25 Feb Assignment Content In class, we learned how to write the introduction and conclusion of the Literature Review section, which includes: Introduction?(6 sentences on p. 10a)
Assignment Content
- In class, we learned how to write the introduction and conclusion of the Literature Review section, which includes:
- Introduction (6 sentences on p. 10a)
- Review of Literature (using notes on p. 13a – ONE objective summary is graded already — apply feedback)
- Analysis of Literature (compare and contrast activity on p. 16a)
- For this submission: You will submit your full draft of the Literature Review in a WORD document.
- YOU MUST CHECK YOUR SIMILARITY prior to submission here.
- Grading:
- Title Page = 10 pts
- Literature Review: Intro, Review of Literature, and Analysis of Literature WITH in-text citations and correct level headings:
- Introduction = 15 pts
- Review of Literature = 40 pts
- Analysis of Literature = 20 pts
- References page with ALL four research articles listed = 15 pts
Welcome!
This is an exciting day!
You will be completing the literature review section of your research paper!
Congratulations! You have what you need for part 2 of the literature review!
Introduction Paragraph for the Literature Review
Review of Literature
Analysis of Literature
Now, let’s write Part 1!
Introduction Paragraph for the Literature Review
Review of Literature
Analysis of Literature
Part 1: Introduction paragraph (this will be for workshop, so pay attention!)
Part 1: introduction paragraph
Method in 6 Steps…
STEP 1:
Opening sentence: isolate your research problem, with citation
SAMPLE
Part 1: introduction paragraph
STEP 1:
Opening sentence: isolate your research problem, with citation
Higher infant weight gain is a known risk factor for obesity later on in life (Azad et al., 2018).
SAMPLE
Part 1: introduction paragraph
STEP 2:
Explain why it is necessary to solve this problem
SAMPLE
Part 1: introduction paragraph
STEP 2:
Explain why it is necessary to solve this problem
With the obesity epidemic continuously affecting the population, examining the risk factors of obesity is essential to protecting public health.
SAMPLE
Part 1: introduction paragraph
STEP 3:
Ensure your reader that you have only included research articles in the literature review and identify the main theme among them
SAMPLE
Part 1: introduction paragraph
STEP 3:
Ensure your reader that you have only included research articles in the literature review and identify the main theme among them
The literature review included only research articles and literature regarding the factors that influence high infant weight gain.
SAMPLE
Part 1: introduction paragraph
STEP 4:
If you notice multiple factors, you should list them
SAMPLE
Part 1: introduction paragraph
STEP 4:
If you notice multiple factors, you should list them
Factors such as maternal behaviors, feeding methods, and mode of feedings were reviewed.
SAMPLE
Part 1: introduction paragraph
STEP 5:
Include the names of the databases you used to conduct your research from the Monroe College Library
SAMPLE
Part 1: introduction paragraph
STEP 5:
Include the names of the databases you used to conduct your research from the Monroe College Library
The databases that were used to conduct the literature review included ProQuest and EBSCO Host from the Monroe College Library.
SAMPLE
Part 1: introduction paragraph
STEP 6:
Lastly, list any search words/terms you used in order to find your research articles
SAMPLE
Part 1: introduction paragraph
STEP 6:
Lastly, list any search words/terms you used in order to find your research articles
Search terms were used to obtain relevant literature, such as: infant weight gain, infant overweight, infant feeding, breastfeeding and weight gain, and formula feeding and weight gain.
SAMPLE
Part 1: introduction paragraph
Now put it together:
Higher infant weight gain is a known risk factor for obesity later on in life (Azad et al.,
2018). With the obesity epidemic continuously affecting the population, examining the risk
factors of obesity is essential to protecting public health. The literature review included only
research articles and literature regarding the factors that influence high infant weight gain.
Factors such as maternal behaviors, feeding methods, and mode of feedings were reviewed.
The databases that were used to conduct the literature review included ProQuest and EBSCO
Host from the Monroe College Library. Search terms were used to obtain relevant literature,
such as: infant weight gain, infant overweight, infant feeding, breastfeeding and weight gain,
and formula feeding and weight gain.
You have these DETAILED instructions on that
on p. 9 of your Final ‘Mission’ Packet!
Ready, Set, GO! Use pp. 9-10 as a sample
Workshop your Introduction to the Literature review!
1. Flip to the activity on p. 10a of the Final ‘Mission’ Packet
2. fill it out
3. put the pieces together to draft YOUR
Introduction Paragraph for the Literature Review
(now! before going to the next slide!)
Congratulations! you are done with parts 1 AND 2 of the literature review!
Introduction Paragraph for the Literature Review
Review of Literature
Analysis of Literature
Now, let’s write Part 3!
