@misc{GrosserHoellerHoltrichterDoyleetal., author = {Grosser, Angelique and H{\"o}ller-Holtrichter, Chantal and Doyle, Ina-Merle and Schmitz, Jutta and Hoffmann, Renata and Ergin-Akkoyun, Emine and Mauro, Antonia and Breckenkamp, J{\"u}rgen and Razum, Oliver and Spallek, Jacob}, title = {Rekrutierungsstrategien f{\"u}r Migrantinnen in einer Geburtskohorte am Beispiel der BaBi-Studie}, series = {Das Gesundheitswesen}, volume = {81}, journal = {Das Gesundheitswesen}, number = {8/9}, issn = {0941-3790}, doi = {10.1055/a-0600-2392}, pages = {621 -- 628}, abstract = {Die Rekrutierung von Studienteilnehmern aller relevanten Bev{\"o}lkerungsgruppen stellt eine der Herausforderungen in der (sozial-)epidemiologischen Forschung dar. Es existiert eine Vielzahl von Strategien, die der Rekrutierung von ethnischen Minderheiten und bestimmter Migrantengruppen dienen k{\"o}nnen. Unklar ist bisher, ob diese Strategien auch bei der Etablierung einer Geburtskohorte geeignet sind. Ziel der vorliegenden Arbeit ist die Darstellung und Evaluation von Rekrutierungsstrategien f{\"u}r Migrantinnen in einer Geburtskohorte am Beispiel der BaBi-Studie. Die Rekrutierung erfolgte von Oktober 2013 bis Oktober 2016. Als Vorbereitung wurden Fokusgruppen mit Schwangeren und M{\"u}ttern und leitfadengest{\"u}tzte Experteninterviews mit Hebammen und Gyn{\"a}kologInnen durchgef{\"u}hrt, um Studienmaterialien, Befragungsinstrumente und Sprachpr{\"a}ferenzen zu pr{\"u}fen. In der Vorstudie wurden unterschiedliche Rekrutierungswege getestet. Im Rekrutierungsverlauf fand eine kontinuierliche Evaluation statt, um erfolgreiche Rekrutierungsstrategien f{\"u}r Teilnehmerinnen mit Migrationshintergrund zu ermitteln und anzupassen. Von den eingeschlossenen 980 Teilnehmerinnen hatten 390 einen Migrationshintergrund (40\%). Es wurden aktive und passive Rekrutierungsstrategien verfolgt, in denen u. a. t{\"u}rkische {\"U}bersetzungen und multikulturelles Personal zum Einsatz kamen. F{\"u}r die passive Rekrutierung {\"u}ber gyn{\"a}kologische Praxen und Hebammen mussten die schwangeren Frauen und W{\"o}chnerinnen eine hohe Motivation f{\"u}r die Rekrutierung mitbringen. Die aktive Rekrutierung in den Geburtskliniken (Ansprache durch Study-Nurses) erh{\"o}hte den Anteil an Teilnehmerinnen mit Migrationshintergrund von 22 auf 49\% aller Teilnehmerinnen. Durch fr{\"u}hzeitige {\"U}berpr{\"u}fungen und Anpassungen der Zugangswege konnte die Teilnahmebereitschaft erh{\"o}ht werden. F{\"u}r die Rekrutierung von Frauen mit Migrationshintergrund sind gr{\"u}ndliche Vorbereitungen in Form von Befragungen (Fokusgruppen, Leitfadeninterviews) und einer Vorstudie sinnvoll. Von Beginn an sind Verfahren zur fr{\"u}hzeitigen Evaluation der unterschiedlichen Rekrutierungsstrategien und ein erh{\"o}hter Personalaufwand (z. B. f{\"u}r (R{\"u}ck-/ {\"U}bersetzungen) einzuplanen). Der Einschluss von Menschen mit Migrationshintergrund in sozialepidemiologischen Studien sollte in Deutschland zur Normalit{\"a}t werden.}, language = {de} } @misc{MianiLudwigDoyleetal., author = {Miani, C{\´e}line and Ludwig, Angelique and Doyle, Ina-Merle and Breckenkamp, J{\"u}rgen and H{\"o}ller-Holtrichter, Chantal and Spallek, Jacob and Razum, Oliver}, title = {The role of education and migration background in explaining differences in folic acid supplementation intake in pregnancy: Results from a German birth cohort study}, series = {Public Health Nutrition}, journal = {Public Health Nutrition}, issn = {1475-2727}, doi = {10.1017/S1368980021003621}, pages = {1 -- 24}, abstract = {Objective: Official German recommendations advise women to start taking folic acid supplementation (FAS) before conception and continue during the first pregnancy trimester to lower the risk of birth defects. Women from lower socioeconomic background and ethnic minorities tend to be less likely to take FAS in other European countries. As little is known about the determinants of FAS in Germany, we aimed to investigate the association between FAS and formal education and migration background, adjusting for demographic factors. Design: We used data (2013-2016) on nutrition and socioeconomic and migration background from the baseline questionnaire of the BaBi cohort study. We performed multivariate regressions and mediation analyses. Setting: Bielefeld, Germany. Participants: 947 women (pregnant or who had given birth in the past two months). Results: 16.7\% of the participants (158/947) didn't use FAS. Migration-related variables (e.g. language, length of stay) were not associated with FAS in the adjusted models. FAS was lower in women with lower level of formal education and in unplanned pregnancies. Reasons given by women for not taking FAS were unplanned pregnancy and lack of knowledge of FAS. Conclusions: Health practitioners may be inclined to see migrant women as an inherently at-risk group for failed intake of FAS. However, it is primarily women who did not plan their pregnancy, and women of lower formal education level, who are at risk. Different public health strategies to counter low supplementation rates should be supported, those addressing the social determinants of health (i.e. education) and those more focussed on family planning.