The Happy Child Program’s Intersectionality: Prenatal Home Visit Frequency, Food Insecurity Risk, Symptoms of Depression, and Parental Practices in Brazilian Women Assisted during Pregnancy
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design and Study Settings
2.2. Sample
2.3. Eligibility Criteria
2.4. Data Collection
2.5. Data Analysis
2.6. Ethical Aspects
3. Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variables | n | % | 95% CI |
---|---|---|---|
Age | |||
≤19 years | 9 | 6.9 | 3.6; 12.8 |
20 to 24 years | 34 | 26.2 | 19.3; 34.5 |
25 to 29 years | 27 | 20.8 | 14.6; 28.7 |
30 to 34 years | 31 | 23.8 | 17.3; 32.0 |
≥35 years | 29 | 22.3 | 15.9; 30.3 |
Gestational Period | |||
1st Trimester | 1 | 0.8 | 0.1; 5.3 |
2nd Trimester | 18 | 13.7 | 8.8; 20.8 |
3rd Trimester | 58 | 44.3 | 35.9; 52.9 |
Postpartum | 54 | 41.2 | 33.1; 49.9 |
Cash Transfer Program-enrolled | |||
No | 33 | 25.0 | 18.3; 33.2 |
Yes | 99 | 75.0 | 66.8; 81.7 |
Educational Level | |||
Elementary School | 33 | 25.2 | 18.4; 33.4 |
High school | 89 | 67.9 | 59.4; 75.4 |
University education | 9 | 6.9 | 3.6; 12.8 |
Ethnicity (color or race) | |||
White | 24 | 18.3 | 12.6; 25.9 |
Black/Brown (Multiracial) | 100 | 76.3 | 68.2; 82.9 |
Yellow (Asian) | 4 | 3.1 | 1.1; 7.9 |
Indigenous | 3 | 2.3 | 0.7; 6.9 |
Monthly Household Income (USD) | |||
Up to 100.00 | 36 | 30.0 | 22.4; 38.9 |
From 100.00 to 200.00 | 61 | 50.8 | 41.9; 59.8 |
Over 200.00 | 23 | 19.2 | 13.0; 27.3 |
Previous Pregnancy | |||
Primiparous | 16 | 12.1 | 7.5; 18.9 |
Multiparous | 116 | 87.9 | 81.1; 92.5 |
Symptoms of Depression | |||
No | 43 | 32.6 | 25.1; 41.1 |
Yes | 89 | 67.4 | 58.9; 74.9 |
Parental Practice | |||
Non-adequate | 65 | 49.2 | 40.7; 57.8 |
Adequate | 67 | 50.8 | 42.2; 59.3 |
Food Insecurity Risk | |||
No | 24 | 18.2 | 12.5; 25.8 |
Yes | 108 | 81.8 | 74.2; 87.6 |
PCF Visit Frequency | |||
<4 | 60 | 45.5 | 37.1; 54.1 |
4 | 72 | 54.5 | 45.9; 62.9 |
Explanatory Variables | No Depression Symptoms | CI 95% | Depressive Symptoms | CI 95% | p-Value | No FI Risk | CI 95% | FI Risk | CI 95% | p-Value | ||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
n | % | n | % | n | % | n | % | |||||||
Age | 0.549 | 0.145 | ||||||||||||
≤19 years | 3 | 7.1 | (2.2–20.5) | 6 | 6.8 | (3.1–14.5) | 1 | 4.5 | (0.6–28.6) | 8 | 7.4 | (3.7–14.2) | ||
20 to 24 years | 12 | 28.6 | (16.7–44.4) | 22 | 25.0 | (17.0–35.2) | 10 | 45.5 | (25.5–67.0) | 24 | 22.2 | (15.3–31.1) | ||
25 to 29 years | 5 | 11.9 | (4.9–26.1) | 22 | 25.0 | (17.0–35.2) | 3 | 13.6 | (4.2–36.5) | 24 | 22.2 | (15.3–31.1) | ||
