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Fredrickson ME, Dragovich R, Boyle J, Cober MP, King CA, Gothard MD, Ballard L. Pharmacy faculty expectations of and experiences with parental leave: A cross-sectional exploratory study. CURRENTS IN PHARMACY TEACHING & LEARNING 2024; 16:102118. [PMID: 38901265 DOI: 10.1016/j.cptl.2024.102118] [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: 01/17/2024] [Revised: 05/10/2024] [Accepted: 05/29/2024] [Indexed: 06/22/2024]
Abstract
INTRODUCTION Parental leave policies have the potential to adversely impact faculty well-being and retention if not designed and deployed in a beneficial manner. This exploratory study aims to determine the perceptions of and experiences with parental leave for faculty at pharmacy institutions. METHODS An exploratory, cross-sectional survey was sent to pharmacy school deans to distribute to faculty. The survey obtained demographic information and asked questions pertaining to parental leave experiences and expectations, including workload coverage and the perceived impact on performance evaluations. Comments regarding ideal parental leave were qualitatively summarized. RESULTS Fifty-five respondents who had taken parental leave completed the survey, and 51 free text responses were received. A large effect size for the association between academic rank and planned timing of leave and a larger than medium effect size for the association with gender identity was identified. CONCLUSION The availability, duration, and requirements of parental leave at pharmacy institutions have the potential to negatively impact faculty well-being and retention. This exploratory study provides initial insight into pharmacy faculty's experiences with and expectations of parental leave. Further research is needed to examine this issue on a broader scale and corroborate these findings.
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Affiliation(s)
- Mary E Fredrickson
- Northeast Ohio Medical University College of Pharmacy, Rootstown, OH, United States of America.
| | - Rachel Dragovich
- Northeast Ohio Medical University, College of Pharmacy, 4209 State Rt 44, Rootstown, OH 44272, United States of America.
| | - Jaclyn Boyle
- Northeast Ohio Medical University, College of Pharmacy, 4209 State Rt 44, Rootstown, OH 44272, United States of America.
| | - M Petrea Cober
- Northeast Ohio Medical University, College of Pharmacy, 4209 State Rt 44, Rootstown, OH 44272, United States of America.
| | - Cynthia A King
- Northeast Ohio Medical University, College of Pharmacy, 4209 State Rt 44, Rootstown, OH 44272, United States of America.
| | - M David Gothard
- Biostats, Inc, 501 Wood Street North, East Canton, OH 44730, United States of America
| | - Lisa Ballard
- Northeast Ohio Medical University College of Pharmacy, Rootstown, OH, United States of America
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2
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Wang G, Hamad R, White JS. Advances in Difference-in-differences Methods for Policy Evaluation Research. Epidemiology 2024; 35:628-637. [PMID: 38968376 PMCID: PMC11305929 DOI: 10.1097/ede.0000000000001755] [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: 09/25/2023] [Accepted: 05/21/2024] [Indexed: 07/07/2024]
Abstract
Difference-in-differences (DiD) is a powerful, quasi-experimental research design widely used in longitudinal policy evaluations with health outcomes. However, DiD designs face several challenges to ensuring reliable causal inference, such as when policy settings are more complex. Recent economics literature has revealed that DiD estimators may exhibit bias when heterogeneous treatment effects, a common consequence of staggered policy implementation, are present. To deepen our understanding of these advancements in epidemiology, in this methodologic primer, we start by presenting an overview of DiD methods. We then summarize fundamental problems associated with DiD designs with heterogeneous treatment effects and provide guidance on recently proposed heterogeneity-robust DiD estimators, which are increasingly being implemented by epidemiologists. We also extend the discussion to violations of the parallel trends assumption, which has received less attention. Last, we present results from a simulation study that compares the performance of several DiD estimators under different scenarios to enhance understanding and application of these methods.
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Affiliation(s)
- Guangyi Wang
- From the Philip R. Lee Institute for Health Policy Studies, University of California San Francisco (UCSF), San Francisco, CA
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Rita Hamad
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA
| | - Justin S White
- From the Philip R. Lee Institute for Health Policy Studies, University of California San Francisco (UCSF), San Francisco, CA
- Department of Health Law, Policy & Management, Boston University, Boston, MA
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3
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Ahrens KA, Janevic T, Strumpf EC, Nandi A, Ortiz JR, Hutcheon JA. Paid Family Leave and Prevention of Acute Respiratory Infections in Young Infants. JAMA Pediatr 2024:2822790. [PMID: 39186259 PMCID: PMC11348083 DOI: 10.1001/jamapediatrics.2024.3184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 05/26/2024] [Indexed: 08/27/2024]
Abstract
Importance Acute respiratory tract infections are the leading cause of emergency department visits and hospitalizations in US children, with highest risks in the first 2 months after birth. Out-of-home childcare settings increase the spread of respiratory tract infections. The study team hypothesized that access to state-paid family leave could reduce acute care encounters (hospital admissions or emergency department visits) for respiratory tract infections in young infants by reducing out-of-home childcare transmissions. Objective To determine if the 2018 introduction of paid family leave in New York state reduced acute care encounters for respiratory tract infections in infants 8 weeks or younger. Design, Setting, and Participants This population-based study of acute care encounters took place in New York state and New England control states (Maine, Massachusetts, New Hampshire, Vermont) from October 2015 through February 2020. Participants included infants aged 8 weeks or younger. Controlled time series analysis using Poisson regression was used to estimate the impact of paid family leave on acute care encounters for respiratory tract infections, comparing observed counts during respiratory virus season (October through March) with those predicted in the absence of the policy. Acute care encounters for respiratory tract infections in 1-year-olds (who would not be expected to benefit as directly from the policy) were modeled as a placebo test. Intervention New York State Paid Family Leave policy, introduced on January 1, 2018, providing 8 weeks of paid leave for eligible parents. Main Outcomes and Measures Emergency department visits or hospitalizations with International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD) codes for upper or lower respiratory tract infections or associated symptoms (ie, fever, cough), excluding newborn hospitalizations. The secondary outcome was acute care encounters for respiratory syncytial virus (RSV) bronchiolitis. Results There were 52 943 acute care encounters for respiratory infection among infants 8 weeks or younger. There were 15 932 encounters that were hospitalizations (30%) and 33 304 of the encounters were paid for by Medicaid (63%). Encounters were 18% lower than predicted (relative percentage change = -17.9; 95% CI, -20.3 to -15.7) after the introduction of paid family leave. RSV encounters were 27.0% lower (95% CI, -30.9 to -23.5) than predicted. Similar reductions were not observed in 1-year-olds (relative percentage change = -1.5; 95% CI, -2.5 to -0.6). Conclusions New York state's paid family leave policy was associated with reduced acute care encounters for respiratory tract infections in young infants. These findings may be useful for informing implementation of paid family leave federally and in the states that have not enacted paid family leave policies.
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Affiliation(s)
- Katherine A. Ahrens
- Muskie School of Public Service, University of Southern Maine, Portland, Maine
| | - Teresa Janevic
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York
| | - Erin C. Strumpf
- Department of Economics and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada
| | - Arijit Nandi
- Department of Equity, Ethics, and Policy and Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Québec, Canada
| | - Justin R. Ortiz
- Center for Vaccine Development and Global Health, University of Maryland School of Medicine, Baltimore, Maryland
| | - Jennifer A. Hutcheon
- Department of Obstetrics & Gynaecology, University of British Columbia, Vancouver, British Columbia, Canada
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Xiao G, Wang H, Hu J, Zhao Z, Li Q, Qin C. Prevalence of antenatal depression and postpartum depression among Chinese fathers: A systematic review and meta-analysis. Heliyon 2024; 10:e35089. [PMID: 39170297 PMCID: PMC11336420 DOI: 10.1016/j.heliyon.2024.e35089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/17/2024] [Accepted: 07/23/2024] [Indexed: 08/23/2024] Open
Abstract
Background Paternal antenatal depression and postpartum depression are associated with adverse health outcomes in mothers and infants; however, their prevalence among Chinese fathers remains controversial. This meta-analysis aimed to summarize the prevalence of antenatal depression and postpartum depression in Chinese fathers. Methods We conducted a systematic meta-analysis on the prevalence of antenatal depression and postpartum depression among Chinese fathers by searching 11 databases. Pooled estimates and 95 % confidence intervals were calculated. The choice between a random-effects model and a fixed-effects model was based on an assessment of heterogeneity among the studies as well as assumptions regarding the similarity of the studies in terms of clinical characteristics, quality, design, and conduct. Subgroup and meta-regression analyses were conducted based on the scale used to measure antenatal depression and postpartum depression, the region where the study was completed, the time of the study, the study design, the number of children, publication language, the study site, and quality assessment. Results This meta-analysis included 28 studies with 8795 participants. The prevalence of antenatal depression among Chinese fathers was 11 % (95 % CI: 5%-17 %, P < 0.01) using a random-effects model. Heterogeneity was I2 = 91 %. Publication language moderated the prevalence of paternal antenatal depression (the amount of heterogeneity accounted for was 92.13 %). The prevalence of postpartum depression among Chinese fathers was 16 % (95 % CI: 13%-18 %, P < 0.01), using a random-effects model. The heterogeneity was I2 = 94 %. The prevalence of paternal postpartum depression was moderated by the scale used to measure postpartum depression (39.17 % heterogeneity) and the region where the study was completed (33.15 % heterogeneity). Moreover, Egger's test (t = 4.542, P < 0.001) indicated publication bias in studies on postpartum depression among Chinese fathers. However, after applying the trimming correction, the pooled prevalence of postpartum depression had a P value of <0.05, indicating that despite the publication bias, the results remain reliable and unaffected in terms of effect size. Conclusion The prevalence of antenatal depression and postpartum depression among Chinese fathers was similar to those reported in low- and middle-income countries. Fathers should receive regular screening, effective prevention, and appropriate treatment. However, interpreting these results requires consideration of the limitations of the study.
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Affiliation(s)
- Gui Xiao
- Health Management Medicine Center and nursing department, The Third Xiangya Hospital, Central South University, Changsha, China
- School of Xiangya Nursing, Central South University, Changsha, China
| | - Hu Wang
- Emergency Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jiaji Hu
- School of Xiangya Nursing, Central South University, Changsha, China
| | - Ziran Zhao
- International Nursing School, Hainan Medical University, Haikou, China
| | - Qiyu Li
- The School of Xiangya Medicine, Central South University, Changsha, China
| | - Chunxiang Qin
- Health Management Medicine Center and nursing department, The Third Xiangya Hospital, Central South University, Changsha, China
- School of Xiangya Nursing, Central South University, Changsha, China
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Pathak A, Musa A, Johnson SC, Berryhill B, Dillon L, Weinberger JJ, Harb A, Harvill M, Altinok G. Take Your Leave: Our Recommendation for an Inclusive and Equitable Parental Leave Policy in Diagnostic and Interventional Radiology Residency. J Am Coll Radiol 2024:S1546-1440(24)00689-6. [PMID: 39134105 DOI: 10.1016/j.jacr.2024.07.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 07/21/2024] [Accepted: 07/30/2024] [Indexed: 09/02/2024]
Affiliation(s)
- Avani Pathak
- Medical Student, Michigan State University College of Osteopathic Medicine, East Lansing, Michigan.
| | - Arif Musa
- Diagnostic Radiology Resident, Department of Radiology, Detroit Medical Center, Detroit, Michigan. https://twitter.com/ArifMusaMD
| | - Samuel C Johnson
- Department Chair, Department of Radiology, Detroit Medical Center, Detroit, Michigan
| | - Brigitte Berryhill
- Diagnostic Radiology Residency Associate Program Director, Department of Radiology, Detroit Medical Center, Detroit, Michigan. https://twitter.com/brigitte34888
| | - Lisa Dillon
- Assistant Designated Institutional Official, Office of Graduate Medical Education, Detroit Medical Center, Detroit, Michigan
| | - Jarrett J Weinberger
- Designated Institutional Official, Office of Graduate Medical Education, Detroit Medical Center, Detroit, Michigan
| | - Ali Harb
- Early Specialization in Interventional Radiology Program Director and Former Diagnostic Radiology Program Director, Department of Radiology, Detroit Medical Center, Detroit, Michigan
| | - Monte Harvill
- Former Early Specialization in Interventional Radiology Program Director, Department of Radiology, Detroit Medical Center, Detroit, Michigan
| | - Gulcin Altinok
- Diagnostic Radiology Residency Program Director, Department of Radiology, Detroit Medical Center, Detroit, Michigan. https://twitter.com/altinokgulcin
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Zhang H, Yang Y, Sun S. It is not a vacation of leisure: The effect of maternity-leave stigma on fertility intentions in China. Acta Psychol (Amst) 2024; 248:104413. [PMID: 39025029 DOI: 10.1016/j.actpsy.2024.104413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2024] [Revised: 06/20/2024] [Accepted: 07/15/2024] [Indexed: 07/20/2024] Open
Abstract
In response to the public's puzzle about why maternity leave has unexpectedly failed to improve fertility problem in the Chinese context of a widespread extension of maternity leave, our study concentrates on a prevailing stigmatization phenomenon of maternity leave in the workplace, proposes the construct "maternity-leave stigma", operationalizes it, and examines its probable detrimental effect on working individuals' fertility intentions drawing on conservation of resources theory, self-verification theory, and research on stigma and psychological contract violation. Conceptually, maternity-leave stigma is a kind of workplace stigma that primarily depicts the extent to which working individuals in the reproductive period view maternity leave or the event of taking maternity leave in a biased way. It mainly consists of four subdimensions called cognitive stigma, emotional stigma, moral stigma, and consequence stigma. Based on multiple analyses of the three-stage questionnaire survey data from working individuals of childbearing age in China, Study 1 (N1 = 296, N2 = 340) acquires a 12-item maternity-leave stigma scale with good reliability and validity and Study 2 (N2 = 340) substantiates that, working individuals' maternity-leave stigma tends to directly and indirectly inhibit their fertility intentions and their anticipatory psychological contract violation from organization is the crucial mediator. Moreover, working women are inclined to display a much stronger inhibiting effect of maternity-leave stigma on fertility intentions compared to working men. Our findings therefore resolve the public's puzzle, enrich workplace stigma, deepen the implementation effectiveness research of maternity leave policy, and are of practical implications for building a fertility-friendly society.
