Central Pennsylvania Women’s Health Study (CePAWHS): Findings of a Health Status and Health Risk Factors Survey of Reproductive-age WomenBaker, S. A.; Weisman, C. S.; Hillemeier, M. M.; Botti, J. J.; Velott, D. L.; Chase, G. A.; Dyer, A-M.

The Central Pennsylvania Women’s Health Study (CePAWHS) is a two-phase research project to reduce adverse pregnancy outcomes by improving women’s health before conception (pre-conceptionally) and in between pregnancies (inter-conceptionally). It is a project of the Central Pennsylvania Center of Excellence for Research on Pregnancy Outcomes (COE) and is funded by a four-year Pennsylvania Department of Health non-formula tobacco settlement grant awarded in June 2004. The CePAWHS research specifically aims to reduce the adverse pregnancy outcomes of preterm birth and low birthweight in Central Pennsylvania (see chart, Fig. 1).

The first phase of the CePAWHS project consisted of a population-based survey of health status and risks among women ages 18-45 residing in a 28-county region in Central Pennsylvania (see map, Fig. 2). This included a random digit dial (RDD) telephone survey of 2,002 women and a household survey of 288 Amish women. Data from Phase I were used to design a multidimensional preventive intervention to address prevalent health risks in women in low-income rural communities.

In the RDD telephone survey, some of the most significant findings of CePAWHS-I concerned the prevalent health risk factors. Reported risk factors included: 23% of respondents were obese by BMI (Body Mass Index); 29% had been diagnosed with depression or anxiety; 68% consumed fruits less than

Fig. 1. Preterm Birth and Low Birthweight Rates in Pennsylvania and Nationwide Compared to the Healthy People 2010 Goal Rates

The CePAWHS-I findings show that reproductive-age women in Central Pennsylvania are at high risk for adverse pregnancy outcomes, including those of preterm birth and low birthweight.

The second phase of CePAWHS is the randomized trial of a community-based multi-session group behavioral intervention designed for reproductive-age women ages 18-35. The group intervention being tested focuses on health education and behavior change skills related to key risk factors for adverse pregnancy outcomes. These include: nutrition, physical activity, psychosocial stress, smoking, alcohol consumption, and pregnancy planning. Field research for CePAWHS-II was completed in March 2007. Study participants from the second phase of CePAWHS will continue to be followed through 2 phone interviews occurring at 6 and 12 months from participant baseline risk assessment (initial study health screening). Findings from the randomized trial of this intervention will be available in June 2007.

Preterm Birth and Low Birthweight

5.0%8.2%8.1%< 2,500 grams

(5 lb, 8 oz)

LBW

7.6%11.8%12.5%< 37 weeks

gestationPreterm

Birth

U.S.Goal

PA

2004

US

2004

Definition

Percentages are based on live births

daily; 56% consumed vegetables less than daily; 48% drank alcohol ever; 34% binge drank (among those who drank ever); 28% smoked cigarettes; and just 38% took a multi-vitamin with folic acid (see chart, Fig. 3). Additional CePAWHS Phase I findings were that 11% of RDD telephone survey respondents had been diagnosed with hypertension; 10% had been diagnosed with high cholesterol; 38% had been diagnosed with one or more gynecologic infections; and 75% reported not getting 30+ minutes of moderate or strenuous physical activity on most days of the week.

Prevalent Risk Factors in RDD Sample, Compared with PA and U.S.*(Women ages 18-45, weighted data)

RDD Sample PA U.S.

Obesity (BMI = 30+) 23% 18% 19%Depression/anxiety dx 29% -- 16%Nutritional deficits:

fruit < daily 68% 57% 60%vegetables < daily 56% 31% 34%

Alcohol use (ever) 48% -- 32%Binge drinking (among drinkers) 34% 29% 23%Smoking 28% 32% 23%Folic acid supplementation 38% 53% 50%

* Comparison data sets include BRFSS 2003, Commonwealth Fund Survey of Women’s Health 1998, National Health Interview Survey 2003

Fig. 2. Central Pennsylvania Project Region for CePAWHS

Fig. 3. CePAWHS Phase I Prevalent Health Risk Factors

CePAWHS (Central Pennsylvania Women’s Health Study)

www.womenshealthcoe.psu.edu

Penn State College of Medicine

717-531-1074