30 to 34 years | 11 | 26.2 | (14.9–41.9) | 20 | 22.7 | (15.1–32.8) | 6 | 27.3 | (12.2–50.4) | 25 | 23.1 | (16.1–32.1) | ||
≥35 years | 11 | 26.2 | (14.9–41.9) | 18 | 20.5 | (13.2–30.3) | 2 | 9.1 | (2.1–31.9) | 27 | 25.0 | (17.7–34.1) | ||
Gestational Period | 0.065 | |||||||||||||
1st Trimester | 1 | 2.3 | (0.3–15.5) | 0 | 0.0 | 0.00 | 0 | 0.0 | 0.00 | 1 | 0.9 | (0.1–6.5) | 0.523 | |
2nd Trimester | 10 | 23.3 | (12.8–38.6) | 8 | 9.1 | (4.6–17.3) | 5 | 20.8 | (8.5–42.7) | 13 | 12.1 | (7.1–19.9) | ||
3rd Trimester | 16 | 37.2 | (23.9–52.8) | 42 | 47.7 | (37.4–58.3) | 8 | 33.3 | (17.0–55.0) | 50 | 46.7 | (37.4–56.3) | ||
Postpartum | 16 | 37.2 | (23.9–52.8) | 38 | 43.2 | (33.1–53.8) | 11 | 45.8 | (26.6–66.4) | 43 | 40.2 | (31.3–49.8) | ||
Cash Transfer Program-enrolled | 0.335 | 0.297 | ||||||||||||
No | 13 | 30.2 | (18.2–45.9) | 20 | 22.5 | (14.9–32.4) | 8 | 33.3 | (17.0–55.1) | 25 | 23.1 | (16.1–32.1) | ||
Yes | 30 | 69.8 | (54.1–81.9) | 69 | 77.5 | (67.6–85.1) | 16 | 66.7 | (45.0–83.1) | 83 | 76.9 | (67.9–83.9) | ||
Schooling | 0.938 | 0.561 | ||||||||||||
Elementary School | 10 | 23.3 | (12.8–38.6) | 23 | 26.1 | (17.9–36.4) | 4 | 16.7 | (6.1–38.3) | 29 | 27.1 | (19.5–36.4) | ||
High school | 30 | 69.8 | (54.1–81.9) | 59 | 67.0 | (56.5–76.2) | 18 | 75.0 | (53.1–88.8) | 71 | 66.4 | (56.8–74.7) | ||
University education | 3 | 7.0 | (2.2–20.1) | 6 | 6.8 | (3.1–14.5) | 2 | 8.3 | (1.9–29.5) | 7 | 6.5 | (3.1–13.2) | ||
Ethnicity (color or race) | 0.181 | |||||||||||||
White | 6 | 14.0 | (6.3–28.3) | 18 | 20.5 | (13.2–30.3) | 5 | 20.8 | (8.5–42.7) | 19 | 17.8 | (11.6–26.3) | ||
Black/Brown (Multiracial) | 37 | 86.0 | (71.8–93.8) | 63 | 71.6 | (61.2–80.1) | 18 | 75.0 | (53.1–88.8) | 82 | 76.6 | (67.6–83.8) | ||
Yellow (Asian) | 0 | 0.0 | 0.00 | 4 | 4.5 | (1.7–11.6) | 0 | 0.0 | 0.00 | 4 | 3.7 | (1.4–9.6) | ||
Indigenous | 0 | 0.0 | 0.00 | 3 | 3.4 | (1.1–10.2) | 1 | 4.2 | (0.5–26.5) | 2 | 1.9 | (0.5–7.3) | ||
Monthly Household Income (USD) | 0.406 | 0.047 | ||||||||||||
Up to 100.00 | 14 | 36.8 | (22.8–53.6) | 22 | 26.8 | (18.3–37.6) | 4 | 19.0 | (6.9–42.9) | 32 | 32.3 | (23.8–42.3) | ||
From 100.00 to 200.00 | 16 | 42.1 | (27.2–58.6) | 45 | 54.9 | (43.9–65.4) | 9 | 42.9 | (23.0–65.3) | 52 | 52.5 | (42.6–62.3) | ||
Over 200.00 | 8 | 21.1 | (10.6–37.4) | 15 | 18.3 | (11.3–28.3) | 8 | 38.1 | (19.4–61.1) | 15 | 15.2 | (9.3–23.8) | ||
Previous Pregnancy | 0.148 | |||||||||||||
Primiparous | 8 | 18.6 | (9.4–33.5) | 8 | 9.0 | (4.5–17.1) | 0.113 | 5 | 20.8 | (8.5–42.7) | 11 | 10.2 | (5.7–17.6) | |