}, language = {en} } @misc{LudwigMianiBreckenkampetal., author = {Ludwig, Angelique and Miani, C{\´e}line and Breckenkamp, J{\"u}rgen and Sauzet, Odile and Borde, Theda and Doyle, Ina-Merle and Brenne, Silke and H{\"o}ller-Holtrichter, Chantal and David, Matthias and Spallek, Jacob and Razum, Oliver}, title = {Are Social Status and Migration Background Associated with Utilization of Non-medical Antenatal Care? Analyses from Two German Studies}, series = {Maternal and Child Health Journal}, volume = {24}, journal = {Maternal and Child Health Journal}, number = {7}, issn = {1573-6628}, doi = {10.1007/s10995-020-02937-z}, pages = {943 -- 952}, abstract = {Objective: Non-medical antenatal care (ANC) refers to a range of non-medical services available to women during pregnancy aiming at supporting women and prepare them for the birth and the postpartum period. In Germany, they include antenatal classes, breastfeeding classes and pregnancy-specific yoga or gymnastics courses. Studies suggest that various types of non-medical ANC carry benefits for both the women and their babies. Little is known about the uptake of non-medical ANC among different socioeconomic population subgroups, but one may expect lower utilization among socio-economically disadvantaged women. We analyzed factors contributing to the utilization of non-medical ANC in general and antenatal classes in particular. Methods: Baseline data of the Bielefeld BaBi birth cohort (2013-2016) and the Berlin perinatal study (2011-2012) were analyzed. Comparing the two cohorts allowed to increase the socio-economic and migration background variance of the study population and to capture the effect of the local context on uptake of services. Multivariate logistic regression analyses were performed to study associations between the uptake of non-medical ANC and socio-economic and migration status.ResultsIn Berlin and Bielefeld, being a first generation migrant and having lower levels of education were associated with lower non-medical ANC uptake. In Berlin, being a 2nd generation woman or having a low income was also associated with lower uptake. Conclusions for Practice: Our study suggests that non-medical ANC remains in some part the prerogative of non-migrant, well-educated and economically privileged women. Since differences in non-medical ANC have the potential to create inequalities in terms of birth outcomes and maternal health during pregnancy and post-partum, more efforts are needed to promote the use of non-medical ANC by all population groups.}, language = {en} } @misc{MianiLudwigBreckenkampetal., author = {Miani, Celine and Ludwig, A. and Breckenkamp, J{\"u}rgen and Sauzet, Odile and Doyle, Ina-Merle and H{\"o}ller-Holtrichter, Chantal and Spallek, Jacob and Razum, Oliver}, title = {Socioeconomic and migration status as predictors of emergency caesarean section: a birth cohort study}, series = {BMC pregnancy and childbirth}, volume = {20}, journal = {BMC pregnancy and childbirth}, issn = {1471-2393}, doi = {10.1186/s12884-020-2725-5}, pages = {7}, abstract = {BACKGROUND: Women with a migration background are reportedly at a higher risk of emergency caesarean section. There is evidence that this is due in part to suboptimal antenatal care use and quality of care. Despite the fact that migrant women and descendants of migrants are often at risk of socioeconomic disadvantage, there is, in comparison, scarce and incomplete evidence on the role of socioeconomic position as an independent risk factor for emergency caesarean delivery. We therefore investigate whether and how migration background and two markers of socioeconomic position affect the risk of an emergency caesarean section and whether they interact with each other. METHODS: In 2013-2016, we recruited women during the perinatal period in Bielefeld, Germany, collecting data on health and socioeconomic and migration background, as well as routine perinatal data. We studied associations between migration background (1st generation migrant, 2nd/3rd generation woman, no migration background), socioeconomic status (educational attainment and net monthly household income), and the outcome emergency caesarean section. RESULTS: Of the 881 participants, 21\% (n = 185) had an emergency caesarean section. Analyses showed no association between having an emergency caesarean section and migration status or education. Women in the lowest (< 800€/month) and second lowest (between 800 and 1750€/month) income categories were more likely (aOR: 1.96, CI: 1.01-3.81; and aOR: 2.36, CI: 1.27-4.40, respectively) to undergo an emergency caesarean section than women in the higher income groups. CONCLUSIONS: Migration status and education did not explain heterogeneity in mode of birth. Having a low household income, however, increased the chances of emergency caesarean section and thereby contributed towards producing health disadvantages. Awareness of these findings and measures to correct these inequalities could help to improve the quality of obstetric care.