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Hill AV, Balascio P, Moore M, Hossain F, Dwarkananth M, De Genna NM. Young black women's desired pregnancy and birthing support during coronavirus disease 2019 pandemic. SSM. QUALITATIVE RESEARCH IN HEALTH 2023; 4:100333. [PMID: 38106375 PMCID: PMC10722556 DOI: 10.1016/j.ssmqr.2023.100333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
Objective To document pregnancy and birthing experiences of young, Black pregnant women in one geographic area to make recommendations for improving young Black women's pregnancy and birthing experiences. Methods Participants were recruited through The YoungMoms Study (R01 DA04640101A1) in Pittsburgh, Pennsylvania, and included Black or biracial participants ages 16-23 (n = 25). Individual interviews were conducted from March 2022-July 2022 to assess pre-, peri-, and post-natal healthcare system encounters; experiences of structural and obstetric racism and discrimination in healthcare settings while obtaining prenatal care; attitudes around healthcare systems and medical professionals; effects of COVID-19 pandemic on participants lives and the impact of enacted healthcare policies in their perinatal experience; substance use changes during pregnancy; and coping mechanisms for stress. NVivo 13 was used to code transcripts, then major themes and subthemes were identified using thematic content analysis and based on grounded theory. Results Twenty-five interviews were conducted, and four themes emerged from participant experiences of racial discrimination in healthcare settings; (1) awareness of historical racism that influences perinatal care; (2) clinical providers assume participant substance use and enact reproductive coercion; (3) clinical providers question validity of Black women's birthing complaint; and (4) Young Black pregnant women know and will express what they desire in their perinatal experience if asked. Conclusions Young Black pregnant women encounter structural racism and intersectional bias from healthcare providers. By centering the perspectives and experiences of this overlooked population, public health researchers and clinical providers can utilize anti-racist frameworks to create more equitable, just practices in reproductive healthcare.
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Affiliation(s)
- Ashley V. Hill
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Phoebe Balascio
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Mikaela Moore
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
| | - Fahmida Hossain
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Megana Dwarkananth
- Department of Pediatrics, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Natacha M. De Genna
- Department of Epidemiology, University of Pittsburgh School of Public Health, Pittsburgh, PA, USA
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
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Tung I, Keenan K, Hipwell AE. Adolescent Mothers' Psychological Wellbeing during Pregnancy and Infant Emotional Health. JOURNAL OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY : THE OFFICIAL JOURNAL FOR THE SOCIETY OF CLINICAL CHILD AND ADOLESCENT PSYCHOLOGY, AMERICAN PSYCHOLOGICAL ASSOCIATION, DIVISION 53 2023; 52:616-632. [PMID: 34605721 PMCID: PMC8977390 DOI: 10.1080/15374416.2021.1981339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVE Although many studies have identified risk factors for adolescent pregnancy, much less is known about factors that support pregnant adolescents' psychological wellbeing and offspring outcomes. This study drew on strength-based frameworks to investigate family and neighborhood factors linked to social connectedness that predict psychological wellbeing during adolescent pregnancy and offspring outcomes. METHOD Participants included 135 adolescent mothers (ages 14-21; 90% Black American) assessed annually since childhood as part of a longitudinal study. During preadolescence (ages 11-13), data on contextual stressors and neighborhood support were gathered from participants' caregivers; participants also rated their perceived trust/attachment with caregivers before and during pregnancy. To assess changes in psychological wellbeing, adolescents reported positive and depressed mood before and during pregnancy. A path analysis model tested the prospective associations between family and neighborhood factors, psychological wellbeing during pregnancy, and offspring outcomes (birth outcomes; observed infant positive/negative emotions at age 3-months). RESULTS Positive mood decreased from pre-pregnancy to pregnancy, whereas depressed mood remained stable. Adjusting for pre-pregnancy mood, perceived caregiver trust/attachment during pregnancy was associated with prenatal positive mood. Prenatal positive mood, in turn, reduced risk of preterm birth and indirectly predicted positive infant emotions via birth outcomes. Neighborhood support in preadolescence predicted lower prenatal depressed mood, but depressed mood did not predict infant outcomes beyond positive mood. Contextual life stress was not associated with prenatal mood after adjusting for family and neighborhood support. CONCLUSIONS Findings highlight changes in positive-valence emotions during adolescent pregnancy that may have unique associations with birth outcomes and offspring emotions.
