CCHN funding recently ended; Network researchers are currently finishing follow-up activities. The research blended social, behavioral, and biomedical approaches into a coherent community-linked study. Some publications from CCHN studies are listed below. Network researchers are preparing additional manuscripts that will examine the nature of maternal and paternal stress and their effects on allostatic load (the body’s response to chronic or repeated episodes of high stress).
A large community-based participatory research network in perinatal medicine, the CCHN was developed to examine how community-, family-, and individual- level stressors may influence and interact with biological factors to affect maternal and child health. CCHN examined how these factors might result in health disparities in pregnancy outcomes and in infant/early childhood mortality and morbidity. It is anticipated that the discoveries from CCHN research will provide evidence-based methods for interventions to reduce disparities in perinatal health.
The Network used community and academic institution partnerships to conduct a multicenter observational study to:
- Determine the factors associated with maternal allostatic load.
- Explore the relationship between maternal allostatic load during the period between births and birth/child health outcomes in a subsequent pregnancy.
- Study how various resiliency factors, such as family and social support and religiosity, can mitigate the negative effects of high allostatic load on biological processes, including reproductive health.
Recruitment for the Network has ended, with 4,837 people in all, 3,079 of them women in their postpartum period and 1,758 spouses. Most participants were from predominantly lower socioeconomic levels, living in African American, Latina, or Caucasian communities in five regions of the United States. Researchers from CCHN sites are completing writing of manuscripts.
The CCHN included cooperative agreements with five collaborating sites and a data coordinating center, in each case involving a partnership between an academic institution and community institutions. Staff from the NICHD’s Pregnancy and Perinatology Branch (PPB)
as well as staff from the National Institute of Nursing Research
were active in this effort.
- Baltimore, Maryland
Baltimore City Healthy Start, Johns Hopkins University Bloomberg School of Public Health, and University of Toronto
- Lake County, Illinois
Evanston Northwestern Healthcare/Northwestern University and Lake County Health Department Community Health Center
- Los Angeles, California
University of California, Los Angeles (UCLA); its affiliates: Cedars-Sinai Medical Center, Good Samaritan Hospital, Harbor-UCLA Medical Center, and King-Drew Medical Center ; and community partners in South and Central Los Angeles organized by Healthy African American Families
- North Carolina
East Carolina University, University of North Carolina, and North Carolina Division of Public Health, Healthy Start Baby Love Plus network
- Washington, D.C.
Georgetown University, University of Alabama at Birmingham
- Hershey, Pennsylvania
Penn State Milton S. Hershey Medical Center (Data Coordinating and Analysis Center)
Ramey SL, et al. The Preconception Stress and Resiliency Pathways Model: A Multi-Level Framework on Maternal, Paternal, and Child Health Disparities Derived by Community-Based Participatory Research. Matern Child Health J. 2014 Jul 29. PMID25070734.
Dolbier, CL, et al. (2013). Relationships of race and socioeconomic status to postpartum depressive symptoms in rural African American and non-Hispanic white women. Maternal and Child Health Journal, 17, 1277−1287. doi: 10.1007/s10995-012-1123-7. PMID22961387.
Dunkel Schetter C, et al. (2013). Shedding light on the mechanisms underlying health disparities through community participatory methods: The stress pathway. Perspectives in Psychological Science (in press).
Abdou, CM, et al (2010). Community perspectives: Mixed-methods investigation of culture, stress, resilience, and health. Ethnicity & Disease, 20(1 Suppl 2), S2-41−48. PMID20629246.
Patchen L; Caruso D; Lanzi RG.(2009). Poor maternal mental health and trauma as risk factors for a short interpregnancy interval among adolescent mothers. Journal of Psychiatric and Mental Health Nursing, 16, 401−403. PMID19383021.
Shalowitz, M. U., Isacco, A., Barquin, N., Clark-Kauffman, E., Delger, P., Nelson, D.,…Wagenaar, K. A. (2009). Community-based participatory research: A review of the literature with strategies for community engagement. Journal of Developmental and Behavioral Pediatrics, 30, 350−361. PMID19672162.