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Ayers BL, Short E, Cline C, Ammerman AS, Council SK, Kabua PM. Assessing the acceptability of a culturally adapted group-based pediatric intervention, Kokajjiriri, for Marshallese mothers and infants to improve nutrition and prevent childhood obesity. Child Care Health Dev 2024; 50:e13311. [PMID: 39056267 DOI: 10.1111/cch.13311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/02/2024] [Revised: 06/25/2024] [Accepted: 07/04/2024] [Indexed: 07/28/2024]
Abstract
BACKGROUND Marshallese Pacific Islanders experience higher rates of obesity than other racial and/or ethnic communities. Despite the obesity rates experienced in this community, there are currently no childhood obesity prevention interventions designed for Marshallese Pacific Islanders in the United States. The purpose of this study is to assess the acceptability and feasibility of a culturally adapted group-based pediatric intervention, Kokajjiriri, with Marshallese mothers to improve nutrition and reduce childhood obesity. METHODS A multi-methods design was used to culturally adapt the Kokajjiriri intervention for Marshallese mothers in Arkansas (n = 17). In phase one, we conducted 24-h dietary recalls with 20 Marshallese mothers to inform the cultural adaptation of the group-based pediatric intervention, and then in phase two, we culturally adapted and piloted three sessions of the intervention to determine the acceptability and feasibility of the intervention. RESULTS Participants found the adapted intervention to be acceptable and feasible, found the location to be convenient and found the facilitator to be knowledgeable. Four themes emerged from the qualitative data: (1) Lactation Support; (2) Introducing Healthy Solids; (3) Rice Portion Control; and (4) Finding Resources. CONCLUSIONS This is the first study to assess the acceptability and feasibility of a culturally adapted group-based pediatric intervention, Kokajjiriri, with Marshallese mothers to improve nutrition and reduce childhood obesity. The results from this culturally adapted group-based pediatric intervention, Kokajjiriri, will be used to inform future adaptations and implementation of the full intervention for Marshallese women and children.
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Affiliation(s)
- Britni L Ayers
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
| | - Eliza Short
- Gretchen Swanson Center for Nutrition, Omaha, Nebraska, USA
| | - Chloe Cline
- College of Medicine, University of Arkansas for Medical Sciences Northwest, Fayetteville, Arkansas, USA
| | - Alice S Ammerman
- Department of Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Sarah K Council
- Institute for Community Health Innovation, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
| | - Philmar Mendoza Kabua
- Institute for Community Health Innovation, University of Arkansas for Medical Sciences Northwest, Springdale, Arkansas, USA
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Viegas da Silva E, Hartwig FP, Yousafzai A, Bertoldi AD, Murray J. The effects of a large-scale home visiting programme for child development on use of health services in Brazil. Health Policy Plan 2024; 39:344-354. [PMID: 38491997 PMCID: PMC11005834 DOI: 10.1093/heapol/czae015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2023] [Revised: 12/22/2023] [Accepted: 02/23/2024] [Indexed: 03/18/2024] Open
Abstract
Partnership between early childhood development interventions and primary health care services can help catalyse health care uptake by socially vulnerable families. This study aimed to assess the real-life effects of a large-scale home visiting programme [Primeira Infância Melhor (PIM)] in Brazil on the use of preventive (prenatal visits, well child visits, dentist visits and vaccination) and recovery (emergency room visits and hospitalization) health services. A quasi-experiment nested in a population-based birth cohort study was conducted. The intervention group was firstly defined as all children enrolled in PIM up to age 6 months, and afterwards stratified between those enrolled during pregnancy or after birth up to 6 months. Children receiving PIM were matched with controls on propensity scores based on 27 confounders to estimate effects on health service use from prenatal to age 2 years. Double adjustment was applied in outcome Quasi-Poisson regressions. No evidence was found for effects of PIM starting anytime up to 6 months (262 pairs), or for the children enrolled only after birth (133 pairs), on outcomes occurring after age 6 months. When the programme started during pregnancy (129 pairs), there was a 13% higher prevalence of adequate prenatal visits (prevalence ratio = 1.13; 95% confidence interval 1.01-1.27), but no effect on use of any other health service. Sensitivity analyses suggested longer participation in the programme with reduced visitor turnover might improve its impact on prenatal visits. Integration between PIM and primary health care was not adequate to affect overall patterns of contacts with health services. Nevertheless, prenatal home visits showed potential to increase health service contact during a sensitive period of development, indicating the need to start such programmes before birth, when there is more time for maternal care, and family engagement in a network of services is facilitated.
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Affiliation(s)
- Eduardo Viegas da Silva
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro - 1160, Pelotas, RS 96020220, Brazil
- Human Development and Violence Research Centre (DOVE), Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro - 1160, Pelotas, RS 96020220, Brazil
- State Health Surveillance Centre, State Health Department, Rio Grande do Sul, Ipiranga - 5400, Porto Alegre, RS 90610000, Brazil
| | - Fernando Pires Hartwig
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro - 1160, Pelotas, RS 96020220, Brazil
| | - Aisha Yousafzai
- Department of Global Health and Population, Harvard School of Public Health, 677 - Huntington Avenue, Boston, MA 02115, United States
| | - Andréa Dâmaso Bertoldi
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro - 1160, Pelotas, RS 96020220, Brazil
| | - Joseph Murray
- Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro - 1160, Pelotas, RS 96020220, Brazil
- Human Development and Violence Research Centre (DOVE), Postgraduate Program in Epidemiology, Federal University of Pelotas, Marechal Deodoro - 1160, Pelotas, RS 96020220, Brazil
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Moon DJ, Nichols CB, Zhang Y, Cruce A, Haran H, Sgourakis A, Lee H, Johnson-Motoyama M. Engagement Measures in Maltreatment Prevention Studies: A Scoping Review. TRAUMA, VIOLENCE & ABUSE 2024; 25:1551-1567. [PMID: 37626470 DOI: 10.1177/15248380231188070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/27/2023]
Abstract
Prevention services can promote public health by building protective factors and reducing maltreatment risk. Yet, engaging caregivers in prevention services presents a unique set of challenges. Measurement studies are important first steps to increase the knowledge of caregiver engagement in prevention services. The purpose of this scoping review was to investigate how family engagement has been measured and operationalized in the studies of maltreatment prevention/positive parenting programs. The review examined quantitative and mixed methods studies conducted in the U.S., which measured multiple dimensions of client engagement, including behavioral, attitudinal, and relational domains. A total of 88 studies selected from PubMed, CINAHL, ERIC, PsycINFO, Social Work Abstracts, Academic Search Premier, and Web of Science were included in this review. Results indicated that studies examine engagement constructs in all three domains of engagement with a primary focus on behavioral engagement. The attitudinal and relational engagement was mostly assessed through general satisfaction surveys, and a limited number of studies utilized validated measures to assess those constructs. While most studies reported acceptable internal reliabilities, only two studies reported other dimensions of psychometric qualities. Only one validated measure was found, which assessed client perceptions of provider cultural competence. More measurement studies are needed to further incorporate multiple dimensions of engagement into the studies of maltreatment prevention programs, which can inform the effort to develop tailored implementation strategies to fully engage various groups of parents in maltreatment prevention programs.