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Affiliation(s)
- Irene Tung
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
| | - Kate Keenan
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL
| | - Alison E. Hipwell
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA
- Department of Psychology, University of Pittsburgh, Pittsburgh, PA
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Hicks A. Risky (information) business: an informational risk research agenda. JOURNAL OF DOCUMENTATION 2023. [DOI: 10.1108/jd-09-2022-0198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2023]
Abstract
PurposeThe purpose of this conceptual paper is to suggest that the growing sociocultural theorisation of risk calls for a more robust research focus on the role that information and in particular, information literacy, plays in mediating hazards and danger.Design/methodology/approachStarting by tracing how information has been conceptualised in relation to risk through technoscientific, cognitive and sociocultural lenses, the paper then focuses on emerging sociocultural understandings of risk to present a research agenda for a renewed sociocultural exploration of how risk is shaped through the enactment of information literacy.FindingsThe paper identifies and examines how information literacy shapes four key aspects of risk, including risk perception, risk management, risk-taking and “at-risk” populations. These four aspects are further connected through broader themes of learning, identity, work and power, which form the basis of the sociocultural risk research agenda.Originality/valueThis paper is the first study bringing together the many understandings related to how risk is informed and establishes risk as a key area of interest within information literacy research.
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Fierloos IN, Windhorst DA, Fang Y, Jonkman H, Crone MR, Hosman CMH, Tan SS, Raat H. Socio-demographic characteristics associated with perceived social support among parents of children aged 0-7 years: the CIKEO study. BMC Public Health 2022; 22:2441. [PMID: 36575393 PMCID: PMC9795715 DOI: 10.1186/s12889-022-14830-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 12/07/2022] [Indexed: 12/28/2022] Open
Abstract
BACKGROUND Social support has been associated with numerous positive outcomes for families' health, wellbeing and empowerment. This study examined which socio-demographic characteristics are associated with perceived social support among parents of children aged 0-7 years. METHOD Cross-sectional data of 1007 parents of children aged 0-7 years, gathered in the CIKEO cohort study in the Netherlands, were analysed. Social support was assessed with the Multi-dimensional Scale of Perceived Social Support (MSPSS). Linear regression models were used to examine associations between socio-demographic characteristics and perceived social support. RESULTS The mean age of the participants was 34.1 years (SD = 5.1); 92.9% were mothers. The multivariable regression model showed that fathers (β: -0.15, 95% CI: - 0.22, - 0.08), parents with a low educational level (β: -0.12, 95% CI: 0.18, - 0.06), parents with a low income (β: -0.10, 95% CI: - 0.19, - 0.01), unemployed parents (β: -0.14, 95% CI: - 0.20, - 0.07), and parents of older children (β: -0.07; 95% CI: - 0.13, 0.00) perceived lower levels of social support. Interaction analyses showed that parents with a migration background and a low educational level were particularly susceptible to perceiving lower levels of support (β: -0.34, 95% CI: - 0.52, - 0.15). CONCLUSION Fathers, parents with a low educational level, parents with a low income, unemployed parents, parents of older children, and parents with both a migration background and a low educational level are at increased risk of perceiving lower levels of social support. IMPLICATIONS We recommend to develop, implement and evaluate intervention strategies to strengthen perceived social support among the abovementioned subgroups of parents, in order to improve families' health, wellbeing and empowerment. TRIAL REGISTRATION NTR7607 in the Netherlands trial registry.
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Affiliation(s)
- Irene N. Fierloos
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Dafna A. Windhorst
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands ,grid.10417.330000 0004 0444 9382Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Kapittelweg 29, 6525 EN Nijmegen, The Netherlands ,grid.4858.10000 0001 0208 7216TNO Child Health, Sylviusweg 71, 2333 BE Leiden, the Netherlands
| | - Yuan Fang
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Harrie Jonkman
- grid.426562.10000 0001 0709 4781Verwey-Jonker Institute, Kromme Nieuwegracht 6, 3512 HG Utrecht, The Netherlands
| | - Matty R. Crone
- grid.10419.3d0000000089452978Department of Public Health and Primary Care, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands
| | - Clemens M. H. Hosman
- grid.5012.60000 0001 0481 6099Department of Health Promotion, Maastricht University, Peter Debyeplein 1, 6229 HA Maastricht, The Netherlands ,grid.5590.90000000122931605Department of Clinical Psychology, Radboud University, Thomas van Aquinostraat 4, 6525 GD Nijmegen, The Netherlands ,Hosman Prevention and Innovation Consultancy, Knapheidepad 6, 6562 DW Berg en Dal, The Netherlands
| | - Siok Swan Tan
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
| | - Hein Raat
- grid.5645.2000000040459992XDepartment of Public Health, Erasmus University Medical Center, Doctor Molewaterplein 40, 3015 GD Rotterdam, The Netherlands
