“We're the Heroes!”: Fathers' Perspectives on Their Role In Protecting Their Preteenage Children from Sexual Risk

CONTEXT: Parents can be an important influence on their children's sexual behavior. However, relatively little research has focused on fathers’ roles in protecting children from sexual risk or on their discussions with children about sex. METHODS: Sixteen focus groups comprising 131 parents of children aged 10–12 were conducted in three U.S. cities in 2007. Separate groups were held for mothers and fathers, and for white, black, English‐speaking Hispanic and Spanish‐speaking Hispanic participants. Content analysis was used to identify core themes and patterns related to fathers’ communications with their children about sex. RESULTS: Fathers were highly invested in ensuring that their children are safe and successful in life. Although some had not talked to their children about sex, others had discussed it frequently and openly, and nearly all agreed that fathers’ perspectives are important for children to hear. Fathers reported being better suited to discussing some topics (e.g., male puberty, how young men think) than others (menstruation). Fathers also described other strategies that they use to guide their children's development, such as emphasizing future goals and monitoring children's activities and friends. Many fathers, especially Hispanic participants, reported being more protective of daughters than of sons, and some had particular difficulty talking with their daughters about sex. CONCLUSIONS: Research and interventions concerning parent‐child communication about sex should not neglect the role of fathers. However, some fathers may need support to overcome barriers to effective communication, especially with their daughters.     

Gender, cancer experience and internet use: a comparative keyword analysis of interviews and online cancer support groups

A new method, comparative keyword analysis, is used to compare the language of men and women with cancer in 97 research interviews and two popular internet based support groups for people with cancer. The method is suited to the conjoint qualitative and quantitative analysis of differences between large bodies of text, an alternative to the 'code and retrieval' approach used in much thematic analysis of qualitative materials. Web forums are a rich source of data about illness experience and gender differences. Marked differences in the performance of gender are evident. These differences follow linguistic and other behavioural patterns (such as social network differences) established in other contexts. Men with prostate cancer indicate in research interviews that they are more likely to seek information on the internet; women with breast cancer that they are more likely to seek social and emotional support. Men's concerns cluster around treatment information, medical personnel and procedures. Their experience of disease is more localised on particular areas of the body, while women's experience is more holistic. Women's forum postings orientate much more towards the exchange of emotional support, including concern with the impact of illness on a wide range of other people. Women's use of superlatives as well as words referring to feelings indicate their enactment of greater emotional expressivity. Web forums are platforms for an intensification of men's knowledge gathering activities. Web forums, though actually quite publicly visible, appear to be subjectively experienced by both sexes as relatively private places for the exchange of intimate personal information. The 'privacy' of the breast cancer forum facilitated interactions found in other studies to be characteristic of women's friendship groups.     

ParentLink: A Model of Integration and Support for Parents*

ParentLink represents a collective of Missouri organizations and agencies striving to simplify parents' access to research‐based information, services, and problem‐solving support pertaining to parenting. It is based on systems theory ( von Bertalanffy, 1981 ) and, more specifically, the ecology of human development ( Bronfenbrenner, 1979 ). A comprehensive array of technologies augments ParentLink professionals' outreach to parents and other citizenry. For parents, the access can be as simple as a telephone call to ParentLink's WarmLine professionals. Other doorways for information and support include ParentLink's Web site, other Web applications, media campaigns, and forthcoming neighborhood‐based Parenting Corners. Information gathered from parents and communities about parenting issues will in turn shape future programs and policies.     

