1
|
Zangerl KE, Hoernke K, Andreas M, Dalglish SL, Kelman I, Nilsson M, Rockloev J, Bärnighausen T, McMahon SA. Child health prioritisation in national adaptation policies on climate change: a policy document analysis across 160 countries. THE LANCET. CHILD & ADOLESCENT HEALTH 2024; 8:532-544. [PMID: 38848733 DOI: 10.1016/s2352-4642(24)00084-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 03/26/2024] [Accepted: 03/27/2024] [Indexed: 06/09/2024]
Abstract
Integration of child-specific adaptation measures into health policies is imperative given children's heightened susceptibility to the health impacts of climate change. Using a document analysis method, we examined 160 national adaptation policies for inclusion of child-relevant measures and identified 19 child health-related adaptation domains. 44 (28%) of 160 countries' policies that were analysed failed to include any domains, 49 (31%) included at least one child-related domain, 62 (39%) included between two and six domains, and five (3%) included at least seven domains. Predominant domains among child-specific adaptation measures included education and awareness raising, followed by community engagement and nutrition. No country addressed children's direct needs in the domain of mental health. National adaptation policies tend towards overly simple conceptualisations of children across four major lenses: age, social role, gender, and agency. Limited inclusion of child-specific measures in national adaptation policies suggests insufficient recognition of and action on children's susceptibility to climate change effects.
Collapse
Affiliation(s)
- Kathrin E Zangerl
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany.
| | - Katarina Hoernke
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany; Children in All Policies 2030, University College London, London, UK
| | - Marike Andreas
- Center for Preventive Medicine and Digital Health, Division of Public Health, Social and Preventive Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Sarah L Dalglish
- Children in All Policies 2030, University College London, London, UK; International Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ilan Kelman
- Institute for Global Health and Institute for Risk and Disaster Reduction, University College London, London, UK; University of Agder, Kristiansand, Norway
| | - Maria Nilsson
- Epidemiology and Global Health, Umeå University, Umeå, Sweden
| | - Joacim Rockloev
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany; Occupational and Environmental Medicine, Umeå University, Umeå, Sweden; Heidelberg Interdisciplinary Centre for Scientific Computing, Heidelberg University, Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany; Africa Health Research Institute, Durban, South Africa; Department of Global Health and Population, Harvard T H Chan School of Public Health, Harvard University, Boston, MA, USA
| | - Shannon A McMahon
- Heidelberg Institute of Global Health, Heidelberg University Hospital, Heidelberg, Germany; International Health Department, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| |
Collapse
|
2
|
Applebaum DL. 2023 Pauline Cerasoli Lecture: It Takes a Village to Raise a Profession. JOURNAL, PHYSICAL THERAPY EDUCATION 2024:00001416-990000000-00107. [PMID: 38684104 DOI: 10.1097/jte.0000000000000344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 02/01/2024] [Indexed: 05/02/2024]
Abstract
BACKGROUND AND PURPOSE Personal and profession-related factors affect graduate transition to practice. Social supports and a sense of belonging are recognized as critical factors affecting success. The need for a professional to postprofessional continuum of learning has been identified. Development of a process to effectively move learners through this continuum are affected by conflicts such as economic issues, varied educational and practice philosophies, and capacity demands for clinical sites and instructors. The purpose of this article was to discuss professional formation as an individual experience that needs environmental support. If we look to the intrinsic needs of the individual to develop effective systems, both individuals and the profession will thrive. POSITION AND RATIONALE The changing demographics of students and factors affecting health care and education offer compelling reasons to reconsider the pathway for early professional development. Education and practice must collaborate to cocreate the foundation for professional formation. Basic needs such as economic security and social belonging must be met to create optimal conditions for learning and growth. DISCUSSION AND CONCLUSION The profession has not adopted an intentional pathway for new graduates to meet foundational practice needs. Some new graduates seek residencies, but residencies are focused on specialization and supply does not meet the demand. Strategies to promote success of early career professionals include a professional to postprofessional curriculum with intentional mentorship, changes in the regulatory environment, and formation of effective partnerships to support education and practice.