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The information behaviours of disadvantaged young first-time mothers. JOURNAL OF DOCUMENTATION 2022. [DOI: 10.1108/jd-03-2022-0072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this study is to explore the information behaviours of socioeconomically disadvantaged young first-time mothers, an understudied and at-risk group (health and well-being).Design/methodology/approachQuestionnaire and semi-structured interviews with 39 young mothers (aged up to 25 years of age) from UK areas of multiple deprivations.FindingsOur participants' preferred sources of information are interpersonal sources with which they have formed close supportive relationships. Support groups are important sources of interpersonal connection, but young mothers are reluctant to attend groups involving older mothers. With the exception of support group staff and health visitors, institutional and professional information sources are used very little. Societal stigma is a significant issue influencing behaviours, but issues of institutional bureaucracy, information overload, conflicting information and practical access are also reported. A further key factor influencing behaviour is self-identity.Research limitations/implicationsFindings should not be considered representative of young mothers as a whole as not all young mothers are disadvantaged. As our participants identified as ethnically white, findings also cannot speak to the additional barriers experienced by women of colour. Further studies with further population groups are recommended. More broadly, further studies exploring the influence of self-identity on people's information behaviours are also recommended.Practical implicationsFindings provide practical direction for health and welfare services, and public libraries, to better support young mothers.Originality/valueFindings contribute to conceptual and practical understanding of information poverty in the socio-ecological context. Findings also evidence the role of self-identity in shaping people's information behaviours.
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Kola L, Abiona D, Oladeji BD, Ayinde O, Bello T, Gureje O. Theory-driven development of a mobile phone supported intervention for adolescents with perinatal depression. Soc Psychiatry Psychiatr Epidemiol 2022; 57:1201-1210. [PMID: 34779878 DOI: 10.1007/s00127-021-02198-3] [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: 02/16/2021] [Accepted: 10/31/2021] [Indexed: 12/16/2022]
Abstract
PURPOSE This paper describes the design of a theory-informed pragmatic intervention for adolescent perinatal depression in primary care in Nigeria. METHODS We conducted Focus Group Discussions (FGDs) among 17 adolescent mothers and 25 maternal health care providers with experience in the receipt and provision of care for perinatal depression. The Consolidated Framework for Implementation Research (CFIR) was used to systematically examine the barriers and facilitators affecting adolescent mothers' use of an existing intervention package for depression. The Theoretical Domain Framework (TDF) and the Capability, Opportunity, Motivation, Behaviour (COM-B) model were used to analyze the results of the data across the five CFIR domains. RESULTS FGD analysis revealed that care providers lacked knowledge on approaches to engage young mothers in treatment. Young mothers had poor treatment engagement, low social support, and little interest in parenting. A main characteristic of the newly designed intervention is the inclusion of age-appropriate psychoeducation supported with weekly mobile phone calls, to address treatment engagement and parenting behaviours of young mothers. Also in the outer setting, low social support from relatives was addressed with education, "as need arises" phone calls, and the involvement of "neighborhood mothers". In the inner settings, care providers' behaviour is addressed with training to increase their capacity to engage young mothers in treatment. CONCLUSION A theory-based approach helped develop an age-appropriate intervention package targeting depression and parenting skills deficit among perinatal adolescents in primary maternal care and in which a pragmatic use of mobile phone was key.
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Affiliation(s)
- Lola Kola
- WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, College of Medicine University of Ibadan, Ibadan, Nigeria. .,BRiTE Centre, Department of Psychiatry, University of Washington, Seattle, USA.
| | - Dolapo Abiona
- WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, College of Medicine University of Ibadan, Ibadan, Nigeria
| | - Bibilola D Oladeji
- Department of Psychiatry, College of the Medicine University of Ibadan, Ibadan, Nigeria
| | - Olatunde Ayinde
- Department of Psychiatry, College of the Medicine University of Ibadan, Ibadan, Nigeria
| | - Toyin Bello
- WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, College of Medicine University of Ibadan, Ibadan, Nigeria
| | - Oye Gureje
- WHO Collaborating Centre for Research and Training in Mental Health, Neurosciences and Drug and Alcohol Abuse, Department of Psychiatry, College of Medicine, College of Medicine University of Ibadan, Ibadan, Nigeria.,Department of Psychiatry, College of the Medicine University of Ibadan, Ibadan, Nigeria
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Hicks A. The missing link: Towards an integrated health and information literacy research agenda. Soc Sci Med 2021; 292:114592. [PMID: 34839085 DOI: 10.1016/j.socscimed.2021.114592] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 10/24/2021] [Accepted: 11/18/2021] [Indexed: 11/18/2022]
Abstract
Information forms one of the main commonalities shared between definitions of health literacy. However, information literacy research, which centres how people become informed within a specific setting, has been almost completely sidelined from health literacy scholarship. This oversight risks limiting understanding of how health literacy is practised as well as narrowing research discourses. It also forms a missed opportunity as the recent sociocultural turn creates a valuable point of synergy between each field. This paper carries out a narrative literature review to identify key areas where information literacy research could help to extend understanding about how people interact with information within health contexts. Centred on exploring theoretical and empirical work, the paper uses examples from literature to suggest that assumptions related to how information, models of information use, social dynamics of information environments, the outcomes of information activity and critical approaches to information practice are understood impact the scope and the reach of health literacy research and practice. The goal of this paper is to establish an initial, shared research agenda that places health and information literacy in dialogue rather than in isolation from each other.