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Affiliation(s)
- Haiyan Zhang
- Business School, Jiangsu Normal University, Xuzhou, China.
| | - Yang Yang
- Business School, Jiangsu Normal University, Xuzhou, China
| | - Shuwei Sun
- School of Mathematics and Statistics, Xuzhou University of Technology, Xuzhou, China
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7
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Pardo C, Watson B, Pinkhasov O, Afable A. Social determinants of perinatal mental health. Semin Perinatol 2024:151946. [PMID: 39174405 DOI: 10.1016/j.semperi.2024.151946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/24/2024]
Abstract
Social inequities and mental health are public health and medical conditions that are inextricably linked. Perinatal mental health is influenced by social, physical, and biological factors, with additional stressors related to pregnancy. The social determinants of health (SDOH) encompasses all conditions in which people live and grow, inclusive of cultural norms that reflect the diverse populations we serve. To best understand the mechanisms by which the SDOH affects perinatal mental health, we introduce the Urban Stress Model and describe the link between urban realities to stress response and potential mechanisms that link urban living to increased risk of adverse perinatal mental health. Given the increased diversity of patient populations, cultural considerations are paramount in understanding the utility and best practices in screening and interventions among ethnically diverse communities. Building on our Urban Stress Model and a structural determinants of health framework, we present examples of interventions to address the social inequities of perinatal mental health from the policy to community levels.
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Affiliation(s)
- Christina Pardo
- Department of Obstetrics and Gynecology, Weill Cornell Medicine, New York, NY, USA.
| | - Breanna Watson
- School of Public Health, Downstate Health Sciences University, Brooklyn NY, USA
| | - Olga Pinkhasov
- College of Medicine, Downstate Health Sciences University, Brooklyn NY, USA
| | - Aimee Afable
- School of Public Health, Downstate Health Sciences University, Brooklyn NY, USA
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8
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Dumet LM, Dow WH, Karasek D, Franck LS, Goodman JM. Barriers to Accessing Paid Parental Leave Among Birthing Parents With Perinatal Health Complications: A Multiple-Methods Study. Womens Health Issues 2024; 34:331-339. [PMID: 38570240 PMCID: PMC11297688 DOI: 10.1016/j.whi.2024.02.002] [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: 03/25/2023] [Revised: 02/05/2024] [Accepted: 02/23/2024] [Indexed: 04/05/2024]
Abstract
INTRODUCTION Even in the small number of U.S. states with paid parental leave (PPL) programs, studies have found awareness of PPL remains low and unevenly distributed among parents. Moreover, little is known about whether parents with perinatal health complications have unmet needs in obtaining information about and support for accessing parental leave during that time. This study aims to address this research gap. Given the strong evidence linking paid leave with improvements in maternal and infant health, it is critical to evaluate access among vulnerable populations. METHODS We used a multiple methods approach, including a subset of the 2016-2017 Bay Area Parental Leave Survey of Mothers (analytic sample = 1,007) and interview data from mothers who stayed at a neonatal intensive care unit in 2019 (n = 7). All participants resided at that time in California, a state that offers PPL. The independent variable for the survey analysis was a composite measure of perinatal complications, quantified as binary with a value of 1 if respondents reported experiencing any of the four complications: poor maternal mental health during or after pregnancy, premature birth, or poor infant health. Dependent variables for the survey analysis measured lack of support or information for accessing PPL. We used linear probability models to assess the relationship between perinatal complications and PPL support. Thematic analysis was conducted with the interview data to understand how perinatal complications shape the process of accessing PPL. RESULTS Survey results revealed that parents with perinatal complications had a lower understanding of PPL benefits and low overall support for accessing leave, including from employers, compared with parents without perinatal complications. From interviews, we learned that perinatal complications present unique challenges to parents navigating PPL. There were multiple entities involved in managing leave and providing information, such as the benefits coordinator and employers. Supervisors were reported as providers of critical emotional and financial support. CONCLUSIONS Taken together, the findings from surveys and interviews suggest that health care and human resources personnel should be better equipped to provide information and support, particularly to those who experience perinatal complications and might struggle to complete paperwork while facing health challenges.
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Affiliation(s)
- Lisset M Dumet
- Oregon Health & Science University - Portland State University School of Public Health, Portland, Oregon.
| | - William H Dow
- School of Public Health, University of California, Berkeley, Berkeley, California
| | - Deborah Karasek
- Oregon Health & Science University - Portland State University School of Public Health, Portland, Oregon; Department of Obstetrics, Gynecology, & Reproductive Sciences, University of California, San Francisco, San Francisco, California; California Preterm Birth Initiative, University of California, San Francisco, San Francisco, California
| | - Linda S Franck
- California Preterm Birth Initiative, University of California, San Francisco, San Francisco, California; School of Nursing, University of California, San Francisco, San Francisco, California
| | - Julia M Goodman
- Oregon Health & Science University - Portland State University School of Public Health, Portland, Oregon
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9
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Lall MD, Jayaprakash N, Carrick A, Chang BP, Himelfarb NT, Thomas Y, Wong ML, Dobiesz V, Raukar NP. Consensus-Driven Recommendations to Support Physician Pregnancy, Adoption, Surrogacy, Parental Leave, and Lactation in Emergency Medicine. Ann Emerg Med 2024; 83:585-597. [PMID: 38639673 DOI: 10.1016/j.annemergmed.2024.03.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 02/17/2024] [Accepted: 03/11/2024] [Indexed: 04/20/2024]
Abstract
The emergency department clinical environment is unique, and guidelines for promoting supportive and equitable workplace cultures ensure success and longevity for pregnant persons and parents in emergency medicine. There is paucity, variability, and dissatisfaction with current parental (historically referred to as maternity and paternity) leave policies. This paper describes the development of consensus-derived recommendations to serve as a framework for emergency departments across the country for incorporating family-friendly policies. Policies that foster a family-inclusive workplace by allowing for professional advancement without sacrificing personal values regardless of sex, gender, and gender identity are critical for emergency medicine recruitment and retention.
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Affiliation(s)
- Michelle D Lall
- Department of Emergency Medicine, Emory University School of Medicine, Atlanta, GA.
| | - Namita Jayaprakash
- Department of Emergency Medicine, Division of Pulmonary and Critical Care Medicine, Henry Ford Hospital, Detroit, MI
| | - Angela Carrick
- Kansas College of Osteopathic Medicine, Wichita, KS; Department of Emergency Medicine, Hutchison Regional Medical Center, Hutchison, KS
| | - Bernard P Chang
- Department of Emergency Medicine, Columbia University Irving Medical Center, New York, NY
| | - Nadine T Himelfarb
- Department of Emergency Medicine, The Warren Alpert Medical School of Brown University, Providence, RI
| | - Ynhi Thomas
- Henry J.N. Taub Department of Emergency Medicine, Baylor College of Medicine, Houston, TX
| | - Matthew L Wong
- Department of Emergency Medicine, Lewis Katz School of Medicine at Temple University, Philadelphia, PA
| | - Valerie Dobiesz
- Department of Emergency Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Neha P Raukar
- Department of Emergency Medicine, Mayo Clinic Alix School of Medicine, Rochester, MN
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10
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Fredrickson ME, Dragovich R, Boyle J, Cober MP, King CA. A call to uncover the availability, structure, and effects of parental leave policies at academic pharmacy institutions. CURRENTS IN PHARMACY TEACHING & LEARNING 2024; 16:389-391. [PMID: 38521625 DOI: 10.1016/j.cptl.2024.03.011] [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: 01/17/2024] [Revised: 02/20/2024] [Accepted: 03/19/2024] [Indexed: 03/25/2024]
Abstract
Parental leave is often an initial barrier to achieving family-career integration, and thus discussing this issue within the broader academic pharmacy community may have important implications for policy development and change. This commentary aims to reveal the implications of inadequate parental leave policies on faculty while highlighting the benefits well-developed policies can have for both parents and their children. Additionally, we put forth a call to action for additional research into the availability and structure of parental leave policies at pharmacy institutions and the effects such policies have on faculty wellbeing, retention, and job satisfaction.
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Affiliation(s)
- Mary E Fredrickson
- Pharmacy Practice and Pharmaceutical Sciences, Northeast Ohio Medical University College of Pharmacy, Rootstown, OH, United States of America.
| | - Rachel Dragovich
- Pharmacy Practice, Northeast Ohio Medical University, College of Pharmacy, 4209 State Rt 44, Rootstown, OH 44272, United States of America.
| | - Jaclyn Boyle
- Pharmacy Practice, Northeast Ohio Medical University, College of Pharmacy, 4209 State Rt 44, Rootstown, OH 44272, United States of America.
| | - M Petrea Cober
- Pharmacy Practice, Northeast Ohio Medical University, College of Pharmacy, 4209 State Rt 44, Rootstown, OH 44272, United States of America.
| | - Cynthia A King
- Pharmacy Practice, Northeast Ohio Medical University, College of Pharmacy, 4209 State Rt 44, Rootstown, OH 44272, United States of America.
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11
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Kim JL, Forster CS, Allan JM, Schondelmeyer A, Ruch-Ross H, Barone L, Fromme HB. Gender and work-life balance: Results of a national survey of pediatric hospitalists. J Hosp Med 2024. [PMID: 38800852 DOI: 10.1002/jhm.13413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Revised: 04/22/2024] [Accepted: 04/25/2024] [Indexed: 05/29/2024]
Abstract
In medicine, difficulty integrating work and home can lead to decreased job satisfaction, diminished well-being, and increased turnover. Understanding the experience of pediatric hospitalists can provide insights into building a stable, long-term workforce. We aim to examine gender differences in work-life balance and parental leave for physicians practicing Pediatric Hospital Medicine. METHODS This was a cross-sectional survey study of 1096 pediatric hospitalists. Responses were collected via an online survey platform and summarized using descriptive statistics, including frequency distributions and measures of central tendency. A multivariable logistic regression was used to examine associated variables and work-life balance satisfaction. We analyzed free responses on parental leave to provide nuance to quantitative survey data. RESULTS Five hundred and sixty-five respondents (52% response rate) completed the survey with 71% women. 343 (62%) prioritize work-life balance in career decision-making. Women report taking on more household responsibilities than their partners (41.4% vs. 8.4%; p < .001) including a larger percentage of caregiving and domestic tasks. Female gender and performing <50% caregiving were associated with decreased work-life balance satisfaction; performing <50% domestic tasks increased satisfaction. Median parental leaves were 4 weeks, with men taking significantly shorter leaves (3.5 vs. 6 weeks; p < .001) and more "paid back" time off. CONCLUSION Work-life balance is an important factor in career decisions for men and women. Women perceive carrying a larger load at home. Qualitative results suggest that parental leave may be inadequate in length and salary support for men and women. This study adds insights into work-life integration in PHM.