The Dark Side of Addiction Support Forums: Impacts of Poor Quality and Insufficient Emotional Support on Perceived Support Availability and Health Efficacy

Research has identified many benefits of participating in online social support forums; however, the potential negative impacts of these communities have rarely been examined. This study explored the negative impacts of low quality (i.e., low person-centered) and insufficient (i.e., under-benefitted) emotional support on online support seekers. Health stigma and perceived support availability were also examined as mediating and moderating variables, respectively, in the model. An online survey of addiction support forum users (N = 321) was conducted. Results showed that for participants with low health stigma, low person-centered support decreased health self-efficacy through reducing perceived online emotional support availability, but under-benefitted support did not impact them. For those with high health stigma, low person-centered emotional support had positive effects on health self-efficacy through increasing perceived support availability, whereas under-benefitted support reduced health self-efficacy through decreasing perceived support availability. Importantly, a considerable proportion of participants (44.86%) reported under-benefitted emotional support. These findings suggest support forum participation can have negative impacts, but not all participants are adversely impacted equally. Instead, moderating variables, such as health stigma, can play an important role. Implications for future research and health care practitioners are discussed.     

Over‐the‐counter analgesic use by urban Aboriginal people in South Australia

Despite recent health gains for Australian Aboriginal people their significantly poorer health status compared with that of non‐Aboriginal Australians remains significant. Within the context of high levels of mortality and morbidity, research highlights significant barriers to timely health‐care, access and safe use of prescribed and over‐the‐counter medicines. The risks to Aboriginal people's health due to unsafe medication use are preventable. The purpose of this article is to present the findings from qualitative research focused on Aboriginal people's knowledge, use and experience of over‐the‐counter analgesics. The study was conducted in the north‐western metropolitan area of Adelaide, which has the largest urban Aboriginal population in South Australia. The employment of an Aboriginal Elder as Cultural Advisor enabled engagement with Aboriginal participants. Purposive ‘snow ball’ sampling was used to recruit participants for four focus groups [n = 30] and one participant opting for a personal semi‐structured interview. Participants worked with the researchers to develop the findings and formulate recommendations. The 25 women and 6 men, aged 20–80 years reported various chronic medical conditions. Focus groups/interview elicited accounts of critical issues concerning safe selection and use of over‐the‐counter analgesics. Serious health risks were evident due to limited knowledge about safe analgesic use and over‐reliance on information from family, friends and advertising. Extremely poor access was reported by participants to culturally and linguistically appropriate information, education and advice from a range of doctors and other health professionals including Aboriginal health workers.     

Temporalities of mental distress: digital immediacy and the meaning of ‘crisis’ in online support

The Internet is increasingly used to seek support by those suffering with mental distress (Bauman, S. and Rivers, I. Mental Health and the Digital Age. Basingstoke: Palgrave Macmillan; 2015). Drawing on research on a major online peer support forum, we analyse discussions around acute distress, self‐harm and suicide. The paper argues that new temporalities of mental health ‘crisis’ are emerging through the intersection of the immediacy of online support, the chronicity of underlying distress and the punctuated nature of professional support. Online support adds a layer of temporal immediacy that does not traditionally feature in other forms of support (e.g. professional in‐person services). This shifts the meaning of a mental health ‘crisis’ from acute to processual, and can lead to definitions of ‘crisis’ being used when not desired nor necessarily accurate. By attending to the layering of temporalities at the intersections of professional in‐person, and online support, we demonstrate how parameters of crisis support are set – by whom, for whom and in relation to whose bodies. This has implications for professional clinical practice internationally in relation to the increased digitisation of support and the meanings of ‘crisis’ that emerge.     

The “Paradox of Empowerment” in Parent Education: A Reflexive Examination of Parents' Pedagogical Expectations

In an action research project designed to develop a new paradigm for parent education in alignment with the “strengths perspective,” a social constructionist epistemology, and the empowerment discourse, it was found that parents joining two parent groups actually valued and sought expert knowledge. Seeking to empower these parents by adopting a collaborative learning approach—facilitating a reflective discussion of their parenting experience while refraining from meeting their expectation to be taught—we were actually exercising professional power in imposing our ideology of empowerment on the parents. To resolve this “paradox of empowerment,” we came to the see that parent educators cannot avoid meeting parents' pedagogical expectation. They should, however, provide expert knowledge and advice with epistemic reflexivity. Moreover, they need to navigate the micropolitics in the interaction between themselves as “educators” and parents as “learners,” so as to negotiate a power relation that is characterized by collaboration and partnership.     

