Attitudes towards disability amongst Pakistani and Bangladeshi parents of disabled children in the UK: considerations for service providers and the disability movement

It has sometimes been assumed that religiously based explanations for and attitudes to having a disabled child have led to the low uptake of health and social services by ethnic minority families in the UK. A series of semi-structured interviews were held between 1999 and 2001 with 19 Pakistani and Bangladeshi families with a disabled child as part of an evaluation of an advocacy service. The families' understandings of the causes of their child's impairment, whether they felt shame and experienced stigma, and whether these factors influenced service uptake and their expectations of their child's future are reported. While religious beliefs did inform the ways in which some families conceptualised their experience, the families' attitudes were complex and varied. There was little evidence that religious beliefs and associated attitudes rather than institutional racism had resulted in the low levels of service provision which the families experienced prior to the advocacy service. There was also no evidence that the families' attitudes had been informed by the disability movement. The implications for service providers and the movement are considered.     

Tobacco control policy advocacy attitudes and self-efficacy among ethnically diverse high school students.

This study applied self-efficacy theory to assess empowerment to advocate on behalf of tobacco control policies. The Youth Tobacco Survey with added policy advocacy self-efficacy, attitudes, and outcome expectations scales was given to 9,177 high school students in Texas. Asians showed the lowest prevalence of experimentation and current smoking, followed by African Americans. Anglo-Europeans had higher rates of current smoking. Latino male students had the highest experimentation and current smoking rates. Policy advocacy self-efficacy was higher among African Americans. Latinos scored lowest. Asians had the highest level of approval for tobacco control policies. African Americans had the highest scores in policy advocacy outcome expectations, followed by Asians and Latinos. Anglo-Europeans scored lowest. Students who had never tried smoking had the highest scores in all three scales, with a decreasing trend as the frequency of smoking increased. Associations with smoking status remained significant when controlling by gender and ethnicity.     

Adolescents' attitudes and self-perceptions about anti-tobacco advocacy

Communities are organizing into coalitions with the goal of reducing tobacco use, particularly among youth. Adolescents could make effective and persuasive anti-tobacco advocates in their respective communities, but their attitudes about tobacco advocacy and their perceptions of their own abilities as advocates are unknown. Therefore, the present project assessed attitudes and self-perceptions about anti-tobacco advocacy in 159 high school students attending a tobacco advocacy conference. After the meeting, they completed the Anti-Tobacco Advocacy Questionnaire, which has five factors (Activism, Personal Commitment, Banning Advertisements, Tobacco Morality and Peer Pressure to Use Tobacco). Overall, these high school students were moderately positive about anti-tobacco advocacy; girls more so than boys. Further, they were very positive about their own commitment to avoid tobacco and willingness to speak to others personally, but only moderately positive about their activism abilities. An implication is that community coalitions that include youth might want to focus on building their activism skills as they guide them in managing their youthful energy and enthusiasm.     

Prosocial behaviors of young children related to parental childrearing attitudes

Thirty preschool children from 3 to 6 years of age whose parents had shown congruence or lack of congruence in their attitudes toward adult control were observed in their homes on three occasions. Prosocial behaviors of children were observed and parent attitudes were measured by a revised Parent as a Teacher Inventory. While the chi‐square was not significant, data show that 5 of the 6 children with the lowest percentages of prosocial behaviors had mothers with scores which represented a high need for adult control. Likewise, all eight of the children who exhibited the lowest level of prosocial behavior had fathers whose scores were all below the factor mean. There is a need for further investigation of the effects of congruence between parent attitudes, parent behavior and child behavior.     

Prosocial behaviors of young children related to parental childrearing attitudes

Thirty preschool children from 3 to 6 years of age whose parents had shown congruence or lack of congruence in their attitudes toward adult control were observed in their homes on three occasions. Prosocial behaviors of children were observed and parent attitudes were measured by a revised Parent as a Teacher Inventory. While the chi-square was not significant, data show that 5 of the 6 children with the lowest percentages of prosocial behaviors had mothers with scores which represented a high need for adult control. Likewise, all eight of the children who exhibited the lowest level of prosocial behavior had fathers whose scores were all below the factor mean. There is a need for further investigation of the effects of congruence between parent attitudes, parent behavior and child behavior.     