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Affiliation(s)
- Alison Hicks
- Department of Information Studies, University College, London (UCL), Foster Court, Gower Street, London, WC1E 6BT, UK.
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Shee AW, Frawley N, Robertson C, McKenzie A, Lodge J, Versace V, Nagle C. Accessing and engaging with antenatal care: an interview study of teenage women. BMC Pregnancy Childbirth 2021; 21:693. [PMID: 34629069 PMCID: PMC8504060 DOI: 10.1186/s12884-021-04137-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 09/22/2021] [Indexed: 11/30/2022] Open
Abstract
Background Pregnant teenagers in rural and regional areas experience distinct disadvantages, that are not simply a function of their age, and these have a substantial impact on their health and that of their baby. Studies demonstrate that antenatal care improves pregnancy outcomes amongst pregnant women, especially adolescents. Understanding teenager’s views and experiences of pregnancy and motherhood is important to ensure antenatal care meets young women’s needs. This study explored teenage women’s experiences and perceptions of barriers and facilitators to engaging in pregnancy care in rural and regional Victoria, Australia. Methods Between February–October 2017, pregnant women aged ≤19 years were purposively recruited from one regional and two rural health services in Victoria. Semi-structured, face-to-face interviews guided by naturalistic inquiry were conducted and an inductive approach to analysis was applied. Results Four key themes emerged from the analysis of the transcripts of 16 interviews: Valuing pregnancy care, Interactions with Maternity Service, Woman-centred care, and Support systems. Teenage women primary motivation to attend care was to ensure their baby’s wellbeing and lack of engagement occurred when the relevance of antenatal care was not understood. Appointment flexibility and an accessible location was important; most participants were reliant on others for transport. Continuity of carer and respectful, non-judgement communication by staff was highly valued. Many young women had fractured families with pregnancy diminishing their social world, yet having a baby gave them purpose in their lives. Conclusion Maternity services and health professionals that provide flexible, adaptable women-centred care and support through pregnancy and early motherhood will assist young women’s engagement in antenatal care. Supplementary Information The online version contains supplementary material available at 10.1186/s12884-021-04137-1.
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Affiliation(s)
- Anna Wong Shee
- Primary and Community Care, Ballarat Health Services, Ballarat, Victoria, 3350, Australia. .,Deakin Rural Health, Deakin University, Warrnambool, Australia.
| | - Natasha Frawley
- Primary and Community Care, Ballarat Health Services, Ballarat, Victoria, 3350, Australia
| | - Carolyn Robertson
- Primary and Community Care, Ballarat Health Services, Ballarat, Victoria, 3350, Australia
| | - AnneMarie McKenzie
- Primary and Community Care, Ballarat Health Services, Ballarat, Victoria, 3350, Australia
| | - Julie Lodge
- Primary and Community Care, Ballarat Health Services, Ballarat, Victoria, 3350, Australia
| | - Vincent Versace
- Deakin Rural Health, Deakin University, Warrnambool, Australia
| | - Cate Nagle
- James Cook University, Centre for Nursing and Midwifery Research, 1 James Cook Drive, Townsville, 4814, Australia.,Townsville Hospital and Health Service, 100 Angus Smith Drive, Douglas, QLD, 4814, Australia
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Jones SW, Darra S, Davies M, Jones C, Sunderland-Evans W, Ward MRM. Collaborative working in health and social care: Lessons learned from post-hoc preliminary findings of a young families' pregnancy to age 2 project in South Wales, United Kingdom. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:1115-1125. [PMID: 32875635 DOI: 10.1111/hsc.13146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Revised: 06/05/2020] [Accepted: 06/10/2020] [Indexed: 06/11/2023]
Abstract
Children of young and socially disadvantaged parents are more likely to experience adverse outcomes. In response to this, a unique young families' project in Swansea, UK, was created, which drew together a team of multi-agency professionals, to support people aged 16-24 from 17 weeks of pregnancy throughout 1,001 days of the child's life. The aim of the JIGSO (the Welsh word for Jigsaw) project is for young people to reach their potential as parents and to break the cycle of health and social inequality. This evaluation analysed routinely collected data held by the project from January 2017 to December 2018 exploring health and social outcomes, including smoking and alcohol use in pregnancy, breastfeeding, maternal diet and social services outcomes. Outcomes were compared to local and national averages, where available. Data relating to parenting knowledge and skills were available via records of 10-point Likert scales, one collected at the start of the JIGSO involvement and one around 4-6 months later. Findings showed higher than average levels of breastfeeding initiation and lower smoking and alcohol use in pregnancy. Parents also reported enhanced knowledge and confidence in their child care skills, as well as improved family relationships. Parents with high levels of engagement with JIGSO also appeared to have positive outcomes with Social Services (their child's name was removed from child protection register or their case was closed to social services). This was a post-hoc evaluation, not an intervention study or trial, and thus findings must be interpreted with caution. Despite this, the findings are promising and more prospective research exploring similar services is required.