The Exchange of Social Support on Online Bariatric Surgery Discussion Forums: A Mixed-Methods Content Analysis

Bariatric surgery patients often experience physical and psychosocial stressors, and difficulty adjusting to significant lifestyle changes. As a result, social support groups that provide patients with support, coping skills, and nutritional information are valuable components of bariatric care. Support group attendance at bariatric centers is associated with greater post-surgery weight loss; however, several barriers hinder attendance at in-person support groups (e.g., travel distance to bariatric centers). Consequently, online support forums are an increasingly utilized resource for patients both before and after surgery. This study examined and described the type and frequency of social support provided on a large online bariatric surgery forum. A total of 1,412 messages in the pre- (n = 822) and post-surgery (n = 590) sections of the forum were coded using qualitative content analysis according to Cutrona and Suhr’s (1992) Social Support Behavior Code model (i.e., including informational, tangible, esteem, network, and emotional support types). The majority of messages provided informational and emotional support regarding: a) factual information about the bariatric procedure and nutrition; b) advice for coping with the surgery preparation process, and physical symptoms; and c) encouragement regarding adherence to surgical guidelines, and weight loss progress. Network, esteem, and tangible support types were less frequent than informational and emotional support types. The results inform healthcare providers about the types of social support available to bariatric patients on online support forums and, thus, encourage appropriate referrals to this resource.     

Reliability and validity of Web‐SPAN,a web‐based method for assessing weight status,diet and physical activity in youth

Background: Web‐based surveys are becoming increasing popular. The present study aimed to assess the reliability and validity of the Web‐Survey of Physical Activity and Nutrition (Web‐SPAN) for self‐report of height and weight, diet and physical activity by youth. Methods: School children aged 11–15 years (grades 7–9; n = 459) participated in the school‐based research (boys, n = 225; girls, n = 233; mean age, 12.8 years). Students completed Web‐SPAN (self‐administered) twice and participated in on‐site school assessments [height, weight, 3‐day food/pedometer record, Physical Activity Questionnaire for Older Children (PAQ‐C), shuttle run]. Intraclass (ICC) and Pearson’s correlation coefficients and paired samples t‐tests were used to assess the test–retest reliability of Web‐SPAN and to compare Web‐SPAN with the on‐site assessments. Results: Test–retest reliability for height (ICC = 0.90), weight (ICC = 0.98) and the PAQ‐C (ICC = 0.79) were highly correlated, whereas correlations for nutrients were not as strong (ICC = 0.37–0.64). There were no differences between Web‐SPAN times 1 and 2 for height and weight, although there were differences for the PAQ‐C and most nutrients. Web‐SPAN was strongly correlated with the on‐site assessments, including height (ICC = 0.88), weight (ICC = 0.93) and the PAQ‐C (ICC = 0.70). Mean differences for height and the PAQ‐C were not significant, whereas mean differences for weight were significant resulting in an underestimation of being overweight/obesity prevalence (84% agreement). Correlations for nutrients were in the range 0.24–0.40; mean differences were small but generally significantly different. Correlations were weak between the web‐based PAQ‐C and 3‐day pedometer record (r = 0.28) and 20‐m shuttle run (r = 0.28). Conclusions: Web‐SPAN is a time‐ and cost‐effective method that can be used to assess the diet and physical activity status of youth in large cross‐sectional studies and to assess group trends (weight status).     