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Affiliation(s)
- Juliann L Kim
- Department of Pediatrics, Pediatric Hospital Medicine, Palo Alto Medical Foundation, Palo Alto, California, USA
| | - Catherine S Forster
- Department of Pediatrics, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Jessica M Allan
- Department of Pediatrics, Pediatric Hospital Medicine, Palo Alto Medical Foundation, Palo Alto, California, USA
| | - Amanda Schondelmeyer
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Holly Ruch-Ross
- Department of Primary Care and Subspecialty Pediatrics, American Academy of Pediatrics, Itasca, Illinois, USA
| | - Lauren Barone
- Department of Primary Care and Subspecialty Pediatrics, American Academy of Pediatrics, Itasca, Illinois, USA
| | - H Barrett Fromme
- Department of Pediatrics, The University of Chicago Pritzker School of Medicine, Chicago, Illinois, USA
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12
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Raub A, Heymann J. Workplace rights around pregnancy and childbirth. BMJ 2024; 385:q1050. [PMID: 38754912 DOI: 10.1136/bmj.q1050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/18/2024]
Affiliation(s)
- Amy Raub
- WORLD Policy Analysis Center, University of California Los Angeles, Los Angeles, CA, USA
| | - Jody Heymann
- WORLD Policy Analysis Center, University of California Los Angeles, Los Angeles, CA, USA
- Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
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13
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Zhao J, Zhang M. Postpartum depression and risk factors among working women one year after delivery in Beijing, China: a cross-sectional study. Front Public Health 2024; 12:1346583. [PMID: 38756876 PMCID: PMC11096489 DOI: 10.3389/fpubh.2024.1346583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 04/22/2024] [Indexed: 05/18/2024] Open
Abstract
Background Postpartum depression (PPD) is the most common mental illness affecting women after childbirth, and working mothers may be faced with unique challenges. This study aimed to examine the depression status among working postpartum women in 1 year of childbirth and explore the relationship between occupational factors and PPD in urban Beijing, China. Methods A cross-sectional survey of 554 postpartum women was conducted among ten community health service centers in six urban districts of Beijing, China. Sociodemographic, occupational, childbirth and postpartum information were collected. Depression status was obtained using the Edinburgh Postnatal Depression Scale. Prevalence of postpartum depression (PPD) was assessed in relation to occupational characteristics, and influencing factors were analyzed through logistic regression. Results Of the postpartum women, 29.42% met the criteria for depression. PPD prevalence was significantly higher among women employed in commercial enterprises (39.81%). The analysis of influencing factors showed that age, family or personal monthly income, maternity leave, feeding methods, and postpartum care affected the psychological health of occupational women after childbirth. Conclusion PPD prevalence is notably elevated among women employed in commercial enterprises, and specific risk factors contribute to its occurrence. These findings highlight the need for targeted interventions to address these risk factors and prevent PPD in this population.
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Affiliation(s)
| | - Min Zhang
- School of Population Medicine and Public Health, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
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Sylvetsky AC, Hughes SA, Kuttamperoor JT, Moore HR, Murphy J, Sacheck J, Smith ER. Mothers' Experiences During the 2022 Infant Formula Shortage in Washington D.C. Matern Child Health J 2024; 28:873-886. [PMID: 38147276 PMCID: PMC11001681 DOI: 10.1007/s10995-023-03860-9] [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: 12/11/2023] [Indexed: 12/27/2023]
Abstract
INTRODUCTION An unprecedented shortage of infant formula occurred in the United States (U.S.) in 2022 and posed widespread challenges to infant feeding nationwide. The purpose of this study is to investigate mothers' experiences during the 2022 infant formula shortage and its perceived impacts on infants' diet and health. METHODS Mothers (n = 45) of infants under 8 months old from Washington D.C. were invited to participate in a virtual study meeting during the summer of 2022. Mothers completed surveys regarding their demographics, infants' anthropometrics, infant feeding practices, information they have received about infant feeding, and knowledge about infant feeding practices. They then participated in a qualitative interview about their experiences during the infant formula shortage. RESULTS Overarching themes were: the shortage (1) had adverse impacts on mothers' mental and emotional health; (2) had significant financial and intangible costs; (3) led to changes in infant feeding practices; (4) social and family networks were helpful in navigating the shortage; and (5) mothers felt fortunate to have resources to breastfeed and/or obtain formula. DISCUSSION The infant formula shortage adversely impacted mothers' mental and emotional health, and was costly, in terms of financial and intangible costs. Findings demonstrate the need to develop clinical and policy approaches to support mothers in feeding their infants and provide education about safe infant feeding practices.
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Affiliation(s)
- Allison C Sylvetsky
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, D.C., 20052, USA.
| | - Sarah A Hughes
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, D.C., 20052, USA
| | - Janae T Kuttamperoor
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, D.C., 20052, USA
| | - Hailey R Moore
- Division of Psychology, Children's National Hospital, 111 Michigan Ave NW, Washington, D.C., 20010, USA
| | - Jeanne Murphy
- School of Nursing, The George Washington University, 1919 Pennsylvania Ave. NW, Washington, D.C., 20006, USA
| | - Jennifer Sacheck
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, D.C., 20052, USA
| | - Emily R Smith
- Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, D.C., 20052, USA
- Department of Global Health, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Avenue NW, Washington, D.C., 20052, USA
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15
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Nestander M, Day C, Lucke A, Gautam S, Horowitz E, Bernstein SM, Bhatia A. Workforce Characteristics of Early Career Neonatologists and Comparison of Practice Sites. Am J Perinatol 2024; 41:e1126-e1134. [PMID: 36649732 DOI: 10.1055/s-0042-1760430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Transitioning into the early career physician workforce is a uniquely challenging period in a neonatologist's career. There are limited educational opportunities in fellowship regarding career progression, practice models, and benefits. Understanding these factors are key when searching for employment. This study evaluates the early career neonatologist (ECN) workforce and employment characteristics to improve identification of professional needs. STUDY DESIGN An anonymous 59-question cross-sectional survey was distributed in July 2020 to members of the American Academy of Pediatrics Section on Neonatal Perinatal Medicine Trainees and Early Career Neonatologists (TECaN). The survey instrument was designed using SurveyMonkey and assessed search methods for identifying employers, employment contract details, and professional duties. Questions addressed clinical service time, level of acuity, protected research time, financial compensation, benefits, job search methods, and promotion requirements. Comparisons were drawn between respondents exclusively working in a university-based setting and respondents employed in nonuniversity locations. Responses were collected using SurveyMonkey and then extracted to a Microsoft Excel Workbook for analysis. Statistical analysis was performed using SAS version 9.4. RESULTS Of 1,302 eligible members, 348 people responded (26.7%). Forty-six percent of respondents worked in a university setting and 54% worked in a nonuniversity setting. Using employment site as a discriminator, significant differences were noted in scheduling models. University-located respondents were more likely to work 2-week block schedules, fewer weekend/weeknight call, less clinical weeks per year, and more research/administrative weeks per year. Between university and nonuniversity located positions, benefits were largely comparable, while factors perceived as influential toward promotion varied depending on practice site. CONCLUSION This study provides ECNs with a contemporary workforce description vital to graduating TECaN seeking employment or renegotiating professional obligations. While benefits were largely similar based on practice site, promotion factors and scheduling models may vary depending on location. KEY POINTS · Data specific to informing employment decisions for graduating Trainees and Early Career Neonatologists are limited.. · This study provides benchmarks for evaluating employment opportunities presented to early career neonatologists.. · Practice site can influence promotion factors..
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Affiliation(s)
- Matt Nestander
- Division of Newborn Medicine, Carl R. Darnall Army Medical Center, Fort Hood, Texas
| | - Colby Day
- Department of Pediatrics, University of Rochester Medical Center, Rochester, New York
| | - Ashley Lucke
- Department of Pediatrics, Dell Children's Medical Center, Austin, Texas
| | - Shiva Gautam
- Department of Biostatistics, University of Florida, Jacksonville, Florida
| | - Eric Horowitz
- Division of Neonatology, Boston Children's Hospital, Boston, Massachusetts
| | - Sarah M Bernstein
- Division of Neonatology, The University of Utah, Salt Lake City, Utah
| | - Anisha Bhatia
- Division of Neonatology, Rush University Medical Center, Chicago, Illinois
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Burgess RC, Nyhan K, Dharia N, Freudenberg N, Ransome Y. Characteristics of commercial determinants of health research on corporate activities: A scoping review. PLoS One 2024; 19:e0300699. [PMID: 38669229 PMCID: PMC11051660 DOI: 10.1371/journal.pone.0300699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2023] [Accepted: 03/04/2024] [Indexed: 04/28/2024] Open
Abstract
INTRODUCTION Business practices have influenced human health for centuries, yet an overarching concept to study these activities across nations, time periods, and industries (called 'the commercial determinants of health' (CDH)) has emerged only recently. The purpose of this review was to assess the descriptive characteristics of CDH research and to identify remaining research gaps. METHODS We systematically searched four databases (Scopus, OVID Medline, Ovid Embase, and Ovid Global Health) on Sept 13, 2022 for literature using CDH terms that described corporate activities that have the potential to influence population health and/or health equity (n = 116). We evaluated the following characteristics of the literature: methods employed, industries studied, regions investigated, funders, reported conflicts of interest, and publication in open-access formats. RESULTS The characteristics of the articles included that many were conceptual (50/116 articles; 43%) or used qualitative methods (37; 32%). Only eight articles (7%) used quantitative or mixed methods. The articles most often discussed corporate activities in relation to the food and beverage (51/116; 44%), tobacco (20; 17%), and alcohol industries (19; 16%), with limited research on activities occurring in other industries. Most articles (42/58 articles reporting a regional focus; 72%) focused on corporate activities occurring in high-income regions of the world. CONCLUSIONS Our findings indicate that literature that has used CDH terms and described corporate practices that influence human health has primarily focused on three major industries in higher-income regions of the world. Qualitative methods were the most common empirical method for investigating these activities. CDH-focused investigations of corporate practices conducted by less-studied industries (e.g., social media) and in lower-income regions are recommended. Longitudinal quantitative studies assessing the associations between corporate practices and a range of health outcomes is also a necessary next step for this field.
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Affiliation(s)
- Raquel C. Burgess
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Kate Nyhan
- Harvey Cushing/John Hay Whitney Medical Library, Yale University, New Haven, Connecticut, United States of America
- Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Naisha Dharia
- Bachelor of Health Sciences Program, Faculty of Health Sciences, McMaster University, Hamilton, ON, Canada
| | - Nicholas Freudenberg
- Department of Community Health and Social Sciences, CUNY Graduate School of Public Health & Health Policy, New York City, New York, United States of America
| | - Yusuf Ransome
- Department of Social and Behavioral Sciences, Yale School of Public Health, New Haven, Connecticut, United States of America
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Dossett EC, Stuebe A, Dillion T, Tabb KM. Perinatal Mental Health: The Need For Broader Understanding And Policies That Meet The Challenges. Health Aff (Millwood) 2024; 43:462-469. [PMID: 38560796 DOI: 10.1377/hlthaff.2023.01455] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Perinatal mental health is gaining recognition as a key antecedent of adverse maternal and child outcomes as the United States experiences a maternal mortality and morbidity crisis. Recent policy efforts have attempted to mitigate adverse outcomes through legislation such as the Taskforce Recommending Improvements for Unaddressed Mental Perinatal and Postpartum Health (TRIUMPH) for New Moms Act of 2021 and postpartum coverage through Medicaid expansion. Even with progress, perinatal mental health policy continues to grapple with a basic truth: The United States lacks an overarching health care system capable of meeting the mental health care needs of perinatal people and their families. Moreover, the burden of undiagnosed and untreated perinatal mental health challenges remains greatest among racially minoritized populations, such as Black, Asian, and multiracial people. A broader understanding of perinatal mental health is needed, grounded in the tenets of reproductive justice. From this perspective, we articulate specific policies to meet perinatal mental health challenges and promote thriving for birthing people and their families.
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Affiliation(s)
- Emily C Dossett
- Emily C. Dossett, University of Southern California, Los Angeles, California
| | - Alison Stuebe
- Alison Stuebe, University of North at Carolina Chapel Hill, Chapel Hill, North Carolina
| | | | - Karen M Tabb
- Karen M. Tabb , University of Illinois at Urbana-Champaign, Urbana, Illinois
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18
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McMullen C, Kejner A, Nicolli E, Abouyared M, Coblens O, Fedder K, Thakkar P, Patel R. Parental leave and family building experiences among head and neck surgeons in the United States: Career impact and opportunities for improvement. Head Neck 2024. [PMID: 38511311 DOI: 10.1002/hed.27752] [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: 01/24/2024] [Revised: 03/05/2024] [Accepted: 03/14/2024] [Indexed: 03/22/2024] Open
Abstract
BACKGROUND The availability of paid parental leave is an important factor for retention and wellness. The experiences of head and neck surgeons with parental leave have never been reported. METHODS A survey was electronically distributed to head and neck subspecialty surgeons in the United States. Responses were collected and analyzed. RESULTS Male surgeons had more children and took significantly less parental leave than women. Thirty percent of respondents reported that parental leave negatively impacted compensation, and 14% reported a delay in promotion due to leave, which impacted women more than men. The vast majority reported they are happy or neutral about covering those on leave. Most respondents utilized paid childcare, and approximately one quarter of respondents spending 11%-20% of their income on childcare. CONCLUSIONS This study illuminates the current disparities regarding parental leave-taking within the subspecialty of head and neck surgery in the United States. Women surgeons are more likely to be impacted professionally and financially.
