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Ohio State nurse seeks to prevent infant mortality in Franklin County

Ohio State’s dean of the College of Nursing has received a grant to study ways the healthcare community can help curb infant mortality, a problem which disproportionately impacts non-Hispanic black babies in Franklin County.

Infant deaths have been  53 percent non-Hispanic black babies in Franklin County. Only 30 percent of births in the area were to non-Hispanic black people, according to the city of Columbus’ public health website.

Bernadette Melnyk, chief wellness officer and dean of the College of Nursing at Ohio State, is looking to change this. Melnyk received a $3.3 million research grant from the National Institutes of Health to test her therapy methods to improve mental-health outcomes and healthy lifestyle behaviors.  

She has primarily focused on parents of critically ill children, preterm babies and a 15-session healthy lifestyle intervention for teenagers. With this grant, Melynk said she will be able to adapt her program for a different population.

A disparity between infant deaths of white babies and minority babies exists; in Franklin County, non-Hispanic black babies are 3.3 times more likely to die before the age of one than non-Hispanic white babies.

Melnyk said when she arrived in Columbus, the infant mortality rate was higher than that of New York City, data which she said inspired her work.

From January to August of this year, 105 babies died before the age of 1 in Franklin County, making the infant mortality rate 8.5 infant deaths per 1,000 live births. The national infant mortality rate is 5.8, but in Columbus the infant mortality rate for non-Hispanic black babies is 2.5 times the rate of white babies, according to the city of Columbus’ public health website.  

In particular, Columbus, which many consider to be an innovative and prosperous Midwestern city, has one of the highest infant mortality rates in the country. Melnyk’s grant is the latest in a series of efforts to address the issue.

“This new grant is allowing us to target a group of very high-risk pregnant minority women who are depressed or suffering from anxiety or high stress,” Melnyk said.

Melnyk said she has firsthand experience with being unable to access mental-health care during her own time of need.

“My whole world changed at 15. I was home alone with my mom when she seized, and she stroked out and died right in front of me,” Melynk said.

After the loss, Melnyk developed post-traumatic stress disorder and anxiety issues. She had no help in her small town. She was driven to her profession because she wanted to help others alleviate their own anxiety.

By adapting her cognitive behavior intervention for this group, Melnyk seeks to help high-risk pregnant women cope better by having them “engage in healthier behaviors, like physical activity, eating healthy during pregnancy,” in order to decrease preterm births and postpartum depression.

Melnyk said according to literature she has read, depression is now a predictor of preterm birth, and other mental-health factors might contribute, as well. Her program will take place in six group sessions throughout pregnancy with about 400 participants between New York City and Columbus.

Cognitive behavior therapy teaches participants that the way they think directly relates to how they feel and behave. It targets negative cyclical thinking — a cause of depression —by teaching people to “monitor how they think” and taking the negative belief that follows a stressor and making it positive. Participants are taught problem-solving skills and coping skills.

“If we can instill healthier lifestyle behaviors in these women, and at the same time decrease depressive symptoms and anxiety symptoms, we may well improve birth outcomes,” Melnyk said.

To gauge the success of this study, Melnyk will measure preterm births, complications and the well-being of the women. Additionally, she will observe symptoms of depression, and other health factors women experience during pregnancy.

Following delivery, the study will follow these women for six months to see if the program’s effects continue after delivery.

The grant money will be used for Melnyk  to hire personnel, and participants will be incentivized with gift cards for completing the different measures. Melnyk will act as the principal investigator with a goal to reach beyond her immediate community.

“If we find out that it produces really great outcomes, we’ve devised it so that it can be scaled across Ohio, across the United States,” Melnyk said.

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