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Chaiyachati BH, Deutsch SA. Improving health and well-being for infants with prenatal substance exposure. Curr Probl Pediatr Adolesc Health Care 2024; 54:101572. [PMID: 38431453 PMCID: PMC11025014 DOI: 10.1016/j.cppeds.2024.101572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2024]
Abstract
Substance use disorders (SUD) among caregiving adults has inexorable linkage to the health and well-being of millions of children in the U.S. This piece provides an overview of such linkages, examples of relevant policies and regulations, and the role of pediatric healthcare within the health trajectories of children and families at this intersection. A commonality throughout this work is need for non-stigmatizing engagement and support to facilitate connections to care and reduce barriers.
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Affiliation(s)
- Barbara H Chaiyachati
- Department of Pediatrics, Perelman School of Medicine, and Leonard Davis Institute, University of Pennsylvania, Philadelphia, PA, USA; Division of General Pediatrics, Clinical Futures & Policy Lab, Children's Hospital of Philadelphia, Philadelphia, PA, USA.
| | - Stephanie A Deutsch
- Department of Pediatrics, Nemours Children's Hospital, Delaware, Wilmington, DE, USA; Sidney Kimmel Medical College of Thomas Jefferson University, Philadelphia, PA, USA
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Gresh A, Batchelder A, Glass N, Mambulasa J, Kapito E, MacDonald A, Ngutwa N, Plesko C, Chirwa E, Patil CL. Adapting group care to the postpartum period using a human-centered design approach in Malawi. BMC Health Serv Res 2023; 23:1098. [PMID: 37838673 PMCID: PMC10576327 DOI: 10.1186/s12913-023-10036-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Accepted: 09/14/2023] [Indexed: 10/16/2023] Open
Abstract
BACKGROUND Responsive and resilient strategies to reduce high rates of maternal and infant mortality and clinician shortages are needed in low- and middle-income countries (LMICs). Malawi has some of the highest maternal and infant mortality rates globally. Group healthcare is a service delivery model that integrates these strategies. Although primarily implemented during the prenatal period, its potential for improving both maternal and infant health outcomes during the postpartum period has not been realized. The purpose of this study was to adapt and co-design the prototype for an evidence-based group care model for the postpartum period using a human-centered design approach with key stakeholders in Malawi. METHODS We completed steps of a framework guiding the use of human-centered design: 1) define the problem and assemble a team; 2) gather information through evidence and inspiration; 3) synthesize; and 4) intervention design: guiding principles and ideation. Qualitative methods were used to complete steps 2-4. In-depth interviews (n = 24), and incubator sessions (n = 6) that employed free listing, pile sorting and ranking were completed with key stakeholders. Data analysis consisted of content analysis of interviews and framework analysis for incubator sessions to produce the integrated group postpartum and well-child care model prototype. The fifth step is detailed in a separate paper. RESULTS All stakeholders reported a desire to participate in and offer group care in the postpartum period. Stakeholders worked collaboratively to co-create the prototype that included a curriculum of health promotion topics and interactive activities and the service delivery structure. Health promotion topic priorities were hygiene, breastfeeding, family planning, nutrition, and mental health. The recommended schedule included 6 sessions corresponding with the child vaccination schedule over the 12-month postpartum period. CONCLUSIONS Using a human-centered design approach to adapt an evidence-based group care model in an LMIC, specifically Malawi, is feasible and acceptable to key stakeholders and resulted in a prototype curriculum and practical strategies for clinic implementation.
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Affiliation(s)
- Ashley Gresh
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21231, USA.