Collapse
Affiliation(s)
- Donna L Applebaum
- Donna L. Applebaum is the assistant professor and director of Clinical Education at the MGH Institute of Health Professions, Charlestown Navy Yard, 36 1st Ave., Boston, MA 02129 . Please address all correspondence to Donna L. Applebaum
| |
Collapse
|
3
|
Charlot-Swilley D, Thomas K, Mondi CF, Willis DW, Condon MC. A Holistic Approach to Early Relational Health: Cultivating Culture, Diversity, and Equity. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:563. [PMID: 38791778 PMCID: PMC11121716 DOI: 10.3390/ijerph21050563] [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: 02/06/2024] [Revised: 04/12/2024] [Accepted: 04/25/2024] [Indexed: 05/26/2024]
Abstract
Early Relational Health (ERH) is the foundation for infant and child emotional and social wellbeing. ERH is a quality of relationships co-created by infants, caregivers, and other members of their families and communities from pregnancy through childhood. Relationships themselves are not ERH; rather, ERH can be a feature of relationships. Those that are characterized by positive, shared emotionality become contexts within which members co-develop mutual capacities that enable them to prevail and flourish. This essay offers a synthesis of current knowledge about ERH in the US and begins to integrate Indigenous and non-Indigenous research and knowledge about ERH in the hope that readers will embrace "Etuaptmumk"-"Two-Eyed Seeing". The authors maintain that systems of care for infants, families, and their communities must first and foremost attend to revitalization, cultural context, diversity, equity, and inclusion. Authors discuss key concepts in ERH; Indigenous and non-Indigenous research that inform ERH; structural and systemic factors in the US that affect ERH ecosystems; the critical intersections of culture, diversity, equity; the broader concept of village support for fostering ERH; and efforts to revitalize ERH discourse, practices, and policies. The authors advocate for a holistic approach to ERH and suggest future directions for research and advocacy.
Collapse
Affiliation(s)
| | | | - Christina F. Mondi
- Brazelton Touchpoints Center, Division of Developmental Medicine, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115, USA;
| | - David W. Willis
- Center for the Study of Social Policy, Washington, DC 20005, USA;
| | - Marie-Celeste Condon
- Independent Consultant and Researcher, University of Washington, Seattle, WA 98105, USA
| |
Collapse
|
4
|
Swanepoel A. Public health for paediatricians: how an evolutionary perspective can help us improve children's well-being. Arch Dis Child Educ Pract Ed 2024:edpract-2023-326522. [PMID: 38580431 DOI: 10.1136/archdischild-2023-326522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2024] [Accepted: 03/27/2024] [Indexed: 04/07/2024]
|
5
|
Bauer A, Cartagena-Farias J, Christiansen H, Goodyear M, Schamschula M, Zechmeister-Koss I, Paul J. Acceptability, engagement and exploratory outcomes and costs of a co-designed intervention to support children of parents with a mental illness: Mixed-methods evaluation and descriptive analysis. Int J Ment Health Nurs 2024. [PMID: 38500242 DOI: 10.1111/inm.13324] [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: 07/14/2023] [Revised: 02/21/2024] [Accepted: 03/11/2024] [Indexed: 03/20/2024]
Abstract
Children whose parents have a mental illness are much more likely to experience mental health problems and other adverse long-term impacts. Child-centred psychosocial interventions can be effective, but not much is known about how to design and implement them in different settings. A pre-post, mixed methods, single-arm evaluation of a co-designed social support intervention with parents and children (4-18 years) measured parents' mental health (PHQ-9), perceived social support (ENRICHD), parental self-efficacy (PSAM) and children's mental health (SDQ), quality of life (Kidscreen-27), and child service use (CAMHSRI-EU) at baseline and 6 months. Qualitative data were gathered at 6 months to explore parents' and children's experience with the intervention. Twenty-nine parents and 21 children completed baseline and follow-up questionnaires; 22 parents and 17 children participated in interviews. Parents' depression (MD -1.36, SD 8.08), perceived social support (MD 1, SD 5.91), and children's mental health potentially improved, and children's service use and costs potentially reduced (€224.6 vs. €122.2, MD 112.4). Parental self-efficacy was potentially reduced (MD -0.11, SD 3.33). The sample was too small to perform statistical analysis. Favourable themes emerged describing the high satisfaction with the intervention, parents' improved understanding of the impact of their mental health problems on children, and improvements in parent-child relationships. This study contributes to an emerging evidence base for co-designed child-centred interventions to prevent the transgenerational transmission of poor mental health.