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Affiliation(s)
- Sara W Jones
- Department of Public Health, Policy and Social Sciences, Swansea University, UK
| | - Susanne Darra
- Department of Public Health, Policy and Social Sciences, Swansea University, UK
| | | | - Catherine Jones
- Department of Public Health, Policy and Social Sciences, Swansea University, UK
| | | | - Mike R M Ward
- Department of Public Health, Policy and Social Sciences, Swansea University, UK
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Pillay N. 'There is no more future for me? Like really, are you kidding?': agency and decision-making in early motherhood in an urban area in Johannesburg, South Africa. Glob Health Action 2021; 14:1886456. [PMID: 33657987 PMCID: PMC7935122 DOI: 10.1080/16549716.2021.1886456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 02/02/2021] [Indexed: 12/02/2022] Open
Abstract
Background: The South African development goals for young women aged 15 to 24 are to reduce HIV incidence, teenage pregnancy and gender-based violence, and to increase school completion and economic security. Early, unintended pregnancy undermines these goals, creating discourses of early motherhood that position young women as powerless. There has been scant attention on the agency of young women in their structural context.Objective: This study explored how young women exercise agency after an unintended pregnancy and make decisions concerning their future, including sexual and reproductive health, school completion and/or income generation, and caregiving for their babies.Methods: I used narrative analysis to explore the lived experiences of young mothers, paying attention to decision-making during pregnancy and motherhood. Domains of analysis included health care, education, and caregiving. I conducted in-depth interviews with 30 young mothers: 30 were interviewed once, nine were interviewed twice, and six were interviewed three times. I interviewed four significant people in the lives of young mothers and six health care providers at a health centre.Results: Progressive policy facilitates increased access to services for young pregnant and parenting women. However, education and health care providers continue to discriminate against them, formally through denying them access to services and informally through discourses of shame which pervade their structural context. Kinship capital in urban and rural contexts and the Child Support Grant mitigate some struggles in early motherhood and help young mothers navigate decision-making.Conclusion: Young mothers exercise agency along a continuum to realise their aspirations. Social and structural support mediate their agency. Policy needs to expand the focus from prevention to include issues of care and support after an early, unintended pregnancy to ensure the health and wellbeing of young mothers and their children.
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Affiliation(s)
- Nirvana Pillay
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Buchanan S, Jardine C. The complex information needs of disadvantaged young first-time mothers: insights into multiplicity of needs. JOURNAL OF DOCUMENTATION 2020. [DOI: 10.1108/jd-07-2019-0142] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
PurposeThe purpose of this paper is to holistically explore the information needs of socioeconomically disadvantaged young first-time mothers and associated issues of complexity.Design/methodology/approachThis paper used survey and semi-structured field interviews with 39 young mothers (aged 15–23) from UK areas of multiple deprivations.FindingsParticipants reported multiple and complex needs spanning interrelated topics of parenting, poverty and personal development. In the majority of instances, participants were either unsure of their ability to meet their needs or needed help with needs, and several described situations of considerable anxiety and stress. Multiplicity is identified and conceptualised as an important factor contributing to complexity, including three component elements: simultaneous occurrence of needs (concurrency), relationships between needs (interconnectivity) and evolving needs (fluidity). In various combinations, these elements influenced a mother's actions and/or ability to selectively attend to needs, with multiple needs often competing for attention, and compounding issues of cognitive load and affect.Research limitations/implicationsThis study draws attention to multiplicity of needs as an understudied topic within human information behaviour and calls for further research into how people recognise and attend to complex needs and influencing factors.Practical implicationsThis study raises important questions regarding how we approach complexity of information needs in our design and delivery of information systems and services.Originality/valueEvidences disadvantaged young mothers to have more extensive and complex information needs than previously understood, and identifies and conceptualised multiplicity as an important factor contributing to the complexity of information needs during major life transitions such as motherhood.
