Central Pennsylvania Women's Health Study (CePAWHS)

CePAWHS is an ongoing program of research designed to improve the health of women of reproductive age and to reduce pregnancy complications and adverse pregnancy outcomes.  Adverse pregnancy outcomes are important public health problems that are difficult to address through traditional programs focused on health care for pregnant women.  CePAWHS therefore focuses on the health of women before and between pregnancies.  The research program is guided by a Steering Committee comprised of community representatives from the 28 counties in the Central Pennsylvania region.

The first phase of CePAWHS (conducted in 2004 - 2005) was a representative population-based telephone survey of 2,002 women ages 18-45 in a 28-county region in Central Pennsylvania, and a companion household interview survey of 288 Amish women ages 18-45 in Lancaster County. The purpose of these surveys was to document prevalent risk factors for adverse pregnancy outcomes in the region.  The surveys focused on health status indicators, health-related behaviors, stress and exposures, pregnancy history, and patterns of health care use.  Two years later, participants in the baseline surveys were re-interviewed to document changes in health and to obtain information about incident pregnancies and births.  Pennsylvania birth records were appended for incident live births.  The resulting data set is a unique resource for studying the impact of pre-pregnancy maternal attributes on pregnancy experiences and outcomes for the mother and baby.

The second phase of CePAWHS (conducted in 2005 – 2008) included the development and testing of Strong Healthy Women, an innovative small-group behavior change intervention for pre- and interconceptional women ages 18-35.   This intervention focused on modifying health risks that were identified as prevalent in the target population in the earlier CePAWHS surveys.  Strong Healthy Women was designed by a multidisciplinary team of investigators at Penn State, with the guidance of the Steering Committee for some content areas and for recruitment strategies. Conducted in 6 sessions over 12 weeks, the intervention focused on nutrition, physical activity, alcohol and tobacco, stress management, and preparing for pregnancy.  Group facilitators were trained by the investigators. The effectiveness of the intervention was tested in a randomized controlled trial of 692 women recruited in 15 low-income rural communities in Central Pennsylvania.  Strong Healthy Women significantly improved attitudes and behaviors related to nutrition, folic acid supplementation, physical activity, and stress management.

The third phase of CePAWHS (conducted 2009 – present) included modifying the Strong Healthy Women intervention based on the trial results and on a focus group project with low-income urban women to identify content relevant for urban women.  Several trials of the modified Strong Healthy Women intervention are planned, and spin-off projects are addressing reducing barriers to rural women’s preventive health care and other topics.  Recently, the Community Engagement and Research Core of the Penn State CTSI funded a project focusing on the feasibility of integrating smartphone technology for delivering the Strong Healthy Women intervention to overweight and obese women in underserved rural and urban Central Pennsylvania communities.  The project's Principal Investigator is Danielle Symons Downs.

CePAWHS research has been funded by the Pennsylvania Department of Health, the Penn State CTSI, the Penn State Social Sciences Research Institute, and Highmark, Inc.  Investigators working on CePAWHS projects also have been funded by the National Institutes of Health, including through the Penn State BIRCWH (Building Interdisciplinary Research Careers in Women’s Health) Program.  CePAWHS co-Principal Investigators are Carol S. Weisman, PhD (Department of Public Health Sciences) and Marianne Hillemeier, PhD (Department of Health Policy and Administration).  Co-investigators include Danielle Symons Downs, PhD (Department of Kinesiology), Mark Feinberg, PhD (Prevention Research Center), and Cynthia Chuang, MD, MSc (Department of Medicine).