Caregivers of Older Adults: Advantages and Disadvantages of Internet‐based Social Support*

We explored the perceptions of caregivers of older adults using Internet‐based social support networks regarding the unique advantages and disadvantages of online social support. Participants were recruited with permission of Web owners through 15 Web sites that offered social networks, and responses from 63 electronically submitted surveys were analyzed qualitatively. Two major advantages of online social support were attributes of computer‐mediated communication (CMC)(anonymity, asynchrony, and ability to personalize use) and connectivity (connecting with other caregivers). Disadvantages included limitations of CMC and complaints with CMC. Findings suggest that Internet use may be a potential resource for caregivers in expanding their status‐similar social support networks.     

Romantic Partner and Biological Father Support: Associations with Maternal Distress in Low‐Income Mexican‐Origin Families

Paternal support is often linked to lower levels of maternal psychological distress; however, research has seldom considered the increasing numbers of Mexican‐origin families with a romantic partner social (RPS) father (i.e., mothers' partners who are not formally identified as stepfathers). This study applied a bioecological systems framework to test linkages between support from RPS fathers and maternal depressive symptoms and parenting stress and to consider whether nonresident biological father support and instrumental social support moderate these associations. Using data from the Fragile Families and Child Wellbeing Study, the authors analyzed a subsample of Mexican‐origin mothers (N = 76) with 3‐year‐old children. Findings indicated that maternal perceptions of support from RPS fathers were inversely related to depressive symptomatology only when mothers also perceived high levels of support from biological fathers, and the relationship with the RPS father began recently. Neither RPS nor biological father support was associated with maternal parenting stress.     

Parenting Stress,Social Support,and Mother‐Child Interactions in Families of Multiple and Singleton Preterm Toddlers

The study investigated family support as a buffer of stress in 153 mothers and preterm toddlers. Data were collected regarding maternal depressive symptoms, parenting stress, and family support; infant health; and videotaped mother‐child interactions. Although more parenting stress related to less optimal child play, only information support functioned as a protective factor. Information support predicted positive play under high, but not low, maternal stress. Mothers of multiples reported more parenting stress than mothers of singletons.     

Building an online community to promote communication and collaborative learning between health professionals and young people who self‐harm: an exploratory study

Background

Online communities are known to break down barriers between supposed experts and non‐experts and to promote collaborative learning and ‘radical trust’ among members. Young people who self‐harm report difficulties in communicating with health professionals, and vice versa.

Aim

We sought to bring these two groups together online to see how well they could communicate with each other about self‐harm and its management, and whether they could agree on what constituted safe and relevant advice.

Methods

We allocated 77 young people aged 16–25 with experience of self‐harm and 18 recently/nearly qualified professionals in relevant health‐care disciplines to three separate Internet discussion forums. The forums contained different proportions of professionals to young people (none; 25%; 50% respectively) to allow us to observe the effect of the professionals on online interaction.

Results

The young people were keen to share their lived experience of self‐harm and its management with health professionals. They engaged in lively discussion and supported one another during emotional crises. Despite registering to take part, health professionals did not actively participate in the forums. Reported barriers included lack of confidence and concerns relating to workload, private–professional boundaries, role clarity, duty of care and accountability. In their absence, the young people built a vibrant lay community, supported by site moderators.

Conclusions

Health professionals may not yet be ready to engage with young people who self‐harm and to exchange knowledge and experience in an anonymous online setting. Further work is needed to understand and overcome their insecurities.     

“How Can You Just Cut Off a Whole Side of the Family and Say Move On?” The Reshaping of Paternal Grandparent‐Grandchild Relationships Following Divorce or Separation in the Middle Generation

On the basis of a qualitative study of 31 grandparents, this article highlights how separation in the middle generation can result in an erosion of trust and quality of paternal grandparent‐grandchild relationships. Notwithstanding these changes, grandparents endeavor to support and remain involved in the lives of their grandchildren by, inter alia, compensating for a perceived lack of their sons' parenting skills, affirming their grandchild's position in the paternal kin network, and acting as a mediator between the separated couple to ensure continued contact with grandchildren. The findings suggest that the actions of paternal grandparents can potentially have important future implications not only for the grandparent‐grandchild relationship, but also the relationship trajectories of their adult son and child in the post‐separation family.     