Collapse
Affiliation(s)
- Annette Bauer
- Care Policy and Evaluation Centre, London School of Economics and Political Science, London, UK
| | | | - Hanna Christiansen
- Clinical Child and Adolescent Psychology, Department of Psychology, Philipps University Marburg, Marburg, Germany
| | - Melinda Goodyear
- School of Rural Health, Monash University, Melbourne, Victoria, Australia
| | - Mona Schamschula
- Mental Health Research Program, The Village, Ludwig Boltzmann Gesellschaft, Wien, Austria
| | | | - Jean Paul
- Division of Psychiatry I, Department of Psychiatry, Psychotherapy and Psychosomatics, Medical University Innsbruck, Innsbruck, Austria
| |
Collapse
|
6
|
Engel de Abreu PMJ, Kumsta R, Wealer C. Risk and protective factors of mental health in children in residential care: A nationwide study from Luxembourg. CHILD ABUSE & NEGLECT 2023; 146:106522. [PMID: 37922618 DOI: 10.1016/j.chiabu.2023.106522] [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: 06/12/2023] [Revised: 09/04/2023] [Accepted: 10/18/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Children who grow up in residential care are at high risk for mental health problems. Existing studies have focused on negative mental health indicators and risk factors. There has been less emphasis on identifying protective factors, particularly those associated with positive mental health outcomes. OBJECTIVE This study explores positive and negative dimensions of mental health and their links to risk and protective factors in children who have experienced early adversity and trauma and have been placed in residential care. PARTICIPANTS AND SETTINGS Children aged 11 to 18 (N = 264) were recruited from residential care homes in Luxembourg, a small, high-income European country. METHODS The children completed self-report questionnaires on mental health, perceived stress, school pressure, and participation. Residential care workers provided information on demographic factors, developmental and care history, and pre-care experiences of early adversity and trauma. RESULTS Confirmatory factor analysis indicated that subjective well-being, internalising problems, and externalising problems are separate yet interconnected components of mental health. Multiple Indicators Multiple Causes models showed that individual, contextual, and psychosocial predictors contribute differentially to positive and negative mental health outcomes. CONCLUSIONS Using a national sample of children in residential care in Luxembourg, this research indicates that subjective well-being, internalising problems, and externalising problems are distinct but related aspects of mental health. 'Child participation' and 'school pressure' displayed strong links with positive mental health outcomes and may serve as a potential path for improving public health interventions for children in care.
Collapse
Affiliation(s)
- Pascale M J Engel de Abreu
- Cognitive and Socio-Emotional Development Group, Department of Humanities, University of Luxembourg, Maison des Sciences Humaines 11, Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg.
| | - Robert Kumsta
- Laboratory for Stress and Gene-Environment Interplay, Department of Behavioural and Cognitive Sciences, University of Luxembourg, Maison des Sciences Humaines 11, Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg.
| | - Cyril Wealer
- Cognitive and Socio-Emotional Development Group, Department of Humanities, University of Luxembourg, Maison des Sciences Humaines 11, Porte des Sciences, L-4366 Esch-sur-Alzette, Luxembourg.
