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41.

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   
42.

Background

Prenatal health promotion provides information regarding pregnancy risks, protective behaviours and clinical and community resources. Typically, women obtain prenatal health information from health care providers, prenatal classes, peers/family, media and increasingly, Internet sites and mobile apps. Barriers to prenatal health promotion and related services include language, rural/remote location, citizenship and disability. Online public health platforms represent the capacity to reach underserved women and can be customised to address the needs of a heterogeneous population of pregnant women.

Aim

Canadian government-hosted websites and online prenatal e-classes were evaluated to determine if accessible, inclusive, comprehensive and evidence-based prenatal health promotion was provided.

Methods

Using a multijurisdictional approach, federal, provincial/territorial, municipal and public health region-hosted websites, along with affiliated prenatal e-classes, were evaluated based on four criteria: comprehensiveness, evidence-based information, accessibility and inclusivity.

Findings

Online prenatal e-classes, federal, provincial/territorial and public health-hosted websites generally provided comprehensive and evidence-based promotion of essential prenatal topics, in contrast to municipal-hosted websites which provided very limited prenatal health information. Gaps in online prenatal health promotion were identified as lack of French and multilingual content, targeted information and representations of Indigenous peoples, immigrants and women with disabilities.

Conclusion

Canadian online prenatal health promotion is broadly comprehensive and evidence-based, but fails to address the needs of non-Anglophones and represent the diverse population of Canadian pregnant women. It is recommended that agencies enhance the organisation of website pregnancy portals/pages and collaborate with other jurisdictions and community groups to ensure linguistically accessible, culturally-competent and inclusive prenatal online resources.  相似文献   
43.
Cross-sectional research on internationally adopted children has indicated an association between early attachment disturbances and language deficits. Raaska et al. (2013 Raaska, H., Elovainio, M., Sinkkonen, J., Stolt, S., Jalonen, I., Matomäki, J., … Lapinleimu, H. (2013). Adopted children's language difficulties and their relation to symptoms of reactive attachment disorder: FinAdo study. Journal of Applied Developmental Psychology, 34(3), 152160.[Crossref], [Web of Science ®] [Google Scholar]) have speculated that this relationship is likely bidirectional. In an attempt to elucidate the causal relationship between these two risk factors, the attachment disturbances and language skills of 44 internationally adopted children were assessed in a cross-lagged structural equation model. Greater attachment disturbances at wave 1 predicted less gain in language by wave 2. In contrast, language at wave 1 was not predictive of attachment disturbances at wave 2. These results suggest that early attachment problems may present an important risk for later language development and should be an immediate and primary focus of post-adoptive intervention for families adopting internationally.  相似文献   
44.
In this article, we define the concept of “risk work,” which aims to make visible working practices to assess or manage risk, in order to subject these practices to sociological critique. This article reviews and synthesizes existing published literature to identify components of risk work: (a) translating risk into different contexts, (b) minimizing risks in practice, and (c) caring in the context of risk. We argue that these three components of risk work raise important tensions for workers that have been inadequately explored in the literature to date. We propose that future research should additionally focus on practitioner subjectivity and identity in risk work. In addition, we argue that comparative research—across type of risk and different contexts—and methodological and theoretical diversity would enhance this emerging field of research.  相似文献   
45.
Drawing on the work of Emile Durkheim ([1912] 1995) and Rodney Stark (2001 Stark, Rodney. 2001. Gods, Rituals, and the Moral Order. Journal for the Scientific Study of Religion, 40(4): 619636. [Crossref], [Web of Science ®] [Google Scholar]) as well as research on the anti-ascetic thesis and reference group theory, we formulate a series of hypotheses regarding the effects of church attendance and importance of religion on adolescents' moral beliefs about marijuana use, getting drunk, hitting, and property offenses. The results of our study suggest that moral beliefs are more consistently and strongly related to importance of religion than to church attendance. Furthermore, much of the effect of church attendance on moral beliefs is mediated by importance of religion. Finally, we find evidence that importance of religion moderates (interaction) the effect of church attendance on moral beliefs. When adolescents believe religion is important, frequent church attendance further strengthens their moral beliefs. On the other hand, when adolescents believe religion is not important, frequent church attendance may actually reduce moral beliefs.  相似文献   
46.
The Revised Dyadic Adjustment Scale (RDAS; Busby, Crane, Larson, & Christensen, 1995) is a measure of couple relationship adjustment that is often used to differentiate between distressed and non‐distressed couples. While the measure currently allows for a determination of whether group mean scores change significantly across administrations, it lacks the ability to determine whether an individual's change in dyadic adjustment is clinically significant. This study addresses this limitation by establishing a cutoff of 47.31 and reliable change index of 11.58 for the RDAS by pooling data across multiple community and clinical samples. An individual whose score on the RDAS moves across the cutoff changes by 12 or more points can be classified as experiencing clinically significant change.  相似文献   
47.
Most cities, counties, and neighborhoods are not designed for an aging population. By providing a range of services to all residents, Lifelong Communities allow individuals to age in place. Although the Lifelong Communities Initiative is based on established guiding principles, little information exists regarding the realities of moving from policy to implementation. The Atlanta Regional Commission conducted a case study in Mableton, Georgia, and found successful implementation requires a combination of support from local citizen groups and government. The Atlanta Regional Commission is replicating these best practices in other communities and providing support to those aspiring to launch or expand Lifelong Communities.  相似文献   
48.
Children who use wheelchairs have few opportunities to play sport with their able-bodied peers and siblings. This appreciative, qualitative study explored the experiences of children, families and stakeholders at a wheelchair sports club. Participant observation, research activities, focus groups and interviews were used. Sixty-three people participated (37 children, 14 stakeholders, 10 parents, two older siblings). Thematic analysis identified one unifying theme (realising potential) and four main themes: invisibility of disability; ambivalence and attraction of the chair; fun and fellowship; and thrills and skills. The Cheetahs created opportunities for meaningful participation in wheelchair sports for children with and without disabilities.  相似文献   
49.
Data from one urban school district is analyzed to examine equity‐based arguments about school choice as they pertain to intradistrict transfer policies. We specifically examine which factors influence the propensity for parents to participate in choice, and how choice schools differ from the schools that students are zoned to attend. We find that advantaged and disadvantaged parents make similar choices in that they are both likely to choose more affluent schools with better academic records than the schools they are zoned to attend. However, these choices operate in different spheres, as advantaged parents choose the most affluent schools with the best academic records, and disadvantaged parents choose away from the least affluent schools with the worst academic records to schools that are slightly better.  相似文献   
50.
The purpose of this study that focused on African American high school girls was threefold. First, the relationship of sports participation and victimization was explored. Second, the impact of sports participation on self-esteem was assessed. Third, the role of self-esteem and its disaggregated components (social acceptance, competence, and self-confidence) as mediators of the relationship between sports participation and victimization was examined. In accordance with the sport protection hypothesis, it was hypothesized that sports participation would be related to enhanced self-esteem and reduce victimization. Results suggest that sports participation appears to have some relationship to lower rates of victimization. There was also support for our assertion that sports participation was related to enhanced self-esteem. Finally, overall self-esteem and, specifically, the individual component competence mediated the relationship between sports participation and victimization.  相似文献   
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