Clinicians as advocates: An exploratory study of responses to managed care by mental health professionals

Utilization review and other managed care techniques require that health care professionals assume new responsibilities as patient advocates. This article explores the extent to which characteristics of providers or their experiences with managed care practices predict the nature and extent of advocacy behavior. Interviews of 142 mental health providers revealed that experiences of harmful utilization review and norms of professionalism significantly predicted advocacy behavior. However, providers who were concerned about disaffiliation were less likely to challenge the plan directly but more likely to alter their presentation of the case to reviewers. Providers who believe that managed care plans retaliate against advocacy behavior appear to substitute covert advocacy for direct advocacy. These results are preliminary but suggest that providers condition their advocacy behavior in response to their experiences with and perceptions of managed care plans.     

对女士香烟四种态度同时评价的多元logistic分析

目的了解广州市女学生对女士香烟态度并探讨其影响因素,为预防和控制女学生吸取女士香烟提供依据。方法采用多阶段分层整群抽样,对广州市女学生进行问卷调查,运用MLwinN2.19软件对资料进行多元logistic回归分析。结果 1834名女生中认为女士香烟更时髦、更有魅力、口味更好、危害更少的分别为15.1%、14.6%、17.0%、12.1%。零花钱多、重点中学生/大学生、城镇户口的女学生更偏爱女士香烟;对女士香烟有所知晓的女学生也偏爱女士香烟;而过去30天是否看到过控烟宣传、烟草广告对女士香烟态度影响未发现有统计学意义。结论通过政府、家庭、学校的教育和宣传来提高女学生对女士香烟有害性认识,改变学生不良的吸烟态度,提高他们的抗烟态度,特别要关注零花钱多的学生、重点中学和大学生。     

A qualitative assessment of US Black and Latino adolescents’ attitudes about targeted marketing of unhealthy food and beverages

ABSTRACT

Food marketing targeted to Black and Latino adolescents primarily promotes energy-dense, nutrient-poor foods and likely contributes to diet-related health disparities. Targeted marketing raises further public health concerns as Black and Latino youth are also exposed to greater amounts of unhealthy food marketing in the media and their communities. However, little is known about Black and Latino adolescents’ attitudes toward brands and marketing that target them directly. Focus groups with Black and Latino adolescents (N= 51) explored their attitudes toward targeted and non-targeted brands of food, beverages, and restaurants. Pile sorting activities using cards printed with targeted and non-targeted brand logos were used as an elicitation technique. Overall, participants indicated more positive attitudes about the targeted brands discussed in the focus groups than the non-targeted brands, and participants often described targeted brands as being for someone most like them. Some participants expressed appreciation for marketing that recognized “someone like them” as potential consumers, while others raised ethical issues regarding targeting of unhealthy foods. Participants’ strong affinity for targeted brands, and ambivalent attitudes about targeted marketing of unhealthy products, highlight an opportunity to increase awareness of food marketing targeting communities of color and address targeted marketing through countermarketing and grassroots advocacy campaigns.     

Dietitians' attitudes toward advocacy.

A survey was conducted to determine dietitians' attitudes toward and readiness for advocacy. Representative members of an affiliated state dietetic association expressed positive attitudes toward the professional's assumption of the advocate role. The respondents looked to the national, state, and local dietetic associations to provide leadership in the area of advocacy.     

Consumers' attitudes toward psychotherapy, hospitalization, and aftercare.

A sample of 204 chronically mentally ill patients from a variety of outpatient settings was surveyed on their attitudes toward psychotherapy, hospitalization, aftercare, and their condition in life. Generally, they felt various types of psychotherapy and aftercare were helpful and reported good relationships with their therapists. However, their goals focused more on quality of life than on symptom reduction. Patients also were concerned about the perceived power of providers over their lives; unfair treatment, discrimination, and lack of respect because of their illness; and anger over their illness and its consequences. Consumers in advocacy groups showed a slightly higher rate of concern than those not in advocacy groups. However, significantly more consumers in advocacy groups reported anger over their experiences with mental illnesses.     

Community Health Workers Promote Civic Engagement and Organizational Capacity to Impact Policy

Community health workers (CHW) have historically served to link structurally vulnerable populations to broad support systems. Emerging evidence suggests that CHWs engage in various forms of advocacy to promote policy and systems change. We assessed the impact of CHW community advocacy on community change, defined as civic engagement, organizational capacity and policy and systems change. Data are drawn from the 2014 National Community Health Worker Advocacy Survey (N?=?1776) aimed to identify the state of the CHW profession, and their impact on health disparities through community advocacy and policy engagement. Our primary analysis used multiple linear regression to assess the association between CHW advocacy and community change. As predicted, there was a significant, positive association between CHW advocacy and change in community conditions. Additionally, both adjusted and sensitivity models had similar standardized beta estimates for advocacy, and adjusted R ² statistics. CHW advocacy predicts positive change in community conditions and further advances the CHW Community Advocacy Framework designed to support and monitor CHW community advocacy to reduce health disparities through advocacy and policy change.     

