Constructing prevention programmes with a Māori health service provider view

Mainstream approaches to chronic condition management and prevention inadequately address the needs of Māori, the Indigenous people of New Zealand. Māori health service providers (MHSPs) are uniquely placed to address the critical gap in the prevention of chronic conditions. In this paper, we report qualitative research findings investigating how prevention was being modelled, practiced and measured in selected MHSP settings. Results indicate barriers to achieving wellbeing through health service delivery. The dominant individualistic, medical conditions-focused discourse, along with responding to acute need, is a driver of service delivery norms.There are examples of shifts in organisational structure and delivery configurations that demonstrate that these norms are being challenged and reframed, in some form, by MHSPs. Consolidation of these approaches requires significant work and increased resources as well as a broader systems-level response that prioritises prevention.     

Parents at‐risk and their children: intersections of gender role attitudes and parenting practices

Existing research demonstrates that parent and child gender may influence important aspects of family relationships; however, most research in this area has been conducted with non‐clinical samples. As clinicians, it is important to consider how gender impacts family relationships, particularly among vulnerable families. This study examined the intersections of gender role attitudes and parenting practices among 34 parents involved with the child welfare system and referred for clinical intervention. Using a mixed methods design, themes regarding gender role beliefs and parenting practices were found through qualitative interviews with parents. Findings suggested that fathers felt responsible for financially providing for their families and expressed challenges in communicating with mothers, and mothers described challenges they face because of a lack of father involvement. Parents also discussed a perceived need to monitor daughters closely while fostering the independence of their sons. Results of the qualitative analyses were supported by quantitative findings indicating significant differences in harsh and inconsistent discipline practices and clear expectations for girls compared to boys. The discussion addresses implications for clinicians, including how a feminist family therapy perspective may help promote client influence over traditional gender norms by questioning gender role attitudes and exploring alternate narratives that may impact family dynamics.     

Perceptions of grandparents who provide auxiliary care: value transmission and child‐rearing practices

A grounded theory qualitative study was developed to explore how grandparents perceive their role as socializing agents. Forty‐two grandparents with grandchildren aged from 6 to 12 years old participated in this study. Data were collected through focus groups, which were conducted until reaching data saturation and analyzed using the constant comparative method. Four general conclusions emerged from the study: (i) grandparents recognized the importance of getting involved in the socialization of grandchildren as supporters of parents' socializing role, and the need to adapt to social changes; (ii) they emphasized traditional value that were perceived in decline, and combination of warmth and involvement were considered the best way to help grandchildren internalize values; (iii) interaction with grandchildren helped grandparents to feel active and useful, increased their life purpose and gave them a second chance to enjoy what they could not with their own children; and (iv) grandparents also accused burden and role ambiguity. These results show the importance of developing family policies that recognize grandparents' socializing role. Also, interventions that promote strategies that enable grandparents to perform their role more successfully and to cope with possible family conflicts should be developed.     

Driving outcomes: learning to drive,resilience and young people living in residential care

There are continuing concerns about the experiences offered to older adolescents being looked after (‘in care’) in the UK and, especially, to care leavers. Questions are asked about the limitations of State care compared with normal family life. This paper reports on an initiative to provide driving lessons to a group of six young men living in residential homes in one city. It links with resilience theory – how individuals can have relatively good outcomes despite early adversity. A qualitative study was undertaken to explore the effects of the initiative, including individual interviews with young men, heads of homes in which they lived and children's services managers. The overall results indicated that the initiative was very worthwhile. The lessons were a significant part of young people's lives. Possible effects on young people were divided into personal, instrumental and social. Benefits were reported from all parties concerning young people's self‐esteem and self‐confidence, as well as in forging close relationships with supportive adults. Driving would not be seen as a panacea for complex personal histories and structural problems, yet this small experiment suggests that driving lessons could be of disproportionate benefit and there is a moral obligation to provide them in any case.     