Introduction Paragraph for the Literature Review
Review of Literature
Analysis of Literature
Please pull up your assignment on p. 16a of YOUR Final ‘Mission’ Packet where you compared and contrasted your articles (last week)
Please make that into an elegant paragraph, now. See sample on p. 17
Congratulations! you are done with parts 1 AND 2 AND 3 of the literature review!
Introduction Paragraph for the Literature Review
Review of Literature
Analysis of Literature
Step Description of Tasks P #
1 Format your APA-7-Compliant Title page. p. 1
2 Use a Level 1 Heading for “Literature Review” and a Level 2 Heading to write your “Introduction to the Literature Review”
p. 10a Sample on p. 10
3 Evaluate your analysis to decide upon the ORDER in which you will present research.
p. 16a
4 Use Level 3 Headings for any potential categories articles that fall under the Level 2 Heading of “Review of Literature” (see sample). Use your
notes p. 13a to write your next three objective summaries and fit in your graded objective summary into your decided order.
p. 13a Sample on p. 14
5 Use a Level 2 Heading for “Analysis of Literature” and write the last paragraph of your Literature Review.
p. 16a Sample on p. 17
6 Create and format your APA-7-Compliant References page including ANY source cited in your document.
7 Complete Checklist p. 17a
8 Submit your Draft of the Literature Review and the checklist Submission
Now …
Be proud! You’ve met a major Milestone in the research paper process!
,
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 1
Racial Disparities in Healthcare Among Pregnant Women in the United States
Tamifer Lewis
Department of Public Health, Monroe College, King Graduate School
KG604-144: Graduate Research and Critical Analysis
Dr. Manya Bouteneff
December 4, 2022
I attest that I have used the checklist on pages 71-78 of my manual
I attest that I passed this paper through the free version of Grammarly
I attest that I incorporated ALL feedback from all previous assignments to make this paper
SHINE
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 2
Racial Disparities in Healthcare Among Pregnant Women in the United States
Introduction
African American, American Indian, and Alaska Native women are up to three times
more likely to die from adverse pregnancy related outcomes, a disparity that increases with age
(Centers for Disease Control and Prevention [CDC], 2019). Researchers found a program which
provided support to African American women through group trainings, entailing of stress
reduction techniques, life skills development, and the building of social support. This enabled
mitigation efforts to be focused and geared around the factors that influence and contributed to
adverse pregnancy outcomes among the minority women within the community, thus reducing
and preventing negative pregnancy outcomes in women of color. In the United States, maternal
mortality and adverse health outcomes persist within the minority community, yet as racial
disparities in healthcare among pregnant women is a current preventable public health concern, it
is vital to understand the determinants of health that influences negative pregnancy related
outcomes in minority women, similar to one of California’s intervention programs, the Black
Infant Health Program (Nichols & Cohen, 2019).
Literature Review
Introduction to Literature Review
Research suggests that racial disparities in healthcare among pregnant women persists in
the United States (Zhang et al., 2013). Due to this continuous occurrence, it is vital to examine
the factors that contribute to the adverse outcomes in maternal health. The literature review
contained only research articles about factors that impacted and influenced disparities in
pregnancy outcomes. Factors that were reviewed were socioeconomic status, public health
insurance, race/ethnicity, and poverty status. The literature review was conducted using EBSCO
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 3
Host and ProQuest databases from the Monroe College Library. The search terms used to
compile pertinent articles were racial disparities maternal health, adverse pregnancy outcomes,
and maternal health outcomes.
Review of Literature
Adverse Pregnancy Outcome Factors
Darling et al. (2021) conducted a study between 2001 and 2018 to examine the efficiency
of qualified interventions in preterm birth, small for gestational age, low birth weight, neonatal
death, cesarean deliveries, maternal care satisfaction, and coast effectiveness programs. A
systematic review was used to collect data from the United States, France, Spain, and the
Netherlands. The studies consisted of mostly non- Caucasian women from low-income
population ranging from 12 to 46 years of age and being between 20 to 32 weeks' gestation.
Interventional programs were implemented into three categories: group prenatal care, augmented
prenatal care, or a combination of both group and augmented prenatal care (Darling et al., 2021).
The researchers found that certain interventions, such as prenatal care and augmented care, or a
combination of both, may decrease adverse outcomes in small-for-gestational-age and preterm
birth, and could aid in increasing maternal care satisfaction. Interventions that worked on
enhancing coordination of care were found to result in providing more effective cost savings.
The researchers also found disparities in the quality of access to care in the vulnerable
population. There was insufficient evidence of suitable quality to confirm that the interventions
were successful at enhancing clinical outcomes in prenatal care for at risk populations (Darling et
al., 2021).
