Reinvigorating the social contract and strengthening social cohesion: Social protection responses to COVID-19

The COVID-19 pandemic has exposed the vulnerability of those who are inadequately covered by social protection in more and less developed countries alike, and has exacerbated the fragility of a social contract that was already under strain in many countries. A weak social contract in the context of an exceptional crisis poses a very real risk to social cohesion. Nevertheless, many States have reasserted themselves as the guarantor of rights by protecting public health and incomes. By sustaining these measures, economic recovery will be supported which will help minimize risks that may weaken social cohesion. However, this is a fast-moving, inherently unstable and protracted crisis. Social protection stands at a critical juncture. Decisive policy action will be required to strengthen social protection systems, including floors, as one of the cornerstones of a reinvigorated social contract.     

Building home on a fault line: Aging out of child welfare with a serious mental health diagnosis

Youth aging out of foster care are at high risk for homelessness. This research explains how and why homelessness occurs among youth with serious mental health struggles after aging out of residential and transitional living programmes. Using a longitudinal constructivist grounded theory design, we analyse 20 in‐depth interviews exploring youth's transition experiences and perceptions of transition success within 4 months of emancipation and at 6 and 12 months postemancipation. Monthly 15‐min check‐ins prevented attrition. A three‐phase transition process was observed driven by participant desires and actions to cultivate psychological home through establishing physical home alone away from social networks. Pre‐emancipation, the promise of home was privacy and opportunity for self‐redefinition. Shortly after emancipation, home became a physical and social space to be, a valuable resource to share and a demonstration of personal transition success. However, later in the year postemancipation, maintaining physical home proves nearly impossible given the risk context. Findings speak to how and why youth aging out appear overly self‐reliant upon emancipation. Cultivating a psychological sense of home has practice implications for child welfare providers who aim to prepare youth to live independently postemancipation.     

Parenthood and Well-Being: A Decade in Review

Understanding social aspects of parental well-being is vital because parents' welfare has implications not only for the parents themselves but also for child development, fertility, and the overall health of a society. This article provides a critical review of scholarship on parenthood and well-being in advanced economies published from 2010 to 2019. It focuses on the role of social, economic, cultural, and institutional contexts of parenting in influencing adult well-being. The authors identify major themes, achievements, and challenges and organize the review around the demands-rewards perspective and two other theoretical frameworks: the stress process model and the life course perspective. The analysis shows that rising economic insecurities and inequalities and a diffusion of intensive parenting ideology were major social contexts of parenting in the 2010s. Scholarship linking parenting contexts and parental well-being illuminated how stressors related to providing and caring for children could unjustly burden some parents, especially mothers, those with fewer socioeconomic resources, and those with marginalized statuses. In that vein, researchers continued to emphasize how stressors diverged by parents' socioeconomic status, gender, and partnership status, with new attention to strains experienced by racial/ethnic minority, immigrant, and sexual minority parents. Scholars' comparisons of parents' positions in various countries expanded, enhancing knowledge regarding specific policy supports that allow parents to thrive. Articulating future research within a stress process model framework, the authors show vibrant theoretical pathways, including conceptualizing potential parental social supports at multiple levels, attending to the intersection of multiple social locations of parents, and renewing attention to local contextual factors and parenting life stages.     

Potentials of care: The uncertain politics of social and emotional ability and difference in American childhood

This article examines middle class children's and parents' complex engagements with contemporary practices of cultivation, care and surveillance focused on children's social and emotional capacities and differences. Emblematic of a sociality and emotion-focused biopolitics of childhood, such care provokes moments of spontaneous connection and self-expression for children even as they engage dynamics of disciplining control and normalisation, an outcome that may work against and towards the objectives of care. Moreover, parental investments in social–emotional care reveal adults' conflicted implication in dynamics of child normalisation, and the potential of this form of caretaking to generate politically valuable empathic insight.     

