A Perinatal and Child Health Survey in Eastern

OntarioA project of the

Hastings and Prince Edward Counties Health Unit

Kingston, Frontenac and Lennox & Addington Health

UnitRenfrew County & District

Health UnitLeeds, Grenville and Lanark

District Health Unit

A Perinatal and Child Health Survey in Eastern Ontario

Hastings and Prince Edward Counties Health UnitPatricia Brown, Stephanie MaFaul, Siroos Hazhabri

Kingston, Frontenac and Lennox & Addington Health Unit

Pam Carr, Kathy MacRae Leeds, Grenville and Lanark District Health Unit

Shani Gates, Jane Hess Renfrew County & District Health Unit

Pat Ripmeester, Carla WaltersPublic Health Research, Education and Development

ProgramKristin Dall, Stacy Gall, Kathleen O’Connor

A Perinatal and Child Health Survey in Eastern Ontario:

Objectives

The overall objective of this survey was to investigate the needs of pregnant women and families with young children, so that services can be planned to best meet those needs.

A Perinatal and Child Health Survey in Eastern Ontario:

Objectives

The survey focused on the following areas:•timing and extent of prenatal care•health behaviours to prepare for pregnancy•working conditions and exposures to hazards during pregnancy•exposure to ETS during pregnancy•prenatal behaviours and attitudes towards alcohol use during pregnancy

A Perinatal and Child Health Survey in Eastern Ontario:

ObjectivesAnd also on the following areas:•availability and accessibility of medical care•attachment and parental readiness•experience of postpartum depression•childhood health care and injury

Target groups were mothers and fathers of children 0-6 as well as pregnant women.

A Perinatal and Child Health Survey in Eastern Ontario:

MethodsThe survey was done by telephone, in two parts. In the first year we extracted random samples of telephone numbers from each of the four health units, and hired and trained interviewers to conduct the calls from their own homes. We supervised all stages of data collection, input and analysis.

A Perinatal and Child Health Survey in Eastern Ontario:

Methods

In the second year we contracted with a survey research group. They extracted random samples of telephone numbers from each health unit, ensuring that no number called in the first year was duplicated. Calls were conducted by their trained interviewers. Data entry took place simultaneously with the interview through the use of CATI software, which results in a dataset ready for analysis.

A Perinatal and Child Health Survey in Eastern Ontario:

Sample

More than 20,000 calls were

made, and 2274 eligible households were identified. Interviews were conducted with 934 individuals. This report includes results from 638 mothers, 234 fathers and 107 pregnant women. Results are weighted so as to be representative of the four health units.

A Perinatal and Child Health Survey in Eastern Ontario:

Characteristics of the Sample

•95% were born in Canada•87% reported being married or living as a couple•47% reported having at least a college education•36% of pregnant women, 33% of mothers, and 85% of fathers reported being employed full-time outside of the home

A Perinatal and Child Health Survey in Eastern Ontario:

Characteristics of the Sample

•Mean age of mothers is 33 years (SD=6)•Mean age of fathers is 36 years (SD=6)•Mean age of pregnant women is 28 years (SD=5)

A Perinatal and Child Health Survey in Eastern Ontario:

Results Timing of First Prenatal Care Visit (Weighted Data)

25

40

6 6

23

0

5

10

15

20

25

30

35

40

45

Weeks 1 to 4 Weeks 5 to 8 Weeks 9 to 12 Weeks 13 to 16 Af ter Week 16

Percentage of pregnant wom

en

A Perinatal and Child Health Survey in Eastern Ontario:

Results

• 20% of pregnant women surveyed were not receiving prenatal care• of these, 45% were at 20 weeks or later in their pregnancies

A Perinatal and Child Health Survey in Eastern Ontario:

Results • 34% of women smoked at some time in their pregnancy; 74% of these women were still smoking at the time of the interview• 40% of women drank at some point in their pregnancy, although 75% stopped when they found out they were pregnant

A Perinatal and Child Health Survey in Eastern Ontario:

Results • 17% of children were exposed to second hand smoke in their first six months• 13% of children were exposed to alcohol while being breastfed

A Perinatal and Child Health Survey in Eastern Ontario:

Results

• 11% of children were injured in the previous year seriously enough to require medical attention

A Perinatal and Child Health Survey in Eastern Ontario:

ResultsProportion of Children Taken to the Dentist by Age

(Weighted Data)

7 7

29

60

84 90 92

0

10

20

30

40

50

60

70

80

90

100

Under

age 1

Age 1 Age 2 Age 3 Age 4 Age 5 Age 6

Age of children

Percentage o

f c

hildren

Not taken to the dentist

Taken to the dentist

A Perinatal and Child Health Survey in Eastern Ontario:

Challenges

Conducting a survey in two phases, with data collection supervised by different coordinators, presents special challenges. Even though the methods used in the first phase were carefully documented and replicated in the second phase, we compared the two sets of results. Some differences were found.

A Perinatal and Child Health Survey in Eastern Ontario:

Challenges PHASE I PHASE I I

Selected Numbers 9653 10702

Known Households in Area

7231

74.9%

8099

75.7%

Ref used Screening 777 320

Screened Households 6424 66.5% 7695 71.9%

I neligible 5827 90.7% 6018 78.3%

Ref used 148 2.3% 551 7.2%

Terminated 0 -- 627 8.1%

Not Contacted 14 0.2% 0 --

I nterviewed 435 6.8% 499 6.5%

A Perinatal and Child Health Survey in Eastern Ontario:

Challenges

15% of respondents knew none of the signs and symptoms of preterm labour in phase I, compared to 32% in phase II.

A Perinatal and Child Health Survey in Eastern Ontario:

Challenges

57% of respondents in phase I took folic acid everyday in the first three months of pregnancy, compared to 77% in phase II.

A Perinatal and Child Health Survey in Eastern Ontario:

Challenges

In Phase I, 95% of fathers said that they encouraged their children, laughed, talked and played together at least once a day. In Phase II, fewer than 75% of fathers claimed to encourage and laugh with their children daily, and only slightly more than half talked and played together every day.

A Perinatal and Child Health Survey in Eastern Ontario:

Challenges

The first two examples of differences may be attributable to chance, given the number of comparisons which were made, but may also represent real change over time. The last example is more difficult to explain. It may have been a product of subtle differences in the way the question was asked.

A Perinatal and Child Health Survey in Eastern Ontario:

Challenges

Overall, results were remarkably consistent. We are confident, therefore, that these phases can be combined to give an accurate picture of the needs of children in the region.