| | - Anne Batchelder
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21231, USA
| | - Nancy Glass
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21231, USA
| | - Janet Mambulasa
- Kamuzu University of Health Sciences, Private Bag 360, Chichiri, Blantyre 3, Malawi
| | - Esnath Kapito
- Kamuzu University of Health Sciences, Private Bag 360, Chichiri, Blantyre 3, Malawi
| | - Amy MacDonald
- Pomelo Care, Hillsborough, North Carolina, USA
- Group Care Global, Philadelphia, PA, USA
| | - Nellie Ngutwa
- Kamuzu University of Health Sciences, Private Bag 360, Chichiri, Blantyre 3, Malawi
| | - Cori Plesko
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21231, USA
| | - Ellen Chirwa
- Kamuzu University of Health Sciences, Private Bag 360, Chichiri, Blantyre 3, Malawi
| | - Crystal L Patil
- School of Nursing, University of Michigan, 400 N. Ingalls, Suite 3320, Ann Arbor, MI, 48109, USA
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Mangrio E, Hjortsjö M. Health, social, and dental professionals' experiences of working within an extended home-visit program in the child healthcare: a qualitative interview study in Sweden. BMC Health Serv Res 2023; 23:820. [PMID: 37525170 PMCID: PMC10391855 DOI: 10.1186/s12913-023-09791-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 07/06/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND The goal of the Swedish child healthcare system is to reach all children with health-promotive actions and to create equal health opportunities for all children. In that context, an extended home-visit program - called Grow Safely - for first-time parents, with an interprofessional collaboration between child healthcare nurses, midwives, social workers, and dental assistants, was initiated. The current study aims at illuminating and evaluating the health, social, and dental professionals' experiences of working within this program and how such collaboration could benefit the professions. METHODS A qualitative method was chosen, and 13 interviews were carried out with professionals working within child healthcare centers that participated in an extended home-visit program in the southernmost part of Sweden. The interviews were analyzed via Burnard's approach to content analysis. RESULTS The results showed that it was satisfying for the health, social, and dental professionals to work with the home-visit program and that they encountered positive feelings among the parents receiving it. The creation of deep conversations and parents opening up about feelings that could otherwise be shameful to express, was a positive aspect of the home visits. A negative aspect was the difficulty of handling the (sometimes necessary) interpretation over the phone during the visits, and another one was the fact that the visits were time-consuming and required logistical planning. Overall, the professionals were positive about the home-visit program in that they felt that they were able to give the families what they needed and to have discussions on sensitive issues. They also appreciated the fact that different professions collaborated in order to reach the same goal. CONCLUSIONS This study showed that the health, social, and dental professionals enjoyed working with the home-visit program and that they encountered positive feelings among the parents regarding the collaborative visits being conducted within the home, where the families felt safe and relaxed. The professionals expressed that the home visits, despite the extended time they required and the logistical challenges involved, created a deeper collaboration between the professionals.
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Affiliation(s)
| | - Maria Hjortsjö
- Department of Social Work, Malmö University, Malmö, Sweden
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Gresh A, Wilson D, Fenick A, Patil CL, Coker T, Rising SS, Glass N, Platt R. A Conceptual Framework for Group Well-Child Care: A Tool to Guide Implementation, Evaluation, and Research. Matern Child Health J 2023; 27:991-1008. [PMID: 37014564 PMCID: PMC10071241 DOI: 10.1007/s10995-023-03641-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/17/2023] [Indexed: 04/05/2023]
Abstract
OBJECTIVE To use scoping review methods to construct a conceptual framework based on current evidence of group well-child care to guide future practice and research. METHODS We conducted a scoping review using Arksey and O'Malley's (2005) six stages. We used constructs from the Consolidated Framework for Implementation Research and the quadruple aim of health care improvement to guide the construction of the conceptual framework. RESULTS The resulting conceptual framework is a synthesis of the key concepts of group well-child care, beginning with a call for a system redesign of well-child care to improve outcomes while acknowledging the theoretical antecedents structuring the rationale that supports the model. Inputs of group well-child care include health systems contexts; administration/logistics; clinical setting; group care clinic team; community/patient population; and curriculum development and training. The core components of group well-child care included structure (e.g., group size, facilitators), content (e.g., health assessments, service linkages). and process (e.g., interactive learning and community building). We found clinical outcomes in all four dimensions of the quadruple aim of healthcare. CONCLUSION Our conceptual framework can guide model implementation and identifies several outcomes that can be used to harmonize model evaluation and research. Future research and practice can use the conceptual framework as a tool to standardize model implementation and evaluation and generate evidence to inform future healthcare policy and practice.
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Affiliation(s)
- Ashley Gresh
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21231, USA.
| | - Deborah Wilson
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21231, USA
| | - Ada Fenick
- Yale School of Medicine, 333 Cedar Street, New Haven, CT, 06520, USA
| | - Crystal L Patil
- College of Nursing, University of Illinois Chicago, 845 S Damen Ave, Chicago, IL, 60612, USA
| | - Tumaini Coker
- Seattle Children's Research Institute, University of Washington School of Medicine, Seattle, USA
| | | | - Nancy Glass
- Johns Hopkins University School of Nursing, 525 North Wolfe Street, Baltimore, MD, 21231, USA
| | - Rheanna Platt
- Johns Hopkins University School of Medicine, 733 N Broadway, Baltimore, MD, 21205, USA
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Short VL, Abatemarco DJ, Sood E, Hand DJ, Gannon M, Hossain J, Goyal NK. The Child Healthcare at MATER Pediatric Study (CHAMPS): a 2-arm cluster randomized control trial of group well child care for mothers in treatment for opioid use disorder and their children. Trials 2023; 24:333. [PMID: 37194074 PMCID: PMC10189945 DOI: 10.1186/s13063-023-07357-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2023] [Accepted: 05/05/2023] [Indexed: 05/18/2023] Open
Abstract
BACKGROUND Studies suggest that group-based well child care-a shared medical appointment where families come together as a group to receive pediatric primary care-increases patient-reported satisfaction and adherence to recommended care. Evidence supporting the use of group well child care for mothers with opioid use disorder, however, is lacking. The overall objective of the Child Healthcare at MATER Pediatric Study (CHAMPS) trial is to evaluate a group model of well child care for mothers with opioid use disorder and their children. METHODS CHAMPS is a single-site 2-arm cluster randomized controlled trial. A total of 108 mother-child dyads will be enrolled into the study. Twenty-six clusters of approximately 4 mother-infant dyads each will be randomized 1:1 to one of two study arms (intervention or control). Clustering will be based on child's month of birth. In the intervention arm, group well child care will be provided on-site at a maternal substance use disorder treatment program. Mother-child dyads in the control arm will receive individual well child care from one nearby pediatric primary care clinic. Dyads in both study arms will be followed prospectively for 18 months, and data will be compared between the two study arms. Primary outcomes include well child care quality and utilization, child health knowledge, and parenting quality. DISCUSSION The CHAMPS trial will provide evidence to determine if a group well child care offered on-site at an opioid treatment program for pregnant and parenting women is beneficial over individual well child care for families impacted by maternal opioid use disorder. TRIAL REGISTRATION ClinicalTrials.gov identifier: NCT05488379. Registered on Aug. 04, 2022.
