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881.

Problem

Pacific Islanders are disproportionately burdened by poorer maternal health outcomes with higher rates of pre-term births, low birth weight babies, infant mortality, and inadequate or no prenatal care.

Purpose

The purpose of this study was twofold: (1) to explore maternal health care providers’ perceptions and experiences of barriers in providing care to Marshallese women, and (2) providers perceived barriers of access to care among Marshallese women. This is the first paper to explore perceived barriers to maternal health care among a Marshallese community from maternal health care providers’ perspectives in the United States.

Methods

A phenomenological, qualitative design, using a focus group and in-depth interviews with 20 maternal health care providers residing in northwest Arkansas was chosen.

Findings

Several perceived barriers were noted, including transportation, lack of health insurance, communication and language, and socio-cultural barriers that described an incongruence between traditional and Western medical models of care. There was an overall discord between the collectivist cultural identity of Marshallese families and the individualistic maternal health care system that merits further research.

Discussion

Solutions to these barriers, such as increased cultural competency training for maternal health care providers and the incorporation of community health workers are discussed.  相似文献   
882.
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.  相似文献   
883.
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.  相似文献   
884.
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.  相似文献   
885.
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.  相似文献   
886.
Understanding the distribution of socioeconomic status (SES) and its temporal dynamics within a population is critical to ensure that policies and interventions adequately and equitably contribute to the well-being and life chances of all individuals. This study assesses the dynamics of SES in a typical rural South African setting over the period 2001–2013 using data on household assets from the Agincourt Health and Demographic Surveillance System. Three SES indices, an absolute index, principal component analysis index and multiple correspondence analysis index, are constructed from the household asset indicators. Relative distribution methods are then applied to the indices to assess changes over time in the distribution of SES with special focus on location and shape shifts. Results show that the proportion of households that own assets associated with greater modern wealth has substantially increased over time. In addition, relative distributions in all three indices show that the median SES index value has shifted up and the distribution has become less polarized and is converging towards the middle. However, the convergence is larger from the upper tail than from the lower tail, which suggests that the improvement in SES has been slower for poorer households. The results also show persistent ethnic differences in SES with households of former Mozambican refugees being at a disadvantage. From a methodological perspective, the study findings demonstrate the comparability of the easy-to-compute absolute index to other SES indices constructed using more advanced statistical techniques in assessing household SES.  相似文献   
887.
Early in the 30-year HIV/AIDS pandemic in Sub-Saharan Africa, epidemiological studies identified formal education attainment as a risk factor: educated Sub-Saharan Africans had a higher risk of contracting HIV/AIDS than their less educated peers. Later demographic research reported that by the mid-1990s the education effect had reversed, and education began to function as a social vaccine. Recent counter-evidence finds a curvilinear pattern, with the association between educational attainment and HIV/AIDS infection changing from positive to negative across the education gradient. To reconcile these inconsistent conclusions, a hypothesis is developed and tested that education at early stages functioned as a risk factor and later functioned (and continues to function) as a social vaccine. We reason that this shift in the direction of the education effect was concurrent with changes in the public health environment in SSA that early on heightened material benefits from educational attainment but later heightened cognitive benefits from schooling. Using the 2003/2004 Demographic Health Surveys from four Sub-Saharan African countries (Cameroon, Ghana, Kenya and Tanzania), we tested this hypothesis (differential effects of schooling) using non-linear regression analysis (probit), identifying the different public health periods and controlling for confounding factors. The results support the hypothesis that the education effect shifted historically in the HIV/AIDS pandemic in SSA as we hypothesized.  相似文献   
888.
This paper explores the intensities of long-distance commuting journeys in order to understand how bodily sensibilities become attuned to the regular mobilities which they undertake. More people are travelling farther to and from work than ever before, owing to a variety of factors which relate to complex social and geographical dynamics of transport, housing, lifestyle, and employment. Yet, the experiential dimensions of long-distance commuting have not received the attention that they deserve within research on mobilities. Drawing from fieldwork conducted in Australia, Canada, and Denmark this paper aims to further develop our collective understanding of the experiential particulars of long-distance workers or ‘supercommuters’. Rather than focusing on the extensive dimensions of mobilities that are implicated in broad social patterns and trends, our paper turns to the intensive dimensions of this experience for supercommuters by developing an understanding of embodied kinetic energy, commotion and quality. Exploring how experiences of supercommuters are constituted by a range of different material and bodily forces enables us to more sensitively consider the practical, technical, and affective implications of this increasingly prevalent yet underexplored travel practice.  相似文献   
889.
890.
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