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孕产妇行为健康:行为分析的沃土。

Maternal Behavioral Health: Fertile Ground for Behavior Analysis.

作者信息

Washio Yukiko, Humphreys Mara

机构信息

1Christiana Care Health System, Newark, DE USA.

2University of Delaware, 4755 Ogletown-Stanton Road, Newark, DE 19713 USA.

出版信息

Perspect Behav Sci. 2018 May 10;41(2):637-652. doi: 10.1007/s40614-018-0143-z. eCollection 2018 Nov.

Abstract

The World Health Organization has identified four behavioral health priorities as risk factors for noncommunicable diseases in maternal populations: tobacco use, harmful alcohol use, poor nutrition, and lack of physical activity. These risk factors also significantly affect pregnant and immediately postpartum mothers, doubling the health risk and economic burden by adversely affecting maternal and birth or infant outcomes. Psychosocial and behavioral interventions are ideal for pregnant and immediately postpartum women as opposed to pharmacotherapy. Among other behavioral interventions, the use of incentives based on the principles of reinforcement has been a successful yet controversial way to change health behaviors. Implementing an incentive-based intervention in maternal health often brings up social validity concerns. The existing guideline on how to develop and conduct research in incentive-based interventions for maternal health lacks enough information on the specific variables to control for to maintain the intervention's effectiveness. This article outlines some of the critical variables in implementing an effective behavior-analytic intervention and addressing social validity concerns to change maternal behaviors in a sustainable manner, along with specific research topics needed in the field to prevent adverse maternal, birth, and infant outcomes.

摘要

世界卫生组织已确定四项行为健康重点作为孕产妇群体非传染性疾病的风险因素

吸烟、有害饮酒、营养不良和缺乏体育活动。这些风险因素也会对怀孕及产后即刻的母亲产生重大影响,通过对孕产妇及分娩或婴儿结局产生不利影响,使健康风险和经济负担加倍。与药物治疗相比,心理社会和行为干预对怀孕及产后即刻的妇女来说是理想的选择。在其他行为干预措施中,基于强化原则的激励措施是改变健康行为的一种成功但存在争议的方式。在孕产妇健康领域实施基于激励的干预措施往往会引发社会效度方面的担忧。现有的关于如何开展孕产妇健康领域基于激励的干预措施研究的指南,缺乏关于为维持干预效果而需控制的具体变量的足够信息。本文概述了实施有效行为分析干预措施和解决社会效度问题以可持续地改变孕产妇行为的一些关键变量,以及该领域为预防不良孕产妇、分娩和婴儿结局所需的具体研究课题。

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