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Affiliation(s)
- Caitlin McMullen
- Department of Head & Neck - Endocrine Oncology, Moffitt Cancer Center, Tampa, Florida, USA
| | - Alexandra Kejner
- Department of Otorhinolaryngology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Elizabeth Nicolli
- Department of Otolaryngology - Head and Neck Surgery, University of Miami, Miami, Florida, USA
| | - Marianne Abouyared
- Department of Otolaryngology - Head and Neck Surgery, UC Davis, Sacramento, California, USA
| | - Orly Coblens
- Department of Otolaryngology - Head and Neck Surgery, University of Texas Medical Branch, Galveston, Texas, USA
| | - Katie Fedder
- Department of Otolaryngology - Head and Neck Surgery, University of Virginia, Charlottesville, Virginia, USA
| | - Punam Thakkar
- Department of Otolaryngology - Head and Neck Surgery, George Washington University, Washington, DC, USA
| | - Rusha Patel
- Division of Otolaryngology - Head and Neck Surgery, University of Oklahoma, Oklahoma City, Oklahoma, USA
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Bush NR. Programming the next generation of prenatal programming of stress research: A review and suggestions for the future of the field. Dev Psychopathol 2024:1-14. [PMID: 38482548 DOI: 10.1017/s0954579424000488] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/10/2024]
Abstract
In this article, I highlight core ideas, empirical findings, and advances in the study of how stress during pregnancy may prenatally program child neurodevelopmental, psychopathological, and health outcomes, emphasizing reviews, metanalyses, and recent contributions of conceptual and empirical work. The article offers a perspective on the history of this area of science, the underrecognized contributions of influential scholars from diverse fields of study, what we know from the evidence to date, the persistent challenges in sorting through what is left to learn, and suggestions for future research. I include sections focused on promoting resilience, pregnancy interventions that demonstrate positive effects across two generations, and the translational implications of the accruing data for practice and policy, highlighting opportunities for integrating across a range of fields and sectors. In the concluding sections, I discuss lessons learned from conducting this work and provide a closing summary of progress and future directions. The goal of this writing was to provide a viewpoint on some ways that emerging intergenerational transmission scholars might responsibly contribute to the future of the field of developmental psychopathology.
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Affiliation(s)
- Nicole R Bush
- Department of Psychiatry and Behavioral Sciences, Center for Health and Community, Department of Pediatrics, Division of Developmental Medicine, University of California, San Francisco, CA, USA
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20
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Buesa J, Lizaran M, Almansa B, Ghosn F, Campos-Berga L, Hervás D, Andreu J, Sierra P, Livianos L, Vento M, Diago V, García-Blanco A. Understanding the course of attention deficit hyperactivity disorder in children born after a threatened preterm labor: a 6-year cohort study. Am J Obstet Gynecol MFM 2024; 6:101289. [PMID: 38280551 DOI: 10.1016/j.ajogmf.2024.101289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/29/2024]
Abstract
BACKGROUND Recent research suggests that children born after suspected preterm labor may observe a potential cluster with different attention deficit hyperactivity disorder features, depending on the time of birth. However, the evolution of symptoms and their predictors remain unknown in this population. OBJECTIVE This study aimed to examine the trajectories of attention deficit hyperactivity disorder symptoms of children born after suspected preterm labor, between ages 2 and 6 years, considering prematurity condition and comparing with controls. In addition, this study aimed to find potential modifiable predictors of evolution to enhance prognosis. STUDY DESIGN In this prospective cohort study, 119 mother-child pairs who experienced suspected preterm labor and 60 controls were included. Patients were divided according to prematurity condition in full term (n=27), late preterm (n=55), and very preterm (n=37). Attention deficit hyperactivity disorder symptoms were assessed at ages 2 and 6 years. The association between potential modifying factors (group, time of assessment, sex, birthweight percentile, maternal history of trauma, maternal anxiety at diagnosis, and maternal anxiety during the children's assessments) and disorder trajectories was assessed by adjusting the Bayesian mixed linear models. All analyses were performed in R (version 4.3.0; R Foundation for Statistical Computing, Vienna, Austria). RESULTS An interaction emerged between time and group, with late-preterm neonates born after suspected preterm labor being the only group to improve from ages 2 to 6 years (-2.26 points in Conners scale per percentile decrease and 0.98 probability of effect). Another interaction between time and maternal anxiety at postnatal time assessments intensified over time (0.07 and 0.84). Predictors of symptom severity included lower weight percentile at birth (-0.2 and 0.96), male sex (-2.99 and <0.99), higher maternal anxiety at diagnosis (+0.08 and 0.99), and maternal history of trauma (+0.23 and 0.98). CONCLUSION Unlike very-preterm and full-term children, those born late preterm showed an improvement over time, probably because late-preterm children do not carry the sequelae derived from severe prematurity but benefit from close monitoring. As maternal psychopathology emerged as a determinant modifier of course and severity, it is crucial to develop targeted psychological interventions for pregnant individuals and reevaluate monitoring programs for their offspring, regardless of prematurity.
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Affiliation(s)
- Julia Buesa
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco)
| | - Marta Lizaran
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Belén Almansa
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Farah Ghosn
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Laura Campos-Berga
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco)
| | - David Hervás
- Department of Applied Statistics, Operations Research, and Quality, Universitat Politècnica de Valencia, Valencia, Spain (Dr Hervás)
| | - Julia Andreu
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco)
| | - Pilar Sierra
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Lorenzo Livianos
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco)
| | - Máximo Vento
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Neonatology Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Vento)
| | - Vicente Diago
- Division of Obstetrics and Gynecology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Diago)
| | - Ana García-Blanco
- Mental Health Research Group, La Fe Health Research Institute, Valencia, Spain (Dr Buesa, Mses Lizaran, Almansa, and Ghosn, Drs Campos-Berga, Andreu, Sierra, Livianos, Vento, and García-Blanco); Division of Psychiatry and Clinical Psychology, La Fe University and Polytechnic Hospital, Valencia, Spain (Dr Buesas, Campos-Berga, Andreu, Sierra, Livianos, and García-Blanco); University of Valencia, Valencia, Spain (Mses Lizaran, Almansa, and Ghosn and Drs Sierra, Livianos, and García-Blanco).
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Herrick MSR, Chai W. Incidence of Postpartum Depression Decreases After Initial Expansion of Military Maternity Leave. Mil Med 2024; 189:e773-e780. [PMID: 37703065 DOI: 10.1093/milmed/usad354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 08/04/2023] [Accepted: 08/25/2023] [Indexed: 09/14/2023] Open
Abstract
INTRODUCTION Postpartum depression impacts 1 in 8 women in the United States. Research has indicated maternity leave duration, and compensation can have an impact on postpartum depression symptoms. The U.S. military increased their maternity leave provision from 6 to 12 weeks in 2016. The aim of this study was to expand upon current literature on the role of maternity leave on postpartum depression by analyzing objective data from 2011 to 2019 utilizing military health records. METHODS All deliveries to active duty women in the Military Health System from 2011 to 2019 were considered for analysis. A total of 60,746 women met inclusion criteria. Active duty women were stratified by year of delivery to identify if they had 6 weeks (2011-2015) or 12 weeks (2016-2019) of maternity leave. International Classification of Disease (ICD)-9 and ICD-10 codes were used for the identification of postpartum depression diagnosis. Logistic regression models were used to assess the association between maternity leave provision and postpartum depression diagnosis adjusting for covariates. RESULTS Overall, 4.8% of the women were diagnosed with postpartum depression. Active duty women who were allotted 12 weeks (2016-2019) of maternity leave had higher odds of postpartum depression diagnosis than those allotted 6 weeks (2011-2015) (12 weeks vs. 6 weeks of leave: odds ratio [OR] = 1.29; 95% confidence interval [CI] = 1.20-1.39, P < 0.0001). However, there was a 50% reduction in odds of postpartum depression during 2016-2017 (the 2 years following the 12-week leave implementation) in comparison to 2011-2015 (OR = 0.50; 95% CI = 0.43-0.57, P < 0.0001). The trends were similar across military branches. Additionally, between 2011 and 2019, the lowest rates of postpartum depression were observed during 2016-2017, but the rates significantly increased starting 2018. Overall, women with lower military ranks had higher postpartum depression rates than those with higher ranks. CONCLUSIONS Our results indicate increasing paid maternity leave in the military from 6 to 12 weeks did initially lower the odds of postpartum depression diagnosis among active duty women from immediately after policy implementation (2016) and prior to the release of the Veterans Affairs and Department of Defense Clinical Practice Guidelines on Pregnancy Management (2018). Later, increased odds of depression (2018-2019) are likely due to increased depression screening protocols at the Military Treatment Facilities in the perinatal period.
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Affiliation(s)
- Minette S R Herrick
- Air Force Institute of Technology PhD Student, Nutrition and Health Sciences, University of Nebraska Lincoln, Lincoln NE 68503, USA
| | - Weiwen Chai
- Nutrition and Health Sciences, University of Nebraska Lincoln, Lincoln NE 68503, USA
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22
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Larose MP, Haeck C, Lefebvre P, Merrigan P. Examining the impact of a change in maternity leave policy in Canada on maternal mental health care visits to the physician. Arch Womens Ment Health 2024:10.1007/s00737-024-01448-y. [PMID: 38411866 DOI: 10.1007/s00737-024-01448-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 02/12/2024] [Indexed: 02/28/2024]
Abstract
PURPOSE Maternity leave is a critical employee benefit that allows mothers to recover from the stress of pregnancy and childbirth and bond with their new baby. We aimed to examine the association between the extension of a maternity leave policy and maternal use of mental health services and prescription drugs in a universal public healthcare system. METHODS This study uses administrative medical records from 18,000 randomly selected women who gave birth three months before and after an extension of the maternity leave policy. More specifically, mothers who gave birth after January 1st 2001, were entitled to 50 weeks of paid maternity leave, while mothers who gave birth before that date were entitled to only 26 weeks of paid maternity leave. Medical records were analyzed over a seven-year period (i.e., from October 1998 to March 2006). We examined the number and costs of mothers' medical visits for mental health care in the five years following delivery, as well as maternal use of prescribed medication for mental health problems. RESULTS We found that mothers with extended maternity leave had - 0.12 (95%CI=-0.21; -0.02) fewer medical visits than mothers without a more generous maternity leave and that the cost of mental health services was Can$5 less expensive per women. These differences were found specifically during the extended maternity leave period. CONCLUSIONS The extra time away from work may help mothers to balance new family dynamics which may result in less demand on the healthcare system.
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Affiliation(s)
- Marie-Pier Larose
- INVEST Flagship Research Center, Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland.
| | - Catherine Haeck
- Département des sciences économiques, Université du Québec à Montréal, P.O. 8888, Box "A", Montreal, QC, Canada
| | - Pierre Lefebvre
- Département des sciences économiques, Université du Québec à Montréal, P.O. 8888, Box "A", Montreal, QC, Canada
| | - Philip Merrigan
- Département des sciences économiques, Université du Québec à Montréal, P.O. 8888, Box "A", Montreal, QC, Canada
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Honkaniemi H, Juárez SP. Alcohol-related morbidity and mortality by fathers' parental leave: A quasi-experimental study in Sweden. Addiction 2024; 119:301-310. [PMID: 37798819 DOI: 10.1111/add.16354] [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: 02/07/2023] [Accepted: 08/30/2023] [Indexed: 10/07/2023]
Abstract
BACKGROUND AND AIMS Fathers' parental leave has been associated with decreased risks of alcohol-related hospitalizations and mortality. Whether this is attributable to the health protections of parental leave itself (through stress reduction or behavioral changes) or to selection into leave uptake remains unclear, given that fathers are more likely to use leave if they are in better health. Using the quasi-experimental variation of a reform incentivizing fathers' leave uptake (the 1995 Father's quota reform), this study aimed to assess whether fathers' parental leave influences alcohol-related morbidity and mortality. DESIGN Quasi-experimental interrupted time series and instrumental variable analyses. SETTING Sweden. PARTICIPANTS Fathers of singleton children born from January 1992 to December 1997 (n = 220 412). MEASUREMENTS Exposure was indicated by the child's birthdate before or after the reform and used to instrument fathers' 2- and 8-year parental leave uptake. Outcomes included fathers' hospitalization rates for acute alcohol-related (intoxication; mental and behavioral disorders) and chronic alcohol-related diagnoses (cardiovascular, stomach and other diseases; liver diseases), as well as alcohol-related mortality, up to 2, 8 and 18 years after the first child's birthdate. FINDINGS In interrupted time series analyses, fathers of children born after the reform exhibited immediate decreases in alcohol-related hospitalization rates up to 2 (incidence rate ratio [IRR] = 0.66, 95% confidence interval [CI] = 0.51-0.87), 8 (IRR = 0.74, 95% CI = 0.57-0.96) and 18 years after birth (IRR = 0.72, 95% CI = 0.54-0.96), particularly in acute alcohol-related hospitalization rates, compared with those with children born before. No changes were found for alcohol-related mortality. Instrumental variable results suggest that alcohol-related hospitalization decreases were driven by fathers' parental leave uptake (e.g. 2-year hospitalizations: IRR = 0.16, 95% CI = 0.03-0.84). CONCLUSIONS In Sweden, a father's parental leave eligibility and uptake may protect against alcohol-related morbidity.
