{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T05:42:19Z","timestamp":1789623739318,"version":"build-2803163510"},"reference-count":69,"publisher":"American Public Health Association","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Am J Public Health"],"published-print":{"date-parts":[[2009,6]]},"abstract":"<jats:p> Objectives. We evaluated the efficacy of a primary care intervention targeting pregnant African American women and focusing on psychosocial and behavioral risk factors for poor reproductive outcomes (cigarette smoking, secondhand smoke exposure, depression, and intimate partner violence). <\/jats:p><jats:p> Methods. Pregnant African American women (N = 1044) were randomized to an intervention or usual care group. Clinic-based, individually tailored counseling sessions were adapted from evidence-based interventions. Follow-up data were obtained for 850 women. Multiple imputation methodology was used to estimate missing data. Outcome measures were number of risks at baseline, first follow-up, and second follow-up and within-person changes in risk from baseline to the second follow-up. <\/jats:p><jats:p> Results. Number of risks did not differ between the intervention and usual care groups at baseline, the second trimester, or the third trimester. Women in the intervention group more frequently resolved some or all of their risks than did women in the usual care group (odds ratio = 1.61; 95% confidence interval = 1.08, 2.39; P = .021). <\/jats:p><jats:p> Conclusions. In comparison with usual care, a clinic-based behavioral intervention significantly reduced psychosocial and behavioral pregnancy risk factors among high-risk African American women receiving prenatal care. <\/jats:p>","DOI":"10.2105\/ajph.2007.131425","type":"journal-article","created":{"date-parts":[[2009,4,17]],"date-time":"2009-04-17T02:25:37Z","timestamp":1239935137000},"page":"1053-1061","source":"Crossref","is-referenced-by-count":73,"title":["Reducing Psychosocial and Behavioral Pregnancy Risk Factors: Results of a Randomized Clinical Trial Among High-Risk Pregnant African American Women"],"prefix":"10.2105","volume":"99","author":[{"given":"Jill G.","family":"Joseph","sequence":"first","affiliation":[{"name":"Jill G. Joseph is with the Children's Research Institute, Children's National Medical Center, Washington, DC. Ayman A E. El-Mohandes and Susan M. Blake are with the Department of Prevention and Community Health, George Washington University, Washington, DC. Michele Kiely is with the Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. M. Nabil El-Khorazaty and Marie G. Gantz are with the Statistics and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ayman A. E.","family":"El-Mohandes","sequence":"additional","affiliation":[{"name":"Jill G. Joseph is with the Children's Research Institute, Children's National Medical Center, Washington, DC. Ayman A E. El-Mohandes and Susan M. Blake are with the Department of Prevention and Community Health, George Washington University, Washington, DC. Michele Kiely is with the Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. M. Nabil El-Khorazaty and Marie G. Gantz are with the Statistics and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Kiely","sequence":"additional","affiliation":[{"name":"Jill G. Joseph is with the Children's Research Institute, Children's National Medical Center, Washington, DC. Ayman A E. El-Mohandes and Susan M. Blake are with the Department of Prevention and Community Health, George Washington University, Washington, DC. Michele Kiely is with the Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. M. Nabil El-Khorazaty and Marie G. Gantz are with the Statistics and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. Nabil","family":"El-Khorazaty","sequence":"additional","affiliation":[{"name":"Jill G. Joseph is with the Children's Research Institute, Children's National Medical Center, Washington, DC. Ayman A E. El-Mohandes and Susan M. 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Gantz are with the Statistics and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allan A.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Jill G. Joseph is with the Children's Research Institute, Children's National Medical Center, Washington, DC. Ayman A E. El-Mohandes and Susan M. Blake are with the Department of Prevention and Community Health, George Washington University, Washington, DC. Michele Kiely is with the Division of Epidemiology, Statistics and Prevention Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, Bethesda, MD. M. Nabil El-Khorazaty and Marie G. Gantz are with the Statistics and..."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathy S.","family":"Katz","sequence":"additional","affiliation":[{"name":"Jill G. Joseph is with the Children's Research Institute, Children's National Medical Center, Washington, DC. Ayman A E. El-Mohandes and Susan M. 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