Implementing a Multidimensional Poverty Measure Using Mixed Methods and a Participatory Framework

Recently, there have been advances in the development of multidimensional poverty measures. Work is needed however on how to implement such measures. This paper deals with the process of selecting dimensions and setting weights in multidimensional poverty measurement using qualitative and quantitative methods in a participatory framework. We estimate the multidimensional poverty measures developed by Alkire and Foster for a particular group: persons with psychiatric diagnoses in the United States. To select relevant dimensions and their relative ordering, two discussion groups are convened: one consisting of persons with lived-experience expertise and the other consisting of people with mental health service provision or research expertise. Several methods are used to convert dimension rankings into weights. The selection and ordering of dimensions differed between the two discussion groups, as did the resulting poverty measures. For instance, the poverty headcount using the dimensions and weights of the ‘lived experience’ group ranged from 20.61 to 26.96% as compared to a range of 18.62–33.19% using those of the ‘provider/researcher’ group. One of the main results of this study is that the Alkire Foster method is sensitive to the selection of dimensions and the methods used to derive rankings and weights. It points toward the limitation of relying exclusively on small scale qualitative methods for the selection and ranking of dimensions. In addition, the participatory framework used in this study was found to be essential in interpreting results, in particular with respect to the limitations of the data set in measuring relevant dimensions.     

Intimate Partner Violence,Minority Stress,and Sexual Risk-Taking Among U.S. Men Who Have Sex With Men

This article examines the prevalence of intimate partner violence (IPV) among a national sample of Internet-recruited U.S. men who have sex with men (MSM) (n = 1,575), and associations between reporting of IPV, minority stress, and sexual risk-taking. Five outcomes are examined: experiences of physical and sexual violence, perpetration of physical and sexual violence, and unprotected anal intercourse (UAI) at last sexual encounter. MSM who reported experiencing more homophobic discrimination and internalized homophobia were more likely to report experiences of IPV. The results point to the need for prevention messages to address the external and internal stressors that influence both violence and sexual risk among MSM.     

Why is the History of Heterosexuality Essential? Beliefs About the History of Sexuality and Their Relationship to Sexual Prejudice

Heterosexual people with more positive attitudes to lesbians and gay men generally believe that homosexuality is immutable, is not a discrete social category, and that homosexuality exists in all cultures and time periods. Equivalent beliefs about heterosexuality and beliefs about components of sexuality have been less often researched. 136 people with diverse sexualities described heterosexuality as more universal across history and culture than homosexuality (Study 1). 69 heterosexual-identified participants similarly believed that love, identity, behavior, and desire were more historically invariant aspects of heterosexuality than of homosexuality (Study 2). Less prejudiced participants thought all components of homosexuality—except for identity—were more historically invariant. Teasing apart beliefs about the history of components of heterosexuality and homosexuality suggests that there is no “essential” relationship between sexual prejudice and the tension between essentialist and constructivist views about the history of sexual identity.     

Curved versus straight scissors to avoid 3rd and 4th degree perineal tears: A randomised feasibility study

BackgroundSevere perineal tears sustained during childbirth cause significant distress and morbidity amongst women. The objective of this study was to compare the use of straight scissors for cutting an episiotomy with the use of curved scissors, which are designed to curve away from the anal sphincter.MethodsWe used a single-centre, randomised feasibility trial. The intervention was the use of curved scissors. Women were recruited during a prenatal visit and randomised in the delivery suite, when it became clear that an episiotomy was required. The feasibility outcomes were the proportion of women able to be recruited, randomised and followed up. We also calculated the incidence of obstetric anal sphincter injury when either straight or curved scissors were used to cut an episiotomy. Other outcomes assessed were pain, length of hospital stay, perineal infection and perineal dehiscence.ResultsOf the 155 patients recruited in the prenatal period, only 20 (12.9%) were eventually randomised at birth. The main reasons for the high loss were that women either did not have a vaginal delivery (38, 24.5%), or they did not need an episiotomy (72, 46.5%). Rates of obstetric anal sphincter injury and other outcomes were similar between groups.DiscussionAnal sphincter injury during childbirth remains an important problem. Although the use of curved scissors provides a theoretical solution, we found that the high attrition rate made feasibility of conducting a suitably powered, randomised trial using the current design untenable. Alternative strategies have been suggested to make any future study more viable.     

Conventional and expanded adverse childhood experiences (ACEs) and maternal functioning among low-income Black mothers

A paucity of research has examined the individual and cumulative effects of conventional and expanded adverse childhood experiences (ACEs) on maternal functioning, especially among low-income Black mothers. Using self-report data from a subsample of Black mothers (N = 157) who participated in a larger study to evaluate the effectiveness of an urban public prekindergarten program in the mid-Atlantic region of the United States, we examined the prevalence of ACEs and the individual and cumulative effects of conventional (i.e., family trauma and dysfunction) and expanded (i.e., community stressors) ACEs on depression and health among low-income Black mothers. Findings indicated that Black mothers had more exposure to expanded than conventional ACEs. Hierarchical regression analyses revealed that experience of physical neglect was significantly associated with depression and physical abuse with compromised health, and perceived experience of racism was a predictor of depression and compromised health. More conventional and expanded ACEs were associated with clinical levels of depression and compromised health. Findings highlight the need for more research related to the impact of ACEs, especially expanded ACEs, on mental and behavioural health outcomes. Additionally, our findings indicate the need for more trauma-informed care to reduce and address the impact of individual and community-level adversities on low-income Black mothers.     

Working and caring for a disabled adopted child during a pandemic

Integrating work and family demands can be challenging for families caring for a child with one or more disabilities. The pandemic and its changes to work, schooling and service delivery potentially added to these challenges. This exploratory mixed methods study sought to understand how the pandemic affected adoptive parents' work–life fit and service use. A total of 200 participants responded to survey questions about parenting an adopted child with a disability prior to, and after, the onset of Covid-19. More than half of the parents (59.2%) reported that it was somewhat to very difficult to integrate both work and family demands. Parents with greater access to workplace flexibility and supportive supervisors had significantly less difficulties combining work and family. Families who reported more problems with accessing mental health services, special education and respite care reported significantly more challenges with work–family fit. Parents reported increased stress due to the pandemic changes, but many also shared positive changes such as more time for family. Online services were experienced as effective for some children and reduced time spent driving to appointments. Recommendations for workplace and social service practice and policy supporting adoptive parents of children with disabilities are discussed.     

“We're in this together”: Attachment insecurities,dyadic coping strategies,and relationship satisfaction in couples involved in medically assisted reproduction

Attachment is an important predictor of relationship satisfaction and attachment insecurities are a risk factor for couples under stress. Drawing from the Vulnerability–Stress–Adaptation model, we investigated whether dyadic coping strategies (DCS) would explain the links between attachment insecurities and relationship satisfaction in 97 couples involved in medically assisted reproduction (MAR). Path analyses revealed that for women and men, attachment insecurities (anxiety, avoidance) were associated with their own lower relationship satisfaction through their lower use of positive DCS. Attachment avoidance was also associated with participants' own lower relationship satisfaction through their own lower use of negative DCS. Men's attachment avoidance was also related to their partner's lower relationship satisfaction via their own and their partner's lower use of positive DCS. The findings suggest that promoting the use of positive DCS may be important to preserve relationship satisfaction in couples involved in MAR.