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Affiliation(s)
- Helena Honkaniemi
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
| | - Sol Pía Juárez
- Department of Public Health Sciences, Stockholm University, Stockholm, Sweden
- Centre for Health Equity Studies (CHESS), Stockholm University/Karolinska Institutet, Stockholm, Sweden
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Kaseda ET, Arentoft A, Bangen KJ, Mahmood Z, Thomas K, Kim SH, Tan A, Prieto S, Dawson EL, Riegler K, Sullivan-Baca E, Ellison RL. Parental, caregiving, and family leave during clinical neuropsychology postdoctoral training: Recommendations and guidelines from the Women in Neuropsychology (WIN) committee and Education Advisory Committee (EAC) of the Society for Clinical Neuropsychology (SCN; APA division 40). Clin Neuropsychol 2024; 38:247-261. [PMID: 37270409 DOI: 10.1080/13854046.2023.2217673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 05/18/2023] [Indexed: 06/04/2023]
Abstract
Objective: Parental and other caregiving leave is important to postdoctoral fellows, yet there is no field-wide recommendation for leave policies among clinical neuropsychology postdoctoral training programs, which is of particular relevance given the two-year requirement for eligibility for board certification. The aims of this manuscript are to (a) discuss general guidelines and recommendations for leave policies, both informed by prior empirical evidence as well as relevant existing policy guidelines from various academic and healthcare organizations, and (b) use vignettes to provide possible solutions for potential leave scenarios. Method: A critical review of literature on family leave from public policy and political science, industrial-organizational psychology, academic medicine, and psychology was conducted and findings were synthesized. Results and Conclusions: Fellowship training programs are encouraged to adopt a competency-based model that permits flexibility in leave during training without necessarily requiring an extended end date. Programs should adopt clear policies and make this information readily available to trainees and think flexibly about training options that best meet the training needs and goals of each individual. We also encourage neuropsychologists at all levels to engage in advocacy for broader systemic supports of trainees seeking equitable family leave.
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Affiliation(s)
- Erin T Kaseda
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, USA
| | - Alyssa Arentoft
- Department of Psychology, California State University, Northridge, CA, USA
| | - Katherine J Bangen
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Zanjbeel Mahmood
- Department of Psychology, University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University, San Diego, CA, USA
| | - Kelsey Thomas
- Research Service, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, CA, USA
| | - Stella H Kim
- McGovern Medical School, Department of Neurology, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Alexander Tan
- Department of Neuropsychology, Children's Health Orange County, Orange, CA, USA
| | - Sarah Prieto
- Department of Psychology, The Ohio State University, Columbus, OH, USA
| | - Erica L Dawson
- Department of Neurology, The Ohio State University, Columbus, OH, USA
| | - Kaitlin Riegler
- Pennsylvania State University, University Park, PA, USA
- Psychology Service, VA Connecticut Healthcare System, West Haven, CT, USA
| | | | - Rachael L Ellison
- Department of Psychology, Illinois Institute of Technology, Chicago, IL, USA
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25
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Cerceo E, Saxer K, Grossman L, Shapley-Quinn K, Feldman-Winter L. The Climate Crisis and Breastfeeding: Opportunities for Resilience. J Hum Lact 2024; 40:33-50. [PMID: 38158719 DOI: 10.1177/08903344231216726] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Abstract
The climate crisis is an emerging global challenge that poses potential risks to breastfeeding practices and outcomes. There are multifaceted effects of climate change affecting the breastfeeding dyad across environmental, societal, and human health dimensions. Breastfeeding support in the face of climate change will require solutions at the structural level-healthcare, community, and workplace settings-and at the mother-infant dyad level. Breastfeeding can additionally be an adaptive response to crisis situations and can mitigate some of the environmental challenges associated with climate change. Despite the undeniable significance of climate change on breastfeeding (and vice versa), our perspective as experts in the field is that this topic has not been systematically addressed. Although we highlight some of the challenges, potential solutions, and co-benefits of breastfeeding in the context of climate change, there are numerous issues that could be further explored and necessitate additional preparedness planning.
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Affiliation(s)
- Elizabeth Cerceo
- Cooper University Healthcare, Cooper Medical School of Rowan University, Camden, NJ, USA
| | | | - Lauren Grossman
- General Internal Medicine and Emergency Medicine, University of Colorado School of Medicine, Aurora, CO, USA
| | | | - Lori Feldman-Winter
- Cooper University Healthcare, Cooper Medical School of Rowan University, Camden, NJ, USA
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Smith H, Wojcieszek AM, Gupta S, Lavelanet A, Nihlén Å, Portela A, Schaaf M, Stahlhofer M, Tunçalp Ö, Bonet M. Integrating international policy standards in the implementation of postnatal care: a rapid review. BMJ Glob Health 2024; 8:e014033. [PMID: 38267069 PMCID: PMC10846851 DOI: 10.1136/bmjgh-2023-014033] [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: 09/22/2023] [Accepted: 11/06/2023] [Indexed: 01/26/2024] Open
Abstract
INTRODUCTION International legal and political documents can assist policy-makers and programme managers in countries to create an enabling environment to promote maternal and newborn health. This review aimed to map and summarise international legal and political documents relevant to the implementation of the WHO recommendations on maternal and newborn care for a positive postnatal experience. METHODS Rapid review of relevant international legal and political documents, including legal and political commitments (declarations, resolutions and treaties) and interpretations (general comments, recommendations from United Nations human rights treaty bodies, joint United Nations statements). Documents were mapped to the domains presented in the WHO postnatal care (PNC) recommendations; relating to maternal care, newborn care, and health systems and health promotion interventions, and by type of human right implied and/or stated in the documents. RESULTS Twenty-nine documents describing international legal and political commitments and interpretations were mapped, out of 45 documents captured. These 29 documents, published or entered into force between 1944 and 2020, contained content relevant to most of the domains of the PNC recommendations, most prominently the domains of breastfeeding and health systems interventions and service delivery arrangements. The most frequently mapped human rights were the right to health and the right to social security. CONCLUSION Existing international legal and political documents can inform and encourage policy and programme development at the country level, to create an enabling environment during the postnatal period and thereby support the provision and uptake of PNC and improve health outcomes for women, newborns, children and families. Governments and civil society organisations should be aware of these documents to support efforts to protect and promote maternal and newborn health.
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Affiliation(s)
- Helen Smith
- International Health Consulting Services Ltd, Liverpool, UK
| | - Aleena M Wojcieszek
- Department of Sexual and Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
- Mater Research Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Shuchita Gupta
- Department of Maternal, Newborn, Child and Adolescent and Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Antonella Lavelanet
- Department of Sexual and Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Åsa Nihlén
- Department of Sexual and Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Anayda Portela
- Department of Maternal, Newborn, Child and Adolescent and Health and Ageing, World Health Organization, Geneva, Switzerland
| | | | - Marcus Stahlhofer
- Department of Maternal, Newborn, Child and Adolescent and Health and Ageing, World Health Organization, Geneva, Switzerland
| | - Özge Tunçalp
- Department of Sexual and Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
| | - Mercedes Bonet
- Department of Sexual and Reproductive Health and Research including UNDP/UNFPA/UNICEF/WHO/World Bank Special Programme of Research, Development and Research Training in Human Reproduction (HRP), World Health Organization, Geneva, Switzerland
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Chai Y, Nandi A, Heymann J. Is the impact of paid maternity leave policy on the prevalence of childhood diarrhoea mediated by breastfeeding duration? A causal mediation analysis using quasi-experimental evidence from 38 low-income and middle-income countries. BMJ Open 2024; 14:e071520. [PMID: 38216191 PMCID: PMC10806753 DOI: 10.1136/bmjopen-2022-071520] [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: 12/31/2022] [Accepted: 09/28/2023] [Indexed: 01/14/2024] Open
Abstract
OBJECTIVES Quasi-experimental evidence suggests that extending the duration of legislated paid maternity leave is associated with lower prevalence of childhood diarrhoea in low-income and middle-income countries (LMICs). This could be due to a variety of mechanisms. This study examines whether this effect is mediated by changes in breastfeeding duration. DESIGN AND SETTING Difference-in-difference approach and causal mediation analysis were used to perform secondary statistical analysis of cross-sectional data from Demographic and Health Surveys (DHSs) in 38 LMICs. PARTICIPANTS We merged longitudinal data on national maternity leave policies with information on childhood diarrhoea related to 639 153 live births between 1996 and 2014 in 38 LMICs that participated in the DHS at least twice between 1995 and 2015. PRIMARY OUTCOME MEASURE Our outcome was whether the child had bloody stools in the 2 weeks prior to the interview. This measure was used as an indicator of severe diarrhoea because the frequency of loose stools in breastfed infants can be difficult to distinguish from pathological diarrhoea based on survey data. RESULTS A 1-month increase in the legislated duration of paid maternity leave was associated with a 34% (risk ratio 0.66, 95% CI 0.47 to 0.91) reduction in the prevalence of bloody diarrhoea. Breast feeding for at least 6 months and 12 months mediated 10.6% and 7.4% of this effect, respectively. CONCLUSION Extending the duration of paid maternity leave appears to lower diarrhoea prevalence in children under 5 years of age in LMICs. This effect is slightly mediated by changes in breastfeeding duration.
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Affiliation(s)
- Yan Chai
- Department of Epidemiology, University of California, Los Angeles, California, USA
| | - Arijit Nandi
- Department of Epidemiology, Biostatistics, and Occupational Health, McGill University, Montreal, Quebec, Canada
| | - Jody Heymann
- Department of Epidemiology, University of California, Los Angeles, California, USA
- Department of Health Policy and Management, University of California, Los Angeles, California, USA
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28
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Mat Pozian N, Miller YD, Mays J. Family-friendly work conditions and well-being among Malaysian women. WOMEN'S HEALTH (LONDON, ENGLAND) 2024; 20:17455057241233113. [PMID: 38426373 PMCID: PMC10908238 DOI: 10.1177/17455057241233113] [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] [Received: 08/28/2023] [Revised: 12/19/2023] [Accepted: 01/25/2024] [Indexed: 03/02/2024]
Abstract
BACKGROUND Although participation in paid work improves women's quality of life and well-being, the health benefits decline for women with young children. Implementing family-friendly work conditions is one strategy for improving working women's well-being, especially those with competing unpaid work responsibilities. OBJECTIVE This study investigated the extent to which accessibility and use of 11 specific family-friendly work conditions were associated with physical health, anxiety and depression in Malaysian women with young children. DESIGN A cross-sectional design using a retrospective self-complete, anonymous, online survey was conducted between March and October 2021. METHODS Women with a child aged 5 years or less (N = 190) completed an online survey measuring their exposure (availability and use) to 11 specific family-friendly work conditions, and their physical health, anxiety, and depression. The sample included women who were currently and recently working and with both formal and informal employment. RESULTS After accounting for potential confounders, women who used paid maternity leave have a lower likelihood of having anxiety symptoms. CONCLUSION Future research is needed to extend the findings from this study by over-sampling women who are informally employed and not currently working. Policy creation and development processes, including research and decision-making, should be led by and inclusive of women. For example, research funding could be allocated to 'lived experience' research that privileges the co-design of research with consumers. Based on these findings, the extent to which family-friendly work conditions fulfill their intent to improve the well-being for working women requires further critique.
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Affiliation(s)
- Nadirah Mat Pozian
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Yvette D Miller
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia
| | - Jenni Mays
- School of Public Health and Social Work, Faculty of Health, Queensland University of Technology, Kelvin Grove, QLD, Australia
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29
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Perry MF, Bui L, Yee LM, Feinglass J. Association Between State Paid Family and Medical Leave and Breastfeeding, Depression, and Postpartum Visits. Obstet Gynecol 2024; 143:14-22. [PMID: 37917931 DOI: 10.1097/aog.0000000000005428] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Accepted: 07/27/2023] [Indexed: 11/04/2023]
Abstract
OBJECTIVE To evaluate the association of state paid family and medical leave policies with the likelihood of breastfeeding, postpartum depression symptoms, and attendance of the postpartum visit. METHODS This was a cross-sectional study that used 2016-2019 data from PRAMS (Pregnancy Risk Assessment Monitoring System) for 43 states and Washington, DC. We describe the association of state paid family and medical leave generosity with rates of breastfeeding, postpartum depression symptoms, and attendance of the postpartum visit. Logistic and Poisson regression models tested the significance of state paid family and medical leave coverage generosity after controlling for individual respondent sociodemographic characteristics, with sensitivity analyses for respondents with deliveries covered by Medicaid insurance. RESULTS Of the 143,131 respondents, representative of an estimated 7,426,725 population, 26.2% lived in eight states and DC with the most generous paid family and medical leave, 20.5% lived in nine states with some paid family and medical leave, and 53.3% lived in 26 states with little or no paid family and medical leave. Overall, 54.8% reported breastfeeding at 6 months or at time of the survey, ranging from 59.5% in the most generous paid family and medical leave states to 51.0% in states with the least paid family and medical leave coverage. Postpartum depression symptoms varied from 11.7% in the most generous states to 13.3% in the least generous states (both P <.001). State differences in postpartum visit attendance rates (90.9% overall) did not differ significantly. After adjusting for respondent characteristics, compared with states with the least paid family and medical leave, breastfeeding was 9% more likely (adjusted incidence rate ratio [aIRR] 1.09, 95% CI, 1.07-1.11) in states with the strongest paid family and medical leave coverage and 32% more likely (aIRR 1.32, 95% CI, 1.25-1.39) in analyses limited to respondents with deliveries covered by Medicaid insurance. A more generous state paid family and medical leave policy was significantly associated with a lower likelihood of postpartum depression symptoms compared with states with the least paid family and medical leave (adjusted odds ratio 0.85, 95% CI, 0.76-0.94) and a modest but significant increase in postpartum visit attendance (aIRR 1.03, 95% CI, 1.01-1.04) among respondents with deliveries covered by Medicaid insurance. CONCLUSION Respondents from states with strong paid family and medical leave had a greater likelihood of breastfeeding and had lower odds of postpartum depression symptoms, with stronger associations among respondents with deliveries covered by Medicaid insurance. Despite major potential health benefits of paid family and medical leave, the United States remains one of the few countries without federally mandated paid parental leave.
