Moving from theory to practice: A participatory social network mapping approach to address unmet need for family planning in Benin

In West Africa, social factors influence whether couples with unmet need for family planning act on birth-spacing desires. Tékponon Jikuagou is testing a social network-based intervention to reduce social barriers by diffusing new ideas. Individuals and groups judged socially influential by their communities provide entrée to networks. A participatory social network mapping methodology was designed to identify these diffusion actors. Analysis of monitoring data, in-depth interviews, and evaluation reports assessed the methodology's acceptability to communities and staff and whether it produced valid, reliable data to identify influential individuals and groups who diffuse new ideas through their networks. Results indicated the methodology's acceptability. Communities were actively and equitably engaged. Staff appreciated its ability to yield timely, actionable information. The mapping methodology also provided valid and reliable information by enabling communities to identify highly connected and influential network actors. Consistent with social network theory, this methodology resulted in the selection of informal groups and individuals in both informal and formal positions. In-depth interview data suggest these actors were diffusing new ideas, further confirming their influence/connectivity. The participatory methodology generated insider knowledge of who has social influence, challenging commonly held assumptions. Collecting and displaying information fostered staff and community learning, laying groundwork for social change.     

Patterns of support among gay lesbian deaf persons

In order to study the patterns of support among gay deaf men and lesbian deaf women a research project was conducted from January, 1977 to May, 1978. Initially, an informal study was conducted at various social gatherings of gay deaf men, such as interpreting at the first and only gay deaf wedding ever to be held in Pennsylvania, possibly the United States. Later research methods included formal interviews with gay deaf men and lesbian deaf women, as well as their families. In addition, survey questionnaires were sent to professionals and agencies serving both the gay/lesbian and the deaf communities. The research project identified a significant client population in need of social services. The project also indicated that trying to determine patterns of support among the gay/lesbian deaf subculture is a complex problem which needs to be studied on several different levels.The author is a clinical social worker and the Deaf-Blind Coordinator at the at the UPSAL Day School for Blind Multi-Handicapped Children in Philadelphia, Pa.     

Informal support for women and intimate partner violence: the crucial yet ambivalent role of neighbours in urban India

Women who experience intimate partner violence often rely on informal support to mitigate intimate partner violence's health effects. Yet there is little known about who gives the support and how it is provided. This paper explores from whom and how low-income women experiencing domestic violence in urban India seek informal support. In South Asia, women's reliance on kin for support is culturally valued, yet the urban social context makes it more likely that they will access such support from non-kin when they experience intimate partner violence. The paper draws on observations and interviews with 10 families collected over 14 months of in-depth ethnographic research in one Delhi slum community. Using a case study approach to explore women's responses to violence longitudinally, it was possible to track how women drew on support. Results show that even as women sought emotional support and direct intervention from their neighbours to deal with their domestic violence, they restricted these relationships, faced stigma, and emphasised the need to protect their families. Understanding the informal, but deeply ambivalent, systems of social support that women engage to deal with intimate partner violence is a first step toward strengthening such networks, a key recommendation to stem the health impacts of domestic violence.     

Constructing queer mother‐knowledge and negotiating medical authority in online lesbian pregnancy journals

Medical interactions around reproduction are increasingly extending beyond the physician's office and onto the Internet, where negotiation with medical authority occurs in complex and dynamic ways. Recently, scholars have noted the Internet's potential for creating spaces where women can dialogue with and reconstruct medical authority, yet this growing body of work is overwhelming heteronormative. This paper thus interrogates how lesbian women use the Internet to challenge, deploy, and rework medical authority around reproduction while navigating the transition to parenthood. I draw from 17 online journals authored by lesbian couples during the conception, pregnancy, and birth of their first child, each spanning between 18 months and 2 years, in order to understand how the transition process unfolds over time. I argue that lesbian couples engage with medical authority when seeking affirmation and normalisation yet discard and publicly reject the heteronormative assumptions that accompany reproductive medicine. Further, they chart a new process that I term ‘constructing queer mother‐knowledge’, in which they critique and balance knowledges from institutionalised medicine, their own bodies, and their queer communities. With this new concept, I complicate understandings of lesbian mothers‐to‐be and their interactions with medical authority as they build subversive families.     