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Affiliation(s)
- Vanessa L. Short
- Thomas Jefferson University, 1233 Locust Street Suite 401, Philadelphia, PA USA
| | - Diane J. Abatemarco
- Thomas Jefferson University, 1233 Locust Street Suite 401, Philadelphia, PA USA
| | - Erica Sood
- Nemours Children’s Health, 1600 Rockland Rd, Wilmington, DE USA
| | - Dennis J. Hand
- Thomas Jefferson University, 1233 Locust Street Suite 401, Philadelphia, PA USA
| | - Meghan Gannon
- Thomas Jefferson University, 1233 Locust Street Suite 401, Philadelphia, PA USA
| | - Jobayer Hossain
- Nemours Children’s Health, 1600 Rockland Rd, Wilmington, DE USA
| | - Neera K. Goyal
- Nemours Children’s Health, 1600 Rockland Rd, Wilmington, DE USA
- Department of Pediatrics, Thomas Jefferson University, 833 Chestnut Street, Philadelphia, PA USA
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Brown LC, Hampton KC, Bloom EM, Lawson D, Cooper SH, Meier ER. No child left behind: Building a comprehensive sickle cell disease care oasis in the Lake County, Indiana care desert. Pediatr Blood Cancer 2022; 69:e29619. [PMID: 35441446 DOI: 10.1002/pbc.29619] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/19/2022] [Accepted: 02/01/2022] [Indexed: 11/07/2022]
Abstract
BACKGROUND Sickle cell disease (SCD) leads to end-organ damage and shortened life expectancy. The second highest incidence of SCD in Indiana is in Lake County, but until 2017, there was no SCD expert within 65 miles. The Indiana Hemophilia and Thrombosis Center (IHTC) developed the Sickle Care coordination OutReach and Education (SCORE) program in 2017 to bring high-quality, guideline-based care to children with SCD. PROCEDURE The St. Vincent IRB deemed this retrospective analysis of SCORE clinic care from 2017 to 2020 exempt. Data on the number of transcranial Dopplers (TCD) performed, HU dosing escalation, and vaccine rates were collected along with the number of school and home visits completed. RESULTS Fifty-three children, adolescents, and young adults completed 288 SCORE clinic visits during the study period; over 75% completed at least three clinic visits. Mean HU dose increased significantly with SCORE clinic care. TCD screening rates increased every year starting in 2018 through 2020 when we added local care coordination. One hundred seventy-three vaccines were administered in SCORE outreach clinics. The PPSV23 vaccines had a 100% acceptance rate, and seasonal influenza had a 75.8% acceptance rate. CONCLUSION Access to care coordination services and local hematology specialty care alleviates barriers to care and enables comprehensive SCD care delivery to children in need. Prior to the establishment of the SCORE clinic, 75% of children in Lake County were not receiving recommended stroke screening. The SCORE clinic model demonstrates feasibility and impact when delivering on the promise of high-quality care for children with SCD.
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Affiliation(s)
- Leticia C Brown
- Department of Community Programs, Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana
| | - Kisha C Hampton
- Department of Community Programs, Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana
| | - Ellen M Bloom
- Department of Community Programs, Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana
| | - DeAuntae Lawson
- Department of Community Programs, Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana
| | - Sarah H Cooper
- Pediatric Hematology, Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana
| | - Emily Riehm Meier
- Pediatric Hematology, Indiana Hemophilia and Thrombosis Center, Indianapolis, Indiana
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Coles DC, Cage J. Mothers and Their Children: An Exploration of the Relationship Between Maternal Mental Health and Child Well-Being. Matern Child Health J 2022; 26:1015-1021. [PMID: 35303222 DOI: 10.1007/s10995-022-03400-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/20/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Psychosocial factors and life stressors have an impact on long-term health effects on mothers and their children. Recent studies examining maternal mental health have predominantly focused on identifying maternal experiences with depression; however, there has been minimal research investigating maternal experiences with psychosocial risk factors and its relationship with child well-being. METHODS Secondary analysis was conducted using data from the Fragile Families and Child Well-Being Study. The study sample includes 2396 adolescents and their biological mothers. Adolescents were between the ages of 14 and 19. We examined primary outcomes regarding mental health (depression and anxiety), life-satisfaction, and substance usage (alcohol and drugs). RESULTS The association between maternal psychosocial factors an adolescent depression was significant, F(26) = 5.29, p < .01. Mothers educational attainment and poverty level significantly predicted adolescent depression; with completion of some college (B = -0.411, p 0.025), a college degree (B = -0.540, p = 0.018), and living at the 300% poverty level (B = -0.725, p = 0.002) predicting lower levels of adolescent depression. CONCLUSION Our study demonstrates that there was a positive relationship between maternal mental health and adolescent mental health. Further, this study demonstrated that maternal mental health and social determinants of health are predictors of adolescent mental health and social functioning, thus indicating an inextricable connection to child well-being.
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Affiliation(s)
- D Crystal Coles
- School of Social Work, Morgan State University, 1700 E Cold Spring Lane, Baltimore, MD, 21251, USA.
| | - Jamie Cage
- School of Social Work, Virginia Commonwealth University, Richmond, VA, USA
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Lack of Maternal Social Capital Increases the Likelihood of Harsh Parenting. CHILDREN 2022; 9:children9010099. [PMID: 35053724 PMCID: PMC8774264 DOI: 10.3390/children9010099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Revised: 12/20/2021] [Accepted: 01/03/2022] [Indexed: 11/16/2022]
Abstract
Does low maternal social capital increase the likelihood of parents using harsh parenting behaviors? We analyzed random digit dial telephone survey data from 661 female primary caregivers across Colorado. Positive reports of the use of either physically or psychologically harsh parenting methods were classified as harsh parenting. Absence of social capital was assessed within the family and the community; lack of social capital within the family was measured in terms of an absence of support from a partner and an additional caregiver. Absence of social capital within the community was measured as lack of interpersonal resources from neighbors and religious activities. Nearly 30% admitted to one or more physically harsh parenting behaviors in the prior year, and 85.8% reported at least one psychologically harsh parenting behavior. Lower levels of neighborhood connectedness were associated with physically harsh parenting (odds ratio = 1.50). Conflict between partners (odd ratio = 2.50) and the absence of an additional caregiver (odds ratio = 1.88) increased psychologically harsh parenting. One practical implication is that mental health and medical providers should help new parents value, access, or develop social networks within the community to prevent children from experiencing harsh parenting.