| |
Collapse
|
7
|
Novak-Pavlic M, Rosenbaum P, Di Rezze B. Changing Directions and Expanding Horizons: Moving towards More Inclusive Healthcare for Parents of Children with Developmental Disabilities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6983. [PMID: 37947541 PMCID: PMC10649410 DOI: 10.3390/ijerph20216983] [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: 07/30/2023] [Revised: 10/16/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
Family-centred service (FCS) acknowledges the importance of family engagement in therapeutic processes and focuses on the needs of all family members. This way of thinking and practicing is becoming increasingly recognized as an optimal care delivery model for families of children with developmental disabilities (DDs). However, in most places, disability services are oftentimes 'child-centric', wherein family members are seen only as partners in therapy or care delivery, while their own needs are not addressed. This arises from the lack of awareness of complex and highly individual family needs by professionals with whom they interact, but also from a significant lack of service infrastructure oriented towards parent-specific needs in existing service delivery models. This concept paper highlights the known challenges associated with parenting a child with a DD and discusses the intersectionality of factors impacting parental health and well-being, with a goal of promoting more equitable, holistic, and inclusive healthcare for all family members of children with DDs.
Collapse
Affiliation(s)
- Monika Novak-Pavlic
- School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada;
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada;
| | - Peter Rosenbaum
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada;
| | - Briano Di Rezze
- School of Rehabilitation Science, McMaster University, Hamilton, ON L8S 1C7, Canada;
- CanChild Centre for Childhood Disability Research, McMaster University, Hamilton, ON L8S 1C7, Canada;
| |
Collapse
|
8
|
Harries CI, Smith DM, Gregg L, Allott R, Wittkowski A. Parents who experience psychosis: A qualitative exploration. Psychol Psychother 2023; 96:590-607. [PMID: 36912129 DOI: 10.1111/papt.12458] [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: 09/02/2022] [Revised: 02/07/2023] [Accepted: 02/16/2023] [Indexed: 03/14/2023]
Abstract
OBJECTIVES Psychosis can present parents with complex parenting challenges and significant adverse outcomes for parents and their children have been reported. However, remarkably little is known about how parenting is experienced by these parents. Therefore, this qualitative study aimed to understand the lived experiences of parents with psychosis, including how parenting support was experienced. DESIGN AND METHODS Using interpretative phenomenological analysis (IPA), eight biological parents (five mothers and three fathers) with psychosis were recruited and interviewed from early intervention in psychosis services in the Northwest of England. RESULTS Three superordinate themes and seven subordinate themes were identified. Theme 1 'Living with the Struggle: Painfully Disconnected' captured a persistent parenting struggle that distanced parents from their children and support due to all-consuming experiences of psychosis, fear and risk-focused service support. Theme 2 'Desired and Vulnerable Position: Comfortably Connected' captured parental experiences of symptom relief through connection with their children, alongside parental need to be integrated with the systems around them. Theme 3 'Exposed: Parenting Under a Spotlight' represented parental experiences of inescapable observation and judgement from the systems around them. CONCLUSIONS Novel insights into the role of misaligned parent and service priorities in parental perceptions of powerlessness, shame and disconnection from their children, valued parenting identities, and system supports are presented. Systemic interventions that target stigma, provide system-wide psychoeducation and promote person-centred, compassionate and meaningful connections between parents and the systems they live within are needed to promote better parenting outcomes.