Substance use,gender inequity,violence and sexual risk among couples in Cape Town

Alcohol and other drug use, gender power inequities and violence are key contributors to sexual risks for HIV among South African men and women. Little is known about the intersection between these sex-risk behaviours among couples in established heterosexual relationships. We conducted 10 focus-group discussions with men and women in relationships of 1 year or longer recruited from shebeens (informal taverns) in Cape Town, South Africa. Participants described: high levels of alcohol consumption at shebeens; low levels of condom use with main and casual sex partners; gender roles disfavouring women's condom negotiating power that also promoted economic dependency on male partners; men often spending a portion of the household income on alcohol and other drugs and sex with others in shebeens; loss of household income driving women to trade sex to provide for their families; and sexual violence and the exploitation of women occurring in shebeens. Findings highlight how the social contexts of alcohol and other drug use, gender inequitable norms and gender violence promote HIV risk within established heterosexual relationships in South African communities. Evidence of this kind should inform the design of HIV-risk-reduction interventions tailored to heterosexual couples who drink alcohol in shebeens.     

Perinatal mental health in lesbian mothers: a review of potential risk and protective factors

Postpartum depression and other perinatal mental illnesses are common complications of childbirth. The majority of research on these conditions has been conducted in heterosexual women; however, increasing numbers of women are choosing to parent in the context of lesbian relationships. Although many of the fundamental aspects of the transition to parenthood are shared between lesbian and heterosexual mothers, lesbian mothers may differ from heterosexual parents on a number of variables that have been previously associated with perinatal mental health. Lesbian mothers may be more likely than their heterosexual peers to lack social support, particularly from their families of origin, and may be exposed to additional stress due to homophobic discrimination. However, the likelihood that lesbian pregnancies will be planned, together with the relatively equal division of child-care labour observed in lesbian couples, may offer protection from perinatal depression. The study of perinatal mental health in lesbian mothers is warranted, both to ensure that the mental health needs of this largely invisible population are being met, and to further illuminate the role of psychosocial stress in perinatal mental health in all women.     

Perinatal Mental Health in Lesbian Mothers: A Review of Potential Risk and Protective Factors

ABSTRACT

Postpartum depression and other perinatal mental illnesses are common complications of childbirth. The majority of research on these conditions has been conducted in heterosexual women; however, increasing numbers of women are choosing to parent in the context of lesbian relationships. Although many of the fundamental aspects of the transition to parenthood are shared between lesbian and heterosexual mothers, lesbian mothers may differ from heterosexual parents on a number of variables that have been previously associated with perinatal mental health. Lesbian mothers may be more likely than their heterosexual peers to lack social support, particularly from their families of origin, and may be exposed to additional stress due to homophobic discrimination. However, the likelihood that lesbian pregnancies will be planned, together with the relatively equal division of child- care labour observed in lesbian couples, may offer protection from perinatal depression. The study of perinatal mental health in lesbian mothers is warranted, both to ensure that the mental health needs of this largely invisible population are being met, and to further illuminate the role of psychosocial stress in perinatal mental health in all women.     