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Affiliation(s)
- Madeline F Perry
- Department of Obstetrics and Gynecology, the Division of Maternal Fetal Medicine, Department of Obstetrics and Gynecology, and the Division of General Internal Medicine, Northwestern University Feinberg School of Medicine, Chicago, and Northwestern University, Evanston, Illinois
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30
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Bruinhof N, Sehic E, Hancock GR, Gartstein MA, de Weerth C. Prenatal anticipatory stress: Baby preparation and worry scale-revised in the Dutch context. Compr Psychiatry 2024; 128:152437. [PMID: 38007905 DOI: 10.1016/j.comppsych.2023.152437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 10/20/2023] [Accepted: 11/07/2023] [Indexed: 11/28/2023] Open
Abstract
BACKGROUND Prenatal distress encompasses a range of different emotions, worries, and experiences of stress. The Baby Preparation and Worry Scale (Baby-PAWS) was recently developed to target anticipatory worries during pregnancy about the postnatal period. However, the Baby-PAWS questionnaire was only examined in the United States of America, limiting the questionnaire's generalizability to different countries. To address this issue, we performed a psychometric evaluation of the questionnaire in a Dutch sample and examined associations between the Baby-PAWS questionnaire and established measures of maternal distress (i.e., EPDS, STAI, PRAQ-R) and infant temperament (i.e., IBQ-R). METHODS Healthy pregnant women (N = 521) completed questionnaires during their third trimester and postnatally, including the Baby-PAWS and distress measures. A subsample of mothers (N = 194) also reported on infant temperament at 12 weeks postpartum. RESULTS Exploratory factor analysis suggested a four-factor structure for the 16-item questionnaire in our Dutch sample, as compared to the expected three-factor structure found in the original psychometric evaluation with the American sample. The total Baby-PAWS score was related to pre-and postnatal depression, anxiety, stress, and specific scales of infant temperament. American women scored higher on the Baby-PAWS items than Dutch women. LIMITATIONS Our participants had higher-than-average socioeconomic status, limiting the generalizability of the findings. CONCLUSION The current analyses indicate good validity of the Baby-PAWS in a Dutch sample. Furthermore, our results highlight cross-cultural differences in perinatal mental health and show the importance of examining instrument structure of context-dependent constructs, such as prenatal worries.
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Affiliation(s)
- Nina Bruinhof
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, P.O. Box 9010, 6500, GL, Nijmegen, the Netherlands.
| | - Ela Sehic
- Washington State University, Department of Psychology, Pullman, WA, United States of America.
| | | | - Maria A Gartstein
- Washington State University, Department of Psychology, Pullman, WA, United States of America.
| | - Carolina de Weerth
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Department of Cognitive Neuroscience, P.O. Box 9010, 6500, GL, Nijmegen, the Netherlands.
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Wang RY, Anand NS, Douglas KE, Gregory JC, Lu N, Pottorff AE, Hsu HE. Formula for a Crisis: Systemic Inequities Highlighted by the US Infant Formula Shortage. Pediatrics 2024; 153:e2023061910. [PMID: 38196392 PMCID: PMC10827642 DOI: 10.1542/peds.2023-061910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/06/2023] [Indexed: 01/11/2024] Open
Affiliation(s)
- Rita Y. Wang
- Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
- Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Neha S. Anand
- Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
- Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Katherine E. Douglas
- Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
- Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Jessica C. Gregory
- Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
- Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Nguyen Lu
- Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
- Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Alexandra E. Pottorff
- Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
- Department of Pediatrics, Boston Children’s Hospital, Boston, Massachusetts
| | - Heather E. Hsu
- Department of Pediatrics, Boston Medical Center, Boston, Massachusetts
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van Tuyll van Serooskereken Rakotomalala S, Stok FM, Yerkes MA, de Wit JBF. A mapping of parenting support policies worldwide to prevent violence against children. CHILD ABUSE & NEGLECT 2023; 146:106484. [PMID: 37788589 DOI: 10.1016/j.chiabu.2023.106484] [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: 04/26/2023] [Revised: 07/25/2023] [Accepted: 09/21/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND While recent systematic reviews indicate that parenting interventions reduce negative parenting behaviours, including child maltreatment, only 26 % of governments worldwide indicate that parenting support programs reach all parents in their country. OBJECTIVE This mapping study investigates which countries have a government policy to provide such parenting support aimed at reducing child-directed violence. SETTING To analyse parenting support within the broad cultural and historical contexts, this study covers all 194 countries and territories worldwide. METHODS A systematic stepwise online search was conducted to establish the existence, or not, of a parenting support policy to prevent violence against children and in the case that a policy was identified, the sectoral policy portfolio in which the policy was published. RESULTS Findings showed that almost half of countries globally have a policy relating to parenting support to prevent child maltreatment. The highest concentration of such policies is in the European, Southeast Asia and Western Pacific Regions and globally parenting support are mainly stand-alone policies or embedded within a child protection policy. CONCLUSIONS Ideas around parenting support have evolved over time however the link between policy and practice as well as the reality of implementation modalities remains unclear. The translation of policy to practice merits further attention if we want to reach every parent in the world who needs it.
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Affiliation(s)
| | - F Marijn Stok
- Department of Interdisciplinary Social Science, Utrecht University, Netherlands.
| | - Mara A Yerkes
- Department of Interdisciplinary Social Science, Utrecht University, Netherlands.
| | - John B F de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Netherlands.
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Gredebäck G, Dorji N, Sen U, Nyström P, Hellberg J, Wangchuk. Context dependent cognitive development in Bhutanese children. Sci Rep 2023; 13:19875. [PMID: 37963958 PMCID: PMC10645759 DOI: 10.1038/s41598-023-47254-x] [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: 08/31/2023] [Accepted: 11/10/2023] [Indexed: 11/16/2023] Open
Abstract
We assessed risk/protective factors for cognitive development of Bhutanese children (504 3-5 year-olds, 49% girls, major ethnicities Ngalop 26%, Tshangla 30%, Lhotsampa 34%) using a non-verbal test of cognitive capacity (SON-R) and primary caregiver interviews. Cognitive capacity was related to the family's SES and whether the family belonged to the primary Buddhist majority ethnic groups (Ngalop or Tshangla) or primarily Hindu minorities (Lhotsampa). In majority families more engagement in Buddhist practices was associated with higher cognitive capacity in children. Minority children were more impacted by parents autonomous-relatedness values. Results demonstrate that cognitive development is dependent on the financial and educational context of the family, societal events, and culture specific risk/protective factors that differ across sub-groups (majority/minority, culture/religion).
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Affiliation(s)
| | - Nidup Dorji
- Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
| | - Umay Sen
- Uppsala University, Uppsala, Sweden
| | | | | | - Wangchuk
- Khesar Gyalpo University of Medical Sciences of Bhutan, Thimphu, Bhutan
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Maramag CC, Samaniego JAR, Castro MC, Zambrano P, Nguyen TT, Cashin J, Datu-Sanguyo J, Mathisen R, Weissman A. Maternity protection policies and the enabling environment for breastfeeding in the Philippines: a qualitative study. Int Breastfeed J 2023; 18:60. [PMID: 37950248 PMCID: PMC10638739 DOI: 10.1186/s13006-023-00594-w] [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: 01/30/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023] Open
Abstract
BACKGROUND The Philippines has enacted maternity protection policies, such as the 105-Day Expanded Maternity Leave Law and the Expanded Breastfeeding Promotion Act of 2009, to protect, promote, and support breastfeeding. This study aimed to review the content and implementation of maternity protection policies in the Philippines and assess their role in enabling recommended breastfeeding practices. It also identified bottlenecks to successful implementation from the perspectives of mothers and their partners, employers, and authorities from the government and non-government organizations involved in developing, implementing, monitoring, and enforcing maternity protection policies. METHODS This study employed a desk review of policies, guidelines, and related documents on maternity protection, and in-depth interviews. Of the 87 in-depth interviews, there were 12 employed pregnant women, 29 mothers of infants, 15 partners of the mothers, 12 employers and 19 key informants from the government and non-government organizations. Respondents for the in-depth interviews were from the Greater Manila Area and were recruited using purposive snowball sampling. Data were collected from December 2020 to April 2021. RESULTS The study shows that maternity protection policies in the Philippines are mostly aligned with the maternity protection standards set by the International Labour Organization. However, their role in improving breastfeeding practices is limited because: (1) not all working women have access to maternity protection entitlements; (2) the duration of maternity leave entitlements is inconsistent with the World Health Organization's recommended duration of exclusive breastfeeding; (3) there are gaps in policy implementation including: a lack of monitoring systems to measure the availability, functionality, and usage of lactation spaces; limited workplace support for breastfeeding; poor communication of maternity and paternity entitlements; and limited breastfeeding advocacy and promotion; and (4) there is limited integration between maternity protection and breastfeeding promotion interventions. CONCLUSIONS There is a need to (1) strengthen communication about and promotion of maternity and paternity entitlements for mothers, fathers and employers, (2) improve monitoring and enforcement mechanisms to ensure utilization of entitlements among mothers, (3) develop modalities to extend the coverage of maternity entitlements to the informal sector, (4) fully cover paid leave entitlements from social insurance or public funding sources in line with International Labour Organization recommendations, and (5) revisit the limitations on the coverage of paternity entitlement.
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Affiliation(s)
- Cherry C Maramag
- Nutrition Center of the Philippines, Muntinlupa City, Philippines
| | | | | | - Paul Zambrano
- Alive & Thrive, Global Nutrition, FHI 360, Manila, Philippines
| | - Tuan T Nguyen
- Alive & Thrive, Global Nutrition, FHI 360, Hanoi, Vietnam
| | - Jennifer Cashin
- Alive & Thrive, Global Nutrition, FHI 360, Washington, District of Columbia, USA
| | | | - Roger Mathisen
- Alive & Thrive, Global Nutrition, FHI 360, Hanoi, Vietnam
| | - Amy Weissman
- Asia Pacific Regional Office, FHI 360, Bangkok, Thailand
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Magudia K, Arleo EK, Porter KK, Ng TSC. A Practical Guide for Paid Family and Medical Leave in Radiology, From the AJR Special Series on DEI. AJR Am J Roentgenol 2023; 221:575-581. [PMID: 37195791 DOI: 10.2214/ajr.23.29327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
Paid family and medical leave (FML) has significant benefits to organizations, including improvements in employee recruitment and retention, workplace culture, and employee morale and productivity, and is supported by evidence for overall cost savings. Furthermore, paid FML related to childbirth has significant benefits to individuals and families, including but not limited to improved maternal and infant health outcomes and improved breastfeeding initiation and duration. In the case of nonchildbearing parental leave, paid FML is associated with more equitable long-term division of household labor and childcare. Paid FML is increasingly being recognized as an important issue in medicine, as evidenced by the recent passage of policies by national societies and governing bodies, including the American Board of Medical Specialties, American Board of Radiology, Accreditation Council for Graduate Medical Education (ACGME), American College of Radiology, and American Medical Association. Implementation of paid FML requires adherence to federal, state, and local laws as well as institutional requirements. Specific requirements pertain to trainees from national governing bodies, such as the ACGME and medical specialty boards. Flexibility, work coverage, culture, and finances are additional considerations for ensuring an optimal paid FML policy that accounts for concerns of all impacted individuals.
