Do empowerment strategies facilitate knowledge and behavioral change? The impact of family health advocacy on health outcomes

Parent Experiences of Empowerment: Understanding the Role of Parent Empowerment in Child Health Promotion

BACKGROUND

Establishing healthy behaviors during a child's first 5 years is essential for healthy growth. Parents are targeted as agents of change because they serve as primary models of behavior during this period. Although parent-focused interventions often target empowerment as a driver of change, our understanding of how parents experience the process of empowerment in the context of child health promotion remains limited.

OBJECTIVE

This qualitative study explored the process by which parents gain empowerment through participation in a health promotion intervention.

METHODS

Semi-structured interviews were conducted with 37 low-income parents who participated in Parents Connect for Healthy Living (PConnect), a 10-week empowerment-centered obesity prevention intervention. Data were analyzed using inductive-deductive thematic analysis and guided by empowerment theories.

RESULTS

Most parents were Hispanic/Latino (41%) and female (97%). Five themes emerged that correspond to the process by which parents gained empowerment: (1) friendships formed and relationships strengthened during PConnect, (2) parents strengthened relationships with their children and believed in their ability to parent successfully, (3) the experience of knowledge led to behavior change, (4) parents used new resources to improve family health, and (5) parents took action.

CONCLUSION

Empowerment theory should be a component of health promotion programs.

Exploring a theory of change: Are increases in parental empowerment associated with healthier weight-related parenting practices?

INTRODUCTION

Parent health-related empowerment is defined as the process by which parents realize control over their life situation and take action to promote a healthier lifestyle. For decades, researchers have described the theoretical potential of empowerment in health promotion efforts, though few have empirically examined this hypothesized relationship. This study is one of the first to examine the relationship between parental empowerment and healthy weight parenting practices (i.e., food, physical activity, sleep, and media parenting), as a mechanism for early childhood health promotion in community settings.

METHODS

Low-income parents of preschool-aged children attending Head Start in Greater Boston between fall 2017 and spring 2019 were invited to complete a survey in the fall and spring of each academic school year (n = 578 with two surveys and n = 45 with four). Parental empowerment and healthy weight parenting practices were assessed using validated surveys. We used a multilevel difference-in-difference approach to estimate changes in healthy weight parenting practices score by changes in parental empowerment score.

RESULTS

Out of a possible score of four, the unadjusted mean (SD) score in fall was 3.20 (0.40) for empowerment and 3.01 (0.40) for parenting. An increase in parental empowerment was associated with an increase in healthier parenting practices (b = 0.14; 95% CI = 0.08, 0.20; p < 0.0001).

CONCLUSIONS

Parent empowerment may be an important target in interventions to prevent obesity in low-income children.

Effects of Birth Control Empowerment Program for Married Immigrant Vietnamese Women in South Korea

PURPOSE

Aims of the researchers were to develop an birth control empowerment program (BCEP) designed to help married immigrant women in Korea to plan their pregnancies.

METHODS

This study was as a randomized controlled trial to verify the effects of the BCEP. The BCEP was developed based on Falk-Rafael (2001)'s Empowerment caring model. The program was offered once a week, for 90 minutes per session, for a total of 10 weeks. The BCEP incorporated group instruction, group discussion, and counseling. The eligible participants were randomly assigned to either experimental group (n=23) or control group (n=23).

RESULTS

Participants in the intervention group had significantly better outcomes in contraceptive knowledge (p<.001), contraceptive self-efficacy (p=.014), perceived contraceptive control (p<.001), sex-related spousal communication (p<.001), and sexual autonomy (p=.009).

CONCLUSION

The BCEP was effective intervention method, which can promote family planning practices among married immigrant women.

Development of an evidence-based decision pathway for vestibular schwannoma treatment options

OBJECTIVE

To integrate multiple sources of clinical information with patient feedback to build evidence-based decision support model to facilitate treatment selection for patients suffering from vestibular schwannomas (VS).

METHODS

This was a mixed methods study utilizing focus group and survey methodology to solicit feedback on factors important for making treatment decisions among patients. Two 90-minute focus groups were conducted by an experienced facilitator. Previously diagnosed VS patients were recruited by clinical investigators at the University of Pittsburgh Medical Center (UPMC). Classical content analysis was used for focus group data analysis. Providers were recruited from practices within the UPMC system and were surveyed using Delphi methods. This information can provide a basis for multi-criteria decision analysis (MCDA) framework to develop a treatment decision support system for patients with VS.

RESULTS

Eight themes were derived from these data (focus group + surveys): doctor/health care system, side effects, effectiveness of treatment, anxiety, mortality, family/other people, quality of life, and post-operative symptoms. These data, as well as feedback from physicians were utilized in building a multi-criteria decision model.

DISCUSSION

The study illustrated steps involved in the development of a decision support model that integrates evidence-based data and patient values to select treatment alternatives.

CONCLUSIONS

Studies focusing on the actual development of the decision support technology for this group of patients are needed, as decisions are highly multifactorial. Such tools have the potential to improve decision making for complex medical problems with alternate treatment pathways.

A systematic review on empowerment for healthy nutrition in health promotion

Objective

The present review aimed to identify and synthesize studies that used an empowerment approach within the field of healthy nutrition.

Design

A systematic review was conducted. Studies were identified by database searching (PubMed, PsycINFO, Web of Science and Psyndex). Searching, selecting and reporting were done according to the PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) Statement.

Setting

Health promotion including the subject of healthy nutrition.

Subjects

Individuals from non-clinical populations.

Results

A total of 1226 studies were screened for eligibility, eight studies were finally included. Three studies used the empowerment approach within a qualitative research paradigm and five studies within (quasi-) experimental intervention studies. Heterogeneity in settings, samples and evaluation methods was high. Most studies referred to the key message of empowerment, i.e. taking control over one’s own life. However, the ways in which this key message was implemented in the interventions differed considerably.

Conclusions

The number of studies included was very low. Furthermore, most studies had some limitations in terms of reporting how the empowerment approach was actually applied. The empowerment approach still seems to be unfamiliar within the field of healthy nutrition.