Reducing Obesity: Motivating Action While Not Blaming the Victim

Context: The rise in obesity in the United States may slow or even reverse the long‐term trend of increasing life expectancy. Like many risk factors for disease, obesity results from behavior and shows a social gradient. Especially among women, obesity is more common among lower‐income individuals, those with less education, and some ethnic/racial minorities. Methods: This article examines the underlying assumptions and implications for policy and the interventions of the two predominant models used to explain the causes of obesity and also suggests a synthesis that avoids “blaming the victim” while acknowledging the role of individuals' health behaviors in weight maintenance. Findings: (1) The medical model focuses primarily on treatment, addressing individuals' personal behaviors as the cause of their obesity. An underlying assumption is that as independent agents, individuals make informed choices. Interventions are providing information and motivating individuals to modify their behaviors. (2) The public health model concentrates more on prevention and sees the roots of obesity in an obesogenic environment awash in influences that lead individuals to engage in health‐damaging behaviors. Interventions are modifying environmental forces through social policies. (3) There is a tension between empowering individuals to manage their weight through diet and exercise and blaming them for failure to do so. Patterns of obesity by race/ethnicity and socioeconomic status highlight this tension. (4) Environments differ in their health‐promoting resources; for example, poorer communities have fewer supermarkets, more fast‐food outlets, and fewer accessible and safe recreational opportunities. Conclusions: A social justice perspective facilitates a synthesis of both models. This article proposes the concept of “behavioral justice” to convey the principle that individuals are responsible for engaging in health‐promoting behaviors but should be held accountable only when they have adequate resources to do so. This perspective maintains both individuals' control and accountability for behaviors and society's responsibility to provide health‐promoting environments.     

Relationship satisfaction in lesbian and heterosexual couples before and after assisted reproduction: a longitudinal follow-up study

Background

More and more lesbian couples are planning parenthood through donor insemination and IVF and the number of planned lesbian families is growing in Sweden and other western countries. Research has shown that lesbian couples report as much overall satisfaction in their relationships as do heterosexual couples. However, although parenthood is highly desired, many parents are unaware of the demands of parenthood and the strain on their relationship that the arrival of the baby might bring. The aim of this study was to compare lesbian and heterosexual couples’ perceptions of relationship satisfaction at a three-year follow up after assisted reproduction.

Methods

The present study is a part of the Swedish study on gamete donation, a prospective longitudinal cohort study. The present study constitutes a three-year follow up assessment of lesbian and heterosexual couples after assisted reproduction. Participants requesting assisted reproduction at all fertility clinics performing gamete donation in Sweden, were recruited consecutively during 2005–2008. A total of 114 lesbian women (57 treated women and 57 partners) and 126 heterosexual women and men (63 women and 63 men) participated. Participants responded to the ENRICH inventory at two time points during 2005–2011; at the commencement of treatment (time point 1) and about three years after treatment termination (time point 3). To evaluate the bivariate relationships between the groups (heterosexual and lesbian) and socio-demographic factors Pearson’s Chi- square test was used. Kolmogorov-Smirnov test was used for testing of normality, Mann–Whitney U- test to examine differences in ENRICH between the groups and paired samples t-test to examine scores over time.

Results

Lesbian couples reported higher relationship satisfaction than heterosexual couples, however the heterosexual couples satisfaction with relationship quality was not low. Both lesbian and heterosexual couples would be classified accordingly to ENRICH-typology as vitalized or harmonious couples.

Conclusions

At a follow-up after assisted reproduction with donated sperm, lesbian couples reported stable relationships and a high satisfaction with their relationships, even when treatment was unsuccessful.

     

Social Support and Psychological Well‐Being in Lesbian and Heterosexual Preadoptive Couples

Abstract: This study examines predictors of social support and mental health among 36 lesbian and 39 heterosexual couples who were waiting to adopt. Lesbian preadoptive partners perceived less support from family than heterosexual partners but similar levels of support from friends. Lesbian and heterosexual partners reported similar levels of well‐being. Aspects of the adoption process were associated with anxiety, whereas couples’ conception history was associated with depression. Adoption practitioners should acknowledge these distinct pathways in prevention efforts.     

