the teens in the intervention group will show increased knowledge and practice of good behavioral health, improved family and partner communication, increased school/training involvement and participation in structured activities, and increased interpartum intervals as compared to a group of teen moms receiving case management only.

Pharmacokinetics of Nicotine Project
The aims of this study are to: 1) establish the pharmacokinetics of nicotine delivered by active- and passive-inhalation of cigarette smoke, and by the nicotine replacement patch in pregnant African American women; 2) establish the pharmacokinetics of cotinine (the primary metabolite of nicotine in humans) in the same population and by the same delivery modes; and 3) determine the implications of the pharmacokinetic studies for treatment of African American women who smoke during pregnancy with the nicotine replacement patch. Secondary aims are to determine the levels of nicotine and cotinine specific to this population that can be used to differentiate between smokers, nonsmokers exposed to environmental tobacco smoke (ETS), and non-ETS-exposed nonsmokers.

Nicotine Replacement Therapy (NRT) Study
The Efficacy of NRT to Reduce the Risk of Nicotine Exposure in Pregnant Minority Smokers includes a qualitative study among pregnant participants to identify barriers and facilitators of using trans-dermal nicotine patches as a method to quit smoking during pregnancy. In addition, the study includes a randomized clinical trial to determine the efficacy of a behavioral intervention plus trans-dermal NRT compared with a behavioral intervention only among pregnant minority women who are heavy smokers.

Environmental Tobacco Smoke (ETS) Study
The specific aims of the ETS study are to: develop and test the efficacy of a brief clinic-based intervention to prevent ETS exposure during infancy that is consistent with clinical practice guidelines; and assess the frequency and types of health effects, major and minor, associated with prenatal and postpartum exposure to tobacco smoke products and ETS among infants.

Pilot Study to Quantify and Normalize Insulin Sensitivity in Overweight Minority Adolescents
The goal is to recruit overweight African American and Hispanic adolescents ages 14 to 18 years old who have insulin resistance demonstrated by intravenous glucose tolerance testing. These subjects will be randomized into control and intervention groups, with the latter participating in a program based on studies in adults (demonstrating that intensity of exercise was not as critical as duration) with the target average of 170 minutes/wk in two to three episodes of supervised exercise using treadmills. This study will not be initiated until year two or three of the project.

DESPR Collaborators

Maurice Davis, MPA-MHSA

Selected Publications

Rose A, Koo HP, Bhaskar B, Anderson K, White G, & Jenkins RR. (2005). The influence of primary caregivers on the sexual behavior of early adolescents. Journal of Adolescent Health, 37(2):135-144. [Abstract]

Brenner RA, Simons-Morton BG, Bhaskar B, Revenis M, Das A, & Clemens JD. (2003). Infant-parent bed sharing in an inner-city population. Archives of Pediatrics and Adolescent Medicine, 157:33-39. [Abstract]

El-Mohandes AE, Katz KS, El-Khorazaty MN, McNeely-Johnson D, Sharps PW, Jarrett MH, et al. (2003). The effect of a parenting education program on the use of preventive pediatric health care services among low-income, minority mothers: A randomized controlled study. Pediatrics, 111(6):1324-1332. [Abstract]

El-Mohandes AE, Herman AA, El-Khorazaty MN, Katta PS, White DB, & Grylack L. (2003). Prenatal care reduces the impact of illicit drug use on perinatal outcomes. Journal of Perinatology, 23(5):354-360. [Abstract]

England L, Brenner R, Bhaskar B, Simons-Morton B, Das A, Revenis M, Mehta N, & Clemens J. (2003). Breastfeeding practices in a cohort of inner-city women: The role of contraindications. BMC Public Health, 3:28. [Abstract]

Johnson AA, El-Khorazaty MN, Hatcher BJ, Wingrove BK, et al. (2003). Determinants of late prenatal care initiation by African American women in Washington, DC. Maternal and Child Health, 7(2):103-114. [Abstract]

Pollack MM, Koch MA, & The NIH-District of Columbia Neonatal Network. (2003). The association of outcomes with organizational characteristics of neonatal ICUs. Critical Care Medicine, 31(6):1620-1629. [Abstract]

Sharps PW, El-Mohandes AE, El-Khorazaty MN, Kiely M, & Walker T. (2003). Health beliefs and parenting attitudes influence breastfeeding patterns among low income African American women. Journal of Perinatology, 23(5):414-419. [Abstract]

Brenner RA, Scheidt PC, Rossi MW, Cheng TL, Overpeck MD, Boenning DA, Wright JL, Kavee JD, & Boyle KE. (2002). Injury surveillance in emergency departments: Design, implementation, and analysis. American Journal of Emergency Medicine, 20(3):181-187 [Abstract]

Poole KW, Pollack MM, Rapoport I, Williams VSL, Koch MA, Rao AV, & Bartel DA. (2002). Use of multivariate methods in quantifying the variability in the perception of neonatal intensive care unit characteristics in nine hospitals in the Washington, DC Area: The NIH-DC Initiative to Reduce Infant Mortality in Minority Populations in the District of Columbia. InterStat, May 2002.

Richards L, Kennedy PH, Krulewitch C, Wingrove BK, Katz KS, Wesley BD, Feinson C, & Herman AA. (2002). Achieving success in poor urban minority community-based research: Strategies for implementing community-based research within an urban minority population. Health Education and Behavior, 3(3):410-420.

Riegelman R, Verme D, Rochon J, & El-Mohandes AE. (2002). Interaction and intervention modeling: Predicting and extrapolating the impact of multiple interventions. Annals of Epidemiology, 12(3):151-156. [Abstract]

Thornberry J, Bhaskar B, Krulewitch CJ, Wesley BD, Hubbard M, Das A, Foudin L, & Adamson M. (2002). Audio computer-assisted self-interview (A-CASI) with touch screen to detect alcohol consumption in pregnant women: Application of a new technology to an old problem. Computers in Nursing, 20(2):46-52. [Abstract]

 

 
For More Information:
News Releases
Publications/Materials
Research Resources
Contact Information:
Dr Germaine M Louis
Senior Investigator
Address:
6100 Executive Blvd Room 7B03, MSC 7510
Rockville, MD 20852
For FedEx use:
Rockville Md 20852
Phone: 301-496-6155
Fax: 301-402-2084
E-mail:
louisg@mail.nih.gov