National Standards in Children's Advocacy—What do Young People Say?

This paper discusses qualitative research into young people's views of independent children's advocacy services in Wales. We conducted focus groups and semi-structured individual interviews with over 80 children who had used advocacy or whose circumstances suggested them as potential users of advocacy. Our topics of enquiry were structured by research themes drawn from requirements and principles contained in recently introduced National Standards in Advocacy. Through these methods and themes we explored children's perceptions of advocacy in order to delineate characteristics of an effective service and to identify where they think services may need to improve.     

Motors of influenza vaccination uptake and vaccination advocacy in healthcare workers: A comparative study in six European countries

BackgroundAnnual vaccination is the most effective way to prevent and control the health and economic burden caused by seasonal influenza. Healthcare workers (HCWs) play a crucial role in vaccine acceptance and advocacy for their patients. This study explored the drivers of HCWs’ vaccine acceptance and advocacy in six European countries.MethodsHealthcare workers (mainly general practitioners, specialist physicians, and nurses) voluntarily completed a questionnaire in Bulgaria (N = 485), Czech Republic (N = 518), Kosovo (N = 466), Poland (N = 772), Romania (N = 155), and the United Kingdom (N = 80). Twelve-item scales were used to analyse sentiment clusters for influenza vaccination acceptance and engagement with vaccination advocacy. Past vaccination behaviour and patient recommendation were also evaluated. All data were included in a single analysis.ResultsFor vaccination acceptance, the main cluster (engaged sentiment: 68%) showed strong positive attitudes for influenza vaccination. A second cluster (hesitant sentiment: 32%) showed more neutral attitudes. Cluster membership was predicted by country of origin and age. The odds ratio for past vaccination in the engaged cluster was 39.6 (95% CI 12.21–128.56) although this varied between countries. For vaccination advocacy, the main cluster (confident sentiment: 73%) showed strong positive attitudes towards advocacy; a second cluster (diffident sentiment: 27%) showed neutral attitudes. Cluster membership was predicted by country of origin, age and profession, with specialist physicians being the least likely to belong to the confident sentiment cluster. HCWs characterised by confident advocacy sentiments were also more likely recommend flu vaccination. Again, this association was moderated by country of origin.ConclusionsThese data show that there is room to improve both vaccination acceptance and advocacy rates in European HCWs, which would be expected to lead to higher rates of HCW vaccination. Benefits that could be expected from such an outcome are improved advocacy and better control of morbidity and mortality related to seasonal influenza infection.     

Access to Health Care for Undocumented Migrant Children and Pregnant Women: The Paradox Between Values and Attitudes of Health Care Professionals

Access to health care for undocumented migrant children and pregnant women confronts human rights and professional values with political and institutional regulations that limit services. In order to understand how health care professionals deal with these diverging mandates, we assessed their attitudes toward providing care to this population. Clinicians, administrators, and support staff (n = 1,048) in hospitals and primary care centers of a large multiethnic city responded to an online survey about attitudes toward access to health care services. Analysis examined the role of personal and institutional correlates of these attitudes. Foreign-born respondents and those in primary care centers were more likely to assess the present access to care as a serious problem, and to endorse broad or full access to services, primarily based on human rights reasons. Clinicians were more likely than support staff to endorse full or broad access to health care services. Respondents who approved of restricted or no access also endorsed health as a basic human right (61.1%) and child development as a priority (68.6%). A wide gap separates attitudes toward entitlement to health care and the endorsement of principles stemming from human rights and the best interest of the child. Case-based discussions with professionals facing value dilemmas and training on children’s rights are needed to promote equitable practices and advocacy against regulations limiting services.     