Collapse
Affiliation(s)
- Claire I Harries
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - Debbie M Smith
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - Lynsey Gregg
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| | - Rory Allott
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Anja Wittkowski
- Division of Psychology and Mental Health, School of Health Sciences, University of Manchester, Manchester, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, UK
| |
Collapse
|
9
|
Harries CI, Smith DM, Gregg L, Wittkowski A. Parenting and Serious Mental Illness (SMI): A Systematic Review and Metasynthesis. Clin Child Fam Psychol Rev 2023; 26:303-342. [PMID: 36807250 PMCID: PMC10123049 DOI: 10.1007/s10567-023-00427-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2023] [Indexed: 02/21/2023]
Abstract
The consequences of Serious Mental Illness (SMI) on parent and child outcomes can be profound. Supporting parents to manage their caregiving roles alongside parental SMI successfully has been recognised as a public health priority. To meet this priority and develop effective and acceptable interventions, it is imperative that parents' experiences and support needs are understood. This systematic review aimed to synthesise qualitative research that explored parents' experiences and perceptions of the impact of SMI on their parenting and their corresponding support needs. The Preferred Reporting Items for Systematic Review and Meta-Analysis guidelines were followed. Five databases were searched for terms associated with SMI, parenting, and qualitative research. Twenty-nine studies involving 562 parents who experienced SMI met inclusion criteria, and the methodological quality of included studies was appraised using the Critical Appraisal Skills Programme. After findings were synthesised using thematic synthesis, six themes were identified: (1) The constrained parent, (2) parenting difficulties, (3) the strained child, (4) inescapable threat, (5) combatting threat, and (6) wrap-around support needs. Novel insights into the centrality of SMI-related parenting difficulties and threat perceptions across parent, family, healthcare, and wider social systems on strained parent-child and distanced parent-support relationships were highlighted. Systemic practice change initiatives via compassionate and inclusive system-wide support were recommended.
Collapse
Affiliation(s)
- C I Harries
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, 2Nd Floor Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
- Manchester Academic Health Science Centre, Manchester, M13 9NQ, UK
| | - D M Smith
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, 2Nd Floor Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - L Gregg
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, 2Nd Floor Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK
- Manchester Academic Health Science Centre, Manchester, M13 9NQ, UK
| | - A Wittkowski
- Division of Psychology and Mental Health, Faculty of Biology, Medicine and Health, School of Health Sciences, University of Manchester, 2Nd Floor Zochonis Building, Brunswick Street, Manchester, M13 9PL, UK.
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
- Manchester Academic Health Science Centre, Manchester, M13 9NQ, UK.
| |
Collapse
|
10
|
Pienaar M, Marais L, Serekoane M, Marais K, Cloete J, Lenka M, Sharp C. 'Being a mother is not child's play': The capabilities of mothers in a low-resource setting in South Africa. Health Expect 2023; 26:651-661. [PMID: 36647701 PMCID: PMC10010090 DOI: 10.1111/hex.13689] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 10/26/2022] [Accepted: 12/09/2022] [Indexed: 01/18/2023] Open
Abstract
BACKGROUND The importance of a child's first 1000 days has now been widely accepted by the medical fraternity. Yet, we do not know much about caring practices in low-resource settings. AIM This study aimed to investigate the caring capabilities of mothers in a low-resource setting. METHOD In this study, in-depth interviews were conducted with 18 mothers with children aged 30 months or younger to better understand the arrangements, means and ends that inform developmental health in a low-resource setting in South Africa. The study was conducted in a low-income area, the former black township of Mangaung in Bloemfontein. The mothers were recruited via pamphlets, and two interviews followed. Because of Covid-19, interviews took place via mobile phones, in Sesotho, the local language in the area. Trained fieldworkers conducted, translated and transcribed the interviews. We used thematic analysis and the capabilities approach as the theoretical framework to analyse the responses from the mothers. FINDINGS We used the following organizing themes: pregnancy and ante-natal care, nutrition, cognitive and physical development, the home environment and access to health care. Although short-term reactions to pregnancy were often negative, the longer-term responses showed that the respondents have agency. Most of them could change their nutrition habits, breastfeed and receive adequate nutrition support from the public health system. Most experienced joy when their children reached milestones (cognitive and others), although they became anxious if milestones were not reached. They emphasized children's play and had dreams for their children's futures. Technology was often mentioned as playing a role in their children's development. A large proportion of the respondents had disrupted homes (because of absent or abusive fathers), but some had stable homes. Most of them showed substantial capability to overcome adverse home environments. The public health system helped them deal with their health problems and their children's health problems, although it also created anxiety in many cases. Our data show how they develop their capabilities and overcome obstacles organically in the face of resource limitations. Despite pregnancies being unexpected and unplanned and fathers being absent, the respondents accepted the pregnancy, adjusted their diets and social behaviour, showed agency by attending primary healthcare facilities and ensured that their children received the required vaccinations. Their extended families played an important role in providing care. Despite the sacrifices, the respondents expressed joy and helped their children function by eating, playing, socializing, learning and using their senses. CONCLUSION Our sample of mothers have the agency to adapt to the demands of parenthood and childcare and overcome adversity. Our data support the notion that mothers are held disproportionately and unfairly responsible for achieving the first 1000 days ideals. Despite considerable curtailment of their functionings and capabilities, they nevertheless showed agency to ensure their health and their children's health. A holistic approach should consider these findings in designing policy interventions for children's developmental health. PATIENT AND PUBLIC CONTRIBUTION We used paid fieldworkers to interact with the research participants.
