Session Innovations in Maternity Services Poster Session APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8) Abstract Prenatal Care Health Behaviors among Pregnant Women Na'Tasha Evans, Ph.D., M.Ed1, Kimberly McBride, PhD, MA2, Jiunn-Jye Sheu, PhD, MSPH, MCHES2 and Shipra Singh, MBBS, MPH, PhD2 (1)Kent State University, Kent, OH, (2)University of Toledo, Toledo, OH APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8) BACKGROUND: Access to prenatal care is an important determinant of successful pregnancy outcomes. A barrier to prenatal care may be poor provider communication. Unfortunately, there is very limited research focusing on patient provider communication and prenatal care. This research study aims to bridge the gap by using qualitative methodology to gain a better understanding of pregnant women’s experiences regarding a range of communication practices and interactions with their prenatal care provider. METHODS: Face-to- face interviews were conducted among pregnant women (18-45 years) in their second or third trimester (n=30) who were receiving prenatal care from various community clinics and health care systems in Lucas County, Ohio. The resulting qualitative data were systematically coded and analyzed to identify themes related to prenatal care and a range of communication practices and interactions. RESULTS: The overarching theme was satisfaction, which was influenced by the overall quality of the encounter and health care system influences. Within the overall quality of the encounter, factors that influence decision-making and communication practices were influential in determining patient’s satisfaction with their prenatal health care provider. In regards to health care system influences, continuity of care, referral for resources, information obtained from another source, and other employee encounters influenced satisfaction with prenatal care. CONCLUSION: Our work identified range of communication practices and interactions that influenced satisfaction among pregnant women. Incorporating findings from this study to improve patient satisfaction during prenatal care visits could provide an increase understanding of many complex variables affecting prenatal care. Public health or related education Abstract Happy women during perinatal periods in Taiwan: A trial to examine effects of the positive emotion intervention Shin-Yow Chang, Ph.D1, Yi-Ting Chen, MS2, Ya-Zhu Lin3 and Yi-Hua Chen, Ph D3 (1)National Open University, New Taipei City, Taiwan, (2)National Taiwan Normal University, Taipei, Taiwan, (3)Taipei Medical University, Taipei, Taiwan APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8) Background: Almost none of previous studies has adopted a controlled design to examine the effects of the positive emotion intervention (PEI) among women during the critical perinatal periods. In this controlled trial, we aimed to assess the effectiveness of a group PEI program on depressive symptoms and feelings of happiness for perinatal women. Methods: Participants of the PEI program were selected from the Longitudinal Examination Across Prenatal and Postpartum Health in Taiwan (LEAPP-HIT) project. A total of 30 women in PEI, together with 30 controls matched on maternal age and perinatal stage from 2014 to 2015 in selected hospitals in Taiwan were recruited. Women in PEI attended an 8-hour course within three weeks and were followed four times up to six months after PEI together with controls. The Edinburgh Postnatal Depression Scale and the Chinese Happiness Inventory were used, with repeated-measures analyses being performed. Results: We found significant decreasing trends on depression scores along time for women in the PEI program (from 9.9 before PEI to 6.5 six months after PEI, p<0.001). The feelings of happiness significantly increased from 27.7 before PEI to 29.3 two weeks after PEI, p=0.049). Nevertheless, the effects of PEI might lessen along time. High course satisfaction was reported for women in PEI group. Conclusions: We suggested beneficial short-term effects of PEI in decreasing levels of depression and promoting feelings of happiness for perinatal women. Maternal positive emotions may be an important theme to target on in promoting maternal and consequent child health. Conduct evaluation related to programs, research, and other areas of practice Epidemiology Implementation of health education strategies, interventions and programs Abstract Improving the Readiness, Recognition, and Response to Hypertension in Pregnancy in Florida Emily Bronson, MA, MPH, CPH1, Annette Phelps, ARNP, MSN2, Paige Alitz, MPH, CPH3, Judette Louis, MD, MPH4, Linda A. Detman, PhD1 and William M. Sappenfield, MD, MPH1 (1)University of South Florida, College of Public Health, Tampa, FL, (2)University of South Florida, Lawton