@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{WandschneiderSauzetBreckenkampetal., author = {Wandschneider, Lisa and Sauzet, Odile and Breckenkamp, J{\"u}rgen and Spallek, Jacob and Razum, Oliver}, title = {Small-Area Factors and Their Impact on Low Birth Weight—Results of a Birth Cohort Study in Bielefeld, Germany}, series = {Frontiers in Public Health}, volume = {8}, journal = {Frontiers in Public Health}, issn = {2296-2565}, doi = {10.3389/fpubh.2020.00136}, pages = {10}, abstract = {Introduction: The location of residence is a factor possibly contributing to social inequalities and emerging evidence indicates that it already affects perinatal development. The underlying pathways remain unknown; theory-based and hypothesis-driven analyses are lacking. To address these challenges, we aim to establish to what extent small-area characteristics contribute to low birth weight (LBW), independently of individual characteristics. First, we select small-area characteristics based on a conceptual model and measure them. Then, we empirically analyse the impact of these characteristics on LBW. Material and methods: Individual data were provided by the birth cohort study "Health of infants and children in Bielefeld/Germany." The sample consists of 892 eligible women and their infants distributed over 80 statistical districts in Bielefeld. Small-area data were obtained from local noise maps, emission inventory, Google Street View and civil registries. A linear multilevel analysis with a two-level structure (individuals nested within statistical districts) was conducted. Results: The effects of the selected small-area characteristics on LBW are small to non-existent, no significant effects are detected. The differences in proportion of LBW based on marginal effects are small, ranging from zero to 1.1\%. Newborns from less aesthetic and subjectively perceived unsafe neighbourhoods tend to have higher proportions of LBW. Discussion: We could not find evidence for negative effects of small-area factors on LBW, but our study confirms that obtaining adequate sample size, reliable measure of exposure and using available data for operationalisation of the small-area context represent the core challenges in this field of research.}, 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{GrosserDoyleLoeffleretal., author = {Grosser, Angelique and Doyle, Ina-Merle and L{\"o}ffler, Antje and Breckenkamp, J{\"u}rgen and Spallek, Jacob and Razum, Oliver and Miani, Celine}, title = {The impact of psychosocial factors on breastfeeding duration in the BaBi cohort study, Germany}, series = {European Journal of Public Health}, volume = {29}, journal = {European Journal of Public Health}, number = {4}, issn = {1464-360X}, doi = {10.1093/eurpub/ckz187.122}, pages = {2}, abstract = {Background: Breastfeeding is considered beneficial for both mother and child. In Germany, national guidelines recommend fully breastfeeding for at least 4 months, a goal reached by only 34\% of mothers in 2012. The WHO's recommendation of exclusively breastfeeding for six months was met by 19\% only. Hardly modifiable factors such as socio-economic status and migration background have been associated with duration of breastfeeding but little is known about the impact of psychosocial factors such as personality traits and social support. We hypothesise that there are differences in the psychosocial profiles of mothers regarding the duration of breastfeeding. Methods: We analyse baseline and follow-up data of the Bielefeld BaBi birth cohort (2013-16). They include detailed migration and socio-economic backgrounds, as well as three measures of psychological characteristics: the optimism scale, the Big Five inventory and the locus of control scales. We perform bivariate and multivariate analyses in order to identify psychosocial determinants of fully breastfeeding for four and six months. Results: Out of 780 BaBi study participants, 548 fully breastfed for four months (70.3\%), of which 279 continued until at least six months (35.8\%). Logistic regression analyses show that fully breastfeeding for at least four or six months is independently associated with the intention to breastfeed and the attendance of antenatal class during this or previous pregnancies. Personality characteristics, social status and migration background show however no significant association with breastfeeding duration. Conclusions: Our study results support the promotion of individuals' breastfeeding intention and attendance to antenatal classes to increase breastfeeding duration. Since differences in breastfeeding practices have the potential to create inequalities in maternal and child health, more efforts are needed to intensify research on modifiable factors influencing breastfeeding duration.}, 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{GrosserDoyleLoeffleretal., author = {Grosser, Angelique and Doyle, Ina-Merle and L{\"o}ffler, Antje and Breckenkamp, J{\"u}rgen and Spallek, Jacob and Razum, Oliver and Miani, Celine}, title = {The impact of psychosocial factors on breastfeeding duration in the BaBi-Study. Analysis of a birth cohort study in Germany}, series = {Gesundheitswesen 2019}, volume = {81}, journal = {Gesundheitswesen 2019}, number = {08/09}, publisher = {Georg Thieme Verlag}, address = {Stuttgart}, doi = {10.1055/s-0039-1694422}, pages = {686 -- 686}, abstract = {Background: Breastfeeding is beneficial for both mother and child. In Germany, national guidelines recommend fully breastfeeding for at least 4 months, which has only been reached by 34\% in 2012. The WHO's aim of exclusively breastfeeding for six months was reached by 19\% only. Socio-economic status and migration background have been identified to be associated with duration of breastfeeding but little is known about the impact of psychosocial factors e.g. personality traits and social support. We hypothesized that there are differences in the psychosocial profiles of mothers regarding the duration of breastfeeding. Methods: Baseline and follow up data of the Bielefeld BaBi birth cohort (2013 - 16) were analysed. Bivariate and multivariate analyses were performed in order to identify psychosocial determinants for fully breastfeeding for four and six months. Results: Out of 780 BaBi study participants, 548 fully breastfeed for four months (70.3\%) and 279 continued until at least six months (35.8\%). Logistic regression analyses shows that fully breastfeeding for at least four or six months is independently associated with the intention to breastfeed (OR 7.3 [C.I. 4.54.