Presenter: Nicole Asay
Authors: Ashley Gold, Nicole Asay, Marc-Aurel Martial, Amy Swanson, Cempaka Martial, Andrew Wilson
Faculty Advisor: Marc-Aurel Martial
Institution: Brigham Young University
Purpose: This longitudinal analysis will evaluate change over time in anemia status among disadvantaged pregnant or lactating women aged 15-49 following the implementation of an anemia prevention program in a rural community in Haiti. Background: In 2019, 48% of Haitian women of reproductive age (15-49 years) were considered anemic, compared to 30% worldwide. Anemia jeopardizes maternal and fetal well-being, designating it as a serious health concern. The Haiti Health Initiative (HHI) and its Haitian sister organization addressed anemia through free biannual clinics, iron-rich vitamin supplementation, and health education. Methods: This longitudinal retrospective secondary analysis utilizes patient data collected at outreach clinics between 2011 and 2019. Inclusion criteria comprise (1) any pregnant/lactating woman in the clinic database who (2) attended at least three clinics, and (3) had at least one recorded blood hemoglobin test. Time-varying anemia states were assigned based on hemoglobin levels and pregnancy status. Multilevel and multistate analyses were conducted in R. Results: Three hundred and twenty-three participantsmet study inclusion criteria. The overall mean hemoglobin of participants was 11.1 g/dL, 10.5 g/dL for pregnant women, and 11.5 g/dL for nonpregnant women. Multilevel and multistate analysis indicated modest improvement in hemoglobin levels (𝞫 = 0.05 g/dL/visit) (p =0.0048) and in women’s anemia category (transition from high-risk to low-risk) over time (transition probability = 0.68 over 5 visits). Women were more likely to stay in the low-risk category once they achieved that status (self-transition probability = 0.68 for 5 visits). Nursing Implications: Longitudinal patient data in resource-limited areas, such as Haiti, is essential to improving healthcare access and quality for vulnerable populations. Nurses need to develop innovative and culturally appropriate approaches to deliver interventions to hard-to-reach populations, including combining iron-rich vitamins with vitamin C to safely enhance iron absorption.