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Division of Reproductive
Health: Activities:
Maternal and Child Health Epidemiology Program: Participating State |
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Maternal and Child Health Epidemiology Program
Hawaii
Current Assignee: Since October 1996, there has been a state
assignee located in the
State of Hawai`i, Department of Health.
Current Fellow: Since 2002, there has been a fellow working with the
assignee.
Projects/Impact:
- Through analysis of Pregnancy Risk Assessment Monitoring System data,
the Hawaii MCH EPI assignee and fellow identified that uninsured women
were more likely to receive no prenatal care or to enter prenatal care
late (44.5%) compared to insured women (17.3%). In addition, pregnant
women without health insurance entered care three weeks later than those
with insurance coverage adjusting for other risk factors including
maternal race and education. In fact, over the last two years, the delay
increased from two to three weeks. Recently, the Department of Human
Services has reduced some of the barriers for enrollment in Medicaid
programs by streamlining the application form and allowing
self-declaration of pregnancy. Further, the Medicaid program will now
offer coverage to non-resident, immigrant pregnant women, even though
federal matching funds are not available to assist with the effort.
- Malama A Ho`opili Pono (Caring for Mothers and Children in the Right
Way): On the Big Island of Hawaii, although perinatal services are
available, access is still a major concern, especially among Native
Hawaiian, Filipina and other Pacific Islander women. These women report
that the current system of care does not adequately address their needs
within the framework of their culture. This project is an effort to
integrate perinatal programs into a collaborative model which will lead to
new standards of care for the delivery of services to pregnant women. Some
of the unique strategies proposed to improve perinatal health and to
create a culturally congruent perinatal system of care include the use of
aloha talk story style of communication and focus groups; and the
integration of cultural healing practices, cross cultural training, and
the Native Hawaiian health care system with standard prenatal and infant
care.
- Evaluation of Breastfeeding Promotion and Support Programs: In January
2000, the Hawai`i WIC program instituted an electric breast pump loan
program for its clients. The purpose of the study is to compare the
breastfeeding duration rates of women in WIC who are using electric breast
pumps on loan from WIC with a control population of women chosen from
within WIC who are not using electric breast pumps. At this point in time,
the cohort of women for the study has been recruited, data collection is
complete, and data cleaning and preliminary analysis is in progress.
Answers to the questions regarding impact of the electric breast pump loan
program are anticipated next year.
- Improved the quality of data on Hawai`i's birth certificate: The
project was to develop an integrated Perinatal Data System (PDS) based on
multiple needs and building on existing resources. The goal of this
project was to assure current and accurate perinatal data dissemination
reflecting state-wide as well as selected community and/or ethnic
perinatal health status. This would help to assist in program and policy
development and in the prioritization of perinatal health issues in
Hawai`i. The birth certificate data are provided in an electronic format,
with all of the hospitals using the new DOH Internet-based birth record
program. As we have met with individual hospitals we learned about
different reporting techniques which influenced the changing profile of
our data and contributed to a number of the NCHS 1999-2001 outliers. In
the future, we plan to continue holding annual workshops with the birth
certificate clerks to ensure that the quality assurance improvements which
have occurred will remain consistent.
State-Related Publications:
Phares TM, Morrow B, Lansky A, Barfield WD, Prince CB, Marchi KS,
Braveman PA, Williams LM, Kinniburgh B. Surveillance for disparities in
maternal health-related behaviors – selected states, Pregnancy Risk
Assessment Monitoring System (PRAMS), 2000-2001. In: Surveillance
Summaries, July 2, 2004. MMWR 2004;53(No. SS–4):1–13.
Prince CB, Song L, Quadri N, Baker KK. The epidemiology of low birth
weight and preterm delivery in Hawai`i, 2000–2001. Californian J Health
Promotion 2003;1(Special Issue:Hawai`i):83–90.
Simmons CS, Budhiraja P, Prince CB. Hawai`i WIC’s unique breastfeeding
initiatives. Californian J Health Promotion 2003;1(Special Issue:Hawai`i):149–159.
Fuddy LJ, Prince CB, Tang MC. Perinatal substance use among high risk
women in Hawai`i: patterns and impact on pregnancy outcomes. Asian Am Pac
Isl J Health 2003;10:50–57.
Prince CB, Miyashiro L, Weirather Y, Heu P. The Epidemiology of Early
Hearing Loss Detection in Hawai`i. Pediatrics 2003;111:1202–1206.
Carmichael SL, Prince CB, Burr R, Nakamoto F, Vogt RL. Breastfeeding
among WIC participants in Hawaii, 1997. J Am Diet Assoc 2001;101:57–6.
Back to
Maternal and Child Health Epidemiology Program Page last reviewed: 2/8/08
Page last modified: 3/6/06
Content source: Division
of Reproductive Health,
National Center for Chronic
Disease Prevention and Health Promotion |
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PRAMS
A surveillance project of CDC and state health departments. PRAMS collects state-specific,
population-based data on maternal attitudes and experiences prior to, during
and immediately following pregnancy.
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