Multiparous | 35 | 81.4 | (66.5–90.6) | 81 | 91.0 | (82.9–95.5) | 19 | 79.2 | (57.3–91.5) | 97 | 89.8 | (82.4–94.3) | ||
Explanatory Variables | Non-Adequate Parental Practices | CI 95% | Adequate Parental Practices | CI 95% | p-Value | PCF Visit Frequency (<4) | CI 95% | PCF Visit Frequency (4) | CI 95% | p-Value | ||||
n | % | n | % | n | % | n | % | |||||||
Age | 0.127 | |||||||||||||
≤19 years | 3 | 4.7 | (1.5–13.8) | 6 | 9.1 | (4.1–19.0) | 0.653 | 4 | 6.9 | (2.6–17.3) | 5 | 6.9 | (2.9–15.8) | |
20 to 24 years | 17 | 26.6 | (17.0–38.9) | 17 | 25.8 | (16.5–37.8) | 17 | 29.3 | (18.9–42.5) | 17 | 23.6 | (15.1–35.0) | ||
25 to 29 years | 15 | 23.4 | (14.5–35.6) | 12 | 18.2 | (10.5–29.6) | 16 | 27.6 | (17.5–40.7) | 11 | 15.3 | (8.6–25.7) | ||
30 to 34 years | 17 | 26.6 | (17.0–38.9) | 14 | 21.2 | (12.9–32.9) | 8 | 13.8 | (7.0–25.5) | 23 | 31.9 | (22.1–43.7) | ||
≥35 years | 12 | 18.8 | (10.9–30.4) | 17 | 25.8 | (16.5–37.8) | 13 | 22.4 | (13.3–35.2) | 16 | 22.2 | (14.0–33.5) | ||
Gestational Period | 0.394 | 0.418 | ||||||||||||
1st Trimester | 0 | 0.0 | 0.00 | 1 | 1.5 | (0.2–10.3) | 0 | 0.0 | 0.00 | 1 | 1.4 | (0.2–9.6) | ||
2nd Trimester | 10 | 15.4 | (8.4–26.5) | 8 | 12.1 | (6.1–22.7) | 6 | 10.0 | (4.5–20.8) | 12 | 16.9 | (9.8–27.7) | ||
3rd Trimester | 25 | 38.5 | (27.3–51.0) | 33 | 50.0 | (38.0–62.0) | 30 | 50.0 | (37.3–62.6) | 28 | 39.4 | (28.6–51.4) | ||
Postpartum | 30 | 46.2 | (34.3–58.5) | 24 | 36.4 | (25.5–48.8) | 24 | 40.0 | (28.2–53.0) | 30 | 42.3 | (31.2–54.2) | ||
Cash Transfer Program-enrolled | 0.615 | 0.001 | ||||||||||||
No | 15 | 23.1 | (14.3–35.1) | 18 | 26.9 | (17.5–38.9) | 27 | 45.0 | (32.7–57.9) | 6 | 8.3 | (3.7–17.5) | ||
Yes | 50 | 76.9 | (64.9–85.7) | 49 | 73.1 | (61.1–82.5) | 33 | 55.0 | (42.1–67.3) | 66 | 91.7 | (82.5–96.3) | ||
Schooling | 0.275 | 0.416 | ||||||||||||
Elementary School | 13 | 20.0 | (0.1–31.7) | 20 | 30.3 | (20.3–42.6) | 14 | 23.3 | (14.2–35.9) | 19 | 26.8 | (17.6–38.4) | ||
High school | 46 | 70.8 | (58.4–80.7) | 43 | 65.2 | (52.7–75.8) | 40 | 66.7 | (53.6–77.6) | 49 | 69.0 | (57.2–78.8) | ||
University education | 6 | 9.2 | (4.1–19.3) | 3 | 4.5 | (1.4–13.4) | 6 | 10.0 | (4.5–20.8) | 3 | 4.2 | (1.3–12.5) | ||
Ethnicity (color or race) | 0.281 | 0.463 | ||||||||||||
White | 15 | 23.1 | (14.3–35.1) | 9 | 13.6 | (7.2–24.4) | 9 | 15.0 | (7.9–26.7) | 15 | 21.1 | (13.0–32.4) | ||
Black/Brown (Multiracial) | 45 | 69.2 | (56.8–79.4) | 55 | 83.3 | (72.1–90.6) | 46 | 76.7 | (64.1–85.8) | 54 | 76.1 | (64.6–84.7) | ||