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Navigating a Minefield: Meta-Synthesis of Teen Mothers' Breastfeeding Experience. MCN Am J Matern Child Nurs 2020; 45:145-154. [PMID: 32039983 DOI: 10.1097/nmc.0000000000000609] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Teen mothers have lower rates of breastfeeding duration and exclusivity than older mothers. A growing body of qualitative research on teen mothers' experience helps to explain these disparities. Following a systematic search to identify relevant research, we synthesized the findings from 22 primary studies to conclude that teen mothers navigate a minefield that undermines their intention to breastfeed and their breastfeeding confidence and skill. This metaphorical minefield reflects competing norms for infant feeding and good mothering, as evident in mixed support from teens' social networks; fragmented and stigmatizing healthcare; and spaces that are inhospitable to teen mothers and breastfeeding mothers in general.In recognition of this minefield, we urge clinicians to: respect teen mothers' infant feeding decisions; develop collaborative relationships based on the principles of patient-centered and strength-based care; challenge stigmatizing healthcare practices; welcome teen mothers and their significant others to clinical settings; and press health systems to fully implement probreastfeeding policies. We also recommend further study to extend our knowledge about teen mothers' breastfeeding experiences.
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Buchanan S, Nicol E. Developing health information literacy in disengaged at-risk populations. JOURNAL OF DOCUMENTATION 2019. [DOI: 10.1108/jd-06-2018-0086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PurposeThe purpose of this paper is to advance our understanding of the challenges of health information literacy (IL) education in disadvantaged and disengaged at-risk populations; and from the perspective of professionals out with information professions occupying everyday support roles.Design/methodology/approachA qualitative in-depth case study. The participants were a team of UK Family Nurses providing outreach support to young expectant mothers from areas of multiple deprivations, and the mothers themselves. The data collection methods were observation, survey, interviews and focus groups.FindingsInformation needs of mothers are multiple, and not always recognised as information problems, or revealed. Several felt overwhelmed, and actively avoided health information. There is low awareness and/or use of state sources of online health information. Family nurses provide an important information intermediary role, but are unfamiliar with IL concepts and models; consequently, there is limited evidence of client transitions to independent information seeking, or underpinning pedagogical practices to achieve such goals.Research limitations/implicationsFurther research is required into appropriate pedagogical approaches to IL education adaptable to semi-structured everyday situations. Recognition of information need requires particular attention, including methods of elicitation and specification in the problematic context.Practical implicationsIn an era of digital transitions and public service reforms, the authors raise important questions regarding the true reach of public health policy.Originality/valueThe paper holistically examines nurse–client information behaviours, and extends the discussion of low IL in nurses beyond issues of evidence-based practice to issues of developing healthcare self-efficacy in at-risk clients.
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Buchanan S, Jardine C, Ruthven I. Information behaviors in disadvantaged and dependent circumstances and the role of information intermediaries. J Assoc Inf Sci Technol 2018. [DOI: 10.1002/asi.24110] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Steven Buchanan
- Department of Computer and Information Sciences; University of Strathclyde; Livingston Tower, 26 Richmond Street, Glasgow G1 1XH UK
| | - Cara Jardine
- Department of Computer and Information Sciences; University of Strathclyde; Livingston Tower, 26 Richmond Street, Glasgow G1 1XH UK
| | - Ian Ruthven
- Department of Computer and Information Sciences; University of Strathclyde; Livingston Tower, 26 Richmond Street, Glasgow G1 1XH UK
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15
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Mangeli M, Tirgari B, Cheraghi MA, Rayyani M. Exploring the experiences of Iranian adolescent mothers about the maternal role: a qualitative study. Electron Physician 2018; 10:6812-6820. [PMID: 29997766 PMCID: PMC6033130 DOI: 10.19082/6812] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 10/28/2017] [Indexed: 11/20/2022] Open
Abstract
Background Early motherhood is one of the most important issues in developing countries. Adolescent mothers are not sufficiently prepared to accept the maternal role. How to achieve success in the maternal role should be studied. Objective To explore the experiences of Iranian adolescent mothers about the maternal role. Methods This qualitative study was conducted through a conventional content analysis approach from March to December 2016. Face to face in-depth semi-structured interviews were conducted with 18 Iranian teenage mothers in Kerman province, Iran. Participants were selected purposefully and with maximum variation of the age of the first birth, child's age, place of residence and financial status. Data collection continued until data saturation and MAXQDA software was utilized to analyze the collected data. Results Data analysis resulted in the extraction of the two main categories including optimizing the process of the maternal experience (use of maximum individual capabilities, planning and management of conditions, efforts to acquire maternal competency, and reliance on spirituality) and supporters for the acceptance of the maternal role (social support, professional services of health care providers, time lapse, care history). Conclusion Early motherhood is not merely an unpleasant experience; if appropriate strategies and facilitators are used, it can have positive consequences. Health care providers should provide satisfactory services in care, education and support with adequate knowledge of adolescent characteristics. Opportunities in the community should also be directed to support this vulnerable group.