and Rhea Chiles Center for Healthy Mothers and Babies, Tampa, FL, (3)University of South Florida, Tampa, FL, (4)University of South Florida, Morsani College of Medicine, Tampa, FL APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8) Background Hypertension is a leading cause of maternal mortality in Florida; these deaths pose significant prevention opportunities. The Florida Perinatal Quality Collaborative (FPQC) led a state-wide quality improvement (QI) project on Hypertension in Pregnancy (HIP) to assist hospitals in implementing nationally recommended best practices from the Alliance on Innovation in Maternity Services (AIM) safety bundle to improve recognition, readiness, response, and reporting on HIP. Methods 32 Florida hospitals enrolled to improve hospital processes, structure, and outcomes. Hospitals received change implementation tools, trainings, education materials, personalized technical assistance, and monthly collaborative learning webinars. Hospitals submitted data on key measures through REDCap and received monthly QI data reports to track their progress and promote on plan, do, study, act cycles. Results After a year of project implementation, hospitals have audited more than 1700 cases of severe new-onset hypertension. Hospitals improved treating women within 1 hour of identified acute elevated blood pressure (baseline median of 24% to 67% in the fourth quarter of 2016) and providing women with discharge education on HIP (20% to 100%). A median of 80% of women had follow-up appointments scheduled in appropriate timing for these patients in Q4. At baseline, 7% of hospitals were debriefing any cases of severe hypertension; 55% of hospitals were debriefing cases in Q4. Recommended hospital structural measures, such as HIP protocols, also significantly increased. Conclusions The Florida HIP initiative showed significant improvement in hospital implementation of the AIM safety bundle. The FPQC model was effective and may inform other hypertension hospital-based QI projects. Administer health education strategies, interventions and programs Clinical medicine applied in public health Implementation of health education strategies, interventions and programs Abstract Peer mentor home visitation model improves outcomes in Hispanic women and their infants: Results from a randomized clinical trial Melanie Lutenbacher, PhD, MSN, FAAN, Tonya Elkins, MSSW and Mary S. Dietrich, PhD Vanderbilt University, Nashville, TN APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8) Maternal Infant Health Outreach Worker (MIHOW) is a home visiting program that utilizes peer mentors to improve maternal/child health outcomes in underserved communities. Findings are presented from a single site randomized clinical trial (RCT) testing the efficacy of MIHOW in a sample of Hispanic women in Tennessee assigned to either a minimal intervention (MI) group (receipt of educational materials) or MIHOW group. A total of 188 pregnant, Hispanic women were enrolled and randomly assigned (MI=94; MIHOW=94), and 178 women completed the study (MI=87; MIHOW=91). Bilingual staff conducted individual interviews at: enrollment; 35th week gestation; 2 weeks; and 2 and 6 months postpartum. Standardized measures were used to assess maternal and infant health outcomes. Statistical analyses were conducted using intention-to- treat principles. Average age at enrollment was 29.6 years (SD=6.5). Most women reported Mexican heritage (66.9%), < a high school education (80.6%), never marrying (56.7%), and incomes <$,000 (96.6%). Groups were similar at enrollment. Positive, statistically significant (p<.01) effects of MIHOW were observed on levels of depressive symptoms and parenting stress, breastfeeding self-efficacy and exclusivity, safe sleep practices, and stimulation to the child in the home. Results expand limited empiric evidence and provide support of the effectiveness of MIHOW to reduce stress and depressive symptoms in Hispanic mothers and improve stimulation and safe sleep practices for their infants. MIHOW is a viable option for immigrant and underserved families. Understanding culturally appropriate ways to address maternal depressive symptoms and stress is crucial to optimizing infant health outcomes. Conduct evaluation related to programs, research, and other areas of practice Diversity and culture Abstract Supporting Home Visitation of Mothers and Children in Need: The Essential Role of Family Support Workers Ndidi Amutah, PhD, MPH, CHES1, Monica Rodriguez, MPH2 and Christine Thorpe, EdD, EdM, CHES (1)Montclair State University, Upper Montclair, NJ, (2)Montclair State University APHA 2017 Annual Meeting & Expo (Nov. 4 - Nov. 8) Background: Home visitation programs improve the health of children in families at greater risk for adverse outcomes.