‘You’re judged all the time!’ Students’ views on professionalism: a multicentre study

Medical Education 2010: 44 : 814–825 Objectives This study describes how medical students perceive professionalism and the context in which it is relevant to them. An understanding of how Phase 1 students perceive professionalism will help us to teach this subject more effectively. Phase 1 medical students are those in the first 2 years of a 5‐year medical degree. Methods Seventy‐two undergraduate students from two UK medical schools participated in 13 semi‐structured focus groups. Focus groups, carried out until thematic saturation occurred, were recorded and transcribed verbatim. Data were analysed and coded using NVivo 8, using a grounded theory approach with constant comparison. Results From the analysis, seven themes regarding professionalism emerged: the context of professionalism; role‐modelling; scrutiny of behaviour; professional identity; ‘switching on’ professionalism; leniency (for students with regard to professional standards), and sacrifice (of freedom as an individual). Students regarded professionalism as being relevant in three contexts: the clinical, the university and the virtual. Students called for leniency during their undergraduate course, opposing the guidance from Good Medical Practice. Unique findings were the impact of clothing and the online social networking site Facebook on professional behaviour and identity. Changing clothing was described as a mechanism by which students ‘switch on’ their professional identity. Students perceived society to be struggling with the distinction between doctors as individuals and professionals. This extended to the students’ online identities on Facebook. Institutions’ expectations of high standards of professionalism were associated with a feeling of sacrifice by students caused by the perception of constantly ‘being watched’; this perception was coupled with resentment of this intrusion. Students described the significant impact that role‐modelling had on their professional attitudes. Conclusions This research offers valuable insight into how Phase 1 medical students construct their personal and professional identities in both the offline and online environments. Acknowledging these learning mechanisms will enhance the development of a genuinely student‐focused professionalism curriculum.     

Formative Evaluation of a Family Life Education Web Site*

Hundreds of family life education Web sites are available on the Internet, allowing individuals and families unprecedented access to family life education information. Evaluation is critical to ensuring the quality of and improving these Web sites; yet, few Web site evaluations have been conducted. We formatively evaluated a new family life education Web site, Forever Families ( http://www.foreverfamilies.net ), assessing site use with Web‐based software and receiving visitor feedback through an online survey. Findings revealed that the site was highly used by individuals throughout the world, that the site was viewed positively and had a positive impact on users, and that site ratings did not substantially vary by user characteristics. Users provided many helpful suggestions for improvement.     

Menopausal Symptom Experience of Hispanic Midlife Women in the United States

Using a feminist approach, we examined the menopausal symptom experience of Hispanic midlife women in the United States This was a qualitative online forum study among 27 Hispanic midlife women in the United States. Seven topics related to menopausal symptom experience were used to administer the 6-month online forum. The data were analyzed using thematic analysis. Four themes were identified: (a) “Cambio de vida (change of life),” (b) “being silent about menopause,” (c) “trying to be optimistic,” and (d) “getting support.” More in-depth studies with diverse groups of Hispanic women are needed while considering family as a contextual factor.     

Parenting Self‐Efficacy Among Mothers of School‐Age Children: Conceptualization,Measurement, and Correlates*

Relationships among parenting self‐efficacy, general self‐efficacy, child and maternal characteristics, and parenting satisfaction in 145 mothers of school‐aged children were examined. Higher parenting self‐efficacy was observed in mothers of less emotional and more sociable children, and among mothers who were better educated, had higher family incomes, and reported more previous experience with children. Higher parenting self‐efficacy and several mother and child variables predicted greater satisfaction with parenting. Influences of mothers' experience with children other than their own and maternal education on parenting satisfaction were mediated by parenting self‐efficacy. Suggestions concerning the conceptualization and measurement of parenting self‐efficacy are provided.