Yellow (Asian) | 3 | 4.6 | (1.5–13.6) | 1 | 1.5 | (0.2–10.3) | 3 | 5.0 | (1.6–14.7) | 1 | 1.4 | (0.2–9.6) | ||
Indigenous | 2 | 3.1 | (0.8–11.8) | 1 | 1.5 | (0.2–10.3) | 2 | 3.3 | (0.8–12.7) | 1 | 1.4 | (0.2–9.6) | ||
Monthly Household Income (USD) | 0.231 | 0.903 | ||||||||||||
Up to 100.00 | 18 | 30.0 | (19.6–43.0) | 18 | 30.0 | (19.6–43.0) | 16 | 28.1 | (17.8–41.3) | 20 | 31.7 | (21.3–44.4) | ||
From 100.00 to 200.00 | 27 | 45.0 | (32.7–57.9) | 34 | 56.7 | (43.7–68.8) | 30 | 52.6 | (39.5–65.4) | 31 | 49.2 | (36.9–61.6) | ||
Over 200.00 | 15 | 25.0 | (15.5–37.7) | 8 | 13.3 | (6.7–24.8) | 11 | 19.3 | (10.9–31.9) | 12 | 19.0 | (11.0–30.9) | ||
Previous Pregnancy | 0.948 | 0.011 | ||||||||||||
Primiparous | 8 | 12.3 | (6.2–23.0) | 8 | 11.9 | (6.0–22.3) | 12 | 20.0 | (11.6–32.3) | 4 | 5.6 | (2.1–14.1) | ||
Multiparous | 57 | 87.7 | (77.0–93.8) | 59 | 88.1 | (77.7–94.0) | 48 | 80.0 | (67.7–88.4) | 68 | 94.4 | (85.9–97.9) |
Variables | PR Crude (95% CI) | p Value * | PR Adjusted (95% CI) ** | p Value * |
---|---|---|---|---|
Parental Practices | ||||
Non-adequate parental practices | (ref) | |||
Adequate parental practices | 1.05 (0.83–1.34) | 0.664 | 1.07 (0.85–1.35) | 0.548 |
Food Insecurity Risk | ||||
No | (ref) | |||
Yes | 1.30 (0.88–1.92) | 0.188 | 1.27 (0.85–1.89) | 0.237 |
PCF Visit Frequency | ||||
<4 | (ref) | |||
4 | 0.81 (0.64–1.03) | 0.089 | 0.76 (0.59–0.98) | 0.032 |
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© 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
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Biete, C.; Gonçalves, V.S.S.; Carmo, A.S.; Pizato, N. The Happy Child Program’s Intersectionality: Prenatal Home Visit Frequency, Food Insecurity Risk, Symptoms of Depression, and Parental Practices in Brazilian Women Assisted during Pregnancy. Nutrients 2024, 16, 2990. https://doi.org/10.3390/nu16172990
Biete C, Gonçalves VSS, Carmo AS, Pizato N. The Happy Child Program’s Intersectionality: Prenatal Home Visit Frequency, Food Insecurity Risk, Symptoms of Depression, and Parental Practices in Brazilian Women Assisted during Pregnancy. Nutrients. 2024; 16(17):2990. https://doi.org/10.3390/nu16172990
Chicago/Turabian StyleBiete, Camila, Vivian S. S. Gonçalves, Ariene S. Carmo, and Nathalia Pizato. 2024. "The Happy Child Program’s Intersectionality: Prenatal Home Visit Frequency, Food Insecurity Risk, Symptoms of Depression, and Parental Practices in Brazilian Women Assisted during Pregnancy" Nutrients 16, no. 17: 2990. https://doi.org/10.3390/nu16172990