}, language = {en} } @misc{GrosserHoellerHoltrichterMianietal., author = {Grosser, Angelique and H{\"o}ller-Holtrichter, Chantal and Miani, Celine and Hoffmann, Renata and Breckenkamp, J{\"u}rgen and Razum, Oliver and Spallek, Jacob}, title = {Impact of migration background on the uptake of antenatal care: the BaBi birth cohort study, Germany}, series = {European Journal of Public Health}, volume = {27}, journal = {European Journal of Public Health}, number = {Suppl. 3}, issn = {1464-360X}, doi = {10.1093/eurpub/ckx187.467}, pages = {S. 183}, language = {en} } @misc{MianiBreckenkampGrosseretal., author = {Miani, Celine and Breckenkamp, J{\"u}rgen and Grosser, Angelique and H{\"o}ller-Holtrichter, Chantal and Ergin-Akkoyun, Emine and Hoffmann, Renata and Doyle, Ina-Merle and Spallek, Jacob and Razum, Oliver}, title = {Socio-economic determinants of breastfeeding uptake and duration intention among women with and without migration background. Results from the BaBi birth cohort study in Bielefeld, Germany}, series = {European Journal of Public Health}, volume = {28}, journal = {European Journal of Public Health}, number = {Vol. 1}, issn = {1464-360X}, doi = {10.1093/eurpub/cky047.093}, pages = {S. 50}, abstract = {Background: Disparities in breastfeeding practices have been observed between migrants and majority populations in many countries. We compared breastfeeding practices among women with and without a migration background in Bielefeld, Germany, using data from a birth cohort. Methods: In 2013-16, we conducted 967 standardised interviews with women aged over 18 during pregnancy or shortly after birth, collecting data on breastfeeding uptake and duration intention, as well as on socio-economic and migration background. Bivariate and multivariate analyses were performed, adjusting for clinical factors (e.g. age, parity, birthweight). Results: Breastfeeding uptake was more common among women with a migration background than among non-immigrants (88.9\% vs. 83\%, p < 0.05). It was particularly high among 2nd and 3rd generation women (92\%). Women with a migration background tended to intend to breastfeed longer than non-immigrants (6.2\% vs 7.6\% between 6 months and one year and 0.67\% vs. 2.53\% beyond one year). When controlling for clinical and socio-economic characteristics, only a statistically significant correlation between breastfeeding uptake and the opinion of the mother and of the partner with regard to breastfeeding remained, with a negative opinion decreasing the chances of uptake (OR 0.5; CI 0.25-0.79 and OR 0.2; CI 0.12-0.36, respectively). Mothers and partners of women with migration background were more likely to strongly support breastfeeding than those of non-immigrants. Duration intention was positively associated with having a migration background (1.98; CI 1.10-3.55) and negatively associated with income, with higher income decreasing likelihood of breastfeeding beyond 6 months (OR 0.6; CI 0.44-0.94). Conclusions: This study found differences in breastfeeding uptake and duration intention among women with and without a migration background. This calls for public health actions targeting different socio-economic groups if one wants to come closer to the WHO recommended breastfeeding rates. Initiatives that are inclusive of the mother and the partner of the expectant women are also worth considering.}, language = {en} } @misc{GrosserHoellerHoltrichterMianietal., author = {Grosser, Angelique and H{\"o}ller-Holtrichter, Chantal and Miani, Celine and Hoffmann, Renata and Breckenkamp, J{\"u}rgen and Spallek, Jacob and Razum, Oliver}, title = {Caesarean birth frequency among women with and without migration background in Germany: the BaBi birth cohort study, Germany}, series = {European Journal of Public Health}, volume = {27}, journal = {European Journal of Public Health}, number = {Suppl. 3}, issn = {1464-360X}, doi = {10.1093/eurpub/ckx187.466}, pages = {S. 183}, language = {en} } @misc{SpallekGrosserHoellerHoltrichteretal., author = {Spallek, Jacob and Grosser, Angelique and H{\"o}ller-Holtrichter, Chantal and Doyle, Ina-Merle and Breckenkamp, J{\"u}rgen and Razum, Oliver}, title = {Early childhood health in Bielefeld, Germany (BaBi study) : study protocol of a social-epidemiological birth cohort}, series = {British Medical Journal Open}, volume = {7}, journal = {British Medical Journal Open}, number = {8}, issn = {2044-6055}, doi = {10.1136/bmjopen-2017-018398}, pages = {5}, language = {en} } @misc{GrosserHoellerHoltrichterBreckenkampetal., author = {Grosser, Angelique and H{\"o}ller-Holtrichter, Chantal and Breckenkamp, J{\"u}rgen and Hoffmann, Renata and Spallek, Jacob and Razum, Oliver}, title = {Impact of migration background on the uptake of antenatal care: the BaBi birth cohort study, Germany}, series = {Das Gesundheitswesen}, volume = {79}, journal = {Das Gesundheitswesen}, number = {08/09}, issn = {1439-4421}, doi = {10.1055/s-0037-1605903}, pages = {656 -- 804}, language = {en} }