Background: Gestational weight gain (GWG), affects almost 50% of pregnant women and effective and scalable interventions are needed and should be inclusive for all irrespectively of origin. The overall aim of this thesis was to evaluate the HealthyMoms app targeting GWG as well as dietary and physical activity behaviors and how the app may be adapted to also reach women of migrant backgrounds. The first part evaluated the effectiveness of the HealthyMoms trial and the dietary assessment method used in it (Paper I-II). The second part aimed to explore how the HealthyMoms app could be adapted to reach Arabic- and Somali-speaking women (Paper III-IV). Methods: Paper I was a randomized controlled trial in healthy pregnant women (n=305). After baseline assessment (week 14), women were randomized to the intervention (n=152) or control group (n=153). The intervention group received standard care and the HealthyMoms app. The primary outcome was GWG between baseline and follow-up measurement (week 37). Secondary outcomes included body fatness (air displacement plethysmography), dietary habits (SHEI score), moderate-to-vigorous physical activity (accelerometry), glycemia and insulin resistance. Paper II: Nested validation study of RiksmatenFlex (dietary assessment method in HealthyMoms) in a subsample of the trial. Three days of dietary data (energy, foods groups, macronutrients and SHEI score) from RiksmatenFlex was compared to 24 h telephone dietary recalls (n=52). Total energy expenditure (TEE) was measured with the doubly labelled water method (n=24). Paper III: A qualitative exploration of healthcare professionals’ views on supporting healthy lifestyle behaviors in pregnant migrant women was performed through individual interviews over phone or in person with healthcare professionals working in maternity healthcare (n=14). An inductive thematic analysis was performed. Paper IV: Individual interviews with Arabic (n=10) and Somali women (n=9) exploring what support is needed for healthy lifestyle behaviors and how the HealthyMoms app could be adapted. Data was analyzed using content analysis (inductive latent approach). Results: Paper I: No statistically significant effect on GWG was observed, although data indicated that the effect of the HealthyMoms app differed according to pre-pregnancy BMI, where women with overweight and obesity in the intervention group had lower GWG compared to the control group in the imputed (–1.33 kg; 95% CI –2.92 to 0.26; P=.10) and completers-only analyses (–1.67 kg; 95% CI –3.26 to –0.09; P=.031). Participants in the intervention group further had higher SHEI score at follow-up compared to the control group (0.27; 95% CI 0.05-0.50; P=.017). No other effects for secondary outcomes were found. Paper II: Average energy intake from RiksmatenFlex (10015 [SD 2004] kJ) was similar to TEE (10252 [SD 1197] kJ) (P=.596). Mean differences between average intakes of unhealthy and healthy foods and average SHEI score between RiksmatenFlex and 24 h telephone dietary recalls were small, although Bland and Altman analyses showed wide limits of agreement for all variables. Moreover, correlations between dietary variables assessed with the two dietary methods were high (r=0.751-0.931; P<.001). Paper III: Healthcare professionals discussed challenges in their health promotion work including cultural and educational aspects as well as the need of increased awareness among pregnant migrant women and persons in the social context. Healthcare professionals further highlighted a lack of resources in the clinical practice and a need for increased cultural awareness in themselves to support healthy lifestyle behaviors. Providing the HealthyMoms app in Arabic and Somali with culturally adjusted information could be a helpful tool for women and for healthcare professionals in maternity healthcare. Paper IV: Arabic- and Somali-speaking women expressed a need of more knowledge about pregnancy and healthy lifestyle behaviors. The social context, and especially partners could support lifestyle behaviors. The social context could further be a source of misinformation which might negatively affect women’s diet or physical activity. Women had high trust in maternity healthcare but wanted more information related to lifestyle behaviors. A translated HealthyMoms app was seen as a helpful support for lifestyle behaviors, and it was reported that translation alone could be sufficient, however, audio- and video content was requested as well as inclusion of partners in the app. Conclusions: This thesis shows that the HealthyMoms app significantly improved dietary habits among pregnant women and has potential to reduce GWG in women with overweight and obesity. The dietary assessment method (RiksmatenFlex) showed acceptable agreement for average energy, macronutrients, key food groups and adherence to dietary guidelines, which strengthens the credibility of the obtained trial results and supports further use of the method. Finally, this thesis demonstrates the potential of the HealthyMoms app also for Arabic- and Somali-speaking women, i.e., two of the largest migrant groups in Sweden. It was requested that the app should include audio and video content, however, the need of other cultural adaptations needs further investigation.

Social changes in European societies place migration and cultural diversity on the European political agenda. The European initiative Migrant Friendly Hospitals (MFH) aims to identify, develop and evaluate models of effective interventions. It has the following objectives: To strengthen the role of hospitals in promoting the health of migrants and ethnic minorities in the European Union and to improve hospital services for these groups. This report reviews models of effective intervention in the medical literature and provides the background information needed to enable partner hospitals taking part in the MFH initiative to select and implement suitable interventions. The interventions reviewed in this study are grouped in four areas: Communication, Responsiveness Empowerment of migrant and minority patients and communities. Monitoring of the health of migrants and minorities and the health care they receive. [Ed.]

