Graduation Year

2017

Document Type

Dissertation

Degree

Ph.D.

Degree Name

Doctor of Philosophy (Ph.D.)

Degree Granting Department

Public Health

Major Professor

Russell Kirby, Ph.D., M.S.

Committee Member

Elizabeth Aranda, Ph.D.

Committee Member

Kay Perrin, Ph.D., M.P.H.

Committee Member

William Sappenfield, M.D., M.P.H.

Keywords

public health, social support, social support theory, stress, birth outcomes, preterm, low birth weight, small for gestational age, Latinas, immigrant health

Abstract

Social supports are linked in public health research to improved birth outcomes. This study explored the relationship of social supports, stress and birth outcomes among pregnant Latinas in Pinellas County, Florida. A sample of 411 Healthy Start women at risk of poor birth outcomes participated in this study (99 Latinas, 142 Black, and 158 White). Study methods included ANOVA, Principal Component Analysis, multivariable regression, logistic regression, and structural equation modeling to identify significant associations between social support scores, stress scores, demographics and health risk factors with infant birth weight, preterm and small for gestational age by ethnic group. Study findings indicated there was a direct association between social support and stress across all ethnic groups. However, many confounding variables did not have an effect in the study sample. Latina study participants exhibited significantly lower mean social support scores compared to White and Black participants (p=0.000). Latinas also presented higher stress scores that were significantly different from White and Black participants (p=0.000). The study also found ethnic differences in stress level perceptions using the Perceived Stress Scale. Recommendations for public health included conducting additional studies to assess if the study variables have an impact on a different population, exploring different ethnic interpretations of stress, using repeated measures to assess stress in high risk populations and considering using alternate stress measures such as biological markers and stress life event scales to assess social support, stress and birth outcomes.

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