Maureen Goates Merrell and Lynn Clark Callister, RN, PhD, FAA, Nursing
The March of Dimes’ Teddy Bear Den (TBD) program aims to promote effective maternal health care among socially disadvantaged Hispanic women. The program has benefitted many women since its inception in 2004, yet there was no research to support the program’s effectiveness or to better understand the women’s needs. The purpose of this project is to (a) to meet the March of Dimes Utah Chapter goal to support an evidence-based chapter driven community program, (b) to improve the quality of the program to more effectively meet the needs of the women, and (c) to generate data that can be provided to potential donors to keep the TBD self sustaining and potentially to expand services.
In the United States, the rate of Hispanic immigration is rapidly increasing, and in 2025 Hispanics are estimated to represent 25% of the US population (United States Census Bureau, 2010). Although this minority group constitutes a significant percentage of the US population, healthcare considers them the “silent or invisible minority” because of limited understanding regarding their health care needs and culture (Callister & Birkead, 2007). More specifically, childbearing women in the Hispanic population have a high fertility rate, but a shockingly low rate of receiving healthcare before, during, and after pregnancy (Pew Hispanic Center, 2010). In order to promote healthcare among socially disadvantaged Hispanic women, the March of Dimes sponsors a Teddy Bear Den Program to encourage healthy maternal behaviors. “Teddy Bear clients ‘earn’ points towards incentives, such as baby care items and clothing, through a variety of positive, health-promoting activities: attending prenatal care appointments, participating in prenatal education classes, keeping well-baby appointments” (Utah Chapter: Mission at work, 2010).
Following IRB approval and informed consent, a convenience sample of 28 Hispanic women who had accessed the services of the TBD participated in three different focus groups. Sixty to ninety minute focus group discussions were conducted at the Oquirrh View Community Health Center in South Jordan, Utah. Focus group participants were provided with a $20 gift certificate as an expression of appreciation for participation in the study. Digital recordings tapes of the focus groups were transcribed and themes generated based on the narrative data.
Study participants appreciated the opportunity to share their perspectives and eagerly engaged in the focus group dialogue. They described the strengths of the TBD and also made suggestions for improvement of the initiative. They said that the incentives motivated them to “earn” points. The TBD strengths were categorized as informational, material, and social support.
Women that participate in the TBD receive points for attending prenatal appointments and classes. The study participants expressed appreciation for these classes and the chance to learn about the progression of pregnancy, potential pregnancy complications, promotion of a healthy lifestyle, and infant care. The knowledge and understanding gained through this education was seen to both empower and promote confidence during the progression of pregnancy.
Study participants were grateful for the materials they received from the TBD, such as diapers and baby clothing. Many women explained the economic strain that they are experiencing in their families. The TBD served as a haven to supply items that they might not get otherwise.
In addition to providing material and educational support, the TBD also gives opportunities for social support. Study participates were very appreciative of the friendships fostered through the TBD program. They also said it is wonderful to know they are not alone in their worries and experiences of pregnancy and motherhood.
Suggestions for improvement included the provision of maternity clothing, having more education classes including parenting classes, increasing the length of time of eligibility for the program, having more locations and longer hours.
This research supports the mission of the March of Dimes to improve maternal/infant health for vulnerable Hispanic women and their families through research, community service, education, and advocacy. Data will be used to accomplish the following three goals: (a) to meet the March of Dimes Utah Chapter goal to support an evidence-based chapter driven community program, (b) to improve the quality of the program to more effectively meet the needs of the women, and (c) to generate data that can be provided to potential donors to keep the TBD self sustaining and potentially to expand services.
This research was used and presented in the following ways. A report of the TBD research was generated for the March of Dimes Utah Chapter. A poster of the research findings was displayed at the April 2011 WIN conference. Lastly, results were presentation at the 2011 Brigham Young University College of Nursing Research Conference.
References:
- Callister, L.C & Birkhead, A. (2007). Mexican immigrant women: Social support and perinatal outcomes. In D.R. Crane & T. Heaton (Eds). Families in Poverty: An Interdisciplinary Approach, pp. 181-197. Thousand Oaks, California: Sage.
- Our Mission – March of Dimes. (2010). Pregnancy, Babies, Prematurity – March of Dimes Foundation. Retrieved Oct. 28, 2010 from http://www.marchofdimes.com/787.asp
- Pew Hispanic Center. (2010). Statistical portrait of Hispanics in the United States, 2008. Washington DC: Pew Hispanic Center. Retrieved September 1, 2010 from http://pewhispanic.org/factsheets/factsheet.php?FactsheetID=35
- United States Census Bureau. (2010). Cumulative estimates of resident population change for the United States. Retrieved Oct. 10, 2010 from http://www.census.gov/popest/states
- Utah Chapter: Mission at Work. (2010). Pregnancy, Babies, Prematurity – March of Dimes Foundation. Retrieved Oct. 28, 2010 from http://www.marchofdimes.com/utah/9851_12216.asp