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Gnyloskurenko GV, Erler T, Sybilski AJ, Saltykova HV, Mityuryaeva IO, Kostiuk OV, Avvakumova OAI. PREVENTIVE EXAMINATIONS OF CHILDREN IN DIFFERENT COUNTRIES: SIMILARITIES AND DIFFERENCES. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:1053-1058. [PMID: 35758477 DOI: 10.36740/wlek202205101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim: The aim of this study was to compare, analize and establish differences the recommendations for well-child visits and screenings till the age of 5 years in different countries . PATIENTS AND METHODS Materials and methods: The comparative analysis of the data from governmental recommendations for pediatricians from Germany, Ukraine and Poland is conducted. It was used the guideline for medical care for a child under 3 years (The Order №149) and for a healthy child from 4 to 18 years (The Order №434) in Ukraine, the book «Kinderuntersuchungsheft» in Germany and child's examination book «Książeczka zdrowia dziecka» in Poland. RESULTS Results: The number of visits to children by the doctors in Ukraine is 1.5-2 times higher than in other countries and the nurses visit are absent in Germany. The neonatal screening for genetic and metabolic diseases, updated in 2021 in Ukraine, corresponds to such screenings in other countries. Physical examination is performed in accordance with WHO standards in Ukraine, while in Poland and Germany the growth references are specially developed for the pediatric population. There was a difference in the age of hearing screening, examination of the hip joints, tactics for assessing vision by a pediatrician. The use of vitamin D, fluoride, iodine and vitamin K is recommended in Poland and Germany from the birth, while in Ukraine only vitamins are used. CONCLUSION Conclusions: It was found that the differences and similarities in preventive program in Ukraine, Poland and Germany. The results of this study may be useful for improving primary pediatric care.
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Affiliation(s)
| | - Tomas Erler
- HMU HEALTH AND MEDICAL UNIVERSITY, POTSDAM, GERMANY
| | - Adam J Sybilski
- CENTRAL CLINICAL HOSPITAL OF THE MINISTRY OF INTERNAL AFFAIRS AND ADMINISTRATION, WARSAW, POLAND
| | | | | | - Olena V Kostiuk
- CENTRAL CLINICAL HOSPITAL OF THE MINISTRY OF INTERNAL AFFAIRS AND ADMINISTRATION, WARSAW, POLAND
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Irigoyen MM, Leib SM, Paoletti AM, DeLago CW. Timeliness of Immunizations in CenteringParenting. Acad Pediatr 2021; 21:948-954. [PMID: 33279737 DOI: 10.1016/j.acap.2020.11.022] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 11/13/2020] [Accepted: 11/19/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To evaluate the timeliness of immunizations of children in CenteringParenting (Centering), a group well-child model, compared to children in individual well-child care. METHODS We conducted a retrospective cohort study of infants born October 1, 2014 to February 18, 2019 with a 2-month and subsequent well-child visit, both Centering or individual, at an academic pediatric practice in an urban, low-income community. In Centering, same age infants/mothers and a provider meet for 10, 2-hour group visits, and facilitated discussions. Providers are trained in group facilitation and participate in both Centering and individual visits. Primary outcome was timeliness of immunizations at 7, 13, 19, and 25 months. Analyses were by intention to treat. RESULTS The study population included 1735 children (Centering n = 342, individual n = 1393). By 25 months, 62% of children in Centering were up to date with all recommended immunizations compared to 44.2% of children in individual care, a 17.8% higher rate (P < .001). By 25 months, children in Centering made 3 additional well-child visits (9.2 vs 6.2, P < .001). Mediation analysis showed 82% of the effect on up to date status was due to increased attendance to well-child visits (P < .001); the remaining 18% was due to a Centering effect beyond the visit increase. CONCLUSIONS Our study showed a strong association of CenteringParenting with timeliness of immunizations and adherence to well-child visits compared to individual visits in a low income community. These findings warrant further exploration of the impact of Centering in reducing health disparities in communities at risk.
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Affiliation(s)
- Matilde M Irigoyen
- Department of Pediatric and Adolescent Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pa.
| | - Susan M Leib
- Department of Pediatric and Adolescent Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pa
| | - Andrew M Paoletti
- Department of Pediatric and Adolescent Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pa
| | - Cynthia W DeLago
- Department of Pediatric and Adolescent Medicine, Einstein Medical Center Philadelphia, Philadelphia, Pa
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14
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Gaskin E, Yorga KW, Berman R, Allison M, Sheeder J. Pediatric Group Care: A Systematic Review. Matern Child Health J 2021; 25:1526-1553. [PMID: 33961210 DOI: 10.1007/s10995-021-03170-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/09/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To describe characteristics and outcomes of Group Well-Child Care programs and provide recommendations for future research. METHODS Informed by Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, an electronic references database, manual search of bibliographies and peer-reviewed journals, and general Internet search were conducted including research published up to July 2019. English language, peer-reviewed research, with provision of medical care were included. Studies without published outcomes, not specific to well-child care, or included only one visit were excluded. Nineteen articles met review criteria. Study quality was assessed using the Downs and Black tool for rigor. RESULTS Programs typically included an individual medical examination, check-in, and group discussion. Demographics varied by race, ethnicity, age, income level, education and parity, though many were used specifically with underserved populations. Group size ranged from 3 to 10 and lasted an average of 1.5 h over a period of 6-24 months. Evidence suggests group well-child care is as effective as individual care with improvement noted for health-care utilization, weight outcomes, and more content covered. Design elements such as patient-led discussion, self-check-in, inclusion of other family members, and use of a variety of health care professionals and para-professionals may influence these outcomes. CONCLUSIONS Group well-child care is useful in providing efficient and patient-centered care and shows promise for use in underserved populations. Future research should utilize more rigorous study design and include evaluations of program components and group processes to address implementation challenges and determine effectiveness.