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Affiliation(s)
- Kirti Magudia
- Department of Radiology, Duke University School of Medicine, 2301 Erwin Rd, Box 3808, Durham, NC 27710
| | - Elizabeth K Arleo
- Department of Radiology, New York-Presbyterian Hospital/Weill Cornell Imaging, New York, NY
| | | | - Thomas S C Ng
- Department of Radiology, Massachusetts General Hospital, Boston, MA
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Catalao R, Zephyrin L, Richardson L, Coghill Y, Smylie J, Hatch SL. Tackling racism in maternal health. BMJ 2023; 383:e076092. [PMID: 37875287 DOI: 10.1136/bmj-2023-076092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2023]
Affiliation(s)
- Raquel Catalao
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Laurie Zephyrin
- Advancing Health Equity, Commonwealth Fund, New York, NY, USA
| | - Lisa Richardson
- Institute of Women and Ethnic Studies, UNO Research and Technology Foundation, New Orleans, USA
| | - Yvonne Coghill
- Excellence in Action, Workforce Race Equality, NHS London, UK
| | - Janet Smylie
- Well Living House, Li Ka Shing Knowledge Institute, Unity Health, Toronto Canada
- Dalla Lana School of Public Health and Department of Family and Community Medicine, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Stephani L Hatch
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- ESRC Centre for Society and Mental Health, King's College London, UK
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Kwon NY, Lee HY, Hwang SI, Sung SH, Cho SJ, Yoon YJ, Park JK. Herbal Medicine for Postpartum Pain: A Systematic Review of Puerperal Wind Syndrome (Sanhupung). Healthcare (Basel) 2023; 11:2743. [PMID: 37893817 PMCID: PMC10606538 DOI: 10.3390/healthcare11202743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 09/27/2023] [Accepted: 10/10/2023] [Indexed: 10/29/2023] Open
Abstract
Mothers in the postpartum period often experience musculoskeletal disorders and pain, impacting their ability to care for themselves and their infants. Conventional treatments have limitations, prompting interest in alternative options like herbal medicine. This systematic review aimed to confirm the effectiveness and safety of herbal medicine treatment to improve maternal health in patients with postpartum pain (puerperal wind syndrome). We searched eight electronic databases for randomized controlled trials (RCTs) to evaluate the effects of herbal medicines on puerperal wind syndrome. Nine RCTs, including 652 patients, were selected. Following a meta-analysis of RCTs, both herbal medicine and combination treatments improved the visual analog scale scores, total effective rate, scores of Traditional Chinese Medicine syndromes, Oswestry Disability Index, and quality of life in patients with role-emotional puerperal wind syndrome. All adverse events were minor, and the incidence rate was not high compared with that of the control group. In conclusion, herbal medicine supports the improvement in pain, other systemic symptoms, and the quality of life of patients with puerperal wind syndrome. Moreover, no serious side effects were observed; therefore, herbal medicines appear to be safe. It can be the preferred treatment option for puerperal wind syndrome, which is currently managed symptomatically.
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Affiliation(s)
- Na-Yoen Kwon
- Department of Obstetrics and Gynecology, College of Korean Medicine, Ga-Chon University, Seongnam-si 13120, Republic of Korea;
| | - Hee-Yoon Lee
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital, Yangsan-si 50612, Republic of Korea; (H.-Y.L.); (Y.-J.Y.)
- Department of Korean Medicine Obstetrics and Gynecology, School of Korean Medicine, Pusan National University, Yangsan-si 50612, Republic of Korea;
| | - Su-In Hwang
- Department of Korean Medicine Obstetrics and Gynecology, School of Korean Medicine, Pusan National University, Yangsan-si 50612, Republic of Korea;
| | - Soo-Hyun Sung
- Department of Policy Development, National Institute of Korean Medicine Development, Seoul 04554, Republic of Korea;
| | - Su-Jin Cho
- Research Institute of Nursing Science, Pusan National University, Yangsan-si 50612, Republic of Korea;
| | - Young-Jin Yoon
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital, Yangsan-si 50612, Republic of Korea; (H.-Y.L.); (Y.-J.Y.)
- Department of Korean Medicine Obstetrics and Gynecology, School of Korean Medicine, Pusan National University, Yangsan-si 50612, Republic of Korea;
| | - Jang-Kyung Park
- Department of Korean Medicine Obstetrics and Gynecology, Pusan National University Korean Medicine Hospital, Yangsan-si 50612, Republic of Korea; (H.-Y.L.); (Y.-J.Y.)
- Department of Korean Medicine Obstetrics and Gynecology, School of Korean Medicine, Pusan National University, Yangsan-si 50612, Republic of Korea;
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Pouranayatihosseinabad M, Taylor M, Hawrelak J, Peterson GM, Veal F, Ling T, Williams M, Whatley M, Ahdieh K, Mirkazemi C. Maternal Antibiotic Exposure and the Risk of Developing Antenatal or Postpartum Depressive Symptoms: The Maternal Experience Study Protocol. Methods Protoc 2023; 6:98. [PMID: 37888030 PMCID: PMC10609134 DOI: 10.3390/mps6050098] [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: 08/18/2023] [Revised: 10/02/2023] [Accepted: 10/02/2023] [Indexed: 10/28/2023] Open
Abstract
Limited epidemiological evidence suggests a link between antibiotic use and developing depression. This study seeks to investigate this association in depth, using a cohort of pregnant individuals. The primary aim is to explore any association between the use of antibiotics during pregnancy and the development of antenatal depressive symptoms up to the third trimester, as well as the use of antibiotics during pregnancy and within 12 months postpartum and the development of postpartum depressive symptoms. A national prospective, observational, longitudinal cohort study has been designed to examine these relationships. A sample size of 1500 pregnant individuals has been sought for this study, assuming 10 potential predictor variables (including antibiotic use) in the final multiple logistic regression model and allowing for a 30% drop-out rate. The development of depressive symptoms is considered either a diagnosis by a medical doctor and/or a scoring 13 or higher on the Edinburgh Postnatal Depression Scale. Data will be collected during the third trimester and at 6 weeks, 6 months, and 12 months postpartum. These surveys include variables previously identified as associated with antenatal and postpartum depression (e.g., level of social support, experience of intimate partner abuse, and obstetric complications), as well as antibiotic and probiotic use. This study will provide an update on the prevalence of the symptoms of depression during pregnancy and postpartum and its associated risk factors. It will also, for the first time, comprehensively explore the potential association between antibiotic use during pregnancy and up to 12 months postpartum and the development of depressive symptoms.
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Affiliation(s)
- Mahsa Pouranayatihosseinabad
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Maggie Taylor
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Jason Hawrelak
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Gregory M. Peterson
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Felicity Veal
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Tristan Ling
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Mackenzie Williams
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
| | - Megan Whatley
- Department of Obstetrics and Gynaecology, Royal Hobart Hospital, Hobart, TAS 7000, Australia
| | - Kyan Ahdieh
- Launceston Medical Centre, Health Hub, Launceston, TAS 7250, Australia
| | - Corinne Mirkazemi
- School of Pharmacy and Pharmacology, College of Health and Medicine, University of Tasmania, Hobart, TAS 7005, Australia
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Bhatia R. Family Leave and Maternal Mortality in the US. JAMA 2023; 330:1387. [PMID: 37815574 DOI: 10.1001/jama.2023.14933] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/11/2023]
Affiliation(s)
- Richa Bhatia
- Stanford University School of Medicine, Stanford, California
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40
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Hidalgo-Padilla L, Toyama M, Zafra-Tanaka JH, Vives A, Diez-Canseco F. Association between maternity leave policies and postpartum depression: a systematic review. Arch Womens Ment Health 2023; 26:571-580. [PMID: 37458837 PMCID: PMC10491689 DOI: 10.1007/s00737-023-01350-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 07/11/2023] [Indexed: 09/09/2023]
Abstract
PURPOSE Working mothers are at greater risk for postpartum depression. Maternity leave characteristics, including length, wage replacement and employment protection, could have relevant implications for mothers' mental health. We propose to explore whether there is an association between maternity leave characteristics and postpartum depression. METHODS We conducted a systematic review searching for randomized controlled trials, quasi-experimental, cohort or cross-sectional studies on five databases using search terms including maternity and parental leave and depression, as well as references in relevant articles. We identified 500 articles and included 23 of those. We used the EPHPP Quality Assessment Tool for Quantitative Studies to assess the quality of the studies. RESULTS Paid and longer maternity leaves tend to be associated with a reduction of postpartum depression symptoms in high-income countries. No studies explored the association between employment protection and postpartum depression. The quality of studies ranged from strong to weak, mostly influenced by study design. CONCLUSION More restrictive maternity leave policies tend to be associated with higher rates of postpartum depression, although more research needs to be conducted in the Global South.
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Affiliation(s)
- Liliana Hidalgo-Padilla
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru.
| | - Mauricio Toyama
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
| | | | - Alejandra Vives
- Departamento de Salud Pública, y CEDEUS, Pontificia Universidad Católica de Chile, Santiago de Chile, Chile
| | - Francisco Diez-Canseco
- CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano Heredia, Lima, Peru
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41
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Chang CY, Liu SR, Glynn LM. One size doesn't fit all: Attitudes towards work modify the relation between parental leave length and postpartum depression. Arch Womens Ment Health 2023:10.1007/s00737-023-01374-5. [PMID: 37737880 DOI: 10.1007/s00737-023-01374-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2023] [Accepted: 09/12/2023] [Indexed: 09/23/2023]
Abstract
The present study aimed to investigate the relationship between parental leave length and maternal depressive symptoms at six- and twelve-months postpartum and whether this relation was influenced by women's attitudes towards leave, whether leave was paid or unpaid, and the reason they returned to work. The sample included 115 working women recruited during pregnancy as part of a larger longitudinal study. Analyses revealed that maternal attitudes toward leave influenced the association between leave length and depressive symptoms. Specifically, longer leaves were associated with increased depressive symptoms for women who missed their previous activities at work. Furthermore, women who missed work and had leave for 16 weeks or more, exhibited higher depressive symptoms at six- and twelve-months. Last, results also indicated that women who returned to work solely for monetary reasons exhibited more depressive symptoms at six-months postpartum than those who returned to work for other reasons. This study is among the first to show that women's attitudes towards parental leave and their individual reasons for returning to work are important factors to consider that may have potential implications for parental leave policies.
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Affiliation(s)
| | - Sabrina R Liu
- Department of Human Development, California State University, San Marcos, San Marcos, CA, USA
| | - Laura M Glynn
- Department of Psychology, Chapman University, Orange, CA, USA
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Jefferson EE. Will it ever change? Lack of parental leave and its detrimental effects on maternal well-being. LANCET REGIONAL HEALTH. AMERICAS 2023; 25:100572. [PMID: 37583650 PMCID: PMC10423924 DOI: 10.1016/j.lana.2023.100572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Accepted: 07/28/2023] [Indexed: 08/17/2023]
Affiliation(s)
- Erin E.Y. Jefferson
- Department of Psychiatry, University of Arkansas for Medical Sciences, Little Rock, AR, USA
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43
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Hawkins SS. Affordable Care Act and Breastfeeding. J Obstet Gynecol Neonatal Nurs 2023; 52:339-349. [PMID: 37604351 DOI: 10.1016/j.jogn.2023.08.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/23/2023] Open
Abstract
In 2010, the Patient Protection and Affordable Care Act was the first federal legislation to protect breastfeeding on a broad scale. Since its implementation, several provisions have been made, including the recent Providing Urgent Maternal Protections for Nursing Mothers (PUMP) Act, which went into effect in April 2023. In this column, I review current breastfeeding recommendations, the policy landscape related to state and federal laws that protect breastfeeding, research findings on breastfeeding policies, and recommendations from professional organizations that support women's breastfeeding decisions.
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Johnson L, Winter SC. Someone you can count on: Examining the mediating effect of social support on economic abuse and depression. AMERICAN JOURNAL OF COMMUNITY PSYCHOLOGY 2023; 72:3-14. [PMID: 37042840 DOI: 10.1002/ajcp.12666] [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: 04/25/2022] [Revised: 02/02/2023] [Accepted: 02/12/2023] [Indexed: 06/19/2023]
Abstract
The aim of this study was to examine whether social support mediated the relationship between economic abuse, a form of intimate partner violence, and mental health, specifically depression, among pregnant women. This cross-sectional study used a sample of 193 pregnant women living in the United States who participated in an online Qualtrics panel survey in January 2021. Hayes Process Macro was used to assess a mediation model. Economic abuse was associated with increased odds of depressive sympto ms and fewer perceived social supports. Social support mediated the relationship between economic abuse and depression. Implications for research, policy, and practice are discussed. Notably, research focused on economic abuse and efforts to respond to it need to pay particularly close attention to the role that social supports may play in survivor's overall well-being, as well as the impact that economic abuse may have on survivors' perceptions of social support. This may be particularly true for pregnant women experiencing economic abuse for whom social support-related interventions have yielded positive health outcomes.