“I luv u :)!”: A Descriptive Study of the Media Use of Individuals in Romantic Relationships

In this study, we address the communication technologies individuals within romantic relationships are using to communicate with one another, the frequency of use, and the association between the use of these technologies and couple's positive and negative communication. Participants consisted of individuals involved in a serious, committed, heterosexual relationship. The Relationship Evaluation Questionnaire instrument was used to assess a variety of relationship variables. The majority of individuals within the study frequently used cell phones and text messaging to communicate with their partner, with “expressing affection” being the most common reason for contact. Younger individuals reported using all forms of media (except for e‐mail) more frequently than older participants. Relationship satisfaction did not predict specific use of media but predicted several reasons for media use. Additional analyses revealed that text messaging had the strongest association with individuals' positive and negative communication within their relationships. Specifically, text messaging to express affection, broach potentially confrontational subjects, and to hurt partners were associated with individuals' view of positive and negative communication within their relationship. Implications of the results are discussed.     

“You Live Where?!” Lesbian Mothers' Attachment to Nonmetropolitan Communities

A positive attachment to one's residential community has been linked to better mental health ( McLaren, 2009 ), stronger social support ( Young, Russell, & Powers, 2004 ), and a higher quality of life ( Mak, Cheung, & Law, 2009 ). Attachment to residential community has been understudied in research on lesbian, gay, bisexual, and transgender (LGBT) families. The current study attempts to fill this gap by using family and minority stress theories to examine the predictors of residential community attachment among 77 lesbian mothers living in nonmetropolitan communities. Our findings indicate that stronger residential community attachment is predicted by more frequent contact with family of origin, low religiosity, and an interaction between close LGBT friendships and the presence of at least one local LGBT organization. Contrary to expectations, anti‐LGBT victimization perpetrated by community members did not have an effect on residential community attachment.     

Creating a Health-Promoting Group for Elderly Couples on a Home Health Care Program

The hospital home care social worker has a unique opportunity to develop a home-keeping, health-promoting group for frail elderly couples within his or her caseload. Through home visits, working as a filial professional, the worker enters, then strengthens the couples' pre-illness formal and informal support networks, and then goes on to create an additional informal peer support group, that meets in each others' homes. The group is capable of decreasing the chance of nursing home placement for all its members. It is proposed that home health care agencies within hospitals incorporate such groups into their regular programs.     

Informal caregivers' experiences of formal support in a changing context

As the location of long-term care of elderly people moves to homes and communities, and responsibility for care shifts to families, understanding the experience of people in this situation is necessary to ensure that support is appropriate, accessible and effective. The present paper explores informal caregivers' and recipients' relationships with formal support, drawing on thematic and narrative analysis of 30 in-depth interviews with self-identified family caregivers conducted over a year in a mid-size city in Ontario, Canada. All but six of these caregivers had had some interaction with formal support. The semistructured interviews explored caregivers' knowledge about, and perceptions and experiences of accessing and using formal support. Interpretation reveals how confusion and lack of knowledge about services, the inflexibility and lack of availability of services, and increasing pressure on the quantity and quality of publicly funded community-based resources combine to impact negatively on the experience of accessing and using formal support. Different ideas about the relative roles and responsibilities of seniors, informal caregivers and 'family' in general, and the state both shape and are shaped by policies and the situated realities of the provision of formal support. Providing care at home creates both opportunities and constraints for caregivers in their interactions with formal support. Lastly, this paper highlights the difficulties of interacting with publicly funded formal support as the costs of care are moved away from the state and onto families and individuals.     

The South Carolina Multigenerational Linked Birth Dataset: Developing Social Mobility Measures Across Generations to Understand Racial/Ethnic Disparities in Adverse Birth Outcomes in the US South

Objectives To describe the creation of a multigenerational linked dataset with social mobility measures for South Carolina (SC), as an example for states in the South and other areas of the country. Methods Using unique identifiers, we linked birth certificates along the maternal line using SC birth certificate data from 1989 to 2014, and compared the subset of records for which linking was possible with two comparison groups on sociodemographic and birth outcome measures. We created four multi-generational social mobility measures using maternal education, paternal education, presence of paternal information, and a summary score incorporating the prior three measures plus payment source for births after 2004. We compared social mobility measures by race/ethnicity. Results Of the 1,366,288 singleton birth certificates in SC from 1989 to 2014, we linked 103,194, resulting in 61,229 unique three-generation units. Mothers and fathers were younger and had lower education, and low birth weight was more common, in the multigenerational linked dataset than in the two comparison groups. Based on the social mobility summary score, only 6.3% of White families were always disadvantaged, compared to 30.4% of Black families and 13.2% of Hispanic families. Moreover, 32.8% of White families were upwardly mobile and 39.1% of Black families were upwardly mobile, but only 29.9% of Hispanic families were upwardly mobile. Conclusions for Practice When states are able to link individuals, birth certificate data may be an excellent source for examining population-level relationships between social mobility and adverse birth outcomes. Due to its location in the Deep South, the multigenerational SC dataset may be particularly useful for understanding racial/ethnic difference in social mobility and birth outcomes.

