Health orientation, beliefs, and use of health services among minority, high-risk expectant mothers.

This article reports on initial findings of a continuing longitudinal study investigating the relationships of health beliefs as conceptualized by the health belief model and the use of well-baby services among first-time black mothers. The health beliefs of mothers about their babies were measured before the babies were born and during their use of the services at the baby’s first and sixth-month visits. Mothers in the sample who became nonusers of the well-baby services were also interviewed. This report describes the results of the first interview of the 662 females who composed the sample for the study, including the following characteristics of a minority, high-risk population: health orientation, health beliefs about their unborn babies, and use of health services. These findings are discussed with implications for community health nursing practice with maternal clients. Cecilia Dawkins is an Assisrant Professor and Assistant Research Scientist in Community Health Nursing, Lisa Weissfeld is an Assisrant Professor in Biostaristics ar the School of Public Health, and Alice Yan is a Research Associate in the School of Nursing. at the University of Michigan, Ann Arbor, Michigan. Naomi Ervin is an Assistant Professor in Public Health Nursing at the University of 111;nois, Chicago, Illinois. Address correspondence to Cecilia Dawkins, The University of Michigan, 400 N . Ingalls Bldg., Ann Arbor, MI 48109. This work was supported by grant 5-ROl-NR01286-03 from the National Center for Nursing Research, National Institutes of Health. The authors are grateful for the cooperation of the Chicago Department of Health. The article is based on a paper presented b y Dawkins and Ervin at the annual meeting of the American Public Health Association, Las Vegas, Nevada, October 1986. Received Feb. I , 1987, and in revised form May 20. Accepted for publication June 4. This article reports on initial findings of a continuing longitudinal study investigating the relationships of health beliefs as conceptualized by the health belief model (HBM) and the use of well-baby services among firsttime black mothers. Focus was on (1) the demographic characteristics of this high-risk population; (2) their health orientation; (3) health beliefs about the unborn baby; and (4) their use of health services. Many studies document the importance of early prenatal care and its continuation throughout pregnancy for the health of the mother and the baby (Ingram, Makuc, & Kleinman, 1986; Morales, Vaughn, & Diebel, 1985; Oxford, Schinfeld, Elkins, & Ryan, 1985; Boone, 1982). Indeed, one priority of the Public Health Service’s National Objectives for Health Promotion and Disease Prevention is that “by 1990, the proportion of women in any county or racial or ethnic group who obtain no prenatal care during the first trimester should not exceed 10 percent” (U.S. Public Health Service, 1980). The Robert Wood Johnson Foundation’s national study (1985, p. 9) showed that “79 percent of white mothers and 62 percent of black mothers began prenatal care in the first three months of pregnancy during 1983. Younger women and those with less than .a college education are less likely to receive early care. 19821983 marked the first period since 1969 (when such data began to be available) that the percent of black women beginning prenatal care in the first trimester declined. As of 1983, among pregnant black women, one in ten received delayed (third trimester) prenatal care or none at all.” These and other reports invariably identify black women, especially the unmarried, young, and poor, as