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Affiliation(s)
- Emily Gaskin
- Prevention Research Center at University of Colorado, Aurora, USA. .,Department of Pediatrics, School of Medicine, Prevention Research Center for Family and Child Health, University of Colorado, Mail Stop 8410, 13121 East 17th Avenue, Aurora, CO, 80045, USA.
| | - Kim Weber Yorga
- Prevention Research Center at University of Colorado, Aurora, USA.,Nurse-Family Partnership National Service Office, Denver, USA
| | - Rebecca Berman
- Prevention Research Center at University of Colorado, Aurora, USA
| | - Mandy Allison
- Obstetrics and Gynecology and Pediatrics at University of Colorado School of Medicine, Aurora, USA.,Children's Hospital School Health Program, Aurora, USA
| | - Jeanelle Sheeder
- Obstetrics and Gynecology and Pediatrics at University of Colorado School of Medicine, Aurora, USA
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15
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Desai S, Chen F, Boynton-Jarrett R. Clinician Satisfaction and Self-Efficacy With CenteringParenting Group Well-Child Care Model: A Pilot Study. J Prim Care Community Health 2020; 10:2150132719876739. [PMID: 31550973 PMCID: PMC6764027 DOI: 10.1177/2150132719876739] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Introduction: Group-based models for well-child care have been shown
to positively affect patient experience. One promising group well-child care
model is CenteringParenting. However, clinician self-efficacy with delivery of
the model is unknown and clinician satisfaction with the model has been
understudied. Objectives: To investigate sense of self-efficacy,
degree of satisfaction, and comfort with trauma-informed care (TIC) among
diverse clinical providers implementing the CenteringParenting curriculum. We
also examined the relationship between self-efficacy, satisfaction, and comfort
with TIC, and delivery of the model. Methods: Electronic surveys
were sent to CenteringParenting providers (N = 98) from 49 clinics. Providers (N
= 41) from 24 clinical sites completed the survey, corresponding to a 42%
individual and 49% site response rate. Surveys explored provider: satisfaction
with the curriculum, perceived self-efficacy, and perspective on competency with
TIC. Results: Providers indicated that the CenteringParenting model
achieves each of its four objectives (means ranged from 4.10 to 4.52 for each
objective, with 5 being the highest possible response). Providers rated their
level of satisfaction (scale of 1 [unsatisfied] to 5 [very satisfied]) with
their ability to address patient concerns higher with CenteringParenting in the
group care setting (mean = 4.10) than in the individual care setting (mean =
3.55). Respondents demonstrated a high mean average Self-Efficacy in Group Care
score of 93.63 (out of 110). Unadjusted logistical regression analyses
demonstrated that higher provider Self-Efficacy in Group Care score (odds ratio
[OR] = 1.08) and higher comfort with TIC (OR = 22.16) is associated with
curriculum content being discussed with a facilitative approach.
Conclusions: Providers from diverse clinical sites report high
satisfaction with and self-efficacy in implementing the CenteringParenting
model.
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Affiliation(s)
- Shyam Desai
- Boston University School of Medicine, Boston, MA, USA.,University of Connecticut School of Medicine, Farmington, CT, USA
| | - Futu Chen
- Boston University School of Medicine, Boston, MA, USA.,Harvard TH Chan School of Public Health, Boston, MA, USA
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16
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Novick G, Womack JA, Sadler LS. Beyond Implementation: Sustaining Group Prenatal Care and Group Well-Child Care. J Midwifery Womens Health 2020; 65:512-519. [PMID: 32519425 DOI: 10.1111/jmwh.13114] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Revised: 03/01/2020] [Accepted: 03/09/2020] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Group prenatal care and group well-child care (collectively called group care) provide health care in groups. Group care is being introduced in many settings, and the model's benefits are increasingly recognized. Yet, little attention has been paid to understanding model sustainability. This study examined barriers to sustainability and offers suggestions for sustaining group care programs. METHODS This qualitative research was guided by interpretive description. Semistructured interviews with 17 professionals were conducted in 4 sites in one community to explore barriers to sustaining group care and key ingredients for sustainability. Sites were 2 clinics that had provided group prenatal care, a clinic currently providing group prenatal care, and a clinic currently providing group well-child care. Two clinics have continued providing group care and 2 have discontinued it. Participants included midwives, physicians, nurses, and nurse practitioners. Interviews were audio recorded, transcribed, and entered in ATLAS.ti. A priori and inductive coding schemes were developed; code content was compared across individuals, participant types, and settings. RESULTS Five themes were identified: administrative buy-in, robust recruitment, clinician and staff buy-in, owning it, and sustainability mindset. Group care needs to be sold to many different constituencies: administrators, staff and clinicians, and patients. Furthermore, sustainability requires having a conscious awareness of the importance of sustainability from the outset, taking ownership by adapting group care to needs of settings, creating venues for expressing divergent viewpoints and problem-solving, and recognizing that these processes are ongoing with change occurring incrementally. It also includes addressing the need for long-term financing. DISCUSSION Those implementing group care must be prepared to go beyond managing the logistics of introducing a complex new program; they must also be prepared to develop sustainability mindsets, sell the model to everyone on all levels within their institutions, and advocate for enhanced reimbursement for group care and value-driven payment systems.
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Affiliation(s)
- Gina Novick
- Yale University School of Nursing, West Haven, Connecticut
| | - Julie A Womack
- Yale University School of Nursing, West Haven, Connecticut.,VA Connecticut Healthcare System, West Haven, Connecticut
| | - Lois S Sadler
- Yale University School of Nursing, West Haven, Connecticut.,Yale Child Study Center, New Haven, Connecticut
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17
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Fenick AM, Leventhal JM, Gilliam W, Rosenthal MS. A Randomized Controlled Trial of Group Well-Child Care: Improved Attendance and Vaccination Timeliness. Clin Pediatr (Phila) 2020; 59:686-691. [PMID: 32107935 DOI: 10.1177/0009922820908582] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Well-child care has suboptimal outcomes regarding adherence to appointments and recall of guidance, especially among families facing structural barriers to health. Group well-child care (GWCC) aims to improve these outcomes by enhancing anticipatory guidance discussions and peer education. We conducted a randomized controlled trial, comparing GWCC with traditional, individual well-child care (IWCC) and assessed health care utilization, immunization timeliness, recall of anticipatory guidance, and family-centered care. Ninety-seven mother-infant dyads were randomized to GWCC or IWCC. Compared with IWCC infants, GWCC infants attended more of the 6 preventive health visits (5.41 vs 4.87, P < .05) and received more timely immunization at 6 months and 1 year but did not differ in emergency or hospital admission rates. There were no differences in mothers' reports of anticipatory guidance received or family-centered care. As primary care is redesigned for value-based care and structural vulnerabilities are considered, GWCC may be a key option to consider.