     

Same‐Sex Relationship Dissolution and LGB Stepfamily Formation: Perspectives of Young Adults with LGB Parents

Research has increasingly focused on intentional or planned lesbian, gay, bisexual (LGB)‐parent families; however, how young adults in these families navigate the aftermath of parental break‐up and subsequent repartnering is unexamined. This qualitative study of 20 young adults who had experienced their LGB parents' relationship dissolution and/or the formation of an LGB stepfamily examined how young adults perceived their parents' relational transitions and their own relationships with stepparents and siblings. Results indicated that (a) nearly all families negotiated relational transitions (e.g., relationship dissolutions) informally and without legal intervention, (b) young adults perceived both advantages and disadvantages in the ambiguity surrounding their family's nonlegal status, (c) relationships with biological mothers were the strongest tie from break‐up to repartnering and stepfamily formation, (d) geographic distance from their nonbiological parents created hardships in interpersonal closeness, (e) yet, on the whole, young people perceived their families as strong and competent in handling familial transitions.     

Financial Stress,Parental Depressive Symptoms,Parenting Practices,and Children's Externalizing Problem Behaviors: Underlying Processes

This study examined the relationships among financial stress encountered by families, parents' social support, parental depressive symptoms, parenting practices, and children's externalizing problem behaviors to advance our understanding of the processes by which family financial stress is associated with children's problem behaviors. We also tested moderated mediation to investigate if these relationships differed depending on children's characteristics. The data were drawn from 290 predominantly rural families with young children who were identified as at risk for the development of serious conduct problems. Using structural equation modeling, we found that the relationship between family income and children's externalizing problem behaviors was mediated by parents' social support, parental depressive symptoms, and parenting practices. The results also showed that the children's levels of aggression severity, academic functioning, and developmental strengths moderated the mediating relationships between family income and parental depressive symptoms and between family income and positive parenting.     

Donor conceived offspring conceive of the donor: The relevance of age,awareness, and family form

Rarely have donor conceived offspring been studied. Recently, it has become more common for parents to disclose the nature of conception to their offspring. This new development raises questions about the donor's place in the offspring's life and identity. Using surveys collected by the Donor Sibling Registry, the largest U.S. web-based registry, during a 15 week period from October 2009 to January 2010, we found that donor offspring view the donor as a whole person, rather than as simple genetic material (he can know you; he has looks; he can teach you about yourself); they also believe that the donor should act on his humanity (he should know about you and not remain an anonymous genetic contributor). Other new issues that emerge from this research include the findings that offspring may want to control the decision about contacting their sperm donor in order to facilitate a bond between themselves and the donor that is separate from their relationship with their parents. They also wish to assure their parents that their natal families are primary and will not be disrupted. We discuss how the age at which offspring learned about their donor conception and their current age each make a difference in their responses to what they want from contact with their donor. Family form (heterosexual two-parent families and lesbian two-parent families) also affects donor terminology. The role of the genetic father is reconsidered in both types of families. Donor conceived offspring raised in heterosexual families discover that their natal father no longer carries biological information and he is relegated to being “only” a social father. Offspring raised by lesbian couples experience a dissipation of the family narrative that they have no father. The donor, an imagined father, offers clues to the offspring's personal identity. The natal family is no longer the sole keeper of identity or ancestry.