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Affiliation(s)
- Maasoumeh Mangeli
- Ph.D. of Nursing, Assistant Professor. Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Batool Tirgari
- Ph.D. of Nursing, Associate Professor, Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
| | - Mohammad Ali Cheraghi
- Ph.D. of Nursing, Full Professor, School of Nursing and Midwifery, Tehran University of Medical Sciences, Tehran, Iran
| | - Masoud Rayyani
- Ph.D. of Nursing, Assistant Professor. Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran
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16
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Asnong C, Fellmeth G, Plugge E, Wai NS, Pimanpanarak M, Paw MK, Charunwatthana P, Nosten F, McGready R. Adolescents' perceptions and experiences of pregnancy in refugee and migrant communities on the Thailand-Myanmar border: a qualitative study. Reprod Health 2018; 15:83. [PMID: 29789019 PMCID: PMC5964643 DOI: 10.1186/s12978-018-0522-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 05/08/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Adolescent pregnancy remains a global health concern, contributing to 11% of all births worldwide and 23% of the overall burden of disease in girls aged 15-19 years. Premature motherhood can create a negative cycle of adverse health, economic and social outcomes for young women, their babies and families. Refugee and migrant adolescent girls might be particularly at risk due to poverty, poor education and health infrastructure, early marriage, limited access to contraception and traditional beliefs. This study aims to explore adolescents' perceptions and experiences of pregnancy in refugee and migrant communities on the Thailand-Myanmar border. METHODS In June 2016 qualitative data were collected in one refugee camp and one migrant clinic along the Thailand-Myanmar border by conducting 20 individual interviews with pregnant refugee and migrant adolescents and 4 focus group discussions with husbands, adolescent boys and non-pregnant girls and antenatal clinic staff. Inductive thematic analysis was used to identify codes and themes emerging from the data. RESULTS Study participants perceived adolescent pregnancy as a premature life event that could jeopardise their future. Important themes were premarital sex, forced marriage, lack of contraception, school dropout, fear of childbirth, financial insecurity, support structures and domestic violence. Supportive relationships with mothers, husbands and friends could turn this largely negative experience into a more positive one. The main underlying reasons for adolescent pregnancy were associated with traditional views and stigma on sexual and reproductive health issues, resulting in a knowledge gap on contraception and life skills necessary to negotiate sexual and reproductive choices, in particular for unmarried adolescents. CONCLUSIONS Adolescents perceive pregnancy as a challenging life event that can be addressed by developing comprehensive adolescent-friendly sexual and reproductive health services and education in refugee and migrant communities on the Thailand-Myanmar border. Creating a more tolerant and less stigmatising environment in these communities and their governing bodies will help to achieve this goal.
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Affiliation(s)
- Carine Asnong
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ UK
| | - Gracia Fellmeth
- Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7FZ UK
| | - Emma Plugge
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ UK
| | - Nan San Wai
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, 63110 Thailand
| | - Mupawjay Pimanpanarak
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, 63110 Thailand
| | - Moo Kho Paw
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, 63110 Thailand
| | | | - François Nosten
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ UK
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, 63110 Thailand
| | - Rose McGready
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, OX3 7FZ UK
- Shoklo Malaria Research Unit, Mahidol-Oxford Tropical Medicine Research Unit, Mahidol University, Mae Sot, 63110 Thailand
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17
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Carson A, Chabot C, Greyson D, Shannon K, Duff P, Shoveller J. A narrative analysis of the birth stories of early-age mothers. SOCIOLOGY OF HEALTH & ILLNESS 2017; 39:816-831. [PMID: 27791267 PMCID: PMC5516245 DOI: 10.1111/1467-9566.12518] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
The telling of birth stories (i.e. stories that describe women's experiences of giving birth) is a common and important social practice. Whereas most research on birth narratives reflects the stories of middle-class, 'adult' women, we examine how the birth stories told by early-age mothers interconnect with broader narratives regarding social stigma and childbearing at 'too early' an age. Drawing on narrative theory, we analyse in-depth interviews with 81 mothers (ages 15-24 years) conducted in Greater Vancouver and Prince George, Canada, in 2014-15. Their accounts of giving birth reveal the central importance of birth narratives in their identity formation as young mothers. Participants' narratives illuminated the complex interactions among identity formation, social expectations, and negotiations of social and physical spaces as they narrated their experiences of labour and birth. Through the use of narrative inquiry, we examine the ways in which re-telling the experience of giving birth serves to situate young mothers in relation to their past and future selves. These personal stories are also told in relation to a meta-narrative regarding social stigma faced by 'teenage' mothers, as well as the public's 'gaze' on motherhood in general - even within the labour and delivery room.