The role of advocacy and interpretation services in the delivery of quality healthcare to diverse minority communities in London, United Kingdom

Inequalities in access to appropriate and acceptable healthcare contributes to a pattern of poorer health status, reduced life expectancy and greater dissatisfaction with healthcare amongst people from Black and minority ethnic communities (BME). Language acts as a further barrier to access. The development of bilingual advocacy fuses two key functions – interpretation and advocacy – to ensure that people from BME communities are able to have their healthcare needs met appropriately. This paper explores the development of bilingual advocacy in East London, which has a highly diverse population speaking over 100 different languages. It considers the development of the bilingual advocacy services by an NHS University Hospital Trust, the local experience of these services and the factors that have influenced their development. We employed the Delphi method amongst the four authors to examine the advocate-, service- or client-related challenges that face advocacy services; and the threats of these challenges to Trust-based advocacy and their implications to the service, client and advocate. Advocate -related challenges included status, esteem and remuneration of bilingual advocates in relation to other health professionals, as well as skills development, career progression, gender, capacity building and potential research contributions. Service -related challenges included work load, case mix, administration, commissioning processes/arrangements; entrepreneurial aspects of advocacy services; and mechanisms/potentials for cost recovery. Client -related challenges included continuity of advocacy; language requirements and advocacy needs of clients; and ways in which mobile populations influence planning and delivery of advocacy services for inner city hospitals. The paper concludes with identifying the implications for future development of bilingual advocacy services and the implications for their workforce.     

不同年龄患儿对护理满意度影响分析

目的：探讨不同年龄阶段患儿对护理满意度的影响。方法：采用问卷调查方法,对2013年1-6月在本院急诊输液患儿直接监护人200人进行护理满意度调查分析,0~3岁占83例（41.5%）,3~7岁为62例（31.0%）,7岁以上55例（27.5%）。结果：患儿年龄分组对业务水平、健康教育和护理满意度总分有影响,差异有统计学意义,P值分别为0.002、0.046和0.026。进一步组间比较得出,0~3岁组和7岁以上组业务水平、健康教育和护理满意度总分比较差异有统计学意义,其余任两组之间总体均数差异无统计学意义。结论：可以认为不同年龄患儿对护理满意度影响有统计学意义,尤其在业务水平和健康教育方面,年龄越小护理满意度越低。     

Doctors'' interest in psychiatry as a career

Fifty pre-registration housemen were interviewed to elicit their attitudes towards a career in psychiatry. The doctors were all those in one academic year who were recommended for honours on the basis of their performance during the psychiatry clerkship. Those who gained honours in other subjects as well as psychiatry were unlikely to choose a career in psychiatry. The study indicates that further improvements in the psychiatry clerkship will not improve recruitment. Factors outside psychiatry--the pull to general practice and other specialties and the negative attitudes towards psychiatry expressed by other doctors--are among the major deterrents for young doctors considering a career in psychiatry. Collaborative teaching between psychiatrist, physicians and surgeons during the pre-registration year should encourage recruitment and gradually improve the widely held negative attitudes towards psychiatry.     

Knowledge and Attitudes of Health Care Workers about AIDS and HIV Infection before and after Distribution of an Educational Booklet

Hospital workers (509) in a health authority were surveyed,and asked if they were in contact with HIV positive or AIDSpatients; about their perception of risk; of their knowledgeabout and attitudes towards HIV and AIDS problems at work; andtheir desire for more information about AIDS and HIV. Overallscores for level of knowledge and attitudes were calculated;clinical workers scored better than non-clinical workers. Following the first survey, an information booklet was distributedto all health authority staff and after distribution, 232 staffwere surveyed again. In this group (the follow-up group), therewas a reduction in perceived risk, an improvement in the levelof knowledge and in attitudes, and a reduction in the desirefor further information. The group who initially had the leastlevel of knowledge and most unfavourable attitudes (non-clinicalworkers) were the group who improved most. Requests for reprints should he addressed to: Dr M. D. McKinnon, Department of Occupational Health, Hampstead Health Authority, 5 Rosslyn Hill, London NW3 5UL, UK     

Geriatric medicine: does teaching alter medical students' attitudes to elderly people?

Summary. The development of a questionnaire to assess the attitudes of medical students towards old people is described. Principal components analysis of the responses of 114 first-year medical students revealed two orthogonal factors, named negative attitudes and medical intervention. Scores on these factors were compared among three groups of medical students: first-year students, 64 clinical phase medical students prior to a geriatric medicine course, and 69 medical students who had completed a geriatric medicine course. Negative attitudes scores did not differ between first year and the clinical years, but were reduced after the geriatric medicine course. Scores on the medical intervention factor reduced significantly from first year to the clinical years and were not reduced further by the geriatric medicine course. Women tended to have lower scores on negative attitudes. Medical students appeared to change their attitudes concerning the degree to which medical intervention is appropriate as a result of preclinical or general medical experience. However, their reservations concerning the reward to be gained from working with elderly people were stable over the same periods, but were altered by a course in geriatric medicine.