1. What to do when Eating for Two!
By: Andrea Howard & Morgan Henson
University of North Florida
A nutrition program to reduce preterm birth

2. Infant Mortality
Infant mortality is the death
of an infant before his or
her first birthday.
One of the top 3 leading
causes of infant mortality is
preterm birth/ low
birth weight.

3. Preterm Birth/ Low Birth Weight
Preterm birth is defined as
birth prior to 37 weeks.
Low birth weight is defined
as being born at less than
5.5 pounds.

4. Preterm Birth
Lack of weight
gain during
pregnancy
Smoking and
using drugs and
alcohol during
pregnancy
Being a teenage
mother (2 times
as likely to
deliver preterm)
Low income
Lack of
education
Factors that contribute to preterm birth:

5. Preterm Birth/ LBW
▪ Nationally, preterm birth was ranked the second highest cause of infant
mortality in 2011 with 104.1 deaths per 1,000 live births.
▪ “Low birth weight infants are 40 times more likely to die within the first 28 days
of life than normal birth weight infants.” (Roth et al., 1998).
▪ “Preterm birth costs the U.S. health care system more than $26 billion each
year.” (CDC, 2012).

6. Duval County Health Zone One
32208 32209 32254 32206 32202 32204
Duval County Health Zone 1
Infant
Mortality
Rate
13.1 deaths per 1,000 live births
Low Birth
Weight
Infants
13.07 percent of all live births
Teen birth
rates, 15-19
y.o.
81.33 per 1,000 births

7. Needs Assessment
Sampled from OBGYN offices in zip codes 32202 & 32204.
• Incentives to fill out survey and provide accurate information
include a $5.00 voucher for a fruit to a local grocery store, a
healthy cooking meal plan, and a nutrition pamphlet
• Ages 15-19, survey taken at OBGYN appointment
National Health and Nutrition Examination Survey (NHANES)
• Designed to determine the health and nutritional status of
adults and children in the United States (CDC, 2013).
Demographic background, housing characteristics,
income, food security, and consumption behaviors
Target
population
Method
Sample
Questions

8. Goals & Objectives
Process
Objective
• During program
implementation,
program
nutritionists will
receive a “very
helpful” feedback
from at least 75%
of participants.
Behavioral
Objective
• Two months after
the program,
60% of
participants will
report eating
recommended
nutrients daily.
Learner
Objective
• At the end of the
program, 60% of
participants will
be able to list all
food groups that
are required for
proper nutrition.
Outcome
Objective
• By 2020, the rate
of preterm births
within zone one
of Duval County
among teenage
females ages 15
to 19 will be
reduced by 10
percent.
The goal of the program is to reduce infant mortality in Duval County.

9. Target Population
Between the
ages of 15
and 19 years
old
Living in zip
codes
32208,32209,
32254, or
32206
Pregnant
Teenager

10. Selecting the Sample
Step1
Give flyers to
OBGYN
offices in zip
codes 32208,
32209,
32254, and
32206.
Step2
If patient
meets
inclusion
criteria,
OBGYN will
give the
patient the
informative
flyer.
Step3
If patient is
interested in
participating
in program,
they will
contact the
program
coordinator to
get involved.

11. Health Belief Model
Concept Activities
Perceived
Susceptibility
Tell the participants statistics about risks and the
about the amount of money that goes into preterm
births during an educational class.
Perceived Severity Discuss the effects that preterm birth has on babies
with the participants.
Perceived Benefits During class, discuss how proper nutrition will benefit
the baby before and after birth and how not having a
preterm birth will save money on hospital bills.
Perceived Barriers Barriers: participants do not know what to eat; money.
Participants will meet with a nutritionist to design a
weekly meal plan to fit their budget.
Cues to Action -Brochures
-Weekly meal plans
-Food Record
Self-Efficacy -Nutrition class
-Meetings with nutritionist

12. Evaluation
True Experimental Design: Randomized control group pre-test post-test
150 participants
randomly
assigned
75 participants in
control group-
will receive
brochure only
75 participants in
intervention group-
will keep a food
journal, receive
brochures, and
attend classes

13. Impact Evaluation
One week prior to start of intervention
• 75 participants in intervention group will keep a
food journal for a week and will record each item
that they consumed each day.
Two months after intervention
• Same participants will keep another food journal
for a week in order for program personnel to
compare the differences.

14. Outcome Evaluation
Duval County preterm birth
data on the DCHD website
at the beginning of program
Duval County preterm birth
data on the DCHD website
in 2020.
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