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Affiliation(s)
- Laura Johnson
- School of Social Work, Temple University, Philadelphia, Pennsylvania, USA
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Onufrak SJ, Moore LV, Pierce SL, MacGowan CA, Galuska DA. Changes in Policy Supports for Healthy Food Retailers, Farmers Markets, and Breastfeeding Among US Municipalities, 2014-2021: National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living (CBS-HEAL). Prev Chronic Dis 2023; 20:E73. [PMID: 37590900 PMCID: PMC10457115 DOI: 10.5888/pcd20.230018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023] Open
Abstract
INTRODUCTION Policies and practices at the local level can help reduce chronic disease risk by providing environments that facilitate healthy decision-making about diet. METHODS We used data from the 2014 and 2021 National Survey of Community-Based Policy and Environmental Supports for Healthy Eating and Active Living to examine prevalence among US municipalities of policies to support access to healthier food in supermarkets, convenience stores, and farmers markets, as well as policies to support breastfeeding among government employees. Chi-square tests were conducted to compare prevalence estimates from 2021 to 2014 overall and according to municipal characteristics. RESULTS In 2021, 29% of municipalities had at least 1 policy to encourage full-service grocery stores to open stores, which was not significantly different from 31% in 2014. Prevalence of having at least 1 policy to help corner stores sell healthier foods declined significantly from 13% in 2014 to 9% in 2021. Prevalence of policies providing all local government employees who were breastfeeding breaktime and space to pump breast milk increased significantly from 25% in 2014 to 52% in 2021. The percentage of municipalities that provided 8 or more weeks of paid maternity leave for employees increased significantly from 16% in 2014 to 19% in 2021. CONCLUSION Prevalence of supports for supermarkets, convenience stores, and farmers markets generally did not increase among US municipalities from 2014 to 2021, while some supports for breastfeeding among municipal employees increased during this time. Opportunities exist to improve municipal-level policies that support healthy eating and breastfeeding among community residents and employees.
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Affiliation(s)
- Stephen J Onufrak
- Division of Diabetes Translation, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, 3679 Hermitage Dr, Berkeley Lake, Georgia 30096
| | - Latetia V Moore
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Samantha L Pierce
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Carol A MacGowan
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Deborah A Galuska
- Division of Nutrition, Physical Activity, and Obesity, National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia
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Wells JCK. An evolutionary perspective on social inequality and health disparities: Insights from the producer-scrounger game. Evol Med Public Health 2023; 11:294-308. [PMID: 37680454 PMCID: PMC10482145 DOI: 10.1093/emph/eoad026] [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: 04/21/2023] [Revised: 07/13/2023] [Indexed: 09/09/2023] Open
Abstract
There is growing concern with social disparities in health, whether relating to gender, ethnicity, caste, socio-economic position or other axes of inequality. Despite addressing inequality, evolutionary biologists have had surprisingly little to say on why human societies are prone to demonstrating exploitation. This article builds on a recent book, 'The Metabolic Ghetto', describing an overarching evolutionary framework for studying all forms of social inequality involving exploitation. The dynamic 'producer-scrounger' game, developed to model social foraging, assumes that some members of a social group produce food, and that others scrounge from them. An evolutionary stable strategy emerges when neither producers nor scroungers can increase their Darwinian fitness by changing strategy. This approach puts food systems central to all forms of human inequality, and provides a valuable lens through which to consider different forms of gender inequality, socio-economic inequality and racial/caste discrimination. Individuals that routinely adopt producer or scrounger tactics may develop divergent phenotypes. This approach can be linked with life history theory to understand how social dynamics drive health disparities. The framework differs from previous evolutionary perspectives on inequality, by focussing on the exploitation of foraging effort rather than inequality in ecological resources themselves. Health inequalities emerge where scroungers acquire different forms of power over producers, driving increasing exploitation. In racialized societies, symbolic categorization is used to systematically assign some individuals to low-rank producer roles, embedding exploitation in society. Efforts to reduce health inequalities must address the whole of society, altering producer-scrounger dynamics rather than simply targeting resources at exploited groups.
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Affiliation(s)
- Jonathan C K Wells
- Childhood Nutrition Research Centre, Population, Policy and Practice Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, UK
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Sebastián-González E, Graciá E, Morán-Ordóñez A, Pérez-Ibarra I, Sanz-Aguilar A, Sobral M. Ten simple rules for a mom-friendly Academia. PLoS Comput Biol 2023; 19:e1011284. [PMID: 37561706 PMCID: PMC10414686 DOI: 10.1371/journal.pcbi.1011284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/12/2023] Open
Abstract
Women (and all gender-discriminated people) are underrepresented in science, especially in leadership positions and higher stages of the scientific career. One of the main causes of career abandonment by women is maternity, with many women leaving Academia after having their first child because of the career penalties associated with motherhood. Thus, more actions to help scientific moms to balance family and academic work are urgently needed to increase representation of women and other gender discriminated people in Academia. Besides mothers, these rules may also benefit other groups such as mothers-to-be, fathers, caregivers, and women in general. Increasing women representation in science, including mothers, is critical because equality is a fundamental right, and because more diverse working environments are more productive and get to more optimal solutions. Here, we describe 10 simple rules that can be adopted in Academia to halt the abandonment of scientific careers by women after motherhood. We strongly encourage their implementation to increase gender diversity and equality in science.
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Affiliation(s)
| | - Eva Graciá
- Department of Applied Biology, Miguel Hernández University, Elche, Spain
- Centro de Investigación e Innovación Agroalimentaria y Agroambiental (CIAGRO-UMH), Miguel Hernández University, Orihuela, Spain
| | | | - Irene Pérez-Ibarra
- Department of Agricultural Sciences and the Environment, University of Zaragoza, Zaragoza, Spain
- AgriFood Institute of Aragón, Zaragoza, Spain
| | - Ana Sanz-Aguilar
- Animal Demography and Ecology Unit, IMEDEA CSIC-UIB, Esporles, Spain
- Department of Biology, University of Balearic Islands, Palma, Spain
| | - Mar Sobral
- Facultade de Bioloxía, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
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48
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Bond AM, Casalino LP, Tai-Seale M, Unruh MA, Zhang M, Qian Y, Kronick R. Physician Turnover in the United States. Ann Intern Med 2023. [PMID: 37429029 DOI: 10.7326/m22-2504] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Medical groups, health systems, and professional associations are concerned about potential increases in physician turnover, which may affect patient access and quality of care. OBJECTIVE To examine whether turnover has changed over time and whether it is higher for certain types of physicians or practice settings. DESIGN The authors developed a novel method using 100% of traditional Medicare billing to create national estimates of turnover. Standardized turnover rates were compared by physician, practice, and patient characteristics. SETTING Traditional Medicare, 2010 to 2020. PARTICIPANTS Physicians billing traditional Medicare. MEASUREMENTS Indicators of physician turnover-physicians who stopped practicing and those who moved from one practice to another-and their sum. RESULTS The annual rate of turnover increased from 5.3% to 7.2% between 2010 and 2014, was stable through 2017, and increased modestly in 2018 to 7.6%. Most of the increase from 2010 to 2014 came from physicians who stopped practicing increasing from 1.6% to 3.1%; physicians moving increased modestly from 3.7% to 4.2%. Modest but statistically significant (P < 0.001) differences existed across rurality, physician sex, specialty, and patient characteristics. In the second and third quarters of 2020, quarterly turnover was slightly lower than in the corresponding quarters of 2019. LIMITATION Measurement was based on traditional Medicare claims. CONCLUSION Over the past decade, physician turnover rates have had periods of increase and stability. These early data, covering the first 3 quarters of 2020, give no indication yet of the COVID-19 pandemic increasing turnover, although continued tracking of turnover is warranted. This novel method will enable future monitoring and further investigations into turnover. PRIMARY FUNDING SOURCE The Physicians Foundation Center for the Study of Physician Practice and Leadership.
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Affiliation(s)
- Amelia M Bond
- Division of Health Policy and Economics, Department of Population Health Sciences, Weill Cornell Medical College, New York, New York (A.M.B., L.P.C., M.A.U., M.Z.)
| | - Lawrence P Casalino
- Division of Health Policy and Economics, Department of Population Health Sciences, Weill Cornell Medical College, New York, New York (A.M.B., L.P.C., M.A.U., M.Z.)
| | - Ming Tai-Seale
- Department of Family Medicine, School of Medicine, University of California San Diego, La Jolla, California (M.T.)
| | - Mark Aaron Unruh
- Division of Health Policy and Economics, Department of Population Health Sciences, Weill Cornell Medical College, New York, New York (A.M.B., L.P.C., M.A.U., M.Z.)
| | - Manyao Zhang
- Division of Health Policy and Economics, Department of Population Health Sciences, Weill Cornell Medical College, New York, New York (A.M.B., L.P.C., M.A.U., M.Z.)
| | - Yuting Qian
- Department of Health Policy and Management, Yale University, New Haven, Connecticut (Y.Q.)
| | - Richard Kronick
- Herbert Wertheim School of Public Health, University of California San Diego, La Jolla, California (R.K.)
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O'Hagan ET, Wallwork SB, Callander E, Stanton TR, Mychasiuk R. The Foundations for Chronic Low Back Pain Management may Start in Early Life. Exploring the Role of Caregiver Parental Leave on Future Low Back Pain in the Offspring. THE JOURNAL OF PAIN 2023; 24:939-945. [PMID: 36646402 DOI: 10.1016/j.jpain.2023.01.008] [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: 09/14/2022] [Revised: 01/02/2023] [Accepted: 01/07/2023] [Indexed: 01/15/2023]
Abstract
Chronic low back pain is difficult to treat and despite increased spending on health services, clinical outcomes for people with low back pain have not improved. Innovative, large scale initiatives seem necessary to stem the cost of low back pain. Psychological health contributes to the development and persistence of chronic low back pain and psychological interventions are important in the management of low back pain. Given the contribution of psychological health to low back pain development and management, it raises the question; can we support psychological health in later life by bolstering emotional development in early life, and reduce the burden of this common condition? Positive early life experiences, including those induced by extended paid parental leave, could bolster emotional development and support the psychological health necessary to manage low back pain in later life. We present the current state of evidence demonstrating the potential value of increasing support for parent-child relationships in early life to reduce the burden of low back pain in future generations. The current evidence is limited to cross-sectional associations, but strong preclinical data clearly shows the potential negative impacts of maternal separation on rodent pup health that compels consideration in human populations. PERSPECTIVE: The benefits stemming from enhanced child development include stable emotional foundations, possibly improving psychological health and low back pain management in the future. This perspective raises questions for future studies - within the context of low back pain, what ingredients bolster stable psychological health? And are these ingredients influenced by parental leave?
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Affiliation(s)
- Edel T O'Hagan
- Westmead Applied Research Centre, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia.
| | - Sarah B Wallwork
- IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Sydney, NSW, Australia
| | - Emily Callander
- Monash Centre for Health Research and Implementation (MCHRI), School of Public Health and Preventative Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, VIC, Australia
| | - Tasha R Stanton
- IIMPACT in Health, Allied Health and Human Performance, University of South Australia, Sydney, NSW, Australia
| | - Richelle Mychasiuk
- Department of Neuroscience, Central Clinical School, Monash University, Clayton, VIC, Australia
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Jarrett DM, Gibson-Oliver L, Kraleti S. An Innovative Resource to Guide and Track Medical Resident Activity and Wellness During At-Home Assignments. Cureus 2023; 15:e40332. [PMID: 37456422 PMCID: PMC10338197 DOI: 10.7759/cureus.40332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 07/18/2023] Open
Abstract
Background and objectives Medical residents may work from home for various reasons, including study electives, isolation due to exposure to illness, or during parental leave when they choose to work at home instead of taking extended time off. The University of Arkansas for Medical Sciences (UAMS) Little Rock Family Medicine residency program recognized the need for a tool that provided residents with a list of resources and approved activities for at-home work and a means of tracking their performance in those activities. Methods The administration team at the UAMS Little Rock Family Medicine residency program custom-designed a Daily Activities Log that served multiple purposes. Family medicine residents used it to choose what activities to participate in from a comprehensive list of activities and resources including virtual conferences, recorded didactics, modules, and other online materials. The program provided the framework on the log, while residents used it to document time spent on those activities. The log also gave the program a daily update on the resident's health, as one question specifically asked about well-being. Since it was built in an electronic survey format already owned by the residency program, it was completely customizable and available at no additional cost. Results In the two years covered by this project, residents logged a total of 593 hours of at-home work. In response to a survey, 76% of participating residents (N=14) rated the log as extremely or very easy to use; 64% indicated that it was a helpful resource; and 50% said that it simplified the reporting of their daily status. The residency program faculty found that having one source to track all off-site residents was an efficient means of monitoring their well-being and their work. Conclusions The Daily Activities Log is a versatile tool that provides comprehensive information, resources, and approved activities for residents, documents their work, and provides updates to residency management. It can be readily modified for use in other programs that have residents working at home.
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Affiliation(s)
- Diane M Jarrett
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Lauren Gibson-Oliver
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, USA
| | - Shashank Kraleti
- Department of Family and Preventive Medicine, University of Arkansas for Medical Sciences, Little Rock, USA
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