Collapse
Affiliation(s)
- Michael Pienaar
- Department of Paediatrics and Child Health, University of the Free State, Bloemfontein, South Africa
| | - Lochner Marais
- Centre for Development Support, University of the Free State, Bloemfontein, South Africa
| | - Mosaathebe Serekoane
- Department of Anthropology, University of the Free State, Bloemfontein, South Africa
| | - Kobus Marais
- Department of Linguistics and Language Practice, University of the Free State, Bloemfontein, South Africa
| | - Jan Cloete
- Centre for Development Support, University of the Free State, Bloemfontein, South Africa
| | - Molefi Lenka
- Centre for Development Support, University of the Free State, Bloemfontein, South Africa
| | - Carla Sharp
- Centre for Development Support, University of the Free State, Bloemfontein, South Africa.,Department of Psychology, University of Houston, Houston, Texas, USA
| |
Collapse
|
11
|
Hinton L, Dumelow C, Hodgkinson J, Montgomery C, Martin A, Allen C, Tucker K, Green ME, Wilson H, McManus RJ, Chappell LC, Band R. 'Nesting networks': Women's experiences of social network support in high-risk pregnancy. Midwifery 2023; 120:103622. [PMID: 36893551 DOI: 10.1016/j.midw.2023.103622] [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: 07/26/2022] [Revised: 01/27/2023] [Accepted: 02/03/2023] [Indexed: 02/18/2023]
Abstract
OBJECTIVE Social support, an individual's social relationships (both online and offline), may provide protection against adverse mental health outcomes, such as anxiety and depression, which are high in women who have been hospitalised with high-risk pregnancy. This study explored the social support available to women at higher risk of preeclampsia during pregnancy by examining personal social networks. DESIGN Semi-structured interviews were accompanied by social network mapping using the web-based social networking tool GENIE. SETTING England. PARTICIPANTS Twenty-one women were recruited, of whom 18 were interviewed both during pregnancy and postnatally between April 2019 and April 2020. Nineteen women completed maps pre-natally, 17 women completed maps pre-natally and post-natally. Women were taking part in the BUMP study, a randomised clinical trial that included 2441 pregnant individuals at higher risk of preeclampsia and recruited at a mean of 20 weeks' gestation from 15 hospital maternity units in England between November 2018 and October 2019. RESULTS Women's social networks tightened during pregnancy. The inner network changed most dramatically postnatally with women reporting fewer network members. Interviews revealed networks were primarily 'real-life' rather than online social networks, with members providing emotional, informational, and practical support. Women with a high-risk pregnancy valued the relationships they developed with health professionals during pregnancy, and would like their midwife to have a more central role in their networks by providing informational and, where needed, emotional support. The social network mapping data supported the qualitative accounts of changing networks across high-risk pregnancy. CONCLUSION Women with a high-risk pregnancy seek to build "nesting networks" to support them through pregnancy into motherhood. Different types of support are sought from trusted sources. Midwives can play a key role. PRACTICE IMPLICATIONS As well as highlighting other potential needs during pregnancy and the ways in which they can be met, support from midwives has a key role. Through talking to women early in their pregnancy, signposting information and explaining ways to contact health professionals regarding informational or emotional support would fill a gap that currently is met by other aspects of their network.