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Affiliation(s)
- Anna Carson
- School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
| | - Cathy Chabot
- School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
| | - Devon Greyson
- School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
- Child and Family Research InstituteVancouverBritish ColumbiaCanada
| | - Kate Shannon
- School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
- British Columbia Centre for Excellence in HIV/AIDSGender and Sexual Health InitiativeVancouverBritish ColumbiaCanada
| | - Putu Duff
- British Columbia Centre for Excellence in HIV/AIDSGender and Sexual Health InitiativeVancouverBritish ColumbiaCanada
- University of New South Wales Faculty of MedicineKirby InstituteSydneyAustralia
| | - Jean Shoveller
- School of Population and Public HealthUniversity of British ColumbiaVancouverCanada
- British Columbia Centre for Excellence in HIV/AIDSGender and Sexual Health InitiativeVancouverBritish ColumbiaCanada
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18
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Reibel T, Wyndow P, Walker R. From Consultation to Application: Practical Solutions for Improving Maternal and Neonatal Outcomes for Adolescent Aboriginal Mothers at a Local Level. Healthcare (Basel) 2016; 4:E90. [PMID: 27929416 PMCID: PMC5198132 DOI: 10.3390/healthcare4040090] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Revised: 11/16/2016] [Accepted: 11/30/2016] [Indexed: 11/16/2022] Open
Abstract
Adolescent pregnancy has been typically linked to a range of adverse outcomes for mother and child. In Australia, Aboriginal and Torres Strait Islander women have a higher proportion of adolescent births compared with other adolescent Australian women, and are at greater risk of poorer psychosocial and clinical outcomes if they are not well supported during pregnancy and beyond. Drawing on existing literature and consultations with young Aboriginal women and health professionals supporting pregnant Aboriginal women in Western Australia, this paper discusses the importance of creating models of antenatal care using a "social determinants of health" framework. Destigmatizing young parenthood and providing continuity of caregiver in culturally safe services, with culturally competent health professionals provides a means to encourage engagement with the health system and improve health outcomes for young mothers and their babies.
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Affiliation(s)
- Tracy Reibel
- Telethon Kids Institute, University of Western Australia, Nedlands 6009, Australia.
| | - Paula Wyndow
- Telethon Kids Institute, University of Western Australia, Nedlands 6009, Australia.
| | - Roz Walker
- Telethon Kids Institute, University of Western Australia, Nedlands 6009, Australia.
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McPeak KE, Sandrock D, Spector ND, Pattishall AE. Important determinants of newborn health: postpartum depression, teen parenting, and breast-feeding. Curr Opin Pediatr 2015; 27:138-44. [PMID: 25564189 DOI: 10.1097/mop.0000000000000185] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
PURPOSE OF REVIEW The present article addresses recent research related to three important determinants of newborn health: postpartum depression, teenage parents and their offspring, and breast-feeding. RECENT FINDINGS Postpartum depression can impact the entire family unit, and fathers may be affected more than previously recognized. Teenage mothers and their infants are at risk of a number of poor physical and mental health outcomes. New research continues to support the benefits of breast-feeding infants, and hospitals have adopted policies to improve breast-feeding rates. SUMMARY Recognizing both maternal and paternal depression during outpatient visits is key to family well-being, as well as to infant development and attachment. Pediatric providers should address the unique emotional, socioeconomic, educational, and health needs of teen mothers. Hospital implementation of evidence-based policies may increase the number of mothers who are successful in establishing breast-feeding, and pediatric healthcare providers should be prepared to support mothers of breast-feeding infants.
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Affiliation(s)
- Katie E McPeak
- aDepartment of Pediatrics, Drexel University College of Medicine, St. Christopher's Hospital for Children, Philadelphia, Pennsylvania bDepartment of Pediatrics, Division of Emergency Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
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