Trajectories of Unintended Fertility

Having an unintended birth is strongly associated with the likelihood of having later unintended births. We use detailed longitudinal data from the Add Health Study (N = 8300) to investigate whether a host of measured sociodemographic, personality, and psychosocial characteristics select women into this “trajectory” of unintended childbearing. While some measured characteristics and aspects of the unfolding life course are related to unintended childbearing, explicitly modeling these effects does not greatly attenuate the association of an unintended birth with a subsequent one. Next, we statistically control for unmeasured time-invariant covariates that affect all birth intervals, and again find that the association of an unintended birth with subsequent ones remains strong. This persistent, strong association may be the direct result of experiencing an earlier unintended birth. We propose several mechanisms that might explain this strong association.     

Footprints in the Sand: Personal,Psychological, and Relational Profiles of Religious,Spiritual, and Atheist LGB Individuals

The present study offers a comparison of the demographic features and lived experiences of lesbian, gay, and bisexual (LGB) individuals with religious, spiritual, or atheist (R/S/A) belief systems. In this sample of 212 participants, the relationship of participants’ R/S/A beliefs to personal variables (e.g., age, gender, race), mental health variables (e.g., life satisfaction, psychological distress, internalized heterosexism, self-esteem), and relational variables (e.g., outness, connection to LGBTQ communities) were assessed. Correlational analyses indicated that level of R/S/A belief was unrelated to self-esteem, life satisfaction, or psychological distress; however, greater religious belief was correlated positively and significantly with internalized heterosexism and outness as LGB. To test the interactions of R/S/A beliefs and categorical variables of interest (e.g., race), log-linear analyses with follow-up chi-square tests were conducted. Findings suggested more similarities than differences for LGB people across R/S/A systems of belief. Limitations and implications for future research are discussed.     

Assessing the Tongzhi Label: Self-Identification and Public Opinion

Tongzhi is one of several Chinese terms that refer to individuals who are attracted to the same sex. Using data from two different surveys in Hong Kong, this research note examines how the term tongzhi coexists with other terms. We investigate the prevalence of self-identification as tongzhi, and we explore the extent to which using the term tongzhi influences public attitudes toward gay people and gay rights. Activists began popularizing the term tongzhi in the late 1980s, but less than one third of the participants in our 2008 survey of sexual orientation minorities (n = 728) described themselves as tongzhi. Using a split-ballot experiment in a 2013 public opinion poll (n = 831), we found that attitudes toward gay people and gay rights were not significantly impacted by whether questions were phrased in terms of tongzhi or the main alternative term tongxinglianzhe. We discuss how our findings can enrich understandings of earlier research and illuminate avenues for future study.     

Best Practice Principles for Community Indicator Systems and a Case Study Analysis: How Community Indicators Victoria is Creating Impact and Bridging Policy,Practice and Research

Numerous community indicator projects have been developed over the past 30 years and are now present in many countries including the United States, Canada, United Kingdom, Europe, Australia, New Zealand and South America. However, creating influence and action using community indicators requires long-term effort strengthened by partnership, policy applications, training and research. This paper provides a reflective case study analysis that reviews the development of the community indicator system of Community Indicators Victoria in Australia. The analysis includes a review of best practice indicator principles guiding the development of current and future community indicator systems and describes how these factors influenced the development, establishment, and expansion of the Community Indicators Victoria system.     

Suicide ideation,anxiety, and depression: Are children a protective factor for male Veterans?

ABSTRACT

Numerous mental health disorders plague our veterans when they return from deployment including anxiety and depressive disorders, which have been linked to elevated suicide risk when left untreated. Family factors, such as parenthood status, may serve as a protective factor against these mental health issues. This study examined the role of parenthood status of male veterans (N = 234) based on age of the child in order to determine whether a child’s age (minor children v. adult children) affects the likelihood of meeting diagnosis criteria for anxiety, depression, and suicide ideation after controlling for marital status. Three hierarchical binary logistic regression models were constructed to assess the predictive influence of children 18 years old and younger, children older than 18, and no children with the results indicating that parenthood status did meaningfully enhance the prediction of suicide ideation. Complete findings, clinical implications, and future considerations are discussed.