-11.21) and the attendance of antenatal class (OR 1.4 [C.I. 1.01.-2.06). Personality characteristics, social status und migration background showed no significant association with breastfeeding duration. Conclusion: Our study results suggest to promote individuals' breastfeeding intention and the attendance of antenatal classes to increase breastfeeding duration. Since differences in breastfeeding practices have the potential to create inequalities in mother and child health, more efforts are needed to intensify research on modifiable factors influencing breastfeeding duration.}, 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{BerensRederRazumetal., author = {Berens, Eva-Maria and Reder, Maren and Razum, Oliver and Kolip, Petra and Spallek, Jacob}, title = {Informed choice in mammography screening program among migrant and non-migrant women: a survey among first-time invitees in Germany, 2013-2015}, series = {European Journal of Public Health}, volume = {28}, journal = {European Journal of Public Health}, number = {Suppl. 1}, issn = {1464-360X}, doi = {10.1093/eurpub/cky047.107}, pages = {S. 55}, abstract = {Background: In Germany, women aged 50 to 69 are invited biennially to the population-based mammography screening programme (MSP). There is still a broad discussion whether the benefits of the programme outweigh its harms. Hence, the concept of informed choice is of particular importance for MSP. The aim of this survey was to assess the proportion of informed choices among migrant and non-migrant women invited to the German MSP for the first time. Methods: A random sample of 17,349 women aged 50 from a sub-region of North Rhine Westphalia was invited to participate in a postal cross-sectional survey conducted in German and Turkish. Turkish and other migrants were identified by country of birth and German resettlers additionally by self-reported resettler-status. Turkish migrant women were oversampled, due to expected lower response-rates. The effect of migration status on informed choice and on its three components (knowledge, attitude and intention) were assessed by chi-square tests and logistic regression modelling. Results:5,847 (33.7\%) women responded to the postal questionnaire. 4,113 complete cases were included in the analyses. The proportion of women making informed choices was low (27.1\%). Turkish migrant women had the highest odds for making an uninformed choice (OR 5.30, 95\%CI 1.92-14.66) independent of educational level. Other migrant groups only had slightly higher odds for making an uninformed choice (German resettlers: OR 1.50, 95\%CI 1.00-2.25; other migrants: OR 1.57, 95\%CI 0.96-2.57) compared to non-migrant women. Fewer Turkish and other immigrant women intended to participate in the MSP. Immigrant women had a more positive attitude and a lower proportion of sufficient knowledge compared to non-migrant women. Conclusions: The overall proportion of informed choice in the German MSP is low and knowledge is poor. Measures are needed to improve information materials, strengthen health literacy and create a user-friendly environment facilitating informed choices especially for migrant women.}, 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} } @misc{BerensRederRazumetal., author = {Berens, Eva-Maria and Reder, Maren and Razum, Oliver and Kolip, Petra and Spallek, Jacob}, title = {Informed choice in mammography screening program: a survey among first-time invitees in 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/ckx187.213}, pages = {S. 83}, language = {en} } @incollection{SpallekBrzoskaYilmazAslanetal., author = {Spallek, Jacob and Brzoska, Patrick and Yilmaz-Aslan, Y{\"u}ce and Exner, Anne-Kathrin and Voigtl{\"a}nder, Sven and Razum, Oliver}, title = {Medizinische Rehabilitation und Leistungen zur Teilhabe am Arbeitsleben bei Menschen mit Migrationshintergrund}, series = {Behinderung und Migration}, booktitle = {Behinderung und Migration}, editor = {Wansing, Gudrun and Westphal, Manuela}, publisher = {Springer VS}, address = {Wiesbaden}, isbn = {978-3-531-19401-1}, doi = {10.1007/978-3-531-19401-1}, pages = {253 -- 262}, abstract = {Eine Bestandsaufnahme zur Zug{\"a}nglichkeit und Qualit{\"a}t der Versorgung.}, language = {de} } @incollection{RazumButlerSpallek, author = {Razum, Oliver and Butler, Jeffrey and Spallek, Jacob}, title = {Gesundheitliche Chancen und Risiken von Migrant*innen: Handlungsm{\"o}glichkeiten einer kommunalen Gesundheitspolitik.}, series = {Handbuch Lokale Integrationspolitik.}, booktitle = {Handbuch Lokale Integrationspolitik.}, editor = {Gesemann, Frank and Filsinger, Dieter and M{\"u}nch, Sybille}, edition = {2. Auflage}, publisher = {Springer VS}, address = {Wiesbaden}, isbn = {978-3-658-43195-2}, doi = {10.1007/978-3-658-43195-2_34-1}, pages = {1 -- 23}, abstract = {Migrant*innen haben gesundheitliche Vor- und Nachteile gegen{\"u}ber der nicht-migrierten Bev{\"o}lkerung. Der Zusammenhang zwischen Migration und Gesundheit ist mehrdimensional, weitere - insbesondere soziale - Faktoren m{\"u}ssen bei der Interpretation beachtet werden. Erkl{\"a}rungsmodelle bilden die Komplexit{\"a}t des Zusammenhangs ab. Die zentralen Modelle haben eine Perspektive auf den gesamten Lebenslauf von migrierten Menschen (vor, w{\"a}hrend und nach der Migration). Sie helfen der kommunalen Gesundheitspolitik, geeignete Daten zu erheben und wirksame Interventionen zu entwickeln.}, language = {de} }