Collapse
Affiliation(s)
- L Hinton
- The Healthcare Improvement Studies (THIS) Institute, University of Cambridge.
| | - C Dumelow
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - J Hodgkinson
- Institute of Applied Health Research, University of Birmingham, Birmingham
| | - C Montgomery
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - A Martin
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - C Allen
- School of Health Sciences, University of Southampton, Southampton, UK. SO17 1BJ
| | - K Tucker
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | | | - H Wilson
- Department of Women and Children's Health, King's College London, London
| | - R J McManus
- Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, OX2 6GG, UK
| | - L C Chappell
- Department of Women and Children's Health, King's College London, London
| | - R Band
- School of Health Sciences, University of Southampton, Southampton, UK. SO17 1BJ
| |
Collapse
|
12
|
Dawson MK, Ivey A, Buggs S. Relationships, resources, and political empowerment: community violence intervention strategies that contest the logics of policing and incarceration. Front Public Health 2023; 11:1143516. [PMID: 37139383 PMCID: PMC10149693 DOI: 10.3389/fpubh.2023.1143516] [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: 01/30/2023] [Accepted: 03/20/2023] [Indexed: 05/05/2023] Open
Abstract
Community violence-defined as unsanctioned violence between unrelated individuals in public places-has devastating physical, psychological, and emotional consequences on individuals, families, and communities. Immense investments in policing and incarceration in the United States have neither prevented community violence nor systemically served those who have been impacted by it, instead often inflicting further harm. However, the logics that uphold policing and incarceration as suitable or preventative responses to community violence are deeply ingrained in societal discourse, limiting our ability to respond differently. In this perspective, we draw from interviews with leading voices in the field of outreach-based community violence intervention and prevention to consider alternative ways to address community violence. We begin by demonstrating that policing and incarceration are distinguished by practices of retribution, isolation, and counterinsurgency that are counterproductive to the prevention of community violence. Then, we identify alternative practices of outreach-based community violence intervention and prevention that include (1) fostering safety nets through relationships among individuals, families, and neighborhoods, (2) fighting poverty and increasing access to resources, and (3) building political capacity among organizations to transform the broader systems in which they are embedded. They also include accountability practices that are preventative and responsive to the needs of those who are harmed. We conclude that elevating the language, narratives, and values of outreach-based community violence intervention and prevention can transform our responses to violence, interrupt cycles of harm, and foster safer communities.
Collapse
Affiliation(s)
- Mia Karisa Dawson
- Geography, University of California, Davis, Davis, CA, United States
- *Correspondence: Mia Karisa Dawson
| | - Asia Ivey
- Sociology, University of California, Davis, Davis, CA, United States
| | - Shani Buggs
- Health, University of California, Davis, Davis, CA, United States
| |
Collapse
|
13
|
Ward E, Pandian V, Brenner MJ. It takes a village to raise a child with a tracheostomy: Translating principles into practice. J Clin Nurs 2022. [PMID: 36183198 DOI: 10.1111/jocn.16549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 08/06/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Erin Ward
- Parent, Family Voice, Global Tracheostomy Collaborative, Raleigh, North Carolina, USA.,Family Liaison, Multidisciplinary Tracheostomy Team, Boston Children's Hospital, Boston, Massachusetts, USA.,President, MTM-CNM Family Connection, Inc., Methuen, Massachusetts, USA
| | - Vinciya Pandian
- Johns Hopkins School of Nursing, Baltimore, Maryland, USA.,Outcomes After Critical Illness and Surgery (OACIS) Research Group, Johns Hopkins University, Baltimore, Maryland, USA
| | - Michael J Brenner
- Department of Otolaryngology-Head & Neck Surgery, University of Michigan Medical Center, Ann Arbor, Michigan, USA.,Global Tracheostomy Collaborative, Raleigh, North Carolina, USA
| |
Collapse
|