Theses and Dissertations from UMD
Permanent URI for this communityhttp://hdl.handle.net/1903/2
New submissions to the thesis/dissertation collections are added automatically as they are received from the Graduate School. Currently, the Graduate School deposits all theses and dissertations from a given semester after the official graduation date. This means that there may be up to a 4 month delay in the appearance of a give thesis/dissertation in DRUM
More information is available at Theses and Dissertations at University of Maryland Libraries.
Browse
2 results
Search Results
Item SOCIAL NETWORK INFLUENCE ON INFANT FEEDING DECISIONS AMONG LATINX WOMEN(2023) Channell Doig, Amara J; Aparicio, Elizabeth M; Public and Community Health; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Nutrition during the first 1000 days of life is critical for lifelong physical and mental health. Infant milk choices, introduction of complementary foods, and responsive feeding methods can contribute to risk for infection, chronic disease, mental health, and later nutrition and dietary practices. Current feeding interventions are likely to focus on the mother’s decision-making and frequently neglect to explore the impact of the people around her. Little is known about how social networks can influence feeding decisions and how this may impact the acceptance of recommendations from health professionals or intervention content. This dissertation used a convergent mixed methods approach to explore how social networks influence infant feeding decisions and practices for Latinx women in the U.S. In the quantitative portion, 30 participants completed egocentric network mapping to explore network structure and tie strength. In the qualitative portion, 15 of the participants completed in-depth interviews to allow for a better understanding of the influence that network members have, as well as mothers’ decision-making processes. The quantitative and qualitative strands were integrated to allow for a deeper understanding of the social context in which feeding decisions are made. Three manuscripts are presented in the dissertation. The first explores infant feeding support networks and other social influences, including culture and maternal intuition. The participants tended to have small networks and different levels of cultural influence depending on immigration status. The second manuscript examined the influence of information about infant feeding from personal communication compared to online channels. Participants valued the information from medical providers or their support networks and although many used the internet, they had concerns about the information found there. The third manuscript looked at the experiences of the participants who were formula-feeding during the 2022 formula shortage. Although the participants fought to breastfeed their children, they needed to switch to formula to protect their physical and mental health and be there for them. The formula shortage added stress and took an emotional toll on the participants. The dissertation results confirm the importance of social networks as sources of information and support for Latinx mothers with infants during the first year of life. Overall, there was a need for additional support during this time and additional barriers to infant feeding for immigrant mothers. Direct practice implications include how interventions can be developed to provide support. Policy implications include the need to improve structural support for infant feeding, including access to lactation care and food. Future research should continue to assess network support and could look at sociodemographic differences.Item Examining Maternal Experiences of Food Insecurity on Birth and Early Childhood Outcomes(2020) De Silva, Dane André; Thoma, Marie E; Family Studies; Digital Repository at the University of Maryland; University of Maryland (College Park, Md.)Food insecurity, or the inadequate access to nutritionally-acceptable food, has been increasingly recognized as a distal determinant of poor health outcomes. While 11.1% of U.S. households suffer from food insecurity, specific populations are disproportionately affected, including pregnant women and single mothers. From a life course perspective, growth trajectories may be influenced by both prenatal exposures and postpartum practices, such as breastfeeding. Since food insecurity is associated with stress and poor nutrition, when occurring during critical periods of development, the fetus may be programmed to have poor future health. Other research on developmental origins have identified patterns that exhibit sex differences, particularly around growth. Therefore, this investigation sought to examine maternal food insecurity on: (i) low birthweight and sex-specific differences; (ii) breastfeeding initiation and exclusive breastfeeding duration; and (iii) obesity at age two and sex-specific differences. In Aim 1, mothers experiencing prenatal food insecurity had a higher odds of delivering a low birthweight infant, though much of the association was explained by sociodemographic factors after adjustment (OR 1.10 [95%CI 0.98, 1.25]), with female infants showing OR 1.21 (95%CI 1.02, 1.43). For Aim 2, food insecurity did not appear to deter women from initiating breastfeeding (OR 1.41 [95%CI 0.58, 3.47]), and minimal differences in exclusive breastfeeding duration between food insecure and food secure women were found (TR 0.89 [95%CI 0.57, 1.39]). Finally, Aim 3 revealed that sociodemographic factors explained much of the association between maternal food insecurity and childhood obesity at 2 years (OR 1.15 [95%CI 0.75, 1.75]), though male offspring showed a stronger magnitude (OR 1.54 [95%CI 0.86, 2.74]). Maternal food insecurity is a multi-faceted exposure that is related to other covariates, which may interact in multiple ways to influence health outcomes through both biologic and behavioral pathways. This preliminary investigation highlights the importance of exploring exposures occurring during critical periods, including food insecurity, on birth and childhood outcomes, and how it may affect the later health of offspring differently by sex. Additional longitudinal data with accurate measures of food insecurity are needed to fully ascertain how it affects the health of mothers and children, and to identify possible mediating pathways.