Children are the foundation of the United States, and supporting them is a key component of building a successful future. However, millions of children face health inequities that compromise their development, well-being, and long-term outcomes, despite substantial scientific evidence about how those adversities contribute to poor health. Advancements in neurobiological and socio-behavioral science show that critical biological systems develop in the prenatal through early childhood periods, and neurobiological development is extremely responsive to environmental influences during these stages. Consequently, social, economic, cultural, and environmental factors significantly affect a child's health ecosystem and ability to thrive throughout adulthood. Vibrant and Healthy Kids: Aligning Science, Practice, and Policy to Advance Health Equity builds upon and updates research from Communities in Action: Pathways to Health Equity (2017) and From Neurons to Neighborhoods: The Science of Early Childhood Development (2000). This report provides a brief overview of stressors that affect childhood development and health, a framework for applying current brain and development science to the real world, a roadmap for implementing tailored interventions, and recommendations about improving systems to better align with our understanding of the significant impact of health equity.

The delivery of high quality and equitable care for both mothers and newborns is complex and requires efforts across many sectors. The United States spends more on childbirth than any other country in the world, yet outcomes are worse than other high-resource countries, and even worse for Black and Native American women. There are a variety of factors that influence childbirth, including social determinants such as income, educational levels, access to care, financing, transportation, structural racism and geographic variability in birth settings. It is important to reevaluate the United States' approach to maternal and newborn care through the lens of these factors across multiple disciplines. Birth Settings in America: Outcomes, Quality, Access, and Choice reviews and evaluates maternal and newborn care in the United States, the epidemiology of social and clinical risks in pregnancy and childbirth, birth settings research, and access to and choice of birth settings.

​This easy to use text provides practitioners and researchers with a global view of current and emerging issues concerned with successful pregnancy outcomes and approaches that have been successful or show promise in ensuring a successful pregnancy. The fully updated and revised second edition expands its scope with topics not covered in the first edition including pregnancy and military service; sleep disorders during pregnancy; the gut microbiome during pregnancy and the newborn; requirement for vitamin D in pregnancy; the environment—contaminants and pregnancy; preeclampsia and new approaches to treatment; health disparities for whites, blacks, and teen pregnancies; depression in pregnancy—role of yoga; safe food handling for successful pregnancy outcome; relationship of epigenetics and diet in pregnancy; caffeine during pregnancy; polycystic ovary syndrome; US Hispanics and preterm births; celiac disease and pregnancy; cannabis use during pregnancy. The second edition of Handbook of Nutrition and Pregnancy will be a valuable resource for clinicians and other healthcare professionals who treat and counsel women of child-bearing age and pregnant women.

In Shapeshifters Aimee Meredith Cox explores how young Black women in a Detroit homeless shelter contest stereotypes, critique their status as partial citizens, and negotiate poverty, racism, and gender violence to create and imagine lives for themselves. Based on eight years of fieldwork at the Fresh Start shelter, Cox shows how the shelter's residents—who range in age from fifteen to twenty-two—employ strategic methods she characterizes as choreography to disrupt the social hierarchies and prescriptive narratives that work to marginalize them. Among these are dance and poetry, which residents learn in shelter workshops. These outlets for performance and self-expression, Cox shows, are key to the residents exercising their agency, while their creation of alternative family structures demands a rethinking of notions of care, protection, and love. Cox also uses these young women's experiences to tell larger stories: of Detroit's history, the Great Migration, deindustrialization, the politics of respectability, and the construction of Black girls and women as social problems. With Shapeshifters Cox gives a voice to young Black women who find creative and non-normative solutions to the problems that come with being young, Black, and female in America.

The standard reference in the field, this acclaimed work synthesizes findings from hundreds of carefully selected studies of mental health treatments for children and adolescents. Chapters on frequently encountered clinical problems systematically review the available data, identify gaps in what is known, and spell out recommendations for evidence-based practice. The authors draw on extensive clinical experience as well as research expertise. Showcasing the most effective psychosocial and pharmacological interventions for young patients, they also address challenges in translating research into real-world clinical practice. New to This Edition *Incorporates over a decade of research advances and evolving models of evidence-based care. *New chapter topic: child maltreatment. *Separate chapters on self-injurious behavior, eating disorders, and substance use disorders (previously covered in a single chapter on self-harming disorders). *Expanded chapters on depression, anxiety, and conduct disorder. *Includes reviews of the burgeoning range of manualized psychosocial "treatment packages" for children.

"Children of Substance-Abusing Parents: Dynamics and Treatment" is a necessary reference for all mental health professionals and students who need to understand and treat this population. It offers an invaluable look attreatment options and programmatic interventions across the life span and fills an important gap in the current literature. The contributors include a wide range of experts who provide up-to-date evidence-based clinical and programmatic strategies for working with children of alcohol and other substance-abusing parents of any age and in almost any practice setting. This highly recommended book is a valuable resource for all practitioners and students concerned about this very large, but often hidden group of individuals and families." From the Foreword by Sis Wenger President/CEO National Association for Children of Alcoholics Parental drug abuse and alcoholism have an enormously detrimental impact on children and adolescents. Children whose parents suffer from drug abuse or alcoholism often face multiple physical, mental, and behavioral issues. They are at a greater risk for depression, anxiety, low self esteem, and addiction, and also are known to have poor school attendance, difficulty concentrating, and lower IQ scores. This book offers health care practitioners proactive programs and innovative strategies to use with this vulnerable population. Taking a comprehensive, life course approach, the authors discuss the implications and interventions at the prenatal stage, through childhood, adolescence, young adulthood, and adulthood. With this book, social workers and health care practitioners can help assess and intervene with children of substance abusing parents. Key topics: Dynamics in families with substance abusing parents and treatment implications Issues across the life span of children of substance abusing parents Prevention and early intervention programs for pregnant women who abuse substances Programs for young children, adolescents, college students, and children with incarcerated parents

This book describes the theory and research evidence underlying Total Worker Health (R), an initiative of the National Institute for Occupational Safety and Health (NIOSH) that aims to create a culture of healthy workplaces nationwide.