Analyzing free-text survey responses: An accessible strategy for developing patient-centered programs and program evaluation

Despite widespread availability of yoga in the Veterans Health Administration (VA), it remains unclear how to best evaluate yoga programs. This is particularly problematic for programs aimed at veterans with mental health concerns, as evaluation typically focuses narrowly upon mental health symptom severity, even though program participants may have other health-related priorities. We analyzed responses to free-text questions on 237 surveys completed by veterans with mental health concerns enrolled in a yoga program at six VA clinics in Louisiana to characterize veteran participants’ experiences with yoga. Qualitative analysis resulted in 15 domains reflecting veterans’ individual health-related values and priorities. We use results to illustrate the potential for analysis of free-text responses to reveal valuable insights into patient experiences, demonstrating how these data can inform patient-centered program evaluation. The approach we present is more accessible to those responsible for decision-making about local programs than conventional methods of analyzing qualitive evaluation data.     

Responding to Adolescent Violence in the Home – A Community Mental Health Approach

Family violence perpetrated by adults is increasingly understood as a health issue, and we argue that this pertains even more strongly to violence by adolescents. The co-dependence of the parent–child bond, lack of maturity in the adolescent, and often related issues of disability or mental illness make these young people both complex and also vulnerable. This research paper reviews the current literature relating to adolescent violence in the home, identifies known best practice, and evaluates the importance of taking a family-focused, therapeutic approach to adolescent family violence, in place of a punitive one. It describes the use of a co-design workshop to unpack gaps in service provision and develop a potential family focused model of care to address the needs both of young people who use violence, and their families. The findings indicate that an inclusive family approach is a key element in addressing adolescent violence in the home across a spectrum of behaviours and mental health care needs. The use of a coordinated, family-inclusive response through mental health care services is recommended to address the complexity of this issue, as well as to provide support both to adolescents and to their families and carers.     

Navigating infant feeding supports after migration: Perspectives of Arabic and Chinese mothers and health professionals in Australia

Optimal feeding practices can establish lifelong, transgenerational and global health benefits. Migration and cultural factors impact infant feeding practices and the support mothers receive for optimal infant feeding. This qualitative study explored support for infant feeding among Arabic and Chinese speaking migrant mothers in Australia.Semi-structured focus groups were conducted in language with 24 Arabic and 22 Chinese-Mandarin speaking migrant mothers with children under five years of age. Individual interviews were conducted in English with 20 health professionals working with Arabic or Chinese speaking migrant families. Data were thematically analysed using the framework method.Traditional family networks and trusted bi-cultural doctors were influential infant feeding supports for mothers. Health professionals perceived maternal and child health services to be poorly understood, and some mothers who accessed services felt they were not always culturally sensitive. Mothers sought additional information and support through online sources and peers. Both mothers and health professionals recognised the challenges of managing conflicting infant feeding advice and seeking best-practice support.The findings of this study highlight opportunities for health professionals to better support migrant mothers’ infant feeding practices, for example through engaging families and working with doctors. There is a need for greater cultural sensitivity within maternal and child health services and culturally relevant programs to support healthy infant feeding practices among migrant communities.     

The importance of systems thinking,context, and inclusion when studying the feasibility of expanding the FoodShare (SNAP) outreach program to rural communities of Northern Wisconsin

Evaluators often neglect to question whether a program has been appropriately designed for a new context prior to a feasibility study’s commencement. In this paper, we document the results of a case study that closely examined context when determining the feasibility of implementing a FoodShare outreach program in rural northern Wisconsin. Using community-based participatory mixed methods, we examine how stakeholder engagement led to both study refinement and a more comprehensive understanding of community food security based on contextual factors and systems thinking. Lessons learned when conducting feasibility studies from this perspective are provided to improve evaluation practice.     

Health insurance literacy: A mixed methods study of college students

Objective: This study examines the health insurance literacy, or the ability to use health insurance effectively, of college students. Participants: A total of 455 students from a large, public university completed an online questionnaire in November 2016. Methods: A questionnaire examined students’ knowledge of commonly encountered health insurance terms and ability to apply that knowledge to determine cost-sharing in a clinical setting. Results: The majority of students were able to correctly identify the most commonly encountered terms, but could not identify terms related to plan types and options. Eighty-eight percent of students could not determine their cost-sharing for two presented scenarios. Approximately half of the students indicated they had been confused about their health insurance plan, with one-quarter of students stopping or delaying medical care due to confusion. Conclusions: Outreach and education for students should target specific deficits in knowledge such as those identified in this study.