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18
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Melton GB, McLeigh JD. The Nature, Logic, and Significance of Strong Communities for Children. INTERNATIONAL JOURNAL ON CHILD MALTREATMENT : RESEARCH, POLICY AND PRACTICE 2020; 3:125-161. [PMID: 35155993 PMCID: PMC8824826 DOI: 10.1007/s42448-020-00050-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
High levels of stress and low levels of support for parents have significant implications for child safety, particularly for families living in neighborhoods which are dangerous and disadvantaged. Building on this knowledge about the causes and correlates of child maltreatment, the U.S. Advisory Board on Child Abuse and Neglect (1993) recommended a neighborhood-based child protection strategy. This article describes Strong Communities for Children, a community-based child maltreatment prevention intervention designed to carry out the Board's recommendations. During an initial period of development and evaluation (lasting more than 7 years) of the first such initiative (located in communities near Greenville, SC), Strong Communities added substantially to the knowledge base on the role of community factors in children's safety. It also advanced understanding of ways to operationalize some of the ideas underlying the Board's proposed strategy. This article (a) describes the conceptual foundation, the logic model, and the engagement strategies that comprise Strong Communities; (b) provides an overview of the results from the first comprehensive initiative; (c) discusses their significance; and (d) concludes with discussion of the possibilities for Strong Communities in the current context.
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Affiliation(s)
- Gary B. Melton
- The Kempe Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045 USA
- 419 Hazel Grove Lane, Crozet, VA 22932 USA
| | - Jill D. McLeigh
- The Kempe Center, University of Colorado Anschutz Medical Campus, Aurora, CO 80045 USA
- Rees-Jones Center for Foster Care Excellence, Children’s Health System of Texas, Dallas, TX 75235 USA
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19
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Goyal NK, Brown CM, Folger AT, Hall ES, Van Ginkel JB, Ammerman RT. Adherence to Well-Child Care and Home Visiting Enrollment Associated with Increased Emergency Department Utilization. Matern Child Health J 2019; 24:73-81. [DOI: 10.1007/s10995-019-02821-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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20
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Hackley B, Elyachar-Stahl E, Savage AK, Stange M, Hoffman A, Kavanaugh M, Aviles MM, Arévalo S, Machuca H, Shapiro A. A Qualitative Study of Women's Recall of Content and Skills Developed in Group Prenatal and Well-Baby Care 2 Years Later. J Midwifery Womens Health 2018; 64:209-216. [PMID: 30407720 DOI: 10.1111/jmwh.12899] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2017] [Revised: 05/25/2018] [Accepted: 06/01/2018] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Group prenatal and well-baby care is a system of health care visits that occur in a group setting. Each individual session lasts approximately 2 hours, allowing more time for education and support than can occur in an individual visit. Compared with individual care, research suggests that group care is associated with similar or better short-term outcomes, but no studies have yet examined potential long-term benefits beyond one year postpartum. The purpose of this qualitative descriptive study was to elicit women's recall about content covered in group prenatal and well-baby care and whether they were or were not continuing to use skills discussed during group prenatal and well-baby care 2 or more years after their group ended. METHODS Eligible women participated in group prenatal and/or well-baby care between 2008 and 2012, were aged at least 18 years, and were English-speaking. Of the 127 eligible women, 32 were reached and 17 agreed to participate. Women were interviewed on average 3 years after group prenatal or well-baby care ended using a semistructured interview guide. Transcripts were reviewed and coded by each team member. Final codes and themes were identified using an iterative review process among the research team. RESULTS Three themes were identified: sustained change, transferable skills, and group as a safe haven. All women were still using strategies discussed during group and had made sustained improvements in nutrition, stress management, and/or in the quality of their interactions with their children, partner, or families. The group environment was described as a safe haven: a respectful, nonjudgmental space that allowed women to share and support each other while learning new skills. DISCUSSION This is the first study to document that group prenatal and well-baby care is associated with long-term benefits in areas not yet reported in the literature: nutrition, family communication, and parenting.
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21
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Foster BA, Fu E, Bendiks N, Gaspard CS, Sharifi M. Capacity-oriented approaches to developing childhood obesity interventions: a systematic review. Clin Obes 2018; 8:95-104. [PMID: 29224227 PMCID: PMC6021132 DOI: 10.1111/cob.12234] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2017] [Revised: 11/14/2017] [Accepted: 11/14/2017] [Indexed: 11/27/2022]
Abstract
Capacity-oriented approaches to health interventions seek to empower the target population or community to manage the health issue themselves using resources they can control. Positive deviance, resilience and asset-based approaches are three such methods of developing and implementing health interventions. This study aimed to review the efficacy of interventions explicitly applying these methods in addressing childhood obesity using adiposity as the primary outcome, measured by standardized body mass index. The search strategy was developed and implemented across four electronic databases. Of the 181 records identified and screened, 11 studies were identified as using a capacity-oriented approach overall. Asset-based approaches (n = 8 studies) consisted of 47 880 participants, positive deviance (n = 2 studies) consisted of 781 participants, and resilience-based interventions (n = 1 study) consisted of 35 participants. The asset-based approaches were mixed, with three of the eight studies showing a significant reduction in adiposity, while the other five did not find a difference. The positive deviance and resilience-based studies showed signs of efficacy in reducing adiposity. There was significant design heterogeneity across studies, and varied interpretations and definitions of the approaches were used. Further work should attempt to achieve some consensus on the use of these approaches to facilitate comparison and advance the science of capacity-oriented interventions for childhood obesity.