Similar observations were made in a study conducted by Nichols and Cohen (2020),
between 2006 and 2018 to examine the methods used to improve the results of maternal
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 4
mortality in California. The study was conducted using a scoping review to evaluate research on
women and maternal health in the United States. The researchers used information from the US
Maternal Fetal Medicine Network to measure the percentage of studies where pregnant women,
women, and children were the main focus. The researchers also reviewed documentation on
healthcare policies and practices from California’s public health department, healthcare
foundation, and Maternal Quality Care Collaborative. Nichols and Cohen (2020) found that
although the health of fetus and children could be adversely affected by the health of the mother,
the majority of maternal programs in the United States places emphasis on the child. The
researchers also found four areas of concern in women health experiences, both in pre and
postnatal care. The problem areas entailed inadequate investment in women's health, inefficient
quality of care and avoidable caesarean delivers, expanding disparities in minority women and
women living in rural areas, and contradictory collection and distribution of data (Nichols &
Cohen, 2020).
Approaches to Improving Pregnancy Outcomes
In contrast to the preceding studies, Zhang et al. (2013) conducted a study between 2005
and 2007 to calculate the excessive rate of unfavorable outcomes in pregnancy within racial and
ethnic groups. The study also aimed to measure the possibility of Medicaid savings that are
linked to paid maternal care claims resulting from the inequalities that contribute to unfavorable
maternal outcomes. A cross-sectional study using Medicaid Analytic eXtract (MAX) data was
used to gather pregnancy outcome information from inpatient hospitals from 14 states (Florida,
Alabama, Arkansas, North Carolina, Georgia, Louisiana, Kentucky, Mississippi, Maryland,
Missouri, Tennessee, South Carolina, Virginia, and Texas). The study consisted of a little over 2
million patients who were insured with Medicaid and had a delivery code of maternal delivery
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 5
stay. Zhang et al. (2013) found that, with the exception of gestational diabetes, African American
women showed the worst outcomes out of all unfavorable pregnancy outcomes. These disparities
are postulated as being multi-factorial, having causes stemming from complicated experiences
with racism, poverty, and complex healthcare interactions. It was also found that women covered
under Medicaid health insurance were more likely to have consistency in care from prenatal care
through delivery compared to their counterparts. However, due to participation in Medicaid
programs being influenced by reimbursement rates, some providers may choose to stop
accepting Medicaid patients because of reimbursement delays and low payment rates, which
could contribute to negative birth outcomes (Zhang et al., 2013).
Analysis of Literature
In the United States, the persistence of maternal mortality continues to be a problem area
in public health. The contributing factors that impact pregnancy outcomes persist in burdening
the U.S., leading to poor healthcare quality, and increasing health disparities. The studies used in
this literature review each used a different form of research methodology to collect data,
including systematic and scoping reviews and cross-sectional studies. Similarly, Darling et al.
(2021), Nichols and Cohen (2020), and Zhang et al. (2013) have emphasized the correlation
between race/ethnicity and financial status playing a part in influencing quality of care, access of
care, and pregnancy outcomes in pregnant minority women. To mitigate the disparities in
maternal health Darling et al. (2021) and Zhang et al. (2013) suggested that interventions should
be inspected and geared towards determining and eradicating the racial and ethnic disparities that
affect pregnancy-related outcomes. Whereas Nichols and Cohen (2020) suggested focusing on
exploring the distinctive experiences of particular at-risk subgroups of women, such as women in
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 6
prison, who are of childbearing age, and the pregnant women who are less likely to pursue
prenatal care, such as undocumented women.
Discussion
Introduction to Discussion
There is current evidence that racial disparities in healthcare among pregnant women
continues to be a problem in the United States. In an article published by The New York Times
(Rabin, 2019), there has been a persistence and growth in racial disparity throughout the years
despite calls to take action to improve medical care access for women of color. Similarly, in a
study conducted by Nichols and Cohen (2019) mounting disparities continue amid women health
outcomes in the United States, primarily among race and ethnicity and within residents living in
urban and rural areas (Nichols & Cohen, 2019). These disparities directly affect African
American, Alaska Native and Native American Women (Rabin, 2019). When compared to other
high-income countries, the United States has substandard records in maternal health outcomes,
and while the rate of maternal mortality dropped across the world, America's maternal health
outcomes have worsened (Rabin, 2019).
Evidence-Based Recommendation
To reduce the disparities among minority women policy changes have been made.