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Affiliation(s)
- Byron A Foster
- Oregon Health & Science University, Departments of Dermatology and Pediatrics
| | - Emily Fu
- Yale University, School of Public Health
| | - Nick Bendiks
- University of Texas Health Science Center at San Antonio, Department of Pediatrics
| | | | - Mona Sharifi
- Yale University School of Medicine, Department of Pediatrics
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22
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Molnar BE, Beatriz ED, Beardslee WR. Community-Level Approaches to Child Maltreatment Prevention. TRAUMA, VIOLENCE & ABUSE 2016; 17:387-397. [PMID: 27580664 DOI: 10.1177/1524838016658879] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Often the focus of the field of child maltreatment has concentrated on identifying and intervening on risk and protective factors at the individual and family levels; however, since the 1970s, the important roles that communities play in both exacerbating and preventing child maltreatment have received attention as well. This article outlines the development of this area of scientific inquiry, describes the theoretical frameworks utilized by existing programs, and describes several community-level programs aimed at preventing child maltreatment that show promise as scalable strategies to enhance individual and family strengths and reduce caregiver stress. Challenges inherent in community-level programming in increasingly diverse environments and in building/maintaining political will for sustainability of evidence-based efforts are discussed as well. A multilevel, holistic approach that takes into account developmental changes and needs of individuals as well as their environments is likely to bring about more sustainable change in protecting children from abuse and neglect than efforts focused solely on individuals.
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Affiliation(s)
- Beth E Molnar
- Institute on Urban Health Research & Practice, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - Elizabeth D Beatriz
- Institute on Urban Health Research & Practice, Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA
| | - William R Beardslee
- Department of Psychiatry, Children's Hospital Boston and Harvard Medical School, Boston, MA, USA
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23
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Beck AF, Tschudy MM, Coker TR, Mistry KB, Cox JE, Gitterman BA, Chamberlain LJ, Grace AM, Hole MK, Klass PE, Lobach KS, Ma CT, Navsaria D, Northrip KD, Sadof MD, Shah AN, Fierman AH. Determinants of Health and Pediatric Primary Care Practices. Pediatrics 2016; 137:e20153673. [PMID: 26933205 DOI: 10.1542/peds.2015-3673] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/17/2015] [Indexed: 11/24/2022] Open
Abstract
More than 20% of children nationally live in poverty. Pediatric primary care practices are critical points-of-contact for these patients and their families. Practices must consider risks that are rooted in poverty as they determine how to best deliver family-centered care and move toward action on the social determinants of health. The Practice-Level Care Delivery Subgroup of the Academic Pediatric Association's Task Force on Poverty has developed a roadmap for pediatric providers and practices to use as they adopt clinical practice redesign strategies aimed at mitigating poverty's negative impact on child health and well-being. The present article describes how care structures and processes can be altered in ways that align with the needs of families living in poverty. Attention is paid to both facilitators of and barriers to successful redesign strategies. We also illustrate how such a roadmap can be adapted by practices depending on the degree of patient need and the availability of practice resources devoted to intervening on the social determinants of health. In addition, ways in which practices can advocate for families in their communities and nationally are identified. Finally, given the relative dearth of evidence for many poverty-focused interventions in primary care, areas that would benefit from more in-depth study are considered. Such a focus is especially relevant as practices consider how they can best help families mitigate the impact of poverty-related risks in ways that promote long-term health and well-being for children.
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Affiliation(s)
- Andrew F Beck
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio;
| | - Megan M Tschudy
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Tumaini R Coker
- Department of Pediatrics, David Geffen School of Medicine and Mattel Children's Hospital, Los Angeles, California
| | - Kamila B Mistry
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland; Agency for Healthcare Research and Quality; Rockville, Maryland
| | - Joanne E Cox
- Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts
| | - Benjamin A Gitterman
- Department of Pediatrics, Children's National Health System; Washington, District of Columbia
| | - Lisa J Chamberlain
- Department of Pediatrics, Lucile Packard Children's Hospital, Palo Alto, California
| | - Aimee M Grace
- Office of US Senator Brian Schatz (D-HI) and George Washington University School of Medicine and Health Sciences, Washington, District of Columbia
| | - Michael K Hole
- Division of General Pediatrics, Boston Children's Hospital, Boston, Massachusetts
| | - Perri E Klass
- Department of Pediatrics, New York University School of Medicine, New York, New York
| | - Katherine S Lobach
- Department of Pediatrics, Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, New York
| | - Christine T Ma
- Department of Pediatrics, UCSF Benioff Children's Hospital Oakland, Oakland, California
| | - Dipesh Navsaria
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin
| | - Kimberly D Northrip
- Department of Pediatrics, University of Kentucky College of Medicine, Lexington, Kentucky; and
| | - Matthew D Sadof
- Department of Pediatrics, Baystate Children's Hospital, Springfield, Massachusetts
| | - Anita N Shah
- Department of Pediatrics, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio
| | - Arthur H Fierman
- Department of Pediatrics, New York University School of Medicine, New York, New York
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24
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Kimbrough-Melton RJ, Melton GB. "Someone will notice, and someone will care": How to build Strong Communities for Children. CHILD ABUSE & NEGLECT 2015; 41:67-78. [PMID: 25765816 DOI: 10.1016/j.chiabu.2015.02.015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Derived from the recommendations of the U.S. Advisory Board on Child Abuse and Neglect, Strong Communities for Children is a universal community-wide approach to prevention of child maltreatment. It is intended to change community norms-to facilitate informal support for families and to strengthen parents' belief that they can improve the quality of life for their own and their neighbors' families. A phased intervention, Strong Communities begins with recruitment and mobilization of volunteers, initially to spread Strong Communities' messages and ultimately to provide direct assistance to families of young children. Principle-driven, Strong Communities uses assets in the community to expand and strengthen networks of supportive relationships and, in particular, to increase support to parents. At least in concept, Strong Communities appears to be applicable in highly disparate communities and societies.
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Affiliation(s)
| | - Gary B Melton
- Colorado School of Public Health and University of Colorado School of Medicine, Aurora, CO, USA
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