Federal law enacted the Preventing Maternal Death Act providing states with grants to explore,
examine and investigate pregnancy related deaths for up to one year after the birth of a child
(Rabin, 2019). Also, The American College of Obstetrics and Gynecologists created new
guidelines in treating cardiovascular disease in pregnant women (Rabin, 2019). In 2014 Alliance
for Innovation on Maternal Health (AIM) was developed by the American College of Obstetrics
and Gynecology to collaborate with partners of the states and hospitals to gather information on
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 7
safety measures being taken to improve maternal health outcomes, allowing partners to assess
and track program progress (Nichols & Cohen, 2019). In the study conducted by Nichols and
Cohen (2019), two out of the various programs that California implemented were the Black
Infant Health Program (BIH) and increasing the states income eligibility for pregnant women to
200% of the federal poverty level. With the implementation of these programs, mortality rates
decreased from 22.1% to 8.3% in the best practices toolkit, a program developed for hemorrhage
and high blood pressure during pregnancy. Altogether, California's maternal mortality rate
decreased by above 50% between 2006 and 2018 (Nichols & Cohen, 2019). To prevent negative
pregnancy outcomes in women of color, California used federal funds to develop programs that
focused on African American mothers and the health determinants that are influenced by social
and structural factors. The Black Infant Health Program provided support to African American
women through group trainings, entailing of stress reduction, life skills development, and
building social support (Nichols & Cohen, 2019). Nearly half of the babies born in the United
States are insured under Medicaid which covers the child through the first year of life. However,
in most states, Medicaid provides coverage for the mother until 60 days postpartum, after which
the mother must meet the federal poverty level to be eligible for coverage (Nichols & Cohen,
2019). This exposes the mother to various risks that can adversely affect her health. Expanding
Medicaid access would mitigate the maternal healthcare barriers that affect low socioeconomic
minority women.
Racial disparities in maternal healthcare are a persistent problem in the United States.
African American mothers experience higher adverse pregnancy outcomes and are less likely to
obtain sufficient prenatal care when compared to Caucasian women (Zhang et al., 2013).
Similarly, racial disparities among women of color are made worse by partialities in the
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 8
healthcare that they receive (Nichols & Cohen, 2019). To mitigate racial disparities in maternal
health among minority women it is important to understand the determinants that contribute to
their health outcomes. With increased federal funding, programs can be geared towards
providing quality care to women of color. This can be established by utilizing specific methods
of care that are relatable to those being serviced in the community, providing them with medical
professionals that are culturally competent and adequately trained in servicing underserved
communities, fostering a trusting provider-patient relationship. Nichols and Cohen (2019)
suggest that funding should be used to address the social factors that influence maternal health to
reduce the psychosocial risks in women who may be more vulnerable to adverse pregnancy
outcomes. The pregnancy-related risks of a mother do not end after her child's birth. The
expansion of Medicaid access and coverage would provide a mother with the means of receiving
adequate care during all stages of pregnancy and during the postpartum period, in which she can
still be adversely affected from her pregnancy. It is vital for the federal government to enact
policies requiring states to provide medical coverage to women for one year after the birth of
their child. Providing coverage to various specialties would ensure the mother has efficient
access to care should adverse symptoms develop. Nichols and Cohen (2019) postulated that state
programs should expand Medicaid coverage for women focusing on their healthcare needs
before, during and after pregnancy, paying close attention to women’s health and chronic disease
management, especially to those who have or had high risk pregnancies. Implementing these
programs would develop a foundation in the quality of racial maternal care across all states and
provide cohesion and uniformity in the delivery of care.
Conclusion
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 9
As seen in one of California’s intervention programs, the Black Infant Health Program
(Nichols & Cohen, 2019), a program which provided support to African American women
through group trainings, which entailed stress reduction techniques, life skills development, and
the building of social support enabled mitigation efforts to be focused and geared around the
influencing factors that contributed to adverse pregnancy outcomes among the minority women
within the community, thus reducing and preventing negative pregnancy outcomes in women of
color. African American, American Indian, and Alaska Native women are up to three times more
likely to die from adverse pregnancy related outcomes, a disparity that increases with age (CDC,
2019). In the United States, maternal mortality and adverse health outcomes persist within the
minority community and as a result racial disparities in healthcare among pregnant women is a
current preventable public health concern, therefore it is vital to understand the determinants of
health that influences negative pregnancy related outcomes in minority women.
RACIAL DISPARITIES IN HEALTH IN PREGNANT WOMEN 10
References
Centers for Disease Control and Prevention. (2019, September 6). Racial and ethnic disparities
continue in pregnancy-related deaths. CDC.
https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-
deaths.html
Darling, E. K., Cody, K., Meara Tubman-Broeren, & Marquez, O. (2021). The effect of prenatal
care delivery models targeting populations with low rates of PNC attendance: A
systematic review. Journal of Health Care for the Poor and Underserved, 32(1), 119-
136. https://www.proquest.com/scholarly-journals/effect-prenatal-care-delivery-models-
targeting/docview/2507722229/se-2
Nichols, C. R., & Cohen, A. K. (2021). Preventing maternal mortality in the United States:
Lessons from California and
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